Dang Gui Liu Huang Tang: Chinese herbal medicine for Yin Deficiency and Excessive Heat
Hongji Medical- Feb 21
- 5 min read
Chinese herbal medicine Dang Gui Liu Huang Tang, a time-honored prescription from traditional Chinese medicine, originates from Li Dongyuan’s Lanshi Mizang, a key text by one of the four great doctors of the Jin and Yuan dynasties.
Renowned as a "holy medicine for treating diarrhea," this formula excels at nourishing yin, clearing excess heat, strengthening the body’s defenses, and stopping excessive sweating. It is particularly effective for conditions caused by yin deficiency and excessive internal fire, such as night sweats, irritability, and dry mouth.
Understanding the Chinese herbal medicine
Dang Gui Liu Huang Tang combines seven herbs, carefully selected to work in harmony based on the traditional Chinese medicine principles of monarch, minister, assistant, and envoy:
Main Herbs (Monarch)
Angelica Root (Dang Gui): Nourishes and activates blood, regulates menstruation, and relieves pain.
Raw Rehmannia Root (Sheng Di Huang): Nourishes yin, cools blood, and calms the mind.
Cooked Rehmannia Root (Shu Di Huang): Strengthens yin, supports kidney function, and promotes healthy tendons and bones.
These herbs replenish blood and fluids, nourish yin, and clear internal heat.
Assistant Herbs (Minister)
Coptis Root (Huang Lian): Clears heat, detoxifies, reduces inflammation, and alleviates dysentery.
Scutellaria Root (Huang Qin): Clears heat, dries dampness, and reduces toxins.
Phellodendron Bark (Huang Bai): Clears heat, dries dampness, and reduces deficiency fire.
These herbs target excess heat and irritability, cooling the body and calming restlessness.
Supporting Herb (Envoy)
Astragalus Root (Huang Qi): Boosts qi, strengthens the body’s exterior defenses, and prevents excessive sweating. When paired with Angelica, it supports qi and blood production, fortifying the body against fluid loss.
Conditions Treated
Dang Gui Liu Huang Tang is primarily used to address symptoms of yin deficiency with excessive fire. Common signs include:
Fever and restlessness
Flushed face and irritability
Dry mouth and lips
Hard, dry stools
Dark, yellow urine
Red tongue with yellow coating
Rapid pulse
These symptoms arise when the body’s yin fluids—likened to cooling water—are depleted, allowing internal “fire” to flare up. This imbalance can force fluids out as sweat, especially during sleep (known as “night sweats”). The formula restores moisture, cools the fire, and prevents further fluid loss.
How Dang Gui Liu Huang Tang Works
The formula addresses the root causes of yin deficiency and excessive heat through a multi-pronged approach:
Nourishing Yin and Replenishing Fluids: Angelica, raw rehmannia, and cooked rehmannia hydrate the body, restoring essential moisture.
Clearing Heat and Fire: Coptis, scutellaria, and phellodendron cool the body, reducing the intensity of internal fire.
Strengthening Defenses and Stopping Sweat: Astragalus fortifies the body’s surface, preventing excessive sweating and supporting qi and blood balance.
Harmonizing Liver and Lungs: By regulating these organs, the formula balances qi and blood, promoting overall comfort and health.
This comprehensive action not only alleviates symptoms like night sweats but also fosters long-term well-being.
Modern Applications
In contemporary medicine, Dang Gui Liu Huang Tang is used to treat conditions linked to yin deficiency and excessive heat, including:
Hyperthyroidism
Tuberculosis
Diabetes
Menopausal syndrome
These conditions often present with internal heat, depleted yin fluids, and symptoms like restlessness or excessive sweating. The formula’s ability to nourish yin, clear heat, and stabilize the body makes it a versatile remedy.
Precautions
As a cooling formula, Dang Gui Liu Huang Tang should be used cautiously in individuals with:
Spleen and stomach deficiency or coldness
Weak digestion, reduced appetite, or loose stools
Yin deficiency without significant internal fire
Sweating can have various causes, so proper diagnosis by a qualified practitioner is essential. While taking this formula, maintain a light diet and avoid spicy or stimulating foods to support its effects.
