Huanglian Tang – Nan Kaiyang

Author: Nan Kaiyang  Editor: Gu Yuxi Translator: Gu Yuxi

Original Text:

Article 173:For Shaoyang disease, if there is heat in the chest, evil qi in the stomach, abdominal pain, and desire to vomit, Huang Lian Tang is the primary treatment.

I. Identification of Disease Location:

This condition is characterized by upper-jiao heat, obstructed qi movement in the middle-jiao, and lower-jiao cold, resulting in a combination of heat and cold lodged in the stomach. It presents as upper heat and lower cold, and all three jiaos are in a state of deficiency.

II. Pathomechanism Analysis:

1. Heat in the chest, evil qi in the stomach:

This may be due to a long-standing deficiency and residual cold in the stomach, preventing the transportation and transformation of refined grains, leading to obstructed qi movement in the middle-jiao. The excessive heart fire in the upper-jiao causes deficiency heat to rush upwards, qi fails to descend, water and fire do not communicate, resulting in a constitution with mixed heat and cold (upper heat and lower cold).

2. Abdominal pain, desire to vomit:

Stabbing abdominal pain should prompt a search for blood stasis and hard masses. Persistent pain indicates spleen deficiency, qi stagnation, and stomach vacuity cold. The heat in the chest cannot reach the middle-jiao and desires to rush upwards, causing vomiting. This differentiates it from the irritability and desire to vomit seen in Shaoyang’s Chai Hu Tang pattern, and there are no symptoms of Shaoyin water toxin stagnation.

Understanding the Medicinal Formula:

The sovereign medicine in this formula, Huang Lian, clears the deficiency heat in the heart (upper-jiao) and the accumulated food and evil qi in the stomach (middle-jiao), which cause vexing heat below the heart. It also reaches the small intestine to stop dysentery and diarrhea. It’s supported by Da Zao to alleviate abdominal cramps. At the same time, Ren Shen and Gan Jiang lift stomach qi, warm the middle, dispel cold, and prevent evil from entering the Taiyin to form cold repletion. They also strengthen the “Gate of Life” fire and dispel cold evil qi. Ren Shen and Zhi Gan Cao strengthen the heart and spleen. Ban Xia combined with Gui Zhi descends rebellious stomach qi, allowing for through-flow between upper and lower, and the interaction of water and fire.

Disclaimer:​

The experiences and insights shared above represent the author’s personal usage and understanding, and are provided for reference only as part of academic exchange. Please do not blindly replicate or apply them; any consequences arising from such actions are solely your responsibility. As individual constitutions vary, medication should be tailored accordingly. It is advisable to use such treatments under the guidance of a qualified physician. If you have additional experiences to share, comments and submissions are welcome.​
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