Minor Bupleurum Decoction

傷寒論

-- Taiyang disease, after ten days or more, if the pulse is floating and fine and the patient likes to lie down, the exterior has already resolved. If there is chest fullness and hypochondriac pain, give Xiao Chai Hu Tang. If the pulse is merely floating, give Ma Huang Tang. (Shang Han Lun (Treatise on Cold Damage)) -- Cold damage for five or six days, or wind-strike, with alternating cold and heat, fullness and distress in the chest and hypochondrium, silent and without desire to eat or drink, vexation in the heart and frequent vomiting, or vexation in the chest without vomiting, or thirst, or abdominal pain, or hardness and distension below the hypochondrium, or palpitations below the heart and difficult urination, or no thirst and slight generalized heat, or cough—Xiao Chai Hu Tang governs. (Shang Han Lun (Treatise on Cold Damage)) -- After taking Chai Hu Tang, if there is thirst, it belongs to Yangming; treat it according to the method. (Shang Han Lun (Treatise on Cold Damage)) -- Cold damage for four or five days, with generalized heat and aversion to wind, stiffness of the neck and nape, fullness below the hypochondrium, and warm hands and feet with thirst—Xiao Chai Hu Tang governs. (Shang Han Lun (Treatise on Cold Damage)) -- Cold damage, if the yang pulse is astringent and the yin pulse is string-like, by law there should be acute pain in the abdomen; first give Xiao Jian Zhong Tang; if there is no improvement, give Xiao Chai Hu Tang. (Shang Han Lun (Treatise on Cold Damage)) -- Cold damage or wind-strike, if there is a Chai Hu pattern, it is enough to see just one sign; it is not necessary that all be present. (Shang Han Lun (Treatise on Cold Damage)) -- Whenever a Chai Hu Tang pattern is purged, if the Chai Hu pattern has not abated, again give Chai Hu Tang; there will surely be steaming and shaking, then fever and sweating, and it resolves. (Shang Han Lun (Treatise on Cold Damage)) -- Taiyang disease, after passing the channel for more than ten days, is instead purged two or three times; four or five days later, if the Chai Hu pattern still remains, first give Xiao Chai Hu Tang. If vomiting does not stop, with urgency below the heart and mild depression and vexation, this is unresolved; give Da Chai Hu Tang to purge, and it will heal. (Shang Han Lun (Treatise on Cold Damage)) -- Cold damage for thirteen days without resolution, with fullness in the hypochondrium and chest and vomiting, tidal fever, and afterward mild diarrhea. This was originally a Chai Hu pattern; when purged, there was no diarrhea, but now there is diarrhea instead—know that the physician purged with pill medicine, which is not the correct treatment. Tidal fever indicates excess. First, one should use Xiao Chai Hu Tang to resolve the exterior; afterward, Chai Hu Jia Mang Xiao Tang governs. (Shang Han Lun (Treatise on Cold Damage)) -- Women with wind-strike, after seven or eight days, then develop cold and heat occurring at intervals; if menstruation just stops, this is heat entering the blood chamber. The blood must be bound, hence causing a malaria-like condition with periodic attacks. Xiao Chai Hu Tang governs. (Shang Han Lun (Treatise on Cold Damage)) -- Women with wind-strike, fever and aversion to cold, with menstruation just coming; after seven or eight days, the fever is gone, but the pulse is slow, the body is cool, and there is fullness below the chest and hypochondrium, like a chest bind pattern, with delirious speech—this is heat entering the blood chamber. One should needle Qimen and treat according to the excess. (Shang Han Lun (Treatise on Cold Damage)) -- Women with cold damage and fever, with menstruation just coming; during the day the consciousness is clear, but at dusk there is delirious speech, as if seeing ghosts—this is heat entering the blood chamber. Do not attack the stomach qi or the upper two burners; it will necessarily heal on its own. (Shang Han Lun (Treatise on Cold Damage)) -- Yangming disease, with blood discharge and delirious speech—this is heat entering the blood chamber. One should needle Qimen and drain according to the excess; if there is copious sweating, it will heal. (Shang Han Lun (Treatise on Cold Damage)) -- Cold damage for five or six days, with vomiting and fever, and the complete Chai Hu Tang pattern, but if purged with other medicines, and the Chai Hu pattern still remains, again give Chai Hu Tang. Although it has been purged, this is not a reverse treatment; there will surely be steaming and