【Source】

Shang Han Lun Fang

 【Composition】

Chai Hu, Zhi Shi, (Bai) Shao Yao, (Zhi) Gan Cao
(4)

 【Classification】

<Blood Nourishing>: Shao Yao

<Regulating Qi>: Zhi Shi

<Tonifying Spleen and Middle Jiao>: Gan Cao

<Dispersing Exterior with Acrid and Cool Herbs>: Chai Hu

【Formula Rationale】

Yi Fang: This formula is for the Shaoyin Meridian. If an external Yang pathogen penetrates internally and causes four-limb coldness, presenting as an internal Yin invasion, we dare not use bitter cold herbs to purge, fearing damage to Yang. The scripture states: ‘All cases of four-limb coldness should not be purged.’ (1) Therefore, Zhi Shi is used to resolve stagnation and heat. (2) Gan Cao is used to harmonize rebellious Qi. (3) Chai Hu is used to disperse external Yang pathogens. (4) Shao Yao is used to nourish Yin. Using acrid, bitter, sour, and cool herbs to harmonize and resolve, allows Yang Qi to circulate to the extremities. This intention is the same as using Xiao Chai Hu Tang for Shao Yang diseases. For combined symptoms, modify according to the addition method. Cheng Fang Bian Du: Chai Hu moves from Yin to Yang; for pathogens that have moved from the exterior to the interior, it helps them return from the interior to the exterior, allowing formless pathogens to be dispersed. However, if pathogens have penetrated to the interior, there may be lingering phlegm or food stagnation. If the pathogens are bound, they cannot be completely eliminated. Therefore, Zhi Shi is used to break stagnation and resolve phlegm, working with Chai Hu, one for the exterior and one for the interior, each serving its purpose. Shao Yao and Gan Cao protect Yin and harmonize the Middle Jiao, mutually supporting each other. Naturally, pathogens will disperse and coldness will recede. Han Dian: This formula is composed of Chai Hu, Shao Yao, Zhi Shi, and Gan Cao. It is derived from Da Chai Hu Tang, with Huang Qin, Ban Xia, Sheng Jiang, and Da Zao removed and Gan Cao added. Therefore, the indications for this formula do not include symptoms like vomiting or constipation, but rather acute epigastric pain can be quite strong. This formula treats conditions that are more deficient than Da Chai Hu Tang, and more substantial than Xiao Chai Hu Tang. Thus, abdominal signs include ‘chest and hypochondriac fullness’ and rigidity in the lower ribs and abdominal rectus muscles. This formula is used for Shaoyin disease with cold limbs, and for stubborn hypochondriac pain.

 【Functions】

Soothes Liver Qi, disperses accumulated heat, stops pain.

 【Indications】

Shaoyin disease with four-limb coldness, accompanied by cough, palpitations, difficult urination, abdominal pain, or severe diarrhea with a feeling of heaviness. Shaoyin disease where cold pathogens transform into heat and penetrate the interior, causing cold extremities due to internal heat accumulation. Or in children with fever and cold limbs. It can also be used for flank pain due to Liver Qi stagnation, and epigastric or abdominal pain caused by disharmony between the Liver and Stomach. Yi Fang: For Shang Han Shaoyin disease, when Yang pathogens enter the interior, causing cold extremities, or cough, palpitations, difficult urination, abdominal pain, or severe diarrhea with a feeling of heaviness (Shang Han, Shaoyin Chapter).

 【Indications (Modern Applications)】

Hepatitis, liver cirrhosis, cholecystitis, gallstones, chronic gastritis, peptic ulcers, menopausal syndrome associated with Liver Qi stagnation. Irregular menstruation, dysmenorrhea, pelvic inflammatory disease in women associated with Liver Qi stagnation and disharmony between the Liver and Spleen.

 【Contraindications】

(1) Not to be used for Yin-type coldness extending above the wrist or below the knee. (2) Not suitable for coldness of the limbs due to true cold. (3) Not suitable for Liver Yin deficiency, Middle Jiao Qi deficiency cold, or Yang deficiency cold.

 【Mnemonic】

Let you disperse (wealth) — only burn dry firewood (Zhi Shao Gan Chai)#

 【Modifications】

Yi Fang: (1) For cough: add Wu Wei Zi, Gan Jiang; also helps with diarrhea. (2) For palpitations: add Gui Zhi. (3) For difficult urination: add Fu Ling. (4) For abdominal pain: add Fu Zi. (5) For severe diarrhea with a feeling of heaviness: add Xie Bai. (1) For distending pain in the flanks or epigastric and abdominal pain, with belching relieving symptoms, or severe pain with vomiting, and a wiry pulse: add Yan Hu Suo, Yu Jin to regulate Qi and stop pain. (2) For food stagnation: add Mai Ya, Ji Nei Jin to aid digestion and resolve stagnation. (3) For jaundice: add Yin Chen, Yu Jin to clear heat, resolve dampness, and reduce jaundice. (4) For cough: add Wu Wei Zi, Gan Jiang to warm the Lungs, disperse cold, and stop cough. (5) For difficult urination: add Fu Ling to promote urination. (6) For abdominal pain: add prepared Fu Zi to warm the interior and dispel cold. (7) For diarrhea with a feeling of heaviness: add Xie Bai to relieve the sensation of heaviness. (8) Adding Huang Lian, Wu Zhu Yu, Qing Pi, Mu Xiang, Liang Jiang, Da Zao to this formula creates Si Zuo Tang, used for duodenal ulcers. (9) Removing Chai Hu and Gan Cao from this formula creates Zhi Shi Shao Yao San (from Jin Gui Yao Lue), used for postpartum abdominal pain, restlessness, and inability to lie down, also treats carbuncles, to be taken with rice gruel. (10) Adding Qing Pi, Chen Pi, San Leng, E Zhu, Da Fu Pi, Mu Xiang, Bai Tong Cao, Yu Li Ren, Jue Ming Zi to this formula creates E Zhu Si Ni San, used for abdominal distention, blocked Qi flow, poor digestion, dry mouth, little fire, dry stools, normal urination, red tongue without coating with little fluid, and a deep, fine, choppy pulse. (11) Adding Xiang Fu, Shan Yu Rou, Gua Lou Pi, Dan Shen, Chi Shao, and replacing Zhi Shi with Zhi Ke in this formula treats chronic hepatitis, persistent hepatitis, characterized by distending pain in the right flank, poor appetite, abdominal fullness, or enlarged liver and spleen, with a red tongue and slightly yellow coating. (12) For palpitations, add Gui Zhi 5 fen.”

 【Pharmacology】

Possesses antispasmodic, anti-ulcer, antiviral, and interferon-inducing effects; sedative, antipyretic, hypotensive, anti-shock, antiarrhythmic, cardiotonic, anti-hypoxic effects; increases cerebral blood flow, improves microcirculation; reduces cholesterol, fibrinogen, and blood viscosity; anti-fatigue; prevents lidocaine toxicity; hepatoprotective, anti-inflammatory, and analgesic effects.”