Chai Hu – Bupleurum root – “Kindling of the Barbarians”

Nature: bitter, acrid, slightly cold

Enters: Liver, Gallbladder, San Jiao, Pericardium

Actions: Frees the liver Qi; disperses pathological factors in the half-interior, half-exterior; lifts spleen Yang Qi; reduces fever; can both lift and descend (acrid and bitter).

Indications:
Shaoyang syndrome: alternating fever and chills, distended chest and hypochondrium, bitter taste in the mouth, flank pain, irritability, vomiting, dry throat, dizziness.
• Liver Qi stagnation: distended hypochondrium, costal pain, headache, irregular menses, dysmenorrhea, dizziness, vertigo, stifling sensation in the chest, flank pain, emotional instability.
• Spleen Qi sinking: prolapsed rectum or uterus, diarrhea, hemorrhoids, shortness of breath.
• Spleen/liver disharmony: epigastric and flank pain, stifling sensation in the chest, abdominal bloating, nausea, indigestion, bloating.
• Some say Chai hu damages the Yin, since it is bitter and drying (often combined with Bai shao to counteract its drying nature).
• Contraindicated in liver Yang rising due to liver/kidney Yin deficiency.
• Antipyretic; some antibiotic/bacteriostatic effects; tranquilizer; anti-tussive.
• Used to treat malarial disorders.
• Occasionally can cause nausea or vomiting (should use a small dose in this case).
Chinensis species (hard, Northern) (Bei/Ying chai hu): better for harmonizing the Shaoyang and clearing heat and wind-heat.
Scorzoneraefolium species (soft, Southern) (Nan/Ruan chai hu): better for spreading liver Qi, resolving depression, and relieving constraint.
Jin: Safe in pregnancy in moderate dose (to 4.5g).
MLT: Some patients are sensitive to Chai hu. Some believe it “consumes the Yin.” Despite its recommendation in the Shan Han Lun, many doctors avoid this herb.
• With blood deficiency, always combine it with Dang gui and/or Gou qi zi.
PFGC: Can purge heat in the uterus; can resolve blood heat; disperses exuberant gallbladder fire.
• Should be used to ascend Shaoyang pathogens to push them over and beyond the diaphragm, forcing them up and out.
• In large doses, it is diaphoretic, but this results in out-of-hand momentum and weakening of its uplifting force.
• Can facilitate smooth bowel movements and can foster proper urination – because uninhibited urination is linked to proper function of the san jiao – Qi dynamics of the san jiao are such that Qi descends only if it is allowed to rise first.
• Use in pre- and post-partum disorders, eruption of macules in children, consumptive fevers, carbuncles, furuncles, all malaria.
• Food accumulation: can move wood Qi to course earth.
• Alternating hot and cold are not a necessary symptom to prescribe Chai hu – it is enough to know the patient has an exterior affliction with nausea or vomiting or frequently spitting sticky saliva – this is sufficient evidence that the disease is in the Shaoyang.
HF: An important herb in anti-Gu therapy to move Qi (Xing Qi) and break accumulation (Po Ji).
DY: Drains the liver and resolves depression; harmonizes the Shaoyang; harmonizes the liver and spleen; abates heat; upbears clear Yang; frees the flow of Qi on the left side of the body.
• With Bai shao to drain the liver without damaging liver Yin, nourish the liver without causing liver depression Qi stagnation, regulate the spleen, stop pain effectively, harmonize the interior and exterior, and constrain Yin while upbearing Yang. For such indications as:
– 1. Liver depression Qi stagnation causing disharmony between Qi and blood.
– 2. Vertigo, unclear vision, chest and lateral costal oppression, pain, and distention due to liver depression Qi stagnation or to disharmony between the exterior and interior.
– 3. Menstrual irregularities, dysmenorrhea, breast distention, low-grade fever during the menses, premenstrual syndrome, and fibrocystic breasts, all caused by liver depression Qi stagnation or disharmony between the liver and spleen.
• The combination of Bai shao and Chai hu is effective for the treatment of liver and digestive problems caused by liver depression Qi stagnation or liver-spleen or liver-stomach disharmony, such as subacute or chronic hepatitis, hepatomegaly, cholecystitis, gallstones, enteritis, and colitis.
• With Huang qin to harmonize the interior with the exterior, the Shaoyang, and liver and gallbladder. Together, they also clear the liver and resolve depression as well as clear and eliminate dampness and heat, particularly in the liver and gallbladder. Chai hu dispels evils (heat) limited to the superficial part of the Shaoyang while Huang qin drains evil heat limited to the internal part of the Shaoyang. For indications such as:
– 1. Alternating fever and chills, a bitter taste in the mouth, dry throat, pain and fullness in the chest and lateral costal regions, nausea, and lack of appetite due to a Shaoyang pattern. (Xiao Chai Hu Tang)
– 2. Malaria due to a Shaoyang pattern.
– 3. Liver depression transforming into fire.
– This combination is remarkably effective for hepato-biliary disorders, such as acute or chronic hepatitis, biliary lithiasis, cholecystitis, and hepatomegaly due to liver-gallbladder heat.
• With Sheng ma for mutual reinforcement, to upbear liver, stomach, and spleen Yang Qi. These two herbs alone don’t raise the Qi efficiently. They must be combined with Ren shen, Huang qi, and Bai zhu to be really effective for this purpose, because one cannot raise what is lacking. Huang qi does appear to upbear the Qi, but not for long. When Chai hu, Sheng ma, and Huang qi are combined, they raise the Qi effectively, and for long periods of time.
For indications such as:
– 1. Uterine prolapse, rectal prolapse, gastric ptosis due to central Qi fall. (Bu Zong Yi Qi Tang)
– 2. Metrorrhagia and abnormal vaginal discharge due to central Qi fall.
– 3. Chronic diarrhea or chronic dysentery due to central Qi fall. (Bu Zhong Yi Qi Tang)
– 4. Shortness of breath and dyspnea with feeling of oppression and downward falling of Lungs due to Qi fall. (Sheng Xian Tang)
– For all the above indications, Sheng ma should be honey mix-fried and Chai hu should be stir-fried until scorched.
– In all the above cases, a small dosage of the two herbs is sufficient (i.e. 3-5g). However, a larger dose of Sheng ma (9-15g) can be used if one wants to simultaneously clear Yin fire due to spleen deficiency from the head and face.
Chai hu is a messenger herb which guides the action of other medicinal substances toward the liver and gallbladder channels, toward the upper part of the body (head and face), along the liver channel pathway (internally) and the gallbladder channel pathway (externally), and toward the lateral costal region.
Chai hu in high dosage (10-18g) resolves the exterior, abates heat, and harmonizes the Shaoyang. In small dosage (2-4g), it upbears Yang Qi. In an average dosage (6-8g), it courses the liver, rectifies the Qi, and resolves depression.
• When pain is predominant, vinegar mix-fried Chai hu is best.
• In cases of liver-spleen disharmony, stir-fried Chai hu should be used.

Dose: 3-12g

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