Library

[Harm] Chai Hu (Bupleuri Radix) is acrid and warm in nature. Its qi moves freely but does not stay fixed. It is contraindicated for women with premature menstruation, those suffering from metrorrhagia due to deficiency, and postpartum dizziness caused by deficiency of Qi and Blood.

[Benefits] Chai Hu (Bupleuri Radix) is acrid, bitter, and warm. It enters the Pericardium Meridian of Hand-Jueyin, Lung Meridian of Hand-Taiyin, Spleen Meridian of Foot-Taiyin, and Liver Meridian of Foot-Jueyin. It can move Qi stagnation in Blood and Blood stagnation in Qi, regulate the menses, treat sudden upward rushing of Blood after childbirth, resolve accumulated Blood from traumatic injuries, treat hernia and relax sinews, relieve various pains throughout the body, stop intestinal pain and heart pain. It is a herb that invigorates Blood and promotes the movement of Qi.

[Processing and Collection] The roots are dug up at the Start of Summer. Currently, they are mostly produced in Jianqiao, Zhejiang. The roots resemble Ban Xia (Pinelliae Rhizoma), are yellow in color and hard in texture. Those produced in Dongyang have small granules. Raw use breaks Blood; stir-fried use regulates Blood; wine-stir-fried use promotes Blood circulation; vinegar-stir-fried use stops bleeding.

[Harm] Chai Hu (Bupleuri Radix) belongs to Yin. It is appropriate only when Yin Qi is not free-flowing, causing Yang Qi to be unable to reach its destination. If Yin fluid is already deficient, and Yang Qi is losing its anchor and attempting to escape, using ascending and dispersing herbs like Chai Hu (Bupleuri Radix) will hasten death. Therefore, it is contraindicated for conditions involving the collapse of Yuan Qi (Original Qi), deficiency patterns, and upward reversal of Qi. It is also contraindicated for vomiting, fever due to Yin deficiency, blazing Fire rising upward, and chills and fever not caused by Blood stasis and Qi obstruction. Misusing this herb in such cases is as dangerous as consuming arsenic or poison. Do not use Chai Hu (Bupleuri Radix) for malaria that does not belong to the Shaoyang Meridian. The belief that Chai Hu (Bupleuri Radix) must be used to treat malaria is a misunderstanding of the classics. Chai Hu (Bupleuri Radix) is antagonistic to Zao Jiao (Gleditsiae Fructus Spina) and fears Nu Wan (Stemonae Radix) and Li Lu (Veratri Radix).

[Benefits] Chai Hu (Bupleuri Radix) is bitter and slightly cold. It enters the Liver, Gallbladder, Sanjiao (Triple Burner), and Pericardium meridians. As a exterior-releasing herb for the Shaoyang stage, it treats malaria by releasing the exterior, harmonizing the interior, and reducing fever. It primarily guides Clear Yang upwards; resolves depression, regulates menstruation, and unblocks Qi and Blood; and treats sinking of Yang Qi. For treating Liver Qi stagnation in the Upper Jiao, Qian Hu (Peucedani Radix) and Ban Xia (Pinelliae Rhizoma) serve as guiding herbs. For acting on the Sanjiao and Gallbladder meridians, Huang Qin (Scutellariae Radix) serves as an assistant herb. For acting on the Pericardium and Liver meridians, Huang Lian (Coptidis Rhizoma) serves as an assistant herb.

[Processing and Collection] Harvest in February and August. Remove the rhizome head and rootlets. Use a copper knife to peel off a small amount of the reddish thin skin. Wipe clean with coarse cloth and slice. Do not expose to fire, as this will immediately render it ineffective. Wine-processing enhances its ascending action; honey-processing moderates its properties. There are two types of Chai Hu (Bupleuri Radix): those that are white-yellow and large are called Yin Hu (Silver Bupleurum), used for labor-related malaria, bone-steaming fever, consumptive disease, and infantile malnutrition fever; those that are slightly black are used for releasing the exterior and dispersing pathogens. The *Shennong Bencao Jing* did not distinguish between them, but stated that Chai Hu (Bupleuri Radix) from Yinzhou is superior, indicating its strength lies in ascending and dispersing, rather than clearing deficiency heat. This is detailed in *Bencao Yan Yi* (Extension of Materia Medica), so I list and differentiate them here.

[Appendix 1]
Li Zhongzi said: Chai Hu (Bupleuri Radix) is a herb for the half-exterior, half-interior stage of the Shaoyang Meridian. If the disease is in the Taiyang Meridian, taking it too early will lead the pathogen into the interior. If the disease is in the Yin meridians, using Chai Hu (Bupleuri Radix) will severely damage the exterior Zheng Qi (Upright Qi). Laypeople do not understand the use of Chai Hu (Bupleuri Radix). Whenever the transmission of Cold Damage is unclear, they assume Chai Hu Tang (Bupleurum Decoction) neither induces sweating, nor causes vomiting, nor purges, allowing them to hide their ignorance. They mix it indiscriminately, killing countless people. Chai Hu (Bupleuri Radix) should only be used for consumptive diseases located in the Liver Meridian. For Qi deficiency, it is used only in small amounts to assist Ren Shen (Ginseng Radix et Rhizoma), not to reduce fever. Using Chai Hu (Bupleuri Radix) for any consumptive disease invites death. This single herb has caused immense harm; I list it here as a warning.

