Chaihu Bieji Decoction: Treating Consumptive Night Sweats and Persistent Cough

Chaihu Bieji Decoction (Bupleurum and Turtle Shell Decoction) is recorded in the Shengji Zonglu (General Records of Divine Assistance). It is composed of Chaihu (Bupleurum Root) and Zhi Biejia (processed Turtle Shell), each 1 liang (30 g); Digupi (Lycium Root-bark) 1.5 liang (45 g); and Zhimu (Anemarrhena Rhizome, dry-fried) 1 liang (30 g). Preparation: pound the above herbs together into a coarse powder. Each time use 3 qian (9 g), add about 150 ml of water, half a Wumei (smoked Plum) and a small amount of Qinghao (Sweet Wormwood), decoct together to about 90 ml, strain, and take warm after meals and before bedtime.

This formula has the action of nourishing yin and clearing heat. It is indicated for consumptive disease with frequent night sweats at night, sallow withered complexion, weakness of the limbs, lack of appetite, and persistent cough. This formula is somewhat similar to Qinghao Bieji Decoction (composed of Qinghao, Biejia, Zhimu, Mudanpi and Shengdi), and both have the main action of nourishing yin and clearing heat. However, Qinghao Bieji Decoction addresses the pattern of pathogenic evil latent in the yin aspect, characterized by fever at night with coolness in the morning, fever resolving without sweating, a red tongue with little coating. The present formula instead addresses the pattern of internal heat from yin deficiency marked by consumptive night sweats, persistent cough, sallow complexion, weakness of the limbs and poor appetite; this condition is often caused by diseases such as pulmonary tuberculosis and lymph node tuberculosis.

This formula replaces Mudanpi (Moutan Bark) and Shengdi (Rehmannia Root) in the Biejia Qinghao Tang with Chaihu and Digupi. Chaihu is an exterior-releasing medicinal with the action of dispersing and dissipating heat; it is one of the commonly used herbs in TCM for treating febrile diseases. Digupi, according to traditional TCM theory, has the actions of cooling blood, steaming away bone-steaming heat, and clearing lung fire. Biejia and Zhimu are both yin-nourishing, heat-clearing herbs; Qinghao, similar to Digupi, has the action of clearing heat and dissipating steaming heat. When these herbs are combined, the formula both releases the exterior to reduce fever and clears heat to dissipate steaming heat. Thus this prescription has a certain antipyretic effect and can be used for low fever, profuse sweating and cough caused by tuberculosis; it may also be used when cancer patients (such as lymphoma patients) present with the above symptoms.