六經
黃煌 · 六經體質

Huang Huang's Six Constitutional Types

A framework mapping the Six Stages of the Shang Han Lun to stable constitutional patterns — who the person is, not just what disease they have.

Stage 01 · Yang
太陽
Taiyang
Exterior reactivity — surface regulation instability
Modern analogy: Autonomic surface instability · Stress-reactive musculature · Heightened proprioceptive sensitivity
Constitutional Person

Lean to medium build. Neck and upper back tension is characteristic — often noticeable on observation. Easily affected by cold, wind, and weather changes. Catches colds readily. Floating or tight pulse. Skin that reacts to contact. The body's boundary with the external world is its weak point.

Abdominal & Physical Signature
Tight, reactive musculature of the upper back and neck. Abdomen may be unremarkable. Key diagnostic: pulsatile or tight quality along the nape and shoulders, worsening with cold exposure.
Formula Families · Expanded
Gui Zhi Tang Family 桂枝湯

The Gui Zhi Tang person is the classic Huang Huang formula-person: lean, delicate-looking, skin slightly pale or with a tendency to spontaneous sweating, easily fatigued. This formula restores the harmonizing function of the surface — it does not simply stop sweating but re-regulates the opening and closing of the wei-qi layer. Modifications extend the range considerably.

Gui Zhi Tang 桂枝湯 Gui Zhi Jia Ge Gen Tang Gui Zhi Jia Long Gu Mu Li Tang Gui Zhi Fu Ling Wan Xiao Jian Zhong Tang Huang Qi Gui Zhi Wu Wu Tang
Ma Huang Tang Family 麻黃湯

The Ma Huang person is more muscular and robust than the Gui Zhi type — surface closure is the problem here (no sweating, tight surface). Ma Huang formulas open the exterior forcefully. Huang Huang uses this family for respiratory, musculoskeletal, and edema conditions where the surface is locked. He is careful about cardiac and hypertensive patients.

Ma Huang Tang 麻黃湯 Ma Huang Fu Zi Xi Xin Tang Xiao Qing Long Tang Ma Xing Yi Gan Tang Yue Bi Tang
Stage 02 · Yang
陽明
Yangming
Excess metabolism — interior heat and fullness
Modern analogy: Inflammatory/metabolic excess phenotype · Cardiovascular risk profile · Type A constitution
Constitutional Person

Robust, well-nourished build. Reddish or florid complexion — Huang Huang notes facial color as a key diagnostic marker. Loud voice, strong energy, strong appetite. Tendency toward constipation, hypertension, irritability. Thick yellow or dry tongue coating. These individuals often thrive under pressure until their system overshoots.

Abdominal & Physical Signature
Full, firm abdomen — often with resistance or tenderness in the epigastric or periumbilical region. In Cheng Qi types: hardness and distension of lower abdomen. Key: well-muscled, dense abdominal wall.
Formula Families · Expanded
Bai Hu Tang Family 白虎湯

For the heat excess without accumulation pattern — the four greats (great fever, great sweating, great thirst, flooding pulse). The person radiates heat, sweats profusely, and is intensely thirsty. Huang Huang uses this for metabolic and inflammatory states — diabetes, high fever, autoimmune flares — in constitutionally robust patients.

Bai Hu Tang 白虎湯 Bai Hu Jia Ren Shen Tang Bai Hu Jia Gui Zhi Tang Zhu Ye Shi Gao Tang
Cheng Qi Tang Family 承氣湯

For dryness and accumulation — the bowel has stopped moving, heat has dried and compacted. Three key variants by degree of force required. Huang Huang extends this beyond acute constipation to chronic metabolic accumulation, neurological excess states, and situations where purging is the therapeutic principle.

Da Cheng Qi Tang 大承氣湯 Xiao Cheng Qi Tang Tiao Wei Cheng Qi Tang Ma Zi Ren Wan Da Huang Mu Dan Tang
Huang Lian / Huang Qin Family 黃連黃芩類

Heat-clearing bitter formulas for interior heat that has not yet formed dry accumulation. Huang Huang uses these widely for the Yangming type with digestive inflammation, irritability, insomnia from heat, and bleeding disorders.

Huang Lian Jie Du Tang San Huang Xie Xin Tang Ge Gen Huang Qin Huang Lian Tang Ban Xia Xie Xin Tang
Stage 03 · Yang
少陽
Shaoyang
Pivot dysregulation — half interior, half exterior
Modern analogy: Neuroendocrine instability · HPA-axis dysregulation · Stress-sensitive regulatory failure
Constitutional Person

Lean, often wiry in build. A tendency toward anxiety, overthinking, and stress reactivity. Alternating symptoms — better and worse in cycles, never fully resolved. Chest and rib-side tightness. Headaches, bitter taste in the mouth, disturbed sleep. Hypertension is common. Huang Huang considers this one of the most prevalent modern constitutional types — especially among professionals, caregivers, and those under chronic cognitive or emotional stress.

Abdominal & Physical Signature
Key diagnostic: hypochondriac (rib-side) resistance and tenderness on palpation. Even gentle pressure reveals tightness or discomfort below the costal margin bilaterally. This is the most reliable physical confirmation of a Shaoyang/Chai Hu constitution.
Formula Families · Expanded
Xiao Chai Hu Tang Family 小柴胡湯

The anchor of the Shaoyang stage and one of Huang Huang's most-discussed formulas. He describes the Chai Hu person in detail: lean, anxious, rib-side reactive, with alternating patterns. Xiao Chai Hu Tang harmonizes the pivot — it neither pushes outward nor inward, but restores the regulatory function itself. Huang Huang uses it for immune dysregulation, chronic inflammation, digestive-emotional overlap, and autoimmune conditions.

