Alternative Names

• jia wei gui pi tang
• chia wei kuei pi tang
• Modified Back to the Spleen Decoction
• kami kihi to
• kamikihito
• kamikihi-to
• Kami-kihi-tō
• 加味帰脾湯
• かみきひとう
• TJ137; TJ-137; TJ 137

This formula’s original version addressed easy bruising, a common indication of what Chinese medical practitioners call “Spleen qi deficiency”. The Spleen is said to “control the blood” which means keeping the blood within the vessels. I like to refer to this function as supporting the structural integrity of the vessels.

However there are other causes for inappropriate bleeding according to Chinese medicine. The first is this so-called Spleen qi deficiency associated with a weakness of the digestion leading to fatigue among other things. For this condition, we use the formula Ginseng and Longan Combination.

Another cause for inappropriate bleeding is “heat in the blood”. This heat is said to cause the blood to boil out of its container, namely the vessels. This heat in the blood can give rise to nosebleeds in children or a heavy menstrual flow in adult females. In the skin, this heat in the blood can manifest as purpura. The treatment principle for this condition is to cool the blood and remove stasis.

One way in which we differentiate between these two causes is by the appearance of the blood or discoloration. As a rule, bleeding that is pale or watery generally points to a deficiency of Spleen qi, for which the original formula (Ginseng and Longan Combination) is very well suited.

Bleeding where the blood is bright red and thick in quality is associated with “heat in the blood”. The herb Zhi Zi 梔子 (Gardeniae Fructus) is used to cool off the Liver. The Chinese medicine Liver is capitalized because this is a slightly different idea than the biomedical “liver”. The Chinese medicine Liver “stores the blood” that is not being used by the body. Zhi Zi cools the Liver, which then cools the blood to support the normal flow of blood within the blood vessels to support a bleeding-free environment.

This formula also includes Chai Hu 柴胡 (Radix Bupleuri), which promotes the circulation of qi. Qi is called the “commander of blood” which means that when the qi is circulating smoothly, the blood will flow appropriately as well. Bleeding is sometimes caused by an obstacle to the flow of blood leading to its exit from the vessels in the same way that a boulder in a stream might force water to wash ashore to flow around it. Chai hu then, prevents energetic boulders from disturbing the flow of blood within the vessels.

I note that this formula is being studied in Japan as a treatment for idiopathic thrombocytopenic purpura, also known as immune thrombocytopenic purpura or immune-mediated thrombocytopenic purpura (ITP). This condition is basically inappropriate bleeding or bruising of unknown cause. Biomedicine is focusing research on an auto-immune reaction as a cause. Researchers in Japan have focused on the formula described on this page because it takes into account three treatment principles to support a bruise and purpura-free environment. those being supporting the Spleen qi, cooling the blood, and moving the qi.

Ingredients

Huang Qi 黃耆 astragalus root, milk-vetch root, milkvetch root Astragali Radix

Bai Zhu 白术 , bai shu ovate atractylodes, (white) atractylodes rhizome [supports pregnancy]

Fu Shen 茯神 spirit poria Poriae Sclerotium pararadicis

Fu Ling 茯苓 Poria

Suan Zao Ren 酸棗仁 sour jujube seed; zizyphus Semen Zizyphi Spinosae

Long Yan Rou 龍眼肉 flesh of the longan fruit, longan Longan Arillus

Dang Shen 参党 Codonopsis

Ren Shen 人蔘 ginseng root Radix Panax Ginseng

• These four herbs all have a calming influence. When there is bleeding, there is a loss of blood which has an affect on the “spirit” in Chinese medicine resulting in a sense of being constantly ill-at-ease even when everything is otherwise okay. Suan Zao Ren for instance is commonly used to support healthy sleep. Ren Shen is used to maintain a mental state of clarity, and Fu Shen calms the mind.

Mu Xiang 木香 costus root, saussurea, auklandia Aucklandiae Radix

Gan Cao 甘草 licorice root Radix Glycyrrhizae [caution]

Dang Gui 當歸 tangkuei, Chinese angelica root Radix Angelicae Sinensis [supports pregnancy]

• The two herbs above both nourish the blood, which is to say support healthy platelet numbers and other essential components of the blood.

Sheng Jiang 生薑 fresh ginger rhizome Zingiberis Rhizoma

Da Zao 大棗 jujube, Chinese date Jujubae Fructus

• These two herbs comprise two of the three so-called “candies” often added to Chinese medicine formulas. The third candy is actually in this formula which is Gan Cao described in the first group of herbs. Anyway, these herbs simply stimulate the efficiency of the digestion. Digestion is the first step in the creation of the Spleen qi necessary to control the blood and keep it within the vessels.

Yuan Zhi 遠志 Chinese senega root; polygala Radix Polygalae Tenuifoliae – calms the mind

Zhi Zi 梔子 cape jasmine fruit, gardenia Gardeniae Fructus

• This herb cools the Liver which keeps the blood cool and maintains a bleeding-free environment in the body. Cooling the Liver can also feel like a chill-pill if you’re easily angered, frustrated or impatient.

Chai Hu 柴胡 hare’s ear root, thorowax root, bupleurum Radix Bupleuri [caution]

• These two herbs promote qi circulation which ends up supporting blood circulation such that it remains within the vessels, where it belongs.

This formula can be used to support health with or without symptoms. If symptoms are present, take 1 level teaspoon of the powder (8 capsules) three times daily. When symptoms are not present, take 1/2 level teaspoon (4 capsules), two times daily. Empty stomach is best for efficient absorption, but not essential. [More…]

At this dosage, your order will last approximately this long (?):

• 100 grams powder (capsules or powder): 8 to 25 days
• 200 grams powder (powder only): 19 to 56 days