Harmonizes and releases Shao-Yang (Lesser-Yang) Stage disorders

• Alternating chills and fevers
• A bitter or sour taste, dry throat
• Dizziness, irritability
• A sensation of fullness in the chest and hypochondrium (often with difficulty taking deep breaths)
• Heartburn, nausea, vomiting and poor appetite
• A thin white tongue coat (possibly on one side only)
• A wiry pulse

• Chai Hu (chief) vents heat and releases Qi constraint and has a cooling, ascending and dispersing action, which affects the half-exterior aspect.
• Huang Qin (deputy) is bitter, cold and descending, and drains (Damp and) Heat from the Liver and Gallbladder, which affects the half-interior aspect.
• Their opposing actions prevent pathogens from sinking further into the body and treat both the inner and outer aspects of Shao-Yang disorders.
• Ban Xia and Sheng Jiang (assistants) warm, harmonise the middle Jiao and transform Phlegm and Dampness, directing Qi downwards and preventing nausea and vomiting.
• Ren Shen, Da Zao and Zhi Gan Cao (assistants) support the normal Qi and prevent pathogens from penetrating the interior, harmonise the Stomach and assist in relieving Qi constraint.
• Da Zao and Zhi Gan Cao also moderate the acrid, dry properties of Ban Xia and Sheng Jiang and regulate the Wei and Zheng Qi to assist Chai Hu in releasing the half-exterior.

• Thirst: remove Ban Xia and add Tian Hua Fen
• Abdominal pain: remove Huang Qin and add Bai Shao
• Fever, chest pain and coughing yellow sputum: add Jie Geng, Gua Luo and Chuan Bei Mu
• Malarial disorders or deep-seated pathogens: add Qing Hao
• Vertigo: add Ju Hua, Gou Teng and Jue Ming Zi
• Urinary tract infections with chills, fever and urgency: take with Liu Wei Di Huang Wan
• Coughs worse around midnight + chills, fever and bitter taste: add Gan Jiang, Xi Xin and Wu Wei Zi

• The half-exterior aspect creates alternating chills and fevers, and fullness in the chest and hypochondrium are due to heat in the Shao-Yang channels.
• The half-interior aspect creates heat rising upward and a bitter or sour taste, dry throat and dizziness.
• Stagnant Gallbladder Qi invades the Stomach, causing heartburn, nausea, vomiting, poor appetite and wiry pulse.
• A fever is more prominent when only Heat is involved, while Damp-Heat makes the fever low-grade, more contained and cyclical.
• With the appropriate presentation, this formula may be used for upper respiratory tract infections, bronchitis, pulmonary tuberculosis, epidemic parotitis, jaundice, acute viral hepatitis, post-partum fever, chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), acute pyelonephritis, cholecystitis, lymphadenitis and intercostal neuralgia.

• Long-term use can cause headaches, dizziness and bleeding gums due to its ascending nature damaging Qi.
• Use with caution when there’s excess above, deficiency below, Liver Yang Rising hypertension or severe Yin deficiency.

Harmonizes and releases Shao-Yang (Lesser-Yang) Stage disorders and drains internal clumping due to Heat

• Alternating chills and fever, fullness in the flanks and chest
• Bitter taste, irritability, nausea and vomiting
• Epigastric hardness, distension or pain
• Constipation or hot, burning diarrhoea
• Irritability and depression
• A yellow tongue coat
• A strong, wiry pulse

• Chai Hu (chief) vents the half-exterior aspect of Shao-Yang, while Huang Qin (deputy) drains (Damp and) Heat from the half-interior aspect.
• Zhi Shi (deputy) strongly regulates Qi and breaks up focal distension and fullness in the chest and abdomen in conjunction with Chai Hu.
• Da Huang (deputy) drains excess Heat from the Stomach and Gallbladder downwards, transforms Blood stasis and promotes the flow of bile, and with Zhi Shi drains clumping Heat in the Interior.
• Bai Shao (assistant) nourishes Blood and softens the Liver, and with Zhi Shi and Da Huang treats abdominal pain and distension.
• Ban Xia (assistant) and Sheng Jiang (envoy) harmonise the middle Jiao and transform Phlegm and Dampness, directing Qi downwards to treat nausea and vomiting.
• Da Zao (envoy) supports Bai Shao softening the Liver and easing abdominal spasms. They also protect the Yin from injury from pathogenic Heat and the harsh draining herbs.

