Yi Guan Jian (All-Along Decoction) yī guàn jiān · 一贯煎

Safety. This formula first appears in the Qing-dynasty case compilation Xu Mingyi Leian (魏之琇); it was later extracted into Liuzhou Yihua, which is why both titles turn up as its source. - The safety item that must not be softened is 川楝子 (toosendan fruit, Melia toosendan). It contains toosendanin and related limonoids, and there are published case reports of liver injury - including acute liver failure - associated with toosendan preparations in humans. Anyone with existing liver disease, or taking other potentially hepatotoxic medicines, should not be given this formula without that consideration being made explicitly. This is a case-report-level signal rather than a quantified risk, and it is stated as such. - 当归 has been reported in individual case reports to potentiate warfarin and raise INR; the evidence is not from controlled trials, but the interaction is commonly flagged and deserves mentioning to anyone on anticoagulants. - The base of this formula is rich and cloying by traditional description (生地黄, 麦冬), so it is traditionally avoided where there is dampness, phlegm, or loose stools from spleen weakness - a person with a weak digestive function may simply feel worse on it. - 北沙参 is a different herb from 人参 and from 南沙参; the three are not interchangeable. - Not for use in pregnancy. Honey-bound commercial preparations matter for blood-sugar management.