An Gong Niu Huang Wan安宫牛黄丸
Calm the Palace Pill with Cattle Gallstone
Ingredients11 herbs
Indications
Heat toxin fallen inward into the Pericardiumwith phlegm-heat sealing the orifices. This is the closed pattern— the patient is shut in, jaw clenched and fists gripped — and must be told apart from the collapse pattern, where the body is letting go rather than shutting down.
Clinical Manifestations
- High fever with delirium or coma
- Wind-stroke with a closed-type loss of consciousness
- Convulsions in children driven by extreme heat
- Clouded consciousness in encephalitis- or meningitis-type illness
- Severe heat stroke with mental collapse
Health Categories
Modern Applications
Common adjustments
- Convulsions and rigidity dominate the picture — the chapter's own answer is Zi Xue, which carries antelope horn and mineral salts for extinguishing wind; practitioners also add wind-extinguishing herbs such as Gou Teng 钩藤
- Thick phlegm rattling in the throat, heavy laboured breathing — Zhi Bao Dan is the better-matched pill of the three; where the decoction route is open, phlegm-transforming herbs such as Dan Nan Xing 胆南星 and Tian Zhu Huang 天竺黄 are added
- Constipation with abdominal fullness and a foul, dry stool held back — a purgative decoction built on Da Huang 大黄 and Mang Xiao 芒硝 is given alongside, so the heat has a downward exit
- Signs shift toward collapse — cold sweat, slack mouth, faint pulse — stop the formula. Opening and dispersing accelerate a collapse pattern; the treatment turns to rescuing yang and securing what is escaping
Contraindications
Contraindicated in the collapse pattern— cold clammy sweat, an open slack mouth, limp hands, incontinence and a faint scattered pulse — where aromatic opening drives the last of the qi outward. Not for cold-type closure, which is the warm-opening territory of Su He Xiang Wan: a pale face, blue lips, white slippery tongue coating and a slow pulse. Not for clouded consciousness arising from deficiency, blood loss or exhaustion. Because of the cinnabar and realgar it carries, it must never be taken repeatedly, in overlapping courses, or as a general-purpose stroke or fever preventive; mercury and arsenic accumulate, and cases of poisoning are on record from exactly that misuse. Avoid alcohol with it, and do not give it to anyone with known liver or kidney impairment except on a physician's explicit decision.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Contraindicated in pregnancy. She Xiang musk is a classical abortifacient that strongly moves blood, and the formula also carries Zhu Sha cinnabar (mercuric sulfide) and Xiong Huang realgar (arsenic disulfide), both of which cross the placenta and are toxic to the fetus. The only situation in which it could be weighed at all is a life-threatening emergency, and that judgment belongs to a physician managing the crisis — never to the patient or family. It is likewise not to be taken while breastfeeding.
Related Formulas
References
Source Wen Bing Tiao Bian 《温病条辨》 · Qing
「邪入心包，舌蹇肢厥，牛黄丸主之，紫雪丹亦主之。」
- Classical source (public domain), cited in the source-quote section.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.
4. CITES Appendix I listings (rhinoceros, musk deer) and pharmacopoeial monographs on 朱砂 cinnabar and 雄黄 realgar — substitution and toxicity notes.
Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.