【Composition】

Gui Zhi (Cinnamon Twig), Shao Yao (Peony Root), Huang Qin (Scutellaria Root), Ren Shen (Ginseng), (Zhi) Gan Cao (Prepared Licorice Root), Ban Xia (Pinellia Tuber), Da Zao (Jujube), Sheng Jiang (Fresh Ginger), Chai Hu (Bupleurum Root)
(9)

 【Classification】

<Blood Tonifying>: Shao Yao

<Spleen and Middle Tonifying>: Gan Cao, Da Zao

<Cool and Acrid for Releasing the Exterior>: Chai Hu

<Clearing Heat and Drying Dampness>: Huang Qin

<Qi Tonifying>: Ren Shen

<Warm and Acrid for Releasing the Exterior>: Sheng Jiang, Gui Zhi

<Transforming Phlegm>: Ban Xia

【Rationale of the Formula】

From the “Shan Bu” (Selection and Supplementation): Ke Qin states that the two formulas, Chai Hu and Gui Zhi, are of utmost importance in the Shang Han Lun. Gui Zhi releases the exterior of the Tai Yang channel and can also harmonize the exterior of all channels. Xiao Chai Hu releases the exterior of the Shao Yang channel and can also harmonize the three Yang channels. Therefore, apart from the diseases of the six channels, there are distinct terms for Gui Zhi Syndrome and Chai Hu Syndrome, indicating that these two formulas have broad applications beyond specific channels. For instance, the statement “Yang is floating and Yin is weak” is Zhang Zhongjing’s own annotation for Gui Zhi syndrome. The statement “blood is weak and qi is deficient” is also Zhang Zhongjing’s own annotation for Chai Hu syndrome. Gui Zhi can lead to complications, and Chai Hu can also lead to complications. Gui Zhi has pseudo-syndromes, and Chai Hu also has pseudo-syndromes. If a condition resembles Gui Zhi syndrome but is not, such as leg cramps and epigastric fullness, it is considered so. If a condition resembles Chai Hu syndrome but is not, such as thirst with desire to drink water, vomiting when eating grains, or only wanting to vomit with epigastric pain and slight looseness of the bowels, it is considered so. This prescription is used when, after six or seven days of Shang Han (cold damage), when the internal heat should be subsiding, there are instead symptoms of fever, aversion to cold, and other external symptoms, as well as epigastric stagnation and other internal symptoms. The exterior and interior are not resolved, and thus both must be treated. However, the aversion to cold is mild, and the fever is also mild, indicating that there is pain and discomfort in the limbs and joints, meaning that the bones and joints are not painful; it also indicates mild vomiting and slight stagnation in the epigastrium, hence the term “stagnation and knotting.” Although the external symptoms have not disappeared, they have become mild. Although internal symptoms have appeared, they are not severe. Therefore, half the dose of Gui Zhi is used to disperse the remaining exterior evil of the Tai Yang channel. Half the dose of Chai Hu is used to resolve the mild stagnation of the Shao Yang channel. If the mouth is not dry and the body has a slight fever, Ren Shen should be removed. Since it has been six or seven days, although the evil has not been resolved, the righteous qi is already deficient, so it is still used. Although external symptoms are present, the disease mechanism has already appeared internally. Therefore, the formula is headed by Chai Hu followed by Gui Zhi, as a mild formula for resolving both Yang channels. From “Han Dian”: This is a combined formula of Xiao Chai Hu Tang and Gui Zhi Tang, used in cases of Shang Han with typical febrile diseases, targeting situations where there are symptoms of Xiao Chai Hu Tang but the external symptoms have not yet resolved. That is, it has developed into a Xiao Chai Hu Tang syndrome, but symptoms such as aversion to wind, aversion to cold, and body aches are still present. When used for general miscellaneous diseases, attention must be paid to the abdominal signs; it is used when there is fullness and oppression in the chest and hypochondria, combined with involuntary contraction of the abdominal muscles and abdominal pain.

 【Functions】

Harmonizes the Shao Yang, releases exterior evil, and resolves both exterior and interior.

 【Indications】

Shao Yang syndrome with concurrent Tai Yang exterior syndrome, exogenous wind-cold, fever with spontaneous sweating, Shang Han fever, mild aversion to cold, pain and vexation in the limbs and joints, mild vomiting, epigastric stagnation, external symptoms not yet resolved, or profuse sweating leading to Yang collapse and delirium, or sudden abdominal pain, or alternating cold and heat, dry retching with nasal sound, headache, stiff neck, fullness and oppression in the chest and hypochondria, wiry or floating and large pulse. “Shan Bu”: Six or seven days of Shang Han, with fever, mild aversion to cold, pain and vexation in the limbs and joints, mild vomiting, and epigastric stagnation. Chai Hu Gui Zhi Tang is the primary treatment for this condition.

 【Applications】

(1) Common cold, influenza, pneumonia; (2) Stomach pain, hyperacidity, gastric ulcer, duodenal ulcer; (3) Epilepsy, epidemic hemorrhagic fever, etc.

 【Contraindications】

Avoid raw, cold, and greasy foods.

 【Mnemonic】

Xiao Chai Hu Tang plus Gui Zhi Tang.

 【Pharmacology】

Has local anesthetic, anticonvulsant, immune-enhancing, and anti-ulcer effects.