Bai Hu Tang — White Tiger Decoction

Overview

Bai Hu Tang — the White Tiger Decoction — is one of the most powerful Heat-clearing formulas in TCM. It originates from Zhang Zhongjing’s Shang Han Lun (c. 200 CE) and is named after the White Tiger, the mythological guardian of the West associated with cooling and descending energy. Its primary action is to clear extreme Heat from the Qi level — the stage where pathogenic Heat has penetrated beyond the body’s defensive surface but has not yet entered the Blood.

TCM pattern

Bai Hu Tang is prescribed for intense Heat in the Qi level (Yangming channel syndrome), characterised by the four cardinal signs: high fever, profuse sweating, intense thirst with a desire for cold drinks, and a surging, flooding pulse. The patient feels extremely hot, is agitated and restless, with a red face and dry mouth. It is also used for excessive Stomach Heat and Lung Heat producing inflammatory conditions.

Key herbs

Shi Gao (Gypsum fibrosum) — the principal herb; a large dose of raw mineral gypsum that dramatically clears Heat and reduces fever; enters the Lung and Stomach channels
Zhi Mu (Anemarrhena asphodeloides rhizome) — clears Heat, nourishes Yin and generates fluids; prevents the Heat from consuming body fluids
Jing Mi (non-glutinous rice) — protects the Stomach and generates fluids
Zhi Gan Cao (honey-fried Glycyrrhiza root) — harmonises the formula and protects the Middle Jiao

Conditions treated

High fever in acute infectious disease with intense thirst, sweating and agitation
Inflammatory arthritis — the modified formula Bai Hu Jia Gui Zhi Tang is the primary formula for Hot Bi syndrome (active rheumatoid arthritis with hot, swollen, acutely tender joints)
Menopausal hot flushes where Stomach Heat is prominent alongside Yin deficiency
Intense thirst and excessive hunger in diabetes
Acne with prominent Stomach Heat and intense redness