Acupuncture Today July, 2007, Vol.08, Issue 07 buy cheap oem Herbal Monograph for Xiao Chai Hu Tang By John Chen, PhD, PharmD, OMD, LAc Xiao chai hu tang (Minor Bupleurum Decoction) is one of the most commonly used herbal formulas today. Historically, it was used to treat shaoyang syndrome. Today, it is used to successfully treat many disorders including hepatitis, liver fibrosis, liver cancer, jaundice, cholecystitis, cholelithiasis, pancreatitis, nephritis, acute tonsillitis, parotitis, stomatitis and many more. To achieve optimal therapeutic outcome, it is of critical importance to learn beyond the traditional aspect of this formula. Understanding of topics such as pharmacological effect, clinical studies and research, toxicology and herb-drug interactions will greatly empower the practitioners to properly select the best herbal formula for treatment. Listed below is the herbal monograph on Xiao chai hu tang (Minor Bupleurum Decoction), an excerpt from Chinese Herbal Formulas and Applications by John and Tina Chen, to be published by Art of Medicine Press in fall, 2007. Xiao Chai Hu Tang (Minor Bupleurum Decoction) Pinyin Name: Xiao Chai Hu Tang Literal Name: Minor Bupleurum Decoction Alternate Names: Hsiao Tsai Hu Tang, Minor Bupleurum Combination Original Source: Shang Han Lun (Discussion of Cold-Induced Disorders) by Zhang Zhong-Jing in the Eastern Han Dynasty Composition -1- cholelithiasis. pulmonary tuberculosis. 2. chronic renal insufficiency. pancreatitis. or any internal injury characterized by shaoyang syndrome. a bitter taste in the mouth. irritability. nephritis. hepatocellular carcinomas. Discard the residue and cook the strained decoction again until it is reduced to 3 cups [600 mL]. fever in cancer. bronchitis. Chinese Therapeutic Actions Harmonizes shaoyang Clinical Manifestations 1. xi (washed) Sheng Jiang (Rhizoma zingiberis recens). infectious parotitis.5 cup [9g] 9g [9g] 9g [6g] Zhi Gan Cao (Radix et rhizoma glycyrrhizae praeparata cum melle) 9g [5g] Da Zao (Fructus jujubae). white tongue coating and a wiry pulse. liver or chong (thoroughfare) channel. hepatic fibrosis and carcinoma. qie (sliced "Slicing") Ren Shen (Radix et rhizoma ginseng) 24g [12g] 9g [9g] 0. jaundice. pneumonia. vomiting. bronchial asthma. stomatitis. reflux esophagitis. chronic hepatitis. jaundice. Take 1 cup [200 mL] of warm decoction per dose. cough. three times daily. allergic rhinitis. the decoction may be prepared using the dosages suggested in brackets. a dry throat.Chai Hu (Radix bupleuri) Huang Qin (Radix scutellariae) Ban Xia (Rhizoma pinelliae). acute tonsillitis. Today. vertigo. nausea. antral -2- . a thin. common cold. Clinical Applications Hepatitis. malaria. Any of the following disorders with shaoyang characteristics: gynecological disorders with heat in the uterus. viral hepatitis. bo (opened) 12 pieces [4 pieces] Dosage/Preparation/Administration The source text specifies to cook the ingredients in 12 cups [2400 mL] of water until 6 cups [1200 mL] of the liquid remain. influenza. chest and hypochondriac fullness and discomfort. lack of appetite. cholecystitis. measles. Shaoyang syndrome: alternating spells of fever and chills. fever. and use of only heat-clearing or downward-draining herbs will bring the pathogens from the exterior into the interior. the harmonizing method is the most appropriate treatment approach in this condition. vertigo. giving rise to chest and hypochondriac fullness and discomfort. one of the six stages of disease progression described in Shang Han Lun (discussion of cold-induced disorders). zhi gan cao (Radix et rhizoma glycyrrhizae praeparata cum melle). nausea and vomiting are the results of gallbladder heat invading the stomach. disperses stagnation in the body. therefore. it is not suitable to use only exterior-releasing herbs or only purgative herbs. The wiry pulse is the result of qi stagnation in the shaoyang channel. or between the exterior and interior. depression.gastritis. besides harmonizing the stomach to relieve nausea and vomiting. premenstrual syndrome and malaria. Chai hu (Radix bupleuri) is the main herb