Dang Gui Liu Huang Tang remains a powerful example of traditional Chinese medicine’s ability to restore balance and promote health, offering relief for those struggling with yin deficiency and excessive heat.
Chinese Name | 當歸六黃湯 |
Phonetic | Dang Gui Liu Huang Tang |
English Name | Chinese Angelica Six Yellow Decoction |
Classification | Heat-clearing formulas |
Source | 《Secrets from the Orchid Chamber》Lan Shi Mi Cang《蘭室秘藏》 |
Combination | Angelicae Sinensis Radix (Dang Gui) 6g, Rehmanniae Radix (Sheng Di Huang) 6g, Scutellariae Radix (Huang Qin) 6g, Phellodendri Chinensis Cortex (Huang Bai) 6g, Coptidis Rhizoma (Huang Lian) 6g, Rehmanniae Radix Praeparata (Shu Di Huang) 6g, Astragali Radix (Huang Qi) 12g |
Method | Grind the medicinals into a crude powder. Decoct one dose of the formula (5 qian/15g) with 2 zhan of water, and boil it until the volume reduces to about 1 zhan. Take the decoction before meals. The dose should be cut in half for children. (Modern use: use water to decoct the medicinals.) |
Action | Nourishes yin, drains fire, consolidates the exterior, and arrests sweating. |
Indication | This formula is indicated for night sweating caused by yin deficiency and intense fire. The symptoms are night sweating with fever, red complexion, vexation, thirst and dry lips, dry stool, dark urine, a red tongue body with a yellow coating, and a rapid pulse. |
Pathogenesis | This is a pattern of night sweating caused by yin deficiency and intense fire. The phase of the heart is fire, and the phase of the kidney is water. Normally, fire and water are coordinated with each other, and the heart and kidney interact with each other in a harmonious relationship. If the kidney yin becomes deficient, the kidney water fails to coordinate with the heart fire. The fire of heart will then intensify because of the lack of water, causing the pattern of yin deficiency and intense fire. The fire will become more intense as more yin is consumed over time. Yin will not be able to stay inside as the intense fire forces fluids to leak outward, causing night sweating with fever. Deficiency-heat flames up causing a red complexion and vexation. Yin and fluids are consumed, which leads to thirst and dry lips, dry stool, and dark urine. A red tongue with a yellow coating, and a rapid pulse are signs of interior heat. The characteristic features of the pattern are deficiency of yin and blood, intense heart fire, outward leaking of yin forced by fire, and damage to the wei qi. Therefore, the therapeutic method is to nourish yin and blood, clear heat and drain fire, and boost qi to consolidate the exterior. |
Clarification | Why is sweet-warm huang qi included in Dang Gui Liu Huang Tang, a formula for yin deficiency with intense fire harassing the interior? While this is a pattern of yin deficiency with intense fire harassing the interior, there is frequent sweating that damages wei qi. Furthermore, since yang enters the yin level when one falls asleep, wei qi is relatively deficient during sleep. Nourishing yin and draining fire alone can not effectively arrests sweating unless a qi-boosting medicinal is added to consolidate the exterior. There is also the aspect of pairing huang qi with other medicinals in the formula to yields further formulaic actions. When huang qi is coupled with dang gui, they nourish qi and blood, consolidate striae and interstices, and prevent sweating. When huang qi, a sweet medicinal, is coupled with huang lian, huang qin, and huang bai, cold medicinals, they drain fire and prevent the bitter-cold medicinals from damaging the middle jiao. In conclusion, huang qi in Dang Gui Liu Huang Tang does not enhance damage to yin by intensifying fire. Huang qi helps nourish yin, arrest sweating, and prevent the bitter-cold medicinals from damaging the middle jiao. |
Application | 1. Essential pattern differentiation Dang Gui Liu Huang Tang is a commonly used formula applicable for night sweating caused by yin deficiency and intense fire. This clinical pattern is marked by night sweating, red complexion, vexation and thirst, red tongue body, and a rapid pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of yin deficiency and intense fire: hyperthyroidism, tuberculosis, diabetes mellitus, and menopausal syndrome. 3. Cautions and contraindications Do not use the formula for patterns of yin deficiency without intense fire, or for patients with poor digestion and thin, unformed stools caused by deficiency of the spleen and stomach. |
