Ge Gen Huang Qin Huang Lian Tang

Ge Gen Huang Qin Huang Lian Tang

From "Shang Han Lun"

[Composition] Ge Gen 12 grams (half a jin), Huang Qin 9 grams (three liang), Huang Lian 9 grams (three liang), Zhigan Cao 6 grams (two liang)

[Usage] Brewed in water and taken orally.

[Indications] Exterior symptoms combined with internal heat.

[Indications] Headache with fever, dry mouth and thirst, profuse sweating with shortness of breath, body heat with diarrhea, and a rapid pulse.

[Functions] Resolve exterior and clear interior.

[Formula Explanation] The patient experiences headache and fever, with intense internal heat. The formula heavily uses Ge Gen, which both resolves the wind-heat in the exterior and helps to uplift the yang energy of the spleen and stomach to treat diarrhea, thereby allowing the exterior to be resolved and the interior to harmonize as the primary focus. Huang Qin and Huang Lian, with their bitter, cooling properties, clear internal heat while treating diarrhea, serving as complementary herbs. Zhigan Cao, which nourishes qi and strengthens the middle burner, can be seen as a supporting herb, while its role in harmonizing the other herbs also serves as a guiding agent.

[Clinical Additions and Subtractions] For those experiencing vomiting, add Banxia; for those with food stagnation, add Shan Zha and Liu Qu; for severe abdominal pain, add Mu Xiang; for bloody stools, add Dang Gui, Bai Shao, and Huai Hua; for severe fever, add Er Hua and Bai Tou Weng.

[Reference Materials] ① "When a person suffers from a Sun-Yang disease and is treated with Guizhi, but the condition persists despite treatment, and the pulse is rapid, it indicates that the exterior has not yet been resolved; when the patient experiences shortness of breath and profuse sweating, the Ge Gen Huang Qin Huang Lian Tang is indicated." (Shang Han Lun) ② "If the disease is in the exterior but treated with methods that weaken the interior, the yang evil takes advantage of the weakened state and enters the body, causing excessive heat and continued diarrhea. The patient experiences headache, fever, and chills on the exterior, so the condition is still considered an exterior symptom, while heat resides within the interior, leading to shortness of breath and profuse sweating. Since the exterior remains active, the formula uses the pungent and sweet properties of Ge Gen and Zhigan Cao to resolve the exterior; because heat resides within the interior, the bitter and cool properties of Huang Qin and Huang Lian are employed to clear the interior." (Yi Fang Kao) ③ The Ge Gen Huang Qin Huang Lian Tang was used to treat 40 cases of acute bacterial dysentery. Among them, 36 cases were cured. Each dose was administered daily, with the shortest course lasting 2 days and the longest 12 days. The average time to reduce fever was 27.76 hours, and the average duration for control of acute symptoms was 3.44 days. Visible pus and blood in the stool disappeared on average after 2.83 days. (Jiangsu Traditional Chinese Medicine, 1960.5:33) ④ There were varying degrees of severity, but generally, children diagnosed in pediatric clinics were found to have neutral enteritis. The report stated that the abdomen was distended and soft, with weight loss, and the child experienced watery diarrhea or even intestinal inflammation. Although the symptoms varied in severity, children were often diagnosed with neutral enteritis in pediatric clinics. The report noted that the abdomen was distended and soft, with weight loss, and the child experienced watery diarrhea or even intestinal inflammation—though the symptoms differed in severity—but these children were generally diagnosed with neutral enteritis in pediatric clinics. All three cases had previously failed to respond to Western medicine; they were switched to traditional Chinese medicine combined with intravenous fluids, and each case was cured after 1–4 doses. The basic formula consisted of Ge Gen, Huang Lian, Huang Qin, and Zhigan Cao. For severe heat, add Yin Hua; for lung heat causing cough, add Sang Bai Pi; for those with food stagnation, add Mai Ya and Lai Fu Zi. (Fujian Traditional Chinese Medicine, 1966, 3:8)

[Commentary] This formula can be used for acute gastroenteritis, acute and chronic bacterial dysentery, digestive disorders in children, and enteric fever.