Dried ginger (Gan Jiang) is the dried rhizome of the ginger plant (Zingiber officinale), primarily containing volatile oils and gingerol.
Dried ginger is listed in the “Shennong’s Classic of Materia Medica” stating: “Dried ginger, pungent and warm in nature, is indicated for chest fullness, cough, and counterflow of qi, warms the middle, stops bleeding, expels wind-dampness, alleviates diarrhea, and is especially good for the living. Long-term use dispels foul odors and opens the mind.” The properties and indications recorded in the “Shennong’s Classic” are precise and comprehensive. Dried ginger is a warming herb that has the function of warming yang and dispersing cold, which corresponds to conditions of yang deficiency and excess cold. Because it can warm the lungs, it is suitable for the condition of “chest fullness, cough, and counterflow of qi” caused by cold phlegm obstructing the lungs. The “Rihua Zibencao” states that dried ginger “dissipates phlegm and descends qi,” referring to this effect; it can warm the middle, thus applicable for “diarrhea and dysentery”; it can warm and unblock the muscles and bones, hence treating “sweating and expelling wind-dampness”; additionally, dried ginger can stop bleeding, thus also applicable for bleeding conditions.
Dried ginger is one of the most commonly used herbs by Zhang Zhongjing, with 43 formulas utilizing dried ginger in classical prescriptions. Besides the conditions listed in the “Shennong’s Classic,” many new applications have been developed, indicating that Zhang Zhongjing’s use of dried ginger has reached a remarkable level.
(1) Used for phlegm and fluid retention:
1. For treating cough and asthma.Dried ginger is a commonly used herb by Zhang Zhongjing for treating cough and asthma due to cold phlegm, often combined with Xi Xin (Asarum) and Wu Wei Zi (Schisandra). Dried ginger and Xi Xin warm the lungs and transform phlegm, while Wu Wei Zi’s sourness helps to consolidate, creating a balance between dispersing and consolidating, preventing excessive consumption of lung qi while restoring the lung’s function of dispersing and descending. There are seven formulas with this structure.
For patients with severe cold phlegm and external cold, it is often combined with Ma Huang (Ephedra) and Gui Zhi (Cinnamon Twig), which is the life-saving remedy for general cough and asthma patients, known as Xiao Qing Long Tang (Minor Blue Dragon Decoction). Due to the severe cold phlegm and the presence of external cold, the cough and asthma become particularly severe, as seen in the symptom of “coughing and unable to lie down.” The formula uses dried ginger with Xi Xin and Ban Xia (Pinellia) to warm yang and transform phlegm, Wu Wei Zi consolidates lung qi, and Ma Huang, Gui Zhi, and Shao Yao (Peony) harmonize the nutritive and defensive qi to dispel cold, while Gan Cao (Licorice) harmonizes the other herbs. If phlegm transforms into heat causing irritability, Shi Gao (Gypsum) can be added to clear heat and eliminate irritability, named Xiao Qing Long Jia Shi Gao Tang (Minor Blue Dragon Decoction with Gypsum). If there is qi stagnation with more severe chest fullness and asthma, and the external cold is lighter, to enhance the descending and calming effect, while reducing the dispersing power, one can use Xiao Qing Long Jia Shi Gao Tang, adding Hou Po (Magnolia Bark), Xing Ren (Apricot Kernel), Xiao Mai (Wheat), and replacing Gui Zhi and Shao Yao with Gan Cao, which is Hou Po Ma Huang Tang (Magnolia Bark and Ephedra Decoction), effective for cough and asthma with chest fullness. If it is purely internal cold phlegm, then using only dried ginger, Xi Xin, Wu Wei Zi, and Fu Ling (Poria) with Gan Cao is Ling Gan Wu Wei Jiang Xin Tang (Poria, Licorice, Wu Wei Zi, and Dried Ginger Decoction), suitable for phlegm and fluid retention after taking Xiao Qing Long Tang, where phlegm and fluid have lessened but not completely transformed, still presenting with cough and chest fullness. If there is also vomiting, add Ban Xia to descend and stop vomiting, which is Gui Ling Wu Wei Gan Cao Qu Gui Jia Jiang Xin Tang (Poria, Licorice, Wu Wei Zi, and Dried Ginger Decoction with Ban Xia). If there is also edema, add Xing Ren to open the lungs and promote urination, which is Ling Gan Wu Wei Jia Jiang Xin Ban Xia Xing Ren Tang (Poria, Licorice, Wu Wei Zi, Dried Ginger, Ban Xia, and Apricot Kernel Decoction). If there is also stomach heat rising and a flushed face, add Da Huang (Rhubarb) to drain stomach heat, named Ling Gan Wu Wei Jia Jiang Xin Ban Xia Da Huang Tang (Poria, Licorice, Wu Wei Zi, Dried Ginger, Ban Xia, and Rhubarb Decoction).
