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Reply To: Herbal Bootcamp

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Hi, Natalia!

This is a great question and I am glad that you asked it!

Chai Hu Shu Gan San is indicated for Liver Qi Stagnation where as Xiao Yao San is indicated for Liver Qi Stagnation with Blood Deficiency and Spleen Deficiency.

Xiao Yao San will have signs of Blood Deficiency such as a dry mouth and throat – even the headache and vertigo could be due to Blood Deficiency (or Liver Qi Stagnation), and signs of Spleen Qi Deficiency such as lassitude and a lack of appetite. This combined Excess-Deficiency presentation will present on the pulse which is Wiry (Xuan) and Deficient (Xu). That is why Xiao Yao San contains herbs to nourish the Blood (Dang Gui, Bai Shao), and tonify Spleen Qi (Bai Zhu, Fu Ling, Zhi Gan Cao).

Chai Hu Shu Gan San is an Excess pattern with hypochondriac pain, irritability, abdominal pain and cramps (due to Wood invading Earth), dysmenorrhea and/or irregular menstrual cycles, and a Wiry (Xuan) pulse. There are signs of Wood invading Earth in both formulas, but Xiao Yao San has an underlying Spleen Qi Deficiency so it occurs more easily.

In this case study the patient is irritable, frustrated to the point of tears, they feel like they are going to start snapping at their coworkers (all Liver Qi Stagnation), they have pain of the abdomen (Wood invading Earth), pain of the side ribs (Liver Qi Stagnation), and haven’t been able to exercise (they aren’t moving their Qi), they bowels aren’t moving regularly (due to the other signs and symptoms this is most likely due to Qi Stagnation and sitting for prolonged periods of time at work plus not exercising), and their menstrual cycle is irregular with premenstrual irritability (the Liver stores the Blood – this is due to Liver Qi Stagnation), their tongue is normal (there is no tongue presentation listed for Chai Hu Shu Gan San but a Xiao Yao San tongue presentation is pale red which indicates the Blood Deficiency), and a Wiry (Xuan) pulse (Liver Qi Stagnation without a concurrent Deficiency).

I hope that helps clarify that Chai Hu Shu Gan San is chosen here because this patient has an Excess presentation without the signs of Blood and Spleen Deficiency that a Xiao Yao San patient would have! Thank you again for asking this question, Natalia!

Have a beautiful study day!