What Gui Zhi Fu Ling Wan is for
This pill is for skin that holds a fixed lump. The lesion is hard, dusky and quiet: a subcutaneous nodule, an old indurated plaque, or a patch of discolouration that has not changed in months. It is not hot, not red and not spreading. The lump is read as Blood congealed with Dampness, which is why it feels doughy rather than sharp, and why the treatment is patient softening over weeks rather than a quick clear.
The lesion is the whole picture. A firm area sits in the tissue and stays in the same place, sometimes painless and sometimes tender on pressure, with skin over it that is dusky, purplish or brownish rather than red. The edge is indistinct and the texture is doughy or nodular, which is Dampness mixed with the congealed Blood. Unlike an abscess it does not fluctuate, throb or point. Between the lumps the skin may look dull and poorly nourished, and old injuries leave colour that never quite clears.
Gui Zhi and Tao Ren move the Blood and break the stasis that forms the lump. Mu Dan Pi cools and moves it at the same time, so the stasis does not turn into Heat. Bai Shao softens the hardness and protects the Blood while the others work, and Fu Ling drains the Dampness that gives the lump its doughy texture. The formula is gentler than the strong Blood-breaking prescriptions, which is exactly what allows it to be taken for weeks while a mass softens.
It suits the quiet chronic stage. Nodules present for months, lipomas and old indurated lesions, dusky patches left after an injury, and the fixed dusky pigmentation of age spots on a stasis base all fit when there is no heat. It is wrong for hot, red, spreading lesions, which need clearing rather than moving, and it is not used in pregnancy because of the Blood-moving herbs. Any new, growing or painful lump needs medical assessment before it is treated as stasis.
Actions
- Invigorates Blood and dispels stasis
- Transforms Phlegm-Dampness
- Softens hardness and dissipates masses
- Relieves fixed pain
Properties
- Taste and temperature: Predominantly pungent, sweet and slightly bitter. Pungent moves Blood, sweet softens and supports, bitter dries and cools.
- Organs: Heart, Liver, Spleen
- Channels: Heart, Liver, Spleen
The pattern behind it
The pattern is Blood stasis that has congealed into a mass, often with Dampness or Phlegm involved. The stasis produces the fixed hardness and the dusky colour; the Dampness makes it feel doughy or nodular. The formula moves the Blood, cools it, softens the mass and drains the Dampness that contributed.
Composition
The herbs in Gui Zhi Fu Ling Wan, with their role and dose.
| Role | Herb | Dose | Properties | Why it is there |
|---|---|---|---|---|
| King | Gui Zhi | 9 to 12 g | Warm, Pungent, sweet | Warms and unblocks the channels and moves Blood, addressing the stasis with a gentle warmth. |
| King | Tao Ren | 9 to 12 g | Neutral, Bitter, sweet | Breaks Blood stasis, the central action for the fixed mass. |
| Mu Dan Pi | 9 to 12 g | Slightly cold, Bitter, pungent | Cools and moves Blood, preventing the stasis from generating Heat. | |
| Bai Shao | 9 to 12 g | Slightly cold, Bitter, sour | Nourishes Blood and softens the hardness, balancing the moving herbs. | |
| Fu Ling | 9 to 12 g | Neutral, Sweet, bland | Transforms Dampness so the stasis does not combine with Phlegm into a firmer mass. |
Patterns it treats
Blood Stagnation
A fixed, hard lump or indurated area with dusky overlying skin, unchanged for months and without heat or redness. The doughy texture is Dampness caught in congealed Blood. The formula moves and softens rather than clearing an inflammation.
How the formula is built
The formula moves and softens at the same time. Gui Zhi and Tao Ren break the stasis, Mu Dan Pi cools and moves, Bai Shao softens the hardness, and Fu Ling drains the Dampness that makes many lumps feel doughy. It is gentler than the strong Blood-breaking formulas, which is why it is suited to longer courses.
