Class 1: Formulas that
Harmonize
Xianhui Li
Formulas that Harmonize
• Formulas that Harmonize Lesser YangStage 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
Xiao Chai Hu Tang (Minor
Bupleurum Decoction)
Chai hu, Huang qin, Ban xia, Ren
shen, Sheng jiang, Da zao, Zhi
gan cao
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.
Analysis of Formula
• Chief: Chai hu
– Vent Lesser 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
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.
Da Chai Hu Tang (Major
Bupleurum Decoction)
Chai hu, Huang qin, Ban xia,
Sheng jiang, Da zao, Zhi shi, Da
huang, Bai shao
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.
Analysis of Formula
• Chief: Chai hu
– Vent Lesser 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
Rambling Powder (xiao yao
san)
Chai hu, Dang gui, Bai zhu, Bai
shao, Fu ling, Zhi gan cao
Bo he, wei jiang
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.
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
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
Frigid Extremities Powder (si
ni san)
Chai hu, Zhi shi, Bai shao,
Zhi gan cao
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.
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
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.
Attention
• Differentiation of Jue syndrome which is
marked by loss of consciousness or/and
coldness of the extremities.
Compassion between Si ni san and
Si ni tang
Formula
Ingredient
Action
Indication
Si ni san
Si ni tang
Chai hu, Zhi shi, Bai shao,
Zhi gan cao
Fu zi, gan jiang, zhi gan cao
Vent pathogenic influences,
release constraint, spread
the liver qi and regulate
spleen
Rescue yang, warm middle
burner and stop diarrhea
Cold fingers and toes
Extremely cold extremities,
(although the body is
aversion to cold, vomiting,
warm), irritability and
diarrhea
fullness in the chest and
epigastrium. A red tongue
with a yellow coating, and
a wiry pulse.
Formula Comparisons
between Chai hu shu gan san and
Xiao yao san
Formula
Ingredient
Chai hu shu gan san
Chai hu, Bai shao, Zhi gan cao
Chen pi, Zhi ke,
Chuan xiong, Xiang fu
Actions
Xiao yao san
Bai zhu, dang gui,
Fu ling,
Wei jiang, Bo he
Spread liver qi
Harmonize blood and
alleviate pain
Strengthen spleen and
nourish blood
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
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
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
Modern application and
modifications
• Modern application
– Irritable bowel syndrome, and colitis
• Modifications
– For chronic diarrhea: add Sheng ma
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
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.
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
Modern application and
modifications
• Modern application
– Gastritis, gastric ulcer, hepatitis, cirrhosis
• Modifications
– Gan cao xie xin tang
– Sheng jiang xie xin tang