Bai Tong Tang (白通汤) — White Penetrating Decoction

Bai Tong Tang is a variant of Si Ni Tang that adds Cong Bai (spring onion white) to lead Yang out to the surface. It is used in severe Yang deficiency where interior Yang has become so weak that surface Yang is trapped internally — producing paradoxical warmth of the face or chest against a background of profound cold in the extremities.

On this page

1. Overview
2. TCM pattern
3. Ingredients
4. Actions and indications
5. Dosing
6. Cautions and contraindications
7. Related formulas
8. Treatment at my clinic

1. Overview

Bai Tong Tang (白通汤) — White Penetrating Decoction — is a classical Chinese herbal formula in the Warm Interior category. Source: Shang Han Lun, by Zhang Zhongjing. I prescribe it as bespoke pharmaceutical-grade granules from Sun Ten in Taiwan at my clinic in Wokingham, Berkshire and via online herbal consultations.

2. TCM pattern

Extreme interior Cold with Yang trapped internally: intense cold in the limbs, flushing of the face and chest (empty-Yang floating up), diarrhoea, no thirst, a pale swollen tongue, a barely-palpable pulse. The pathognomonic sign is the mismatch between very cold limbs and paradoxical facial warmth.

3. Ingredients

1. Cong Bai — Allium fistulosum (spring onion white) (4 stalks) — chief; opens Yang and leads it out to the surface
2. Gan Jiang — Zingiber officinale (dried ginger) (6g) — warms the Middle
3. Fu Zi — Aconite carmichaelii (processed) (9–15g) — strongly rescues Yang

4. Actions and indications

Principal actions

1. Rescues devastated Yang
2. Guides Yang out to the surface
3. Warms the interior

Indications

1. Severe Yang collapse with paradoxical facial flushing
2. Extreme cold with trapped Yang (Ge Yang syndrome)
3. Yang collapse post-partum or post-surgery
4. Late-stage severe diarrhoea with cold extremities and flushed face

5. Dosing

As decoction, once daily. Emergency short-course use in expert hands only.

6. Cautions and contraindications

1. Contains processed Aconite — qualified prescriber only.
2. Contraindicated in true Heat patterns.
3. Rescue formula — always used within a wider conventional emergency care plan.
4. Contraindicated in pregnancy.

7. Related formulas

• Si Ni Tang — without Cong Bai; for standard Yang collapse
• Tong Mai Si Ni Tang — stronger dose for more severe Yang collapse

8. Treatment at my clinic

I prescribe Bai Tong Tang where the TCM pattern above matches the patient’s presentation, typically as part of a wider prescription tailored to the individual. Return to the Chinese herbal formulas directory or the Chinese herbal medicine main page.