Herb Formulas Notebook

Xiao Chai Hu Tang

Lesser Bupleurum Decoction


Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)


Category: Formulas that Harmonise

Pattern: Wind-Cold lasting more than 5 days constraining the Shoayang; Shaoyang disharmony; Shaoyang type disharmony of Yang Wei Mai; Gu parasites and latent pathogens stuck half Interior and half Exterior.

Key Symptoms: A bitter taste in the mouth, dryness of the throat, blurred vision, alternating chills and fever, distention in the chest & rib sides, taciturnity with no desire for food or drink, nausea and vomiting plus any of the following:
1. Heart vexation without retching
2. Thirst
3. Abdominal pain
4. A hard glomus under the rib side
5. Palpitation below the heart with inhibited urination
6. Absence of thirst with mild generalized heat
7. Cough
Secondary Symptoms: Fever of unknown origin, abdominal pain, feeling downcast, frequent sighing or difficulty taking breaths, reduced intake of food or drink, disinterest in food, dry retching, tinntus, thirst, focal distention in the epigastrium, heartburn, palpitations, coughing, urinary dysfunction, constipation

Tongue: Thin, white or greasy coating
Pulse: Wiry
Abdomen: Tension in the hypochondrium (especially on left), discomfort or focal distention in the epigastrium


Ingredients

Chai Hu 12-24g
Huang Qin 9g
Zhi Ban Xia 9g
Ren Shen 6-9g
Zhi Gan Cao 5-9g
Sheng Jiang 6sl
Da Zao 4pc


Preparation: Decoction.


Actions: Harmonises Shaoyang, supports normal Qi, dispels pathogens

Contraindications: Excess above and deficiency below, Liver Fire, or bleeding of the gums. Use with caution in ascendant Liver Yang, hypertension, or vomiting of blood due to Yin deficiency



Notes:
Can be used for a variety of 'strange disorders' that manifest in unusual symptoms or presentations that are difficult to match to common patterns, hence the enormous number potential secondary symptoms. Often these are nervous or emotional disorders. Providing at least one of the key symptoms of bitter taste in the mouth, dry throat, dizziness or distorted vision are present it indicates a Shaoyang disharmony and Xiao Chai Hu Tang can be used.

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Extraordinary Vessel attributions come from Li Shi-Zhen's (1577-8) Exposition on the Eight Extraordinary Vessels (Qi Jing Ba Mai Kao), trans. Chace & Shima (2009).

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One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).

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Although Hu Xishu lineage have recently expanded the usage of Xiao Chai Hu Tang to include a number of latent pathogens trapped in the half interior and half exterior, the Fire God school of though considers this a patch and that subsequent release through the Jueyin, Taiyang and Yangming is necessary, or the pathogen will simply return.

The Academy of Source Based Medicine, 2023
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Ploberger (2017), in Westliche und traditionell chinesische Heilkräuter, offers the following alternative using western herbs:

Herba Millefolii(Yarrow)3g(Emperor)
Herba Alchemillae(Lady's Mantle)3g(Minister)
Fructus Juniperi (Juniper berries)4g(Minister)
Fructus Carvi (Caraway seed)2g(Assistant)
Herba Menthae (Peppermint)5g(Assistant)
Pericarpium Citri ret.(Orange peel)3g(Assistant)
Rhizoma Zingiberis recens(Fresh Ginger)1g(Assistant)
Radix Ginseng(Ginseng root)3g(Assistant)
Radix Glycyrrhizae(Licorice root)3g(Assistant)



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Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.