Bupleurum roots (Chai Hu) Szechuan lovage roots (Chuan Xiong) Coco-grass rhizomes (Xiang Fu) White peony roots (Bai Shao)

Chai Hu Shu Gan San

Chinese: 柴胡疏肝散

Pinyin: Chái Hú Shū Gān Sàn

Other names: Bupleurum Powder to Dredge the Liver

Number of ingredients: 7 herbs

Formula category: Formulas that promote Qi movement

Conditions for which it may be prescribed: HepatitisPeptic ulcersLate menstruation and three other conditions

  1. Disperses Stagnant Liver Qi and Blood
  2. Alleviates pain
  3. Harmonizes Blood

Contraindications: Contraindicated for long-term use or for patients with Liver Qi stagnation type... Contraindicated for long-term use or for patients with Liver Qi stagnation type pain due to Qi or Yin Deficiency, because his formula is aromatic, acrid, and drying and it injures the Qi and Yin. see more

Source date: 1602

Source book: Indispensable Tools for Pattern Treatment

Chai Hu Shu Gan San is a 7-ingredient Chinese Medicine formula with Bupleurum Roots (Chai Hu) as a principal ingredient.

Invented in 1602, it belongs to the category of formulas that promote Qi movement. Its main actions are: 1) disperses Stagnant Liver Qi and Blood and 2) alleviates pain.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Chai Hu Shu Gan San is used by TCM practitioners to fight patterns like Rebellious Qi, Liver Blood Stagnation or Heart Vessel obstructed. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as late menstruation, hepatitis or chronic gastritis for instance.

On this page, after a detailed description of each of the seven ingredients in Chai Hu Shu Gan San, we review the patterns and conditions that Chai Hu Shu Gan San helps treat.

The seven ingredients in Chai Hu Shu Gan San

Chai Hu is a king ingredient in Chai Hu Shu Gan San. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Bupleurum Roots (Chai Hu)

Part used: Dried root and rhizome

Nature: Cool

Taste(s): Bitter

Meridian affinity: GallbladderLiver

Category: Cool/Acrid herbs that release the Exterior

Chai Hu enters the Liver and Gallbladder meridians to facilitate the Liver's out thrusting functions by clearing Stagnation.

Learn more about Bupleurum Roots (Chai Hu)

Chuan Xiong is a deputy ingredient in Chai Hu Shu Gan San. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Szechuan Lovage Roots (Chuan Xiong)

Part used: Dried rhizome

Nature: Warm

Taste(s): Pungent

Meridian affinity: GallbladderLiverPericardium

Category: Herbs that invigorate the Blood

Chuan Xiong is a powerful herb that can enter the Qi and Blood aspects of the Liver to remove stagnation and stop pain.

Learn more about Szechuan Lovage Roots (Chuan Xiong)

Xiang Fu is a deputy ingredient in Chai Hu Shu Gan San. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

3. Coco-Grass Rhizomes (Xiang Fu)

Part used: Dried rhizome

Nature: Neutral

Taste(s): BitterPungentSweet

Meridian affinity: SpleenLiverSanjiao

Category: Herbs that regulate Qi

In general Xiang Fu's main actions are as follows: "Unblocks Stagnant Liver Qi and relieves pain. Regulates the Liver and Spleen. Assists the regulation of menses and relieves pain."

In the context of Chai Hu Shu Gan San, it is used because it enters the Liver meridian to regulate its Qi.

Learn more about Coco-Grass Rhizomes (Xiang Fu)

Bai Shao is an assistant ingredient in Chai Hu Shu Gan San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. White Peony Roots (Bai Shao)

Part used: Dried root

Nature: Neutral

Taste(s): BitterSour

Meridian affinity: SpleenLiver

Category: Tonic herbs for Blood Deficiency

Bai Shao acts to nourish the Blood, together with Liquorice another assistant. This softens the Liver (which, according to Chinese medicine, stores the Blood) which helps stop the pain.

