Yi Huang Tang — Change Yellow Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Comparisons with related formulas
7. Cautions

Overview

Yi Huang Tang — the “Change Yellow Decoction” — is Fu Qingzhu’s (1607–1684) companion formula to Wan Dai Tang. While Wan Dai Tang treats white damp discharge from Spleen weakness, Yi Huang Tang treats yellow damp-heat discharge in the lower burner from Spleen-Kidney deficiency with damp-heat accumulation.

The elegance of the formula is that it uses Kidney-Spleen-tonifying herbs (Shan Yao, Qian Shi) alongside Heat-clearing herbs (Huang Bai, Che Qian Zi) and an astringent (Bai Guo). It cools and clears without further depleting the already-weak Spleen-Kidney foundation.

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

TCM pattern

Yi Huang Tang is prescribed for damp-heat vaginal discharge with underlying Spleen-Kidney deficiency:

• Yellow, sticky, foul-smelling vaginal discharge
• Vulval itching or burning
• Urinary discomfort in some cases
• Lower back ache
• Sticky, bitter mouth
• Possibly mild fever or warm feeling in afternoons
• Tongue — red, yellow greasy coat at the back
• Pulse — slippery, rapid, possibly weak at proximal positions

Key herbs

1. Shan Yao (large dose) — tonifies Spleen and Kidney; astringes
2. Qian Shi (Euryale ferox) — astringes Essence and Damp; tonifies Spleen-Kidney
3. Huang Bai (Phellodendron amurense) — clears damp-heat from lower burner
4. Che Qian Zi — drains damp-heat through urination
5. Bai Guo (ginkgo seed) — astringes leakage

Formula actions

1. Clears damp-heat from the lower burner
2. Tonifies Spleen and Kidney Qi
3. Astringes leakage
4. Stops yellow leukorrhoea

Conditions treated

1. Yellow vaginal discharge from damp-heat
2. Recurrent yeast infections with chronic pattern (alongside conventional care)
3. Bacterial vaginosis with foul discharge
4. Chronic cervicitis with yellow discharge
5. Chronic urinary tract infection with damp-heat — see UTIs
6. Chronic pelvic inflammatory disease with damp-heat pattern
7. Recurrent thrush in diabetic patients — alongside conventional management

Comparisons with related formulas

• Wan Dai Tang — for white damp discharge from Spleen weakness; opposite indication.
• Long Dan Xie Gan Tang — for stronger Liver-Gallbladder damp-heat with foul yellow-green discharge; more draining.
• Er Miao San — simpler damp-heat formula.

Cautions

Persistent or recurrent vaginal discharge with itching, bleeding or foul odour needs gynaecological assessment for infection, sexually transmitted disease, polyp or cervical pathology.

Use cautiously in pregnancy — consult a qualified practitioner.

Always consult a qualified Chinese herbalist registered with the RCHM.

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