In issue #7, 2003 of Jiang Xi Chong Yi Yao (Jiangxi Chinese Medicine & Medicinals), Ceng Guo-xing published an article titled, "The Use of Xiao Chai Hu Tang (Minor Bupleuru m Decoction) in Dfigestive System Diseases." This article appeared on page 37 of that journal and a summary appears below. It consists of a collection of four case histories in which Xiao Chai Hu Tang was the base formula used even though each patient presented with a different disease diagnosis.

The patient was a 23 year-old female who was initially seen on July 6, 1995. The patient had had stomach duct pain for three years and had been previously diagnosed at the author's hospital as suffering from bile reflux gastritis. Her signs and symptoms included upper central abdominal pain accompanied abdominal distention and rib-side pain, eating leading to hiccup and vomiting of bitter water, fatigue of the four limbs, a greenish facial complexion which was also slightly yellow, pale red lips and tongue with yellow fur and a bowstring pulse. Thus this patient's pattern was categorized as liver depression-spleen vacuity with liver-stomach disharmony. The treatment principles were to course the liver and harmonize the stomach, and the formula used was Xiao Chai Hu Tang Jia Wei (Minor Bupleuru m Decoction with Added Flavors): Radix Bupleuri (Chai Hu), 10g, Rhizoma Pinelliae Ternatae (Ban Xia), 10g, Radix Scutellariae Baicalensis (Huang Qin), 10g, Radix Codonopsitis Pilosulae (Dang Shen), 10g, Radix Glycyrrhizae Uralensis (Gan C a o), 5g, uncooked Rhizoma Zingiberis O fficinalis (Sheng Jiang), 2 slices, Fru c t u s Meliae Toosendam (Chuan Lian Zi), 10g, Fructus Immaturus Citri Aurantii (Zhi Shi), 10g, and Fructus Zizyphi Jujubae (Da Zao), 4 pieces. One packet of these medicinals was decocted in water and administered per day. After f ive days' administration, the abdominal pain wa s decreased and the hiccup and vomiting of bitter water had stopped. Therefore, another 25 packets of the same formula were prescribed and all the symptoms disappeared.

The patient was a 65 year-old female who was first seen on June 4, 1995. This patient had had right rib-side pain for two years which was sometimes better and sometimes worse. She had tried a number of different treatments, but nothing was a ble to achieve any great improve m e n t . Ultrasonography revealed gallbladder polyps and cholecystitis. At the time of examination, there was right rib-side pain accompanied by chest oppression, a bitter taste in the mouth, burping, no thought for food or drink, lack of strength, dizziness, loose stools, a red tongue with yellow fur, and a bowstring, fine pulse. This pattern was categorized as liver depression-spleen vacuity. Therefore, Xiao Chai Hu Tang Jia Jian (Minor B u p l e u rum Decoction with Additions & Subtractions) was prescribed: Radix Bupleuri (Chai Hu), 10g, Radix Scutellariae Baicalensis

(Huang Qin), 15g, Radix Codonopsitis Pilosulae (Dang Shen), 10g, Rhizoma Pinelliae Ternatae (Ban Xia), 10g, Fructus Immaturus Citri Aurantii (Zhi Shi), 10g, Fructus Meliae To o s e n d a m (Chuan Lian Zi), 10g, Rhizoma Cory d a l i s Yanhusuo (Yan Hu Suo), 10g, Radix Et Rhizoma Rhei (Da Huang), 10g added later, uncooked Rhizoma Zingiberis Off icinalis (Sheng Jiang), 2 slices, Radix Glycyrrhizae Uralensis (Gan Cao), 3g, and Fructus Zizyphi Jujubae (Da Zao), 4 pieces. One packet of these medicinals wa s decocted in water and administered per day. After taking five such packets, the patient's rib-side pain, chest oppression, and bu rp i n g / b e l c h i n g were improved, while the bitter taste in the mouth was gone. The tongue and pulse, however, were the same as before. Therefore, Dr. Ceng prescribed another 36 packets of the same basic formula with modifications following the patient's signs and symptoms. By the end of that time, the woman's appetite had increased and her mood had improved. On follow-up after a half year, there had been no recurrence.

