Bupleurum

The Messenger of Banpyo-Banri, Bupleurum (Siho)

The Shennong Bencao Jing first recorded Bupleurum, stating, "The taste is bitter and neutral. It primarily treats the heart and abdomen, removing stagnant Qi from the intestines and stomach, resolving food accumulation, and clearing cold and heat pathogenic factors to replace the old with the new." It was also noted that long-term use makes the body feel light, brightens the eyes, and supports vital energy. This book left the alias 'Jihun' for Bupleurum. Later, the Mingyi Bielu added the names 'Sanchae' and 'Yeocho,' and the Bencao Gangmu explained the origins of these names: "Bupleurum grows in the mountains; when young, it is an edible vegetable, and when old, it becomes hard like wood and can be used as firewood. Thus, the leaves are called Unho, Sanchae, or Yeocho, and the root is called Siho." In other words, the name Siho carries a heavy image, originating from a 'root hard enough to become firewood.'

Many people commonly know Bupleurum simply as a 'medicinal herb that relaxes the energy of the liver.' However, its core position in classical texts is more sophisticated. In the Sosihotang (Minor Bupleurum Decoction) of the Shanghan Lun, Bupleurum is used in a significant proportion of 8 liang, serving as the sovereign herb that harmonizes the pathogenic factors residing in 'Banpyo-Banri' (the half-exterior, half-interior region) along with Scutellaria. The Bencao Sibeonrok expanded its application, stating that "symptoms related to Shaoyang are not limited to cold damage," and the Bencao Sinpyeon even claimed regarding Bojungikkitang that "the subtlety of Bojungikkitang lies entirely in the use of Bupleurum." Rather than being a simple liver medicine, it acted as a 'messenger' that guides energy lingering on the boundaries within the body in the proper direction and raises sunken clear yang energy.

However, this 'guiding power' only shines when the direction is correct. Since Bupleurum is an herb with ascending properties, it may actually worsen symptoms in individuals with a constitution where Qi is deficient and reverses, those with Yin deficiency and hyperactivity of fire (Eumheo-hwawang), liver yang hyperactivity (Ganyang-sanghang), or those lacking true Yin (Jineum). In Japan during the 1990s, cases of interstitial pneumonia were reported after long-term use of Sosihotang in patients with chronic hepatitis, and it was noted that the risk could increase particularly when used in combination with interferon. These facts demonstrate that Bupleurum is not always a mild herb, but one where the dosage, the patient, and the duration of use are critical. The content covered on this page is precisely that criterion.

Summary at a Glance

Bupleurum may seem ordinary by its name, but it is a medicinal herb that frequently appears at the center of prescriptions from classical times to the present. The table below provides a summary of its properties and the situations where caution is required.

Category	Content
Origin	Hanja Name 柴胡 / Scientific Name Bupleurum falcatum A Korean herbal medicine made from the dried root of a perennial plant belonging to the Apiaceae family.
Properties and Meridian Tropism	Bitter taste, Neutral/Slightly Cold property, Non-toxic. Acts on the Liver meridian and Gallbladder meridian.
Representative Aliases	Jihun, Sanchae, Yeocho
Efficacy Recorded in Literature	Dispersing and reducing fever, Harmonizing and reducing fever, Raising yang energy, Soothing the liver and relieving stagnation
Main Ingredients	Saponins (such as saikosides and bupleurol), flavonoids, and volatile oils have been reported.
Combination & Precautions	A core component in prescriptions for Shaoyang Banpyo-Banri, frequently paired with Scutellaria (Hwanggeum). Due to its strong ascending properties, caution is required for those with Qi deficiency, Yin deficiency and hyperactivity of fire, liver yang hyperactivity, hypotension, or decreased cardiac function. It is generally avoided during pregnancy and lactation.

The first thing that stands out in this table is that Bupleurum (Siho) is not a 'fever-reducing medicine,' but rather a 'medicine that raises and releases energy.' Therefore, prescriptions containing Bupleurum are not used simply because 'the body is hot,' but are prescribed by considering the direction of energy and the location of the meridians.

Is this medicinal herb right for me?

Bupleurum is a medicinal herb with a directionality that governs the 'Soyang' (lesser yang) and lifts energy. When the body's condition aligns with this direction, it works harmoniously; however, in constitutions or conditions with the opposite direction, it may actually exacerbate symptoms. It is helpful to first categorize your condition into the following three groups.

• Generally suitable cases: Traditionally, it has been considered for cases where fatigue, nausea, or chest tightness remain even after a fever from a cold has subsided, or for recurring indigestion and tightness in the upper chest caused by stress. Prescriptions such as Sosihotang from the 'Shanghan Lun' or Soyosan from the 'Heji Jufang' are used in this context.

