Formula Decoction (Tang)

Bai Ye Tang

Biota Leaf Decoction · 柏叶汤

A classical formula from the Jin Gui Yao Lue that warms the middle jiao and stops bleeding, used for vomiting blood, nosebleeds or coughing up blood due to deficiency cold of the Spleen and Stomach.

Origin Jin Gui Yao Lue (金匮要略) — Han Dynasty (东汉), ~200 CE
Category Hemostatic formulas Interior-warming formulas
Therapeutic focus Bleeding control Digestive health Cold sensitivity
Composition 3 herbs
Ce
King
Ce Bai Ye
Gan Jiang
Deputy
Gan Jiang
Ai Ye
Assistant
Ai Ye
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 Ye Tang is designed to correct these specific patterns.

Why Bai Ye Tang addresses this pattern

Bai Ye Tang directly warms the middle burner and stops bleeding. The formula's combination of Ce Bai Ye's cooling hemostatic action with Gan Jiang and Ai Ye's interior-warming effect restores the yang qi that has failed to hold blood. This pattern is marked by vomiting of blood, epigastric cold pain, and cold extremities — all signs that the stomach's yang is too weak to govern the blood. The formula's warm strategy resolves the root while its astringent action addresses the branch.

A practitioner would look for one or more of these signs

Hematemesis

Vomiting of blood, often dark red, associated with coldness in the epigastrium

Epistaxis

Nosebleeds that occur with a pale tongue and fear of cold

Pale Face

Pale or sallow complexion reflecting blood loss and yang deficiency

Cold Extremities

Cold hands and feet

Commonly Prescribed For

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

Arises from: Stomach Yang Deficient and Cold

TCM Interpretation

From a TCM perspective, a gastric ulcer that bleeds when the patient experiences coldness in the stomach, prefers warm drinks, and has a pale tongue indicates that the Stomach's yang qi is too weak to protect the mucosa and contain the blood. The cold constricts the vessels and impairs the Spleen's ability to govern blood, causing oozing rather than forceful bleeding.

Why Bai Ye Tang Helps

Bai Ye Tang directly warms the middle burner with Gan Jiang and Ai Ye, dispelling the cold that underlies the ulcer. Ce Bai Ye cools and astringes the blood, stopping the leakage without causing stasis. The balance of warm and cool herbs allows healing of the ulcer while arresting hemorrhage in a cold constitution.

Also commonly used for

Peptic Ulcer

Controls gastrointestinal bleeding with cold signs

Hemoptysis

Stops coughing of blood due to Spleen-Stomach cold deficiency

Epistaxis

Astringes blood in nosebleeds with a cold pattern

Uterine Bleeding

Warms the uterus and stanches bleeding from cold deficiency

Anemia

Addresses blood loss anemia by stopping the source of bleeding

What This Formula Does

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

Therapeutic focus

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

Bleeding control Digestive health Cold sensitivity

TCM Actions

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

Warms the channels and stops bleeding Dispels cold Warms the middle and dispels cold to stop bleeding

How It Addresses the Root Cause

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

Bai Ye Tang addresses bleeding caused by deficiency cold of the Spleen and Stomach, where the yang qi is too weak to govern the blood. When the middle burner is cold, the Spleen fails to hold blood within the vessels, leading to upward extravasation — primarily hematemesis (vomiting blood), but also epistaxis (nosebleed) or hemoptysis (coughing up blood). The cold impairs the transformation of qi, often accompanied by a pale or sallow complexion, cold limbs, a pale tongue, and a weak, slow pulse. The pathomechanism is one of cold-induced failure of containment, not heat-driven reckless blood movement.

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

Warm

Taste Profile

Predominantly bitter and pungent — bitter to descend and astringe bleeding, pungent to warm the middle and dispel cold.

Target Organs

Spleen Stomach

Channels Entered

Spleen Stomach

Ingredients

3 herbs

The herbs that make up Bai Ye Tang, organized by their role in the prescription

King — Main ingredient driving the formula
Deputy — Assists and enhances the King
Assistant — Supports or moderates other herbs
King — Main ingredient driving the formula
Ce

Ce Bai Ye

Dosage 10 - 15g

Role in Bai Ye Tang

Ce Bai Ye is the sovereign herb; it is cool in nature and enters the Blood level to cool the blood and stop bleeding, while also astringing the blood. Despite its cool nature, it is balanced by the warming herbs in the formula.
Deputy — Assists and enhances the King
Gan Jiang

Gan Jiang

Dried ginger rhizome

Dosage 3 - 6g
Temperature Hot
Taste Acrid / Pungent (辛 xīn)
Organ Affinity Heart, Spleen, Lungs, Stomach

