Yellow Dragon Decoction

Yellow Dragon Decoction

Rhei Radix et Rhizoma (Da Huang) 9g, Natrii Sulfas (Mang Xiao) 12g, Aurantii Fructus Immaturus (Zhi Shi) 6g, Magnoliae Officinalis Cortex (Hou Po) 3g, Angelicae Sinensis Radix (Dang Gui) 9g, Ginseng Radix et Rhizoma (Ren Shen) 6g, Glycyrrhizae Radix et Rhizoma (Gan Cao) 3g

Prepare Huang Long Tang without the mang xiao as a decoction; then infuse jie geng 3g, sheng jiang 3 pieces, da zao 2 pieces, and the mang xiao with the decoction.

Purges by promoting defecation, supplements qi and nourishes the blood.

This formula may be prescribed for yangming bowel excess with deficiency of qi and blood. This pattern is characterized by either the discharge of clear, watery stool that is pure green or constipation. There is stomach cavity and abdominal distention and pain which refuses pressure, fever, thirst, mental fatigue, shortness of breath, delirious speech, picking at their pajamas, teasing air as if arranging thread, unconsciousness, reversal counterflow cold of the four limbs, a dry yellow or dry black tongue coating, and a weak pulse.

Binding of interior pathogenic heat, dry stool obstructing bowel qi, and deficiency of qi and blood are the cause of this pattern. Pathogenic heat enters the interior and combines with the dry stool in the intestines to create bowel qi obstruction. This causes constipation, stomach cavity and abdominal distention, pain which refuses pressure, fever, thirst, a dry yellow or black tongue coating. There may also be discharge of clear, watery stool that is pure green, the typical symptom of heat retention with watery discharge due to yangming bowel excess. When the patient has a constitution of qi and blood deficiency or prolonged excess interior heat that failed to be treated on time, and thereafter exhausts qi and blood, he or she may have mental fatigue, shortness of breath, and a weak pulse. Exuberant heat harasses the mind causing mental disorder and zheng qi collapsing, resulting in dangerous symptoms such as unconsciousness, delirious speech, reversal counterflow cold of the four limbs, and picking at pajamas. Given the two aspects of interior excess and zheng qi deficiency, treatments should involve draining heat and removing stagnation through purgation, as well as boosting qi and nourishing blood.

As a formula with Da Cheng Qi Tang as a main aspect of its construct, why is da huang is not added later as it is in Da Cheng Qi Tang?

1. Essential pattern differentiation Huang Long Tang serves as the representative prescription that combines the attacking method with the supplementing method. It is the common formula used to treat yangming bowel excess with concurrent deficiency of qi and blood. This clinical pattern is marked by dry stool, diarrhea with watery discharge, stomach cavity and abdominal distention, fever, thirst, mental fatigue, shortness of breath, dry yellow or black tongue coating, and a weak pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of the coexistence of yangming bowel excess and deficiency of both qi and blood: abdominal typhus, paratyphoid fever, epidemic cerebrospinal meningitis, epidemic encephalitis B, and senile intestinal infarction. 3. Cautions and contraindications It is forbidden to use for patients with constipation due to cold accumulation or deficiency of qi, yin, and blood.

Xin Jia Huang Long Tang (Newly Supplemented Yellow Dragon Decoction, 新加黃龍湯)

Ginseng ( Panax ginseng ) is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II. Its trade is allowed but subject to licensing controls.