Sorry, I forgot to address your ratio in my response. I actually address this in quite detail in the book I’m working on, but I will try to concisely explain this question here.

First one must look at the function of gui zhi in gui zhi tang. It primarily works on the protective level. He has chosen to use other herbs to assist in gui zhi’s “normal” function. For example, zi su geng, xing ren, zhe bei mu, and even qin jiao. In addition, one can think of gu ya as supplementing the nutritive. Hence he obtains a balance using the functions of various herbs to create harmony between the nutritive and protective levels.

This strategy is not uncommon and again one should look at the treatment principles not the specific herbs. For example, one could choose to use gui zhi 9 and bai shao 4.5 and dang gui 4.5. It is not just about gui zhi and bai shao.

However, this is not a random choice, but based on the specific presentation of the individual. Obviously, if the patient just had a tai yang presentation then he would have just used gui zhi tang. This though would not have been that interesting and probably would have never made it into his book. Here, he treats the underlying constitution with the external attack. Too often, when people get sick we try to fit them into some purely external formula box, ignoring their constitutional pattern. This case demonstrates one way to start thinking about this method.

(to Cara) Doctors such as Ding Gan-Ren were masters of both Shang Han and Wen Bing. They routinely integrated both ideas into one formula. This is one reason why this lineage of doctors was considered so interesting.

No one is saying that such a formula is easy to understand, and is definitely not as straightforward when compared to practitioners who just use a stock formula for their patients. However, by looking at multiple cases from the same doctor we can start to get an idea of how they think and try to understand the methodology.

Does that help?

But can you answer the question I had about the ratio between ingredients? Given that these gentlemen were undoubtedly SHL masters, why would DGR call it a “guizhi tang method” when the ratio between the ingredients is much more like a xiao jianzhong tang method or a guizhi jia shaoyao tang method, which is much more a taiyin strategy than a taiyang strategy.

Is it customary to change the ratio of doses when taking this more liberal method of using a particular method in your experience? How does one approach dosing in general in this method if the original ratio between ingredients is not followed?

-Steve

Once one understands the core principles behind the formula and can treat flexible without restraints, meaning one does not have to rigidly stick to the exact formula. I will present some more cases and hopefully this idea will become clearer. In this case there is obviously more going on besides just gui zhi tang / tai yang. He is treating a dual pattern.

One thing to keep in mind is that people like Ye Tian-Shi and Ding Gan-Ren knew Shang Han material very well. It is not that they didn’t understand something. Essentially they are taking the knowledge to the next level and creating specific treatments for their individual patients. They are not just fitting people into SHL boxes.
Hope this helps…

I am always intrigued by people that claim to use a method, in this case the “guizhi tang method,” but then do not use the formula in their prescription, and in this case not even the right ratio between ingredients (guizhi and shaoyao are not equal doses here). If anything, the ratio of guizhi to shaoyao in this case is more like a xiao jianzhong tang ratio. What do you think DGR was getting at here?

-Steve