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Major Bupleurum

大柴胡湯 · dà chái hú tāng

A strong harmonizing formula for relentless nausea, belly pain, and a bitter taste that won't clear.

What it's for

This is Minor Bupleurum's more powerful cousin, built for when you have both the lesser yang picture, a pattern where heat gets caught between your body's surface and its interior, and a second layer of heat that has settled into your digestive tract. You feel the combined picture: relentless nausea and vomiting, alternating chills and fever, a bitter taste that won't clear, and hard tight pain in your upper belly and under your ribs. Practitioners confirm the pattern before prescribing because rhubarb needs to be dosed precisely, and using it against a deficient gut drains what should not be touched.

Signs this formula is a fit

At least 2 of the 3 main signs below should sound like you. Relentless nausea paired with hard belly pain is the signal that locks this pattern in.

Main signs

  • Relentless nausea and vomiting

    heavy and continuous, not just a single wave after eating

  • Hard, tight pain in your upper belly and under your ribs

    feels blocked and pressurized; pressing on it makes it worse

  • Alternating chills and fever with a bitter taste

    feel hot then cold, and the mouth stays bitter even after drinking water

Extra signs

  • Burning diarrhea or constipation alongside the belly pain
  • Fullness and pressure across your chest and under the ribs on both sides
  • Irritability or low mood without a clear cause
  • Yellow coating on the tongue with a wiry, forceful pulse

Signs it isn't

  • Your digestion is weak with loose stools and low appetite, without heat or blockage signs
  • You feel exhausted and depleted rather than blocked and pressurized
  • Your illness is still at the surface with body aches and no internal cramping or vomiting
  • You are pregnant or breastfeeding

What's in it

Safety

  • Built for excess patterns in a robust constitution. Wrong choice if you feel weak, depleted, or run cold.
  • Contains Chinese rhubarb, which purges heat downward. Not for diarrhea from deficiency.
  • Do not take while pregnant. The Plum Flower label contraindicates it and cautions while nursing.
  • Rhubarb is the herb behind that, and it also calls for caution during menstruation.
  • Not for intestinal obstruction, unexplained belly pain, or inflammatory bowel conditions.
  • A short course only. Rhubarb is a stimulant laxative and is not for long-term use.
  • Stop taking it if you get diarrhea or watery stools. Cramping and nausea can also occur.
  • Contains prepared pinellia. Only the processed form is safe internally; buy from a reputable maker.
  • Baical skullcap can lower blood levels of cyclosporine and the cholesterol drug rosuvastatin.
  • Long-term rhubarb use can worsen potassium loss from thiazide diuretics, corticosteroids, or licorice.
  • As a stimulant laxative, rhubarb speeds transit and can reduce absorption of other medication.

How to take it

This formula is best obtained through a licensed TCM practitioner who can confirm it matches your pattern.

Find a practitioner (NCCAOM directory)