Xiao Chai Hu Tang 小柴胡湯 Da Chai Hu Tang Chai Hu Gui Zhi Tang Chai Hu Gui Zhi Gan Jiang Tang Chai Hu Jia Long Gu Mu Li Tang
Chai Hu Jia Long Gu Mu Li Tang 柴胡加龍骨牡蠣湯

Huang Huang regards this as one of his most important formulas for modern practice. It addresses the Shaoyang type with significant neuropsychiatric involvement — anxiety, palpitations, insomnia, emotional dysregulation. The addition of Long Gu and Mu Li anchors the spirit while Chai Hu continues to harmonize. He applies it to hypertension, panic disorder, and stress-driven cardiac arrhythmia.

Core formula — not a family Modifications: add Huang Lian for heat Combine with Gui Zhi for cold extremities
Chai Hu Gui Zhi Gan Jiang Tang 柴胡桂枝乾薑湯

For the Shaoyang type with an underlying Taiyin deficiency — the anxious, reactive person who also has cold abdomen, loose stool, and fatigue. This formula holds a bridging position between Shaoyang and Taiyin constitutions and reflects Huang Huang's sensitivity to mixed-stage presentations.

Shaoyang-Taiyin overlap Anxiety + cold gut Chronic fatigue with stress overlay
Stage 04 · Yin
太陰
Taiyin
Digestive weakness — fluid accumulation and dampness
Modern analogy: Metabolic slowdown · Gut-energy deficiency · Hypometabolic phenotype
Constitutional Person

Fatigues easily, especially after eating. Loose stool or a tendency toward dampness and heaviness. Bloating, poor appetite or easily full. Low motivation. Soft, often slightly distended or lax abdomen on palpation. This person is functionally deficient at the middle level — not the deep depletion of Shaoyin, but a failure of transformation and transportation that accumulates as damp, phlegm, and stagnation.

Abdominal & Physical Signature
Soft, lax abdomen — often described as "like cotton." May have epigastric splash sound (water accumulation). No significant resistance. The key differential from Shaoyin: the Taiyin abdomen is soft and damp, not sunken or cold to depth.
Formula Families · Expanded
Li Zhong Tang Family 理中湯

The primary Taiyin formula — warms and restores the middle. Huang Huang uses this for cold-damp Spleen patterns with loose stool, nausea, cold abdomen, and fatigue. He notes this constitution does poorly with cold, raw foods and responds strongly to warmth. Ren Shen provides qi while Gan Jiang warms the cold.

Li Zhong Tang 理中湯 Fu Zi Li Zhong Tang Gui Zhi Ren Shen Tang
Ban Xia / Phlegm-Damp Family 半夏類

For Taiyin constitutions where damp has transformed into phlegm — the accumulation has thickened. Huang Huang uses Ban Xia-centered formulas extensively for nausea, vertigo, insomnia from phlegm-disturbance, and what he describes as the phlegm person: well-nourished, slightly sluggish, with a slippery pulse.

Ban Xia Bai Zhu Tian Ma Tang Wen Dan Tang 溫膽湯 Er Chen Tang Ban Xia Hou Po Tang Xiao Ban Xia Tang
Zhu Ling / Fu Ling Water-Damp Family 苓類

For fluid accumulation — damp that has not transformed to phlegm but pools as edema, loose stool, heaviness, or urinary changes. These formulas drain and transform without warming aggressively.

Wu Ling San 五苓散 Fang Ji Huang Qi Tang Ling Gui Zhu Gan Tang
Stage 05 · Yin
少陰
Shaoyin
Deep vitality depletion — core regulatory energy failing
Modern analogy: HPA exhaustion · Adrenal fatigue pattern · Deep constitutional insufficiency
Constitutional Person — Two Subtypes
Yang-Deficient Subtype

Profound cold intolerance. Exhaustion that sleep does not restore. Low drive, flat affect, social withdrawal. Sleepiness. The body cannot generate warmth or activation. Huang Huang notes a characteristic psychological quality: emotional blunting, not simply sadness.

Yin-Deficient Subtype

Insomnia, dryness of mucous membranes, anxiety, night sweating, heat sensations. The regulatory energy is depleted but in the yin-nourishing direction — the system is depleted and irritable simultaneously. Often blends with Shaoyang features.

Abdominal & Physical Signature
Sunken, thin abdomen — cold to the touch in yang-deficient type. Pulsatile epigastric activity (palpable aortic pulse) sometimes present. Weak, deep pulse. Pale or dusky complexion. Distinct from Taiyin: the deficiency is deeper and colder, involving constitutional rather than functional failure.
Formula Families · Expanded
Si Ni Tang Family 四逆湯

The core yang-rescue formulas. Fu Zi (aconite) is the primary herb — Huang Huang discusses Fu Zi's indications in detail, emphasizing cold signs at the constitutional level: cold limbs beyond the wrist and ankle, extreme fatigue, sunken weak pulse. He is meticulous about proper preparation and cautious dosing. Used in collapse states, chronic autoimmune exhaustion, and deep cold constitutions.

Si Ni Tang 四逆湯 Tong Mai Si Ni Tang Bai Tong Tang Fu Zi Tang
Zhen Wu Tang 真武湯

Yang deficiency with water accumulation — the body cannot transform fluids because yang is insufficient. Edema, dizziness, palpitations, cold limbs, and loose stool in a depleted patient. Huang Huang applies this to heart failure, renal insufficiency, and hypothyroid patterns where water metabolism has broken down.

