A venom based poison associated with black magic practices dating back to oracle bone inscriptions from the 14th century BCE. Early forms involved sealing three 蟲 Chong (venemous creatures such as a centipede, snake and scorpions) inside a closed container where they devoured one another and concentrated their toxins into a single survivor which could then be used to cause harm to others. The medical classics make few mentions of Gu with the following exceptions:
Su Wen ch. 19, On the Jade Mechanism, makes reference to the transmission of Wind, starting with the famous quote: "Wind is the cause of the 100 diseases." After its transmission from the Lungs to the Liver, the Spleen and then the Kidneys, it describes a hernial disorder (疝瘕 Shan Jia) where "the lower abdomen feels pressure, is hot and painful, with white discharge. Another name is Gu 蠱. At this time, press and give medicines." After this, if the disease is not cured it transmits to the Heart where it must be cured within 10 days or death will occur.
Ling Shu, ch. 23, On Heat Diseases, concludes by referring to men who have a condition like Gu 蠱, where "the body, lower back and spine feel detatched, with the patient neither wishing to drink, nor eat, then the Yongquan is to be chosen first to bleed, and if the instep is full, then blood is to be let from here."
The Jin Gui Yao Lue, ch. 11, On Combined Treatment of Syndromes Caused by Accumulation of Wind and Cold in the Five Internal Organs, describes severe Wind Strike of the Heart as "a pain in the back that pierces the heart, like a Gu injection (蠱注)."
Sun Simiao, in the Emergency Prescriptions Worth 1000 Gold, volume 44, line 59, describes the 13 Ghosts Points as applicable for a Dian Kuang type of person, who has a "flying Gu" assailing them.
Wei Zhixiu, in the Qing Dynasty, described it as a toxic substance that would attach itself to a person (often a woman) who could use it to kill others. Sometimes the Po of their victim would then become more Gu for them to use against future victims (Wilcox, 2024).
Over time it has changed and been almost forgotten in modern Chinese medicine but definitions have included:
Van Straten (1983) considered it psychoanalytically as a concrete manifestation of instincts that have been repressed in order to avoid sexual and social conflicts.
Fruehauf (1998, 2015) takes a more medical view, that it referred to chronic parasitic infections which may never have existed as a black magic practice but rather, like many beliefs in witchcraft and sorcery, were a means to explain and blame a malignant force for bizarre and confusing symptoms that may suddenly appear. He believes it may still be applied to modern disorders like fungal, bacterial or parasitic overgrowth, autoimmune disorders and symptom presentations that involve a variety of mental and physical symptoms (especially digestive) that cannot be explained by standard medical categories, usually against a background of deficiency that has caused an over-reaction to environment factors. In this respect the ancient "three bugs sealed in a vessel to fight until a super-bug remains" may refer to the cultivation of a pathological microbiome in our digestive tract that develops into a debilitating ecosystem and chronic inflammation.
For treatment, formulas are constructed using a combination of herbs across six main categories that include exterior releasing, Blood regulating and internally tonifying herbs from a list of specific Gu treating herbs in order to expel the pathogen while restoring the depleted Qi and Yang of the patient. The formula must be adjusted every six weeks in order to keep ahead of the pathogen which has a tendency to lurk, hide and adapt to the remedy.
Other authors (Lovie, 2021) have suggested it may also apply to other chronic, difficult to treat disorders, such as long Covid.
For further information see:
Fruehauf, H. (1998). Driving Out the Demons and Snakes - Gu Syndrome: A Forgotten Clinical Approach to Chronic Parasitism. Journal of Chinese Medicine.
Fruehauf, H. (2010). Thunder Pearls: An Effective Chinese Herbal Treatment for Chronic Parasitism. Classical Pearls Lecture Series.
Fruehauf, H. (2015). Treating Chronic Inflammatory Diseases with Chinese Herbs: "Gu Syndrome" in Modern Clinical Practice. Pacific College.
Fruehauf, H. (2025). Thunder Pearls. Classical Pearls.
Fruehauf, H. (2025). Lightning Pearls. Classical Pearls.
Gu poison (2018). https://en.wikipedia.org/wiki/Gu_(poison). Wikepdia.org.
Lovie H. (2021). Gu Syndrome, Lurking Pathogens, and Long Covid: An Old Take on a New Disease. Integrative medicine (Encinitas, Calif.), 20(5), 22–24. https://pubmed.ncbi.nlm.nih.gov/34803536/
Quinn, B. (2008). Gu Parasite Herbs From Heiner Fruehauf. https://chineseherbinfo.com.
Quinn, B. & Fruehauf, H. (2011). Lyme Disease: an in-depth interview with Heiner Fruehauf. Classical Chinese Medicine.
Quinn, B., Moreland, E. & Fruehauf, H. (2008). Gu Syndrome: An In-depth Interview with Heiner Fruehauf. https://chineseherbinfo.com.
Weichert, R. & Fruehauf, H. (2015). Voice from the Mountaintop: Heiner Fruehauf on Traditional Chinese Medicine and Lyme Disease (3 Parts). Classical Chinese Medicine.
Unschuld, P.U. (1984). Medicine in China: A History of Ideas. Reprint: Berkeley: University of California Press, 2010.
Van Straten, N.H. (1983). Concepts of Health, Disease and Vitality in Traditional Chinese Society: A Psychological Interpretation Based on the Material of Georg Koeppen. Wiesbaden: Franz Steiner Verlag GMBH
Wilcox, L. (2023). Gu, Gu Toxins and Gu Distention. https://www.youtube.com/watch?v=Os9ZZwNh89w
Wilcox, L. (2024). Case Studies 29: Cases and stories of Gu Toxins. https://www.youtube.com/watch?v=xo2hQFuvbiI
See also interviews and additional articles with Fruehauf at: Gu Syndrome Archives. classicalchinesemedicine.org.
Steve Woodley Acupuncture & Traditional Medicine
90 Deane Croft Road,
Eascote, Pinner, Greater London. HA5 1SP
Tel/WhatsApp: +44 (0) 7946 174 829
Email: steve@steve-woodley.co.uk
