HERB FORMULAS

CHAI HU GUI ZHI TANG - 柴胡桂枝湯 - BUPLEURUM AND CINNAMON TWIG DECOCTION

English: Bupleurum and Cinnamon Twig Decoction
Also Known As: Bupleurum and Cinnamon Combination

HERBS AND ACTIONS

Pharmaceutical Latin
Pin Yin
Dosage
Actions
Ram. Cinnamomi Gui Zhi 2.5-8g Releases the exterior, assists the Yang, adjusts the Ying and Wei, releases the muscle layer, warms the channels and collaterals to relieve pain, assists the Heart Yang and warms and facilitates the flow of Yang Qi in the chest, warms and facilitates the flow of Qi through the channels and collaterals and Blood through the vessels, warms the Middle and directs Turbid Yin downward.
With Bai Shao for External Wind-Cold with disharmony between the Ying and Wei (Tai Yang Zhong Feng), with spontaneous sweating, fever and chills and warms and tonifies the Middle Jiao.
With Chai Hu, for Tai Yang Stage moving to Shao Yang Stage.
Rx. Scutellariae Huang Qin 2-6g Clears Heat and drains Fire especially from the Upper Jiao, dries Dampness and sedates Liver Yang rising.
With Chai Hu, for Heat in the Shao Yang with alternating chills and fever, and nausea.
With Bai Shao, for Dysenteric disorders with abdominal pain due to Heat entering the Interior.
Rx. Ginseng Ren Shen 2-6g
Strongly tonifies Qi, tonifies the Lungs, strengthens the Spleen and Stomach and generates Fluids.
Rx. Glycyrrhizae Gan Cao 1.5-5g Tonifies the Spleen, augments Qi, moistens the Lungs, stops cough, clears Heat, relieves Fire toxicity and moderates and harmonizes the harsh properties of the other herbs.
With Bai Shao for abdominal pain due to disharmony between the Liver and Stomach.
With Bai Shao and Huang Qin, for abdominal pain and dysenteric diarrhea from Damp-Heat.
Rz. Pinelliae Preparatum Zhi Ban Xia 4-12g Dries Dampness, transforms Phlegm, descends rebellious Qi, harmonizes the Stomach and stops vomiting.
With Sheng Jiang, for vomiting.
With Ren Shen,. for vomiting due to Stomach Deficiency.
With Huang Qin, for Phlegm-Heat induced Rebellious Qi with cough, nausea, and vomiting.
Rx. Paeoniae Alba Bai Shao 2-8g Nourishes the Blood, regulates the menses, calms and curbs Liver Yang, alleviates pain, preserves Yin and adjusts the Ying and Wei.
With Chai Hu for vertigo, dizziness, and flank pain due to Liver Qi Stagnation.
With Gui Zhi, Sheng Jiang and Da Zao, for Wind-Cold with Deficiency and perspiration.
Rx. Bupleuri Chai Hu 5-15g Resolves the Shao Yang, reduces fever, spreads Liver Qi, relieves constraint and raises Yang Qi in Spleen and Stomach Deficiency patterns.
With Huang Qin and Zhi Ban Xia, for Shao Yang disorders with alternating chills and fever and a sensation of fullness in the hypochondria and chest.
With Huang Qin, Zhi Ban Xia, Ren Shen and Gan Cao, for weak patients.
With Gan Cao, for hepatitis and upper right quadrant pain and Wind-Heat fever.
Rz. Zingiberis Recens Sheng Jiang 1-4.5g Releases the exterior, disperses Cold, warms the Middle Jiao, stops vomiting, stops cough, adjusts the Ying and Wei and reduces toxicity of other herbs.
With Da Zao, Protects Stomach Qi and regulates the Ying and Wei.
With Zhi Ban Xia, for vomiting due to many causes including Stomach Cold and productive cough due to Phlegm-Dampness.
With Gui Zhi, strongly induces sweating for treatment of External Wind-Cold with chills, fever, body aches and anhidrosis and warms and dispels thin mucus in the Stomach with nausea, hiccup, Stomach pain, acid reflux or vomiting of clear fluid.
With Gui Zhi and Da Zao, harmonizes the Ying and Wei to drive out pathogens.
Fr. Jujube Da Zao 2-6g Tonifies Qi, strengthens the Spleen and moderates and harmonizes the harsh properties of other herbs.

