Ren Shen Bai Du San: The Legendary TCM Formula for Plague and Modern Health
Health Lab- Feb 21
- 8 min read
Updated: Apr 26
Ren Shen Bai Du San, often hailed as the "top formula for treating plague," traces its origins to the Northern Song Dynasty. First documented by the renowned physician Zhu Gong in Lei Zheng Huo Ren Shu, it was later standardized in the Taiping Huimin Hejiju Fang, the official formulary of the Song Dynasty’s imperial pharmacy.
For centuries, this powerful herbal blend has been used to combat plagues and various ailments, showcasing its enduring effectiveness in Traditional Chinese Medicine (TCM).
What is Ren Shen Bai Du San?
Ren Shen Bai Du San is a carefully crafted herbal formula designed to expel external pathogens like wind, cold, and dampness while boosting the body’s vital energy (Qi).
Its balanced combination of herbs works to relieve symptoms, restore harmony, and strengthen immunity, making it a versatile remedy for both acute and chronic conditions.
Key Ingredients and Their Roles
The formula follows the TCM principle of "monarch, minister, assistant, and envoy" to maximize therapeutic effects. Here’s a breakdown of its ingredients:
Monarch Herbs (Main Herbs):
Qiang Huo: Promotes sweating, clears external pathogens, and relieves joint pain. Known as a "miracle herb" for colds.
Du Huo: Dispels wind and dampness, unblocks meridians, and alleviates body aches.
Minister Herbs (Supporting Herbs):
Chuan Xiong: Enhances blood and Qi circulation, relieving pain and wind-related symptoms.
Bupleurum: Soothes the liver, reduces tension, and supports detoxification.
Platycodon: Opens lung Qi, eases cough, and clears phlegm.
Citrus Aurantium: Regulates Qi, relieves chest tightness, and improves digestion.
Peucedanum: Lowers Qi and dissolves phlegm, aiding respiratory health.
Assistant Herbs:
Poria: Drains dampness, strengthens the spleen, and reduces phlegm production.
Ginseng: Boosts Qi, strengthens the body, and supports recovery without depleting energy.
Ginger and Mint: Guide the formula’s effects to the surface, enhancing symptom relief.
This synergistic blend ensures the formula addresses symptoms while protecting the body’s vitality.
How Ren Shen Bai Du San Works
Understanding the Pathogenesis
Ren Shen Bai Du San targets conditions caused by external wind, cold, and dampness invading the body, which weaken Qi and allow toxins to take hold. These pathogens disrupt the body’s balance, leading to symptoms such as:
Chills, fever, and aversion to cold
Headaches, neck pain, and body aches
Cough, nasal congestion, and phlegm
Chest tightness, poor appetite, and fatigue
When cold and dampness stagnate in the meridians, blood and Qi circulation falter, causing pain and discomfort. Meanwhile, lung Qi becomes blocked, leading to respiratory issues like coughing or a heavy voice. Ren Shen Bai Du San restores balance by expelling pathogens, clearing blockages, and replenishing Qi.
Treatment Principles
The formula’s approach is twofold:
Expel Pathogens: Qiang Huo and Du Huo induce sweating to clear wind, cold, and dampness, while unblocking meridians to relieve pain.
Strengthen the Body: Ginseng boosts Qi, ensuring the body remains strong during recovery, preventing further invasions of pathogens.
This dual action makes Ren Shen Bai Du San effective for symptom relief and long-term health.
Benefits and Applications of Ren Shen Bai Du San
Ren Shen Bai Du San is a versatile formula with wide-ranging benefits, particularly for conditions caused by external pathogens. It excels at:
Relieving Cold and Flu Symptoms: Eases fever, chills, headaches, body aches, and nasal congestion.
Clearing Respiratory Issues: Reduces cough, phlegm, and chest tightness through herbs like Platycodon and Peucedanum.
Alleviating Pain: Treats neck pain, sciatica, and joint discomfort caused by dampness and cold.
Boosting Immunity: Ginseng strengthens the body’s defenses, preventing recurrent infections.
It’s also used for conditions like sore throat, diarrhea, asthma, and even skin issues caused by dampness, such as rashes or swelling.
Modern Applications of Ren Shen Bai Du San
Ren Shen Bai Du San has gained renewed attention in modern times, particularly during the COVID-19 pandemic, as searches for TCM remedies surged. Research highlights its multifaceted effects:
Antipyretic and Analgesic: Bupleurum reduces fever, while Angelica Dahurica and Chuan Xiong relieve pain.
Antibacterial and Antiviral: The formula inhibits pathogens like influenza A, respiratory bacteria, and fungi.
