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Source: Jīn Guì Yào Lüè 金匮要略

Ingredients:

• Dà huáng (大黄 Rhei Radix et Rhizoma, rhubarb) 12g
• Huáng lián (黄连 Coptidis Rhizoma, coptis [root]) 9g
• Huáng qín (黄芩 Scutellariae Radix, scutellaria [root]) 9g

Action: Drains fire and resolves toxin; dries dampness and discharges heat.

Indication: (a) Intense internal fire evil causing frenetic movement of hot blood with vomiting of blood (blood ejection), nosebleed, constipation, and reddish urine; (b) damp-heat brewing internally with jaundice, glomus in the chest and heat vexation, and a slimy yellow tongue fur; (c) or accumulated heat surging upward to cause red swollen eyes and mouth and tongue sores; or (d) sores with vexing heat in the heart and chest and dry bound stool.

Category: Heat-clearing formulas / Heat-clearing toxin-resolving formulas

Method: Decoct with water.

Rationale: Like huanglianjiedutang[1], this formula discharges fire and resolves toxin, but uses the heat-draining action of Dà huáng for stronger action. Dà huáng is the sovereign agent, which is supported by Huáng lián and Huáng qín. These three agents are highly cold and bitter. They drain fire and resolve toxin, and also dry dampness. Dà huáng is a precipitant, and thus drains the heat out through the stool. Although, as its name suggests, this formula drains the heart, it can actually treat any pattern of high fever, vexation and agitation of the exuberant repletion heat type. Since the three yellows dry dampness as well as clear fire, they are effective for damp-heat obstructing the center with oppression in the chest, upwelling and nausea, jaundice, and dysentery. Today, they are used for acute gastroenteritis, hepatitis, cholecystitis, conjunctivitis, stomatitis, tuberculosis with coughing of blood, and sores.

Variations:

• Damp-heat transforming into fire with consequent damage to fluid (e.g., dry mouth): Add Tiān huā fěn (天花粉 Trichosanthis Radix, trichosanthes root), fresh Lú gēn (芦根 Phragmitis Rhizoma, phragmites [root]), or in severe cases fresh Shí hú (石斛 Dendrobii Herba, dendrobium) or Shú dì huáng (熟地黄 Rehmanniae Radix Praeparata, cooked rehmannia [root]).
• Nausea and vomiting: Add three slices of Shēng jiāng (生姜 Zingiberis Rhizoma Recens, fresh ginger).
• Mild abdominal fullness normal stool: Use prepared Dà huáng (大黄 Rhei Radix et Rhizoma, rhubarb).
• Severe abdominal pain add Zhǐ shí (枳实 Aurantii Fructus Immaturus, unripe bitter orange), Mù xiāng (木香 Aucklandiae Radix, costusroot), Chuān liàn zǐ (川楝子 Toosendan Fructus, toosendan [fruit]), and Yán hú suǒ (延胡索 Corydalis Rhizoma, corydalis [rhizome]).

See also: 三黄泻心汤

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