Chai Ling Tang — Bupleurum & Poria Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Chai Ling Tang — the “Bupleurum and Poria Decoction” — is a combination formula from the Ming-dynasty Jing Yue Quan Shu that merges Xiao Chai Hu Tang with Wu Ling San. The clinical picture: Shao Yang pattern (alternating chills and fever, bitter taste, chest fullness) combined with water/fluid retention (scant urination, mild oedema, possible diarrhoea). The formula is widely used in modern Japanese Kampo practice (where it is called Sairei-to) for diverse conditions involving immune dysregulation and water-metabolism disorders.

I prescribe Chai Ling Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Chai Ling Tang is prescribed for Shao Yang pattern with water/Damp accumulation:

• Alternating chills and fever
• Bitter taste, possible nausea
• Chest and lateral-costal fullness
• Scant urination, mild peripheral oedema
• Possible diarrhoea or loose stools
• Thirst with desire to drink but vomiting after
• Tongue — pale to slightly red, white-greasy coat
• Pulse — wiry, slippery

Key herbs

1. Chai Hu (Rx. Bupleuri, 6–12g) — harmonises Shao Yang
2. Huang Qin (Rx. Scutellariae, 6–9g) — clears Shao Yang Heat
3. Ban Xia (Rz. Pinelliae, 6–9g) — harmonises Stomach; stops nausea
4. Ren Shen (Rx. Ginseng, 3–9g) — tonifies middle Qi
5. Zhi Gan Cao (Rx. Glycyrrhizae Preparata, 3–6g), Sheng Jiang (Rz. Zingiberis Recens, 3–6g), Da Zao (Fr. Jujubae, 3–12g) — harmonise (Xiao Chai Hu core)
6. Ze Xie (Rz. Alismatis, 6–15g) — drains Damp
7. Fu Ling (Poria, 6–15g), Zhu Ling (Polyporus, 6–12g) — drain Damp via urination
8. Bai Zhu (Rz. Atractylodis Macrocephalae, 6–12g) — tonifies Spleen; dries Damp
9. Gui Zhi (Ram. Cinnamomi, 3–6g) — warms; assists fluid metabolism (Wu Ling San core)

Formula actions

1. Harmonises the Shao Yang
2. Promotes urination; resolves Damp-water retention
3. Tonifies Spleen; addresses the Damp source

Conditions treated

1. Acute or persistent febrile illness with water retention
2. Acute or chronic gastroenteritis with low-grade fever
3. Nephrotic syndrome with persistent oedema (adjunctive, with conventional care)
4. Idiopathic oedema with bitter taste and chest fullness
5. Inflammatory autoimmune flares (widely used in Kampo practice)
6. Hot flushes with fluid retention in menopause

Cautions

Not appropriate for severe Yin deficiency or pure Heat patterns — the Wu Ling San diuretic component can damage fluids if used inappropriately.

Acute severe oedema (nephrotic syndrome, heart failure) requires conventional medical care.

Always consult a qualified Chinese herbalist registered with the RCHM.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.