Class 1: Formulas that Harmonize

1. Class 1: Formulas that Harmonize Xianhui Li

2. Formulas that Harmonize • Formulas that Harmonize Lesser Yang-Stage Disorders • Xiao chai hu tang • Da chai hu tang • Formulas that Harmonize the Liver and Spleen • Si ni san • Xiao yao san • Tong xie yao fang • Formulas that Harmonize the Stomach and Intestines • Ban xia xie xin tang

3. Xiao Chai Hu Tang (Minor Bupleurum Decoction) Chai hu, Huang qin, Ban xia, Ren shen, Sheng jiang, Da zao, Zhi gan cao

4. Actions and indications of the formula • Actions • Harmonize and release Lesser Yang-Stage Disorders • Indications • Alternating fever and chills, dry throat, bitter or sour taste in mouth, dizziness, irritability, sensation of fullness in the chest and hypochondria, heart burn, nausea and vomiting, reduced appetite, a thin white tongue coating, and a wiry pulse.

5. Analysis of Formula • Chief: Chai hu • VentLesser Yang-Stage Disorders • Deputy: Huang qin • Drain heat from liver and gallbladder. • Assistant: Ban xia and sheng jiang • Ban xia: warm and transform phlegm and turbidity in the middle burner. • Sheng jiang: harmonize middle burner, direct rebellious qi downward, stop nausea and vomiting. • Envoy: Ren shen, Zhi gan cao, da zao • Harmonize and support normal qi

6. Modifications • Modifications • For abdominal pain, omit huang qin, and add bai shao. • Add gui zhi, bai shao yao for shao yang disorder with joint pain, epigastric pain due to liver and spleen disharmony. • Add mang xiao for constipation. • Add chen pi, zhi ke for qi stagnation in middle jiao. • Attention: • Contraindicated in patients with excess above and deficiency below, liver fire, yin deficiency or bleeding of gums.

7. Da Chai Hu Tang (Major Bupleurum Decoction) Chai hu, Huang qin, Ban xia, Sheng jiang, Da zao, Zhi shi, Da huang, Bai shao

8. Actions and indications of the formula • Actions • Harmonize and release Lesser Yang-Stage Disorders, drain internal clumping due to heat • Indications • Alternating fever and chills, dry throat, bitter or sour taste in mouth, dizziness, despondency, irritability, sensation of fullness in the chest and hypochondria, heart burn, nausea and vomiting, reduced appetite, • Burning diarrhea or no bowel movements, a yellow tongue coating, and a wiry forceful pulse.

9. Analysis of Formula • Chief: Chai hu • VentLesser Yang-Stage Disorders • Deputy: Huang qin, Zhi shi, Da huang • Huang qin: drain heat from liver and gallbladder. • Zhi shi: break up qi stagnation, reduce focal distention and fullness in the chest. • Da huang: drain excess heat from gallbladder and stomach through intestines, transform blood stasis and facilitate the flow of bile. • Assistant: Bai shao, Ban xia and sheng jiang • Bai shao: soften liver, nourish blood and relieve pain. • Ban xia: warm and transform phlegm and turbidity in the middle burner. • Sheng jiang: harmonize middle burner, direct rebellious qi downward, stop nausea and vomiting. • Envoy: da zao • Harmonize and support normal qi

10. Rambling Powder (xiao yao san) Chai hu, Dang gui, Bai zhu, Bai shao, Fu ling, Zhi gan cao Bo he, wei jiang

11. Actions and indications of the formula • Actions • Spread liver qi, strengthen spleen, and nourish blood • Indications • Hypochondriac pain, headache, vertigo, a bitter taste in mouth, dry mouth and throat, fatigue, reduced appetite, irregular period, pale-red tongue, a wiry deficient pulse.

