Rinhoceros Horn and Rehmannia Root Decoction

Rinhoceros Horn and Rehmannia Root Decoction

From “Qianjin Fang”

[Composition] Rhinoceros horn: 3 grams; Rehmannia root: 30 grams; Peony root: 12 grams; Paeonia bark: 12 grams

[Administration] Grind the rhinoceros horn into juice, then decoct the remaining herbs in water and mix the juices together before taking.

[Indication] Heat entering the blood vessels.

[Indications] Fever, thirst, confusion, delirium, red spots on the skin due to poison, vomiting, nosebleeds, bloody stools, hematuria, red tongue without coating, and a fine, rapid pulse.

[Function] Clear heat and detoxify, cool the blood and stop bleeding.

[Explanation] When heat enters the blood vessels, the patient experiences fever, thirst, confusion, and a red tongue without coating, with a fine, rapid pulse. When blood is affected by heat, red spots appear on the skin due to poison, leading to vomiting, nosebleeds, bloody stools, and hematuria. This formula is intended for cases where heat enters the blood vessels but focuses on the blood. The heart governs blood and fire; rhinoceros horn, with its cold nature, enters the heart to clear heart fire and remove heat toxins, while also having the effect of cooling the blood and stopping bleeding—making it the primary remedy. Rehmannia root is sweet and cold, cooling the blood and stopping bleeding, while also serving as a supporting agent to clear heat and nourish yin. Peony root nourishes yin, and peony bark disperses blood stasis; when heat enters the blood vessels and causes yin and blood damage, the combined effects of these two herbs—nourishing yin and dispersing blood—can be used for complementary treatment.

[Clinical Additions and Subtractions]

① “If the patient frequently forgets things and becomes frantic, add rhubarb and Scutellaria root.” (Qianjin Fang)

② For severe confusion, use Zixue Dan or An Gong Niu Huang Wan in combination; for those who are angry and harbor liver fire, add Chai Hu, Scutellaria root, and Gardenia to clear the liver and relieve anger; for those with intense heart fire, add Coptis chinensis and Gardenia; for severe vomiting and bleeding, add Mao Gen, Zhu Ru, and Dry Lotus Leaf; for significant blood in the stool, add Sophora flower and Yin Qiao; for severe hematuria, add Mao Gen and Small Thistle.

[References]

① “Compared with Qingying Tang, the former combines clearing heat and cooling the blood with clearing qi, enabling heat to be released from the blood vessels and moved to the Qi level—making it suitable for cases where heat first enters the blood vessels but has not yet caused blood loss. This formula consists entirely of blood vessels’ herbs, focusing on clearing heat and detoxifying, cooling the blood and dispersing blood, to treat cases of blood heat. This is the key difference between the two formulas.” (Jiangsu New Medical College: Chinese Medicine Formulaology)

② Using the Rinhoceros Horn and Rehmannia Root Decoction with modifications, 10 cases of primary thrombocytopenic purpura were treated. All patients had platelet counts below 80,000/mm³, with 5 cases having platelet counts below 60,000/mm³. The treatment resulted in 6 cases being cured, 4 cases showing marked improvement, and no cases resulting in death. For cases with severe heat, use Zixue Dan or Antelope Horn; for cases with heavy bleeding, add Sanqi powder or Yunnan Baiyao. (Chinese Medicine Magazine, 1963.11)

[Commentary] This formula is suitable for various acute infectious diseases characterized by bleeding and rash, such as meningitis, Japanese encephalitis, septicemia, trench fever, and epidemic hemorrhagic fever. It can also be used for aplastic anemia, leukemia, thrombocytopenic purpura, acute yellow atrophy of the liver, uremia, and other conditions with bleeding symptoms.

III. Clearing Both Qi and Blood

When heat attacks the Qi level while also entering the blood vessels, it is referred to as “both Qi and blood being burned,” and the treatment approach should combine clearing Qi and clearing blood while cooling the blood—commonly known as the “both Qi and blood clearing” method.