Bu Fei E Jiao Tang
Do not self-treat with Bu Fei E Jiao Tang
Practitioner-prepared only. If a licensed herbalist offers you a version with no Ma Dou Ling, ask to see the full herb list, and ask them to write the dose down.
If this is an emergency
Some reactions to Bu Fei E Jiao Tang need urgent care. Call your local emergency number or go to an emergency department straight away — do not wait to see whether it passes.
Who should avoid Bu Fei E Jiao Tang?
- Do not use if you cannot prove the product is free of Ma Dou Ling, also sold as Aristolochia or birthwort.
- Do not use if you are pregnant, trying to get pregnant, or breastfeeding.
- Do not use if you are buying it for a child or a teenager.
- Do not use if you have any kidney disease, one working kidney, or you are on dialysis (a machine that cleans the blood).
- Do not use if you have had a kidney transplant.
- Do not use if you have ever had cancer of the bladder, kidney or urinary tract.
- Do not use if you have high blood pressure, heart failure, or a heart rhythm problem.
- Do not use if you have low potassium (hypokalaemia, a low level of a salt your heart needs).
- Do not use if you take digoxin, water pills (diuretics), or steroid tablets such as prednisone.
- Do not use if you take warfarin or another blood thinner, unless your doctor agrees and checks your blood.
- Do not use if you have liver disease, since the apricot kernel in the mix can be hard to clear.
When should you see a doctor?
Get help the same day if you cough up blood, run a fever, lose weight without trying, or your cough lasts more than three weeks.
Go to an emergency room now if you pass little or no urine, swell up fast, feel your heart race or skip, or feel weak, dizzy and confused. Feeling faint with a flushed face and a bad headache after taking apricot kernel is also an emergency.
Tell any doctor you see that you took an Aristolochia herb, even years ago. It changes the tests they will run.
- What it is: An old Chinese herb mix for a dry cough, whose classic recipe holds a herb that harms the kidneys.
- Active ingredients: Collagen from E Jiao, Glycyrrhizin from licorice, Amygdalin from apricot kernel, Aristolochic acid from Ma Dou Ling, Arctiin from burdock seed
- Side effects: Stomach upset is common; kidney harm, high blood pressure and low potassium are the serious risks.
- Pregnancy & breastfeeding: Avoid in pregnancy and while breastfeeding.
Educational information, not medical advice — ask your doctor or midwife.
What is Bu Fei E Jiao Tang?
Bu Fei E Jiao Tang is an old Chinese herb mix. The name means Tonify the Lungs Decoction with Ass-Hide Gelatin. It was used for a dry, barking cough, sometimes with a little blood in the phlegm.
This page treats it as a single drug (TCM formula), not as loose herbs. The classic recipe holds donkey-hide gelatin, licorice, apricot kernel, burdock seed, rice, and Ma Dou Ling.
Ma Dou Ling is the problem. It holds aristolochic acid, a plant chemical that scars the kidneys and can cause cancer. For that reason the classic form is not safe to take.
Long use in a tradition is not proof that a remedy works or that it is safe. Human trial proof for this mix is very thin. Some modern makers leave Ma Dou Ling out, but a label may not tell you.
How does Bu Fei E Jiao Tang work?
No one has shown how this mix works in the body. What follows is the old theory plus a little lab work.
In Chinese medicine, the herbs are said to moisten a dry lung, stop a cough, and settle the breath. E Jiao (donkey-hide gelatin) is said to build blood and body fluid.
Lab work shows licorice can calm swelling, and that gelatin is mostly protein. That is a long way from proof that the whole mix helps a cough in people.
What forms does Bu Fei E Jiao Tang come in?
Most often it is a tea. A trained herbalist weighs the raw herbs and you boil them in water.
You may also find it as granules you stir into hot water, as small pills, or as a sweet syrup.
Check the full herb list on any product. If it names Ma Dou Ling, Aristolochia, or birthwort, do not take it.
Where it comes from:
The recipe comes from a children's medicine book by Qian Yi, written in Song dynasty China around 1119 CE.
It has stayed in Chinese herb texts ever since, mostly for a dry cough in children. That gives it a long record in one tradition.
Its standing is historical. It does not rest on modern trials.
What does Bu Fei E Jiao Tang help with?
- Dry cough that will not clear: This is the main old use. Herbalists chose it for a cough with little or no phlegm and a dry throat. We found no human trials that test the mix against a dummy pill for this.
- Cough with a streak of blood in the phlegm: Old texts name this as the key sign. Blood in phlegm needs a doctor, not a herb tea. It can point to an infection, a clot in the lung, or cancer.
- Cough in children (the classic use): The source book was a children's text. We do not pass that use on. The apricot kernel and the Ma Dou Ling make this mix unsafe for a child.
- Hoarse or raw voice: Tradition links this mix to a dry, raw throat. There is no trial evidence in people. A hoarse voice lasting more than three weeks needs a doctor.
- Wheezy, short breath: Some herbalists use it for a dry wheeze. Asthma and heart failure both cause wheeze and both need real treatment. Do not swap a prescribed inhaler for a tea.
What are the side effects of Bu Fei E Jiao Tang?
- Kidney damage that may not heal (from Ma Dou Ling)
- Blood in the urine
- Raised blood pressure (from licorice)
- Low potassium, which can cause weak muscles and an odd heart beat
- Puffy face, hands or ankles from held water
- Headache
- Upset stomach, loose stools or nausea
- Headache, dizziness, flushing or confusion, which can be early signs of cyanide from apricot kernel
- Rash or other allergy signs
Good to know:
Mild stomach upset is the common one. The serious risks are not common, but they are severe and some cannot be undone.
Kidney scarring from Ma Dou Ling is permanent. It has led to dialysis and to cancer of the urinary tract in people who took Aristolochia herbs.
Licorice effects build up with weeks of use, not with one cup.
Options to discuss with a clinician
For every reason people reach for this formula, there are routes that have been studied far more carefully — and each one begins as a conversation with a doctor, pharmacist or qualified herbalist rather than a straight swap.
**A cough in a child.** Children's coughs are worth having looked at properly; a GP or pharmacist can tell apart the kinds that settle on their own from the ones that need treating, and can advise on what is suitable at a child's age.
**Blood in the phlegm, even a streak.** This is a symptom that warrants prompt medical assessment. A clinician will want to find the cause before anything is given for it — that assessment is the priority, not a remedy.
**A dry cough that will not clear, or a hoarse, raw voice.** Lasting more than about three weeks, both deserve a doctor's review. Reflux (stomach acid rising into the throat), post-nasal drip (mucus running down the back of the nose), asthma and medication side effects are all common and all treatable once identified.
**Wheeze or breathlessness.** These point to the airways and need proper assessment; ask about tests such as spirometry (a breathing test).
With any of these, ask your clinician directly: what fits my situation, and what is the evidence behind it?
Review status
This page has not been signed off by a pharmacist and is not published. It is shown here for a policy decision only.