Gui Zhi Fu Ling Wan

What It Is

Gui Zhi Fu Ling Wan (桂枝茯苓丸) is a classical Chinese herbal formula that originated from the ancient medical text Jin Gui Yao Lue (Essentials from the Golden Cabinet) by Zhang Zhongjing. It consists of five main herbs:

1. Gui Zhi (Cinnamon Twig) – Warms and unblocks the channels, promotes circulation of Qi and blood.
2. Fu Ling (Poria Mushroom) – Promotes urination, reduces dampness, and strengthens the spleen.
3. Mu Dan Pi (Moutan Cortex / Tree Peony Bark) – Cools the blood and promotes circulation.
4. Chi Shao (Red Peony Root) – Invigorates blood and removes stasis, also cools the blood.
5. Tao Ren (Peach Kernel) – Breaks up blood stasis and moistens the intestines.

This formula is traditionally made into small pills or capsules and is used in TCM to address blood stasis with cold and stagnation, particularly in the lower abdomen or uterus.

How It Works

Gui Zhi Fu Ling Wan works primarily by promoting blood circulation, resolving stasis, and regulating menstruation. In TCM theory, many gynecological and reproductive disorders arise from blood stasis—a condition where blood flow is sluggish or obstructed, leading to pain, clots, or palpable masses.

• Warming and moving (Gui Zhi): Warms the meridians and assists in dispersing cold-induced stagnation.
• Circulating and breaking stasis (Tao Ren, Chi Shao, Mu Dan Pi): These herbs help remove congealed blood, reduce swelling or masses, and restore normal flow of Qi and blood.
• Draining dampness and supporting fluid metabolism (Fu Ling): Balances fluid movement, helping the body to clear excess moisture that might contribute to stagnation.

In modern pharmacological studies, the formula is thought to improve uterine blood flow, modulate hormonal balance, and reduce inflammation. It has been used to support conditions such as uterine fibroids, ovarian cysts, endometriosis, dysmenorrhea (painful periods), and infertility related to blood stasis.

Why It’s Important

Gui Zhi Fu Ling Wan holds great importance in both classical and modern Chinese medicine for women’s health. It is one of the few traditional formulas that effectively addresses both cold and heat patterns simultaneously, because it includes warming (Gui Zhi) and cooling (Mu Dan Pi, Chi Shao) ingredients in balance.

Its significance lies in several areas:

• Women’s reproductive health: It is widely used to promote healthy menstruation and fertility by ensuring smooth blood flow and resolving stagnation.
• Postpartum recovery: Helps the body eliminate retained blood and restore uterine tone after childbirth.
• Chronic gynecological conditions: Provides non-invasive support for fibroids or cysts when surgery or hormonal therapy is not preferred.
• Circulatory health: Although primarily used for gynecological purposes, it can also be applied in some cases of blood stasis elsewhere in the body, such as bruising or pelvic congestion.

In essence, Gui Zhi Fu Ling Wan embodies the TCM principle of harmonizing contradictions—balancing warm and cool, moving and nourishing—to restore the natural rhythm of the body.

Considerations

While Gui Zhi Fu Ling Wan is a gentle yet potent herbal formula, several important considerations should be noted:

1. Individual diagnosis: It should be prescribed based on a proper TCM assessment of blood stasis. Using it without stasis symptoms (e.g., in people with deficiency or bleeding tendencies) may worsen the condition.
2. Pregnancy: The formula contains Tao Ren (Peach Kernel), which has blood-moving and stasis-breaking properties. These can potentially stimulate uterine contractions and are not recommended during pregnancy, except under close supervision by a qualified practitioner.
3. Dosage and duration: Overuse can deplete the body’s energy or Yin. The formula is typically taken in moderate doses over a defined period, with reassessment every few weeks.
4. Potential interactions: Herbal medicines can interact with anticoagulant or antiplatelet drugs (e.g., warfarin, aspirin). Individuals on such medications should use this formula only with professional guidance.
5. Symptoms indicating caution: Avoid during active bleeding, heavy menstrual flow, or if signs of Yin deficiency (dry mouth, hot flashes, night sweats) are present.
6. Quality and sourcing: Use products from reputable manufacturers to avoid contamination or adulteration, as purity and accurate formulation affect both safety and efficacy.