• Cases requiring caution: Caution is required if your face flushes easily, your eyes are often bloodshot, or you frequently experience dizziness and headaches, as the ascending property of Bupleurum may stimulate these symptoms. Additionally, those with low blood pressure, weak heart function, or diabetes should be cautious about long-term or high-dose use. If you are pregnant or breastfeeding, please inform us during your consultation, as use is not recommended due to insufficient evidence on sites like Drugs.com.

• Cases to avoid: In cases of 'Qi reversal' (a feeling of energy rising upward due to deficiency), constitutions where 'fire' surges upward due to a lack of 'Yin' (Yin deficiency with fire flourishing), or states where 'Liver Yang' has already surged upward, the lifting force of Bupleurum may actually have the opposite effect. The 'Jiayou Bencao' records that Bupleurum uses Pinellia as a messenger herb, dislikes Gleditsia, and fears Aster and Veratrum; however, further verification is needed regarding the modern application of these records.

Practical Q&A

We have gathered frequently asked questions from actual practice. While Bupleurum often appears at the center of a prescription, it is a medicinal herb that gains meaning within a combination with other herbs rather than when used alone. Therefore, questions such as "Can I take this herb by itself?" or "What symptoms is it used for?" must be answered within the context of the full prescription. Below is a summary of interests actually raised in the consultation room.

Can I drink Bupleurum tea or health tea every day?

While Bupleurum tea is occasionally used as a health tea in folk medicine, Bupleurum is generally used as a component of a prescription rather than as a standalone tea herb. Although the 'Shennong Bencao Jing' mentions the effects of long-term intake, stating "long-term use lightens the body, brightens the eyes, and increases essence," this is a classical record and cannot be applied directly to the constitutions and conditions of modern people. In particular, because Bupleurum has an ascending property (rising upward), it may exacerbate symptoms in constitutions characterized by Qi reversal due to deficiency, Yin deficiency with fire flourishing, depletion of true Yin, or ascending Liver Yang. It is safer to use it within a prescription from a Korean medicine doctor rather than drinking it as a daily tea.

In what cases are prescriptions like Sosihotang used?

Sosihotang is a representative prescription recorded in the 'Shanghan Lun,' 'Jingui Yaolue,' and 'Qiandjin Yifang.' It consists of 8 liang of Bupleurum, 3 liang of Scutellaria, 3 liang of Ginseng, 3 liang of prepared Licorice, 3 liang of Ginger, half a sheng of Pinellia, and 12 pieces of Jujube; Bupleurum and Scutellaria are the core medicinal pair that harmonizes the 'Soyang' half-exterior half-interior region. The 'Bencao Sibian Lu' suggests that "whenever a condition involves the Soyang, it is not only limited to cold-induced fevers," implying it can be used for other conditions beyond the common cold if the symptoms correspond to Soyang. However, as this prescription is used according to specific conditions and constitutions, you must confirm through a consultation whether your symptoms correspond to Soyang.

Why is Bupleurum included in Bojungikgitang?

Bojungikgitang is a prescription found in Li Dongyuan's 'Piwei Lun,' consisting of Astragalus, prepared Licorice, Ginseng, Angelica, Citrus peel, Cimicifuga, Bupleurum, and Atractylodes. The 'Bencao Xinbian' emphasized the role of Bupleurum, stating, "The excellence of Bojungikgitang lies entirely in the use of Bupleurum, which cannot be discussed in the same terms as Cimicifuga." In this prescription, Bupleurum and Cimicifuga work to lift the clear Yang energy of the spleen and stomach to treat the sinking of Qi due to deficiency. In other words, it is not just a prescription for supplementing energy, but one where Bupleurum plays the role of organizing the direction of energy upward.

Can long-term use of Bupleurum cause problems with the liver or lungs?

In Japan during the 1990s, 88 cases of interstitial pneumonia and 10 deaths were reported after administering So-si-ho-tang to patients with chronic hepatitis. It was noted that the risk could increase particularly when used in combination with interferon. Additionally, academic data reports a risk of drug-induced liver injury, such as elevated AST and ALT levels, during long-term or high-dose use. The PubMed study “Toxicological aspects of Kampo medicines in clinical use” also summarizes the chronic and mutagenic toxicity of prescriptions containing Bupleurum, such as So-si-ho-tang. For these reasons, it is important to use Bupleurum or prescriptions containing it within the designated period and dosage, under the observation of a professional.

Can I use Bupleurum during pregnancy or breastfeeding?

The Bupleurum entry on Drugs.com states “Avoid use” due to a lack of sufficient evidence regarding pregnancy and breastfeeding. In other words, since safety data is insufficient, the general rule is to avoid use during these periods. If you are pregnant or breastfeeding, please be sure to inform us during your consultation so we can discuss other alternatives.

