Augmented Bupleurum Decoction

Gamisiho-tang

한글 가미시호탕 · Pinyin Jia Wei Chai Hu Tang

加味柴胡湯

The leaf gives no indication of its own; the indication is in the body of the 瘴疫 section just above it, which prescribes this formula for the pestilence of the south that carries the steaming poison of mountain mists and valley springs. The source label 醫鍳 is given as 醫鑑.

Composition 構成

Siho Chai Hu
柴胡 시호 · Bupleurum

8 g
Chief 君
Hwanggeum Huang Qin
黃芩 황금 · Scutellaria

4 g
Deputy 臣
Banha Ban Xia
半夏 반하 · Pinellia

4 g
Deputy 臣

pinellia — toxic raw, must be properly processed
Insam Ren Shen
人蔘 인삼 · Ginseng

4 g
Deputy 臣
Jigak Zhi Qiao
枳殼 지각 · Bitter Orange

4 g
Assistant 佐
Daehwang Da Huang
大黃 대황 · Rhubarb

4 g
Assistant 佐
Gamcho Gan Cao
甘草 감초 · Licorice

4 g
Envoy 使
Saenggang Sheng Jiang
生薑 생강 · Fresh Ginger

—
Envoy 使

三片, three slices
Daejo Da Zao
大棗 대조 · Jujube

—
Envoy 使

二枚, two jujubes

Total g per packet (첩) · representative dosage — verify against source texts. Excludes 2 ingredients measured by count or used as a vehicle, shown as —.

Received this formula from your practitioner? Amounts shown here are classical reference values — granule and prepared products differ. Always follow your prescribed dosage and directions.

Actions 效能

Given for the miasmic pestilence of the south, where the heat rides in the upper burner
Opens the exterior with bupleurum while rhubarb and bitter orange peel move the interior downward

Indications 主治

Pattern-based

Miasmic pestilence (瘴疫) of the south, with the steaming poison of mountain mists and valley springs
Heat riding the upper burner, with daze and stupor as the illness comes on
Severe cases with agitation, wild talk, or muteness
Spoiled blood stagnant in the heart and poisonous drool gathered in the spleen

Biomedical correlates

Miasmic epidemic fever of the south, malaria among them
Febrile illness with delirium and stupor

Source text 原文

Donguibogam 東醫寶鑑

柴胡二錢, 黃芩ㆍ半夏ㆍ人參ㆍ枳殼ㆍ大黃ㆍ甘草各一錢. 右剉, 作一貼, 入薑三ㆍ棗二, 水煎服. 《醫鑑》

Translation

Bupleurum 2 don; scutellaria, pinellia, ginseng, bitter orange peel, rhubarb and licorice 1 don each. Cut the above up, make one packet, add three slices of ginger and two jujubes, decoct in water and take. — Uigam 醫鑑 (Donguibogam · On)

Clinical commentary 臨床

Minor Bupleurum Decoction with bitter orange peel and rhubarb added — which is to say Minor Bupleurum pushed most of the way toward Major Bupleurum, the ginger and jujube kept and the rhubarb held to a single don. Two don of bupleurum still leads it. The section explains the addition. Southern miasmic pestilence is described as a heat that rides up into the upper burner and brings on daze and stupor, and in bad cases agitation, raving or loss of speech, which the Uigam attributes to spoiled blood stagnant in the heart and poisonous drool gathered in the spleen. A formula built for that reading has to clear downward as well as harmonize the exterior, and the rhubarb and bitter orange peel are there for the drool and the stagnation. The fevers gathered under 瘴疫 include malaria, and that is the honest modern reading of a southern mountain fever with stupor, though the chapter name covers more than one illness. **Contains pinellia, which is toxic raw and must be properly processed before use.** — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.