Danggui Liu Huang Tang

Danggui Liu Huang Tang

(Lan Shi Mi Zang)

[Composition] Danggui, Shengdi, Shuodi, Huangqin, Huanglian, Huangbai, each in equal parts, plus Huangqi doubled.

[Usage] Grind into coarse powder, take 15 grams each time, and brew in water.

[Indications] Pathogenic heat combined with deficiency heat.

[Indications] Red face and dry lips, difficulty in defecation and urination with red urine, bone marrow depletion and night sweats, profuse sweating, red tongue with a rapid pulse.

[Functions] Clear heat and nourish yin, consolidate the exterior and stop sweating.

[Formula Explanation] In the later stages of fever, the pathogenic heat has not yet fully subsided; yin fluids are greatly depleted, and false fire is stirring within. The former represents true fire, while the latter indicates deficiency heat—when both coexist, this condition arises. The pathogenic heat has not yet fully subsided, so the face appears red and lips are dry, while defecation and urination are difficult; when false fire stirs within, bone marrow depletion and night sweats occur. In the formula, the three Huangs use bitter and cold properties to clear the remaining pathogenic heat; the two Shengdis nourish yin and calm the internal movement of false fire. Together, the five herbs work to clear heat and nourish yin as their primary functions. When yin is deficient internally, night sweats occur; when pathogenic heat is present, excessive sweating occurs—thus, sweating is an important manifestation of this condition. This formula heavily emphasizes Huangqi, and its use to consolidate the exterior and stop sweating can be considered an auxiliary herb. Danggui nourishes blood and activates blood circulation to benefit the blood vessels, which can be seen as a complementary treatment.

[Clinical Additions and Subtractions]

Add Digeopi, Baishao, Mujin, Mahuang Gen, Fu Xian Mai, and Nuodao Gen to strengthen the effect of stopping sweating; in severe cases, add Zhimu, Guibian, and Baojia.

[Reference Materials]

① “The blood is what the heart stores internally, while sweat is what the heart releases externally—sweat is the liquid of the heart. When you wake up and sweat, it’s spontaneous sweating because the defensive yang is weak and unable to hold onto the body; when you sleep and sweat, it’s nocturnal sweating because the yin is deficient and fire disturbs the body. But when yin deficiency causes fire to disturb the mind, why do you sweat while you sleep, but not when you wake up? The defensive qi travels through the yin portion while you sleep, but because the defensive qi is weak, you sweat; when you wake up, the defensive qi still flows outward through the yang portion, and the defensive qi is again secure. The two Shengdis nourish yin and replenish blood, while Danggui guides them into the heart; the three Huangs use bitter properties to clear the hidden fire in the yin—fire is calmed, blood is tranquil, and sweat naturally does not come out, staying on the surface, so Huangqi is added to reinforce this process.” (Cheng Fang Jian Du)

② Cai Xiaohong, a 8-year-old girl, had a persistent fever for 10 days, never dropping below 39–40°C, with her body sweating profusely until almost dawn. She had a fever of around 38.5°C at night, with dry mouth, tongue sores, and restlessness. Examination revealed a slippery, rapid pulse, a red tongue with a thin, yellow, and dry coating, and a bright red tip. The formula used was Danggui Liu Huang Tang with Lotus Seed Heart, Mai Men Dong, and Mahuang Gen; after five doses, her night sweats stopped completely, her nighttime fever decreased, and she was cured by switching to Zhiku Dihuang Tang. (Jiangxi Pharmaceutical Magazine, 1965, 6)

[Commentary] This formula is used for fever and night sweats in tuberculosis, rheumatism, and blood diseases.

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Chapter Six: Summer-Dispelling Agents

Summer is one of the six external evils and a major causative factor in external diseases. The Suwen’s “Five Movements Great Discussion” states: “In heaven, it is heat; on earth, it is fire… Its energy is summer.” It is evident that summer and heat-related illnesses share similar characteristics; therefore, the clearing method can also be used to treat summer conditions. Ancient physicians said, “Summer is the heat of the summer months,” with spring preceding summer—spring governs wind, and summer easily combines with wind; after summer comes long summer, which governs dampness, and summer is prone to dampness as well; since summer is a heat illness, it often harms yin; summer’s energy flows to the heart, and sweat is the liquid of the heart—when sweat appears, qi is consumed. For simple summer conditions, it is advisable to clear summer heat; when summer is accompanied by wind, it is necessary to dispel summer heat and release the exterior; when summer is mixed with dampness, it is advisable to clear summer heat and promote dampness elimination; when summer consumes qi, it is advisable to clear summer heat and replenish qi.