12. Analysis of Formula • Chief: Chai hu • Soothe liver. • Deputy: Bai shao, dang gui • Nourish liver blood and preserve yin • Assistant: Fu ling, Bai zhu • Tonify spleen • Envoy: Zhi gan cao, wei jiang, bo he • Zhi gan cao: harmonize and relieve pain • Wei jiang: harmonize stomach • Bo he: relieve liver constraint and disperse heat

13. Modern application and modifications • Modern application • Irregular menstruation • PMS • Chronic gastritis and peptic ulcer • Mental problems • Modifications • Jia wei xiao yao san: add dan pi, zhi zi

14. Frigid Extremities Powder (si ni san) Chai hu, Zhi shi, Bai shao, Zhi gan cao

15. Actions and indications of the formula • Actions • Vents pathogenic influences, releases constraint, spreads the liver qi, and regulates the spleen. • Indications • Cold fingers and toes (although the body is warm), sometimes accompanied by a sensation of irritability and fullness in the chest and epigastrium. A red tongue with a yellow coating, and a wiry pulse. • There may also be abdominal pain and/or severe diarrhea.

16. Analysis of Formula • Chief: Chai hu • Release the constraint and vent heat. • Deputy: Zhi shi • Remove stagnation • Assistant: Bai shao • Nourish liver and preserve yin • Envoy: Zhi gan cao • Harmonize and relieve pain

17. Modern application and modifications • Modern application • Chronic gastritis and peptic ulcer • Hepatitis • Fibrocystic breasts • Modifications • Chai hu shu gan san : Add chen pi, chuan xiong, xiang fu, substitute zhi shi with zhi ke.

18. Attention • Differentiation of Jue syndrome which is marked by loss of consciousness or/and coldness of the extremities.

19. Compassion between Si ni san and Si ni tang

20. Formula Comparisons between Chai hu shu gan san and Xiao yao san

21. Tong Xie Yao Fang (Important Formula for Painful Diarrhea) Chao bai zhu 9-12g, Chao bai shao 6-24g, Chao chen pi 4.5-9g, Fang feng 3-6g

22. Actions and indications of the formula • Actions • Spread liver qi and tonify the spleen • Indications • Recurrent problems of borborygmus, abdominal pain, diarrhea with pain, a thin white tongue coating and a wiry, or wiry thin pulse

23. Analysis of Formula • Chief: Bai zhu, Bai shao • Bai zhu: strengthen the spleen and dry dampness • Bai shao: soften the overactive liver and alleviate pain. • Deputy: Chen pi • Harmonize the function of middle burner, strengthen spleen and transform dampness. • Assistant and Envoy: Fang feng • Enter the liver and spleen channels and help relieve the overcontrol of the spleen by the liver

24. Modern application and modifications • Modern application • Irritable bowel syndrome, and colitis • Modifications • For chronic diarrhea: add Sheng ma

25. Ban Xia Xie Xin Tang (Pinellia Decoction to Drain the Epigastrium) Ban xia, Gan jiang, Huang qin, Huang lian, Ren shen, Da zao, Zhi gan cao

26. Actions and indications of the formula • Actions • Harmonize stomach, direct rebellious qi downward, disperses clumping, and eliminate focal distention. • Indications • Epigastric focal distention, fullness and tightness with very slight or no pain, dry heaves or frank vomiting, borborygmus with diarrhea, reduced appetite, a thin, yellow and greasy tongue coating, and a wiry rapid pulse.

27. Analysis of Formula • Chief: Ban xia • Ban xia: disperse clump, stop vomiting, and eliminate focal distention. • Deputy: Gan jiang, huang qin, huang lian • Gan jiang: expel cold • Huang qin, Huang lian: clear heat • Assistant: Ren shen, da zao • Ren shen, Da zao: protect qi in middle jiao • Envoy: Zhigancao • Zhi gan cao---tonify qi in middle jiao and harmonize

28. Modern application and modifications • Modern application • Gastritis, gastric ulcer, hepatitis, cirrhosis • Modifications • Gan cao xie xin tang • Sheng jiang xie xin tang