San Huang Xie Xin Tang — Drain the Epigastrium with Three Yellows

On this page

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

Overview

San Huang Xie Xin Tang — the “Three Yellows Drain the Epigastrium Decoction” — is from Zhang Zhongjing’s Jin Gui Yao Lue. Three powerful cold draining herbs — Da Huang, Huang Lian, Huang Qin (the three “Huangs” or yellows) — combine to drain Excess Fire throughout the upper three burners, with particular use for Fire-type bleeding (nosebleed, haematemesis) and severe agitation.

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

TCM pattern

San Huang Xie Xin Tang is prescribed for Excess Fire in the upper three burners:

• Restlessness, agitation, severe irritability
• Red face, possibly red eyes
• Bleeding from upper body — epistaxis, haematemesis, haemoptysis
• Bitter taste, foul breath
• Severe constipation
• Possible delirium or insomnia from Fire disturbing the Shen
• Severe acute mouth ulcers
• Hot, painful, swollen face or neck
• Tongue — red, yellow coat
• Pulse — rapid, forceful, possibly slippery

Key herbs

1. Da Huang — purges Fire downward through bowels
2. Huang Lian — clears Heart and Stomach Fire
3. Huang Qin — clears Lung and upper-burner Fire

Formula actions

1. Drains Fire from the three burners
2. Cools Blood and stops Fire-type bleeding
3. Resolves severe agitation and delirium from Fire
4. Purges accumulation

Conditions treated

1. Severe acute hypertensive crisis with red face and headache (alongside conventional care)
2. Acute haemorrhage from Fire — epistaxis, haemoptysis, haematemesis
3. Severe acute hyperthyroidism with marked agitation
4. Severe acute mania or psychosis with Fire pattern
5. Severe acute conjunctivitis with red eyes
6. Severe acute oral toxicity with mouth ulcers and bleeding gums
7. Acute toxic febrile illness

Cautions

Contains Da Huang — strictly contraindicated in pregnancy.

Not appropriate for cold-deficient or Yin-deficient patterns — the cold draining herbs damage Yang and depleted Yin.

For short-term acute use only; not for chronic use.

Acute hypertensive crisis, severe bleeding or severe psychiatric emergency require urgent medical care.

Always consult a qualified Chinese herbalist registered with the RCHM.

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