Chai Hu Si Wu Tang - 柴胡四物湯 - Bupleurum And Four Substance Decoction

English:	Bupleurum and Four Substance Decoction
Also Known As:

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Rx. Bupleuri	Chai Hu	8-24g	Resolves Shao Yang disorders and reduces fever Spreads Liver Qi and relieves Stagnation. With Huang Qin, for Heat in the Shao Yang. 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, Zhi Gan Cao and Ren Shen, for weak patients. With Bai Shao, for Liver Blood Deficiency with Liver Qi Stagnation and vertigo, dizziness, thoracic and costal pain, due to Liver Qi Stagnation. With Bai Shao, Dang Gui and Chuan Xiong, harmonizes the Blood for irregular menstruation.
Rx. Scutellariae	Huang Qin	3-9g	Drains Fire and detoxifies.
Rz. Pinelliae Preparatum	Zhi Ban Xia	3-9g	Dries Dampness and transforms Phlegm. With Ren Shen, for vomiting due to Stomach Deficiency.
Rx. Glycyrrhizae Preparata	Zhi Gan Cao	3-9g	Tonifies the Spleen, augments Qi, clears Heat, relieves Fire toxicity and moderates and harmonizes the harsh properties of other herbs. With Ren Shen, relieves palpitations and anxiety.
Rx. Ginseng	Ren Shen	3-9g	Tonifies Spleen and Stomach Qi. With Shu Di Huang, for severe Qi and Blood Deficiency due to loss of Blood.
Rx. Paeoniae Alba	Bai Shao	15-45g	Nourishes the Blood, regulates menstruation, softens the Liver and relieves pain. With Dang Gui and Shu Di Huang, for dizziness, blurred vision, and dysmenorrhea due to Blood Deficiency or Stasis. With Zhi Gan Cao, for abdominal pain due to disharmony between the Liver and Stomach. With Chai Hu, for flank pain due to Liver Qi Stagnation. With Dang Gui, nourishes Yin and Blood.
Rx. Rehmanniae Preparata	Shu Di Huang	15-45g	Nourishes the Blood and nourishes Liver and Kidney Yin. With Dang Gui, for Blood Deficiency marked by dizziness, palpitations, insomnia and menstrual dysfunction. With Dang Gui, Bai Shao and Chuan Xiong, for anemia.
Rx. Angelicae Sinensis	Dang Gui	15-45g	Tonifies, invigorates and harmonizes the Blood, disperses Cold, stops pain due to Blood Stasis and regulates the menses. With Shu Di Huang, for Heat symptoms due to Yin Deficiency and Devastated Blood. With Shu Di Huang, Bai Shao and Chuan Xiong, for menstrual irregularity, amenorrhea, and dysmenorrhea due to Blood Deficiency or Blood Stasis. With Chai Hu and Bai Shao, for dysmenorrhea from Liver Qi Stagnation and Blood Deficiency. With Chuan Xiong, harmonizes, nourishes and invigorates the Blood and disperses Blood Stasis.
Rz. Chuanxiong	Chuan Xiong	15-45g	Invigorates the Blood, promotes the movement of Qi, expels Wind and alleviates pain. With Dang Gui, for Blood Deficiency causing menstrual problems including dysmenorrhea, scanty menses, and amenorrhea.

Formula Actions

• Spreads Liver Qi
• Harmonizes the Blood
• Alleviates pain

Syndromes

• Jue Yin Stage
• Chronic consumptive disorders
• Blood Deficiency with Stasis

Clinical Manifestations

Pain extending from the chest to the back Alternating chills and fever Symptoms worsen at night Late menstruation Menstrual discharge is scant, dark and clotted

Lower abdominal pain and distention Flank discomfort Breast discomfort T: Pale with purple spots C: Thin P: Thready and wiry

Treats

Chronic consumptive disorders Colds during menstruation

Delayed menstruation

Contraindications And Herb/Drug Interactions

Notes

Modifications

For delayed menstruation:
- Rx. Scutellariae	Huang Qin
- Rz. Pinelliae Preparatum	Zhi Ban Xia
- Rx. Glycyrrhizae Preparata	Zhi Gan Cao
+ Rz. Cyperi X	Xiang Fu
+ Rx. Curcumae	Yu Jin
+ Rx. Salviae Miltiorrhizae	Dan Shen
+ Fr. Citri Sarcodactylis	Fo Shou
+ Fr. Mume	Wu Mei