huang long tang

Yellow Dragon Decoction

About huang long tang

Huang Long Tang, Yellow Dragon Decoction, adds Ren Shen, Dang Gui, Jie Geng, Sheng Jiang, Da Zao and Gan Cao to the Da Cheng Qi Tang base. The catalogue classes it among the formulas that drain downward.

Ingredients

Herb	Amount
da huang	9 g
mang xiao	12 g
zhi shi	6 g
hou po	3 g
ren shen	6 g
dang gui	9 g
jie geng	3 g
sheng jiang	9 g
da zao	2 g
gan cao	3 g

Actions and indications

Purges Heat accumulation and moves the bowels

Excess Heat accumulated in the Yang Ming organs (dry Heat in the Intestines at the Qi stage) in a patient already short of Qi and Blood
Severe constipation with hard, dry stool, or only clear watery fluid passing; or foul, green, watery diarrhoea seeping around the blockage
Hard, painful epigastrium and abdomen, the pain worse on pressure
Fever with thirst and a dry mouth and tongue
Clouded consciousness or delirium; when severe, hallucinations, picking at the bedclothes, grasping at the air, and loss of consciousness with cold, contracted limbs
Tongue body variable, with a dry yellow or dry black coat; pulse weak

Tonifies Qi and Blood

Classically the elderly, women after childbirth, or the chronically ill or frail, who could not bear purging on its own
Low energy, shortness of breath and a weak voice
Fatigue and weakness; sometimes cold limbs despite the internal Heat

Modern uses

Constipation
Constipation in the elderly or after surgery
Intestinal obstruction
Paralytic ileus
Fever with impacted stool in weak or frail patients
Typhoid fever
Paratyphoid
Chronic bacterial dysentery
Haemorrhoids
False diarrhoea
Pelvic inflammatory disease
Salpingitis
Gastroenteritis
Recovery of bowel function after surgery
Meningitis
Encephalitis
Intestinal tuberculosis
Abdominal pain
Crohn's disease
Mesenteric lymphadenitis
Trichomonas

Symptoms

Abdominal pain
Abdominal rigidity
Altered consciousness
Cold limbs
Constipation
Delirium
Diarrhea
Dry mouth
Epigastric pain
Fatigue
Fever
Hallucinations
High fever
Involuntary movements
Loss of consciousness
Pain aggravated by pressure
Shortness of breath
Thirst
Weak voice
Weakness

Modifications

Constipation in weak, deficient elderly patients: + mang xiao, + ren shen, + dang gui
Dry lips and mouth from excess Heat: + sheng di huang, + xuan shen, + mai men dong
Recovery after surgery: + dang shen, + mai men dong, − mang xiao, − ren shen, − gan cao
Very weak patients: − mang xiao

Cautions

contraindication Deficiency alone, without any excess accumulation
pregnancy Avoid in pregnancy: Da Huang and Mang Xiao are strong draining purgatives that also move Blood, and Dang Gui invigorates Blood as well
caution Use only under a practitioner's supervision and never for self-treatment, since it gives two of the strongest purgatives to patients who are weak by definition
caution If there is no real build-up of Heat and stool, the purgatives can damage Spleen and Stomach Qi and deepen the deficiency; the tonics lessen this risk but do not remove it
caution Elderly, frail or critically ill patients need careful dosing and monitoring; some sources cut back or leave out Mang Xiao for the very weak
caution When depletion of Yin and fluids outweighs the Qi and Blood deficiency, a more Yin-nourishing variant is traditionally chosen instead

Preparation

Decoction; Jie Geng goes in near the end for a brief boil, and Mang Xiao is dissolved in the hot strained liquid rather than boiled; given for a short course only and stopped once the bowels move

Names

Pinyin	huang long tang
English Name	Yellow Dragon Decoction

Classification

Category: Drain Downward