Next, Xiao Chai Hu Tang (Minor Bupleurum Decoction) states: “If there is coughing, remove Ren Shen (Ginseng), Da Zao (Jujube), and Sheng Jiang (Fresh Ginger), add Wu Wei Zi half a sheng, and two liang of dried ginger”; Si Ni San (Frigid Extremities Powder) states: “If there is coughing, add Wu Wei Zi and dried ginger each five fen”; Zhen Wu Tang (True Warrior Decoction) states: “If there is coughing, add half a sheng of Wu Wei Zi, and one liang each of Xi Xin and dried ginger”. These are all examples of using dried ginger for cough and asthma.
All the above formulas for cough and asthma almost encompass all classical prescriptions for treating cough and asthma. It can be seen that dried ginger is an indispensable herb for Zhang Zhongjing in treating phlegm and cough asthma. Severe cold phlegm is often paired with Xi Xin to achieve the effect of warming and transforming water and phlegm, and if it is more severe, Ban Xia can be added to dry dampness and transform phlegm to assist its function. To prevent excessive dispersing, it must always be combined with Wu Wei Zi, which is Zhang Zhongjing’s unique approach to using dried ginger for cough and asthma. This is something we should study and inherit seriously.
2. Used for fluid retention under the ribs.When phlegm and dampness obstruct the area under the ribs, the qi transformation of the three burners is impaired, presenting with fullness and slight distension in the chest and ribs, difficulty in urination, thirst without desire to drink, but sweating on the head, alternating chills and fever, and irritability, Zhang Zhongjing used Chai Hu Gui Zhi Gan Jiang Tang (Bupleurum, Cinnamon, and Dried Ginger Decoction) for treatment, where the purpose of using dried ginger is to combine with Gui Zhi to promote the qi mechanism and warm and transform water and phlegm, which aligns with the principle that “for phlegm and fluid retention, one should use warming herbs to harmonize it.”
(2) Used for Shaoyin Yang Deficiency Syndrome:
Shaoyin is primarily a heart and kidney condition, which should ideally use Gui Zhi and Fu Zi (Aconite) for warming, but in classical formulas, dried ginger is often combined with Fu Zi, achieving satisfactory results, continuously validated by clinical practice in later generations. Therefore, “Bencao Qiuzhen” states: “Dried ginger is very hot and non-toxic, it stays and does not leave; when the original yang is about to escape, it can be combined with Fu Zi to return the yang and achieve results, hence the saying that there is no heat without dried ginger in Fu Zi.” Zhang Zhongjing’s Si Ni Tang, Bai Tong Tang, and Jiang Fu Tang all use it. The combination of dried ginger and Fu Zi is used in eight formulas, mainly for the following situations.
1. For treating irritability.
“Shang Han Lun” states: “After purging, if sweating recurs, and there is daytime irritability and inability to sleep, but calm at night, no vomiting, no thirst, and no exterior symptoms, the pulse is deep and weak, and there is no significant fever, Gan Jiang Fu Zi Tang (Dried Ginger and Aconite Decoction) is indicated.” It also states: “If sweating occurs after purging, and the illness is not resolved, and there is irritability, Fu Ling Si Ni Tang (Poria Frigid Extremities Decoction) is indicated.” Gan Jiang Fu Zi Tang is composed of dried ginger and Fu Zi, belonging to a small and effective formula, suitable for irritability caused by severe yang deficiency in Shaoyin, characterized by “daytime irritability and inability to sleep, calm at night.” Using only dried ginger and Fu Zi, decocting and taking it directly, it has a direct and rapid effect, aiming to restore the severely deficient yang immediately, turning danger into safety. This formula is designed for pure yang deficiency, with a simple pathogenesis. Fu Ling Si Ni Tang is designed for both yin and yang deficiency, hence the irritability is continuous without relief. This formula uses dried ginger and Fu Zi to return the yang and rescue the reverse, adding Gan Cao, Fu Ling, and Ren Shen to open the pulse and nourish yin to calm the spirit, achieving the function of returning yang and nourishing yin completely. The pathogenesis of this syndrome is complex, thus requiring a large dose of a compound treatment.
2. For treating cold limbs due to excess yin and deficiency of yang.
In cases of Shaoyin yang deficiency with excess yin, presenting with cold limbs, weak pulse, vomiting, and diarrhea of clear fluids, Zhang Zhongjing used Si Ni Tang (Frigid Extremities Decoction) for treatment. Si Ni Tang is composed of dried ginger, Fu Zi, and Gan Cao, where the purpose of using dried ginger is to combine with Fu Zi to urgently return the yang of Shaoyin and disperse the cold evil; secondly, it can be combined with Gan Cao to restore spleen yang and stop vomiting and diarrhea; thirdly, Gan Cao in this formula also has the function of expelling blood stasis and enhancing the effect of returning yang and rescuing the reverse, while dried ginger can enhance Gan Cao’s function of opening the pulse. Zhang Yuanliang states: “The “Main Treatment Secret” says, it opens the heart qi and assists yang,” referring to this function of dried ginger.
