Bupleurum and Bitter Orange Decoction

Sihojigak-tang

한글 시호지각탕 · Pinyin Chai Hu Zhi Ke Tang

柴胡枳殼湯

Composition 構成

Daecheong Da Qing
大靑 대청 · Woad Leaf

6 g
Chief 君
Saengjihwang Sheng Di Huang
生地黃 생지황 · Raw Rehmannia

6 g
Chief 君
Seokgo Shi Gao
石膏 석고 · Gypsum

6 g
Chief 君
Siho Chai Hu
柴胡 시호 · Bupleurum

4 g
Deputy 臣
Hwanggeum Huang Qin
黃芩 황금 · Scutellaria

2 g
Deputy 臣
Chija Zhi Zi
梔子 치자 · Gardenia

2 g
Deputy 臣
Jimo Zhi Mu
知母 지모 · Anemarrhena

2 g
Deputy 臣
Maengmundong Mai Men Dong
麥門冬 맥문동 · Liriope

2 g
Deputy 臣
Galgeun Ge Gen
葛根 갈근 · Kudzu Root

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

2 g
Assistant 佐
Seungma Sheng Ma
升麻 승마 · Cimicifuga

1.6 g
Envoy 使
Gamcho Gan Cao
甘草 감초 · Licorice

0.8 g
Envoy 使

Total 36.4 g per packet (첩) · representative dosage — verify against source texts.

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

Clears heat and cools the blood in a pregnant patient
Resolves constipation and delirium without harming the fetus

Indications 主治

Pattern-based

Cold damage in pregnancy with fever
dry mouth
abdominal fullness
constipation and delirium
Heat in the blood with macules erupting

Biomedical correlates

Febrile illness in pregnancy
Sepsis with rash in pregnancy

Source text 原文

Donguibogam 東醫寶鑑

治孕婦傷寒, 發熱ㆍ口乾ㆍ腹滿ㆍ便閉ㆍ譫語, 或發癍. 大靑<span class='sochu'>無則代以藍葉</span>ㆍ生地黃ㆍ石膏各一錢半, 柴胡一錢, 枳殼ㆍ黃芩ㆍ梔子ㆍ知母ㆍ麥門冬ㆍ乾葛各五分, 升麻四分, 甘草二分. 右剉, 水煎服. 《入門》

Translation

Treats cold damage in a pregnant woman with fever, dry mouth, abdominal fullness, constipation and delirium, or with macules erupting. Isatis leaf <span class='sochu'>where unavailable, substitute indigo leaf</span>, fresh rehmannia and gypsum, 1 don 5 fun each; bupleurum, 1 don; bitter orange, scutellaria, gardenia, anemarrhena, ophiopogon and pueraria, 5 fun each; cimicifuga, 4 fun; licorice, 2 fun. Cut up and decoct in water. — Immun 入門 (Donguibogam · Han, lower)

Clinical commentary 臨床

Fever in pregnancy with constipation and delirium would ordinarily call for a purgative, and this formula is built around not using one. Gypsum, isatis leaf and fresh rehmannia clear and cool at the top of the dose range; bitter orange at 5 fun is the only drug addressing the bowel, and it moves qi rather than purging. The rest cools, moistens and vents. Macules erupting is the sign that the heat has reached the blood, which is where isatis earns its chief's place — it is the classical drug for a febrile rash. The substitution note for indigo leaf is the kind of practical provision that makes the Bogam usable far from a well-stocked pharmacy. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.