Skin conditions it is used for
Where this formula appears in the skin conditions of the library.
Preparation and use
Taken as prepared pills, two to three times a day.
Modifications
- If the mass is hard, Blood-breaking herbs are added.
- If Dampness dominates, draining herbs are increased.
- If pain is marked, Qi-moving and pain-relieving herbs are added.
- If the person is depleted, tonics are added so the moving does not exhaust them.
Timing
Taken two to three times a day, as prepared pills.
Duration
Often four to twelve weeks, reassessed; longer for chronic masses under supervision.
Diet while taking it
Avoid cold and raw food, since Cold congeals Blood and opposes the moving action.
Safety
Contraindications
Avoid in pregnancy without specialist supervision. Avoid in acute hot, red, spreading lesions, which need clearing rather than moving. Use care where the person is depleted.
Interactions
The Blood-moving herbs may add to anticoagulant and antiplatelet medication. Any new lump should be medically assessed before treatment.
Pregnancy
Contraindicated in standard modern practice. Tao Ren and Mu Dan Pi both move Blood, and the formula is classically treated as unsuitable in pregnancy.
Breastfeeding
Use only under professional guidance.
Children
Used only with professional supervision.
Before you use it
Recorded from the classical record and rewritten in this project's own words. Educational only: not a prescription. Any new, growing or painful lump needs medical assessment before it is treated as stasis.
General safety references
General references for herbal hepatotoxicity and herb-drug interactions; they are not specific to this formula.
- Review article: Herbal hepatotoxicity - an update on traditional Chinese medicine preparations. Alimentary Pharmacology & Therapeutics, 2014. PMID: 24844799.
- Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs, 2009. PMID: 19719333.
- Warfarin and food, herbal or dietary supplement interactions: a systematic review. British Journal of Clinical Pharmacology, 2021. PMID: 32478963.
Selected PubMed records
Real PubMed records for the modern, non-TCM discussion of this formula. They are references, not a claim that the formula is proven for any skin condition.
- Gui-zhi-fu-ling-wan alleviates bleomycin-induced pulmonary fibrosis through inhibiting epithelial-mesenchymal transition and ferroptosis.. Frontiers in pharmacology, 2025. PMID: 40308766.
- Gyejibongnyeong-Hwan (Gui Zhi Fu Ling Wan) Ameliorates Human Uterine Myomas via Apoptosis.. Frontiers in pharmacology, 2019. PMID: 31607930.
Origin and history
Jin Gui Yao Lue (金匮要略, Synopsis of Prescriptions of the Golden Chamber) by Zhang Zhongjing, Eastern Han dynasty, around 220 CE.
The formula comes from Zhang Zhongjing's Synopsis of the Golden Chamber, where it treats fixed abdominal masses in women. Its classical instruction is to take it gradually, so that the mass softens over time rather than being broken violently, and that patient approach is why it suits long-standing nodules in the skin as well.
Classical record
Zhang Zhongjing recorded the pill for fixed abdominal masses in women that are not yet suppurating, to be taken gradually so the mass is softened rather than forcibly broken.
Jin Gui Yao Lue (金匮要略, Synopsis of Prescriptions of the Golden Chamber), Zhang Zhongjing, Eastern Han dynasty.
Evidence note
No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.
Common questions
Can it be used for lumps under the skin?
For fixed, hard, non-inflamed lumps on a stasis pattern, yes, over weeks. Any new or growing lump needs medical assessment first to confirm what it is.
Why is it gentler than other stasis formulas?
Because it is designed to soften a mass gradually, with Fu Ling draining the Dampness and Bai Shao protecting the Blood, rather than breaking stasis hard.
Is it safe in pregnancy?
No. Tao Ren and Mu Dan Pi move Blood, and the formula is classically contraindicated in pregnancy.
How long does it take?
Four to twelve weeks typically, because a mass is softened slowly.