The patient was a 27 year-old female who was first seen by Dr. Ceng on June 12, 1995. This woman had had recurrent upper right abdominal and central epigastric pain for more than three years and had been diagnosed at Dr. Ceng's hospital as suffering from duodenal ulcers. The patient had been treated with several different Western medicines which sometimes helped and sometimes did not. Typically, there was insidious pain which never went away. In the last month, the woman's condition had gotten worse. Besides the central epigastric and upper right abdominal pain, there was chest oppression, abdominal distention after eating, lack of strength in the four limbs, clear watery drooling from her mouth, loose stools, thin, yellow tongue fur, and a bowstring, fine pulse. Thus Dr. Ceng categorized this young woman's Chinese medical pattern as liver depression-spleen vacuity and again prescribed Xiao Chai Hu Tang Jia Jian: Radix Bupleuri (Chai Hu), 10g, Radix Codonopsitis Pilosulae (Dang Shen), 30g, Radix Scutellariae Baicalensis (Huang Qin), 10g, Rhizoma Pinelliae Te rnatae (Ban Xia), 10g, mix-fried Radix Glycyrrhizae Uralensis (Gan Cao), 6g, and dry Rhizoma Zingiberis Officinalis (Gan Jiang), 5g. One packet of these medicinals was decocted in water and administered per day. After taking five packets, the abdominal pain and drooling were markedly reduced. However, the abdominal distention was the same as before. Therefore, Dr. Ceng added 10 grams of Pericarpium Citri Reticulatae (Chen Pi) to the above formula. After taking another 10 packets of these medicinals, all the woman's symptoms were eliminated. On follow-up after a half year, there had been no recurrence.

The patient was a 48 year-old male who was first seen on June 25, 1995. Two years previous, the man had developed piercing esophageal pain when he ate. This was accompanied by an obstructed feeling in his bowels and epigastric distention. There was a bitter taste in his mouth, chest oppression, lack of strength, and dizziness. The man had been already diagnosed with esophagitis and hyperemic seeping gastritis and been treated with antibiotics with no apparent i m p r ovement. Therefore, he decided to try Chinese medicine. At the time of Dr. Ceng's examination, the man's lips and tongue were pale red with yellow fur and a bowstring, fine pulse. Thus Dr. Ceng categorized his pattern as liver

depression transforming fire which was ascending to burn the esophagus. Yet again, treatment consisted of Xiao Chai Hu Tang Jia Jian: Radix Bupleuri (Chai Hu), 10g, Rhizoma Pinelliae Te rnatae (Ban Xia), 10g, Radix Scutellariae Baicalensis (Huang Qin), 12g, Rhizoma Coptidis Chinensis (Huang Lian), 6g, Fructus Immaturus Citri Aurantii (Zhi Shi), 10g, Rhizoma Polygonati Odorati (Yu Zhu), 10g, uncooked Rhizoma Zingiberis Officinalis (Sheng Jiang), 2 slices, uncooked Radix Glycyrrhizae Uralensis (Gan Cao), 5g, and Fructus Zizyphi Jujubae (Da Zao), 4 pieces. One packet of these medicinals was decocted in water and administered per day. After tasking three packets, the man had markedly improved, and, after taking another 10 packets, his symptoms were all completely eliminated.

Readers should note that all four of these case histories occurred at roughly the same time. This suggests how commonly Dr. Ceng prescribed Xiao Chai Hu Tang. Because Xiao Chai Hu Tang treats a liver-spleen, liver-stomach disharmony and these patterns are extremely common in adults, this formula is a commonly used and especially effective one for a wide range of ailments.