Chinese: 知柏地黄丸
Pinyin: Zhī Bo Dì Huáng Wán
Other names: Anemarrhena Phellodendron and Rehmannia Pill
Number of ingredients: 8 herbs
Formula category: Formulas that nourish Yin and tonify
Mother formula: Liu Wei Di Huang Wan
Conditions for which it may be prescribed: Vaginal itching
- Tonifies Yin
- Drains Fire
Source date: 1584 AD
Source book: Investigations of Medical Formulas
The information provided here is not a replacement for a doctor. You shouldn't use it for the purpose of self-diagnosing or self-medicating but rather so you can have a more informed discussion with a professional TCM practitioner.
Zhi Bo Di Huang Wan is a 8-ingredient Chinese Medicine formula with Anemarrhena Rhizomes (Zhi Mu), Phellodendron Bark (Huang Bo) and Prepared Rehmannia (Shu Di huang) as principal ingredients.
Invented in 1584 AD, it belongs to the category of formulas that nourish Yin and tonify. Its main actions are: 1) tonifies Yin and 2) drains Fire.
In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.
In this case Zhi Bo Di Huang Wan is used by TCM practitioners to fight patterns like Kidney Yin Deficiency With Empty-Heat Blazing, Kidney Yin Deficiency or Kidney and Liver Yin Deficiency. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as vaginal itching for instance.
On this page, after a detailed description of each of the eight ingredients in Zhi Bo Di Huang Wan, we review the patterns and conditions that Zhi Bo Di Huang Wan helps treat.
The eight ingredients in Zhi Bo Di Huang Wan
Zhi Mu is a king ingredient in Zhi Bo Di Huang Wan. Like the name indicates, it means it has more power than other ingredients in the formula.
1. Anemarrhena Rhizomes (Zhi Mu)
Part used: Dried rhizome
Nature: Cold
Meridian affinity: KidneyLungStomach
Category: Herbs that clear Heat and purge Fire and/or clear Summer Heat
In general Zhi Mu's main actions are as follows: "Clears Heat and Fire from the Qi level. Clears Heat and Fire from the Lung and Stomach. Clears Heat and tonifies the Yin."
In the context of Zhi Bo Di Huang Wan, it is used because it is bitter and cooling. It removes excess Heat from the body.
Huang Bo is a king ingredient in Zhi Bo Di Huang Wan. Like the name indicates, it means it has more power than other ingredients in the formula.
2. Phellodendron Bark (Huang Bo)
Part used: Dried bark
Nature: Cold
Taste(s): Bitter
Meridian affinity: BladderKidneyLarge intestine
Category: Herbs that clear Heat and dry Dampness
In general Huang Bo's main actions are as follows: "Expels Damp-Heat in the Lower Burner. Clears Kidney Yin Deficient Heat. Applied externally or toxic Fire, especially associated with Dampness."
In the context of Zhi Bo Di Huang Wan, it is used because it is bitter and cooling. It removes excess Heat from the body.
Shu Di huang is a king ingredient in Zhi Bo Di Huang Wan. Like the name indicates, it means it has more power than other ingredients in the formula.
3. Prepared Rehmannia (Shu Di huang)
Part used: Prepared dried root tuber
Nature: Warm
Taste(s): Sweet
Meridian affinity: KidneyLiver
Category: Tonic herbs for Blood Deficiency
In general Shu Di huang's main actions are as follows: "Tonifies the Blood. Tonifies the Yin of the Kidneys."
In the context of Zhi Bo Di Huang Wan, it is used because it strongly enriches the Kidney Yin and Essence.
Shan Zhu Yu is a deputy ingredient in Zhi Bo Di Huang Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
4. Cornelian Cherries (Shan Zhu Yu)
Part used: Dried ripe sarcocarp
Nature: Warm
Taste(s): Sour
Meridian affinity: KidneyLiver
Category: Herbs that stabilize and bind
Shan Zhu Yu nourishes the Liver and restrains the leakage of Essence. It performs the latter function by inhibiting the improper dispersion and drainage through the Liver, thereby enabling the Essence to build up in the Kidneys. For this to occur, a substance with the strong, Essence building properties of the key herb (Shu Di Huang) is also required.