Immune Support: Ginseng enhances white blood cell activity and immune response.
Cardiovascular Benefits: Ginseng supports heart function and improves adaptability to stress.
In clinical settings, Ren Shen Bai Du San is used for:
Colds, bronchitis, and chronic rhinitis
Rheumatoid arthritis and frozen shoulder
Skin conditions like atopic dermatitis and urticaria
Chronic conditions such as hypertension and laryngitis
Precautions and Considerations
As a warming and drying formula, Ren Shen Bai Du San is not suitable for conditions involving high fever or excessive heat.
It should be used cautiously, tailored to the patient’s condition. For cases with severe cold but no Qi deficiency, ginseng can be omitted, and herbs like Jing Jie and Fang Feng added to enhance pathogen expulsion (forming the related formula Jing Fang Bai Du San).
Always consult a qualified TCM practitioner before use to ensure safety and efficacy.
Conclusion
Ren Shen Bai Du San is a testament to the wisdom of Traditional Chinese Medicine, blending ancient knowledge with modern relevance. Its ability to expel pathogens, relieve symptoms, and strengthen the body makes it a cornerstone of TCM for treating plagues, colds, and chronic ailments. Whether you’re seeking relief from a stubborn cold or exploring TCM’s holistic benefits, this legendary formula continues to shine as a beacon of health and balance.
Chinese Name | 敗毒散 |
Phonetic | Bai Du San |
English Name | Toxin-Resolving Powder |
Classification | Exterior-releasing formulas |
Source | 《Formulas from the Imperial Pharmacy》Tai Ping Hui Min He Ji Ju Fang《太平惠民和劑局方》 |
Combination | Bupleuri Radix (Chai Hu) 30 liang (900g), Peucedani Radix (Qian Hu) 30 liang (900g), Chuanxiong Rhizoma (Chuan Xiong) 30 liang (900g), Aurantii Fructus (Zhi Qiao) 30 liang (900g), Notopterygii Rhizoma et Radix (Qiang Huo) 30 liang (900g), Angelicae Pubescentis Radix (Du Huo) 30 liang (900g), Poria (Fu Ling) 30 liang (900g), Platycodonis Radix (Jie Geng) 30 liang (900g), Ginseng Radix et Rhizoma (Ren Shen) 30 liang (900g), Glycyrrhizae Radix et Rhizoma (Gan Cao) 30 liang (900g) |
Method | Take 6g of the powder per dose, add 1g of sheng jiang and bo he to it and boil them together. It can be taken any time. Take it warm if the cold is more severe, and lukewarm if the fever is more serious. It can also be prepared as a decoction following the ratio of each ingredient in the original formula. |
Action | Dissipates cold, removes dampness, boosts qi, and releases the exterior. |
Indication | Bai Du San is indicated for the pattern of externally contracted wind-cold-dampness. The symptoms are strong aversion to cold, high fever, headache, neck stiffness and pain, body soreness and pain, absence of sweating, stuffy nose, harsh voice, cough with phlegm, pi, and distressed chest and diaphragm. The tongue is pale with a white coating, and the pulse is superficial and forceless upon pressing. |
Pathogenesis | This formula treats patterns of zheng qi deficiency with externally contracted wind-cold-dampness. Strong aversion to cold, stiff and painful head and neck, body aches, and an absence of sweat are signs of wind-cold-dampness attacking the surface of the flesh and lingering within the channels. The stuffy nose with a harsh voice, cough with phlegm, pi, and suppressed chest and diaphragm are symptoms of wind-cold invading the lung, blocking it, and causing the lung qi to fail to diffuse which further results in fluid accumulation transforming into phlegm. A white and greasy tongue coating, and a superficial pulse that is forceless with pressure are characteristic for deficient constitution contracted external wind-cold-dampness. The treatment should dissipate cold, remove dampness, and boost qi to release the exterior. |
Clarification | 1. The combination of ren shen with other medicinals The addition of a small amount of ren shen to the wind-cold dispelling medicinals helps to boost qi and enhance zheng qi. Here is why this is necessary. If we only consider the removal of pathogens without replenishing zheng qi in a pattern of externally contracted pathogens in a qi-deficient constitution, the body will not have the strength to dispel the pathogens. Even with the temporary release of the exterior pathogen, it will later reenter because insufficient zheng qi is not able to defend the body. Even though exterior-releasing medicinals direct pathogens outward, a zheng qi-deficient person who has contracted external pathogens will not have enough center qi to follow through. In a less serious situation, only a portion of the necessary sweating will be induced; in a more serious one, exterior pathogens can counter-attack because of the