[Source]

Volume 1 of “Wen Bing Tiao Bian”.

 [Composition]

Calculus bovis, Curcuma, Rhinoceros horn, Coptis chinensis, 砂/’>Realgar, Borneol, Musk, Pearl, Gardenia (Gardenia fruit), Orpiment, Scutellaria baicalensis, Gold foil (now rarely used)
(12)

 [Classification Group]

<Clearing Heat and Cooling Blood>: Rhinoceros horn

<Clearing Heat and Drying Dampness>: Coptis chinensis, Scutellaria baicalensis

<Invigorating Blood and Removing Stasis>: Curcuma

<Calming the Spirit>: 砂/’>Realgar

<Clearing Heat and Purging Fire>: Gardenia

<Clearing Heat and Detoxifying>: Calculus bovis

<Calming the Liver and Extinguishing Wind>: Pearl

<Opening the Sensory Orifices>: Musk, Borneol

<External Use and Others>: Gold foil, Orpiment

[Formula Rationale]

“Cheng Fang Bian Du”: When pathogenic heat invades internally, and the Shaoyang transforms into the Yangming Stomach, it then enters the Pericardium. If the pathogen enters the Pericardium, symptoms such as delirium and coma will appear, which is the most concerning internal closure. Calculus bovis is a product with aromatic and clear properties, light and agile, which directly enters the Pericardium, dispels evil, and resolves filth; however, in cases of internal invasion of warm pathogens, there must be sticky and filthy Qi lingering in the diaphragm, so Curcuma, with its aromatic, pungent, and bitter properties, disperses Qi and promotes blood circulation, reaching the site of illness directly, acting as a vanguard. Then, Huang Qin and Huang Lian, with their bitter cold and dry properties, expel damp-heat from the upper Jiao; Hei Zhi clears the upper Jiao and guides the lower, to remove residual pathogens; Chen Sha, with its red color and cold Qi, contains true mercury, clears heart heat, protects heart Yin, calms the spirit, and anchors the sovereign, dispelling evil and detoxifying.

 [Functions]

Clears heat and detoxifies, calms fright, and opens the sensory orifices.

 [Efficacy]

Taiyin warm diseases. Excessive sweating after diaphoresis, febrile diseases, heat entering the Pericardium, high fever and restlessness, convulsions, coma and delirium; sudden syncope due to flying corpses, epilepsy, sudden coma due to evil spirits, convulsions in adults and children due to heat; Shaoyin warm diseases of summer, body heat without aversion to cold, mental confusion, intermittent delirium; invasion of the Pericardium by pathogens, stiff tongue and cold extremities; Yangming warm diseases, maculae, variola, miliaria, toxic eruptions. Jaundice, coma and delirium, with a non-excessive pulse.

 [Indications]

Epidemic cerebrospinal meningitis, Japanese encephalitis, toxic dysentery, uremia, hepatic coma, cerebrovascular accidents, toxic pneumonia, craniocerebral trauma, post-traumatic syndrome, icteric hepatitis, sinusitis, and high fever caused by infection or poisoning, and other conditions.

 [Contraindications]

Contraindicated in pregnant women.

 [Mnemonic]

: Three chickens playing the zither with a rhinoceros (Shanzhi, Huangqin, Xiong Huang, Xijiao, Niuhuang).<…> : There is precious golden sand, fragrant slices, and golden (Zhen Zhu, Yujin, Shacha, Xiang Pian, Jin).

 [Modifications]

(1) If the pulse is weak, add Ginseng Decoction to support vital Qi and facilitate the opening of the orifices. (2) If the pulse is full, add Honeysuckle and Mint Decoction to enhance the effect of clearing heat and detoxifying. (3) If accompanied by coma, short tongue, constipation, and thirst that cannot be quenched, add three qian of Rhubarb powder, which is Niuhuang Chengqi Pills. (4) This formula, with Rhinoceros horn, Borneol, Musk, Pearl, and gold foil removed, becomes 牛黃清心丸/’>Niuhuang Qingxin Pills (Wan Shi Niuhuang Pills, Huang Shi Niuhuang Qingxin Pills), which treats warm-evil invading the Pericardium, causing body heat, coma, delirium, restlessness, as well as high fever and convulsions in children, blocked orifices due to stroke, and other conditions.