Since this formula can return the yang of Shaoyin, it can be used for the syndrome of severe deficiency of heart and kidney yang, as “Shang Han Lun” states: “If there is vomiting and diarrhea, and urination is frequent, with profuse sweating, diarrhea of clear fluids, internal cold and external heat, and the pulse is weak and about to disappear, Si Ni Tang (Frigid Extremities Decoction) is indicated.” Also, since it can warm the spleen yang and stop vomiting and diarrhea, it can also be applied to the syndrome of spleen yang deficiency with vomiting and diarrhea. As “Shang Han Lun” states: “If there is vomiting and weak pulse, frequent urination, and slight fever, if there is cold limbs, Si Ni Tang (Frigid Extremities Decoction) is indicated.” “If there is profuse sweating, if there is severe diarrhea and cold limbs, Si Ni Tang (Frigid Extremities Decoction) is indicated.”
Additionally, the Si Ni Tang composed of dried ginger is also suitable for cases of exterior cold combined with interior deficiency, where the interior condition is urgent. After the interior condition is alleviated, the exterior should be treated, as “Shang Han Lun” states: “If there is a cold, and after treatment, if there is still diarrhea of clear fluids, and body aches, it is urgent to rescue the interior; if the body aches and the clear stools self-regulate, it is urgent to rescue the exterior; for rescuing the interior, use Si Ni Tang (Frigid Extremities Decoction); for rescuing the exterior, use Gui Zhi Tang (Cinnamon Decoction).”
3. For treating the syndrome of counterflow of yang.
“Shang Han Lun” states: “In Shaoyin disease, if there is diarrhea of clear fluids, internal cold and external heat, with cold limbs and reverse pulse, and the person does not dislike cold, but has a red face… Tong Mai Si Ni Tang (Open Pulse Frigid Extremities Decoction) is indicated.” The composition of Tong Mai Si Ni Tang is the same as Si Ni Tang, but with increased amounts of dried ginger and Fu Zi, which greatly enhances the ability to strengthen the original yang and break the yin to return the yang, thus capable of addressing the syndrome of counterflow of original yang, quickly returning the externally dispersed original yang to the interior.
Above are the uses of dried ginger for treating counterflow of yang, and dried ginger can also be used for the syndrome of counterflow of yang. “Shang Han Lun” states: “In Shaoyin disease, if there is diarrhea, and the pulse is weak, use Bai Tong Tang (White Passage Decoction).” Bai Tong Tang is composed of dried ginger, Fu Zi, and scallions. According to the postscript of Tong Mai Si Ni Tang, “If the face is red, add nine scallions,” it can be seen that this syndrome must have the phenomenon of a red face. This formula uses ginger and Fu Zi to return the yang and break the yin, while scallions, as Zhang Yuanliang states, “specifically promote dispersing to open the upward and downward yang,” allowing the yang qi that is blocked above to return downward.
If taking Bai Tong Tang results in counterflow, where the medicine cannot be absorbed, leading to qi stagnation, one can add human urine and pig bile, which is Bai Tong Jia Zhu Gan Zhi Tang (White Passage Decoction with Pig Bile). “Shang Han Lun” states: “In Shaoyin disease, if there is diarrhea and the pulse is weak, use Bai Tong Tang (White Passage Decoction). If diarrhea does not stop, with counterflow and no pulse, dry vomiting and irritability, Bai Tong Jia Zhu Gan Zhi Tang (White Passage Decoction with Pig Bile) is indicated. If the pulse suddenly appears, the person dies; if it continues weakly, they live.” The fact that diarrhea does not stop indicates that the medicine has not been absorbed and is not functioning; counterflow and no pulse, dry vomiting and irritability indicate that the medicine and condition have counterflow, stagnating in the stomach, causing qi stagnation and chaotic stomach qi. Therefore, adding human urine and pig bile, which are salty, cold, and bitter, helps to assist the ginger and Fu Zi into the yin, allowing the warming and dispersing of cold to take effect.
In summary, although dried ginger is not a typical Shaoyin herb, Zhang Zhongjing’s ability to draw from various formulas and innovate, uniquely pairing it with Fu Zi, has achieved significant benefits for restoring original yang. Dried ginger and Fu Zi are mutually beneficial, forming a small and effective formula that can quickly restore the violently escaping yang and stop irritability; adding Gan Cao makes it the renowned Si Ni Tang (Frigid Extremities Decoction), capable of returning yang and reversing counterflow; increasing the amount of ginger and Fu Zi transforms it into Tong Mai Si Ni Tang (Open Pulse Frigid Extremities Decoction), which can change the tide and rescue the escaping yang; if removing Gan Cao and adding scallions, it becomes Bai Tong Tang (White Passage Decoction), suitable for the syndrome of counterflow of yang; if the syndrome of counterflow of yang occurs and the medicine is not absorbed, adding pig bile and human urine is Bai Tong Jia Zhu Gan Zhi Tang (White Passage Decoction with Pig Bile); if both yin and yang are deficient with irritability as the main symptom, one can use Si Ni Tang (Frigid Extremities Decoction) with Ren Shen and Fu Ling, which is Fu Ling Si Ni Tang (Poria Frigid Extremities Decoction).
Modern medicine has found that while dried ginger primarily acts on the gastrointestinal tract, it reflexively stimulates the vascular motor center, causing blood pressure to rise through sympathetic nervous system excitation, which is known as the effect of returning yang and rescuing the reverse. The combination of dried ginger and Fu Zi not only reduces the toxicity of Fu Zi but also enhances and prolongs its effects, which is the true meaning of the saying that there is no heat without dried ginger in Fu Zi.