for treating shaoyang disorders. The shaoyang is situated between yang and yin. Sheng jiang (Rhizoma zingiberis recens) helps ban xia (Rhizoma pinelliae) harmonize the middle jiao. a bitter and cold herb that enters the gallbladder channel. chronic fatigue syndrome. Because the disease resides between the exterior and the interior. The light quality of chai hu (Radix bupleuri) lifts and disperses stagnation. postpartum infection. morning sickness. Therefore. nourish body fluids and harmonize -3- . dizziness. seizures. alternating spells of fever and chills may occur in shaoyang syndrome if the body is fighting both the pathogens outside and the disharmony inside. angina. Together. as well as releases to the exterior. gastritis. Meniere’s syndrome. gastric prolapse. Use of only exterior-releasing herbs will not treat the interior condition. and da zao (Fructus jujubae) tonify stomach qi. Disorders in the shaoyang might cause qi stagnation and eventual heat formation in the gallbladder channel (a shaoyang channel). Explanation Xiao chai hu tang (Minor Bupleurum Decoction) is the main formula for harmonizing shaoyang syndrome. is ideal for clearing shaoyang heat. gastric pain. It also reduces the toxicity of ban xia (Rhizoma pinelliae). constipation. chai hu (Radix bupleuri) disperses the exterior while huang qin (Radix scutellariae) clears the interior to achieve the harmonizing effect. postpartum fever. Ren shen (Radix et rhizoma ginseng). The tongue coating is thin and white because the pathogenic factors have not yet transformed into internal heat. Huang qin (Radix scutellariae). a bitter taste in the mouth. Lack of appetite. a dry throat and irritability. dysmenorrhea. migraine. Ban xia (Rhizoma pinelliae). Ren shen (Radix et rhizoma ginseng). zhi gan cao (Radix et rhizoma glycyrrhizae praeparata cum melle). Xiao Chai Hu Tang (Minor Bupleurum Decoction) Diagnosis Shaoyang syndrome Signs and Symptoms Alternating spells of fever and chills: the location of the illness between exterior and interior. this formula can be applied even if there is only one shaoyang symptom clinically present. white tongue coating: exterior condition. and disperses stagnation. Chest and hypochondriac fullness and discomfort: qi stagnation. and da zao (Fructus jujubae) tonify Stomach qi. a dry throat. The combination of chai hu (Radix bupleuri) and ren shen (Radix et rhizoma ginseng) also provides a mutual check and balance for each other: chai hu (Radix bupleuri) prevents the tonic effect of ren shen (Radix et rhizoma ginseng) from retaining the pathogens in the body. Lack of appetite. Thin. these herbs expel the pathogens and strengthen bodily constitution. Therefore. and harmonize the ying (nutritive) and wei (defensive) levels. Together. Modifications -4- . Sheng jiang (Rhizoma zingiberis Recens) harmonizes the middle jiao. Treatment Harmonizes shaoyang Herbs Chai hu (Radix bupleuri) releases the exterior.the ying (nutritive) and wei (defensive) levels. the symptoms listed above may not be clinically present all at the same time. nausea. while ren shen (Radix et rhizoma ginseng) prevents the dispersing effect of chai hu (Radix bupleuri) from damaging qi. as suggested in shang han lun (discussion of cold-induced disorders). and huang qin (Radix scutellariae) clears the interior. and vomiting: gallbladder heat invading the stomach. Combined. Because the shaoyang stage is unstable and often short and transient. and irritability: heat in the shaoyang gallbladder channel. Ban xia (Rhizoma pinelliae) harmonizes the stomach to relieve nausea and vomiting. nourish body fluids. Wiry pulse: qi stagnation. they harmonize shaoyang disorders. A bitter taste in the mouth. add zhi shi (Fructus aurantii immaturus) and qing pi (Pericarpium citri reticulatae viride). add bai zhu (Rhizoma atractylodis macrocephalae). remove ban xia (Rhizoma pinelliae) and add tian hua fen (Radix trichosanthis). add chuan xiong (Rhizoma chuanxiong). add shi gao (Gypsum fibrosum). If the hypochondriac pain is severe. remove huang qin (Radix scutellariae) and add fu ling (Poria). If there is thirst. With irritability. fu