Are there any herbs or foods that should be avoided when taking Bupleurum?

The 《Ga-yu-bon-cho》 records Pinellia as a coordinating herb (sa-yak) for Bupleurum, and Gleditsia, Aster, and Veratrum as incompatible herbs. However, these are classical records, and their applicability in modern practice needs to be verified. Additionally, some commercial health information mentions that the quercetin component of Bupleurum may reduce the absorption of metal ion preparations such as aluminum, calcium, and zinc, and that saponins may be decomposed when used with Vitamin C, but official clinical trial evidence has not been confirmed. If you are currently taking Western medicine or health functional supplements, please tell us before the prescription. Since the possibility of interactions varies depending on an individual's medical history and concurrent medications, it is most accurate to review this during your consultation.

Relationship with Other Medicinal Herbs (Yakdae/Pairing)

Bupleurum is rarely used alone. Its therapeutic direction becomes clear when paired with other herbs within a prescription, which is traditionally called “yak-dae” (medicinal pairs). For example, when combined with Scutellaria, it resolves the half-exterior half-interior state of the Shao Yang; when combined with Sophora, it lifts the clear yang of the spleen and stomach. Below are representative prescriptions where Bupleurum forms a core combination.

• Bupleurum + Scutellaria, So-si-ho-tang This is a prescription recorded in the 《Shanghan Lun》 and 《Jingui Yaolue》. It consists of 8 nyang of Bupleurum, 3 nyang of Scutellaria, 3 nyang of Ginseng, 3 nyang of Licorice (roasted), 3 nyang of Ginger, half a doe of Pinellia, and 12 Jujubes. Bupleurum and Scutellaria act as the core pair to harmonize the half-exterior half-interior of the Shao Yang, while Ginseng, Licorice, Ginger, and Jujube soothe the stomach and lower the rebellious qi of Pinellia.

• Bupleurum + Sophora, Bo-jung-ik-gi-tang This prescription is found in Li Dong-yuan's 《Pi-wei-lun》. It consists of Astragalus, Licorice (roasted), Ginseng, Angelica, Citrus peel, Sophora, Bupleurum, and Atractylodes. Bupleurum and Sophora have traditionally been used to lift the clear yang of the spleen and stomach to treat the sinking of qi due to deficiency.

• Bupleurum + Angelica, White Peony, etc., So-yo-san This is a prescription from the 《Hwa-je-guk-bang》, traditionally used by combining the liver-soothing effect of Bupleurum with Angelica and White Peony. The 《Bon-cho-sa-byeon-rok》 mentions that “So-yo-san is used for chills and fever caused by blood deficiency.”

It is also helpful to remember contraindications based on combinations. The 《Ga-yu-bon-cho》 records that Bupleurum dislikes Gleditsia and fears Aster and Veratrum. Furthermore, because Bupleurum has a strong lifting property, traditional guidance suggests avoiding it for those whose qi rises due to qi deficiency, those with yin deficiency and hyperactivity of fire, those with damaged true yin, or those with a constitution where liver yang already rises.

In what form is it consumed?

Rather than being a tea or food ingredient enjoyed on its own, Bupleurum is a medicinal herb overwhelmingly used in combination with other herbs within a prescription. Therefore, it is important to understand its possible forms of intake within the context of a prescription.

• Tea: It is sometimes used as a health tea called ‘Bupleurum tea’ in folk medicine. A known method is to decoct 20g of dried Bupleurum in 600mL of water. However, it is more common for Bupleurum to be used as a component of a prescription rather than as a standalone tea.
• Food: It is not used as a general food ingredient. While classical records mention that young Bupleurum leaves can be eaten as vegetables, consuming Bupleurum as food is not common in modern Korea.
• Decoction: This is the most typical form. Most prescriptions containing Bupleurum, such as So-si-ho-tang from the 《Shanghan Lun》 or Bo-jung-ik-gi-tang from the 《Pi-wei-lun》, are used in the form of a decoction boiled in water.
• Professional Prescription: This is where Bupleurum actually exerts its effect. When prescribed for Shao Yang meridian issues, sinking of qi due to deficiency, or soothing the liver and relieving depression, the combination with other herbs and the dosage are adjusted together. Since a customized prescription is necessary based on individual constitution and symptoms, please decide on any prescription containing Bupleurum only after consulting with a Korean medicine doctor.

Interactions and Safety During Use

While Bupleurum is a herb that harmonizes with others at the center of a prescription, its potency requires caution depending on the situation of use. Particular care is needed during long-term use, in specific disease states, or when overlapping with other treatments. Below are the confirmed interactions and contraindications.

