Phellodendron bark (Huang Bo) Black atractylodes rhizomes (Cang Zhu)

Er Miao San

Chinese: 二妙散

Pinyin: Èr Miào Sàn

Other names: Two Marvel Powder

Number of ingredients: 2 herbs

Formula category: Formulas that expel Dampness

Conditions for which it may be prescribed: GoutVaginitisOsteoarthritis and two other conditions

  1. Expels Dampness from the Lower Burner
  2. Drains Heat from the Lower Burner

Contraindications: Contraindicated for Lung Heat or Liver and Kidney Deficiency unless some... Contraindicated for Lung Heat or Liver and Kidney Deficiency unless some modifications are made. see more

Source date: 1481 AD

Source book: Essential Teachings of [Zhu] Dan Xi

Er Miao San is a 2-ingredient Chinese Medicine formula with Phellodendron Bark (Huang Bo) as a principal ingredient.

Invented in 1481 AD, it belongs to the category of formulas that expel Dampness. Its main actions are: 1) expels Dampness from the Lower Burner and 2) drains Heat from the Lower Burner.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Er Miao San is used by TCM practitioners to fight patterns like Damp-Heat or Damp-Heat in the Lower Burner. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as menstrual cramps, osteoarthritis or gout for instance.

On this page, after a detailed description of each of the two ingredients in Er Miao San, we review the patterns and conditions that Er Miao San helps treat.

The two ingredients in Er Miao San

Huang Bo is a king ingredient in Er Miao San. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Phellodendron Bark (Huang Bo)

Part used: Dried bark

Nature: Cold

Taste(s): Bitter

Meridian affinity: BladderKidneyLarge intestine

Category: Herbs that clear Heat and dry Dampness

Huang Bo directly enters into the Lower Burner to eliminate Heat and dry Dampness. The cooling nature of Phellodendron bark prevents the warmth of Black atractylodes rhizome from further aggravating pathogenic Heat, even as each herb supports the other in drying Dampness.

Learn more about Phellodendron Bark (Huang Bo)

2. Black Atractylodes Rhizomes (Cang Zhu)

Part used: The dried rhizome

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: SpleenStomach

Category: Aromatic herbs that transform Dampness

Cang Zhu resolves Damp Heat from the Middle Burner such as the Spleen. Its acrid and warming nature supports the Spleen's transformation and transportation function. It also moderates the bitter, cooling, and downward-directing aspect of Phellodendron bark.

Learn more about Black Atractylodes Rhizomes (Cang Zhu)

Conditions and patterns for which Er Miao San may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Er Miao San is used by TCM practitioners to treat two different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Menstrual cramps Osteoarthritis Gout Spasm of the gastrocnemius muscle Vaginitis

Again it wouldn't be correct to say "Er Miao San treats menstrual cramps" for instance. Rather, Er Miao San is used to treat patterns that are sometimes the root cause behind menstrual cramps.

Now let's look at the two patterns commonly treated with Er Miao San.

'Heat' as a body pattern in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Heat pattern in Chinese Medicine

Damp-Heat

Er Miao San is sometimes prescribed by TCM practitioners to treat Damp-Heat. This pattern leads to symptoms such as bitter taste in the mouth, scanty dark urination, aversion to cold and fever. Patients with Damp-Heat typically exhibit soggy (Ru) pulses.

Within the Four-Levels theory, Damp-Heat is the first level of invasion of External Pathogens, when it still resides in the body's Exterior.

The general symptoms of Damp-Heat are the heaviness of the body and head as well as low temperature fever rising in the afternoon. The patients are not hot on... read more about Damp-Heat

The Triple Burner is a so-called "Fu" Organ. Learn more about the Triple Burner in Chinese Medicine

Damp-Heat in the Lower Burner

Er Miao San is sometimes prescribed by TCM practitioners to treat Damp-Heat in the Lower Burner. This pattern leads to symptoms such as scanty and yellow urine, lower back pain, weakness of the lower extremities and red and swollen feet. Patients with Damp-Heat in the Lower Burner typically exhibit rapid (Shu) or slippery (Hua) pulses as well as a tongue with sticky coating.

Learn more about Damp-Heat in the Lower Burner

Formulas similar to Er Miao San

Ping Wei San is 25% similar to Er Miao San

Huang Lian Jie Du Tang is 25% similar to Er Miao San

Da Bu Yin Wan is 25% similar to Er Miao San

Yi Huang Tang is 20% similar to Er Miao San

Er Xian Tang is 17% similar to Er Miao San

Qing Jing San is 14% similar to Er Miao San