Gao (pastes) are one of the eight traditional forms of Chinese medicine—pills, powders, pastes, pills, decoctions, wines, tinctures, and tablets. They can be taken internally or applied externally, with records of their medicinal use dating back to the Western Han Dynasty in the medical text “Wushi Er Bing Fang”. The term gao currently refers to internal pastes, known for their nourishing and tonifying effects, also called gao zi yao. Renowned modern physician Qin Bo Wei noted: “They are made by simmering medicinal juices or fatty liquids to nourish the dryness and weakness of the five organs and six bowels, hence they are commonly referred to as gao zi yao.” They can be widely used in various medical fields including internal medicine, gynecology, pediatrics, orthopedics, and otolaryngology. The traditional medical classic “Huang Di Nei Jing” states that the four seasons of yin and yang are the foundation of all things, and the human body corresponds with heaven and earth, with winter being the time for storage, thus it is essential to supplement during winter, which is a principle of TCM health preservation. As the saying goes: “Winter supplementation is like going up the mountain to hunt tigers,” thus gao has become the best choice for winter supplementation.
Director Ge Lai An, an expert in liver and gallbladder diseases, has further developed the theory related to gao, believing that gao can be both nourishing and cleansing. Gao should not be limited to winter use, especially the cleansing gao, which can be made for all seasons. The Qing Gan Fa Zhi Gao he created is a type of cleansing gao for treating fatty liver. This gao is derived from the classic formula Bie Jia Jian Wan and Chai Hu Shu Gan San, composed of sixteen herbs including Zhi Zi (Gardenia), He Ye (Lotus Leaf), Ji Gu Cao (Chicken Bone Grass), Chai Hu (Bupleurum), Fo Shou (Buddha’s Hand), Bie Jia (Soft-shelled Turtle Shell), Chuan Xiong (Szechuan Lovage), E Zhu (Curcuma), Ji Xue Teng (Spatholobus), and Gan Cao (Licorice). It has the effects of clearing the liver and transforming dampness, soothing the liver and activating channels, resolving phlegm and dissolving nodules, mainly used for conditions of damp-heat obstructing the liver meridian and phlegm-stasis blocking the liver collaterals, such as fatty liver, liver cirrhosis, obesity, and metabolic syndrome, with clinical manifestations including fullness or stabbing pain in the hypochondrium, fatigue, chest tightness, obesity, bitter and sticky mouth, sticky stools, yellow and red urine, dull complexion, dark red tongue, yellow greasy coating, and slippery pulse. TCM believes that the liver is yin in nature but functions with yang, governing the smooth flow of qi and storing blood. Damp-heat stagnates in the liver meridian, leading to qi stagnation and phlegm-stasis, forming liver distension. Qing Gan Fa Zhi Gao uses Zhi Zi, He Ye, and Ji Gu Cao to clear the liver and transform dampness, Chai Hu and Fo Shou to soothe the liver and regulate qi, and Bie Jia, Chuan Xiong, E Zhu, and Ji Xue Teng to invigorate blood and soften hardness to dissolve nodules, with Gan Cao harmonizing the other herbs. The entire formula has clear monarch, minister, assistant, and envoy roles, like a well-structured army, effectively sweeping away chronic liver diseases.
In contrast to Qing Gan Fa Zhi Gao, which treats those already ill, the Bao Gan Xing Jiu Gao focuses more on preventing illness. This gao is based on Ge Hua Jie Chang Tang, modified and composed of twelve herbs including Ge Gen (Kudzu Root), Ge Hua (Kudzu Flower), Zhi Zhi Zi (Bitter Orange), and Sang Shen Zi (Mulberry Fruit), with the effects of protecting and nourishing the liver, awakening from intoxication, and detoxifying, suitable for various alcoholic liver disease patients and those who drink to prevent intoxication and aid recovery. TCM has long recorded the toxic effects of excessive alcohol consumption in the Liang Dynasty’s “Ben Cao Jing Ji Zhu” by Tao Hongjing: “Alcohol is the essence of grains, the liquid of cooked grains, its energy is fierce, and drinking it causes bodily harm and mental confusion, hence it is toxic.” TCM believes that alcohol is the liquid of cooked grains, the essence of grains, and excessive consumption first harms the spleen and stomach, eventually affecting the liver and gallbladder, leading to abdominal pain, diarrhea, and even severe conditions like ascites. The main herbs in Director Ge’s Bao Gan Xing Jiu Gao, Ge Gen, Ge Hua, and Zhi Zhi Zi, have been renowned since ancient times for their ability to detoxify alcohol. Their light and clear energy helps to elevate the yang qi that is suppressed by alcohol, while their mild and descending flavor helps to drain the damp-heat generated by alcohol. Additionally, Sang Shen Zi nourishes the liver and replenishes the liver, providing excellent clinical efficacy in preventing alcohol-induced liver damage and repairing liver injury.
