Herb Formulas Notebook

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Huang Long Tang

(Yellow Dragon Decoction)

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Source: Six Texts on Cold Damage (1445)
Author: Tao Hua

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Category: Formulas that Drain Downward

Pattern: Heat Excess in the Interior with Qi and Blood deficiency

Key Symptoms: Green, watery and foul smelling diarrhoea, abdominal pain that increases upon pressure, fever, thirst, a dry tongue and mouth, shortness of breath, lethargy delirious speech
Secondary Symptoms: Constipation with firm, painful abdominal distention. In severe cases there may be hallucinations and "grabbing the air" or impaired consciousness with frigid, contracted extremities.

Tongue: Dry, yellow or black tongue coating
Pulse: Deficient

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Ingredients

Da Huang	9-12g
Pinyin: Da Huang  Chinese: 大黄  Western: Radix et Rhizoma Rhei Tastes: Bitter, cold Meridians Entered: Large Intestine, Spleen, Stomach, Liver and Heart Actions & Indications: Drains Heat and purges accumulations Intestinal Heat Excess, with high fever, profuse sweating, thirst, constipation, abdominal distention and pain, delirium, a yellow tongue coat and a full pulse Yang-Ming Fu Stage Qi Level Heat in the Intestines Drains Fire Fire from Excess with intense fever, sore throat, and painful eyes and constipation Fire toxin sores due to Xue Level Heat, especially with constipation Clears Heat, transforms Dampness and promotes urination Damp-Heat with edema, jaundice, painful urinary dysfunction and acute, hot dysenteric disorders Drains Heat from the Blood Bloody stool either from hemorrhoids or Heat in the Intestines Chaotic movement of hot Blood with hemoptysis or epistaxis with constipation It can be powdered and administered orally for bleeding in the upper digestive tract Invigorates the Blood and dispels Blood Stasis Blood Stasis with amenorrhea, fixed abdominal masses or fixed pain Blood Stasis due to traumatic injury Intestinal abscess Clears Heat and reduces Fire toxicity Topically or internally for burns or skin lesions (Chuang Yung) due to Heat Clears Heat and eliminates Phlegm Chronic Accumulation of Phlegm-Heat with cough, dyspnea, mania, disorientation and other symptoms of Phlegm Misting the Heart Standard Dosage: 10-15g in decoction. Excessive decoction with reduce purgative action so it should be added at end to achieve this purpose and over-decocted to eliminate this action. Cautions: It should be used with caution in case of spleen and stomach deficiency for its bitter and cold property which is easily to damage stomach qi. It is contraindicated to women during pregnancy, menstruation or lactation for it has actions of activating blood and resolving stasis, and can make the purged substances follow lactating out.
Mang Xiao	9-12g
Pinyin: Mang Xiao  Chinese: 芒硝  Western: Natrii Sulfas Tastes: Salty, bitter, cold Meridians Entered: Stomach and Large Intestine Actions & Indications: Purges accumulations, guides out Stagnation, softens hardness and moistens Dryness Heat in the Stomach and Intestines with constipation and hard knots Clears Heat and drains Fire Heat in the Stomach or Lungs especially accumulated Phlegm or clumping in the Intestines Clears Heat and reduces swelling Red, swollen, painful eyes Painful, ulcerated, swollen mouth or throat (topical) Red, swollen skin lesions (topical) Mastitis (topical) (promotes lactation) Standard Dosage: 10-15g dissolved into decoction at end. Cautions: Use with caution for women during lactation for its milk regurgitation action. It is contraindicated to pregnant women. Mineral products are prohibited from use in the UK under the Medicines Act 1968 ch. 67 which restricts herbalists to the use of plant products only. It is generally substituted with Yu Li Ren.
Zhi Shi	6-9g