Zhen Wu Tang 真武湯 Modifications with Ren Shen for severe qi collapse
Yin-Deficiency Formulas 滋陰類

For the yin-depleted Shaoyin type. Huang Lian E Jiao Tang is the classic — heat and dryness with agitation and inability to sleep. In practice, Huang Huang notes this pattern often presents in complex mixed forms, particularly with Shaoyang overlap (anxiety + depletion).

Huang Lian E Jiao Tang Zhi Gan Cao Tang 炙甘草湯 Mai Men Dong Tang
Stage 06 · Yin
厥陰
Jueyin
Heat-cold inversion — loss of regulatory harmony
Modern analogy: Autonomic dysregulation · Paradoxical responders · Complex mixed neuroendocrine failure
Constitutional Person

The most complex constitutional type. Simultaneous and paradoxical symptoms: heat above, cold below — anxiety co-existing with cold limbs; hunger with inability to eat; agitation with exhaustion. These patients often have a history of treatments that worsened or paradoxically affected them. Hypersensitivity is a hallmark. Huang Huang advises clinicians to be careful not to over-assign this category, as complexity alone does not confirm Jueyin.

Abdominal & Physical Signature
Variable and contradictory signs — may show simultaneous cold lower abdomen with epigastric heat or fullness. No single consistent palpation finding. The paradox itself is the signature.
Formula Families · Expanded
Wu Mei Wan 烏梅丸

The anchor Jueyin formula. Wu Mei Wan contains both warming and cooling herbs — it is structurally a paradox-resolving formula. Huang Huang uses it for complex digestive disorders (chronic dysentery, irritable bowel), parasitic conditions, menopausal syndrome, and patients with simultaneous heat and cold signs who have failed simpler approaches. The Wu Mei person is chronically ill, hypersensitive, and often has a strong reaction to dietary triggers.

Wu Mei Wan 烏梅丸 Cold limbs + internal heat Chronic parasitic or dysenteric patterns Menopausal complex
Dang Gui Si Ni Tang Family 當歸四逆湯

For Jueyin cold obstructing the vessels — cold extremities with blood deficiency. Huang Huang uses this for Raynaud's phenomenon, cold-limb syndromes, dysmenorrhea from cold-blood obstruction, and chilblains. The Dang Gui nourishes blood while the formula warms the channels.

Dang Gui Si Ni Tang Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang Raynaud's / cold limbs + blood deficiency
Xiao Yao / Chai Hu + Blood Overlap

Some Jueyin presentations overlap with Shaoyang-blood deficiency combinations. Huang Huang occasionally uses Jia Wei Xiao Yao San for female patients with heat-cold inversion, emotional dysregulation, and menstrual irregularity — recognizing the boundary between Shaoyang and Jueyin as clinically porous.

