Major Bupleurum Decoction

Major Bupleurum Decoction

Bupleuri Radix (Chai Hu) 0.5 jin (15g), Scutellariae Radix (Huang Qin) 3 liang (9g), Paeoniae Radix Alba (Shao Yao) 3 liang (9g), Pinelliae Rhizoma (Ban Xia) 0.5 sheng (9g), Zingiberis Rhizoma Recens (Sheng Jiang) 5 liang (15g), Aurantii Fructus Immaturus (Zhi Shi) 4 pieces (9g), Jujubae Fructus (Da Zao) 12 pcs (3g), Rhei Radix et Rhizoma (Da Huang) 2 liang (6g)

Decoct all medicinals with one dou and two sheng of water, boil them until six sheng of water is left, remove the dregs and bring the decoction to a boil one more time. Take one sheng of the warm decoction three times a day. (Modern use: prepare as a decoction.)

Harmonizes shaoyang and drains interior heat bind.

This formula treats a combined shaoyang-yangming pattern characterized by alternating chills and fever, fullness and discomfort in the chest and rib-side, frequent vomiting, constant vexation, epigastric pi and hardness or epigastric fullness and pain, constipation or diarrhea with fever, a yellow tongue coating, and a powerful wiry, rapid pulse.

Although this formula treats a combination of shaoyang and yangming patterns, it has its primary focus on addressing the shaoyang. The alternating chills and fever and fullness and discomfort in the chest are symptoms that stem from the pathogen that is remaining in the shaoyang. The frequent vomiting and continuous vexation are worse than those found in the Xiao Chai Hu Tang pattern. These symptoms in combination with epigastric pi and hardness or epigastric fullness and pain, constipation or diarrhea with fever, the yellow tongue coating, and the powerful wiry, rapid pulse allow us to conclude that the pathogen has entered the yangming and transformed into excess. The purgative method is prohibited in a shaoyang pattern. However, because it is combined with the yangming bowel pattern, the exterior and interior needs to be treated simultaneously. The treatment is to harmonize shaoyang and drain the heat bind from the interior.

1. Essential pattern differentiation Da Chai Hu Tang serves as the most common formula used to treat a combined shaoyang-yangming pattern. This clinical pattern is marked by alternating chills and fever, fullness and discomfort in the chest and rib-side, epigastric fullness and pain, vomiting, yellow tongue coating, constipation, and a powerful wiry, rapid pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of a combined shaoyang-yangming pattern: acute pancreatitis, acute cholecystitis, cholelithiasis, gastric and duodenal ulcers due to deficiency-cold of middle jiao, and disharmony of the liver and spleen.

Hou Po Qi Wu Tang (Officinal Magnolia Bark Seven Substances Decoction, 厚朴七物湯)