shaking, then fever and sweating, and it resolves. If there is fullness below the heart with hard pain, this is chest bind; Da Xian Xiong Tang governs. If there is only fullness without pain, this is stuffiness; Chai Hu is not suitable to give; Ban Xia Xie Xin Tang is appropriate. (Shang Han Lun (Treatise on Cold Damage)) -- Yangming disease, with tidal fever, loose stools, normal urination, and chest and hypochondriac fullness that does not go away—Xiao Chai Hu Tang governs. (Shang Han Lun (Treatise on Cold Damage)) -- Yangming disease, with hardness and fullness below the hypochondrium, no bowel movement and vomiting, and white coating on the tongue, one may give Xiao Chai Hu Tang. When the upper burner is freed, the Body Fluids can descend, and the stomach qi thereby becomes harmonious; the body will profusely sweat and resolve. (Shang Han Lun (Treatise on Cold Damage)) -- Yangming wind-strike, with pulse string-like, floating, and large, and shortness of breath, abdominal fullness, pain below the hypochondrium and in the heart, and when pressed for a long time the qi does not move freely; dry nose, no sweating, somnolence, yellowing of the whole body and face and eyes, difficult urination, tidal fever, frequent hiccup, swelling anterior and posterior to the ears; after needling there is slight improvement, but the exterior is not resolved. If the disease has passed ten days and the pulse continues floating, give Xiao Chai Hu Tang. If the pulse is merely floating and there are no other signs, give Ma Huang Tang. If there is no urination and abdominal fullness with added hiccup, it is not treated. (Shang Han Lun (Treatise on Cold Damage)) -- Originally Taiyang disease that does not resolve and transfers into Shaoyang, with hardness and fullness below the hypochondrium, dry vomiting and inability to eat, alternating cold and heat, and if there has not yet been vomiting, purging, sweating, or warm needling, and the pulse is deep and tight, give Xiao Chai Hu Tang. If there has already been vomiting, purging, sweating, or warm needling, with delirious speech, and the Chai Hu Tang pattern is gone, this is a deteriorated disease. Know what error was committed and treat it according to the method. (Shang Han Lun (Treatise on Cold Damage)) -- Vomiting with fever—Xiao Chai Hu Tang governs. (Shang Han Lun (Treatise on Cold Damage)) -- After cold damage has recovered, if there is renewed fever, Xiao Chai Hu Tang governs. If the pulse is floating, resolve by sweating; if the pulse is deep, resolve by purging. (Shang Han Lun (Treatise on Cold Damage)) -- Various types of jaundice, with abdominal pain and vomiting—Xiao Chai Hu Tang governs. (Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet)) -- Question: A newly delivered woman has three diseases: the first is convulsion, the second is depression and dizziness, the third is difficult defecation. What does this mean? Master says: After recent delivery, blood is deficient and there is much sweating, and she is prone to wind-strike, hence causing convulsion. Loss of blood, further sweating, and much cold, hence causing depression and dizziness. Loss of Body Fluids and dryness of the stomach, hence causing difficult defecation. -- The parturient woman has depression and dizziness; her pulse is faint and weak, she vomits and cannot eat, her stool is instead hard, and she sweats only from the head. The reason is that blood deficiency causes counterflow cold of the limbs; with counterflow cold there will necessarily be dizziness. When a person with dizziness is about to resolve, there must be profuse sweating. Because blood deficiency causes counterflow cold below and the solitary Yang floats upward, there is sweating from the head. The reason parturient women are prone to sweating is loss of Yin and blood deficiency, with Yang qi alone exuberant, so there should be sweating; only then do Yin and Yang return to normal. If the stool is hard and there is vomiting and inability to eat, Xiao Chai Hu Tang governs. If after the disease resolves she can eat, and seven or eight days later there is renewed fever, this is stomach excess; Da Cheng Qi Tang governs. (Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet)) -- Women during the lying-in period, who expose themselves and contract wind, with severe vexing heat in the four limbs and headache—give Xiao Chai Hu Tang. If there is no headache but only vexation, this decoction (San Wu Huang Qin Tang) governs. (Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet))