Learn more about White Peony Roots (Bai Shao)

Ju He is an assistant ingredient in Chai Hu Shu Gan San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

5. Bitter Orange Seeds (Ju He)

Part used: Dried ripe seeds

Nature: Neutral

Taste(s): Bitter

Meridian affinity: KidneyLiver

Category: Herbs that regulate Qi

Ju He works together with Tangerine peel, another assistant, to regulate the Qi of the Stomach and the Intestines. Also they together direct Qi downward to help remove the excess buildup of it in the chest and th Middle Burner (what creates the symptoms of distention and a sensation of fullness).

Learn more about Bitter Orange Seeds (Ju He)

Chen Pi is an assistant ingredient in Chai Hu Shu Gan San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

6. Tangerine Peel (Chen Pi)

Part used: Dried pericarp of the ripe fruit

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: SpleenLung

Category: Herbs that regulate Qi

Chen Pi works together with Bitter orange seeds , another assistant, to regulate the Qi of the Stomach and the Intestines. Also they together direct Qi downward to help remove the excess buildup of it in the chest and th Middle Burner (what creates the symptoms of distention and a sensation of fullness).

Learn more about Tangerine Peel (Chen Pi)

Gan Cao is an envoy ingredient in Chai Hu Shu Gan San. This means that it directs the formula towards certain area of the body and/or harmonizes the actions of other ingredients.

7. Liquorice (Gan Cao)

Part used: Dried root and rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenStomachHeartLung

Category: Tonic herbs for Qi Deficiency

In general Gan Cao's main actions are as follows: "Tonifies the Basal Qi and nourishes the Spleen Qi. Clears Heat and dispels toxicity. Moistens the Lungsexpel phlegm and stop coughing. Relieves spasms and alleviates pain. Harmonizes and moderates the effects of other herbs."

In the context of Chai Hu Shu Gan San, it is used because it is used as an envoy to harmonize the various actions of the other herbs.

Learn more about Liquorice (Gan Cao)

Conditions and patterns for which Chai Hu Shu Gan San may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Chai Hu Shu Gan San is used by TCM practitioners to treat nine different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Late menstruation Hepatitis Chronic gastritis Chronic cholecystitis Peptic ulcers Intercostal neuralgia

Again it wouldn't be correct to say "Chai Hu Shu Gan San treats late menstruation" for instance. Rather, Chai Hu Shu Gan San is used to treat patterns that are sometimes the root cause behind late menstruation.

Now let's look at the nine patterns commonly treated with Chai Hu Shu Gan San.

Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine

Rebellious Qi

Pulse type(s): Wiry (Xian)

Tongue color: Normal (light red), Red sides

Symptoms: Nausea Asthma Belching Vomiting Coughing Diarrhea Insomnia Hiccuping Headaches Restlnessness

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Rebellious Qi. This pattern leads to symptoms such as hiccuping, belching, nausea and vomiting. Patients with Rebellious Qi typically exhibit wiry (Xian) pulses as well as a normal (light red), red sides tongue.

Rebellious Qi is an Excess/Full condition and it is another form of Qi Stagnation. In this case, Qi flows in the wrong direction from the normal physiological one for a given Organ or Channel. 

The Organs whose Qi should descend are Stomach, Lungs, Heart, Small Intestine, Large Intestine, Kidneys... read more about Rebellious Qi

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Blood Stagnation

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Liver Blood Stagnation. This pattern leads to symptoms such as hypochondrial pain, abdominal pain, vomiting of blood and epistaxis. Patients with Liver Blood Stagnation typically exhibit wiry (Xian) pulses as well as Purple tongue or purple spots on sides. .

Liver Blood Stagnation usually develops from other patterns and Liver Qi Stagnation, Cold and Heat are the three most common ones. Sometimes Qi Deficiency, Blood Deficiency and Phlegm can also be the precursors. 

Liver Qi Stagnation is the most common cause. If left unchecked for a while without... read more about Liver Blood Stagnation

The Heart is a so-called "Zang" Organ. Learn more about the Heart in Chinese Medicine

Heart Vessel obstructed

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Heart Vessel obstructed. This pattern leads to symptoms such as palpitations, shortness of breath, depression and restlnessness. Patients with Heart Vessel obstructed typically exhibit choppy (Se), knotted (Jie), slippery (Hua) or wiry (Xian) pulses.

