Bupleurum Soothing Liver Formula is the key formula to address Liver Qi stagnation, manifesting as a constraint and clumping of Liver Qi, and is applicable for all patterns due to Liver Qi stagnation. This includes various types of abdominal stagnation and premenstrual syndrome. A key marker for the use of this formula is stagnation that comes and goes, depending on the person’s emotional state and energy. This indicates that the stagnation is not due to external causes. When Liver Qi stagnates and does not ascend as it normally would, it begins to flow horizontally by invading the Stomach and Spleen, causing distention and fullness in the abdomen. When Liver Qi constraint blocks the circulation of Yang Qi, cold symptoms can also arise. Symptoms range from digestive disharmonies, such as occasional nausea, vomiting, low appetite and loose stools to occasional emotional upsets such as irritability, frustration or occasional depression. As the formula name suggests, the herbs comprised in this formula soothe or “soften” the Liver. Bupleurum Soothing Liver Formula is an ideal choice for numerous disharmonies occurring against a background of Liver Qi stagnation with internal constraint which needs releasing. It contains most of the ingredients of Four Cold Extremities (Si Ni San), a formula from the Shang Han Lun, famous for addressing a pattern of overall body warmth with chilled fingers and toes. Both Four Cold Extremities and Bupleurum Soothing Liver Formula address Liver Qi stagnation. Four Cold Extremities focuses on constraint of the Yang Qi in the abdomen failing to reach and warm the extremities, while Bupleurum Soothing Liver Formula focuses solely on the Liver channel, by moving its Qi, resolving constraint and opening up clumps, and it is better for patterns characterized by Qi stagnation. The chief herb, Bupleurum root, spreads Liver Qi and dredges constraint and clumping. It is supported by two deputies: prepared Cyperus rhizome regulates Liver Qi and Sichuan lovage rhizome enters the Qi and Blood of the Liver to dissipate constraint and stagnation. Tangerine dried rind of mature fruit and dry fried Bitter orange mature fruit regulate Stomach and Intestine Qi. They facilitate the discharge of excess Qi from the chest and Middle Burners that can manifest as an occasional sensation of fullness and distention by directing the Qi downward. White Peony root and honey fried Chinese licorice root and rhizome nourish Blood, soften the Liver and address stagnation. Being moist in nature, they balance the drying action of the chief and deputies herbs. Chinese salvia root and rhizome has been added to invigorate Blood, break up stagnation due to constrained Liver Qi with Blood stasis and soothe irritability. Several formulas have similar actions and need to be differentiated. Bupleurum Soothing Liver Formula addresses excess patterns of Liver Qi stagnation. Stomach Support addresses Stomach Fire with concurrent Stomach and Kidney Yin deficiency. Liver Flow addresses Liver overacting on the Stomach. Digestive Harmony Formula addresses excess patterns of food stagnation. Peaceful Earth addresses a pattern of food stagnation while simultaneously strengthening the Spleen Qi and expelling Wind. Wei Te Ling calms rebellious Stomach Qi and harmonizes and strengthens the Middle Burner. ORIGINS AND DEVELOPMENTThis formula was composed by the Ming dynasty scholar Ye Wen-Ling, and was popularized by Zhang Jie-Bin who included it in his book, Collected Treatises of Zhang Ling Yue.
