an gong niu huang wan

Name: an gong niu huang wan
Creator: Bencao Index

Calm the Palace Pill with Cattle Gallstone

About an gong niu huang wan

An Gong Niu Huang Wan, Calm the Palace Pill with Cattle Gallstone, is Niu Huang, Xi Jiao, She Xiang, Huang Lian, Huang Qin, Zhi Zi, Xiong Huang, Bing Pian, Yu Jin, Zhu Sha and Zhen Zhu. The catalogue classes it among the formulas that clear Heat and open the orifices.

Ingredients

Herb	Amount
niu huang	30 g
xi jiao	30 g
she xiang	7.5 g
huang lian	30 g
huang qin	30 g
zhi zi	30 g
xiong huang	30 g
bing pian	7.5 g
yu jin	30 g
zhu sha	30 g
zhen zhu	15 g

Actions and indications

Clears Heat and resolves toxicity

The most severe stage of a warm-febrile disease, with Heat at the Ying level attacking the Pericardium
High fever with restlessness, irritability and delirious speech
Tongue red or deep red, sometimes stiff, with a yellow coat; pulse rapid

Transforms Phlegm and opens the orifices

Heat-toxin and Phlegm blocking the Pericardium, with clouded consciousness or coma
Phlegm obstructing the Heart orifices, tense (Yang) closed type
Sudden collapse into coma from Wind-stroke
Stiffness of the tongue

Calms the Shen and revives consciousness

Convulsions in children with high fever from Phlegm-Heat
Dizziness and vertigo
Icy extremities with faint erythema of the skin

Modern uses

Encephalitis, acute
Meningitis, acute
Hepatitis, acute or infectious
Hepatic coma
Pneumonia
Dysentery
Uremia, including toxic uremia and uremic coma
Kidney failure
Stroke (cerebrovascular accident)
Hemiplegia
Aphasia
Facial paralysis
Coma after brain injury
Delirium
Schizophrenia
Convulsions, including infantile convulsions
Epilepsy
Trismus
Insomnia
Forgetfulness
Optic atrophy
Dizziness and vertigo
Jaundice
AIDS/HIV
Acute pancreatitis
Upper respiratory tract infection
Acute tonsillitis
Tracheitis
Acute bronchitis
Pertussis
Pleurisy
Bronchiectasis
Hemoptysis
Epistaxis
Lung cancer
Liver cancer
Bad breath
Nasal furuncles
Ascites
Erythema
Summer heatstroke
Septicemia
High fever
Puerperal fever
Chronic diarrhea
Constipation
Hypertension

Symptoms

Cold limbs
Coma
Convulsions
Delirium
Disorientation
Dizziness
Erythema
High fever
Irritability
Loss of consciousness
Restlessness
Stiff tongue

Modifications

Weak pulse: + ren shen
Excess pulse: + jin yin hua, + bo he
Nasal furuncles (combined with Qing Wen Bai Du Yin)
Summerheat in the Blood causing limb convulsions: + ling yang jiao, + gou teng
Phlegm stagnation: + tian zhu huang, + dan nan xing, + zhu li
Phlegm stagnation, alternatively combined with Zhi Jing San or Hou Zao San
Unconsciousness or convulsions: + ling yang jiao, + gou teng, + quan xie, + wu gong
Extreme thirst: + dan zhu ye, + mu li, + shi gao
Acute jaundice in liver cancer: + shi chang pu, + yu jin

Cautions

pregnancy Not to be used during pregnancy
contraindication Collapse from devastated Yang, with cold limbs, heavy sweating and a faint pulse; this differs from the closed Heat pattern the formula is meant for
caution Reserved for the deep, orifice-blocking stage of a febrile illness; not for milder Heat patterns
caution Not meant for repeated or long-term use
caution Never heat Zhu Sha (cinnabar) or give it in large amounts
caution Contains Zhu Sha (mercury sulfide) and Xiong Huang (arsenic sulfide); both have been studied for liver and kidney toxicity in this formula, and products containing them are restricted in several countries
caution The classical Xi Jiao is rhinoceros horn, whose international trade is banned; lawful products replace it with water buffalo horn (Shui Niu Jiao)

Preparation

Honey pills of the finely powdered ingredients, classically wrapped in gold foil; when the patient cannot swallow, the pill is mixed into warm boiled water and spooned in or passed through a feeding tube

Names

Pinyin	an gong niu huang wan
English Name	Calm the Palace Pill with Cattle Gallstone

Classification

Category: Clear Heat and Open the Orifices

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