FORMULA ACTIONS

  • Releases the Exterior and muscle layer
  • Harmonizes and releases the Shao-Yang
  • Harmonizes the Liver, Spleen and Intestines
  • Dispels Water Accumulation

SYNDROMES

  • Shao-Yang stage disorders where the exterior has not been completely released (Tai Yang - Shao Yang)
  • Epigastric pain due to Liver and Spleen disharmony

CLINICAL MANIFESTATIONS

  • Joint pain with a crackling sensation
  • Epigastric pain
  • Fatigue
  • Gastrointestinal weakness
  • Headache
  • Heaviness in the head
  • Fever
  • Moderately severe chills
  • Distension beneath the Heart
  • Periumbilical or lower abdominal pain
  • Tenseness around the pubic bone
  • Subcostal pain
  • Epigastric fullness
  • Nausea
  • Mild vomiting
  • Mild thoraco-costal discomfort
  • Costal distress
  • Tension in the rectus abdominus
  • Chest distension
  • Abdominal pain
  • Abdominal distension
  • Constipation
  • Irritability
  • Insomnia
  • Repeated loss of spinal alignment due to muscular tension
  • P: Floating and weak

TREATS

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
HERB/DRUG INTERACTIONS
  • Concurrent administration with anticonvulsants, such as benzodiazepines has been found to have a synergistic effect in the treatment of epilepsy.
  • Concurrent administration with pentobarbitol was associated with shortened pentobarbitol induced sleeping time in mice.