Jia Wei Xiao Yao San Shaoyang-Jueyin boundary
Clinical Differential

Comparative Reference Table

Key differentiating features across the six constitutional types

Type Build / Appearance Chief Complaint Pattern Abdomen (Fukushin) Pulse Psychological Keynote Key Differentiating Feature Anchor Formula
太陽
Taiyang		 Lean–medium. Tight upper back and neck visible on inspection. Reactive skin. Cold/wind sensitivity. Repeated colds. Neck stiffness. Surface symptoms predominate. Often unremarkable. Tight nape & shoulders the key finding, not the abdomen. Floating or tight Reactive, vigilant. Body registers environmental change strongly. Surface is the battleground — all pathology plays out at the body's boundary Gui Zhi Tang / Ma Huang Tang
陽明
Yangming		 Robust, well-nourished. Florid or reddish complexion. Thick neck. Dense musculature. Constipation, heat signs, irritability, hypertension. Excess and fullness dominate. Full, firm. Resistance or tenderness epigastric or periumbilical. Dense abdominal wall. Flooding, rapid, forceful Driven, assertive, easily irritated. High metabolic baseline. Interior excess — the fire burns too hot and too full, not a deficiency problem Bai Hu Tang / Da Cheng Qi Tang
少陽
Shaoyang		 Lean to wiry. Often anxious-looking. May appear tense around jaw and shoulders. Alternating, shifting symptoms. Rib-side tightness. Stress triggers. Never fully well. Hypochondriac resistance bilateral — key confirmatory finding on palpation. Wiry (xian) Overthinking, stress-sensitive, emotionally reactive. Tends to ruminate. Pivot dysfunction — symptoms alternate, shift, never settle; the regulatory function itself is the problem Xiao Chai Hu Tang / Chai Hu Long Gu Mu Li Tang
太陰
Taiyin		 Soft build, possibly overweight from damp accumulation. Pale or sallow. Low muscle tone. Fatigue post-eating. Loose stool. Bloating, heaviness. Damp and phlegm accumulate. Soft, lax — "like cotton." Possible epigastric splash. No significant resistance. Soft, moderate, possibly slippery Low motivation, introverted, avoids cold and exertion. Needs rest. Middle-level deficiency — not as deep as Shaoyin; the Spleen cannot transform, so damp accumulates Li Zhong Tang / Wen Dan Tang
少陰
Shaoyin		 Thin, drawn. Pale or dusky. Cold appearance. Low vitality visible in posture and eyes. Deep exhaustion unrelieved by sleep. Cold limbs past wrist/ankle. Or: insomnia, dryness, night heat (yin subtype). Sunken, thin, cold to touch (yang type). Palpable epigastric aortic pulsation sometimes present. Deep, weak, thin Flat affect, withdrawn, emotionally blunted (yang type). Or anxious, desiccated (yin type). Constitutional depth — deficiency is at the root level, not functional; the system itself is running out of fuel Si Ni Tang / Zhen Wu Tang (yang) · Huang Lian E Jiao Tang (yin)
厥陰
Jueyin		 Variable — often chronically ill appearance. Hypersensitive skin or reactions. Mixed signs. Paradoxical and mixed: cold limbs + internal heat; hunger + cannot eat; anxiety + exhaustion simultaneously. Variable and contradictory. No consistent pattern — the paradox itself is the signature. Variable; may be wiry-thin or irregular Hypersensitive, paradoxical reactors. History of treatments that backfired. Inversion and paradox — heat and cold coexist; the system has lost its axis; simple treatments make things worse Wu Mei Wan / Dang Gui Si Ni Tang
Clinically Tricky Pairs
Deficiency Look-alikes
Taiyin vs Shaoyin
Both present as fatigued and deficient. Key: Taiyin deficiency is at the Spleen/middle level — digestive symptoms, damp accumulation, soft abdomen, functional failure. Shaoyin is deeper — the constitutional core itself is depleted, cold limbs past the wrist/ankle, deep weak pulse, psychological blunting. Ask: does warmth and food help? (Taiyin) Or is the person depleted even at rest? (Shaoyin)
Stress & Anxiety
Shaoyang vs Shaoyin (yin)
Both present with anxiety and insomnia. Key: Shaoyang anxiety is regulatory — shifting, stress-driven, with rib-side tightness and wiry pulse. Shaoyin yin-deficient anxiety is desiccation anxiety — insomnia from dryness and heat, night sweating, thin body, deficient feeling underneath the agitation. Chai Hu formulas for Shaoyang; Huang Lian E Jiao Tang for yin-depleted Shaoyin.
Cold Limbs
Shaoyin vs Jueyin
Both have cold extremities. Key: Shaoyin cold is uniform, constitutional, and accompanies deep exhaustion and flat affect. Jueyin cold is paradoxical — cold limbs co-exist with internal heat, agitation, or hunger. The Shaoyin patient is depleted and quiet; the Jueyin patient is cold below and disturbed above simultaneously. Si Ni Tang vs Wu Mei Wan / Dang Gui Si Ni Tang.
Robust with Heat
Yangming vs Shaoyang
Both may present with heat signs and irritability. Key: Yangming heat is interior excess in a constitutionally strong person — robust build, constipation, flooding pulse. Shaoyang heat is regulatory — the wiry lean person with alternating symptoms, rib-side tightness, stress reactivity. Yangming is about too much; Shaoyang is about dysregulation. Check the abdomen: full/firm vs. rib-side resistance.
Surface Symptoms
Taiyang vs Shaoyang
Both can present with recurring or unresolved surface symptoms. Key: Taiyang pathology is at the body's boundary — cold sensitivity, neck stiffness, floating pulse, external triggers. Shaoyang pathology is at the pivot — the surface symptoms alternate, shift, and never fully resolve because the regulation between interior and exterior is dysfunctional. Chai Hu Gui Zhi Tang bridges them when both are present.
Complex Mixed Cases
Shaoyang vs Jueyin
Huang Huang warns against over-assigning Jueyin. Key: Shaoyang complexity is regulatory — alternating and stress-driven, but the regulatory mechanism itself is intact and responsive. Jueyin complexity involves true inversion — heat and cold as simultaneous physiological states, not just alternating. If Chai Hu formulas fail or worsen the patient, reconsider toward Jueyin. Paradoxical drug reactions are a strong Jueyin signal.
舌診 · Tongue Diagnosis

Tongue Findings by Constitutional Type

Tongue body, coating, moisture and shape — as used by Huang Huang in constitutional assessment

