After reading numerous Hu Xi Shu case studies over the last few years, I have come to realize that he had a special affinity to the use of Da Chai Hu Tang and utilized this great formula in combination with other medicinals and/or formulas to treat a vast array of medical conditions.  His unique way of using this formula have been mentioned in previous posts, and I would like to offer yet another of his innovative cases.

A 48 year old male presented at the clinic on August 12, 1964 complaining of feeling flustered and unwell for over six months. He was treated at a previous hospital with various qi supplementing, blood nourishing formulas consisting of modified versions of Zhi Gan Cao Tang, Bai Zi Yang Xin Tang, and Tian Wang Bu Xin Dan. None of these treatments were effective and in addition he started feeling warm and had trouble sleeping. An Electrocardiogram revealed atrioventricular blockage and cardiac muscle strain.

Current symptoms: Flustered feeling, insomnia, poor food intake, epigastric pain, dull pain in the region of the heart, numbness in the hands and feet, a bitter taste in the mouth, yellow urination, dry stools, a greasy white tongue coating and a bound and intermittent pulse.
He was prescribed Da Chai Hu Tang with Gui Zhi Fu Ling Wan and Sheng Long (Gu) Mu (Li)

Chai Hu 4qian
Ban Xia 3qian
Huang Qin 3qian
Gui Zhi 3qian
Fu Ling 3qian
Bai Shao 3qian
Zhi Shi 3qian
Tao Ren 3qian
Hong Hua 2qian
Da Zao 4pcs
Sheng Jiang 3qian
Da Huang 2qian
Sheng Long Gu 5qian
Sheng Mu Li 5qian

Results: After taking 3 packages of the above formula the epigastric pain was alleviated, his appetite had improved, the numbness in the hands and feet were gone and sleep was improving. Hong Hua was removed from the formula and 3qian of Mu Dan Pi were added. After 6 packages, the chest pain had receded, his sleep was excellent, the flustered feeling was not as apparent and the pulse was normal.

Comments: Originally this patient presented as feeling flustered, with a poor appetite, numbness in the hands and feet and a bound and intermittent pulse. These symptoms can indicate a vacuous condition, which is why a modified version of Zhi Gan Cao Tang was originally administered. After taking the formula, the patient had a bitter taste in his mouth, yellow urination, dry stools, a dull pain in the area of the heart, etc. These symptoms belong to a Shao-Yang Yang-Ming combination disease, therefore Da Chai Hu Tang with Gui Zhi Fu Ling Wan and Long Gu and Mu Li were administered. This formula is used to resolve both the Shao-Yang and Yang-Ming, quicken the blood, eliminate stasis and calm the spirit. Because the herbs were chosen according to the pattern, an extended period of treatment time was unnecessary.