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Da Chai Hu Tang大柴胡汤

Major Bupleurum Decoction (Major Bupleurum Combination)

Releasing Exterior and Interior Together 表里双解剂和解少阳

Ingredients8 herbs

柴Chai Hu柴胡15g君 ChiefOpens the shaoyang pivot and lifts the pathogen outward黄Huang Qin黄芩9g臣 DeputyClears the heat held in the shaoyang, the classical partner of Chai Hu
芍Bai Shao芍药9g佐 AssistantSoftens the Liver and eases the cramping abdominal pain
半Ban Xia半夏洗9g佐 AssistantDownbears rebellious Stomach qi and stops the vomiting生Sheng Jiang生姜切15g佐 AssistantGiven in a large dose here to assist Ban Xia against persistent vomiting枳Zhi Shi枳实炙9g臣 DeputyBreaks up the hard fullness below the heart and moves the stagnation with Da Huang大Da Zao大枣擘4枚佐使 Assistant–EnvoyProtects the middle burner against the purging and harmonizes with Sheng Jiang大Da Huang大黄6g臣 DeputyDrains the accumulated heat downward through the stool

Indications

Harmonizes the shaoyangDrains interior heat accumulationStops rebellious vomiting

Shaoyang with yangming interior excess: the pathogen still sits at the pivot while heat has already bound in the bowel. Both a wiry pulse and a hard, pressure-refusing epigastrium must be present — this is not a formula for shaoyang alone.

Clinical Manifestations

  • Alternating chills and fever with hard, painful fullness below the ribs
  • Persistent vomiting that will not settle
  • Bitter taste, irritability, constipation with dark scanty urine
  • Gallbladder and biliary pain presentations
  • Jaundice with damp-heat
TongueYellow, dry coating
PulseWiry and forceful

Health Categories

Digestive HealthLiver Health & DetoxUrinary & Bladder Health

Modern Applications

CholecystitisCholelithiasisBiliary colicAcute pancreatitisAcute gastritisJaundice

Common adjustments

Contraindications

Only for a genuine interior excess. A shaoyang pattern without bowel accumulation belongs to Xiao Chai Hu Tang; in cold or deficient constitutions, in chronic loose stools, and once the heat has been cleared, the Da Huang and Zhi Shi here do harm. Stop when the bowel moves and the fullness resolves. Severe, worsening abdominal pain needs urgent medical assessment, not a longer course of herbs.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Contraindicated in pregnancy — Da Huang and Zhi Shi drive downward and are withheld from pregnant patients. It is also unsuitable while breastfeeding without practitioner supervision.

Related Formulas

References

Source 《金匮要略》 · Eastern Han

「呕不止，心下急，郁郁微烦者，为未解也，与大柴胡汤下之则愈。」
— 《伤寒论》(classical source, public domain)
  1. Classical source (public domain), cited in the source-quote section.
    2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
    3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.