• Strong chest and epigastric pain: add Mu Xiang, Yu Jin and Yin Chen Hao
• Severe abdominal pain: add Yan Hu Suo, Wu Yao and Xiang Fu
• Continuous vomiting: add Huang Lian and Wu Zhu Yu
• Manic behaviour from Liver Fire: add Zhi Zi, Qing Dai, Mu Dan Pi and Mang Xiao
• Acute jaundice: add Zhi Zi and Huang Bai
• Marked chills: add Ma Huang, Lian Qiao and Chi Xiao Dou
• Acute cholecystitis: add Jin Yin Hua, Lian Qiao, Pu Gong Ying and Zi Hua Di Ding
• Gallstones: add Jin Qian Cao, Shi Wei and Hai Jin Sha
• Pancreatitis: take with Ban Xia Xie Xin Tang
• Intercostal neuralgia: take with Xiao Xian Xiong Tang

• Concurrent Shao-Yang and Yang-Ming Stage disorders.
• Alternating chills and fever, fullness in the flanks and chest, bitter taste, irritability, vomiting and wiry pulse indicate a Shao-Yang disorder.
• A sensation of hardness, distension or pain in the epigastrium, no bowel movements or hot, burning diarrhoea, yellow tongue coat and forceful pulse indicate a Yang-Ming disorder, which can also be considered excess Heat in the Stomach and Gallbladder.
• The key symptom of continuous vomiting is due to Gallbladder Qi invading the Stomach.
• With the appropriate presentation, this formula may be used for acute gastroenteritis, gastrointestinal flu, dysentery, acute pancreatitis, hepatitis, cholecystitis, cholelithiasis, pleurisy, peritonitis, migraine headache, trigeminal neuralgia, malignant hypertension and malaria (especially when fever predominates).

• Long-term use can cause headaches, dizziness and bleeding gums due to its ascending nature damaging Qi.
• Use with caution when there’s excess above, deficiency below, Liver Yang Rising hypertension or severe Yin deficiency.

Vents pathogenic influences, releases constraint, spreads Liver Qi and regulates the Spleen

• Cold fingers and toes (although the limbs and body are warm)
• Irritablility and fullness in the chest and epigastrium
• Abdominal pain, diarrhoea
• Belching, bitter taste
• Hypochondria pain and distension
• Cough
• A red tongue
• A wiry pulse

• Chai Hu (chief) vents heat, releases Qi constraint and works with Zhi Shi to regulate Qi and disperse heat as it ascends (Zhi Shi is descending).
• Zhi Shi (deputy) drains heat from the middle Jiao, which aids the transforming and transporting functions of the Spleen Qi.
• Bai Shao (assistant) nourishes the Liver, preserves the Yin, and holds things in to counteract the first two herbs.
• Zhi Gan Cao with Bai Shao moderates colicky pain and harmonises the actions of the other herbs.

• Cough: add Wu Wei Zi and Gan Jiang
• Palpitations: add Gui Zhi
• Blood deficiency with hypochondriac pain and irregular menses: remove Zhi Shi and add Bai Zhu, Fu Ling and Dang Gui
• Food stagnation and abdominal pain: add Shan Zha, Mai Ya and Ji Nei Jin

• The formula is appropriate when stagnation of the Qi mechanism occurs due to Heat entering the Interior and constraining Yang Qi.
• The formula is also appropriate when a patient with underlying Spleen-Qi deficiency contracts a pathogen that enters the Shao-Yin (Lesser Yin Stage).
• When there are cold extremities with chills that involve the whole hands and feet use Dang Gui Si Ni Tang.
• With the appropriate presentation, this formula may be used for gastritis, peptic ulcer, cholecystitis, cholelithiasis, hepatitis, intestinal obstruction, mastitis, and fibrocystic breasts.

Spreads Liver-Qi, Harmonises the Blood and Middle Jiao and alleviates pain

• Irritability, depression
• Hypochondriac and epigastric pain and distension
• Alternating chills and fever, aches and pains
• Waking in the early hours, unable to get back to sleep
• Tiredness that’s worse for stress
• Constipation or diarrhoea
• Belching, bitter taste, heartburn, abnormal appetite
• Premenstrual syndrome and dysmenorrhoea
• Red, dark or mauve tongue
• A wiry pulse

• Chai Hu (chief) vents heat and releases Qi constraint and works with Zhi Ke to regulate Qi and disperse heat as it has an ascending action (Zhi Ke is descending).
• Zhi Ke, Chen Pi and Xiang Fu (deputies) regulate Liver Qi and drain Heat from the middle Jiao and promote the movement of fluids.
• Chuan Xiong moves Qi and activates the movement of Blood.
• Bai Shao (assistant) nourishes the Liver and preserves the Yin and holds things in to counteract the dispersing nature of the first herbs.
• Zhi Gan Cao harmonises the actions of the other herbs and moderates colicky pain with Bai Shao.