太陽 Taiyang
thin white coat · normal body
BodyNormal to slightly pale. No significant changes — tongue body is rarely a primary diagnostic here.
CoatingThin white coat. May be slightly thicker at the root if cold has penetrated.
MoistureNormal to slightly moist. Not dry.
ShapeNo significant changes. Tongue is often a minor diagnostic in acute Taiyang patterns.
The tongue is not the star finding here — the pulse (floating/tight) and neck/surface symptoms carry the diagnosis. A normal tongue does not rule out Taiyang.
陽明 Yangming
thick yellow coat · red body · dry
BodyRed to deep red. Reflects interior heat accumulation. More intensely red as heat deepens.
CoatingThick yellow coat (heat); thick dry yellow-grey or black coat in severe Cheng Qi patterns (dry accumulation). Bai Hu type may have yellow but moist coat.
MoistureDry — especially in Cheng Qi (accumulation) patterns. Moist coat suggests heat without dryness (Bai Hu range).
ShapeMay be swollen or broad reflecting fullness. Cracking possible in chronic dryness patterns.
Coat thickness and dryness distinguish Bai Hu (thick-yellow-moist) from Cheng Qi (thick-dry-dark). The redder and drier the tongue, the deeper the accumulation.
少陽 Shaoyang
red lateral edges · thin coat
BodyNormal to slightly red at edges or tip. Redness at the sides (liver/gallbladder zones) is characteristic.
CoatingThin white or thin yellow coat. May be uneven — thicker in patches. Bitter taste reported by patient.
MoistureNormal to slightly dry. Chai Hu Gui Zhi Gan Jiang subtype may show dryness with cold abdomen.
ShapeNormal size. May show slight quivering or tension at edges in highly stressed patients.
Redness at the tongue's lateral margins (sides) is a valuable Shaoyang sign. Paired with rib-side palpation tenderness, it strongly confirms a Chai Hu constitution.
太陰 Taiyin
pale · swollen · greasy coat · teethmarks
BodyPale to pale-pink. Dull quality. Reflects qi deficiency and poor circulation in the middle.
CoatingThick white coat (damp). In phlegm-dominant presentations: greasy white or greasy yellow coating. Greasy quality is key.
MoistureWet to very wet. Excess moisture reflects failure to transform fluids. Slippery surface common.
ShapeSwollen, possibly with teethmarks (scalloped edges) — classic damp-Spleen finding. Flabby body.
Greasy coat + swollen body + teethmarks is the Taiyin tongue triad. The greasier and wetter the coat, the more fluid accumulation is present. Phlegm presentations add thickness to the grease.
少陰 Shaoyin
yang def. pale · wet · swollen vs yin def. red · dry · peeled
BodyYang type: Pale, sometimes bluish-purple (cold obstructing blood). Yin type: Red or deep red, dry, possibly cracked or peeled coat.
CoatingYang type: Thin white, wet or slippery. Yin type: Little or no coat; mirror tongue (peeled) in severe yin depletion.
MoistureYang type: Excessively wet — cold prevents transformation. Yin type: Very dry — depleted fluids cannot moisten.
ShapeYang type: Swollen, possibly tender. Yin type: Thin, small, contracted or cracked.
The two Shaoyin subtypes show opposite tongues: pale-wet-swollen (yang deficiency) vs red-dry-peeled (yin deficiency). Confusing them leads to catastrophic treatment errors.
厥陰 Jueyin
red tip (heat) coat patch dusky · mottled · patchy coat
BodyOften dusky, purplish, or mottled — reflecting blood stasis and cold-heat inversion. Mixed signals on the same tongue.
CoatingUneven or patchy — may be thick in one area, absent in another. No single clear pattern; the incoherence of the coating mirrors the incoherence of the constitution.
MoistureVariable — may be wet at root (cold below) and dry at tip (heat above) simultaneously.
ShapeMay show asymmetry. Purplish discoloration of lateral edges or tip in cold-stasis presentations.
A patchy, uneven, or self-contradictory tongue — wet in one zone, dry in another; pale body with red tip — is a Jueyin signal. The tongue itself is paradoxical, just like the constitution.
方證索引 · Formula Index

Symptom → Formula Lookup

Filter by symptom cluster to find the relevant formula family and constitutional context

太陰 Taiyin
Nausea, vomiting, epigastric fullness
Ban Xia Xie Xin Tang Xiao Ban Xia Tang Wu Ling San

Damp-phlegm blocking the middle. Nausea from water accumulation or cold-damp. Match to coat: greasy = Ban Xia; clear fluid = Wu Ling San.

太陰 Taiyin
Loose stool, diarrhoea, cold abdomen
Li Zhong Tang Fu Zi Li Zhong Tang Si Ni Tang

Cold-damp Spleen failing to transform. Li Zhong for mild; Fu Zi Li Zhong if cold is significant; Si Ni Tang if deep Shaoyin coldness is present.

陽明 Yangming
Constipation, dry stools, abdominal fullness
Da Cheng Qi Tang Xiao Cheng Qi Tang Ma Zi Ren Wan

Interior excess accumulation. Match formula to urgency: Da Cheng Qi for acute/severe; Ma Zi Ren Wan for chronic habitual constipation in drier constitution.

陽明 Yangming
Acid reflux, gastritis, epigastric burning
Ban Xia Xie Xin Tang Huang Lian Jie Du Tang Da Chai Hu Tang

Heat-cold complex in the middle (Ban Xia Xie Xin) or pure heat excess (Huang Lian Jie Du). Da Chai Hu for Shaoyang-Yangming overlap with rib-side fullness.

厥陰 Jueyin
Chronic diarrhoea/dysentery, alternating bowel
Wu Mei Wan

Heat-cold inversion in the gut. Wu Mei Wan for chronic, complex, or parasitic bowel disorders. Patient often has paradoxical food reactions and complex history.

太陰 Taiyin
Bloating, distension, post-meal fatigue
Li Zhong Tang Hou Po Sheng Jiang Ban Xia Gan Cao Ren Shen Tang Ping Wei San

Spleen failing to transform and transport. Match to cold/damp quality: cold-dominant → Li Zhong; damp-dominant → Ping Wei San.

少陽 Shaoyang
Insomnia, anxiety, palpitations (stress-driven)
Chai Hu Long Gu Mu Li Tang Xiao Chai Hu Tang

Shaoyang pivot dysregulation with spirit disturbance. Wiry pulse, rib-side tightness. Chai Hu Long Gu Mu Li is Huang Huang's flagship formula for modern stress-driven insomnia.

少陰 Shaoyin (yin)
Insomnia with anxiety, dryness, night heat
Huang Lian E Jiao Tang Zhi Gan Cao Tang

Yin-depleted Shaoyin — insomnia from desiccation and empty heat. Distinguished from Shaoyang insomnia by thin body, peeled tongue, deep deficient quality underlying the agitation.

太陰 Taiyin
Insomnia, dizziness from phlegm-heat
Wen Dan Tang Huang Lian Wen Dan Tang

Phlegm disturbing the spirit — greasy coat, slippery pulse, insomnia with vivid dreams or phlegm-related symptoms. Wen Dan Tang is classic; add Huang Lian for heat component.

