Source: Wenbing Tiaobian (Treatise on Differentiation and Treatment of Seasonal Febrile Diseases).

Ingredients:
No. 1 Niuhuang (Calculus Bovis) 30 g;
No. 2 Shuiniujiao (Cornu Bubali) (concentrated powder) 30 g [originally Xijiao (Cornu Rhinocerotis)];
No. 3 Huanglian (Rhizoma Coptidis) 30 g;
No. 4 Huangqin (Radix Scutellariae) 30 g;
No. 5 Zhizi (Fructus Gardeniae) 30 g;
No. 6 Yujin (Radix Curcumae) 30 g;
No. 7 Zhusha (Cinnabaris) 30 g;
No. 8 Xionghuang (Realgar) 30 g;
No. 9 Shexiang (Moschus) 7.5 g; (Generally use artificial one)
No. 10 Bingpian (Borneolum) 7.5 g;
No. 11 Zhenzhu (Margarita) 15 g.

Administration:
Grind the above ingredients into fine powder and mix the powder with honey to make boluses weighing 3 g each. Take one bolus each time and once daily, but twice or three times daily for severe case.

Actions:
Clearing away heat and inducing resuscitation, eliminating phlegm and toxin.

Clinical Application:
This recipe is indicated for pathogenic heat invading the pericardium, marked by high fever, restlessness, coma with delirium, dry tongue and mouth, excessive sputum or saliva, reddened or deep-red tongue, rapid pulse. It is applicable to epidemic encephalitis B, epidemic cerebrospinal meningitis, toxic dysentery, uremia, cerebrovascular accident, hepatic coma and others, which belong to pathogenic heat invading the pericardium. In case of forceful pulse, it is advisable to take the boluses orally with the decoction of Jinyinhua (Flos Lonicerae) and Bohe (Herba Menthae) to enhance the effect of clearing away heat and inducing perspiration.

In case of feeble pulse, take the boluses orally with the decoction of Renshen (Radix Ginseng) to promote the effect of strengthening body resistance. If concomitant with excess syndrome of the yangming fu organ manifesting coma and constipation, it is recommended to dissolve 2 boluses in water and mix it with 9 g powder of Dahuang (Radix et Rhizoma Rhei) for oral administration, which is known as Niuhuang Chengqi Tang.

Elucidation:
The syndrome arises when warm heat invades the pericardium and phlegm-heat blocks the clear orifice. It should be treated by clearing away heat and eliminating phlegm. The first ingredient bears the action of clearing away heat from the heart, relieving convulsion, eliminating phlegm to restore consciousness. Ingredient No. 9 can remove obstruction from the twelve meridians and is good at inducing resuscitation. Both act as monarch drugs. Ingredients No. 2, No. 3, No. 4 and No. 5 possess the effect of clearing away heat and reducing fire and help the first ingredient clear away heat from the pericardium.

Ingredients No. 10 and No. 6 are aromatic and can promote the effect of No. 9 in restoring mental activity. These six together serve as minister drugs. Ingredients No. 7, No. 11 and No. 8 are used as adjuvant drugs, of which No. 7 and No. 11 are capable of tranquilizing mind and relieving restlessness and the last promoting No. 1 in eliminating phlegm. Honey regulates the stomach and serves as guiding drug. In the original recipe, gold foil was used as coating for the boluses, which is effective in restoring mentality. But it has presently been deleted from Chinese Pharmacopoeia.