Da Chai Hu Tang

[Explanation]

This pattern is a shaoyang / yangming combination disease. Alternating heat and cold, chest, rib, or hypocardium fullness and pain, constipation, and yellow tongue fur are the main diagnostic points. Regarding the treatment method, when the sickness is in the shaoyang, the use of purgation methods should be prohibited. Only precipitate in situations with simultaneous bowel repletion, when the interior and exterior must be attended to simultaneously. This formula is Xiao Chai Hu Tang with the removal of Ren Shen and Gan Cao and the addition of Da Huang, Zhi Shi, and Shao Yao. The formula is governed with harmonizing and resolving herbs, but with the simultaneous usage of downward draining herbs. This is compatible and not contrary to the principle of prohibiting the use of purgation for the shaoyang. It can treat the exterior and the interior together, engaging the shaoyang / yangming evil with paired resolve. It could be called one application with two results. This clinical usage of this formula is very extensive. Not only can it treat many types of acute gallbladder diseases, but can be modified and utilized for all diseases belonging to gallbladder / stomach heat repletion, obstruction of the qi mechanism, inhibition of free discharge, and acute pain of the sides.

3. Rib Pain (Chronic Gallbladder Sac Inflammation)

Yue Mei Chinese Medicine Case: Li XX, Female, suffers gallbladder sac inflammation. The right rib region has spontaneous pain giving the sensation of pressure and pain. Regularly there is small heat, also the appearance of nausea, poor appetite, swollen and full belly region, drum-belly and belching. Pulse appears stringlike and large. Prescribe modified Da Chai Hu Tang.

Chai Hu 12, Bai Shao 9, Zhi Shi 6, Da Huang 6, Huang Qin 9, Ban Xia 9, Sheng Jiang 15, Da Zao 4 pieces, Jin Qian Cao 24, Hua Shi 12, Ji Nei Jin 12.

Altogether 7 bags were taken. The appetite was seen to improve, the drum-belly and belching all greatly decreased. Again the original formula was taken for 4 bags, the rib pain also eased, but the small heat has not yet receded. It was correct to use Xiao Chai Hu Tang plus Bie Jia, Qing Hao, Qin Qiu, and Yu Jin for treatment.

Note: Rib pain is one pattern, the pain position being mainly at the liver / gallbladder. In this case there is rib pain as well as nausea, dull appetite, belly fullness and belching caused by liver / gallbladder constraint reaching the spleen / stomach. Therefore this is ruled by shaoyang / yangming combined disease. This is suited to the Da Chai Hu Tang pattern mechanism. According to reports, this formula treats gallbladder sac inflammation belonging to liver / gallbladder damp heat, and inhibition of the qi and blood. Its effect is comparatively good.  

(Shang Han Lun Ming Yi Ya Nan Jing Xuan, pp. 368-370. Chen, Ming, & Sheng. 1998.)