Xi Huang Wan犀黄丸
Cattle Gallstone Pill (Xi Huang Wan)
Ingredients5 herbs
Indications
Fire toxin congealing phlegm and blood into hard masses: the classical picture is a firm, deep swelling with little colour change, slow to come up and slow to break down, painful when pressed. The formula's strategy is to open and penetrate a stagnation that ordinary heat-clearing cannot reach.
Clinical Manifestations
- Hard, deep nodules attributed to congealed phlegm and stasis
- Scrofulous neck nodesand subcutaneous phlegm nodules
- Multiple deep abscesses that move between sites
- Internal abscess of the lung or intestine, as recorded in the source
- — the classical name for what is now diagnosed as breast cancer, recorded here as history only
Health Categories
Modern Applications
Common adjustments
- Nodes hard and long-standing — combine with softening herbs such as Xia Ku Cao 夏枯草 and Zhe Bei Mu 浙贝母
- Marked heat toxin — combine with a heat-clearing toxin-resolving formula such as Wu Wei Xiao Du Yin 五味消毒饮
- Underlying deficiency after a long illness — qi and blood separately; this formula attacks and does not tonify
Contraindications
Constituent by constituent: She Xiang opens and penetrates so strongly that it is an absolute contraindication in pregnancy — classical texts treat it as abortifacient — and it comes from musk deer listed under CITES Appendix I, so genuine musk cannot be traded lawfully in most countries and the synthetic substitute is what modern products contain; buying anything sold as real musk risks both prosecution and adulteration. Niu Huang is a gallstone of cattle, now scarce, and commercial preparations generally use cultured or synthetic; Niu Huang is cold and unsuitable for a deficient, cold-natured patient. Ru Xiang and Mo Yao are resins that irritate the stomach and commonly cause nausea; both move blood, so they warrant caution alongside anticoagulant or antiplatelet drugs and around surgery. The formula as a whole attacks: it is not for a patient who is depleted, for a sore that has already collapsed inward from deficiency, or for the yin-type flat, cold swelling that needs warming instead. Above all, a hard fixed lump, a growing neck node or an ulcerating breast must be investigated medically — imaging, biopsy, and treatment for what is found. Breast cancer and lymphoma are treatable diseases when diagnosed, and delay costs outcomes; this entry documents a classical formula, not a substitute for cancer care.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Absolutely contraindicated in pregnancy. She Xiang is strongly penetrating and is treated in the classical literature as capable of causing miscarriage; Ru Xiang and Mo Yao also move blood. Not used while breastfeeding.
References
Source Wai Ke Zheng Zhi Quan Sheng Ji 《外科证治全生集》 · Qing
- Classical source named in the source fields (pre-1900, public domain).
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）— chapter placement, 功用 and 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.