Role in Bai Ye Tang

Gan Jiang warms the middle burner, dispels interior cold, and stops bleeding arising from yang deficiency. Its pungent-warm nature counteracts the coldness of Ce Bai Ye and restores the Spleen's ability to hold blood.
View herb details
Assistant — Supports or moderates other herbs
Ai Ye

Ai Ye

Mugwort leaf

Dosage 3 - 6g
Temperature Warm
Taste Acrid / Pungent (辛 xīn), Bitter (苦 kǔ)
Organ Affinity Liver, Spleen, Kidneys

Role in Bai Ye Tang

Ai Ye warms the channels and stops bleeding by strengthening the warming action of Gan Jiang. It also harmonizes the effects of Ce Bai Ye and Gan Jiang, ensuring the formula stays warm but not too drying.
View herb details

Why This Combination Works

How the herbs in Bai Ye Tang complement each other

Overall strategy

The formula is a bridge between cooling and warming, designed to stop bleeding caused by cold deficiency while preventing the stagnation that pure warming might engender. Ce Bai Ye cools the blood and astringes bleeding, Gan Jiang warms the middle and dispels cold, and Ai Ye harmonises the two while reinforcing the warming action.

King herbs

Ce Bai Ye is the primary herb for stopping bleeding. It works on the Blood level to cool and astringe, directly addressing the haemorrhage. Its cold nature is kept in check by the warming deputies, making it suitable for a cold deficiency pattern.

Deputy herbs

Gan Jiang is the powerhouse of warmth. It targets the Spleen and Stomach yang deficiency at the root of the bleeding. By warming the middle burner, it restores the Spleen's ability to contain blood. Its pungent-dispersing quality also prevents the astringent action of Ce Bai Ye from creating stasis.

Assistant herbs

Ai Ye assists Gan Jiang in warming the channels and also contributes its own gentle hemostatic effect. It mediates between the cool Ce Bai Ye and the hot Gan Jiang, creating a tempered, balanced formula that is warm but not overly drying.

Envoy herbs

In the classical version, Ma Tong Zhi (horse urine) served as an envoy to direct the herbs to the lower burner and promote the downward movement of qi and blood. Modern practice omits it without loss of efficacy.

Notable synergies

The pairing of Ce Bai Ye with Gan Jiang is a classic yin-yang duo: the cold herb prevents bleeding without causing stasis, and the hot herb warms without forcing blood upward. Together, they allow safe treatment of bleeding in a cold pattern.

How to Prepare

Traditional preparation instructions for Bai Ye Tang

In the classical Jin Gui Yao Lue, the three herbs were boiled in 5 sheng of water together with 1 sheng of horse urine (Ma Tong Zhi), reduced to 1 sheng, strained, and taken warm in two doses. Modern practice omits Ma Tong Zhi. The standard modern method: combine Ce Bai Ye 15g, Gan Jiang 6g, and Ai Ye 6g with 600–800 ml water. Bring to a boil, then simmer until 200 ml remains. Strain and take warm in two divided doses, preferably on an empty stomach.

Common Modifications

How practitioners adapt Bai Ye Tang for specific situations

Added
Dang Shen

9g, to tonify Spleen Qi

Huang Qi

9g, to boost Qi and help hold blood

Bai Zhu

6g, to strengthen Spleen function

Adding Qi-tonifying herbs addresses the root deficiency that fails to contain blood, enhancing the formula's ability to stop bleeding.

Related Formulas

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

Contrasting approach
Warm 7 herbs Decoction (Tang)

A classical formula for chronic or recurring bleeding caused by weakness and coldness in the digestive system. It warms and strengthens the Spleen's ability to keep blood flowing within its proper channels, while also nourishing the blood that has already been lost. Commonly used for dark-colored blood in the stool, heavy menstrual bleeding, or nosebleeds accompanied by cold hands and feet, fatigue, and a pale complexion.

Therapeutic focus
Intestinal Bleeding Support Uterine Bleeding Support Anemia Support Spleen health

How it compares

Both treat bleeding from Spleen yang deficiency, but Huang Tu Tang (Yellow Earth Decoction) warms the Spleen and restrains blood with Fu Long Gan (cooked stove earth) and Fu Zi, making it stronger for bleeding from the lower body (rectal, uterine) with signs of deep cold. Bai Ye Tang uses Ce Bai Ye to cool and astringe, making it more suitable for upper body bleeding (vomiting, nose) and cases where cold is not extreme.

Composition comparison

Shared (0)
—
Only in Bai Ye Tang (3)
Ce Bai Ye Gan Jiang Ai Ye
Only in Huang Tu Tang (7)
Zao Xin Tu Bai Zhu Zhi Fu Zi Di Huang E Jiao Huang Qin Gan Cao
Similar indication
Warm 7 herbs Decoction (Tang)

A classical formula from the Jin Gui Yao Lue used to nourish Blood, warm the uterus, and stop bleeding. It is primarily used for women experiencing prolonged or excessive menstrual bleeding, spotting between periods, bleeding during pregnancy (threatened miscarriage), or post-miscarriage bleeding, especially when these occur alongside signs of Blood deficiency and coldness in the lower abdomen.

