Huang Lian Tang — Coptis Decoction

On this page

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

Overview

Huang Lian Tang — the “Coptis Decoction” — is from Zhang Zhongjing’s Shang Han Lun. It treats the difficult clinical picture where Heat is lodged in the upper burner / Stomach while Cold is lodged in the lower burner / Intestines, producing simultaneous Heat symptoms (epigastric burning, nausea, bitter taste) and Cold symptoms (abdominal pain that responds to warmth, loose or cold-pattern diarrhoea). The formula is a relative of Ban Xia Xie Xin Tang with Gui Zhi added to better warm the channels and circulate Yang in the chest.

I prescribe Huang Lian Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Huang Lian Tang is prescribed for Heat in the upper burner with Cold in the lower:

• Epigastric pain, burning, nausea or vomiting (upper Heat)
• Abdominal pain that improves with warmth and pressure (lower Cold)
• Loose stools or cold-pattern diarrhoea
• Bitter taste, dry mouth above; cool sensation in lower abdomen
• Possibly belching or hiccups
• Tongue — mixed yellow-and-white coat, often greasy
• Pulse — wiry above, deep below

Key herbs

1. Huang Lian — chief; clears Stomach Heat; stops vomiting and burning
2. Gan Jiang (dried ginger) — warms the middle and lower burners; counters cold-pattern diarrhoea
3. Gui Zhi — warms the channels; circulates Yang in the chest
4. Ban Xia — harmonises the Stomach; descends rebellious Qi; stops vomiting
5. Ren Shen, Zhi Gan Cao, Da Zao — tonify and harmonise the middle

Formula actions

1. Clears Heat from the Stomach
2. Warms Cold in the Intestines
3. Harmonises the middle burner
4. Descends rebellious Qi; stops vomiting

Conditions treated

1. Mixed Cold-Heat IBS with vomiting/burning above and loose stool with cold pain below — see IBS
2. GORD with intestinal cold pattern
3. Chronic gastritis with upper-Heat and lower-Cold
4. Bile reflux gastritis with mixed pattern
5. Functional dyspepsia with mixed Cold-Heat
6. Chemotherapy nausea with cold-pattern diarrhoea

Cautions

Not appropriate for pure Heat patterns or pure Cold patterns — pattern identification is essential.

Acute severe upper abdominal pain, haematemesis or melaena require urgent medical assessment.

Always consult a qualified Chinese herbalist registered with the RCHM.

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