Da Chai Hu Tang: A Chinese Herbal Formula for Shaoyang and Yangming Disorders
Hongji Medical- Feb 2
- 6 min read
Da Chai Hu Tang, or Major Bupleurum Decoction, is a classic formula from the ancient Chinese medical text Shang Han Lun (Treatise on Cold Damage Diseases), written by Zhang Zhongjing.
This herbal blend is designed to treat combined Shaoyang and Yangming disorders, where external pathogens cause heat accumulation and stagnation in the liver, gallbladder, and digestive system.
By harmonizing Shaoyang energy and clearing internal heat, Da Chai Hu Tang relieves symptoms like alternating chills and fever, abdominal fullness, and constipation. This article explores its composition, efficacy, indications, modern uses, and dietary support.
Da Chai Hu Tang Formula Composition
Da Chai Hu Tang consists of eight herbs, each contributing to its therapeutic effects:
Chai Hu (Bupleurum, 24g): Soothes the liver and balances Shaoyang energy.
Huang Qin (Skullcap, 9g): Clears heat and reduces inflammation.
Bai Shao (White Peony, 9g): Calms the liver and alleviates pain.
Ban Xia (Pinellia, 9g): Eases nausea and clears phlegm.
Sheng Jiang (Fresh Ginger, 9g): Warms the stomach and reduces vomiting.
Zhi Shi (Bitter Orange, 9g): Relieves bloating and promotes digestion.
Da Zao (Jujube Dates, 4 pieces): Nourishes the spleen and balances the formula.
Da Huang (Rhubarb, 6g): Clears heat and promotes bowel movements.
Preparation: Boil the herbs in 1.2 liters of water until reduced to 600ml, strain, and take 200ml warm, three times daily. Modern methods involve boiling twice, straining, and dividing into two warm doses.
How the Herbs Work Together
Chai Hu (Bupleurum): The lead herb, it regulates liver energy, relieving chest tightness and Shaoyang symptoms like alternating chills and fever.
Huang Qin (Skullcap): Cools the body, targeting heat in the gallbladder and digestive system.
Bai Shao (White Peony): Soothes liver tension, reduces pain, and supports spleen health.
Ban Xia (Pinellia): Addresses nausea, vomiting, and phlegm, easing digestive discomfort.
Sheng Jiang (Fresh Ginger): Warms the stomach, reduces nausea, and enhances the formula’s harmony.
Zhi Shi (Bitter Orange): Breaks up stagnation, alleviating bloating and improving digestion.
Da Zao (Jujube Dates): Nourishes the spleen and softens the formula’s intensity.
Da Huang (Rhubarb): Acts as a laxative, clearing heat and relieving constipation.
This blend works synergistically to balance energy, clear heat, and restore digestive and liver function.
Efficacy and Indications of Da Chai Hu Tang
Efficacy:
Harmonizes Shaoyang energy to resolve alternating chills and fever.
Clears internal heat accumulation in the Yangming system to relieve constipation and abdominal fullness.
Indications:
Da Chai Hu Tang is used for combined Shaoyang and Yangming disorders, where a cold-induced illness progresses into the Yangming stage but retains Shaoyang symptoms. Key symptoms include:
Alternating chills and fever
Hardness or fullness in the upper abdomen (below the heart)
Persistent vomiting
Irritability
Constipation
Yellow tongue coating
Strong, rapid pulse
These symptoms indicate that external pathogens have penetrated deeper, causing heat accumulation in the digestive system alongside lingering Shaoyang imbalance.
Modern Applications
Da Chai Hu Tang is effective for modern conditions involving liver, gallbladder, and digestive issues, including:
Gallbladder disorders: Gallstones, cholecystitis, and cholestasis.
Digestive conditions: Acute pancreatitis, gastritis, and gastric ulcers.
Inflammatory diseases: Reduces inflammation in conditions like hepatitis or enteritis.
Metabolic disorders: Supports management of obesity and diabetes.
Pharmacological studies highlight its ability to reduce fever, promote bile secretion, relieve inflammation, and improve digestion, making it a versatile remedy.
Dietary Support
Pairing Da Chai Hu Tang with dietary remedies can enhance its effects:
Weak digestion (fatigue, bloating): Cook porridge with yam, lotus seeds, and coix seeds to support the spleen.
Irritability and heat (dry mouth, restlessness): Make soup with lily, tremella, and mung beans to cool and nourish the body.
Abdominal discomfort (bloating, constipation): Brew tea with tangerine peel or hawthorn to promote digestion.
Low energy (fatigue, poor appetite): Add astragalus or codonopsis to chicken soup to boost vitality.
These dietary additions complement the formula and aid recovery.
Precautions
Use Da Chai Hu Tang cautiously:
Side effects: May cause dizziness, nausea, or, rarely, abdominal discomfort.
Contraindications: Avoid in cases of yin deficiency, excessive heat, or weak constitution. Not suitable for those with loose stools or no signs of heat accumulation.
Professional guidance: Consult a qualified Chinese medicine practitioner to ensure safe and effective use.
Conclusion
Da Chai Hu Tang is a powerful and time-tested formula in traditional Chinese medicine, excelling in the treatment of combined Shaoyang and Yangming disorders. By harmonizing energy, clearing heat, and supporting digestion,
it addresses symptoms like alternating chills and fever, abdominal fullness, and constipation. Its modern applications for liver, gallbladder, and digestive conditions highlight its enduring value. With proper use and dietary support, Da Chai Hu Tang promotes balance and restores health effectively.
Chinese Name | 大柴胡湯 |
Phonetic | Da Chai Hu Tang |
English Name | Major Bupleurum Decoction |
Classification | Harmonizing formulas |
Source | 《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 |
Combination | 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) |
Method | 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.) |
Action | Harmonizes shaoyang and drains interior heat bind. |
Indication | 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. |
Pathogenesis | 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. |
Application | 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. |
Additonal formulae | Hou Po Qi Wu Tang (Officinal Magnolia Bark Seven Substances Decoction, 厚朴七物湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Hou po 0.5 jin (24g), gan cao 3 liang (9g), da huang 3 liang (9g), da zao 10 pcs (4 pcs), zhi shi 5 pcs (12g), gui zhi 2 liang (6g), sheng jiang 5 liang (15g) [Preparation and Administration] Decoct all medicinals with one dou of water, boil them until four sheng of water is left. Take eight he of the warm decoction three times a day. [Actions] Releases the flesh and vents pathogens from the exterior, moves qi to promote defecation. [Applicable Patterns] Exterior pattern with interior excess. Symptoms include: fullness in the abdomen, inhibited stool, fever, floating and rapid pulse. |