Pinyin: Zhi Shi  Chinese: 枳实  Western: Fructus Aurantii Immaturus Tastes: Pungent, bitter, slightly cold Meridians Entered: Spleen, Stomach and Large Intestine Actions & Indications: Breaks up Stagnant Qi, reduces accumulation, descends Qi, unblocks the bowels and removes Stagnant Food Qi Stagnation and accumulation with epigastric or abdominal pain and distention or indigestion with focal distention or gas Food Stagnation Transforms Phlegm, reduces distention and resolves hardenings Turbid Phlegm Obstructing the Qi with focal distention and fullness in the chest and epigastrium Standard Dosage: 3-10g in decoction. Cautions: It should be used with cautions for pregnant women.
Hou Po	3-12g
Pinyin: Hou Po  Chinese: 厚朴  Western: Cortex Magnoliae Officinalis Tastes: Bitter, pungent, warm Meridians Entered: Spleen, Stomach, Lung and Large Intestine Actions & Indications: Promotes the movement of Qi in the Middle Jiao and resolves Stagnation (Resolves Food Stagnation) Qi Stagnation affecting the Spleen and Stomach and Food Stagnation with chest and/or abdominal distention and fullness Promotes the movement of Qi downward, dries Dampness and transforms Phlegm Dampness or Phlegm Obstructing the Middle Jiao with distention, fullness, nausea and diarrhea Descends Rebellious Qi, reduces Phlegm and calms wheezing Cough and wheezing due to Phlegm congesting the Lungs Standard Dosage: 3-10g in decoction. Cautions: It should be used with cautions for the syndrome of qi deficiency and fluid consumption, and the pregnant women.
Ren Shen	6-9g
Pinyin: Ren Shen  Chinese: 人参  Western: Ginseng Tastes: Sweet, slightly warm Meridians Entered: Spleen, Lung and Heart Actions & Indications: Powerfully tonifies Yuan Qi Extreme collapse of Qi or abandoned conditions that manifest in shallow breathing, shortness of breath, cold limbs, profuse sweating and an almost imperceptible pulse (after blood loss, overly profuse sweating or other problems related to severe fluid loss - it can be used alone in these emergencies) Collapse of Yang Collapse of Yin Tonifies Spleen and Stomach Qi Lethargy, anorexia, chest and abdominal distention, chronic diarrhea and, in severe cases, prolapse of the Stomach, uterus or rectum Tonifies Lung Qi Lung Qi Deficiency with wheezing, shortness of breath and labored breathing on exertion Generates Body Fluids and stops thirst Wasting and thirsting disorder (Xiao Ke) and high fevers with profuse sweating which injures Qi and fluids Tonifies Heart Qi and calms the Spirit Heart Qi and Blood Deficiency with palpitations, anxiety, insomnia, forgetfulness and restlessness Treats impotence With Kidney Yang tonics for impotence Tonifies Qi in Deficiency patients with Exterior conditions Exterior disorder with Interior Deficiency Standard Dosage: 5-10g in decoction, 10-30g for exhaustion syndrome due to Qi deficiency. Cautions: Antagonizing to Li Lu; the warm nature of sun-dried raw Ren Shen is weaker than that of Hong Shen. Contraindicated to warfarin as it has an additive effect and may cause bleeding.
Dang Gui	9-12g
Pinyin: Dang Gui  Chinese: 当归  Western: Radix Angelicae Sinensis Tastes: Sweet, Pungent, Warm Meridians Entered: Heart and Liver Actions & Indications: Tonifies the Blood and regulates the menses Blood Deficiency, especially when affecting the Heart and Liver with pale, ashen complexion, lusterless nails, tinnitus, blurred vision and palpitations Blood Deficiency associated irregular menstruation, amenorrhea and dysmenorrhea Invigorates and harmonizes the Blood and disperses Cold (stops pain due to Blood Stasis) Blood Stasis causing abdominal pain and carbuncles and pain due to Blood Stasis from traumatic injury, especially when accompanied by Deficiency Cold Postpartum menstruation Pregnancy (use with caution) Blood Deficiency with chronic Wind-Damp-Bi Moistens the Intestines and unblocks the bowels Dry Intestines due to Blood Deficiency Reduces swelling, expels pus, generates flesh and alleviates pain Sores and abscess (Chuang Yung), internally and topically Stops coughing and treats dyspnea Used adjunctively for coughing Standard Dosage: 6-12g in decoction. Cautions: It is contraindicated in cases of damp-heat stagnating in the middle, lung heat with phlegm fire, and yin deficiency with effulgent yang because it is warm and sweet in properties. In addition, it should be used with cautions in cases of loose stool because it can moisten intestines to smooth stool.
Jie Geng	3-6g
