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Yibian
 Shen Yaozi 
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formula nameMajor Bupleurum Decoction
sourceShanghan Zabing Lun
smart_toy
bubble_chart Preparation and Dosage

Bupleurum (Radix Bupleuri) 15gm (8 liǎng)
Skullcap Root (Radix Scutellariae) 9gm (3 liǎng)
Pineilia (Rhizoma Pinelliae) 9gm (half shēng) wash
Immature Orange Fruit (Fructus Aurantii Immaturus) 9gm (4 pieces) broil
Rhubarb Rhizoma (Radix et Rhizoma Rhei) 6gm (2 liǎng)
Peony Root (Radix Paeoniae Alba) 9gm (3 liǎng)
Fresh Ginger Rhizome (Rhizoma Zingiberis) 15gm (5 liǎng) cut
Chinese Date (Fructus Jujubae) 12 pieces break

Take the seven ingredients on the right, boil them in one dou and two sheng of water until six sheng remain. Remove the dregs and decoct again. Take one sheng warm, three times a day.

bubble_chart Efficacy

Releasing exterior pathogens, and clearing interior excess.

bubble_chart Indications

Shaoyang and Yangming combination of diseases, alternating chills and fever, fullness and discomfort in the chest and hypochondrium, persistent vomiting, bitter taste in the mouth, mild depression and irritability, fullness and pain or stuffiness and hardness below the heart, constipation or diarrhea with heat, yellow and thick tongue coating, wiry and strong pulse.

bubble_chart Formula Principles

This formula is derived from Minor Bupleurum Decoction by removing Ginseng, Liquorice Root, and adding Rhubarb Rhizoma, Immature Orange Fruit, and Peony Root. It can be considered a combination of Minor Bupleurum Decoction and Minor Purgative Decoction, integrating harmonizing and purgative actions. In the formula, Bupleurum is used in large amounts as the sovereign herb, combined with Skullcap Root to expel the pathogenic factors of the lesser yang. Rhubarb Rhizoma is used in small amounts along with Immature Orange Fruit to purge the heat accumulation in the yangming, serving as the minister herbs. Peony Root alleviates urgency and pain, and when paired with Rhubarb Rhizoma, it treats severe abdominal pain. When combined with Immature Orange Fruit, it treats abdominal pain and restlessness due to disharmony of qi and blood. Pinellia harmonizes the stomach and directs rebellious qi downward to stop vomiting, and when paired with Fresh Ginger Rhizome, it treats incessant vomiting, both serving as assistant herbs. Chinese Date and Fresh Ginger Rhizome are used together to harmonize the nutrient-defense and regulate the actions of the other herbs, serving as the envoy. Together, these herbs harmonize the lesser yang and purge internal heat accumulation, resolving the pathogenic factors in both the lesser yang and yangming.

bubble_chart Syndrome Differentiation

  1. Exterior pathogen and interior excess.
  2. Alternating chills and fever.
  3. Fullness and discomfort in the chest and hypochondrium.
  4. Bitter taste in the mouth and vomiting.
  5. Constipation or diarrhea.
  6. Pulse is wiry and forceful.

bubble_chart Formula Modification

  1. Yangming heat and agitation: add Gypsum and Anemarrhena.
  2. Shaoyang chest heat: add Coptis Rhizome.
  3. Heat toxin predominance: add Lonicera, Forsythia, and Dandelion.
  4. Dampness-heat jaundice: add Virgate Wormwood, Gardenia, Canton Love-pea Vine, and Christina Loosestrife.
  5. Abdominal distension and fullness with pain: add Magnolia Bark, Aucklandia Root, green tangerine peel, Curcuma Root, and Corydalis Tuber.
  6. Acute otitis media: add Gentian and Cap Shield.
  7. Viral diseases: add Isatis Root and wild chrysanthemum flower.

bubble_chart Cautions and Contraindications

Use with caution in cases that are not excess syndrome/pattern.

bubble_chart Modern Application

This formula reduces fever, promotes bile flow, and relieves constipation. It is used for liver dysfunction, liver abscess, gallstones, cholecystitis, hypertension, pancreatitis, gastritis, gastric and duodenal ulcers, constipation, asthma, dysentery, diabetes, obesity, common cold, and tinnitus.

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