(3) Used for cold cholera syndrome.
In traditional Chinese medicine, cholera syndrome refers to severe vomiting and diarrhea, due to its sudden onset and chaotic nature, hence the name cholera. It is caused by evil affecting the middle burner, disrupting the ascending and descending functions. The cholera syndrome applicable to dried ginger is caused by cold dampness obstructing it. There are four formulas for this.
The first is Li Zhong Wan (Regulate the Middle Pill). “Shang Han Lun” states: “For cholera, headache, fever, and body aches… if there is much cold and no water is used, Li Zhong Wan (Regulate the Middle Pill) is indicated.” Li Zhong Wan is a well-regarded formula for treating spleen deficiency and internal cold, composed of dried ginger, Bai Zhu (Atractylodes), Ren Shen, and Gan Cao, where the use of dried ginger warms the middle and disperses cold, aligning with the “warming the middle” statement in the “Shennong’s Classic.” It pairs with Ren Shen and Gan Cao to warm the middle and strengthen the spleen; combined with Bai Zhu, it can warm the middle and dry dampness. This formula reliably warms and tonifies the middle burner. Therefore, it can be used not only for cholera vomiting and diarrhea but also for any disease belonging to middle burner deficiency and cold.
If the yang deficiency of the middle burner affects the lower burner, then Si Ni Tang (Frigid Extremities Decoction) should be used to warm and tonify the yang of the spleen and kidney. “Shang Han Lun” states: “If there is vomiting and diarrhea, sweating, fever, aversion to cold, and cold limbs, Si Ni Tang (Frigid Extremities Decoction) is indicated.” At this time, using only dried ginger to warm the middle and disperse cold is no longer sufficient; it must be combined with Fu Zi to tonify both the spleen and kidney yang, benefiting fire to generate earth, thus harmonizing the treatment.
If treatment is delayed, or if the condition is severe, with excessive vomiting and diarrhea, leading to loss of yang and fluids, one can select Si Ni Jia Ren Shen Tang (Frigid Extremities Decoction with Ginseng) or Tong Mai Si Ni Jia Zhu Gan Zhi Tang (Open Pulse Frigid Extremities Decoction with Pig Bile) based on the severity of the condition. “Shang Han Lun” states: “If there is aversion to cold, weak pulse, and then diarrhea, if the diarrhea stops, it indicates loss of blood, Si Ni Jia Ren Shen Tang (Frigid Extremities Decoction with Ginseng) is indicated.” It also states, “If vomiting has stopped and there is diarrhea, sweating, and cold limbs that do not resolve, with a weak pulse, Tong Mai Si Ni Jia Zhu Gan Zhi Tang (Open Pulse Frigid Extremities Decoction with Pig Bile) is indicated.” Tong Mai Si Ni Tang is stronger in returning yang and rescuing the reverse than Si Ni Jia Ren Shen Tang, while pig bile can not only replenish the lost yin fluids but also, due to its bitter cold nature, assist the ginger and Fu Zi into the yin, preventing excessive yin from counteracting the warming and dispersing herbs. Si Ni Jia Ren Shen Tang does not have the risk of counterflow, thus the former is for lighter conditions, while the latter is for more severe cases.
All four formulas are suitable for cholera syndrome, with Li Zhong Wan being lighter, where the yang deficiency is limited to the middle burner, thus using only dried ginger to warm and disperse cold; if the yang deficiency involves the lower burner, it must be paired with Fu Zi; if there is yang deficiency with fluid loss, it must be combined with Ren Shen; if counterflow occurs, it should be combined with pig bile.
(4) Used for chest fullness syndrome:
In classical formulas, there are four formulas that explicitly use dried ginger to treat chest fullness syndrome, three of which are for the syndrome of cold-heat intermingling in the chest, and one for spleen and stomach deficiency and cold leading to fullness.
The three formulas suitable for the syndrome of cold-heat intermingling in the chest are Ban Xia Xie Xin Tang (Pinellia Decoction), Sheng Jiang Xie Xin Tang (Fresh Ginger Decoction), and Gan Cao Xie Xin Tang (Licorice Decoction). All three are suitable for chest fullness with vomiting and diarrhea, with similar compositions, primarily using dried ginger combined with Ban Xia, Huang Qin (Scutellaria), and Huang Lian (Coptis) to promote downward movement. As Yu Zaiqing states: “The pungent nature of Ban Xia and dried ginger can disperse the obstruction, while the bitter nature of Huang Lian and Huang Qin can drain the fullness,” which are the main herbs for treating chest fullness with cold-heat intermingling and vomiting and diarrhea. Additionally, the qi stagnation can also be dispersed by the spleen and stomach’s transformation. Therefore, all three formulas use Ren Shen, Gan Cao, and Da Zao (Jujube) to tonify qi and strengthen the spleen and stomach’s ascending and descending functions. The purpose of using dried ginger in these three formulas is entirely the same, which is to combine with Huang Qin and Huang Lian to drain the fullness.