• Pregnancy and Breastfeeding: Drugs.com records that use is not recommended due to lack of evidence.
• Constitution and Symptom Contraindications: Due to its property of lifting energy, it should be avoided in those with a tendency for qi to rebel due to deficiency, yin deficiency and hyperactivity of fire, a state of insufficient true yin, or a constitution where liver yang surges upward. Additionally, those with low blood pressure, weak heart function, or diabetes should be cautious regarding long-term or high-dose use.
• Sosihotang and Interstitial Pneumonia: In the 1990s in Japan, interstitial pneumonia was reported after administering Sosihotang to patients with chronic hepatitis, and there is data suggesting that the risk may increase particularly when used in combination with interferon.
• Drug-Induced Liver Injury: There are reports that liver function abnormalities, such as elevated AST and ALT, may occur during long-term use or when taken in excessive doses.
• Classical Contraindications: The 《Gayu Boncho》 records that Gleditsia (皂莢) should be avoided, and caution is advised regarding Aster Vulnare (女菀) and Veratrum (藜蘆).

If you are taking other prescriptions containing Bupleurum (Siho) or if you fall under any of the conditions listed above, please consult with a Korean medicine doctor before making a decision.

If you experience these symptoms

If you experience these symptoms

When taking a prescription containing Bupleurum, if the following signs appear, do not dismiss them as simply a 'process of the medicine working' and be sure to inform your attending Korean medicine doctor. It is especially important to recognize these signs quickly when taking the medicine long-term or when it overlaps with other treatments.

• Respiratory Related: New onset or worsening of cough, difficulty breathing, or a feeling of shortness of breath
• Liver Function Related: Abnormally severe fatigue, darkening of urine color, or a feeling of yellowing of the skin or eyes
• Blood Pressure and Heart Related: Dizziness, vertigo, heart palpitations, or chest tightness
• Digestive and Systemic Related: Persistent abdominal discomfort, loss of appetite, or nausea

These symptoms are known warning signs that may appear when a prescription containing Bupleurum interacts with a specific constitution, disease state, or other treatments. Rather than reducing the dose or stopping the medication on your own, please consult your doctor with a summary of when the symptoms appeared and any other medications or health supplements you are taking.

If there are sudden changes such as severe difficulty breathing, decreased consciousness, or chest pain, please use emergency medical services (119 or the nearest emergency room) first.

Differences from other restorative medicines

Siho (Bupleurum root) is a medicinal herb that is difficult to categorize simply as a 'tonic.' Rather, it acts more like a 'regulator' that releases the energy of the Soyang (lesser yang) or lifts a feeling of stagnation. Therefore, it is rarely sought after individually when the goal is to supplement overall energy, as is the case with Gongjindan or Gyeongokgo. Traditionally, the effects of Siho are summarized as dispersing and reducing fever, lifting yang energy, and soothing the liver to relieve stagnation, focusing on correcting the flow of energy or clearing heat.

Restorative tonics like Gongjindan or Gyeongokgo aim to 'supplement deficiency (虛)' in a broad sense. In contrast, Bupleurum is an herb whose role is revealed only when paired with other herbs within a prescription. For example, when used with Scutellaria, it resolves the 'half-exterior, half-interior' (半表半裏) state of the Shao Yang, and when used with Astragalus, it lifts the clear Yang energy of the spleen and stomach. Rather than being taken alone, it holds meaning within traditional prescriptions such as Sosihotang, Bojungikgitang, or Soyosan.

Therefore, if you feel that you 'want to take a restorative tonic because you lack energy,' a prescription containing Bupleurum might be appropriate, but it is different from achieving the same purpose as tonics like Gongjindan or Gyeongokgo. The choice of prescription varies depending on whether your condition is Qi deficiency (氣虛), whether unbalanced energy needs to be corrected, or whether heat is knotted in the Shao Yang meridian. It is safest to determine whether Bupleurum is necessary or if another restorative tonic is more appropriate through a consultation with a Korean medicine doctor.

References

1. Evidence for Bupleurum 1: PubMed academic paper.
2. Evidence for Bupleurum 2: Supporting data from data.go.kr.
3. Evidence for Bupleurum 3: Korea Institute of Korean Medicine official data.
4. Supporting evidence for Bupleurum 4: Crude drug data from the National Institute of Food and Drug Safety Evaluation.
5. Supporting evidence for Bupleurum 5: Korea Institute of Korean Medicine official data.
6. Supporting evidence for Bupleurum 6: GBIF plant classification data.
7. Supporting evidence for Bupleurum 7: GBIF plant classification data.
8. Supporting evidence for Bupleurum 8: GBIF plant classification data.

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