Bai Tou Weng Tang白头翁汤

Pulsatilla Decoction

Clearing Heat 清热剂Clear Organ Heat 清脏腑热

Ingredients4 herbs

HerbDosageRoleWhat it does in this formula

白Bai Tou Weng白头翁Pulsatillae Radix15g君 ChiefCools the blood and resolves the heat toxin at the root of the bloody stool 黄Huang Bai黄柏Phellodendri Chinensis Cortex12g臣 DeputyClears damp-heat from the lower burner, where the burning is felt 黄Huang Lian黄连Coptidis Rhizoma6g臣 DeputyDrains fire from the middle burner and dries the damp that carries it 秦Qin Pi秦皮Fraxini Cortex12g佐使 Assistant–EnvoyCold and astringent at once — firms the Intestines while it cools them

Indications

Clears heat and resolves toxicityCools the blood and stops dysenteric bleedingFirms the Intestines

Heat-toxin dysentery: toxic heat sears the blood network of the Intestines, so blood predominates in the stool and the anus burns. The thirst distinguishes it — damp-heat dysentery is usually not thirsty, because damp still holds fluid in place.

Clinical Manifestations

Dysentery with more blood than mucus in the stool
Burning at the anus with urgency and tenesmus
Abdominal pain with thirst for cold drinks
Amoebic or bacillary dysentery presenting as heat toxin
Acute colitis with bloody stool and fever

TongueRed with a yellow coating

PulseWiry and rapid

Health Categories

Digestive HealthImmune Support

Modern Applications

Dysentery Amoebiasis Bacillary dysentery Bloody diarrhoea Colitis

Common adjustments

Exterior fever still present — add Ge Gen 葛根 and Lian Qiao 连翘
Marked tenesmus — add Mu Xiang 木香 and Bing Lang 槟榔
Blood loss with weakness and a dry mouth — add E Jiao 阿胶 and Gan Cao 甘草 — Bai Tou Weng Jia Gan Cao E Jiao Tang
Food stagnation with a thick coating — add Shan Zha 山楂

Contraindications

Not for dysentery or chronic diarrhoea of deficiency cold — the stool is pale and watery, the abdomen is cold and eased by warmth, and there is no thirst. The formula is entirely bitter cold and will injure a weak Spleen and Stomach if continued past the point of benefit. Bloody diarrhoea with fever requires medical diagnosis; amoebic and bacillary dysentery are reportable infections in many places.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Use in pregnancy only under practitioner supervision — the formula is uniformly bitter and cold and readily injures the middle burner, though none of its four herbs is classically forbidden in pregnancy. Bloody diarrhoea in pregnancy needs medical assessment.

References

Source Shang Han Lun 《伤寒论》 · Eastern Han

「热利下重者，白头翁汤主之。」
— 《伤寒论》(classical source, public domain)

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.

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.