Niu Huang Qing Xin Wan牛黄清心丸
Cattle Gallstone Pill to Clear the Heart
Ingredients6 herbs
Indications
Heat toxin harassing the Heart and beginning to obscure the orifices. The spirit is disturbed and clouded but not yet sealed in — the patient can still be roused, unlike the full closed pattern that calls for An Gong Niu Huang Wan.
Clinical Manifestations
- Fever with restlessness and muddled speech
- Milder heat-clouding of consciousness in a warm-disease course
- High fever with fright reactions in children
- Step-down management after the acute closed pattern has opened
Health Categories
Modern Applications
Common adjustments
- Consciousness closes down completely — unrousable, jaw clenched — this formula is no longer strong enough; the parent An Gong Niu Huang Wan, or Zhi Bao Dan where phlegm dominates, is the correct step up
- Convulsions appear — wind-extinguishing support is added, e.g. Gou Teng 钩藤; marked rigidity points to Zi Xue instead
- Constipation with a hot, dry interior — Da Huang 大黄 is added to the accompanying decoction so the heat drains downward
Contraindications
Not for collapse patternsor for clouded consciousness from deficiency, blood loss or cold. Not for cold-type closure, which needs warm opening. Because of the cinnabar it contains, it must not be taken over an extended period, in repeated courses, or as a routine remedy for irritability or insomnia — that misuse is the usual route to mercury accumulation. Avoid in known liver or kidney impairment unless a physician decides otherwise, and do not combine it with other cinnabar-containing preparations.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Contraindicated in pregnancy. Zhu Sha cinnabar is a mercury mineral that reaches the fetus, and the bitter cold body of the formula is in any case unsuited to pregnancy. Not to be used while breastfeeding either. If heat-clouding arises during pregnancy it is managed by a physician with a purpose-built prescription, not with this one.
Related Formulas
References
Source Dou Zhen Shi Yi Xin Fa 《痘疹世医心法》 · Ming
- Classical source (public domain) — 《痘疹世医心法》, Ming dynasty.
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）— listed as the appended formula (附方) to 安宫牛黄丸.
4. Pharmacopoeial monograph on 朱砂 cinnabar — mercury content and course-length limits.
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.