Formula Decoction (Tang)

Bai He Zhi Mu Tang

Lily Bulb and Anemarrhena Decoction · 百合知母汤

A classical formula for lily disease (bǎi hé bìng) after sweating, used to nourish Yin, clear deficiency heat and calm the mind. It helps with restlessness, palpitations, dry cough, insomnia and irritability that arise when body fluids are depleted.

Origin 《金匮要略》卷上 (Essential Prescriptions of the Golden Cabinet, Volume 1) — Eastern Han dynasty, ~200 CE
Category Heart-nourishing and spirit-calming formulas Yin-enriching and Dryness-moistening formulas
Therapeutic focus Mental Wellbeing Sleep Lung Health Menopausal Support
Composition 2 herbs
Bai He
King
Bai He
Zhi Mu
Deputy
Zhi Mu
Explore composition

Educational content • Consult qualified TCM practitioners for diagnosis and treatment

Patterns Addressed

In TCM, symptoms don't appear randomly — they cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Bai He Zhi Mu Tang is designed to correct these specific patterns.

Why Bai He Zhi Mu Tang addresses this pattern

This formula nourishes Heart Yin and clears deficiency heat that disturbs the Shen (spirit). Bai He directly enters the Heart channel and calms the mind, while Zhi Mu clears heat without damaging Yin. The combination is ideal when Ying‑level Yin is injured by sweating, leaving palpitations, irritability, and insomnia.

A practitioner would look for one or more of these signs

Palpitations

often described as a fluttering sensation

Insomnia

difficulty falling asleep due to mental restlessness

Irritability

unexplained emotional upset and agitation

Dry Mouth And Throat At Night

worse in the evening

Commonly Prescribed For

These conditions can arise from the patterns above. A practitioner would consider Bai He Zhi Mu Tang when these conditions are specifically caused by those patterns — not for all cases of these conditions.

Arises from: Heart Yin Deficiency Empty-Heat or Fire caused by Yin Deficiency

TCM Interpretation

In TCM, anxiety often arises when Heart Yin is insufficient to anchor the Shen (spirit), and deficiency heat flares upward. This creates a state of inner nervousness, palpitations, and a feeling of heat in the chest. The condition is similar to lily disease, where a lingering heat after illness or emotional strain depletes Yin and disturbs the mind.

Why Bai He Zhi Mu Tang Helps

Bai He enters the Heart channel and directly calms the spirit while nourishing Yin. Zhi Mu clears the floating heat that drives the restlessness. Together they restore the cooling, stabilizing action of Yin on the Heart, reducing the mental agitation and the physical sensation of heat.

Also commonly used for

Depressive Disorder

Addresses Yin‑deficiency with internal heat that manifests as mental depression and disorientation

Post-Viral Fatigue

Replenishes Yin and clears residual heat after febrile illness

Irritability

Soothes emotional agitation caused by Yin deficiency and internal heat

Palpitations

Moistens Heart Yin and restrains deficiency fire to calm palpitations

Dry Cough

Moistens the Lung and stops dry, non‑productive cough

Menopausal Syndrome

Enriches Yin and clears empty heat that contributes to hot flashes and mood swings

What This Formula Does

Every TCM formula has a specific set of actions — here's what Bai He Zhi Mu Tang does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Bai He Zhi Mu Tang is primarily used to support these areas of health:

Mental Wellbeing Sleep Lung Health Menopausal Support

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Bai He Zhi Mu Tang performs to restore balance in the body:

Nourishes Yin and moistens dryness Clears heat and calms the spirit Moistens the Lungs and stops cough Tonifies the Heart and relieves irritability

How It Addresses the Root Cause

TCM doesn't just suppress symptoms — it aims to resolve the underlying imbalance. Here's how Bai He Zhi Mu Tang works at the root level.

The formula is designed for the lily disease (bǎi hé bìng) after erroneous sweating treatment. In lily disease there is already an underlying Yin deficiency with subtle internal heat affecting the Heart and Lung. Sweating further depletes Yin and body fluids, intensifying the deficiency heat. This heat rises to disturb the Heart spirit, causing restlessness, mental agitation, palpitations, and insomnia, while Lung Yin dryness leads to dry cough, thirst, and a dry mouth. The tongue becomes red with little or no coating, and the pulse is thin and rapid. By enriching Yin, clearing deficiency heat, and calming the spirit, the formula resolves this post-sweating aggravation.