太陽 Taiyang
Neck stiffness, upper back tension, headache
Ge Gen Tang Gui Zhi Jia Ge Gen Tang Ge Gen Huang Qin Huang Lian Tang

Taiyang surface cold contracting the nape and upper back. Ge Gen Tang for tight-no-sweat type; Gui Zhi Jia Ge Gen for spontaneous sweating type. Essential Taiyang formulas.

厥陰 Jueyin
Cold limbs, Raynaud's, chilblains, cold pain
Dang Gui Si Ni Tang Dang Gui Si Ni Jia Wu Zhu Yu Sheng Jiang Tang

Jueyin cold obstructing vessels with blood deficiency. Classic for Raynaud's, dysmenorrhoea from cold, cold-induced pain patterns. Add Wu Zhu Yu for deeper cold with vomiting.

太陽 Taiyang
Generalised body aches, muscle pain, fibromyalgia-like
Huang Qi Gui Zhi Wu Wu Tang Gui Zhi Tang

Nutritive-defensive disharmony causing diffuse body pain, numbness, or sensitivity. Huang Qi Gui Zhi Wu Wu Tang for blood-bi, numbness, and the deficient Taiyang person with fatigue overlay.

少陽 Shaoyang
Rib-side pain, intercostal tension, flank discomfort
Xiao Chai Hu Tang Da Chai Hu Tang Si Ni San

Shaoyang qi stagnation in the lateral costal region. Confirm with palpation resistance under the ribs. Da Chai Hu for Shaoyang + Yangming fullness pattern.

陽明 Yangming
High fever, profuse sweating, intense thirst
Bai Hu Tang Bai Hu Jia Ren Shen Tang

Classic four-greats Yangming heat. Bai Hu Jia Ren Shen for qi damage alongside heat (more thirst, more exhaustion). Constitutionally robust patient — do not use in deficient constitution.

少陰 Shaoyin (yang)
Extreme cold intolerance, cold limbs past wrist/ankle
Si Ni Tang Zhen Wu Tang Ma Huang Fu Zi Xi Xin Tang

Deep yang insufficiency. Cold past the wrist and ankle is Huang Huang's key anatomical marker for Shaoyin. Si Ni for pure cold collapse; Zhen Wu for cold + water accumulation; Ma Huang Fu Zi Xi Xin for cold surface with deep yang deficiency.

厥陰 Jueyin
Cold limbs with internal heat — simultaneous
Wu Mei Wan Dang Gui Si Ni Tang

True heat-cold inversion, not alternating. Cold periphery with heat or agitation centrally. Wu Mei Wan for the full paradoxical pattern; Dang Gui Si Ni for cold-vessel obstruction with blood deficiency.

太陽 Taiyang
Common cold, chills, no sweating, body aches
Ma Huang Tang Ge Gen Tang

Taiyang cold-type (shang han) — surface closed, no sweating, tight pulse. Ma Huang Tang opens forcefully. Use in constitutionally robust patients; caution with cardiac or hypertensive patients.

太陽 Taiyang
Cold with sweating, aversion to wind, runny nose
Gui Zhi Tang Gui Zhi Jia Ge Gen Tang

Taiyang wind-type (zhong feng) — surface open, spontaneous sweating, floating moderate pulse. Gui Zhi Tang harmonises without aggressive opening. Classic for the delicate Gui Zhi constitution.

太陽 Taiyang
Wheeze, cough with thin watery sputum, cold trigger
Xiao Qing Long Tang She Gan Ma Huang Tang

Cold-water rheum in the lungs — classic cold-triggered asthma or bronchitis pattern. Thin, white, watery sputum. Cold weather trigger. Xiao Qing Long is the cornerstone formula.

少陽 Shaoyang
Hypertension, stress-driven, with anxiety/insomnia
Chai Hu Long Gu Mu Li Tang Da Chai Hu Tang

Shaoyang constitution hypertension — wiry pulse, rib-side tension, stress-reactive. Huang Huang uses Chai Hu Long Gu Mu Li as a primary formula for hypertension in this constitution.

少陰 Shaoyin
Palpitations, irregular pulse, heart insufficiency
Zhi Gan Cao Tang Gui Zhi Gan Cao Long Gu Mu Li Tang

Shaoyin-level cardiac deficiency — irregular or intermittent pulse (dai mai), palpitations, exhaustion. Zhi Gan Cao Tang is classic for yin-blood deficient cardiac patterns; Gui Zhi Gan Cao Long Gu Mu Li for yang-deficient palpitation.

少陰 Shaoyin
Heart failure pattern, oedema, cold extremities
Zhen Wu Tang Si Ni Tang

Yang-deficient Shaoyin with water accumulation — the classic cardiac oedema constitutional pattern. Zhen Wu Tang: Fu Zi + Fu Ling + Bai Zhu drives water out while warming yang.

太陰 Taiyin
Fatigue, digestive weakness, post-meal tiredness
Li Zhong Tang Xiao Jian Zhong Tang Huang Qi Jian Zhong Tang

Middle-level Spleen-qi deficiency. Xiao Jian Zhong and Huang Qi Jian Zhong for the deficient, thin, easily fatigued Gui Zhi constitution with digestive weakness — tonify without cloying.

少陰 Shaoyin
Deep exhaustion, adrenal-type fatigue, no recovery from rest
Si Ni Tang Fu Zi Tang

Constitutional core depletion — rest does not restore. Fu Zi is essential. Huang Huang's marker: deep weak pulse, cold limbs past wrist/ankle, psychological blunting or flat affect.