Shan Yao is a deputy ingredient in Zhi Bo Di Huang Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
5. Yam (Shan Yao)
Part used: Dried rhizome
Nature: Neutral
Taste(s): Sweet
Meridian affinity: KidneyLungSpleen
Category: Tonic herbs for Qi Deficiency
Shan Yao stabilizes the Essence by tonifying the Spleen. Indeed, to reinforce Essence and improve its function, the Spleen (the source of postnatal Essence) must function properly.
Ze Xie is an assistant ingredient in Zhi Bo Di Huang Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
6. Water Plantain (Ze Xie)
Part used: Dried tuber
Nature: Cold
Taste(s): Sweet
Meridian affinity: BladderKidney
Category: Herbs that drain Dampness
Ze Xie clears and drains the overabundance of Kidney Fire. It is used here to prevent the rich, cloying properties of the key herb (Shu Di Huang) from congesting the mechanisms of the Kidneys, which would induce even more Heat from Deficiency.
Mu Dan Pi is an assistant ingredient in Zhi Bo Di Huang Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
7. Mudan Peony Bark (Mu Dan Pi)
Part used: Root barks
Nature: Cool
Meridian affinity: HeartKidneyLiver
Category: Herbs that cool the Blood
Mu Dan Pi clears and drains Liver Fire and is used here to counterbalance the warm properties of Cornelian cherries (Shan Zhu Yu).
Fu Ling is an assistant ingredient in Zhi Bo Di Huang Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
8. Poria-Cocos Mushrooms (Fu Ling)
Part used: Dried sclerotium
Nature: Neutral
Taste(s): Sweet
Meridian affinity: HeartKidneyLungSpleen
Category: Herbs that drain Dampness
Fu Ling is a bland herb that leaches out Dampness from the Spleen. Here it notably helps Yam (Shan Yao) strengthen the transportive functions of the Spleen. This prevents the formula from clogging up the digestive process and reinforces the Spleen's function of nourishing the body. Poria-cocos mushrooms also works together with the Water plantain (Ze Xie) to improve the metabolism of Fluids and promote urination, thereby preventing a buildup of stagnant fluids.
Conditions and patterns for which Zhi Bo Di Huang Wan may be prescribed
It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.
As such Zhi Bo Di Huang Wan is used by TCM practitioners to treat three different patterns which we describe below.
But before we delve into these patterns it is worth mentioning that they're often associated with the condition "vaginal itching". Again it wouldn't be correct to say "Zhi Bo Di Huang Wan treats vaginal itching". Rather, Zhi Bo Di Huang Wan is used to treat patterns that are sometimes the root cause behind vaginal itching.
Now let's look at the three patterns commonly treated with Zhi Bo Di Huang Wan.
The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine
Kidney Yin Deficiency With Empty-Heat Blazing
Pulse type(s): Rapid (Shu), Empty (Xu), Floating (Fu)
Symptoms: Insomnia Tinnitus Dizziness Dry throat Dry stools Malar flush Night sweats Bloody urine Restlnessness Five palm heat Lower back pain Diminished hearing Nocturnal emissions Scanty and dark urine Excessive sexual desire Feeling of heat in the evening Low-grade fever in the afternoon Feeling of heat in the afternoon Thirst with desire to drink in small sips
Zhi Bo Di Huang Wan is sometimes prescribed by TCM practitioners to treat Kidney Yin Deficiency With Empty-Heat Blazing. This pattern leads to symptoms such as malar flush, restlnessness, insomnia and night sweats. Patients with Kidney Yin Deficiency With Empty-Heat Blazing typically exhibit rapid (Shu), empty (Xu) or floating (Fu) pulses.
