In my practice one of the most useful formulas has been chai hu long gu mu li tang. This formula, although very practically applied today, was developed approximately 1800 years ago. Typical modern applications include helping people get off drugs, alcohol and/or smoking; panic attacks; irritability; palpitations; epilepsy; gastritis; headaches (including migraines); insomnia; acid regurgitation; and hypertension. Typically it is administered for clients who have a wiry, rapid pulse, with a red tongue. Clients may also report a sensation of heaviness. In ancient times, this formula was used for diseases caused by cold with symptoms of fullness of chest; delirium; irritability; dysuria; heaviness of the extremities; and general malaise. Below is a discussion of the formula's constituents.
Bupleurum (chai hu) promotes healthy liver function. It is one of the most important ingredients in Japanese herbal medicine, where it is recommended for liver conditions such as chronic hepatitis, as well as nephrotic syndrome and autoimmune diseases. An important (though overlooked) usage of this herb is to "raise the qi." Thus, it is combined with other herbs for hemorrhoids, anal or uterine prolapse. It may be combined with herbs such as astragalus (huang qi) and cimicifuga (sheng ma) for chronic fatigue. Laboratory research has demonstrated liver restorative, fever reducing, sedative and anti-inflammatory effects. Classically, bupleurum is combined with other herbs for shao yang syndrome, which is characterized by alternating chills and fever; fullness of the chest and ribcage area; bitter taste in the mouth; nausea; and wiry or tight pulse.
Cinnamon twig (gui zhi) is a pain-relieving ingredient said to promote the flow of yang qi. Scute (huang qin) is a heat-clearing herb, which possesses antibacterial effects. Rhubarb (da huang) has the property of relieving constipation and directing perverse energy downward, making chai hu long gu mu li effective for palpitations and headaches. It also possesses antibacterial, antifungal and antiviral effects. The special ingredients dragonbone (long gu), which is fossilized bone, and oyster shell (mu li), have sedative properties. Because of the mineral content, these formulas tend, over time, to weaken the digestive system. Ginseng (ren shen) and poria (fu ling) are included in this formula to strengthen digestive functions. Ginseng has the added ability to improve the detoxification process. According to laboratory experiments, it increases the activity of alcohol dehydrogenase and aldehyde dehydrogenase. Experiments in humans and animals have demonstrated radio protective, improved resistance to disease, and anti-stress effects. The remaining herbs also support digestive functions.
Case Reports
Case 1: Dan, a 45-year old computer programmer, had frequent headaches and weekly migraines. He initially sought consultation, as he was very stressed out and wanted to reduce his nightly drinking. Dan's pulse was wiry, and his tongue was red and dry. We recommended three tablets of chai hu long gu mu li TID, along with a stress reduction and exercise program, and plenty of water. After one week, Dan saw a reduction in his headaches and said he felt calmer. His pulse and tongue were unchanged.
At this point, we decided to add a formula containing magnesium aspartate, taurine, enzymes, biota (bai zi ren), peony (bai shao), tang kuei (dang gui), fu shen (fu shen), polygala (yuan zhi), zizyphus (suan zao ren), ophiopogon (mai men dong), codonopsis (dang shen) and succinum (hu po) to nourish yin and increase the calming effects of chai hu long gu mu li. Thus, his new dosage was two tablets of each formula QID. After three weeks, Dan was delighted with the results he had achieved. His headaches and drinking were reduced 80 percent. His pulse was less wiry, and his tongue was less dry. Dan stayed on the herbal formulas for another month, then used them only on an as needed basis.
Case 2: Al was a 39-year old chemical engineer whose complaints included constant headaches, low back pain and sciatic pain. He was also very stressed, as had a full time job and also attended college at night. Al believed he may have been chemically exposed at work, although Western tests were inconclusive. Al's pulse was fast and his tongue was pale. I recommended two tablets TID of chai hu long gu mu li and two tablets TID of an astragalus formula containing astragalus root and seed (huang qi and sha yuan ji zi), ligustrum (nu zhen zi), ho-shou-wu (he shou wu), lycium fruit (gou qi zi), rehmannia (shu di huang), eucommia (du zhong), cuscuta (tu si zi), ginseng, tang kuei and cornus (shan zhu yu). After two weeks, Al reported a reduction in headaches; however, he felt hot. His pulse and tongue were unchanged.
At this point I recommended that he continue with chai hu long gu mu li, and we substituted two tablets TID of a formula containing rehmannia (shu di huang & sheng di huang), dioscorea (shan yao), poria, cornus, moutan (mu dan pi), alisma (ze xie), dendrobium (shi hu), scrophularia (xuan shen) and ophiopogon for the astragalus formula. This substitute formula consists of yin tonics which have a cooling function, whereas the astragalus formula is a balanced tonic. We also counseled Al to drink more water and eat more vegetables, which have cooling functions. After three weeks on the new protocol, Al's headaches were 90% improved, and he didn't feel as hot.
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