Another formula is Gui Zhi Ren Shen Tang (Cinnamon and Ginseng Decoction). “Shang Han Lun” states: “In Taiyang disease, if the exterior symptoms have not been resolved, and there is frequent diarrhea, leading to heat and continuous diarrhea, with chest fullness and hardness, and the exterior and interior are unresolved, Gui Zhi Ren Shen Tang (Cinnamon and Ginseng Decoction) is indicated.” Gui Zhi Ren Shen Tang is essentially Li Zhong Wan with Gui Zhi added, thus the purpose of using dried ginger is the same as in Li Zhong Wan, which is to warm the middle, disperse cold, and eliminate fullness. This syndrome has a simple pathogenesis, differing from the aforementioned three formulas with mixed cold and heat, thus paired with warming and tonifying herbs to benefit qi and tonify the middle.
(5) Used for upper heat and lower cold syndrome:
Upper heat and lower cold is a general concept. It includes stomach heat and spleen cold (intestinal cold), lung heat and spleen cold, as well as diaphragm heat and spleen cold syndromes. The purpose of using dried ginger in these cases is to warm the spleen.
1. For treating diaphragm heat and spleen cold syndrome.“Shang Han Lun” states: “In cold damage, if the physician uses pills to purge heavily, and the body heat does not dissipate, with slight irritability, Zhi Zi Gan Jiang Tang (Gardenia and Dried Ginger Decoction) is indicated.” Ke Yunbo states: “If purging with pills leads to slight irritability and the exterior heat does not dissipate, it indicates that cold qi remains in the middle while heat lingers in the upper burner.” Therefore, dried ginger is used to warm the middle and disperse cold, while Zhi Zi clears and drains diaphragm heat, with the combination of cold and heat working together to achieve the effect of clearing the upper and warming the middle.
2. For treating lung heat and spleen cold syndrome. Ma Huang Sheng Ma Tang (Ephedra and Cimicifuga Decoction) is a formula for treating lung heat and spleen cold syndrome, suitable for cases of lung heat presenting with phlegm and blood, throat discomfort, and spleen deficiency with continuous diarrhea. The purpose of using dried ginger in this formula is to combine with Bai Zhu, Fu Ling, Gui Zhi, and Gan Cao to warm the middle, strengthen the spleen, and stop diarrhea, while Ma Huang, Sheng Ma, Shi Gao (Gypsum), Zhi Mu (Anemarrhena), and Tian Dong (Asparagus) are designed to clear and drain the lung’s accumulated heat.
3. For treating stomach heat and spleen (intestinal) cold syndrome.In classical formulas, there are three formulas using dried ginger to treat stomach heat and spleen (intestinal) cold syndrome. One is for treating cold counterflow, which is Gan Jiang Huang Qin Huang Lian Ren Shen Tang (Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction), where dried ginger is paired with Ren Shen to tonify qi and warm the spleen, forming half of Li Zhong Wan, combined with Huang Qin and Huang Lian to clear stomach heat, achieving the effects of bitter cold clearing and pungent warmth promoting yang; the second is Huang Lian Tang (Coptis Decoction), also suitable for stomach heat and spleen cold syndrome, but with more severe spleen cold and lighter stomach heat, thus using dried ginger, Huang Lian, and Huang Qin, removing Huang Qin’s bitterness; adding Ban Xia, Gui Zhi, Gan Cao, and Da Zao to enhance the warming and tonifying effects of dried ginger and Ren Shen on the spleen; the third is Wu Mei Wan (Mume Pill), suitable for stomach heat and spleen cold, with disturbances caused by roundworms, treating this syndrome requires addressing the internal pathological changes of stomach heat and spleen cold to treat from the root. The use of dried ginger in this formula is to combine with Fu Zi, Xi Xin, Shu Jiao (Zanthoxylum), and Gui Zhi to enhance the warming and dispersing effects on the spleen. Additionally, Wu Yiluo states: “Roundworms are calmed by sourness, subdued by pungency, and purged by bitterness.” The pungent nature of dried ginger can also calm roundworms, which is another purpose of using dried ginger in Wu Mei Wan, while Huang Lian and Huang Bai clear stomach heat, forming the effect of clearing the stomach and warming the spleen. Although the main symptoms treated by these three formulas differ, they all pertain to stomach heat and spleen cold syndrome. Therefore, they all incorporate Huang Lian to clear stomach heat, and dried ginger to warm the spleen, enhancing the warming and dispersing effects of dried ginger on the spleen by adding Gui Zhi, Fu Zi, and other warming herbs.
It can be seen that dried ginger can be used for upper heat and lower cold syndrome, pairing with Zhi Zi for diaphragm heat; with Huang Lian (and possibly Huang Qin or Huang Bai) for stomach heat; with Ma Huang, Sheng Ma, Shi Gao, etc., for lung heat, achieving the effect of clearing the upper and warming the spleen.