太陽 Taiyang
Fatigue with surface sensitivity, muscle weakness, numbness
Huang Qi Gui Zhi Wu Wu Tang Gui Zhi Tang

Defensive qi insufficiency with vessel weakness — the Huang Qi Gui Zhi Wu Wu constitution: fatigue + peripheral numbness or weakness + surface reactivity. Common in post-illness recovery and elderly deficient types.

厥陰 Jueyin
Dysmenorrhoea with cold, endometriosis-like cold pain
Dang Gui Si Ni Tang Wen Jing Tang

Cold obstructing the uterine vessels with blood deficiency. Dang Gui Si Ni for classic Jueyin cold-limbs presentation; Wen Jing Tang for cold-blood deficiency in gynaecology broadly.

太陽 Taiyang
Blood stasis in lower jiao, gynaecological blood stasis
Gui Zhi Fu Ling Wan Tao He Cheng Qi Tang

Taiyang blood stasis formula — one of Huang Huang's most commonly used. Gui Zhi Fu Ling Wan for the robust or mixed constitution with pelvic stasis: fibroids, endometriosis, dysmenorrhoea.

厥陰 Jueyin
Menopausal syndrome, hot flushes with cold extremities
Wu Mei Wan Chai Hu Gui Zhi Gan Jiang Tang

Classic Jueyin inversion in menopause — upper heat (flushes) with lower cold (cold limbs, cold uterus). Wu Mei Wan for the complex paradoxical pattern; Chai Hu Gui Zhi Gan Jiang if Shaoyang-Taiyin overlap predominates.

少陽 Shaoyang
Depression, anxiety, emotional dysregulation (stress type)
Chai Hu Long Gu Mu Li Tang Xiao Chai Hu Tang Jia Wei Xiao Yao San

Shaoyang spirit disturbance — the overthinking, stress-reactive person. Huang Huang uses Chai Hu Long Gu Mu Li as his primary neuropsychiatric Shaoyang formula. Jia Wei Xiao Yao for female patients with emotional-menstrual overlap.

少陰 Shaoyin (yang)
Flat affect, low motivation, withdrawal, depression (cold type)
Si Ni Tang Fu Zi Tang

Yang-deficient Shaoyin depression — not reactive or anxious but blunted, withdrawn, cold, slow. Huang Huang notes the psychological keynote of flat affect as a constitutional Shaoyin marker, not just a symptom.

太陰 Taiyin
Vertigo, dizziness, phlegm-type headache
Ban Xia Bai Zhu Tian Ma Tang Ze Xie Tang

Phlegm-damp obstructing the clear yang from ascending. Ban Xia Bai Zhu Tian Ma Tang is the classic damp-phlegm vertigo formula — greasy coat, slippery pulse, heaviness in the head.

失眠 · Insomnia

Insomnia by Constitutional Type

The shen is disturbed for different reasons in each constitution — formula selection follows the why, not just the symptom

龍牡
Clinical Pearl · Long Gu & Mu Li across constitutions

The pair Long Gu 龍骨 (dragon bone) + Mu Li 牡蠣 (oyster shell) appears across multiple constitutional types in Huang Huang's insomnia formulas — in Shaoyang (Chai Hu Long Gu Mu Li Tang), Taiyang (Gui Zhi Jia Long Gu Mu Li Tang), and Shaoyin yang-deficient (Gui Zhi Gan Cao Long Gu Mu Li Tang). This pair is not constitution-specific: it anchors the shen regardless of mechanism. The constitutional base formula determines why the shen is adrift; Long Gu and Mu Li help hold it. Understanding this lets the clinician recognise why the same mineral pair appears in very different formulas — the anchor is the same, the vessel it sits in changes.

少陽 Shaoyang Most common modern type
stress / overthinking → pivot dysregulation → shen cannot settle

Lies awake ruminating. Heart pounding at night. Alternating sleep — sometimes sleeping fine, then weeks of insomnia. Wiry pulse. Rib-side tension. Often a professional under chronic cognitive or emotional stress. The mind cannot switch off because the regulatory mechanism itself is stuck.

Chai Hu Long Gu Mu Li Tang ✦ Xiao Chai Hu Tang Chai Hu Gui Zhi Gan Jiang Tang

Chai Hu Long Gu Mu Li Tang is Huang Huang's flagship modern insomnia formula. Use Chai Hu Gui Zhi Gan Jiang Tang when insomnia accompanies cold abdomen and fatigue — the Shaoyang-Taiyin overlap type.

太陰 Taiyin Phlegm-damp type
Spleen fails → damp accumulates → phlegm clouds shen → disturbed sleep, vivid dreams

Not anxious in a wiry reactive way — rather cloudy, heavy, and disturbed. Vivid or disturbing dreams. Nausea or digestive unease at night. Greasy tongue coat. Slippery pulse. Often heavier build. The problem is accumulation obscuring clarity, not heat or depletion.

Wen Dan Tang ✦ Huang Lian Wen Dan Tang Ban Xia Xie Xin Tang Ban Xia Shu Mi Tang

Ban Xia Shu Mi Tang (Ban Xia + sorghum) is a simple classical formula from the Nei Jing specifically for stomach-insomnia — often overlooked. Wen Dan Tang for phlegm-heat with palpitations and vivid dreams; add Huang Lian when agitation is prominent.

少陰 Shaoyin · Yin-Deficient Desiccation type
yin depleted → empty heat rises → shen floats, cannot anchor

Wakes repeatedly at night. Feels hot, especially in the second half of the night. Night sweating. Dry mouth and throat. Thin body. Red peeled or cracked tongue. Thin rapid pulse. Anxiety that has a depleted, hollow quality underneath it — not the driven Shaoyang anxiety. The body simply cannot nourish the spirit.