This pattern is when Kidney Yin Deficiency, because of the depletion of Fluids and Essence (both Yin in nature), has given rise to pronounced Empty-Heat with symptoms such as night sweats, thirst, five palm heat, dry throat at night, scanty urine and dry stools.
The afternoon fever is typical of... read more about Kidney Yin Deficiency With Empty-Heat Blazing
The Kidneys is a so-called "Zang" Organ. Learn more about the Kidneys in Chinese Medicine
Kidney Yin Deficiency
Pulse type(s): Rapid (Shu), Empty (Xu), Floating (Fu)
Tongue coating: Complete absence of coating
Tongue color: Red
Tongue shape: Cracked
Symptoms: Anxiety Vertigo Itching Sweating Tinnitus Insomnia Dry hair Dry skin Back pain Tiredness Lassitude Dizziness Bone ache Sore back Dry mouth Depression Sore knees Weak knees Dry throat Dry tongue Dry stools Limbs pain Infertility Malar flush Poor memory Constipation Night sweats Little sperm Irritability Restlnessness Five palm heat Scanty periods Blurred vision Lower back pain Evening anxiety Weak lower back Feeling of heat Poor constitution Diminished hearing Nocturnal emissions Hot palms and soles Scanty dark urination Premature ejaculation Menopausal hot flushes Excessive sexual desire White vaginal discharge Dry mouth and throat at night Feeling of heat in the evening Low-grade fever in the afternoon Thirst with desire to drink in small sips
Zhi Bo Di Huang Wan is sometimes prescribed by TCM practitioners to treat Kidney Yin Deficiency. This pattern leads to symptoms such as sweating, back pain, diminished hearing and dry mouth and throat at night. Patients with Kidney Yin Deficiency typically exhibit rapid (Shu), empty (Xu) or floating (Fu) pulses as well as Red tongue without coating, cracked in severe cases.
This pattern often accompanies Kidney Essence Deficiency, as Kidney Yin includes Essence. When both element are depleted in the Kidneys, not enough Marrow is generated to fill the Brain, thus the symptoms of dizziness, tinnitus, vertigo and poor memory. The dizziness is mild and the tinnitus is... read more about Kidney Yin Deficiency
The Liver is a so-called "Zang" Organ. Learn more about the Liver in Chinese Medicine
Kidney and Liver Yin Deficiency
Pulse type(s): Empty (Xu), Floating (Fu)
Tongue coating: Partial absence of coating
Tongue color: Red
Symptoms: Tics Vertigo Fatigue Tinnitus Insomnia Dry eyes Dry hair Dry skin Dizziness Dry mouth Sore back Headaches Dry throat Dry vagina Dry stools Amenorrhea Joint pain Infertility Hot flushes Night sweats Blurred vision Scanty periods Delayed period Excessive tear Lower back pain Lightheadedness Afraid of light Tingling of limbs Diminished hearing Vertical headaches Occipital headaches Nocturnal emissions Chronic sore throat Hot palms and soles Numbness in the limbs Withered and brittle nails Heat in vaginal and vulvar Feeling of heat in the afternoon Spontaneous and nocturnal emissions Soreness and weakness in the lower back
Zhi Bo Di Huang Wan is sometimes prescribed by TCM practitioners to treat Kidney and Liver Yin Deficiency. This pattern leads to symptoms such as dizziness, tinnitus, diminished hearing and lower back pain. Patients with Kidney and Liver Yin Deficiency typically exhibit empty (Xu) or floating (Fu) pulses as well as Normal-coloured without coating or with rootless coating.
The Liver stores Blood while the Kidneys store Essence.
Liver Blood depends on Essence for nourishment, while Essence depends on Blood for replenishment. Both have a common source: Grain Qi derived from the Spleen. In terms of Five Elements, the Kidneys nourish the Liver.
A long term Liver Blood... read more about Kidney and Liver Yin Deficiency
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