(6) Used for vomiting syndrome:
In classical formulas, the use of dried ginger for treating vomiting syndrome includes the previously mentioned Li Zhong Wan (Regulate the Middle Pill) for cholera syndrome; applicable for Shaoyin yang deficiency, Si Ni Tang (Frigid Extremities Decoction), Tong Mai Si Ni Tang (Open Pulse Frigid Extremities Decoction), Bai Tong Jia Zhu Gan Zhi Tang (White Passage Decoction with Pig Bile); applicable for cold-heat intermingling with vomiting and diarrhea, Ban Xia Xie Xin Tang (Pinellia Decoction), Sheng Jiang Xie Xin Tang (Fresh Ginger Decoction), and Gan Cao Xie Xin Tang (Licorice Decoction); applicable for stomach heat and spleen cold, Gan Jiang Huang Qin Huang Lian Ren Shen Tang (Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction), Huang Lian Tang (Coptis Decoction), and Wu Mei Wan (Mume Pill); in addition, there are three formulas specifically for vomiting syndrome.
“Jin Kui” states: “If there is lung atrophy with vomiting of phlegm and foam without coughing, the person is not thirsty, and there is frequent urination, this is due to the upper deficiency not being able to control the lower, leading to cold in the lung, causing dizziness and excessive salivation, Gan Cao Gan Jiang Tang (Licorice and Dried Ginger Decoction) is indicated.” This is a syndrome of upper yang deficiency, with cold in the lung leading to atrophy, where the yang deficiency cannot transform qi and control fluids, resulting in frequent vomiting of phlegm and foam. The formula uses dried ginger combined with Gan Cao to warm the lung and restore qi. This formula is half of Li Zhong Wan. In “Shang Han Lun,” this formula is directly used to treat “irritability and vomiting due to deficiency of middle yang.” Although this formula states it warms the lung, it also warms the spleen, as the spleen is the mother of the lung and the source of phlegm production, while the lung is the storage vessel for phlegm. Warming the spleen also means warming the lung, which is the source of the method of nourishing earth to generate metal. Zhang Zhongjing’s thought is also reflected in “Shang Han Lun.” “Shang Han Lun” states: “After a major illness, if there is a preference for salivation, and it has not resolved for a long time, with cold in the chest, one should use pills to warm it, suitable for Li Zhong Wan (Regulate the Middle Pill).” This is one example.
“Jin Kui” states: “If there is dry vomiting, counterflow, and vomiting of phlegm and foam, Ban Xia Gan Jiang San (Pinellia and Dried Ginger Powder) is indicated.” This is a syndrome of insufficient middle yang, with excessive cold phlegm leading to vomiting of phlegm and foam, where dried ginger is combined with Ban Xia to warm the middle, disperse cold, and descend to stop vomiting. This is the second example.
“Jin Kui” states: “If there is persistent vomiting during pregnancy, Gan Jiang Ren Shen Ban Xia Wan (Dried Ginger, Ginseng, and Pinellia Pill) is indicated.” The causes of pregnancy-related vomiting are numerous, and this case describes it as due to stomach deficiency and cold phlegm. The formula uses dried ginger to both warm the middle and benefit qi, dispersing cold; it also assists Ban Xia and fresh ginger juice to clear phlegm and descend counterflow. Together, they achieve the effects of warming the middle, benefiting qi, and descending counterflow to stop vomiting. This is the third example.
From the above, it can be seen that dried ginger is an excellent medicine for treating cold-induced vomiting. If there is deficiency, it can be combined with Gan Cao and Ren Shen; if there is severe deficiency and cold, it can be combined with Fu Zi and other warming herbs; if there is counterflow, it can be combined with pig bile; if there is mixed cold and heat, it can be combined with Huang Qin and Huang Lian; if there is excessive damp phlegm, it can be added with Bai Zhu and fresh ginger juice or Ban Xia; to enhance its descending and counterflow-stopping effects, Ban Xia can be added.
(7) Used for diarrhea syndrome:
In classical formulas, the use of dried ginger for treating diarrhea includes the previously mentioned Li Zhong Wan (Regulate the Middle Pill), Si Ni Tang (Frigid Extremities Decoction), Tong Mai Si Ni Tang (Open Pulse Frigid Extremities Decoction), Bai Tong Tang (White Passage Decoction), Bai Tong Jia Zhu Gan Zhi Tang (White Passage Decoction with Pig Bile), Ban Xia Xie Xin Tang (Pinellia Decoction), Sheng Jiang Xie Xin Tang (Fresh Ginger Decoction), Gan Cao Xie Xin Tang (Licorice Decoction), Ma Huang Sheng Ma Tang (Ephedra and Cimicifuga Decoction), Gan Jiang Huang Qin Huang Lian Ren Shen Tang (Dried Ginger, Scutellaria, Coptis, and Ginseng Decoction), Wu Mei Wan (Mume Pill); in addition, there is a formula for treating cold-induced diarrhea with slippery discharge, which is Tao Hua Tang (Peach Blossom Decoction).
“Shang Han Lun” states: “In Shaoyin disease, if there is diarrhea with pus and blood, Tao Hua Tang (Peach Blossom Decoction) is indicated.” This formula uses dried ginger combined with Chi Shi Zhi (Red Stone Fat) and Jing Mi (Glutinous Rice) to warm the middle and astringe the intestines, effectively stopping diarrhea while also stopping blood. Additionally, the postscript of Zhen Wu Tang states: “If there is diarrhea, remove Shao Yao, and add two liang of dried ginger.” This is also an example of using dried ginger to warm the middle and stop diarrhea.