Formula Properties

Every formula has an inherent temperature, taste, and affinity for specific organs — these properties determine how it interacts with the body

Overall Temperature

Cold

Taste Profile

Predominantly sweet and bitter — sweet to nourish Yin and moisten dryness, bitter to clear heat and drain fire.

Target Organs

Lungs Heart Kidneys

Channels Entered

Lung Heart Kidney Stomach

Ingredients

2 herbs

The herbs that make up Bai He Zhi Mu Tang, organized by their role in the prescription

King — Main ingredient driving the formula
Deputy — Assists and enhances the King
King — Main ingredient driving the formula
Bai He

Bai He

Lily bulb

Dosage 10 - 30g
Temperature Slightly Cool
Taste Sweet (甘 gān), Bitter (苦 kǔ)
Organ Affinity Heart, Lungs

Role in Bai He Zhi Mu Tang

Moistens Lung Yin and Heart Yin, clears deficiency heat, calms the mind and spirit, and directly treats the core lily disease mechanism of Yin deficiency with internal heat.
View herb details
Deputy — Assists and enhances the King
Zhi Mu

Zhi Mu

Anemarrhena rhizome

Dosage 6 - 12g
Temperature Cold
Taste Bitter (苦 kǔ), Sweet (甘 gān)
Organ Affinity Lungs, Stomach, Kidneys

Role in Bai He Zhi Mu Tang

Clears heat, drains fire, nourishes Yin and generates fluids. It reinforces the heat‑clearing and Yin‑nourishing actions of the King herb, alleviates irritability and thirst, and addresses the dryness in the Lung and Stomach.
View herb details

Why This Combination Works

How the herbs in Bai He Zhi Mu Tang complement each other

Overall strategy

This two‑herb formula addresses Yin deficiency and internal heat that flare after sweating in lily disease. It simultaneously nourishes Yin, clears heat, and stabilises the mind.

King herb

Bai He is sweet, slightly cold, and enters the Heart and Lung channels. It moistens Lung Yin, clears deficiency heat from the Lung, and calms the Heart spirit. It is uniquely suited to lily disease because it targets both the organ‑level dryness and the mental disturbance.

Deputy herb

Zhi Mu is bitter, cold, and enters the Lung, Stomach, and Kidney channels. It drains fire, clears Lung and Stomach heat, and nourishes Yin to generate fluids. It strengthens Bai He's Yin‑enriching action while directly soothing irritability and thirst.

Notable synergies

Bai He and Zhi Mu together form a classic pair: Bai He moistens the upper body and calms the mind, while Zhi Mu descends to enrich the Kidney Yin and drain floating heat, restoring the balance between the Heart and Kidney systems.

How to Prepare

Traditional preparation instructions for Bai He Zhi Mu Tang

Soak Bai He (lily bulb) in spring water overnight. Discard the soaking water. Add 400 ml fresh spring water and decoct Bai He until 200 ml remain. Separately, decoct Zhi Mu in 400 ml spring water until 200 ml remain. Combine the two decoctions, simmer until the total volume reduces to 300 ml. Strain and divide into two doses, taken warm.

Common Modifications

How practitioners adapt Bai He Zhi Mu Tang for specific situations

Added
Gua Lou Pi

9 - 12g, clears Lung heat and transforms phlegm

Pi Pa Ye

6 - 9g, directs Lung Qi downward and stops cough

Adds heat‑clearing and phlegm‑transforming herbs without damaging Yin, suitable when deficiency heat in the Lung has congealed into phlegm.

