Huang Long Tang — Yellow Dragon Decoction

On this page

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

Overview

Huang Long Tang — the “Yellow Dragon Decoction” — is from the Ming-dynasty Shang Han Liu Shu. It addresses one of the most difficult clinical situations: a patient with severe Heat accumulation in the bowels who is also Qi- and Blood-deficient. Pure purging with Da Cheng Qi Tang would collapse the depleted patient; pure tonification would feed the Heat and worsen the obstruction. Huang Long Tang combines Da Cheng Qi Tang’s purging core with Ren Shen, Dang Gui and Gan Cao to provide simultaneous support and clearance.

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

TCM pattern

Huang Long Tang is prescribed for Heat accumulation in the bowels with Qi-Blood deficiency:

• Constipation with hard stool or impaction
• Abdominal distention and pain that refuses pressure
• Tidal fever, possible delirium
• Dry mouth, thirst
• Marked fatigue, exhaustion
• Pale or sallow complexion despite Heat signs
• Tongue — dry yellow coat, may be cracked
• Pulse — possibly forceless yet deep and full at the guan

Key herbs

1. Da Huang, Mang Xiao — purge Heat-accumulation through the bowels
2. Zhi Shi, Hou Po — move Qi; break stagnation
3. Ren Shen — tonifies Original Qi (critical to prevent collapse from purging)
4. Dang Gui — nourishes Blood and moistens the Intestines
5. Gan Cao, Sheng Jiang, Da Zao — harmonise; protect the Stomach
6. Jie Geng — opens the Lung (encourages descent below)

Formula actions

1. Purges Heat-accumulation from the bowels
2. Tonifies Qi and Blood
3. Generates fluids; moistens the Intestines

Conditions treated

1. Severe constipation with impaction in elderly or debilitated patients
2. Post-operative ileus with marked depletion
3. Constipation in advanced cancer with Heat-accumulation and exhaustion
4. Severe acute febrile illness in a deficient host with bowel impaction
5. Sepsis-associated ileus with deficiency (alongside conventional care)
6. Acute on chronic constipation in frail patients

Cautions

Contains Da Huang and Mang Xiao — strictly contraindicated in pregnancy.

Acute febrile illness with delirium, ileus, or severe constipation in elderly patients requires urgent medical assessment alongside any herbal support.

For short-term use only — once bowels move and Heat is cleared, switch to a purely tonifying formula.

Not appropriate for cold-deficient constipation — use Ji Chuan Jian.

Always consult a qualified Chinese herbalist registered with the RCHM.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.