【Chinese Name】 當歸六黃湯

【Phonetic】 Dang Gui Liu Huang Tang

【English Name】 Chinese Angelica Six Yellow Decoction

【Classification】 Heat-clearing formulas

【Source】 《Secrets from the Orchid Chamber》Lan Shi Mi Cang《蘭室秘藏》

【Combination】 Angelicae Sinensis Radix (Dang Gui) 6g, Rehmanniae Radix (Sheng Di Huang) 6g, Scutellariae Radix (Huang Qin) 6g, Phellodendri Chinensis Cortex (Huang Bai) 6g, Coptidis Rhizoma (Huang Lian) 6g, Rehmanniae Radix Praeparata (Shu Di Huang) 6g, Astragali Radix (Huang Qi) 12g

【Method】 Grind the medicinals into a crude powder. Decoct one dose of the formula (5 qian/15g) with 2 zhan of water, and boil it until the volume reduces to about 1 zhan. Take the decoction before meals. The dose should be cut in half for children. (Modern use: use water to decoct the medicinals.)

【Action】 Nourishes yin, drains fire, consolidates the exterior, and arrests sweating.

【Indication】 This formula is indicated for night sweating caused by yin deficiency and intense fire. The symptoms are night sweating with fever, red complexion, vexation, thirst and dry lips, dry stool, dark urine, a red tongue body with a yellow coating, and a rapid pulse.

【Pathogenesis】 This is a pattern of night sweating caused by yin deficiency and intense fire. The phase of the heart is fire, and the phase of the kidney is water. Normally, fire and water are coordinated with each other, and the heart and kidney interact with each other in a harmonious relationship. If the kidney yin becomes deficient, the kidney water fails to coordinate with the heart fire. The fire of heart will then intensify because of the lack of water, causing the pattern of yin deficiency and intense fire. The fire will become more intense as more yin is consumed over time. Yin will not be able to stay inside as the intense fire forces fluids to leak outward, causing night sweating with fever. Deficiency-heat flames up causing a red complexion and vexation. Yin and fluids are consumed, which leads to thirst and dry lips, dry stool, and dark urine. A red tongue with a yellow coating, and a rapid pulse are signs of interior heat. The characteristic features of the pattern are deficiency of yin and blood, intense heart fire, outward leaking of yin forced by fire, and damage to the wei qi. Therefore, the therapeutic method is to nourish yin and blood, clear heat and drain fire, and boost qi to consolidate the exterior.

【Clarification】 Why is sweet-warm huang qi included in Dang Gui Liu Huang Tang, a formula for yin deficiency with intense fire harassing the interior?

While this is a pattern of yin deficiency with intense fire harassing the interior, there is frequent sweating that damages wei qi. Furthermore, since yang enters the yin level when one falls asleep, wei qi is relatively deficient during sleep. Nourishing yin and draining fire alone can not effectively arrests sweating unless a qi-boosting medicinal is added to consolidate the exterior. There is also the aspect of pairing huang qi with other medicinals in the formula to yields further formulaic actions. When huang qi is coupled with dang gui, they nourish qi and blood, consolidate striae and interstices, and prevent sweating. When huang qi, a sweet medicinal, is coupled with huang lian, huang qin, and huang bai, cold medicinals, they drain fire and prevent the bitter-cold medicinals from damaging the middle jiao. In conclusion, huang qi in Dang Gui Liu Huang Tang does not enhance damage to yin by intensifying fire. Huang qi helps nourish yin, arrest sweating, and prevent the bitter-cold medicinals from damaging the middle jiao.

【Application】 1. Essential pattern differentiation

Dang Gui Liu Huang Tang is a commonly used formula applicable for night sweating caused by yin deficiency and intense fire. This clinical pattern is marked by night sweating, red complexion, vexation and thirst, red tongue body, and a rapid pulse.

2. Modern applications

This formula may be used in the following biomedically defined disorders when the patient shows signs of yin deficiency and intense fire: hyperthyroidism, tuberculosis, diabetes mellitus, and menopausal syndrome.

3. Cautions and contraindications

Do not use the formula for patterns of yin deficiency without intense fire, or for patients with poor digestion and thin, unformed stools caused by deficiency of the spleen and stomach.

Source：HKBU

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