Prepared Sichuan aconite (Zhi Chuan Wu) Ephedra (Ma Huang) White peony roots (Bai Shao) Liquorice (Gan Cao)

Chinese: 乌头汤

Pinyin: Wū Tóu Tāng

Number of ingredients: 6 herbs

Formula category: Formulas that warm the Meridians and disperse Cold

Conditions for which it may be prescribed: Joint painTrident painJoint numbness and four other conditions

  1. Warms the channels and remove obstruaction
  2. Disperse Cold and Dampness
  3. Warms the joints
  4. Relieve joints pain

Source date: 220 AD

Source book: Essentials from the Golden Cabinet

Wu Tou Tang is a 6-ingredient Chinese Medicine formula with Prepared Sichuan Aconite (Zhi Chuan Wu) and Ephedra (Ma Huang) as principal ingredients.

Invented in 220 AD, it belongs to the category of formulas that warm the Meridians and disperse Cold. Its main actions are: 1) warms the channels and remove obstruaction and 2) disperse Cold and Dampness.

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 Wu Tou Tang is used by TCM practitioners to fight patterns like Cold invading the Channels joints and muscles or Painful Obstruction. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as joint pain, joint stiffness or joint numbness for instance.

On this page, after a detailed description of each of the six ingredients in Wu Tou Tang, we review the patterns and conditions that Wu Tou Tang helps treat.

The six ingredients in Wu Tou Tang

Zhi Chuan Wu is a king ingredient in Wu Tou Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

1. Prepared Sichuan Aconite (Zhi Chuan Wu)

Part used: Processed mother root

Nature: Hot

Taste(s): BitterPungent

Meridian affinity: SpleenHeartKidneyLiver

Category: Herbs that dispel Wind and Dampness

Zhi Chuan Wu is pungent, bitter and hot. It is a very powerful herb to remove Cold from the channels and release it from the Exterior. It is used to stop joint pain due to Cold obstructed in the joints. Together with Ephedra, they work closely to warms the Interior and fight against external Pernicious Influence.

Learn more about Prepared Sichuan Aconite (Zhi Chuan Wu)

Ma Huang is a king ingredient in Wu Tou Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

2. Ephedra (Ma Huang)

Part used: Dried herbaceous stems

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: BladderLung

Category: Warm/Acrid herbs that release the Exterior

Ma Huang is warm and slightly bitter. It enters the Lungs and Bladder channels and invigorate Qi there so as to remove Stagnation in the Lungs. It can disperse Wind Cold through the Exterior.

Learn more about Ephedra (Ma Huang)

Bai Shao is an assistant ingredient in Wu Tou Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

3. White Peony Roots (Bai Shao)

Part used: Dried root

Nature: Neutral

Taste(s): BitterSour

Meridian affinity: LiverSpleen

Category: Tonic herbs for Blood Deficiency

In general Bai Shao's main actions are as follows: "Tonifies the Blood and preserves the Yin. Nourishes the Liver and assists in the smooth flow of Qi. Regulates the meridians and eases the pain."

In the context of Wu Tou Tang, it is used because it helps reduce the muscle spasms caused by Blood Deficiency and Stagnation.

Learn more about White Peony Roots (Bai Shao)

Gan Cao is an assistant ingredient in Wu Tou Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. Liquorice (Gan Cao)

Part used: Dried root and rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: HeartLungSpleenStomach

Category: Tonic herbs for Qi Deficiency

In general Gan Cao's main actions are as follows: "Tonifies the Basal Qi and nourishes the Spleen Qi. Clears Heat and dispels toxicity. Moistens the Lungsexpel phlegm and stop coughing. Relieves spasms and alleviates pain. Harmonizes and moderates the effects of other herbs."

In the context of Wu Tou Tang, it is used because it harmonizes the actions of the other herbs, detoxing and eases pain.

Learn more about Liquorice (Gan Cao)

Huang Qi is an assistant ingredient in Wu Tou Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

5. Milkvetch Roots (Huang Qi)

Part used: Dried root

Nature: Warm

Taste(s): Sweet

Meridian affinity: LungSpleen

Category: Tonic herbs for Qi Deficiency

In general Huang Qi's main actions are as follows: "Tonifies the Wei Qi and stops perspiration. Tonifies the Spleen Qi and the Yang Qi of the Earth Element. Tonifies the Qi and Blood. Expels pus and assists in the healing of wounds. Helps to regulate water metabolism in the body and reduce edema."

In the context of Wu Tou Tang, it is used because it strengthens the original Qi by tonifying it. It helps the Ephedra and in releasing the Exterior.

Learn more about Milkvetch Roots (Huang Qi)

Feng Mi is an envoy ingredient in Wu Tou Tang. This means that it directs the formula towards certain area of the body and/or harmonizes the actions of other ingredients.

6. Honey (Feng Mi)

Part used: Honey

Nature: Neutral

Taste(s): Sweet

Meridian affinity: StomachLarge intestineLung

Category: Laxative herbs that drain downward

In general Feng Mi's main actions are as follows: "Reinforces the spleen and stomach. Moistens dryness, relieves pain, and detoxifies."

In the context of Wu Tou Tang, it is used because it harmonizes all the other herbs of the formula and detoxing.

Learn more about Honey (Feng Mi)

Conditions and patterns for which Wu Tou Tang 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 Wu Tou Tang 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:

Joint pain Joint stiffness Joint numbness Rheumatoid arthritis Scapulohumeral periarthritis Trident pain Lumbar vertebra hyperplantation

Again it wouldn't be correct to say "Wu Tou Tang treats joint pain" for instance. Rather, Wu Tou Tang is used to treat patterns that are sometimes the root cause behind joint pain.

Now let's look at the two patterns commonly treated with Wu Tou Tang.

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

Cold invading the Channels joints and muscles

Pulse type(s): Tight (Jin), Floating (Fu)

Symptoms: Joint pain Stiff neck Joint stiff Swollen joints Pain in the muscles Numbness of the muscles

Wu Tou Tang is sometimes prescribed by TCM practitioners to treat Cold invading the Channels joints and muscles. This pattern leads to symptoms such as joint pain, joint stiff, pain in the muscles and swollen joints. Patients with Cold invading the Channels joints and muscles typically exhibit tight (Jin) or floating (Fu) pulses.

It is a type of the Painful Obstruction Syndrome (Bi Syndrome 痹证). The Chinese name is called Tong Bi or Han Bi (痛痹 / 寒痹). 

The Defensive Qi can be penetrated by external Pernicious Influences when the patients is in poor health. When the Cold invades the Channels and joints and settles there, it... read more about Cold invading the Channels joints and muscles

Painful Obstruction

Wu Tou Tang is sometimes prescribed by TCM practitioners to treat Painful Obstruction. This pattern leads to symptoms such as lumbar pain, shoulder pain, knee pain and elbow pain. Patients with Painful Obstruction typically exhibit tight (Jin) or wiry (Xian) pulses.

Painful Obstruction Syndrome is also called Bi Symdrome (Bi Zheng). 'Bi' means Stagnation or blockage in Chinese. It occurs mainly due to Exterior Pernicious Factors invasion such as Wind, Cold, Dampness or Heat

There are four types of Painful Obstruction Syndrome patterns according to the... read more about Painful Obstruction

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