Skip to content

Bupleurum Spread the Liver

柴胡疏肝散 · chái hú shū gān sǎn

For rib-side pain, deep sighs, and irritability when Liver qi is constrained

What it's for

The Liver, in TCM, is responsible for the free, outward movement of qi, your body's vital energy, through the channels it traverses. When that movement is constrained, often by emotional stress or situations where one cannot speak freely, qi stagnates in the flank and rib-side areas the Liver channel crosses, producing a characteristic pain that tightens with frustration and loosens with movement or expression. This formula, composed in the Ming dynasty, treats the pattern directly: bupleurum opens Liver constraint, cyperus and chuanxiong move qi and blood together in the Liver channel, and the citrus herbs (tangerine peel, bitter orange fruit) vent the stagnant qi downward before it rises into the chest. White peony and licorice root soften the Liver, nourish the blood, and balance the formula's otherwise drying nature.

Signs this formula is a fit

At least 2 of the 3 main signs below should sound like you. The emotional connection to the pain is the most characteristic signal.

Main signs

  • Pain or tightness along the ribs and flanks

    hypochondriac discomfort that comes and goes, especially under emotional stress

  • Frequent sighing, chest tightness, or a stifling sensation

    feeling of something held in the chest that you want to release with a deep breath

  • Irritability or frustration that builds when you cannot speak your mind

    emotions that feel physically stuck rather than just mental

Extra signs

  • Belching or bloating that moves and shifts
  • Abdominal distention and fullness
  • Alternating feelings of heat and cold
  • Wiry pulse
  • Symptoms that improve with activity or emotional release and worsen with stress

Signs it isn't

  • Your flank pain is constant, heavy, and not tied to emotional state or stress
  • You have significant yin deficiency: dry mouth, night sweats, hot palms and soles
  • Your signs point to qi deficiency: fatigue, loose stools, pale tongue, no stagnation signs

What's in it

Safety

  • Aromatic, acrid, and drying. Not for long-term continuous use; injures qi and yin over time.
  • Contraindicated during pregnancy. The Plum Flower label states this outright.
  • Chuanxiong is the herb behind that: it is not for use in pregnancy without practitioner supervision.
  • Chuanxiong also calls for caution if your periods are unusually heavy.
  • Contains licorice. Avoid with high blood pressure, edema, low potassium, or heart, liver, or kidney disease.
  • The Plum Flower teapill contains wheat, since the bitter orange fruit is bran-fried.
  • Contraindicated where Liver qi stagnation pain is rooted in qi or yin deficiency.
  • Not appropriate when tongue is peeled or coating is absent, indicating depleted yin.
  • Licorice root in large doses can interact with blood pressure medications, digoxin, and diuretics.
  • Bitter orange fruit can affect how the liver clears some drugs, much like grapefruit does.

How to take it

What to get

Plum Flower Bupleurum Shu Gan Teapills, 200 ct

Bupleurum Shu Gan Teapills

Plum Flower200 ct

Not yet available through Amazon.

A practitioner may be able to source it directly. Find a practitioner

Dose

Take 8 pills, 3 times a day. Other brands and forms use different doses, so follow the label on what you buy.

How long

Follow any time limit on the product label. If it gives none, ask a qualified TCM practitioner when to reassess. Do not keep taking it unchanged if nothing improves.