NOTES

MODIFICATIONS

For shoulder and neck tension (including whiplash): For arthritis:
+ Rx. Puerariae (large dose) Ge Gen + Sm. Coicis Yi Yi Ren
For headaches:
+ Rx. Angelicae Sinensis Dang Gui
+ Flos Chrysanthemi Ju Hua
For Intestinal disorders with a tendency toward diarrhea:
For colds or influenza with headaches:
+ Poria Fu Ling
+ Rz. Schizonepetae Jing Jie + Rz. Atractylodis Macrocephalae Bai Zhu
+ Rz. Chuanxiong Chuan Xiong
For constipation:
Fro fever predominant:
+ Rx. et Rz. Rhei Da Huang
+ Increase Rx. Bupleuri to 30g Chai Hu
For fever with pronounced thirst:
For chills predominant:
+ Gypsum Fibrosum Shi Gao
+ Less Rx. Bupleuri Chai Hu
For epigastric pain due to Liver and Spleen Disharmony:
For painful joints:
+ 2 to 3 times as much Rx. Paeoniae Alba Bai Shao
+ Rx. Puerariae Ge Gen
For a feeling of fullness and oppression in the epigastric area:
+ Rz. Cimicifugae Sheng Ma + Fr. Aurantii Immaturus Zhi Shi
For epilepsy with Heart and Liver Fire Flaring:
+ Rx. Platycodi Jie Geng
+ Rz. Coptidis Huang Lian
For epilepsy with Cold Phlegm:
+ Fr. Gardeniae Zhi Zi + Rz. Arisaematis Preparatum Zhi Tian Nan Xing
+ Rx. Gentianae Long Dan Cao
+ Rx. et Rz. Rhei Da Huang + Rz. Acori Tatarinowii Shi Chang Pu
For epilepsy with Phlegm-Heat:
For epilepsy with Wind-Phlegm:
+ Arisaemae cum Bile Dan Nan Xing + Rz. Typhonii Preparatum Zhi Bai Fu Zi
+ Bul. Fritillariae Cirrhosae Chuan Bei Mu
+ Scolopendra Wu Gong
For epilepsy with fright-Phlegm:
 + Scorpio Quan Xie
+ Fossilia Ossis Mastodi Long Gu + Bombyx Batryticatus Jiang Can
+ Cinnabaris Zhu Sha
For epilepsy with Stasis maculae on the sides of the tongue:
+ Caulis Polygoni Multiflori Ye Jiao Teng
+ Rx. Salviae Miltiorrhizae Dan Shen
+ Ram. cum Uncis Uncariae Gou Teng
+ Rx. Paeoniae Rubra Chi Shao
For epilepsy with Phlegm:
+ Rx. Curcumae Yu Jin
+ Cinnabaris Zhu Sha
For colds and flu with more Cold:
+ Rz. Pinelliae Preparatum Zhi Ban Xia + Hb. Ephedrae Ma Huang
+ Hb. cum Rx. Asari Xi Xin
+ Caul Bambusae in Taeniam Zhu Ru
For colds and flu with more Wind:
+ Rz. et Rx. Notopterygii Qiang Huo
+ Rz. Arisaematis Preparatum Zhi Tian Nan Xing + Rx. Saposhnikoviae Fang Feng
For colds and flu with more Heat:
+ Magnetitum Ci Shi + Flos Lonicerae Jin Yin Hua
For colds and flu with more Dampness:
+ Fr. Forsythiae Lian Qiao
+ Rx. Agastaches Huo Xiang + Gypsum Fibrosum Shi Gao
+ Rz. Atractylodis Cang Zhu + Rx. Isatidis Ban Lan Gen
For colds and flu with Qi Deficiency:
For colds and flu with Yang Deficiency:
+ Rx. Astragali Huang Qi + Rx. Aconiti Lateralis Preparata Zhi Fu Zi
+ Rx. Codonopsis Dang Shen
For colds and flu with Yin Deficiency:
+ Rz. Zingiberis Gan Jiang
+ Rx. Ophiopogonis Mai Men Dong
For colds and flu with profuse perspiration:
+ Rx. Trichosanthis Tian Hua Fen + Fossilia Ossis Mastodi Long Gu
+ Rz. Anemarrhenae Zhi Mu + Concha Ostreae Mu Li
For neurasthenia with anorexia and epigastric fullness and distention:
For neurasthenia with dizziness and headache:
+ Flos Chrysanthemi Ju Hua
+ Fr. Crataegi Shan Zha + Rx. Angelicae Dahuricae Bai Zhi
+ Massa Medicata Fermentata Shen Qu
For neurasthenia with insomnia:
+ Fr. Hordei Germinatus Mai Ya + Flos. Albizziae He Huan Hua
For neurasthenia with an inability to concentrate:
+ Concha Ostreae Mu Li
For neurasthenia with chest oppression and discomfort:
+ Sm. Platycladi Bai Zi Ren
+ Rz. Acori Tatarinowii Shi Chang Pu + Fr. Toosendan Chuan Lian Zi
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Qi Stagnation predominant:
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Spleen Deficiency predominant:
+ two or three of the following:
 + Rz. Atractylodis Macrocephalae Bai Zhu
Rz. Cyperi Xiang Fu
Per. Citri Reticulatae Chen Pi + Poria Fu Ling
Per. Citri Reticulatae Viride Qing Pi
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Dampness predominant:
Fr. Aurantii Immaturus Zhi Shi
+ two or three of the following:
Fr. Aurantii Zhi Ke Cx. Magnoliae Officinalis Hou Po
Sm. Citri Reticulatae Ju He Rz. Atractylodis Cang Zhu
Fr. Foeniculi Xiao Hui Xiang Rz Alismatis Ze Xie
Rx. Linderae Wu Yao Sm. Plantaginis Che Qian Zi
Lignum Aquilariae Chen Xiang Sm. Coicis Yi Yi Ren
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Blood Deficiency predominant:
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Stagnant Heat:
+ two or three of the following:
 + less Ram. Cinnamomi Gui Zhi
Rx. Angelicae Sinensis Dang Gui + Cx. Moutan Mu Dan Pi
Rx. Rehmanniae Preparata Shu Di Huang + Fr. Gardeniae Zhi Zi
+ Rx. Curcumae Yu Jin
Fr. Mori Sang Shen
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Deficiency Heat:
Fr. Lycii Gou Qi Zi
Rx. Polygoni Multiflori He Shou Wu
Fr. Ligustri Lucidi Nu Zhen Zi - Rx. Bupleuri Chai Hu
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Yin Deficiency:
+ Rx. Stellariae Yin Chai Hu
+ Cx. Lycii Di Gu Pi
+ Rx. Cynanchi Atrati Bai Wei
+ Hb. Ecliptae Han Lian Cao + Rx. Rehmanniae Sheng Di Huang
+ Fr. Ligustri Lucidi Nu Zhen Zi
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Lung Yin Deficiency:
+ Rx. Rehmanniae Preparata Shu Di Huang
For premenstrual syndrome due to Liver Qi Stagnation with Heat and Heart Blood Deficiency with Yang Deficiency:
- Rx. Ginseng Ren Shen
+ Rx. Pseudostellariae Tai Zi Shen
+ Rx. Glehniae Bei Sha Shen
- Ram. Cinnamomi Gui Zhi    
+ Cx. Cinnamomi Rou Gui    
+ Rx. Aconiti Lateralis Preparata Zhi Fu Zi