Chaihu Qinggan Tang from Waike Zhengzong for Lymphadenopathy

Chaihu Qinggan Tang (Bupleurum Liver-Clearing Decoction) comes from the Ming-dynasty physician Chen Shigong's work Waike Zhengzong (Orthodox Manual of External Diseases). Its ingredients are Sichuan lovage (Chuanxiong), dong quai (Danggui), white peony (Baishao), raw rehmannia (Shengdihuang), bupleurum (Chaihu), scutellaria (Huangqin), gardenia (Zhizi), trichosanthes root (Tianhuafen), saposhnikovia (Fangfeng), burdock seed (Niubangzi), forsythia (Lianqiao), and licorice (Gancao), each 1 qian (3 g); the method is to decoct in water for oral use.

This formula has the actions of dispersing wind and activating blood, and dissipating nodules and dispersing swelling. It is used for early-stage, not-yet-pustular conditions such as temporal abscess and hypochondriac abscess caused by wind-heat in the liver, gallbladder, and sanjiao, presenting with local redness, swelling, heat, and pain; bitter mouth and hypochondriac pain; dizziness and vertigo; a red tongue with thin yellow coating; and a wiry, rapid pulse.

It is now commonly used for conditions such as pharyngitis, chronic tonsillitis, and cervical lymphadenitis that present the pattern of wind-heat in the liver, gallbladder, and sanjiao. This formula has hepatoprotective, cholagogic, antibacterial, antipyretic, anti-inflammatory, and antitumor effects.

This formula can serve as one of the base formulas for treating lymphoma. If a lymphoma patient presents with redness, swelling, heat, and pain, bitter mouth and hypochondriac pain, dizziness and vertigo, a red tongue with thin yellow coating, and a wiry, rapid pulse, one may take this formula as the base, raise each medicine's dose to 10 g, additionally add burreed (Sanleng) 10 g and curcuma zedoaria (Ezhu) 10 g, and add 10-30 g each of hairy vein agrimony (Xianhecao), Oldenlandia diffusa (Baihua Shebancao), dandelion (Pugongying), and selfheal (Xiakucao), which clear heat, resolve toxin, fight cancer, and disperse swelling. This is combined with antitumor proprietary medicines such as Xiaojin Wan and Xihuang Wan. If the patient has other symptoms, such as dizziness and vertigo, add uncaria (Gouteng) and Gastrodia (Tianma).

This formula is composed of Siwu Tang combined with half of Xiaochaihu Tang, and then augmented with wind-heat-dispersing, swelling-dispersing, and nodule-dissolving herbs such as Fangfeng, Niubangzi, and Lianqiao. So the formula's rationale is to nourish and activate blood, harmonize the shaoyang, disperse wind and heat, and dissipate nodules and swelling. TCM holds that lymphadenopathy is a shaoyang pattern, so the Chaihu Tang approach is needed. Since a formed mass or nodule has appeared, there is a problem of blood stasis, so one should combine the approach of activating blood and resolving stasis. Hence this formula is built on the combination of Xiaochaihu Tang and Siwu Tang.

Both forsythia and burdock seed are Chinese medicinals that both disperse wind-heat and dispel abscess and dissipate nodules; these two are also commonly used antitumor medicinals. But using this formula alone to fight cancer has limited effect; when we use it to build a tumor treatment, we must increase its force.