Dried ginger is one of the first-choice herbs for treating deficiency and cold-induced diarrhea, often combined with Ren Shen, Gan Cao, and Bai Zhu; for those with cold, it can be combined with Fu Zi and other warming herbs; if there is heat, it can generally be combined with Huang Qin and Huang Lian, of course, distinguishing the location of heat and selecting appropriate herbs for satisfactory efficacy; if it is due to slippery discharge, astringent herbs such as Wu Mei and Chi Shi Zhi can be added. “Bencao Zheng” states: “If there is deficiency and cold in the lower burner, leading to abdominal pain and diarrhea, it is best to warm and tonify, using dried ginger that has been stir-fried until yellow.” This can serve as a clinical reference.
(8) Used for abdominal pain syndrome:
In classical formulas, the formula explicitly using dried ginger for treating abdominal pain is Da Jian Zhong Tang (Major Construct the Middle Decoction).
“Jin Kui” states: “If there is severe pain in the chest and abdomen, inability to eat due to vomiting, cold in the abdomen, and pain that cannot be touched, Da Jian Zhong Tang (Major Construct the Middle Decoction) is indicated.” This is caused by spleen and stomach deficiency and cold, where yang deficiency generates internal cold, leading to various symptoms. The formula uses dried ginger combined with Shu Jiao (Zanthoxylum), Ren Shen, and honey to assist Shu Jiao in warming the middle, dispersing cold, and descending counterflow; it also assists Ren Shen and honey in warming and tonifying the middle qi. Together, they achieve the effects of warming the middle, tonifying deficiency, and alleviating pain.
(9) Used for chest obstruction and heart pain syndrome:
Zhang Zhongjing believes that the occurrence of chest obstruction is due to insufficient yang and excessive yin, meaning insufficient yang qi and excessive cold evil. Dried ginger has the function of warming the middle and dispersing cold, thus it is sometimes used for chest obstruction syndrome.
In classical formulas for treating chest obstruction and heart pain, there are two formulas that include dried ginger; one is Wu Tou Chi Shi Zhi Wan (Aconite and Red Stone Fat Pill); the other is Ren Shen Tang (Ginseng Decoction).
“Jin Kui” states: “If there is chest pain radiating to the back, and back pain radiating to the heart, Wu Tou Chi Shi Zhi Wan (Aconite and Red Stone Fat Pill) is indicated.” This is a syndrome of cold evil obstructing the heart, where dried ginger is used to warm yang and disperse cold, assisting Wu Tou, Fu Zi, and Shu Jiao in forcefully expelling the cold evil and unblocking the heart vessels.
“Jin Kui” states: “If there is chest obstruction, with fullness in the heart, and qi stagnation in the chest, Ren Shen Tang (Ginseng Decoction) is also indicated.” Ren Shen Tang (Ginseng Decoction) is essentially Li Zhong Wan. Both formulas are due to deficiency, but the former is primarily cold, thus all used are warming and dispersing herbs, while to prevent excessive dispersing, red stone fat is added as a counteracting agent; while the latter is primarily deficiency, as stated in the “Jing Jian”: “Chest obstruction is due to qi stagnation in the heart, leading to fullness in the chest.” Therefore, the latter focuses on supporting the righteous qi and expelling cold. Although both formulas use dried ginger, the emphasis on the pathogenesis differs, thus the herbal combinations also vary. This is something to pay attention to.
(10) Used for blood syndrome:
According to the “Shennong’s Classic,” dried ginger can “stop bleeding,” as it is warm in nature and enters the middle burner, thus primarily used for vomiting and bleeding due to inability to control blood caused by deficiency of middle yang. Additionally, due to its pungent and warm nature, it can stimulate blood flow, quickly dispersing stagnant blood, and dried ginger can also be used for blood stasis syndrome. In classical formulas for treating blood syndromes, besides the previously mentioned Tao Hua Tang (Peach Blossom Decoction) for treating diarrhea with pus and blood, there are three other formulas.
“Jin Kui” states: “For persistent vomiting of blood, Bai Ye Tang (Cypress Leaf Decoction) is indicated.” Bai Ye Tang is suitable for cases where yang deficiency cannot control blood, but due to persistent vomiting of blood, with both qi and blood deficiency, using only dried ginger and Ai Ye (Mugwort) to warm yang and control blood may burn the yin blood, thus it is combined with Bai Ye to nourish yin and cool blood to stop bleeding. The combination of cold and heat, addressing both yin and yang, achieves the effect of stopping bleeding. If there is no yin injury, it can be combined with Fu Zi, etc., as seen in later formulas like Jiang Fu Gu Chong Tang (Ginger and Fu Zi Decoction) and Jiang Fu Si Wu Tang (Ginger and Four Substances Decoction), which are examples of this.