Chai Hu (Bupleurum) half a jin, Huang Qin (Scutellaria) three liang, Ban Xia (Pinellia) half a sheng, Ren Shen (Ginseng) three liang, Gan Cao (Licorice) three liang, Sheng Jiang (Fresh Ginger) three liang, Da Zao (Jujube) twelve pieces. For the above seven ingredients, use one dou and two sheng of water, boil down to six sheng, remove the dregs, then decoct again to three sheng. Take one sheng warm, three times daily. (Shang Han Za Bing Lun (Treatise on Cold Damage and Miscellaneous Diseases))

For the above seven ingredients, use one dou and two sheng of water, boil down to six sheng, remove the dregs, decoct again, and take three sheng; take one sheng warm, three times daily. (Modern usage: boil nine bowls of water down to three bowls, and take one bowl warm after each of the three meals.)

湯劑

Harmonize Shaoyang.

1. Cold damage Shaoyang pattern. Alternating cold and heat, fullness and distress in the chest and hypochondrium, silent and without desire to eat or drink, vexation in the heart and frequent vomiting, bitter taste in the mouth, dry throat, dizziness, thin white tongue coating, string-like pulse. 2. Women with cold damage, heat entering the blood chamber; and malaria, jaundice, and internal damage miscellaneous diseases that present with a Shaoyang pattern.

High fever, yellow urine, foul stool, tongue slightly red, pulse wiry and rapid: add Gypsum: 30. -- Fever, sore throat: add Platycodon root: 10, Gypsum: 15. -- Jaundice with yellowing: add Artemisia capillaris: 30. -- Enlarged lymph nodes and increased lymphocytes: add Forsythia: 10. -- Thirst, which is heat damaging Body Fluids: add Trichosanthes root: 20. -- Hard fullness below the hypochondrium, or hard lumps in the breasts, which are qi stagnation and phlegm depression: add Oyster shell: 30. -- Fever that drags on and does not resolve, with pain in the shoulders, back, and joints: add Cinnamon twig: 10, White peony root: 10. -- Cough with sticky phlegm, accompanied by chest and hypochondriac fullness and tenderness below the heart: add Coptis rhizome: 6, Trichosanthes fruit: 20. -- Chest oppression and hypochondriac pain, foreign body sensation in the throat or esophagus, mental restlessness, poor appetite, nausea and vomiting, white greasy tongue coating, or bronchitis, asthma, etc.: add Magnolia bark: 10, Poria: 15, Perilla seed: 10. -- Eye and ear problems, such as eye pain, itchy eyes, oily ears with thick ear secretions, elevated intraocular pressure, etc.: combine with Ling Gui Zhu Gan Tang. -- Eye disease, excessive eye discharge, red tongue and rapid pulse: combine with Zhu Ye Shi Gao Tang. -- Daytime sleepiness, or in those wishing to adjust jet lag: add Caulis Polygoni Multiflori: 30.

1. The more severe the fever, the larger the dose of Bupleurum can be, up to 30 g. 2. Because Bupleurum in the formula is ascending and dispersing, and Scutellaria and Pinellia are drying in nature, it is contraindicated for those with yin deficiency and blood deficiency.