Huang Tu Tang (黄土汤) — Yellow Earth Decoction

Huang Tu Tang (Yellow Earth Decoction) is the classical Chinese formula for chronic bleeding driven by Spleen Yang failing to hold Blood in the vessels. It is typically used for chronic haematemesis, melaena, uterine bleeding and blood in stool with a cold-deficient constitutional background. The formula centres on Zao Xin Tu (calcined yellow earth from the stove) — a warming, Blood-stabilising mineral.

On this page

Overview
TCM pattern
Modern welfare-compliant modification
Ingredients
Actions and indications
Dosing
Cautions and contraindications
Related formulas
Treatment at my clinic

1. Overview

Huang Tu Tang (黄土汤) — Yellow Earth Decoction — is a classical Chinese herbal formula in the Regulate Blood (stop bleeding) category. Source: Jin Gui Yao Lue (Essentials of the Golden Cabinet), 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

Spleen Yang deficiency failing to control the Blood, presenting with chronic bleeding — melaena, blood in vomit, uterine spotting, blood in stool — alongside pallor, cold extremities, cold abdomen, poor appetite and a pale swollen tongue.

3. Modern welfare-compliant modification

The classical formula includes E Jiao (donkey-hide gelatin). This entry describes a welfare-compliant version in which E Jiao is omitted and the blood-nourishing action is preserved by increased Shu Di Huang and the addition of Dang Gui and Bai Shao — a modern modification widely adopted in welfare-conscious integrative practice.

4. Ingredients

Zao Xin Huang Tu — calcined yellow earth from the stove (mineral) (30–60g (decocted first)) — chief herb; warms the Middle, strengthens Spleen, stops bleeding
Fu Zi — Aconite carmichaelii (processed) (9g) — warms Spleen and Kidney Yang
Bai Zhu — Atractylodes macrocephala (9g) — strengthens Spleen Qi
Shu Di Huang — Rehmannia glutinosa (prepared) (9–15g) — nourishes Blood and Yin (increased from classical dose to compensate for E Jiao omission)
Dang Gui — Angelica sinensis (9g) — added in the modified form; nourishes and moves Blood
Bai Shao — Paeonia lactiflora (white peony) (9g) — added in the modified form; nourishes Blood and preserves Yin
Huang Qin — Scutellaria baicalensis (6g) — clears any residual Heat — prevents the warming herbs from causing counter-Fire
Zhi Gan Cao — Glycyrrhiza uralensis (honey-fried) (6g) — harmonises the formula

5. Actions and indications

Principal actions

Warms the Middle to strengthen Spleen
Restrains the Blood (stops bleeding)
Nourishes Blood

Indications

Chronic melaena (blood-tinged dark stool) from Spleen Yang deficiency
Chronic haematemesis (vomiting blood)
Uterine bleeding with cold and pallor
Blood in stool with cold hands and feet, pale tongue, weak pulse
Post-partum uterine bleeding with cold constitution

6. Dosing

As decoction, once daily during active bleeding; granule form 6–9g/day. Continue for 1–3 weeks after bleeding stops for consolidation.

7. Cautions and contraindications

Contraindicated in Heat-type bleeding (Blood-Heat) — would worsen the condition.
Contains processed Aconite (Fu Zi) — qualified prescriber only.
Any new or unexplained bleeding requires conventional medical assessment first.
Not for bleeding due to structural causes (fibroids, tumours, polyps) without conventional workup.

9. Treatment at my clinic

I prescribe Huang Tu 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.