San Huang Xie Xin Tang: A TCM Formula for Clearing Intense Heat and Relieving Fullness
Hongji Medical- 9 hours ago
- 3 min read
San Huang Xie Xin Tang comes from the Eastern Han Dynasty physician Zhang Zhongjing’s Essentials from the Golden Cabinet (Jin Gui Yao Lue), a classic Chinese medicine text.
This work focuses on diagnosing and treating various internal disorders and includes many formulas still widely used today. San Huang Xie Xin Tang is a key formula designed to treat intense internal heat and fullness under the heart.
Known for its simple yet powerful composition, San Huang Xie Xin Tang consists of three herbs—Da Huang, Huang Lian, and Huang Qin—all yellow in color, hence the name “Three Yellows.” Together, these herbs clear heat, detoxify, and relieve fullness, making it a go-to formula for intense internal heat and fullness under the heart.
San Huang Xie Xin Tang Formula
The formula consists of:
Monarch Herb: Da Huang (Rhubarb)Da Huang, bitter and cold, clears heat, promotes bowel movements, and breaks up stagnation. As the main herb, it purges intense heat from the lower burner, allowing heat to exit through the stool.
Minister Herbs: Huang Lian (Coptis) and Huang Qin (Scutellaria)
Huang Lian, bitter and cold, clears heat, dries dampness, and detoxifies, targeting heat in the middle burner to calm heart fire.
Huang Qin, bitter and cold, clears heat, dries dampness, and detoxifies, addressing heat in the upper burner to reduce lung fire.
San Huang Xie Xin Tang uses only these three herbs, with no assistant or envoy herbs.
Pathophysiology of San Huang Xie Xin Tang
San Huang Xie Xin Tang treats intense internal heat and fullness under the heart, with the following pathophysiology:
Intense Internal Heat: Caused by poor diet, emotional stress, or other factors, excessive heat builds up in the middle burner, disrupting normal function.
Fullness Under the Heart: Heat blocks qi movement in the middle burner, causing a feeling of fullness or blockage under the heart that is soft and painless when pressed.
Overall Symptoms: Patients often experience fullness under the heart, irritability, red face, red eyes, bitter or dry mouth, constipation, red tongue with yellow coating, and a rapid, slippery pulse.
Effects and Indications of San Huang Xie Xin Tang
Effects: Clears heat, promotes bowel movements, detoxifies, and relieves fullness under the heart.
Main Indication: Intense internal heat with fullness under the heart.
Symptoms:
Fullness under the heart, soft and painless when pressed.
Irritability, sometimes with delirium.
Red face and eyes.
Bitter or dry mouth.
Constipation.
Red tongue with yellow coating.
Rapid, slippery pulse.
Additional Uses:
High blood pressure with symptoms like irritability, heavy head, light feet, or poor bowel movements.
Robust patients with bleeding tendencies, such as nosebleeds or hemorrhoid bleeding.
Comparison with Related Formulas
San Huang Xie Xin Tang stands out among formulas for fullness, with unique strengths:
Ban Xia Xie Xin Tang: Treats spleen-stomach weakness with mixed cold-heat and fullness under the heart, plus nausea, vomiting, and diarrhea. Unlike San Huang Xie Xin Tang, it targets mixed deficiency-excess conditions.
Sheng Jiang Xie Xin Tang: Treats water retention with fullness under the heart, dry retching, and intestinal sounds. It focuses on water retention, unlike San Huang Xie Xin Tang’s heat-clearing focus.
Huang Lian Jie Du Tang: Also clears heat and detoxifies but targets all types of intense heat-toxin conditions. San Huang Xie Xin Tang is more specific for fullness under the heart and constipation, while Huang Lian Jie Du Tang is better for heat symptoms like mouth sores without constipation.
San Huang Xie Xin Tang excels at clearing heat, promoting bowel movements, detoxifying, and relieving fullness caused by intense internal heat.
Modern Applications and Research
Modern research highlights San Huang Xie Xin Tang’s benefits:
Anti-inflammatory: Reduces inflammation and tissue damage.
Antibacterial: Inhibits various bacteria.
Blood Pressure Reduction: Dilates blood vessels to lower blood pressure.
Improved Gut Function: Promotes intestinal movement to relieve constipation.
Clinical Uses: Widely used for high blood pressure, acute gastritis, duodenal ulcers, and constipation.
Additional Applications:
Helps with stress, tension, or high blood pressure tendencies.
Effective for anxiety or restlessness from trauma-related bleeding, like cuts or wounds.
Precautions
When using San Huang Xie Xin Tang, note the following:
Syndrome Differentiation: Suitable only for intense internal heat with fullness. Avoid in cases of spleen-stomach weakness or cold-deficiency conditions.
Pregnancy Caution: Pregnant women should use cautiously or under medical guidance.
Avoid Tonic Herbs: As a purging formula, it should not be combined with nourishing herbs to avoid reducing efficacy.
Conclusion
San Huang Xie Xin Tang is a classic Chinese medicine formula for treating intense internal heat and fullness under the heart, known for clearing heat, detoxifying, and promoting bowel movements. Proper syndrome differentiation, along with attention to diet and precautions, is essential for safe and effective use. Consult a doctor or Chinese medicine practitioner with any questions.