[Appendix 2]
On the Contraindication of Chai Hu (Bupleuri Radix) in Warm Diseases (Written by Ding Shouchang of Shanyang): Warm diseases occur in all seasons but are most severe in Spring. The Classics state: "Cold injured in Winter leads to Warm Disease in Spring." Cold contracted in Winter that manifests immediately is Cold Damage (Shang Han); if it does not manifest immediately but lingers in the meridians and transforms into Heat by Spring, it becomes a Warm Disease (Wen Bing). Cold Damage is injury by Cold (Yin injuring Yang), requiring assistance to Yang with Acrid-Warm herbs. Warm Disease is injury by Warmth (Yang injuring Yin), requiring preservation of Yin with Sweet-Cold herbs. In the early stage of Warm Disease, or if accompanied by external Wind-Cold, herbs like Jing Jie (Schizonepetae Herba), Fang Feng (Saposhnikoviae Radix), Bo He (Menthae Haplocalycis Herba), and Xing Ren (Armeniacae Semen Amarum) may be used sparingly, combined with Sweet-Cold herbs to clear Heat and nourish Yin. If external symptoms are mild but fever persists, or if the pulse is surging and thirst is present at onset, it is a Warm Disease, not Cold Damage. All Acrid-Warm exterior-releasing herbs are contraindicated. Mild cases use Sang Ju Yin (Mulberry Leaf and Chrysanthemum Decoction); severe cases use Yin Qiao San (Honeysuckle and Forsythia Powder); Warm Disease with macules and papules uses Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction); thirst, surging pulse, high fever worsening daily uses Bai Hu Tang (White Tiger Decoction), adding Ren Shen (Ginseng Radix et Rhizoma) if the pulse is empty; tongue with prickles, deep pulse despite fever, coma and delirium, no bowel movement for six to seven days uses Da or Xiao Tiao Wei Cheng Qi Tang (Major or Minor Regulate the Stomach and Order the Qi Decoction). Use according to the patient's strength and the urgency of the disease. This is elaborated in Wu Jutong's *Wen Bing Tiao Bian* (Systematic Differentiation of Warm Diseases). Physicians who study this book and prescribe according to symptoms will avoid errors. *Wen Bing Tiao Bian* strongly warns against using Acrid-Warm exterior-releasing herbs for Warm Diseases, especially Chai Hu (Bupleuri Radix). Why? Chai Hu (Bupleuri Radix) enters the Foot Shaoyang Gallbladder Meridian and is an exterior-releasing, Yang-ascending agent. In early Warm Disease, the pathogen is in the Taiyang, but the root pathology is in the Yangming. Using Chai Hu (Bupleuri Radix) introduces the pathogen into the Shaoyang, which is termed "punishing the innocent." Furthermore, during Spring when Shaoyang governs, many suffer from Warm Disease. Warm Disease injures Yin; one should preserve Yin, but Chai Hu (Bupleuri Radix) ascends Shaoyang Qi, further aiding Yang. Rising Yang Fire dries up Yin Water. Thus, upon swallowing Chai Hu (Bupleuri Radix), profuse sweating and coma ensue, becoming incurable. Sweat is Yin fluid. Sweating can cause loss of Yang or loss of Yin. Forcing sweat when none exists damages and depletes Yin. Using Chai Hu (Bupleuri Radix) in Warm Disease kills swiftly. I witnessed this with sorrow and wrote this treatise to warn others. May practitioners correct their mistakes. Show compassion: using one less dose of Chai Hu (Bupleuri Radix) saves one life. Even if exterior release is necessary, there are many herbs other than Chai Hu (Bupleuri Radix). Treat with Acrid-Cool herbs assisted by Sweet-Cold herbs to avoid damaging Yin and causing complications. Patients' families should also be cautious. Discarding Chai Hu (Bupleuri Radix) and heavy Acrid-Warm exterior-releasing formulas is a way to ensure survival.

[Appendix 3]
Case Note: Side effects of Chai Hu (Bupleuri Radix) and toxicity associated with different varieties have been reported frequently in recent years. For example, *Coal Mine Medicine* (3-4) p.25, 1980, reports allergic reactions to Chai Hu (Bupleuri Radix) injection. *Chinese Journal of Internal Medicine* (8/12) p.130, 1979, includes adverse drug reactions to Chai Hu (Bupleuri Radix) injection in a comprehensive report. Additionally, *Heilongjiang Medicine* 15:48, 1978, mentions that Da Ye Chai Hu (Bupleuri Radix Macrophyllum) is toxic and has caused deaths. The Heilongjiang Institute of Traditional Chinese Medicine investigated the toxicity of Da Ye Chai Hu (Bupleuri Radix Macrophyllum), recording three deaths from severe poisoning. This is appended here to draw attention from relevant authorities.