【Source】
《Shang Han Lun, Jin Gui Yao Lue》 (Treatise on Cold Damage, Essentials from the Golden Cabinet)
【Ingredients】
Bupleurum Root (Chai Hu), Pinellia Rhizome (Ban Xia), Scutellaria Root (Huang Qin), Citrus aurantium (Zhi Shi), White Peony Root (Bai Shao), Ginger (Sheng Jiang), Rhubarb (Da Huang), Jujube (Da Zao)
(8)
【Category】
<Blood Tonifying>: Peony Root
<Qi Regulating>: Citrus aurantium (Zhi Shi)
<Spleen and Middle Jiao Tonifying>: Jujube (Da Zao)
<Acrid Cool Exterior Releasing>: Bupleurum Root (Chai Hu)
<Clearing Heat and Drying Dampness>: Scutellaria Root (Huang Qin)
<Purgatives>: Rhubarb (Da Huang)
<Acrid Warm Exterior Releasing>: Ginger (Sheng Jiang)
<Phlegm Resolving>: Pinellia Rhizome (Ban Xia)
【Formula Analysis】
《Medical Formulas》: Medicine for Foot Shao Yang and Yang Ming. (1) Since the exterior syndrome has not been eliminated, Bupleurum is used to release the exterior. (2) Because the interior syndrome is dry and replete, Rhubarb and Zhi Shi are used to purge the interior. (3) Peony root: calms the Spleen and restrains Yin. (4) Scutellaria: reduces fever and quenches thirst. (5) Pinellia: harmonizes the stomach and stops vomiting. (6) Ginger is pungent and dispersing, while Jujube is sweet and moderating, to regulate the Ying and Wei and promote the movement of body fluids. (7) This is a formula that treats both the exterior and interior, a mild purgative. 《Shan Bu》: Because the Bupleurum syndrome is present, and there is also an interior condition, a method of resolving both Shao Yang and the interior is established. <a href='https://whatsintcm.com/dt_articles/小柴胡湯/’>Xiao Chai Hu Tang with added Zhi Shi and Peony Root is used to resolve the exterior and harmonize the interior. Ginseng and Licorice are removed because the interior is not deficient. A small amount of Rhubarb is added to drain knotted heat. The amount of Ginger is doubled because vomiting is incessant. In this formula, Bupleurum with twice the amount of Ginger quickly resolves half of the exterior, and Zhi Shi and Peony Root with a small amount of Rhubarb slowly attack half of the interior. Although it is called a purgative, it is a harmonizing purgative among purgatives. 《Han Dian》: This formula replaces the Ginseng and Licorice in <a href='https://whatsintcm.com/dt_articles/小柴胡湯/’>Xiao Chai Hu Tang with Zhi Shi, Peony Root, and Rhubarb. Zhi Shi and Peony Root together can relax muscle tension and have a bitter stomach-strengthening effect. This can remove the tension and fullness in the epigastrium. Rhubarb has a laxative effect while also having anti-inflammatory effects. This formula is used for symptoms similar to <a href='https://whatsintcm.com/dt_articles/小柴胡湯/’>Xiao Chai Hu Tang syndrome, but with more repletion and a tendency to constipation.
【Functions】
Releases the exterior and attacks the interior, harmonizes Shao Yang, drains heat accumulation, and unblocks the replete interior.
【Indications】
Shao Yang and Yang Ming combined disease; although cold damage has entered Yang Ming, Shao Yang is not yet resolved. Symptoms include alternating chills and fever, fullness in the chest and hypochondria, fullness below the chest, vexation, incessant vomiting, constipation, yellow tongue coating, and a deep, replete, wiry, and forceful pulse. 《Medical Formulas》: (1) Fever from cold damage, with failure to resolve after sweating, pathogenic heat entering the interior, heat accumulation in the interior, epigastric fullness, vomiting without smooth bowel movements (Shang Han Lun, Shao Yang chapter). (2) Or alternating chills and fever, vexation and thirst with delirium, abdominal distention and constipation. (3) Exterior syndrome unresolved, with an urgent interior syndrome, and a surging or deep, replete, wiry, rapid pulse. 《Shan Bu》: Heat accumulation in the interior, urgent vomiting in the epigastrium that does not stop, mild vexation, with Bupleurum syndrome still present, use <a href='https://whatsintcm.com/dt_articles/大柴胡湯/’>Da Chai Hu Tang to purge it.
【Applications】
The application range of this formula and <a href='https://whatsintcm.com/dt_articles/小柴胡湯/’>Xiao Chai Hu Tang is very broad. Liver and gallbladder system diseases, chronic hepatitis, acute pancreatitis, acute cholecystitis, chronic cholecystitis, gallstones, biliary colic, biliary tract infection. Hyperacidity, gastritis, gastric ulcer, duodenal ulcer, constipation, hypertension, obesity.
【Mnemonic】
Earned a great fortune – Ambassador Hu invites a young general to accompany the performance – to celebrate (Hu Da Shi Qin Shao Jiang Ban Zuo) — # (Bupleurum, Da Huang, Zhi Shi, Scutellaria, Peony, Ginger, Pinellia, Jujube)
【Modifications】
(1) For gallstones, add Lysimachia, Chicken Gizzard Lining (Ji Nei Jin), Curcuma to dissolve stones and relieve stagnation. (2) For concurrent jaundice, add Artemisia capillaris (Yin Chen Hao), Gardenia (Zhi Zi) to clear heat, resolve dampness, and reduce jaundice. (3) For severe hypochondriac pain, add Sichuan Chinaberry (Chuan Lian Zi), Corydalis Rhizome (Yan Hu Suo) to move Qi, invigorate blood, and stop pain. (4) If vomiting persists, add Zuojin Wan (Left Metal Pill), Ginger Bamboo Shavings (Zhu Ru) to clear heat and stop vomiting. (5) For constipation, severe heat with vexation, dry tongue with thirst, thirst with a desire to drink, red face, surging and replete pulse, add Glauber’s Salt (Mang Xiao) to purge heat and unblock the bowels. (6) For epigastric pain extending to the left hypochondrium, difficulty in turning, and solid stools, add Trichosanthes Fruit (Gua Lou), Green Citrus Peel (Qing Pi) to clear heat and move Qi. (7) For severe heart and stomach fire, delirium with confusion, add Coptis Rhizome (Huang Lian), Gypsum (Shi Gao), Mountain Gardenia (Zhi Zi) to clear heat and drain fire. (8) For concurrent toxicity, add Coptis Rhizome (Huang Lian), Polygonum cuspidatum (Hu Zhang), Honeysuckle Flower (Yin Hua), Gardenia (Zhi Zi) to clear heat and resolve toxicity. (9) For syndromes with both exterior and interior signs, add Gypsum (Shi Gao), Anemarrhena Rhizome (Zhi Mu). For dry mouth and thirst, remove Pinellia (Ban Xia); for abdominal distention, add Citrus aurantium (Zhi Ke); for difficult urination, add Akebia Stem (Mu Tong).
【Pharmacology】
Liver protection, cholagogue, anti-experimental cholelithiasis, anti-inflammatory, antipyretic, excites adrenal function, anti-platelet aggregation, prevents arteriosclerosis, inhibits in vitro smooth muscle contraction, and other effects.