SAN HUANG XIE XIN TANG

Drain Fire & Resolve Toxicity • Heart & Stomach Heat-Clearing Formula

Symptoms

Mental Agitation: Extreme irritability, restlessness, or insomnia where the patient feels "wired" or "burning up" inside.

Heat-Induced Bleeding: Acute nosebleeds (epistaxis), vomiting blood (hematemesis), or blood in the stool caused by "Heat forcing the Blood out of the vessels."

Digestive Excess: A bitter taste in the mouth, foul breath, and "focal distension"—a feeling of stuffiness in the epigastrium that is painful when pressed.

Facial Signs: Redness of the face and eyes, possible mouth ulcers, or a dry throat.

Key Indicator: "Flaring Fire in the Upper/Middle Burner"—where excess heat has accumulated to the point of "overflowing," affecting both the physical blood and the mental state (Shen).

Tongue: Red body with a thick, dry, yellow coating.

Pulse: Rapid (Shu) and forceful (Shi).

Ingredients

Huang Lian (Coptidis Rhizoma)

Huang Qin (Scutellariae Radix)

Da Huang (Rhei Radix et Rhizoma)

(Typically used in equal proportions or with a higher ratio of Da Huang if constipation is present).

Description

San Huang Xie Xin Tang uses the "Three Yellows" to provide a massive downward drain for internal fire. It is one of the coldest and most bitter formulas in the pharmacopeia.

The Heart-Fire Specialist (Huang Lian): It enters the Heart channel to drain "Social Fire," stopping irritability and cooling the blood. It is the primary herb for clearing heat from the upper burner.

The Lung/Stomach Specialist (Huang Qin): It clears heat from the "Qi Level," specifically targeting the chest and epigastrium. It helps resolve the "fullness" and protects the middle burner from being scorched.

The Purgative Drain (Da Huang): This is the "Anchor." While the other two clear the heat, Da Huang physically pulls the fire downward and out through the bowels. It is also a powerful blood-cooling herb, which is why it is essential for stopping Heat-driven bleeding.

Posology

Granules

 3 to 9g daily, divided into 2–3 doses, taken with warm water.

Raw Plants

Decoct in 600–800ml of water. CRITICAL: To maintain the strong purgative (laxative) effect, Da Huang should only be added in the last 5 minutes of boiling. If you want to clear heat without strong purging, boil it longer.

Cautions

Strictly contraindicated for Cold, Deficiency, or Yin Deficiency. This formula is "aggressively cold"; using it in a weak patient can lead to a collapse of the Spleen Yang and severe diarrhea. Not intended for long-term use. It is a "Crisis" formula; once the bleeding stops, the fever drops, or the yellow tongue coating thins, the formula must be discontinued.