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Bupleurum-S is a derivative of several traditional prescriptions that are used for treating digestive disturbance and abdominal swelling. The formula is related to the Atractylodes Stomach Harmonizing Pill (Baizhu Hewei Wan), which contains magnolia bark, saussurea, atractylodes, pinellia, citrus, and licorice, used to treat deficiencies in digestive function leading to lassitude. It is also related to Muxiang Shunqi Wan, a formula that includes 7 of the 9 ingredients of Bupleurum-S, and is indicated for liver qi stagnation leading to abdominal swellings. In common with these formulas, Bupleurum-S has several aromatic qi-regulating herbs that relieve the central stagnation. Bupleurum and malt are the unique additions, included to help regulate the liver qi circulation and treat abdominal distention. This formula is similar to those used in Chinese hospitals for treating swelling of internal organs (e.g., pancreatitis, swollen spleen, hepatic inflammation). Other potentially useful formulas for abdominal distress include Peony 9 (for irritable bowel syndrome), Gallus-Malt Tablets (for indigestion due to stomach weakness), Shen-chu 16 (for accumulations due to incomplete digestion of food), Coptis/Evodia Tablets (for acid reflux die to liver qi affecting the stomach), and Shu Gan Wan (Pine Mountain; useful for sensation of fullness). The key considerations for use of Bupleurum-S are involvement of liver-qi stagnation and accumulation requiring the penetrating action of the aromatic agents. The formula also addresses upward qi reaction in the stomach, with nausea, vomiting, acid reflux (see Coptis/Evodia Tablets), or eructation as symptoms.
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