This is a complicated pattern as it is the combination of four other patterns and their features at the same time: Phlegm, Heart Blood Stagnation, Heart Qi Stagnation,  and Cold.  

If Phlegm is the dominant one out of the above four patterns, the pulse is rather Slippery instead of Wiry, Choppy or... read more about Heart Vessel obstructed

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Rebellious Liver Qi

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Rebellious Liver Qi. This pattern leads to symptoms such as hypochondrial distention, epigastric distension, hiccuping and frequent sighing. Patients with Rebellious Liver Qi typically exhibit wiry (Xian) pulses.

Most Organs' normal physiological Qi goes in one direction (up or down) and their pathological Qi normally goes toward the opposite direction. 

The Liver is an exceptional one as its Qi goes in all directions, especially upwards. It is because it's responsible for ensuring the smooth flow of Qi... read more about Rebellious Liver Qi

The Small Intestine is a so-called "Fu" Organ. Learn more about the Small Intestine in Chinese Medicine

Small Intestine Qi Pain

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Small Intestine Qi Pain. This pattern leads to symptoms such as lower abdominal twisting pain, abdominal distension, dislike of pressure on the abdomen and borborygmi. Patients with Small Intestine Qi Pain typically exhibit deep (Chen) or wiry (Xian) pulses.

The "Qi pain" involved in this pattern is due to Qi Stagnation in the Small Intestine.

It is usually associated with Liver Qi Stagnation invading the Spleen (giving rise to Spleen Qi Deficiency).

The symptoms, such as the twisting abdominal pain with distension, are due to Qi Stagnation preventing... read more about Small Intestine Qi Pain

The Large Intestine is a so-called "Fu" Organ. Learn more about the Large Intestine in Chinese Medicine

Large Intestine Qi Stagnation

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Large Intestine Qi Stagnation. This pattern leads to symptoms such as abdominal distension, abdominal pain, constipation and anxiety. Patients with Large Intestine Qi Stagnation typically exhibit wiry (Xian) pulses.

The main symptoms of Large Intestine Qi Stagnation are abdominal distension and pain, as Qi fails to circulate properly there. The bitty stools and irritability are also the typical manifestation. 

read more about Large Intestine Qi Stagnation

Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine

Qi And Blood Stagnation

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Qi And Blood Stagnation. This pattern leads to symptoms such as chest fullness, chest pain, boring fixed stabbing pain and dark face. Patients with Qi And Blood Stagnation typically exhibit choppy (Se), deep (Chen) or fine (Xi) pulses.

The typical symptoms of Qi stagnation are distension, oppression and swelling. There are also emotional issues like mood swing, depression or irritability. However, the Blood Stagnation is more on pains and purple color manifestation on skin, face, lips and nails. 

Qi Stagnation can cause the... read more about Qi And Blood Stagnation

The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine

Liver Qi Stagnation

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Liver Qi Stagnation. This pattern leads to symptoms such as hypochondriai distension, chest distension, epigastrium distension and abdomen distension. Patients with Liver Qi Stagnation typically exhibit wiry (Xian) pulses as well as Normal or slightly red on the sides.

When Liver Qi does not flow smoothly or regularly, it becomes Stagnant and in Excess. This leads to Heat accumulating in the Liver. This affects not only the Liver, but other connected Organs as well as the Seven Emotions.

Liver Qi Stagnation is not only the most seen Liver disharmony, but also one... read more about Liver Qi Stagnation

Qi is one of Chinese Medicine's vital subtances. Learn more about Qi in Chinese Medicine

Qi Stagnation

Chai Hu Shu Gan San is sometimes prescribed by TCM practitioners to treat Qi Stagnation. This pattern leads to symptoms such as feeling of distension, moving distending pain, depression and irritability. Patients with Qi Stagnation typically exhibit tight (Jin) or wiry (Xian) pulses as well as Normal or slightly dark on side with white or yellow coating.

If the flow of Qi is impeded in any way, it becomes stuck or stagnant. This can be likened to a traffic jam on the freeway. That's why, unlike in the cases of Qi Deficiency or Qi Sinking, tonification is contraindicated: it would be like adding more cars to the traffic jam. Instead, Qi moving or... read more about Qi Stagnation

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