BUPLEURUM & DANG GUI
Xiao Yao San

  

 ‘Free & Easy Wanderer Pills’
Source: Imperial Grace Formulary of the Tai Ping Era (Tai Ping Hui Min He Ji Ju Fang, 1080)

Keywords
gynaecological and gastrointestinal disorders with an emotional component

Ingredients
Bupleurum chinense (Chai Hu, bupleurum)
angelica sinensis (Dang Gui)
Paeonia alba (Bai Shao, white peony)
atractylodes macrocephala (Bai Zhu, atractylodes)
Poria cocos (Fu Ling, hoelen)
Glycyrrhiza uralensis (Gan Cao, liquorice)
Zingiber officinalis (Sheng Jiang, ginger)
Mentha arvensis (Bo He, mint)

Major therapeutic action
Softens the Liver and moves energy, nourishes the Blood and strengthens the digestion.

 Biomedical action
Regulates the hormones that influence the menstrual cycle, emmenagogue, relieves depression and emotional stress. Gynaecological: irregular menstruation, premenstrual syndrome.

Indications
*  This is the main formula for stress/emotional patterns with digestive disorders and mild anaemia. This mixed pattern is extremely common in women due to the nature of female physiology and the pathological
relationship between these symptoms.
*  Widely used for all menstrual disorders with a strong emotional component, and for the effects of stress on the body in general, and in particular on the gastrointestinal system.
*  With the appropriate key symptoms this formula can be used to treat disorders such as premenstrual syndrome, irregular menstruation, dysmenorrhoea, irritable bowel syndrome, chronic gastritis, peptic ulcers, anaemia, fibrocystic breast disease, neurasthenia, depression, tension headaches and migraines, chronic tension in the gastrointestinal system, and the early stages of liver cirrhosis.

Key symptoms for use
*  all symptoms worse with stress or emotional upset
*  Gynaecological: irregular menstruation, premenstrual syndrome, especially breast tenderness or lumps, premenstrual headaches
*  Gastrointestinal: abdominal bloating, alternating bowel habits, abdominal pain, hypochondriac pain
*  irritability, depression, mood swings, generally uptight
*  generalised muscle tightness, especially neck and upper back
*  pale edges on the tongue

Combinations
*  With heat causing facial flushing or sweats, add Shan Zhi Zi & Mu Dan Pi (Dan Zhi Xiao Yao San).
*  With breast tenderness or premenstrual lumpiness, add Qing Pi & Xiang Fu.
*  For fibrocystic breast disease, combine with Xiao Luo Wan.
*  With severe tiredness and dryness, or amenorrhoea, add Shu Di & He Shou Wu.
*  With stress headache, add Chuan Xiong.
*  With dysmenorrhoea, add Jin Ling Zi San. 		Dosage
The typical dose is three grams twice daily before meals. In severe cases or the early stages of treatment (the first two weeks), a 50-100% increase in dose may be used, then reduced as the treatment takes effect.

Cautions and contraindications
In some patients this formula can cause bloating and loose stools.
Contraindicated during the acute phase of colds and flu.

Differentiation
Si Ni San:  Stress or emotional issues in an otherwise robust patient with little or no underlying weakness or lethargy.
Dang Gui Shao Yao San:  Used for a similar pattern without the emotional components and with fluid accumulation with symptoms of premenstrual fluid retention, low backache.