Related Formulas

Formulas often compared to or combined with Bai He Zhi Mu Tang, with a side-by-side look at how their compositions differ

Contrasting approach
Cool 2 herbs Decoction (Tang)

A gentle, two-herb classical formula used to nourish the body's cooling, moistening reserves (Yin) in the Heart and Lungs, and to clear the low-grade internal Heat that arises when these reserves are depleted. It is best known for treating a pattern of vague mental fogginess, emotional withdrawal, sleep difficulty, fluctuating appetite, and inner restlessness — symptoms that in modern practice often overlap with depression, anxiety, insomnia, and menopausal complaints.

Therapeutic focus
Emotional Wellbeing Sleep Support Menopausal support Stress and Anxiety

How it compares

Bai He Di Huang Tang is for lily disease that has not been treated with sweating, vomiting or purging. It uses fresh Rehmannia (Sheng Di Huang) to cool Blood and clear Heat. Bai He Zhi Mu Tang replaces Di Huang with Zhi Mu, making it better suited when sweating has already damaged Yin and increased irritability, with a stronger emphasis on moistening and calming.

Composition comparison

Shared (1)
Bai He
Only in Bai He Zhi Mu Tang (1)
Zhi Mu
Only in Bai He Di Huang Tang (1)
Di Huang

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any herbal formula.

Contraindications

Situations where Bai He Zhi Mu Tang should not be used or requires extra caution

Avoid

Spleen-Stomach deficiency cold with diarrhea or loose stools (脾胃虚寒便溏). The cold nature of the formula may exacerbate digestive weakness and diarrhea.

Caution

Qi or Yang deficiency constitution without signs of heat. The cooling and moistening properties may further weaken Yang Qi.

Caution

Exterior pathogenic factor not yet resolved (e.g., early-stage cold or flu). Using this formula may drive the pathogen deeper.

Caution

Cold cough due to Lung cold with thin white sputum. The formula's cold nature is unsuitable.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Not recommended during pregnancy. The formula is cold in nature and Zhi Mu (知母) is traditionally considered to have potential for stimulating uterine contractions. No adequate safety studies exist for use in pregnancy. Use only under strict supervision of a qualified practitioner if absolutely necessary.

Breastfeeding

No specific data on breast milk transfer exists for the herbs in this formula. Due to its cold nature and lack of safety data, it should be used with caution during breastfeeding and only under the guidance of a qualified practitioner.

Children

Dosage must be reduced for children. For ages 2–6, use 1/4 to 1/3 of the adult dose (Bai He 3–5 g, Zhi Mu 3–5 g per day); for ages 7–12, use 1/2 to 2/3 of the adult dose (Bai He 5–8 g, Zhi Mu 5–8 g per day), divided into two warm doses. Not suitable for children with Spleen-Stomach cold, diarrhea, or early-stage colds. Avoid in infants under 2 years. Discontinue if digestive upset, rash, or vomiting occurs. Use only under professional guidance.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Bai He Zhi Mu Tang

No well-documented clinical drug interactions exist. However, pharmacokinetic studies suggest Bai He Zhi Mu Tang may affect drug metabolism enzymes (e.g., CYP3A4). Caution is advised when used concurrently with sedatives, antidepressants, antidiabetic agents, or anticoagulants. Consult a healthcare provider before combining with prescription medications.

Usage Guidance

Practical advice for getting the most out of Bai He Zhi Mu Tang

Best time to take

Take warm, divided into two doses, preferably after meals to minimize potential stomach irritation from the cold nature of the herbs.

Typical duration

Acute use: 3–7 days. For chronic conditions such as insomnia or mood disorders, may be taken for 2–4 weeks under practitioner supervision.

Dietary advice

Avoid cold, raw foods, greasy and spicy foods, and alcohol while taking this formula. These can injure the Spleen and Stomach, exacerbate internal cold, and counteract the formula's cooling and moistening effects.

