Herb Formulas Notebook

Xi Jiao Di Huang Tang

Rhinocerous Horn and Rehmannia Decoction

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Source: Important Formulas Worth a Thousand Gold Pieces (650)
Author: Sun Si-Miao

Category: Formulas that Clear Heat

Pattern: Heat in the Blood Level

Key Symptoms: Fever, various types of bleeding (vomiting of blood, nosebleed, blood in the stool or urine and rashes), black tarry stools, abdominal distention and fullness, thirst with an inability to swallow
Secondary Symptoms: Delirium

Tongue: Scarlet with prickles
Pulse: Thin, rapid

Xi Jiao 3g (30-120g of Shui Niu Jiao is normally used instead)
Sheng Di Huang 24g
Shan Yao 9g
Mu Dan Pi 6g

Xi Jiao is prohibited by international law and its alternative, Shui Niu Jiao, must also be replaced in the UK too. The best substitution is probably Xuan Shen and Huang Lian in a 3:1 ratio.

Preparation: Decoction.

Actions: Clears Heat, resolves Fire Toxicity, cools the Blood, nourishes the Yin, dispels Blood stasis, stops bleeding

Contraindications: Bleeding due to Yang deficiency

This formula is always going to generate controversy due to its use of rhino horn. These were considered magical creatures in ancient China, the equivalent of a unicorn, whose horns could detect and detoxify poison. It seems unlikely it was ever intended for widespread use. Given the symptoms indicated it seems like the Tang dynasty physicians were pharmacologically helpless against such a severe presentation and resorting to magical cures.

Whatever the origin of this formula it should no longer be used. Patients with the original presentation should be in emergency care. It remains in use as the other ingredients and the substitutions can be useful as a base in disorders of Blood level Heat with similar presentations such as frequent nosebleeds or bleeding skin conditions with red tongue and rapid pulse.

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

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.