Guizhi jia gui tang : Terror and the Heart in Chinese medicine

Last week we discussed how chronic anxiety can deplete the yin of the organs in the chest (heart, pericardium, lung) and cause various heat symptoms. In this article we’ll explore the opposite phenomenon: how terror can deplete the yang of the heart.

Yang is the motive force in the body. Yang is the force of warmth, growth, expansion and speed. The yang of the heart is what propels its contraction, keeps its rhythm stable, and helps it to adjust in real time to the changing circumstances of our movement and our emotions. The heart also contains a part of our souls, the part reflected in the eyes that we call Shen in Chinese medicine.

A healthy heart is a warm and open place, free of clutter or debris.

Terror, however, can injure the yang of the heart. While chronic anxiety is a hot process that occurs over time, fright is a cold process that is sudden and intense. Terror is said to “scatter the qi”, causing the person to have an out-of-body-experience, which can involve seeing the incident from above or from another vantage point and to feel numb.

In Chinese medicine, the animal representing Heart is Horse

A car accident, an assault of some kind, or even very bad news can cause terror, and this cold insult to the heart is very physiologically intense. In people who are otherwise robust and healthy, the shock will dissipate and the heart will heal itself in time.

However, in the very young, the very old, or people who are already compromised by illness or stress, the injury to the yang of the heart can become its own lasting problem.

What might the symptoms of this picture be like? Chinese medicine is often very literal. Yang is hot, and therefore an injury to yang causes cold. People who have a heart yang deficiency will often experience a feeling of cold in or around their heart. This can be the very strange sensation of having transient heart palpitations that feel cold, or having the chest directly over the heart be cold to the teach.

The feeling of cold can often radiate behind the heart and into the back, between the shoulder blades. Sleep issues are common, as with all anxiety patterns. The predominant feeling that such a person will have is intense fear. This is both the terror left over from the original event and also a more existential fear: the fear of imminent death. We can survive without many of our organs, but our hearts must be functioning in order for us to remain living.

Therefore, when the heart in injured, our bodies send the strongest possible signals that something is very wrong.

A heart yang injury does not necessarily mean that someone will die immediately. Left untreated, though, it can lead to more physical symptoms as time goes on. The yang of the heart maintains rhythm and contraction, and issues with it can lead to deterioration of those functions.

Frank heart attacks can occur, heart rhythm problems beyond occasional palpitations can arise, and other organs like the lungs can become drained as they lend their qi to assist the heart. This can lead to tendency towards bronchitis or pneumonia, and even in very dire cases to chronic obstructive pulmonary disease (COPD).

Luckily, none of these down-stream illnesses need to happen.

Injuries to the yang of the heart can be readily treated with herbal medicine and acupuncture. The first herbal formula we would consider in this kind of case would be Guizhi Jia Gui tang, or cinnamon combination plus extra cinnamon. This formula is the same as Guizhi Tang (cinnamon combination), a famous cold and flu formula, but the amount of cinnamon is doubled, changing the focus to the heart.

Cinnamon is a blood tonic, heart yang tonic, and mild blood mover, among other things.

Guizhi / 桂枝 / Cinnamon twig

It is an excellent herb for many kinds of heart conditions, and when combined with peony, ginger, dates and licorice, this formula helps improve digestive function so that the body can produce more blood to send to the heart, and to warm the heart. While the patient takes this formula, we would also apply acupuncture to points that drive out cold, warm the heart, and open the chest. Because this is usually an acute pattern, these kinds of symptoms tend to resolve fairly quickly once treatment begins.

This article is not intended to help you diagnose yourself or your friends, but simply to shed light on how Chinese medicine understands and treats emotional distress. Your particular fear or heart palpitations may or may not fit this Chinese medical pattern, which is why finding a qualified practitioner who can diagnose and treat your condition is important.

If these ideas resonate and you would like to see how Chinese medicine treatment could help you with your symptoms of anxiety – press the orange button below this article to be taken to the convenient online scheduler.

I look forward to learning more about you & helping you find greater balance – and less discomfort – in your life.

Written by Rowan Everard


I discovered Chinese medicine shortly after moving to Portland to complete my undergraduate studies. I began my journey as a patient, but after several years of being an increasingly curious patient I found myself drawn into the formal study of this medicine. In Chinese medicine, I found tools that helped me to transform myself, and which I have seen lead to dramatic positive shifts in patients.