Hai Zao Yu Hu Tang海藻玉壶汤
Sargassum Jade Flask Decoction
Ingredients12 herbs
Indications
Qi stagnation with phlegm congealingin the neck: a swelling that is soft to firm, not red and not hot, growing slowly, with a sense of oppression in the chest and a lump in the throat. The pattern is one of accumulation without heat toxin, which is why the strategy is to soften and move rather than to clear and drain.
Clinical Manifestations
- Goitre and neck swelling of the qi-and-phlegm type
- Thyroid nodules, alongside medical assessment
- Scrofulous neck nodesand subcutaneous phlegm nodules
- A soft, mobile swelling at the front of the neck that moves on swallowing
Health Categories
Modern Applications
Common adjustments
- Marked qi stagnation with irritability — add Xiang Fu 香附 and Yu Jin 郁金
- Nodules hard and long-standing — add Xia Ku Cao 夏枯草 and Mu Li 牡蛎
- Heat signs appearing — irritability, heat intolerance, rapid pulse — reassess before continuing: this may be thyroid overactivity, which iodine-rich seaweed can worsen
- Where the Hai Zao–Gan Cao pair is not acceptable — the is omitted; the formula still functions as a phlegm-softening, qi-moving prescription
Contraindications
Two issues dominate. First, iodine: Hai Zao, Kun Bu and Hai Dai are iodine-rich, and an iodine load can both trigger and worsen thyroid disease — iodine-induced hyperthyroidism as well as hypothyroidism are documented, and the effect is unpredictable in a nodular gland. Anyone with a neck swelling needs thyroid function tests and imaging before this formula is considered, and it is unsuitable in hyperthyroidism, in autoimmune thyroid disease, in anyone on thyroid hormone or antithyroid medication, and before or after radioiodine treatment. Second, the deliberate pairing: Hai Zao with is a classically incompatible combination, used here on purpose; it should never be reproduced casually, never self-prescribed, and in jurisdictions whose pharmacy rules forbid dispensing pairs the Gan Cao is simply left out. Beyond these: Ban Xia requires processed material and is used with caution in pregnancy; Chuan Xiong and Dang Gui move blood, warranting care with anticoagulants; the acrid, drying herbs are unsuitable in yin deficiency with dryness. Most importantly, a neck lump is a diagnosis to be made, not assumed — a hard, fixed or rapidly growing node, hoarseness, difficulty swallowing or breathing, or a lump with weight loss and night sweats needs prompt medical assessment for thyroid cancer, lymphoma or tuberculous nodes.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Not used in pregnancy. The iodine load from three seaweeds can disturb the fetal thyroid, Ban Xia requires caution, and Chuan Xiong with Dang Gui move the blood. A neck swelling appearing in pregnancy should be assessed medically.
References
Source Wai Ke Zheng Zong 《外科正宗》 · Ming
- Classical source named in the source fields (pre-1900, public domain).
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）— chapter placement, 功用 and 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.