Huang Lian E Jiao Tang ✦ Zhi Gan Cao Tang Mai Men Dong Tang

Huang Lian E Jiao Tang: Huang Lian clears empty heat; E Jiao nourishes yin-blood to anchor shen. Zhi Gan Cao Tang for insomnia with palpitations and irregular pulse — the cardiac-yin overlap. Mai Men Dong Tang when dryness and cough accompany the sleeplessness.

少陰 Shaoyin · Yang-Deficient Cold collapse type
yang too depleted → cannot consolidate shen → light sleep · easy waking · fright

Exhausted but cannot sleep, or sleeps very lightly with sudden waking. Easy fright or startling. Palpitations. Cold body. Deep weak pulse. Pale-bluish tongue. The shen is unanchored not from heat but from the yang being too weak to hold it — a less recognised but important insomnia pattern in depleted elderly or chronically ill patients.

Gui Zhi Gan Cao Long Gu Mu Li Tang ✦ Si Ni Tang

Gui Zhi Gan Cao Long Gu Mu Li Tang warms yang and anchors the shen — simpler than Chai Hu Long Gu Mu Li Tang, used when there is no Shaoyang pivot involvement. Si Ni Tang for profound yang depletion where insomnia is one symptom of a global collapse pattern.

陽明 Yangming Heat-excess type
interior heat / accumulation → shen over-activated → cannot wind down · agitation

Robust, hot, irritable. Cannot sleep because the system is too activated and full — not from anxiety but from excess. Constipation common. Loud, active mind with heat quality. Red tongue with thick dry coat. Flooding rapid pulse. Often worse in warm weather or after alcohol and rich food.

San Huang Xie Xin Tang ✦ Huang Lian Jie Du Tang Zhu Ye Shi Gao Tang Da Cheng Qi Tang

Purging and clearing are the therapeutic principle — resolving the excess directly resolves the spirit disturbance. Zhu Ye Shi Gao Tang for post-febrile or lingering heat insomnia; Da Cheng Qi Tang when constipation and abdominal fullness are prominent alongside insomnia.

太陽 Taiyang Surface-instability type
defensive qi unstable at night → surface fails to consolidate → easy waking · fright · sweating

Rarely a primary insomnia presentation — but seen in the lean, delicate Gui Zhi constitution with spontaneous sweating, palpitations at night, easy startling, and a general sensitivity. The defensive-qi instability that affects the body's boundary by day extends to the spirit at night. Floating moderate pulse.

Gui Zhi Jia Long Gu Mu Li Tang ✦ Gui Zhi Long Gu Mu Li Tang

The Gui Zhi base formula harmonises the surface; Long Gu and Mu Li anchor the shen. Classic for the constitutionally delicate person with nocturnal disturbances, sexual dreams, or spontaneous emission — the surface instability expressed through the spirit at night.

厥陰 Jueyin Paradoxical / complex type
heat-cold inversion → regulatory axis lost → paradoxical · treatment-resistant

The difficult insomniac — exhausted but agitated, cold in body but hot in mind, tried many approaches that didn't work or made things worse. Often a long history of failed treatments. Cold limbs with inner restlessness. Menopausal insomnia with heat flushes and cold extremities is a common Jueyin presentation.

Wu Mei Wan ✦ Dang Gui Si Ni Tang

Wu Mei Wan for the full paradoxical heat-cold insomnia — particularly menopausal complex. Dang Gui Si Ni Tang when cold limb pain is actively keeping the patient awake at night. Huang Huang cautions against over-assigning Jueyin: complexity alone does not confirm it — look for true simultaneous heat and cold, and a history of treatment paradox.

Summary Reference
Type Mechanism Insomnia Character Distinguishing Signs Primary Formula Secondary / Variants
Shaoyang Pivot dysregulation — shen cannot settle Rumination, mind won't stop, cyclical Wiry pulse, rib-side tightness, stress trigger Chai Hu Long Gu Mu Li Tang Xiao Chai Hu Tang · Chai Hu Gui Zhi Gan Jiang Tang
Taiyin Phlegm-damp obscuring the shen Vivid/disturbing dreams, cloudy, heavy Greasy coat, slippery pulse, nausea, heavy build Wen Dan Tang Huang Lian Wen Dan Tang · Ban Xia Xie Xin Tang · Ban Xia Shu Mi Tang
Shaoyin (yin) Empty heat floating shen upward Wakes at 2–4am, night heat, dry throat Red peeled tongue, thin rapid pulse, thin body Huang Lian E Jiao Tang Zhi Gan Cao Tang · Mai Men Dong Tang
Shaoyin (yang) Yang too weak to hold shen Light sleep, startles easily, exhausted but awake Pale-bluish tongue, deep weak pulse, cold body Gui Zhi Gan Cao Long Gu Mu Li Tang Si Ni Tang (severe)
Yangming Interior heat/excess over-activating shen Cannot wind down, hot, irritable, active mind Red tongue thick coat, constipation, robust build San Huang Xie Xin Tang Huang Lian Jie Du Tang · Zhu Ye Shi Gao Tang · Da Cheng Qi Tang
Taiyang Defensive qi instability at night Easy waking, fright, palpitations, sweating Lean delicate build, floating pulse, spontaneous sweat Gui Zhi Jia Long Gu Mu Li Tang Gui Zhi Long Gu Mu Li Tang
Jueyin Heat-cold inversion — axis lost Exhausted + agitated, paradoxical, treatment-resistant Cold limbs + inner heat, history of treatment failure Wu Mei Wan Dang Gui Si Ni Tang (cold-pain type)