Classic formula · Tonify yang
Er Xian Tang
二仙汤 Two-Immortal Decoction
The modern menopause formula for the mixed picture: hot flashes and night sweats on top, cold feet and a cold aching back underneath, with tiredness, irritability, and sometimes high blood pressure. Kidney yin and yang are both low and the fire is flaring. It warms, cools, and nourishes at the same time.
A furnace that is both running out of fuel and sputtering flames. Two warming herbs rebuild the fuel, two cooling herbs calm the sputter, and two more feed the blood and the back.
Also sold as: Er Xian Wan · Two Immortals Formula · Curculigo and Epimedium Combination
Who Er Xian Tang is for
This formula is chosen for 2 patterns. Match your own picture before you match the name.
Signs it is classically given for
- Hot flashes and night sweats with cold feet and a cold low back
- Menopausal tiredness, irritability, and low mood
- High blood pressure around menopause
- Palpitations and poor sleep in the same picture
- Low drive with a mixed hot and cold pattern
- Irregular periods in the years before menopause
- Tongue
- Pale or pale red, possibly with a thin coat.
- Pulse
- Thin, deep, or thin and rapid.
What is in Er Xian Tang
Amounts are the classic decoction range in grams. Patent pills use the same herbs in the same proportion, so read the box for these names.
| Herb | Amount | Role | Job in the formula |
|---|---|---|---|
| Xian Mao Rhizome of Common Curculigo High caution | 9 g | Chief | Curculigo warms Kidney yang. |
| Yin Yang Huo Epimedium Herb Use caution | 9 g | Chief | Epimedium warms Kidney yang and the drive. |
| Ba Ji Tian Root of Morinda Officinalis Use caution | 9 g | Deputy | Morinda warms the Kidney and the low back. |
| Dang Gui Root of Chinese Angelica Use caution | 9 g | Deputy | Angelica nourishes blood and regulates the cycle. |
| Huang Bai Phellodendron Bark | 6 g | Assistant | Phellodendron drains the empty fire. |
| Zhi Mu Rhizome of Common Anamarrhena | 6 g | Assistant | Anemarrhena clears heat and moistens. |
How Er Xian Tang works
Three warming herbs rebuild the yang that the cold feet and back are missing. Two cooling herbs, the same pair as in Zhi Bai Di Huang Wan, settle the flashes. Angelica feeds the blood between them. It treats the contradiction instead of picking a side, which is why it suits menopause so well.
Actions in classic terms
- Warms Kidney yang and nourishes Kidney yin
- Drains empty fire and regulates the cycle
Common changes to Er Xian Tang
A practitioner rarely gives the bare formula. These are the classic additions for a specific picture.
- Heavy night sweats add Fu Xiao Mai, Mu Li Light wheat and oyster shell.
- More heat than cold add Sheng Di Huang, Gui Ban Or combine with Zhi Bai Di Huang Wan and reduce the warming herbs.
- Poor sleep add Suan Zao Ren, Ye Jiao Teng Calming herbs.
Cautions with Er Xian Tang
- Not for a purely hot, dry picture with no cold signs; that is Zhi Bai Di Huang Wan.
- Not for a purely cold picture with no flashes; that is Jin Gui Shen Qi Wan.
- Epimedium can be stimulating. Reduce the dose if sleep worsens.
- Not for use in pregnancy.
Forms and typical dose
Sold as teapills, granules, decoction.
- Teapills
- 8 pills, three times a day, the usual label dose
- Course
- One to three months.
Follow the label of the brand you buy. Pill sizes differ between makers.
Buying Er Xian Tang
The box reads Er Xian Tang or Wan with the characters 二仙. Six ingredients: Curculigo, Epimedium, Morinda, Angelica, Phellodendron, and Anemarrhena.
Brand comparisons for formulas live on Supplements Apothecary, the buying side of this library.
Formulas often confused with Er Xian Tang
- Zhi Bai Di Huang Wan 知柏地黄丸 For flashes from empty Kidney yin alone, with no cold signs.
- Jia Wei Xiao Yao San 加味逍遥散 For flashes with stress, anger, and a stuck Liver. Often combined.
- You Gui Wan 右归丸 A deep yang tonic with no cooling at all.
Conditions where Er Xian Tang comes up
Sources
- Bensky, Scheid, Ellis and Barolet, Chinese Herbal Medicine: Formulas and Strategies, 2nd edition Composition, actions, and indications.
Important Note
Formula pages describe classic use so you can read a label, ask a better question, and find the right monographs. They are education, not a prescription. A formula that fits the wrong pattern can make things worse, so match the picture first.