‘Bupleurum with Dragon Bone & Oyster Shell’
Source: Treatise on Febrile Diseases Caused by Cold (Shang Han Lun, 200)

Keywords
Mental or emotional disorders, stress, palpitations, insomnia

Ingredients
Bupleurum chinense (Chai Hu, bupleurum)
Pinellia ternata (Ban Xia, pinellia)
Scutellaria baicalensis (Huang Qin, scute)
Panax ginseng (Ren Shen, ginseng)
Zingiber officinalis (Sheng Jiang, ginger)
Cinnamomum cassia (Gui Zhi, cinnamon twigs)
Os Draconis (Long Gu, dragon bone)
Concha ostrea (Mu Li, oyster shell)
Poria cocos (Fu Ling, hoelen)
Rheum palmatum (Da Huang, rhubarb)
Zizyphus jujuba (Da Zao, Chinese dates)

Major therapeutic action
Clears fevers and calms the mind and mental restlessness, aids digestion and strengthens the digestive organs, harmonises the Liver and digestion, resolves mucus and sputum.

Indications
o  Disturbances of the mind in an otherwise robust or excess patient. This is a very popular and widely used formula for numerous problems associated  with symptoms such as yellow, sticky phlegm, red face, dry mouth and lips, restlessness (both physical and mental), a red tongue with a yellow sticky coating, and a rapid pulse.
o  Acute disorders of the abdomen and thorax with such symptoms as: fullness in the chest, irritability, palpitations, urinary difficulty, constipation, and difficulty in rotating the trunk. The traditional aetiology of this pattern is associated with inappropriate herbal prescription given during a cold, which pushes the pathogen deeper into the body.
o  Used to alleviate the withdrawal symptoms when giving up tobacco or other drugs of addiction.
o  With the appropriate key symptoms, this formula can be used to treat biomedical conditions such as neurosis, agitation, mania, delusional states, drug withdrawal, phobias, stress disorders, arrhythmias, first or second degree AV block, tachycardia, hyperthyroidism, depression, hypertension, epilepsy, post traumatic
stress disorder and Attention Deficit Hyperactivity Disorder (ADHD).

Key symptoms for use
o  irritability, short-tempered, tendency to fly off the handle
o  insomnia, racing mind at night, waking between 1-3 A.M.
o  palpitations
o  fullness in the chest (often described as ‘difficulty getting a full breath’)
o  tendency to constipation
o  red edges on the tongue, greasy yellow tongue coat
o  may be rapid pulse

Cautions and contraindications
Not suitable for deficiency states causing disturbances of the mind. Avoid concurrent use with stimulants like coffee, chilli and cola drinks.
Contraindicated during pregnancy.

Differentiation
Gui Pi Tang & Tian Wang Bu Xin Dan:  Both these formulas are widely used for disturbances of the mind,
in particular insomnia, anxiety states and palpitations, however, the associated pathology is one of deficiency with symptoms of malar flush, afternoon fevers, night sweats, and red dry tongue.