Bai Hu Tang (白虎汤) — White Tiger Decoction

On this page

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

Overview

Bai Hu Tang — the White Tiger Decoction — is one of the most powerful Heat-clearing formulas in TCM. It originates from Zhang Zhongjing’s Shang Han Lun (c. 200 CE) and is named after the White Tiger, the mythological guardian of the West associated with cooling and descending energy. Its primary action is to clear extreme Heat from the Qi level — the stage where pathogenic Heat has penetrated beyond the body’s defensive surface but has not yet entered the Blood.

TCM pattern

Bai Hu Tang is prescribed for intense Heat in the Qi level (Yangming channel syndrome), characterised by the four cardinal signs: high fever, profuse sweating, intense thirst with a desire for cold drinks, and a surging, flooding pulse. The patient feels extremely hot, is agitated and restless, with a red face and dry mouth. It is also used for excessive Stomach Heat and Lung Heat producing inflammatory conditions.

Key herbs

1. Shi Gao (Gypsum fibrosum, 15-120g) — the principal herb; a large dose of raw mineral gypsum that dramatically clears Heat and reduces fever; enters the Lung and Stomach channels
2. Zhi Mu (Anemarrhena asphodeloides rhizome, 5-30g) — clears Heat, nourishes Yin and generates fluids; prevents the Heat from consuming body fluids
3. Jing Mi (non-glutinous rice) — protects the Stomach and generates fluids
4. Zhi Gan Cao (honey-fried Glycyrrhiza root, 2-6g) — harmonises the formula and protects the Middle Jiao

Formula actions

1. Clears Heat from the Qi level
2. Generates Body Fluids
3. Alleviates thirst

Conditions treated

1. High fever in acute infectious disease with intense thirst, sweating and agitation
2. Inflammatory arthritis — the modified formula Bai Hu Jia Gui Zhi Tang is the primary formula for Hot Bi syndrome (active rheumatoid arthritis[14] with hot, swollen, acutely tender joints)
3. Menopausal hot flushes[3] where Stomach Heat is prominent alongside Yin deficiency
4. Intense thirst and excessive hunger in diabetes
5. Acne[16] with prominent Stomach Heat and intense redness

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.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide. After a full video consultation, Dr (TCM) Attilio D'Alberto formulates a bespoke herbal prescription and posts your Chinese herbs directly to your door.

References

[3] Li M, Hung A, Lenon GB, Yang AWH. Chinese herbal formulae for the treatment of menopausal hot flushes: A systematic review and meta-analysis. PLoS One. 2019 Sep 19;14(9):e0222383. https://doi.org/10.1371/journal.pone.0222383. PMID: 31536531.

[14] Han R, Ren HC, Zhou S, Gu S, Gu YY, Sze DM, Chen MH. Conventional disease-modifying anti-rheumatic drugs combined with Chinese Herbal Medicines for rheumatoid arthritis: A systematic review and meta-analysis. J Tradit Complement Med. 2022 Jan 26;12(5):437-446. https://doi.org/10.1016/j.jtcme.2022.01.005. PMID: 36081815.

[16] Sung SH, Choi GH, Lee NW, Shin BC. External Application of Herbal Medicines for Acne Vulgaris: A Systematic Review and Meta Analysis. J Pharmacopuncture. 2020 Mar 31;23(1):8-17. https://doi.org/10.3831/KPI.2020.23.002. PMID: 32322430.