Hua Ban Tang — Transform Maculae Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Hua Ban Tang — the “Transform Maculae Decoction” — is from Wu Jutong’s Qing-dynasty Wen Bing Tiao Bian. It is a modification of Bai Hu Tang with the addition of Xuan Shen and Dian Dao Pao Cao (sometimes substituted by Dan Pi or other Blood-cooling herbs) to address the transition where Heat that was clearing at the Qi level has begun penetrating into the Blood level, producing dark red maculopapular rash that does not blanch. This is the classical “clearing Qi and cooling Blood simultaneously” strategy for high acute febrile illness with prominent skin manifestations.

I prescribe Hua Ban Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan, always alongside conventional management for any acute case.

TCM pattern

Hua Ban Tang is prescribed for Heat at the Qi level penetrating into the Blood:

• High fever
• Dark red or purplish maculopapular rash that does not blanch
• Severe thirst, restlessness
• Possible delirium
• Dry mouth, possibly with cracked lips
• Possible spontaneous bleeding (nosebleed, gums)
• Tongue — deep red (crimson), dry yellow coat
• Pulse — surging, rapid

Key herbs

1. Shi Gao — chief; clears intense Heat at the Qi level
2. Zhi Mu — clears Heat; nourishes Yin and generates fluids
3. Xuan Shen — cools Blood; nourishes Yin; resolves toxin
4. Geng Mi, Gan Cao — protect the Stomach from the cold herbs
5. (Modern modifications often add Sheng Di Huang, Mu Dan Pi, Chi Shao for stronger Blood-cooling)

Formula actions

1. Clears Heat at the Qi level
2. Cools Blood and resolves maculae
3. Nourishes Yin; generates fluids

Conditions treated

1. Severe acute febrile illness with petechial or purpuric rash (alongside conventional care)
2. Bacterial septicaemia with skin manifestations (with antibiotics)
3. Severe viral exanthems with confluent rash and high fever
4. Severe drug rash with high fever and dark red eruption
5. Henoch-Schönlein purpura with high Heat pattern
6. Severe acute COVID-19 with high fever and rash (with conventional care)

Cautions

Petechial or purpuric rash with high fever is a medical emergency — meningococcal disease, septicaemia and severe drug reactions require urgent hospital care. Use of this formula does not substitute for emergency assessment.

Not appropriate for cold-deficient, Yang-deficient or Yin-deficient patterns without high Heat.

For short-term acute use only.

Always consult a qualified Chinese herbalist registered with the RCHM.

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