Bai He Zhi Mu Tang originates from 《金匮要略》卷上 (Essential Prescriptions of the Golden Cabinet, Volume 1) — Eastern Han dynasty, ~200 CE

Classical Texts

Key passages from the classical Chinese medical texts that first described Bai He Zhi Mu Tang and its clinical use

《金匮要略·百合狐惑阴阳毒病脉证治》：

“百合病发汗后者，百合知母汤主之。百合七枚，擘，知母三两，切。上先以水洗百合，渍一宿，当白沫出，去其水，更以泉水二升，煮取一升，去滓；另以泉水二升煎知母，取一升，去滓；后合和，煎取一升五合，分温再服。”

Translation: “For lily disease after sweating, Bai He Zhi Mu Tang governs. Bai He (Lily bulb) seven pieces, broken; Zhi Mu (Anemarrhena rhizome) three liang, sliced. First wash Bai He with water, soak overnight; when white foam appears, discard the water, then add two sheng of spring water, boil down to one sheng, remove dregs. Separately boil Zhi Mu with two sheng of spring water down to one sheng, remove dregs. Combine the two liquids and boil again down to one and a half sheng. Divide into two doses taken warm.”

Historical Context

How Bai He Zhi Mu Tang evolved over the centuries — its origins, lineage, and place in the broader tradition of Chinese medicine

Bai He Zhi Mu Tang first appears in Zhang Zhongjing’s Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet, Eastern Han dynasty). It is one of several formulas for “lily disease” (百合病), a condition characterized by emotional instability, mental restlessness, and physical symptoms arising from Yin deficiency with internal heat, often following a febrile illness or emotional distress. The formula was designed for cases where the patient had been incorrectly treated with sweating, which further depleted Yin and aggravated the heat.

Zhang Zhongjing’s approach to lily disease is notable for its nuanced differentiation: different formulas were prescribed depending on prior treatments—sweating, purgation, or vomiting—each causing a different imbalance. Bai He Zhi Mu Tang specifically addresses post-sweating Yin damage. The unique preparation method, soaking the lily bulb overnight and decocting the two herbs separately before combining, was believed to harmonize Yin and Yang. In modern practice, the formula has been adapted for depression, anxiety, insomnia, menopausal syndrome, and chronic low-grade fever, reflecting its enduring relevance in treating neuropsychiatric and Yin-deficiency disorders.

Modern Research

3 published studies investigating the pharmacological effects or clinical outcomes of Bai He Zhi Mu Tang

1

Pharmacokinetic study of Baihe-zhimu decoction and its single herbs (2022)

Qin S, Yang B, Dai Q, et al. China Pharmacy, 2022, 33(18): 2204-2209.

A rat study comparing the pharmacokinetics of 7 active components (neomangiferin, mangiferin, regaloside A, regaloside I, timosaponin BII, timosaponin E, timosaponin AIII) after oral administration of Bai He Zhi Mu Tang versus single herbs. Results showed significantly increased AUC and Cmax and decreased clearance for most components in the combined formula, indicating enhanced absorption and prolonged retention, supporting the advantage of the herbal pair combination.

DOI
2

Exploration of the antidepressant mechanism of Baihe Zhimu decoction based on NLRP1 inflammasome (2024)

Yue C, Ben Y, Wang H. Journal of Pharmaceutical Practice and Service, 2024, 42(8): 325-333.

In a chronic unpredictable mild stress (CUMS) mouse model of depression, Bai He Zhi Mu Tang significantly improved depressive-like behaviors, increased hippocampal levels of neurotransmitters (DA, 5-HT, NE) and BDNF, suppressed inflammatory cytokines (IL-1β, IL-6, TNF-α), and inhibited NLRP1 inflammasome activation. The study suggests the formula exerts antidepressant effects through anti-inflammatory and neuroprotective mechanisms.

DOI
3

Network pharmacology, molecular docking, and SPR study of Ganmai Dazao Decoction combined with Baihe Zhimu Decoction in treating depression (2024)

Wang H, He L, Meng X, et al. Shanghai Journal of Traditional Chinese Medicine, 2024, 58(10): 79-90.

A network pharmacology analysis combined with surface plasmon resonance (SPR) identified key active compounds (formononetin, licochalcone A, vestitol) from the combined formula that bind to MAPK14, a potential target in depression. The study provides molecular evidence for the antidepressant mechanism of Bai He Zhi Mu Tang in combination therapy.

DOI

Research on TCM formulas is growing but still limited by Western clinical trial standards. These studies provide emerging evidence and should be considered alongside practitioner expertise.