• Cough: add Wu Wei Zi and Gan Jiang
• Palpitations: add Gui Zhi
• Blood deficiency with hypochondriac pain and irregular menses: remove Zhi Ke and add Bai Zhu, Fu Ling and Dang Gui
• Food stagnation and abdominal pain: add Shan Zha, Mai Ya and Ji Nei Jin
• Pinpoint fixed pain due to Blood stasis: add Pu Huang, Wu Ling Zhi and Dan Shen
• Urinary difficulty: add Fu Ling
• Epigastric pain with acid reflux: add Zou Ji Wan
• Damp-Heat leukorrhoea: take with Er Miao San
• Biliary tract disorders: add Yin Chen Hao, Dan Shen, Yu Jin, Chi Shao and Jin Qian Cao
• Intercostal neuralgia: add Wu Mei and Ku Lian Gen Pi
• Intestinal obstruction: add Da Huang

• This formula is a variation of Si Ni San that treats a greater degree of Liver Qi Stagnation, which reduces the flow of Blood and causes abdominal pain.
• Cold extremities with chills involving the whole hands and feet: Dang Gui Si Ni Tang

Spreads Liver Qi, strengthens the Spleen and nourishes the Blood

• Hypochondriac pain
• Headache, vertigo, irritability, bitter taste
• Dry mouth and throat
• Fatigue, poor appetite and abdominal distension
• Possible alternating chills and fevers
• Irregular menses, premenstrual syndrome
• A red tongue
• A wiry, deficient pulse

• Chai Hu (chief) vents heat and releases Qi constraint and has an ascending, dispersing action.
• Dang Gui and Bai Shao (deputies) nourish Blood and soften the Liver to ease constraint, with Dang Gui affecting the Qi of the Blood.
• Bai Zhu, Fu Ling and Zhi Gan Cao (assistants) strengthen the Spleen and promote transformation and transportation.
• Zhi Gan Cao with Bai Shao moderates colicky pain and harmonises the actions of the other herbs.
• Sheng Jiang (envoy) harmonises and prevents rebellious Stomach Qi from developing.
• Bo He (envoy) supports Chai Hu in relieving Liver Qi constraint and dispersing Heat.

• Insomnia and palpitations: add Suan Zao Ren 6-15g, Yuan Zhi 3-6g and Bai Zi Ren 9-12g or He Huan Pi 12g
• Urinary frequency: swap Sheng Jiang for Pao Jiang, add Wu Yao 6g
• Food stagnation and abdominal pain: add Shan Zha, Mai Ya and Ji Nei Jin
• Blood stagnation: add Hong Hua 9g and Tao Ren 12g

• For Liver Qi constraint and Blood deficiency where Liver Qi stagnation violates the Spleen dynamic, causing Spleen Qi and Blood deficiency.
• Or for Blood deficiency; “Blood is the mother of Qi“, (from Spleen Qi deficiency or some other cause) leads to Liver Qi constraint.
• With the appropriate presentation, this formula may be used for hepatitis, pleurisy, chronic gastritis, peptic ulcer, anaemia, functional uterine bleeding, menopausal syndrome, pelvic inflammatory disease, fibrocystic breasts, neurasthenia, optic nerve atrophy, and central retinitis.

Spreads Liver Qi, strengthens the Spleen, nourishes the Blood and clears Heat

• Irritability, a short temper, hypochondriac pain
• Headache, vertigo
• Bitter taste, dry mouth
• Possible tidal fever and sweating
• Palpitations
• Pressure in the lower abdomen, difficult, painful urination
• Increased menstrual flow or uterine bleeding
• Red edges to the tongue
• A wiry, forceful pulse

• Chai Hu (chief) vents heat and releases Qi constraint and has an ascending, dispersing action.
• Dang Gui and Bai Shao (deputies) nourish Blood and soften the Liver to ease constraint, with Dang Gui affecting the Qi of the Blood.
• Bai Zhu, Fu Ling and Zhi Gan Cao (assistants) strengthen the Spleen and promote transformation and transportation.
• Zhi Zi and Mu Dan Pi (assistants) clear heat caused by deficiency or excess from the Liver, cool and move Blood and drain Damp-Heat.
• Sheng Jiang and Bo He (envoys) harmonise the Stomach and assist in relieving Qi constraint.
• The formula is primarily used when Liver Qi constraint and Spleen deficiency transform into Heat.
• Or when Blood deficiency “Blood is the mother of Qi”, (from Spleen Qi deficiency or some other cause) leads to Liver Qi constraint.

• Insomnia and palpitations: add Ye Jiao Teng 9-12g and Dan Shen 9-12g