【Chinese Name】 |
黃龍湯
|
【Phonetic】 |
Huang Long Tang
|
【English Name】 |
Yellow Dragon Decoction |
【Classification】 |
Purgative formulas |
【Source】 |
《Six Texts on Cold Damage》Shang Han Liu Shu《傷寒六書》 |
【Combination】 |
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 |
【Method】 |
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. |
【Action】 |
Purges by promoting defecation, supplements qi and nourishes the blood. |
【Indication】 |
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. |
【Pathogenesis】 |
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. |
【Clarification】 |
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? Although this syndrome is marked by interior excess due to heat bind, qi and blood is so deficient that the zheng qi is on the edge of collapsing. If the purgation is too strong, it is very likely that the original qi will collapse. So when purgation is used, measures should be taken to prevent zheng qi from collapsing; people should be protected when pathogens are attacked. That is why da huang is not added later as it is in Da Cheng Qi Tang. This formula is milder than Da Cheng Qi Tang in its purgative action. |
【Application】 |
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. |
【Additonal formulae】 |
Xin Jia Huang Long Tang (Newly Supplemented Yellow Dragon Decoction, 新加黃龍湯) [Source]《Systematic Differentiation of Warm Diseases》Wen Bing Tiao Bian《溫病條辨》 [Ingredients] Sheng di 5 qian (15g), gan cao 2 qian (6g), ren shen 1.5 qian (4.5g) (decocted separately), da huang 3 qian (9g), mang xiao 1 qian (3g), xuan shen 5 qian (15g), mai dong 5 qian (15g), dang gui 1.5 qian (4.5g), hai shen 2 pieces, jiang zhi 6 spoonful [Preparation and Administration] Prepare Xin Jia Huang Long Tang without the ren shen and ginger juice as a decoction as 3 cups. Take 1 cup with ren shen 5 fen and two spoonful ginger juice each time. Once the loose stool appeared, the use of decoction should be discontinued. [Actions] Drains heat to promote defecation, nourishes yin and boosts qi. [Applicable Patterns] Interior excess due to heat bind, deficiency of qi and yin. Symptoms include: constipation, distention, fullness and hardness in abdomen, mental fatigue, shortness of breath, dry mouth, cracked lips, a dry, cracked tongue, and a dry yellow or black tongue coating. |
【Remark】 |
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. |
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