insufficient original qi and penetrate the interior. This leads to continuous fever and makes the situation more complicated. Therefore, ren shen is added to increase the zheng qi in order to expel the pathogens and prevent them from entering the interior. Also, by using a small amount of ren shen to supplement in a scattering formula, it prevents over-consumption of the original kidney qi. 2. “Rowing the boat against the stream” method Yu Jia-yan often applied this method to treat patterns of dysentery caused by external pathogens that have penetrated the interior. This method was named “rowing the boat against the stream” by later generations. Dysentery is mostly the result of epidemic damp-heat toxins blocking the intestines where the disease progresses interiorly and downward. Therefore the treatment usually follows this momentum by clearing heat, removing dampness, and resolving toxins, and is accompanied by rectifying qi and blood and guiding out the obstruction. This is the common method used for treating dysentery. On the other hand, “rowing the boat against the stream” is an alternative method used to treat dysentery with a different cause, which is the inward invasion of exterior pathogen, resulting in obstruction of the intestines and disharmony of qi and blood. Although the disease trend is inward and downward, the root cause of intestinal obstruction was the inward invasion of exterior pathogen. Therefore, by “counter”, it means to counter the tendency of the disease and the usual way of treatment. By utilizing exterior releasing medicinals, the inward pathogen is dispelled from the superficial level, as if pulling a boat upstream, and that is where the name comes from. By looking at the disease tendency, it seems this method goes opposite direction. However, by analyzing the disease mechanism, it actually follows the momentum, reflecting the difference between the superficial phenomenon and the essential nature of the disease. |
Application | 1. Essential pattern differentiation This is a commonly used formula to boost qi and release the exterior. This clinical pattern is marked by strong aversion to cold, high fever, body soreness and pain, absence of sweat, superficial pulse that is forceless with pressure. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of the externally contracted wind-cold-dampness with qi-deficient constitution pattern: common cold, flu, bronchitis, allergic dermatitis, and eczema. 3. Cautions and contraindications Most of the medicinals in this formula are acrid, warm, aromatic, and dry. It is not applicable for yin-deficient patients with externally contracted pathogens, and is forbidden for dysentery caused by epidemic pestilence, damp-warmth, or intestinal accumulation of damp-heat. |
Additonal formulae | 1. Jing Fang Bai Du San (Schizonepeta and Saposhnikovia Toxin-Resolving Powder, 荊防敗毒散) [Source]《Numerous Miraculous Prescriptions for Health Cultivation》She Sheng Zhong Miao Fang《攝生眾妙方》 [Ingredients] Qiang huo 1.5 qian (4.5g), du huo 1.5 qian (4.5g), chai hu 1.5 qian (4.5g), qian hu 1.5 qian (4.5g), zhi qiao 1.5 qian (4.5g), fu ling 1.5 qian (4.5g), jing jie 1.5 qian (4.5g), fang feng 1.5 qian (4.5g), jie geng 1.5 qian (4.5g), chuan xiong 1.5 qian (4.5g), gan cao 0.5 qian (1.5g) [Preparation and Administration] Prepare it as decoction with 1.5 cups of water and boil down to 0.8 cup, and take while it is warm. [Actions] Induces sweat to release the exterior, dissolves furuncles and stops pain. [Applicable Patterns] Early stages of furuncles. Symptoms include: red swelling and painful furuncles, aversion to cold, fever, no sweat, thirst, a thin and white tongue coating, and a superficial, rapid pulse. 2. Cang Lin San (Granary Powder, 倉廩散) [Ingredients] Ren shen 9g, fu ling 9g, gan cao 9g, qian hu 9g, chuan xiong 9g, qiang huo 9g, du huo 9g, jie geng 9g, zhi qiao 9g, chai hu 9g,, chen cang mi 9g [Source]《Formulas for Universal Relief》Pu Ji Fang《普濟方》 [Preparation and Administration] Add sheng jiang and bo he, prepare it as decoction and take while it is warm. [Actions] Boost qi and release the exterior, dispel dampness and harmonize the stomach. [Applicable Patterns] Dysentery with inability to eat. Symptoms include: diarrhea and dysentery, vomiting, ascending counterflow, inability to eat, aversion to cold with fever, absence of sweating, aching pain of body, white and greasy tongue coating, and a superficial, soggy pulse. |
Remark | Ginseng (Panax ginseng) is listed in the Convention on International Trade in Endangered Species of Wild Fauna and Flora (CITES) Appendix II. Its trade is allowed but subject to licensing controls. |
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