Zhi Bai Di Huang Wan — Anemarrhena, Phellodendron and Rehmannia Pill

On this page

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

Overview

Zhi Bai Di Huang Wan is a modification of Liu Wei Di Huang Wan with the addition of two herbs — Zhi Mu (Anemarrhena) and Huang Bai (Phellodendron) — that specifically clear Empty Fire from the Kidney channel. Where Liu Wei Di Huang Wan purely nourishes Kidney Yin without addressing Heat, Zhi Bai Di Huang Wan is indicated when Kidney Yin deficiency has generated sufficient Empty Fire to produce obvious heat symptoms alongside the deficiency signs. It is one of the most frequently prescribed formulas for the classic menopausal presentation of hot flushes and night sweats from Kidney Yin deficiency with Empty Fire rising.

TCM pattern

Prescribed for Kidney Yin deficiency with Empty Fire blazing upward, characterised by: hot flushes (particularly in the afternoon and evening), night sweats, heat sensations in the palms, soles and chest, dry mouth and throat at night, tinnitus, lower back ache, dark urine, restless sleep, a red tongue with little or no coating, and a thin, rapid pulse.

Key herbs

All six herbs of Liu Wei Di Huang Wan plus:

1. Zhi Mu (Anemarrhena asphodeloides rhizome) — clears Heat and nourishes Yin; enters the Kidney and Lung channels; generates fluids and alleviates dry mouth
2. Huang Bai (Phellodendron amurense bark) — drains Empty Fire specifically from the Kidney channel; clears Damp-Heat from the lower burner; works synergistically with Zhi Mu

Conditions treated

1. Menopausal hot flushes and night sweats — the formula’s most widely used and clinically confirmed indication
2. Night sweats and afternoon heat sensations from Kidney Yin deficiency with Empty Heat
3. Tinnitus from Kidney Yin deficiency with rising Empty Fire
4. Dark urine and urethral discomfort from Kidney Yin deficiency with Damp-Heat
5. Hyperthyroidism with Yin deficiency Heat pattern
6. Insomnia with prominent heat sensations, restlessness and night sweats

Not suitable for Spleen deficiency with Dampness, Cold patterns, or Yang deficiency as the primary presentation. Only use when genuine Empty Heat is present — this formula is more cooling than plain Liu Wei Di Huang Wan.

Cautions

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available. See the prices page for costs.