Secondly, for treating traumatic injuries, Wang Bu Liu Xing San (Not Stay in the Field Powder) uses dried ginger to warm yang and move blood, promoting the dispersal of stagnant blood to achieve the purpose of stopping bleeding, while also aiding in the resolution of swelling. Based on this, Zhang Zhongjing also used dried ginger for the syndrome of blood stasis and phlegm obstruction, as in the formula Bie Jia Jian Wan (Soft-Shelled Turtle Shell Decoction). This formula uses dried ginger combined with a large number of blood-moving and softening herbs, which also belongs to this category.
Later generations have found that dried ginger, when stir-fried until black, has an excellent effect in stopping bleeding, which is a practical experience that should be taken seriously.
(11) Used for cold-dampness obstruction syndrome:
According to the “Shennong’s Classic,” dried ginger can “expel wind-dampness and obstruction.” Dried ginger is very pungent and hot, primarily suitable for cold-dampness obstruction syndrome. In classical formulas, Gan Cao Gan Jiang Fu Ling Bai Zhu Tang (Licorice, Dried Ginger, Poria, and Atractylodes Decoction) can be used. “Jin Kui” states: “For kidney obstruction disease, the person feels heavy in the body, with cold in the waist, as if sitting in water, the body appears water-like, and they do not feel thirsty, with urination being normal, and eating as usual; the disease belongs to the lower burner. If there is fatigue and sweating, with cold dampness in the clothing, and if this persists, there will be cold pain in the waist, feeling heavy as if carrying five thousand coins, Gan Jiang Fu Ling Bai Zhu Tang (Dried Ginger, Poria, and Atractylodes Decoction) is indicated.” Yu Zaiqing states: “The disease is not in the kidney’s internal organs, but in the kidney’s external pathways, thus the treatment method is not to warm the kidney to disperse cold, but to warm the earth to overcome water. Gan, Jiang, Fu Ling, and Bai Zhu are all warming and sweet, not kidney herbs, but the name kidney obstruction refers to the disease itself.” It can be seen that the use of dried ginger in this disease is to warm yang, disperse dampness, and relieve pain.
(12) Others
1. For treating stroke syndrome.“Jin Kui” states: “Hao’s black powder: for treating great wind with heavy limbs and cold in the heart.” This syndrome is due to spleen deficiency and liver excess, where external wind triggers internal wind. The purpose of using dried ginger in this formula is to combine with Ren Shen, Bai Zhu, and Fu Ling to warm and tonify spleen qi, while dried ginger, being pungent and warm, also prevents the stagnation of herbs like Dang Gui (Angelica) and Bai Zhu, which could obstruct the flow of qi.
2. For treating deficiency syndrome.“Jin Kui” states: “For deficiency syndromes, with wind qi causing a hundred diseases, Shu Yu Wan (Dioscorea Pill) is indicated.” This deficiency syndrome is primarily caused by spleen deficiency, further developing into deficiency of qi and blood, thus the formula includes a large number of qi and blood tonifying herbs, with the addition of dried ginger to assist Ren Shen and Bai Zhu in warming the middle and strengthening the spleen, enhancing the spleen’s qi movement, increasing appetite, and providing a source for qi and blood, leading to recovery from deficiency syndrome.
3. Counteracting herbs.Zhang Zhongjing’s prescriptions often do not use excessive force, often adding some counteracting herbs to the main herbs to make the formula more effective. Dried ginger is also used as a counteracting herb, as in Feng Yin Tang (Wind Inducing Decoction). Feng Yin Tang is a formula for treating heat-induced seizures, which should ideally use cold and heavy herbs, but to prevent excessive cold descent, Zhang Zhongjing added some warming and ascending herbs. In Feng Yin Tang, besides Long Gu (Dragon Bone), Mu Li (Oyster Shell), Han Shui Shi (Cold Water Stone), Hua Shi (Talc), Chi Bai Shi (Red and White Stone Fat), Zi Shi Ying (Purple Quartz), Shi Gao (Gypsum), and Da Huang (Rhubarb), dried ginger and Gui Zhi (Cinnamon Twig) are added. By adding dried ginger and Gui Zhi to many cold and descending herbs, it prevents excessive cold descent, protecting the stomach, and also allows for the release of trapped fire. This medication technique is something we should study and inherit seriously.
In summary, dried ginger is a highly favored herb by Zhang Zhongjing, used to treat conditions including: phlegm and cough asthma, lung cold qi counterflow, phlegm and fluid retention, fullness syndrome, obstruction syndrome, vomiting, diarrhea, deficiency, vomiting blood, blood stasis, traumatic injuries, stroke, and more than 13 types of syndromes, with a total of 43 formulas. These formulas include decoctions and powders. The richness of content and clever combinations are valuable treasures that we should study and inherit.
The dosage of dried ginger in classical formulas can be as high as four liang, generally two to three liang, with some being one liang or one and a half liang. In modern practice, the general dosage is 3 to 9 grams, and can be used up to 15 grams in larger amounts.
This herb is very pungent and hot, thus contraindicated for those with yin deficiency and internal heat, and should be used cautiously in pregnant women.
This article was compiled and organized by the Yueya Lake Classical Formula Team from “Research on the Use of Classical Formulas” and online sources. If there are any objections, please inform the editor, and we will delete it promptly.
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