Case Study 1:
Zhang, male, 43 years old, from Ganzhou, Jiangxi Province, on May 17, 2020, presented with fullness and discomfort in the right hypochondrium for six months. The patient is obese and has experienced fullness and discomfort in the right hypochondrium, occasional stabbing pain, fatigue, and poor appetite, but is obese, feeling drowsy and reluctant to drive long distances, with loose stools, pale dark tongue, yellow greasy coating, and slippery pulse. Relevant biochemical tests indicated moderate fatty liver, with serum total cholesterol at 5.8 mmol/L, triglycerides at 3.5 mmol/L, and blood glucose at 6.1 mmol/L.
TCM diagnosis: Liver distension (damp-heat obstructing, phlegm-stasis blocking collaterals), Western diagnosis: Fatty liver.
Prescription: Qing Gan Fa Zhi Gao (Mannitol Paste).After three months of medication, the patient’s right hypochondrium fullness improved, fatigue, drowsiness, and loose stools significantly improved, able to drive long distances, weight reduced by 5 kg, cholesterol at 5.9 mmol/L, triglycerides at 2.7 mmol/L, blood glucose at 5.8 mmol/L. After continuing for six months, all symptoms disappeared, except for triglycerides at 2.35 mmol/L, cholesterol and blood glucose returned to normal, and ultrasound showed normal liver size and shape with slightly enhanced echo.
Case Study 2:
Ke, male, 58 years old, from Nanchang, Jiangxi Province, on March 25, 2021, reported drinking for over 30 years, often getting drunk, and recently had a major social event coming up, hoping to get a prescription to help increase alcohol tolerance and prevent intoxication.
Prescription: Bao Gan Xing Jiu Gao.Instructed to take the medicine half an hour before drinking, on that day, although the alcohol intake was far beyond usual, he did not get drunk, achieving a good preventive effect. However, it must be advised that one should not drink excessively, as the World Health Organization has classified alcohol as a Class 1 carcinogen, and the previous health concept of “balanced diet, moderate drinking” should be revised to “balanced diet, absolutely no drinking.”
Expert Introduction
Ge Lai An
MD, Chief TCM Physician
Specializes in treating diseases: Engaged in clinical practice, teaching, and research in TCM internal medicine for 28 years, proficient in treating viral hepatitis, liver cirrhosis, ascites, autoimmune liver diseases, alcoholic liver diseases, fatty liver diseases, cholecystitis, gallstones, acute and chronic pancreatitis, acute and chronic gastritis, precancerous lesions of gastric cancer, functional dyspepsia, gastroesophageal reflux, gastric and duodenal ulcers, gastrointestinal bleeding, and ulcerative colitis.
Consultation Information:
Health Examination Department (Main Hospital): Saturday morning
Gastroenterology (Liver and Gallbladder Department) Outpatient: Tuesday and Thursday morning, Wednesday afternoon
Yangming Road Outpatient: Wednesday morning
West Lake Hospital: Friday afternoon
Editor: Zhong Shifang
Reviewed by: Shen Desen
Gao Fang Collection
【Qu Shi Gao – Expel Dampness and Strengthen the Spleen, Regulate Qi and Blood
【Zhi Xuan Gao – Strengthen the Spleen and Nourish the Kidney, Transform Phlegm and Stop Dizziness
【Bu Fei Yi Shen Ping Chuan Gao】 – Nourish Lung and Kidney, Strengthen Spleen and Transform Phlegm
【Yi Jing Tian Sui Sheng Xue Gao – Fatigue and Weakness, Bone Marrow Suppression
【Jian Pi Zhu Zhang Gao – Improve Children’s Constitution, Enhance Immunity, Promote Growth
【Jian Pi Tiao Zhi Qu Ban Gao – Strengthen Spleen, Transform Turbidity, Regulate Fat and Remove Spots
【Wen Zhong Jian Pi Gao – Benefit Qi, Warm the Middle, Strengthen the Spleen, Regulate Qi, Disperse Cold and Remove Dampness
【Yi Qi Wen Yang Hu Wei Gao – Warm Yang, Benefit Qi, Harmonize Ying and Wei, Revitalize True Yuan
【Jian Pi An Shen Gao – Benefit Qi, Strengthen Spleen, Nourish Blood, Calm the Spirit
【Bu Qi Yang Fei Gu Ben Gao – Benefit Qi, Nourish Lung, Secure the Foundation, Transform Phlegm, Stop Cough, and Calm Wheezing
【Qi Xue Shuang Bu Gao – Double Supplement Qi and Blood, Strengthen the Body
【Luan Chao Bao Yang Gao – Extend Youth, Delay Aging
【Gu Ben Jian Shen Gao – Harmonize Spleen and Stomach, Strengthen Spleen and Assist Movement
【Er Xian Gui Lu Gao – Nourish Kidney, Fill Essence, Benefit Marrow, Warm Yang, Open the Governor Vessel
【Yi Qi Yang Wei Gao – Strengthen Spleen, Benefit Qi, Harmonize Stomach, Clear Heat, Drain Dampness, Activate Blood
【Jie Du Zhi Yang Gao – Expel Wind, Remove Dampness, Detoxify, and Stop Itching
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