Da Chai Hu Tang

Da Chai Hu Tang (Major Bupleurum Decoction), from the Jin Gui Yao Lue (Essentials from the Golden Cabinet) by Zhang Zhong-Jing.

Actions: Harmonizes shaoyang syndrome; Purges interior heat in yangming syndrome.

Presentation: Shaoyang and yangming syndromes: alternate spells of chills and fever, fullness of chest and hypochondrium, continuous vomiting, a feeling of depression with slight fidgeting, fullness, distention and pain in the epigastrium, constipation or discharge of fluids rectally, a thick yellow tongue coating, and a wiry, forceful pulse.

Cautions:

• Contraindicated with Spleen and Stomach deficiency.
• Use Da Huang in moderation; excessive or prolonged use depletes fluids and can drive the disease deeper.
• Possible side effects: poor appetite, abdominal distention, diarrhea, edema.
• Avoid cold/raw, pungent/spicy, and oily/greasy foods during use.

Toxicology: One Japanese case report of autoimmune hepatitis associated with Dai-saiko-to (Da Chai Hu Tang); further history unavailable.

Herb–drug interactions:

• Aspirin- and ethanol-induced gastric hemorrhagic lesions in rats: gastroprotection comparable to sucralfate, cimetidine, and 16,16-dimethyl-PGE2

Pharmacological effects reported:

• Gastrointestinal: antispasmodic on intestinal smooth muscle, inhibited gastric acid, and extract at 250 mg/kg protected rat gastric mucosa against aspirin
• Hepatoprotective: lowered SGPT/SGOT, protected against drug-induced damage, and limited CCl4 liver injury by inhibiting lipid peroxidation and improving active-oxygen metabolism
• Cardiovascular: little effect on blood pressure or heart rate/rhythm; slight fall in cholesterol and triglycerides
• Immunologic: increased T-cells in immunosuppressed mice; no significant IgM/IgG change
• Antibiotic: strong in vitro inhibition of Staphylococcus aureus and E. coli
• Anti-inflammatory: effect comparable to aspirin in mice with induced joint inflammation
• Antihyperglycemic: lower blood glucose at 30/60/120 min and higher insulin at 120 min in glucose tolerance testing
• Lipid biosynthesis: reduced hepatic triglyceride synthesis and plasma VLDL; lowered plasma and liver cholesterol on high-cholesterol diet; raised HDL; lowered plasma triglycerides

Source: Chen JK, Chen TT. Chinese Herbal Formulas and Applications: Pharmacological Effects & Clinical Research. Art of Medicine Press, 2009, p. 283.

Source: cook in 12 cups [2,400 mL] water to 6 cups [1,200 mL]; discard dregs and reduce further; take 1 cup [200 mL] warm three times daily. Today decocted at bracketed doses.