柴葛解肌汤

3. Tongue and pulse

• Tongue: thin yellow coating, or red tongue edges and tip.
• Pulse: floating, slightly surging.

4. Common modifications

• For absence of sweating with severe aversion to cold, indicating pronounced exterior cold: add Ma Huang (ephedra herb) to strengthen the effect of inducing sweating and releasing the exterior.
• For pronounced thirst and dry throat, indicating severe damage to fluids: add Tian Hua Fen (trichosanthes root) and Zhi Mu (anemarrhena rhizome) to clear heat and generate fluids.
  • For cough with yellow phlegm, indicating pronounced Lung heat: add Gua Lou Pi (trichosanthes peel) and Bei Mu (fritillaria bulb) to clear the Lungs and transform phlegm.
  • For pronounced Shaoyang signs, with bitter taste in the mouth and fullness and oppression in the chest and hypochondria: the dosage of Chai Hu (bupleurum root) and Huang Qin (scutellaria root) may be increased.

5. Cautions and clinical notes

• Contraindications:
  • Not to be used for Taiyang exterior patterns that have not yet entered the interior and transformed into heat. This presents with pronounced aversion to cold, mild fever, absence of sweating, no thirst, and a floating tight pulse.
  • Not suitable for Yangming bowel excess patterns (constipation, abdominal pain resisting pressure).
  • Use with caution in cases of yin deficiency with interior heat.

6. Granule conversion and dose

• Calculation of the total raw herb weight of the original formula:
  • Chai Hu (bupleurum root) 9 g + Ge Gen (kudzu root) 9 g + Qiang Huo (notopterygium rhizome) 6 g + Bai Zhi (angelica dahurica root) 6 g + Huang Qin (scutellaria root) 6 g + Bai Shao (white peony root) 6 g + Jie Geng (platycodon root) 6 g + Shi Gao (gypsum) 15 g + Gan Cao (licorice root) 3 g + Sheng Jiang (fresh ginger) 3 g + Da Zao (jujube) 3 g = 72 g.
• Conversion to 5:1 granules:
  • 72 g raw herb ÷ 5 = 14.4 g granules.
• Recommended dose:
  • One dose daily, taken in 2 divided doses (morning and evening) dissolved in warm water, about 7 g per dose.
  • Or as directed by the practitioner; for acute externally contracted conditions, the practitioner may direct taking 1.5 doses per day, stopping once the fever resolves. Please follow the prescription strictly.