Xiao Chai Hu Jia Sheng Shi Gao Tang to treat Diarrhea

Clinical case reviewed in 2015 SHL webinar 6 with Dr. Feng


Mr. Tong, 40 years old, Huang Hua Men hospital case no. 17
1st consultation on July 15th, 1943
The patient was ordinarily healthy with a robust constitution. During the summer he contracted an infectious disease, presenting with high fever, alternating fever and chills, abdominal pain, frequent diarrhea and tenesmus, nausea, vomiting continued and he could not drink any fluids, passing foul smelling black and greyish stools over 30 times a day of bloody watery fluids. He was unable to stand from severe weakness. The treatment from biomedicine were ineffective, and the Chinese medicine formulas given were also ineffective. He then sought out prof. Hu for consultation. By the time he reached prof. Hu’s home, he had a pale and grey complexion, white and sticky tongue coating with scant saliva and a thready and rapid pulse. It was clear his condition was very critical.


Six syndrome: Shao yang Yang ming consecutive syndrome

The Shao Yang syndrome is identified in the high fever, nausea and the alternative fever and chills pointing to heat above and the weakness and diarrhea showing the deficiency below. The Yang Ming internal heat is confirmed in the foul smelling loose stools, bloody diarrhea, high fever and rapid pulse.

Treatment method: For such a case, sweating and purgation methods are highly contraindicated because the pathogen has now entered the half exterior half interior syndrome explaining why only harmonizing method can be applied.

Formula: Xiao Chai Hu Jia Sheng Shi Gao Tang pattern. Also the patient was told to eat watermelon.

Chai Hu 24g Huang Qin 10g Dang Shen 10g
Ban Xia 12g Sheng Jiang 10g Da Zao 4 pcs
Zhi Gan Cao 6g Sheng Shi Gao 90g

Analysis: Xiao Chai Hu Tang consists of Chai Hu that clears heat from the half exterior half interior layer and Huang Qin clears heat from above. Because of the high fever, Chai Hu was raised to double the normal dosage and taken for 7 days. Sheng Jiang, Da Zao, Gan Cao and Dang Shen nourishes the middle and protect the stomach. It supplements deficiency in the middle and nourished body fluid to strengthen the body’s defense against the pathogen. Ban Xia clear internal rheum and combined with Sheng Jiang treats brings the stomach qi downwards to treat the nausea and vomiting.


Many Chinese doctors avoid using Sheng Shi Gao in cases of severe diarrhea since it is a very cold herb which can harm the stomach. However this is because they do not fully understand the Six Syndrome. In this case of dysentery there is severe internal Yang Ming heat with fever, foul smelling stools and rapid pulse. it the internal heat is not cleared the patient will continue to show these symptoms. Sheng Shi Gao was added to clear the internal heat without purging.

Result: After he began eating the watermelon, he started vomiting but later resumed eating. The next day, he was able to eat without vomiting, so at this point he was also able to drink the decoction. At this point, he was able to slowly regain his strength more and more every day.

By the 7th day his diarrhea had greatly improved and he passed normal stools 2-3 times a day, reporting his stomach had cool sensations, which implied his internal heat had resolved. At this time he was prescribed Xiao Chai Hu by replacing Dang Shen by 10g of Xi Yang Shen.

On the 8th day he started eating normally again and the patient stopped taking the medicine. He fully recovered within the following 2 weeks.


Note: This was a severe case of food-denying dysentery which was treated by biomedicine without any results. The patient was no only in a critical state by the time he consulted Pruf. Hu he had no other medicine which was effective. By using the Six Syndrome differentiation system, Prof. Hu correctly identified the pattern and was able to treat him successfully. Chinese medicine was about to save this patients life with a simple formula.


It is noteworthy to say that Prof. Hu often treated diarrhea and tenesmus with a Shao Yang Yang Ming Syndrome with Da Huang with Xiao Chai Hu Jia Sheng Shi Gao Tang”.


However in this case, there was a severe deficiency so Prof. Hu Avoided using the purgative effective of Da Huang and only gave Xiao Chai Hu plus Shi Gao Tang. Not only was the patient unable to ingest food but also when Prof. Hu palpated his abdomen it was soft and soggy demonstrating a deficient syndrome.