Yue Bi Tang — Maidservant from Yue Decoction

On this page

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

Overview

Yue Bi Tang — the “Maidservant from Yue Decoction” — is from Zhang Zhongjing’s Jin Gui Yao Lue. The name is poetic and obscure: “Yue” was an ancient state and “bi” meant a young attendant; the formula was originally for “wind-water” (feng shui) where wind invasion combines with internal Heat to produce sudden facial and body edema.

The clinical picture is striking: a patient develops sudden swelling of the face, eyelids and limbs, with mild fever, no sweating, thirst and reduced urination. In modern terms this is the picture of acute nephritis, acute allergic angioedema, post-viral nephrotic presentations, or sudden urticaria with edema.

The formula combines Ma Huang (powerful surface-releaser and diuretic) with Shi Gao (cold, Heat-clearing) at unusually large doses. This unusual cold-warm combination is what makes it work for the very specific wind-water pattern.

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

TCM pattern

Yue Bi Tang is prescribed for wind-water edema (Yang water type):

• Sudden facial and eyelid swelling
• Generalised body edema
• Mild fever with aversion to wind
• No sweating or scanty sweating
• Thirst with desire for cold drinks
• Reduced urination
• Cough and shortness of breath in some cases
• Tongue — red or normal, thin white or yellow coat
• Pulse — floating, slippery, rapid

Key herbs

1. Ma Huang (Ephedra sinica) — chief, large dose; releases the surface and promotes urination
2. Shi Gao (gypsum) — clears Lung and Stomach Heat
3. Sheng Jiang — assists Ma Huang to disperse Wind-Cold
4. Da Zao — protects Stomach Qi
5. Gan Cao — harmonises

Formula actions

1. Releases the surface and disperses Wind
2. Clears interior Heat
3. Promotes urination and reduces edema
4. Resolves Wind-Water

Conditions treated

1. Acute nephritis with facial edema (alongside conventional care)
2. Acute glomerulonephritis
3. Nephrotic syndrome early stage
4. Acute angioedema with no anaphylaxis
5. Urticaria with edema
6. Acute conjunctivitis with eyelid swelling
7. Severe hay fever with facial swelling

Comparisons with related formulas

• Yue Bi Jia Zhu Tang — Yue Bi Tang + Bai Zhu; for similar wind-water with prominent body heaviness and Spleen weakness.
• Wu Pi San — for chronic edema without wind; opposite indication.
• Zhen Wu Tang — for Yang-deficient cold edema; opposite indication.
• Ma Huang Tang — for wind-cold cold/flu without edema.

Modifications

• For prominent body heaviness, add Bai Zhu (becomes Yue Bi Jia Zhu Tang)
• For prominent cough/wheeze, add Xing Ren and Sang Bai Pi
• For severe edema, add Fu Ling and Ze Xie
• For prominent skin urticaria, add Chan Tui and Jin Yin Hua

Cautions

Contains Ma Huang (Ephedra). Not appropriate in pregnancy, hypertension, hyperthyroidism, cardiac arrhythmias, glaucoma, prostate enlargement, severe anxiety, or with MAO inhibitors or stimulants. Always declare to your medical team. Ephedra is a restricted herb in some countries.

Acute nephritis and nephrotic syndrome are serious conditions requiring nephrology assessment and conventional treatment. Chinese herbs are an adjunct.

Acute angioedema with throat involvement, breathing difficulty or anaphylaxis is a medical emergency — call 999.

Not for long-term use; for the acute wind-water phase only.

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.