Danggui Liuhuang Tang: The Sovereign Formula for Night Sweats

Danggui Liuhuang Tang is a classic formula from the "Spontaneous Sweating" chapter of Lanshi Micang (Orchid Chamber Secret Storage). The original text describes its effect in a single sentence: "Danggui Liuhuang Tang is the sovereign medicine for night sweats."

Night sweats refer to sweating during sleep that stops upon waking. It is common in children and in frail, chronically ill patients. Night sweats are very common in children and usually need no treatment. But if a child's night sweats come with a cluster of complications—night crying, poor appetite, occasional bad breath, thin lusterless hair, pale or sallow complexion, irregular bowels (either dry or loose), lassitude and fatigue, cold limbs or hot palms, frequent colds, cough—then targeted treatment is needed.

The causes of childhood night sweats are complex: undigested food retention can cause it, constitutional deficiency can cause it, and yin deficiency with effulgent fire can cause it. Adult night sweats are generally due to yin deficiency with effulgent fire. Danggui Liuhuang Tang is the sovereign remedy for night sweats from yin deficiency with effulgent fire.

Danggui Liuhuang Tang consists of equal parts Danggui (Angelica), Shengdihuang (raw Rehmannia), Shudihuang (processed Rehmannia), Huangbai (Phellodendron), Huangqin (Scutellaria), and Huanglian (Coptis), with double the amount of Huangqi (Astragalus). A typical adult dose is Danggui 6 g, Shudihuang 6 g, Shengdihuang 6 g, Huangbai 6 g, Huangqin 6 g, Huanglian 6 g, raw Huangqi 12 g; children and the elderly take less. Huangbai, Huangqin, and Huanglian are bitter, so the formula would actually be better made into honey pills, though no Danggui Liuhuang Wan patent medicine appears to be sold.

This formula both nourishes blood and yin and drains fire and clears heat. Danggui, Shengdihuang, Shudihuang, and Huangqi supplement qi and blood; the combination of Huangbai, Huangqin, and Huanglian constitutes Huanglian Jiedu Tang (Coptis Detox Decoction). Modern pharmacology shows Huangqin, Huanglian, and Huangbai treat respiratory and digestive inflammation well—corresponding in Chinese medicine to "heat in the lung and stomach" and "yin deficiency with effulgent fire."

Thus Danggui Liuhuang Tang works well for night sweats caused by chronic gastritis/enteritis, cholecystitis, and respiratory disease. Such conditions usually also present with five-center heat, restless sleep at night, dry throat and mouth, bad breath, and unclear breath.