What Dang Gui Liu Huang Tang is for
This formula is for skin that runs warm and flushes, and for a surface that cannot hold its fluids, so the skin is damp by morning and the person looks drained. It nourishes the Blood and Yin, clears the Heat from every burner, and consolidates the surface so the skin can keep what it needs.
Warmth comes first: the face and upper body colour easily, the surface feels hot to the hand, and the flush carries a sense of heat rather than swelling or scaling. Overnight the skin becomes damp with sweat and is left cool and limp by morning, which is the picture of a surface being pushed open from inside. Between episodes the skin is usually dry, because the fluids that should moisten it are leaving.
Yin and Blood are the cooling, holding side of the body. When they are low, Heat has nothing to restrain it, and the surface is too weakly held to keep the fluids in, so they escape while the person rests and the skin is left both hot and depleted. Dang Gui, Sheng Di Huang and Shu Di Huang rebuild Blood and Yin, Huang Lian, Huang Qin and Huang Bo clear Heat from the three burners, and a large dose of Huang Qi consolidates the surface. It nourishes, clears and holds the surface together.
It is for deficiency heat, not for sweating from Cold or from simple Qi deficiency without heat, and not for Dampness. The distinction is visible on the skin: here the surface is warm, flushed and dry between episodes, whereas cold sweating leaves the skin cool and pale. A flush or sweat that persists unexplained needs medical assessment, since not every warm skin is deficiency heat.
Actions
- Nourishes Blood and Yin
- Clears Heat from the three burners
- Consolidates the surface and stops sweating
- Relieves deficiency-type night sweats
Properties
- Taste and temperature: Predominantly bitter and sweet with a cold quality. Bitter clears Heat, sweet nourishes Blood and consolidates.
- Organs: Heart, Liver, Kidney, Lungs
- Channels: Heart, Liver, Kidney, Lung
The pattern behind it
The pattern is Yin and Blood deficiency with Heat that drives the fluids out at night. The deficiency produces the dryness and restlessness, the Heat pushes the sweat out, and the surface is too weak to hold it. The formula nourishes, clears and consolidates, which is why it is used for this specific combination.
Composition
The herbs in Dang Gui Liu Huang Tang, with their role and dose.
| Role | Herb | Dose | Properties | Why it is there |
|---|---|---|---|---|
| Dang Gui | 6 to 9 g | Warm, Sweet, pungent | Nourishes and moves Blood, addressing the deficiency. | |
| Sheng Di Huang | 6 to 9 g | Cold, Sweet, bitter | Cools the Blood and nourishes Yin. | |
| King | Shu Di Huang | 6 to 9 g | Slightly warm, Sweet | Nourishes Blood and Yin deeply, the substance of the formula. |
| Huang Lian | 3 to 6 g | Cold, Bitter | Clears Heat from the Heart and middle burner. | |
| Huang Qin | 6 to 9 g | Cold, Bitter | Clears Heat from the upper burner. | |
| Assistant | Huang Bo | 6 to 9 g | Cold, Bitter | Clears Heat from the lower burner and dries Dampness. |
| Huang Qi | 12 to 18 g | Slightly warm, Sweet | In a large dose it consolidates the surface and stops the sweating, the distinctive move of the formula. |
Patterns it treats
Yin Deficiency with Empty Heat
Warm, flushed skin that sweats during rest and is left dry and depleted between episodes. The Yin and Blood are low, the Heat is unopposed and the surface cannot hold its fluids.
How the formula is built
The formula does three things at once: three herbs nourish, three clear and one consolidates. Nourishing without clearing would leave the Heat, clearing without nourishing would dry the Yin further, and neither would stop the sweat without the large Huang Qi dose.
Skin conditions it is used for
Where this formula appears in the skin conditions of the library.
Preparation and use
Decocted in water and taken warm, in two divided doses.
Modifications
- If the Heat is marked, the clearing herbs are increased.
- If the deficiency dominates, the nourishing herbs are increased.
- If the sweating is severe, the consolidating dose is increased.
- If there is Cold or Dampness, the formula is not used.
Timing
Taken warm in two divided doses.
Duration
One to four weeks, reassessed as the sweating resolves.
Diet while taking it
Avoid hot spicy and drying food and alcohol; avoid heavy night meals.
Safety
Contraindications
Avoid in Spleen and Stomach deficiency-cold, and in sweating from Cold or simple Qi deficiency without heat. Avoid in Dampness.
Interactions
Berberine from Huang Lian and Huang Bo can affect drug metabolism and blood sugar. Huang Qi may affect blood sugar and immune function.
Pregnancy
Use with caution in pregnancy because Dang Gui has mild Blood-moving properties.
Breastfeeding
Use only under professional guidance.
Children
Used only with professional supervision.
Before you use it
Recorded from the classical record and rewritten in this project's own words. Educational only: not a prescription, and persistent night sweats need medical assessment, as they can indicate serious illness.
General safety references
General references for herbal hepatotoxicity and herb-drug interactions; they are not specific to this formula.
- Review article: Herbal hepatotoxicity - an update on traditional Chinese medicine preparations. Alimentary Pharmacology & Therapeutics, 2014. PMID: 24844799.
- Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs, 2009. PMID: 19719333.
- Warfarin and food, herbal or dietary supplement interactions: a systematic review. British Journal of Clinical Pharmacology, 2021. PMID: 32478963.
Selected PubMed records
Real PubMed records for the modern, non-TCM discussion of this formula. They are references, not a claim that the formula is proven for any skin condition.
- Dang-Gui-Liu-Huang Tang a traditional herbal formula, ameliorates imiquimod-induced psoriasis-like skin inflammation in mice by inhibiting IL-22 production.. Phytomedicine : international journal of phytotherapy and phytopharmacology, 2018. PMID: 30166108.
Origin and history
Lan Shi Mi Cang (兰室秘藏, Secret Record of the Orchid Chamber) by Li Dongyuan, Jin dynasty, 13th century.
Li Dongyuan, the physician of the Spleen and Stomach, also wrote this formula for the night sweats of deficiency heat. Its combination of nourishing, clearing and consolidating herbs is a compact model of how the tradition treats a symptom by addressing its mechanism.
Classical record
Li Dongyuan recorded the formula for night sweats from Yin deficiency with Heat, nourishing the Blood, clearing the three burners and consolidating the surface with a large dose of astragalus.
Lan Shi Mi Cang (兰室秘藏, Secret Record of the Orchid Chamber), Li Dongyuan, Jin dynasty.
Evidence note
No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.
Common questions
What is the formula for?
Night sweats from Yin deficiency with Heat, with flushing, a dry mouth and a red tongue with a yellow coat.
Why a large dose of Huang Qi?
Because the surface is too weak to hold the sweat. Huang Qi consolidates it, which is why it is given in a dose larger than the other herbs.
Should night sweats be investigated?
Yes. Persistent night sweats can indicate serious illness and need medical assessment before herbal treatment.
How long is it used?
One to four weeks, reassessed as the sweating resolves.