Minor and Major Bupleurum Decoction: Famous Formulas for Cancer Fever and Common Fever in Cancer Patients
Minor Bupleurum Decoction (Xiao Chaihu Tang) and Major Bupleurum Decoction (Da Chaihu Tang) are two famous formulas from the Shanghan Lun (Treatise on Cold Damage) by the Eastern Han dynasty physician Zhang Zhongjing. When some cancer patients develop cancer fever, Minor or Major Bupleurum Decoction may be selected for treatment according to the patient's condition.
The Bupleurum series of formulas mainly harmonizes and resolves the shaoyang; their sweating action is mild, so they are very safe to use. In practice, when a considerable number of patients develop cancer fever, Minor Bupleurum Decoction can resolve the problem.
Minor and Major Bupleurum Decoction are the most frequently used prescriptions in my own practice when treating cancer fever or fevers of various unknown causes in cancer patients.
As long as the patient's symptoms match the indications of a Bupleurum decoction, the results are excellent; often just one dose is enough to bring down the fever.
Among patent Chinese medicines, there are also granule preparations of Minor and Major Bupleurum Decoction that can be dissolved in water, but the effect is not as good as decocting the herbs oneself.
Minor Bupleurum Decoction prescription:
Chaihu (Bupleurum root) 24 g, Huangqin (Scutellaria root) 9 g, Renshen (ginseng) 9 g (generally used as raw sun-dried ginseng; may be replaced by Dangshen 15–30 g), Zhi Gancao (honey-fried licorice) 9 g, Banxia (Pinellia) 9 g, Shengjiang (fresh ginger) 9 g (sliced), Dazao (jujube) 4 pieces (broken apart).
Indications for Minor Bupleurum Decoction: In Zhang Zhongjing's Shanghan Lun, Minor Bupleurum Decoction treats shaoyang syndrome, wind-stroke in women, and heat entering the blood chamber (re xue shi). It resolves alternating chills and fever (chill and fever coming in turns), fullness and discomfort in the chest and hypochondria, depression with no desire to eat, vexation and frequent nausea, bitter taste in the mouth, dry throat, dizziness, and a thin white tongue coating. The pulse in such patients is often a wiry (xian) pulse.
Clinically, when cancer patients develop fevers of various unknown causes, regardless of the Western diagnosis, as long as one or several of the above symptoms are present, Minor Bupleurum Decoction may be used.
Many cancer-fever patients are not feverish all day long; generally they run a higher fever in the afternoon or evening, which is also the time of day when most people's temperature is highest.
Major Bupleurum Decoction prescription:
Chaihu (Bupleurum root) 24 g, Huangqin (Scutellaria root) 9 g, Shaoyao (peony root) 9 g, Banxia (Pinellia) 9 g, Zhishi (immature bitter orange) 9 g, Shengjiang (fresh ginger) 15 g (sliced), Dazao (jujube) 4 pieces (broken apart), Dahuang (rhubarb) 6 g (added later).
The fever-reducing principle of Major Bupleurum Decoction is basically similar to that of Minor Bupleurum Decoction, but when using Major Bupleurum Decoction the patient must have constipation and abdominal fullness. On abdominal examination, one must find the abdomen full and hard, with fullness and hardness around the navel, before using Major Bupleurum Decoction; otherwise it is extremely easy to cause diarrhea and bring about the disaster of further damaging a deficient state.
In addition, Minor and Major Bupleurum Decoctions are among the decoctions commonly used in TCM to treat various cancers. When a cancer patient presents with one or more of the Bupleurum-decoction indications, the physician may adjust the dosage, add corresponding anti-cancer Chinese herbs, or combine the formula with other prescriptions to form an anti-cancer TCM formula, which can also achieve good results.
In treating liver cancer and intestinal cancer, I often use modified Minor Bupleurum Decoction. In treating various other cancers, I often incorporate the chief medicinal Chaihu and the deputy medicinal Huangqin into the prescription, also taking the idea of Minor Bupleurum Decoction harmonizing and resolving shaoyang. This is a bit of experience I learned from a late, highly effective anti-cancer TCM physician in Beijing.
When the anti-cancer formula includes the two herbs Chaihu and Huangqin, cancer patients who take it long-term generally do not develop cancer fever and other cancer complications. Thus combining Chaihu and Huangqin can prevent the occurrence of cancer fever.
Although the Bupleurum series formulas have a weak sweating action, patients often develop a slight sweat when taking them. When writing the prescription, the doctor should remind the patient that this may happen, so that the patient will not panic when sweating occurs.
Note: This is one of a series of articles I am writing on commonly used famous TCM formulas for handling common cancer symptoms. The rest of the series will be written over time. Each article is only suitable for some patients, not all patients. Please read this article with caution before using it as a basis for medication.