ling (Poria) and shan zha (Fructus crataegi). With thirst and irritability from deficiency in heat. With more vomiting or nausea. add mai dong (Radix ophiopogonis) and wu wei zi (Fructus schisandrae chinensis). With a stifling sensation in the chest. add dan zhu ye (Herba lophatheri) and geng mi (Semen oryzae). For influenza. remove ban xia (Rhizoma pinelliae) and ren shen (Radix et rhizoma ginseng) and add gua lou (Fructus trichosanthis). With palpitations and dysuria. If there is gum pain caused by yin deficiency. bai shao (Radix paeoniae alba) and xiang fu (Rhizoma cyperi). add sheng jiang (Rhizoma zingiberis recens) and chen pi (Pericarpium citri reticulatae). remove ren shen (Radix et rhizoma ginseng) and add gui zhi (Ramulus cinnamomi). add jing jie (Herba schizonepetae).General Signs and Symptoms: If accompanied by headache. With more irritability but absence of nausea or vomiting. ku xing ren (Semen -5- . zhi qiao (Fructus aurantii). add jin yin hua (Flos lonicerae japonicae). For acute bronchitis. When there is indigestion in children. With abdominal pain. Infectious Disorders: For common colds. remove da zao (Fructus jujubae) and add mu li (Concha ostreae). add jie geng (Radix platycodonis). fang feng (Radix saposhnikoviae) and ge gen (Radix puerariae lobatae). With distention and hardness of the hypochondriac area caused by phlegm accumulation. If there is no thirst but a slight fever and exterior symptoms are present. remove huang qin (Radix cutellariae) and add bai shao (Radix paeoniae alba). chen pi (Pericarpium citri reticulatae). lian qiao (Fructus forsythiae) and ban lan gen (Radix isatidis). add qing pi (Pericarpium citri reticulatae viride). For malaria.armeniacae amarum) and bai bu (Radix stemonae). For postpartum wind invasion with marked deficiency. add bian xu (Herba polygoni avicularis). For jaundice resulting from hepatitis or cholecystitis. remove huang qin (Radix scutellariae). add zhi shi (Fructus aurantii immaturus). remove chai hu (Radix bupleuri). Cautions/Contraindications -6- . When there is wind invasion during the menstrual period. zhi zi (Fructus gardeniae) and ban lan gen (Radix isatidis). increase the dosage of sheng jiang (Rhizoma zingiberis recens). bai shao (Radix paeoniae alba) and jin qian cao (Herba lysimachiae). For chronic bronchitis. bai shao (Radix paeoniae alba) and jin qian cao (Herba lysimachiae). Gynecological Disorders: For postpartum wind invasion with perspiration. add long dan (Radix et rhizoma gentianae) and zhi zi (Fructus gardeniae). For acute otitis media. Liver and Gallbladder Disorders: For icteric jaundice and hepatitis. increase the dosage of ren shen (Radix et rhizoma ginseng). add niu xi (Radix achyranthis bidentatae). add fu ling (Poria). For urinary tract infection. yin chen (Herba artemisiae scopariae). bing lang (Semen arecae) and wu mei (Fructus mume). For jaundice with more heat. For postpartum wind invasion with increased vomiting or nausea. chen pi (Pericarpium citri reticulatae). For damp-heat jaundice. add zhi zi (Fructus gardeniae) and huang bo (Cortex phellodendri chinensis). add chang shan (Radix dichroae). For postpartum wind invasion without fever. tao ren (Semen persicae) and mu dan pi (Cortex moutan). add yin chen (Herba artemisiae scopariae). yin chen (Herba artemisiae scopariae). che qian cao (Herba plantaginis) and hai jin sha (Spora lygodii). add zhi shi (Fructus aurantii immaturus). zi wan (Radix et rhizoma asteris) and kuan dong hua (Flos farfarae). Shan Xi Zhong Yi. et al. 10. Kawakita T. Avoid cold.16(1):41-53. 11. Kayaba Y. Immunopharmacol Immunotoxicol.(5)279. 1997. Inappropriate use of this formula may result in headache.25(11):1417-21. 1984. Journal of Medicinals. 13. In general. dizziness or bleeding gums.13(4):43.11(8):376. 1992. 5. Effect of Sho-saiko-to extract on hepatic inflammation and fibrosis in dimethylnitrosamine induced liver injury rats. February 1994. since it harmonizes.13(4):46. Journal of Gansu University of Chinese Medicine. Zhong Yi Fang Ji Xian Dai Yan Jiu. 1984.104(7):798. Qiu B. 1990. 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