Therapeutic focus
Menstrual health Fertility and pregnancy support Women's health Bleeding disorders

How it compares

Jiao Ai Tang (Ass-Hide Gelatin and Mugwort Decoction) also stops bleeding from a cold deficiency pattern, but focuses on the uterus and Chong and Ren channels. It incorporates E Jiao and Dang Gui to nourish blood, making it preferred for gynecological bleeding with blood deficiency. Bai Ye Tang is simpler and more direct for gastric or respiratory bleeding.

Composition comparison

Shared (1)
Ai Ye
Only in Bai Ye Tang (2)
Ce Bai Ye Gan Jiang
Only in Jiao Ai Tang (6)
E Jiao Dang Gui Di Huang Bai Shao Chuan Xiong Gan Cao

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

Contraindications

Situations where Bai Ye Tang should not be used or requires extra caution

Avoid

Heat pattern bleeding: Bleeding from heat or fire, characterized by bright red blood, thirst, dry mouth, rapid pulse.

Avoid

Yin deficiency with internal heat: Signs of night sweating, five-palm heat, malar flush.

Caution

Pregnancy: Contains Ai Ye which may stimulate uterine contractions in high doses; use only under strict professional guidance.

Caution

Active, severe bleeding with signs of collapse: Requires emergency care; formula alone insufficient.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Caution advised. Ai Ye may stimulate uterine contractions at high doses, and Gan Jiang's warming nature could theoretically disperse blood. No well-controlled human studies exist. Generally contraindicated in pregnancy unless strongly indicated and supervised by a qualified TCM practitioner. If used, dosages must be carefully adjusted.

Breastfeeding

No specific data on the safety of Bai Ye Tang during breastfeeding. Constituent herbs may pass into breast milk. Use only if clearly needed and under professional supervision; monitor infant for any adverse effects.

Children

Children's doses should be proportionally reduced based on body weight and age, typically 1/3 to 1/2 of the adult dose. Use only when the presenting pattern clearly matches deficiency‑cold with bleeding. Not recommended for infants or very young children without expert guidance. Duration should be short (2–3 days) and reevaluated.

Drug Interactions

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

No well-documented drug interactions exist. The cooling-blood and hemostatic actions of Ce Bai Ye may theoretically alter responses to anticoagulants (warfarin, aspirin) or antiplatelet drugs, but no clinical reports confirm this. Consult a healthcare provider before concurrent use with prescription medications.

Usage Guidance

Practical advice for getting the most out of Bai Ye Tang

Best time to take

After meals, to coat the stomach and reduce potential irritation.

Typical duration

For acute bleeding, typically 3–7 days, then reassess. May be extended with modifications under practitioner supervision if the pattern remains consistent.

Dietary advice

Avoid cold, raw foods, iced drinks, and greasy or spicy irritants that can impair Spleen Yang or aggravate the stomach lining. Favour warm, easily digestible foods such as congee, steamed vegetables, and mild broths. Eat small frequent meals to avoid overburdening the middle jiao.

Bai Ye Tang originates from Jin Gui Yao Lue (金匮要略) — Han Dynasty (东汉), ~200 CE

Classical Texts

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

《金匮要略》云：“吐血不止者，柏叶汤主之。柏叶三两，干姜三两，艾叶三把。右三味，以水五升，取马通汁一升，合煮取一升，分温再服。”

Translation: “For unremitting vomiting of blood, Bai Ye Tang governs. Ce Bai Ye (three liang), Gan Jiang (three liang), Ai Ye (three full handfuls). The three ingredients: boil with five sheng of water, add one sheng of horse urine juice, cook down to one sheng, and drink in two warm doses.”

Historical Context

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

Bai Ye Tang first appears in Zhang Zhongjing's Jin Gui Yao Lue (Essential Prescriptions of the Golden Cabinet, ~200 CE) as a warming hemostatic for deficiency-cold bleeding, notably vomiting blood. The original formula included horse urine juice (马通汁) to guide blood downward. Over subsequent dynasties, physicians adapted it: Sun Simiao’s Bei Ji Qian Jin Yao Fang added E Jiao (Ass-hide Glue) to augment blood nourishment; many later versions omitted the animal products and increased emphasis on warming the middle jiao. In modern clinical use, Tong Bian (children's urine) is often substituted when an alkali-like blood-guiding agent is desired, though the three‑herb core is most common. The formula exemplifies the ‘cold in a warm formula’ strategy, using the cold astringent Ce Bai Ye to safely stop bleeding without injuring Yang.