Pinyin: Jie Geng  Chinese: 桔梗  Western: Radix Platycodi Tastes: Bitter, pungent, neutral Meridians Entered: Lung Actions & Indications: Opens the Lungs, spreads Lung Qi, expels Phlegm and benefits the throat Cough due to Wind-Cold or Wind-Heat (with profuse sputum, sore throat, loss of voice) Loss of voice or sore throat due to external Heat, Phlegm Heat or Yin Deficiency Heat Expels pus Lung or throat abscess (Phlegm and Qi Stagnation) with fevers, chest pain, coughing of yellow sputum with a fishy smell and hemoptysis Opens and raises Lung Qi, directing the effects of other herbs to the upper body Reinforces the actions of the other herbs and focuses the formula on the upper body Standard Dosage: 3-10g in decoction. Cautions: Overdose can cause nausea and vomiting.
Gan Cao	3g
Pinyin: Gan Cao  Chinese: 甘草  Western: Radix Glycyrrhizae Tastes: Sweet, slightly cold Meridians Entered: Heart, Lung and Spleen Actions & Indications: Tonifies the Spleen and augments Qi Spleen Qi Deficiency with shortness of breath, lassitude and loose stools Qi and Blood Deficiency with an irregular pulse and/or palpitations Heart Qi Deficiency or Heart Yang Deficiency Moistens the Lungs, resolves Phlegm and stops coughing Lung Heat or Cold Productive or non-productive coughing Moderates spasms and alleviates pain Painful muscle spasms of the abdomen and legs Clears Heat and relieves Fire toxicity Raw for Toxic Heat with sore throat or carbuncles and sores (Chuang Yung) Antidote for many toxic substances (internal and topical) Poisoning Moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels Standard Dosage: 3-10g in decoction. Cautions: It is contraindicated for combining with Hai Zao, Da Ji, Gan Sui and Yuan Hua because of "eighteen antagonisms". It is also contraindicated in cases of dampness obstruction in middle energizer and edema because it can help dampness obstruct qi, and it is prohibited from long-term usage in large dosage (more than 20g/day) and should be avoided or used with extreme caution in patients with high blood pressure because it may raise aldosterone levels in the blood causing retention of sodium.
Sheng Jiang	9g
Pinyin: Sheng Jiang  Chinese: 生姜  Western: Rhizoma Zingiberis Recens Tastes: Pungent, warm Meridians Entered: Lung, Spleen and Stomach Actions & Indications: Releases the Exterior, induces perspiration and disperses Cold Wind-Cold Warms the Middle and stops vomiting Cold in the Stomach especially with vomiting Warms the Lungs and stops coughing Cough due to Wind-Cold Cough due to Lung Deficiency with Phlegm Reduces the toxicity of other herbs and seafood Herb toxicity or seafood poisoning Adjusts the Ying and Wei - normalizes the flow of Qi at the center Taiyang Zhong Feng - Wind-Cold with Deficiency Standard Dosage: 3-10g in decoction. Cautions: It should be used with caution for yin deficiency with internal heat and heat exuberance because it helps promote fire and injure yin. Caution with patients on anticoagulants as it may alter bleeding time and contraindicated to warfarin as it has an additive effect.
Da Zao	2pcs
Pinyin: Da Zao  Chinese: 大枣  Western: Fructus Jujubae Tastes: Sweet, warm Meridians Entered: Spleen, Stomach and Heart Actions & Indications: Tonifies the Spleen and Stomach and augments Qi Spleen and Stomach Deficiency with weakness, shortness of breath, lassitude, anorexia and loose stools Nourishes the Blood and calms the Spirit Blood Deficiency Restless Organ Syndrome with wan complexion, irritability and severe emotional debility Moderates and harmonizes the harsh properties of other herbs   Standard Dosage: 10-30g in decoction. Cautions: It is used with cautions in cases of damp-phlegm or food stagnation because it can help dampness produce heat, and induce distention in middle energizer.

Subsitutions:
In the UK Mang Xiao must be substituted with Yu Li Ren.

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Preparation: Decoction. Some sources recommend adding Jie Geng near the end.

Actions: Purges Heat from the Interior and supports the normal Qi.

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Research Links:
Pubmed
Science Direct
Google Scholar
Journal of Chinese Medicine
American Dragon

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Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.

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