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Theory of diseases treated with Major Bupleurum decoction

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Woodcut illustration from an edition of 1833 (13th year of Daoguang reign period of Qing dynasty). The image and text give an account of the principles of diseases treated with Major Bupleurum decoction (da chaihu tang), and the therapeutic effects of the individual ingredients of this remedy. Major Bupleurum decoction is used to treat combined syndromes of the shaoyang and yangming channels. These involve internal heat retention, violent and persistent vomiting, depression and general malaise. The conditions treated with Minor Bupleurum decoction (xiao chaihu tang) present mainly as yangming fu-organ excess syndrome (yangming fushizheng). This recipe contains thorowax (chaihu), Golden Thread (huanglian, Rhizoma Coptidis) and pinellia tuber (banxia) to harmonise heat in the shaoyang channel, fresh ginger to treat vomiting due to reflux of Qi; and a little rhubarb (dahuang), which purges the retained heat associated with fu-organ excess syndrome, and in conjunction with Chinese herbaceous peony (shaoyao) and trifoliate orange (zhishi), regulates the digestive tract. This is a classic prescription, which combines purgative and harmonising effects.

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Daying (Great Welcome) point; stomach; small intestine; large intestine; liver; gall bladder; exterior shaoyang symptoms. Where there is a bitter taste in the mouth, deafness, constant pain in the sides, persist in the use of the original Minor Bupleurum decoction (xiao chaihu tang). This image shows the [conditions treated with?] Major and Minor decoctions. Both display the somewhat firey complexion clearly indicative of a syndrome requiring purgation. It is unlike Minor Bupleurum decoction [syndrome] in that fire is retained in the lower part of the stomach cavity causing constipation. With trifoliate orange as an adjuvant, rhubarb purges this. The fire exerts pressure in the stomach, and mucus is expelled upwards. With trifoliate orange as an adjuvant, pinellia tuber brings this down.

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