Xi Jiao Di Huang Tang
Quick Facts
- What it is: A classic Chinese herbal formula of water buffalo horn, raw rehmannia, red peony and tree peony bark, traditionally used for fever with bleeding.
- Main uses: Fever with bleeding signs, Nosebleeds and blood in vomit or stool, Purple spots under the skin, Hot red skin rashes during fever
- Best for: Short-term use under a qualified herbalist, alongside medical care
- Active ingredients: Keratin and amino acids from water buffalo horn, Catalpol from rehmannia, Paeoniflorin from red peony, Paeonol from tree peony bark
- Forms: Decoction (herbs boiled into a strong tea), Granules or powder, Pills or capsules
- Time to effect: No reliable data; traditionally judged over a few days.
- Side effects: Loose stools and stomach upset are most common; easier bruising or bleeding is the main safety worry.
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What is Xi Jiao Di Huang Tang?
Xi Jiao Di Huang Tang is an old Chinese herbal formula. The name means Rhinoceros Horn and Rehmannia Decoction. It is filed here as a single drug (TCM formula), even though four herbs go into the pot.
Rhino horn is banned by law in every country. Modern versions swap in water buffalo horn, and the name is often given as Water Buffalo Horn and Rehmannia Decoction. The other three herbs are raw rehmannia root, red peony root and tree peony bark.
In Chinese medicine the formula is used for high fever with bleeding signs. That means nosebleeds, blood in vomit, blood in the stool, or purple spots under the skin (called purpura). Old texts also describe restless, confused patients with a deep red tongue.
The honest verdict on evidence is thin. The formula has a clear, long record inside one tradition, but I could not find good human trials that test it. A long history of use is not proof that something works, and that caution applies to everything on this page.
All of the signs this formula was built for are serious. Bleeding with fever needs a doctor, not a herbal tea, and nothing here should replace emergency care.
How does Xi Jiao Di Huang Tang work?
The plain answer is that no one has shown how this formula works in people.
In Chinese medicine theory, fever is said to move from the surface into the blood, where it pushes blood out of its normal path. This formula is described as cooling that heat and settling the blood. That is a traditional model, not a lab finding.
Lab and animal studies have looked at the single herbs. Water buffalo horn has been studied for effects on fever and on clotting. Rehmannia, red peony and tree peony bark have been studied for anti-inflammatory effects, meaning they may calm swelling and irritation in test tubes and in animals.
Those findings do not carry over on their own. A result in a dish or in a mouse often fails in people, and the doses used in labs rarely match a cup of tea. Treat the mechanism as a reasonable idea that has not been tested well in humans.
What forms does Xi Jiao Di Huang Tang come in?
The classic form is a decoction, which is a strong tea made by boiling the herbs in water.
You may also meet it as:
Granules or powder that dissolve in hot water, sold as a ready-made version of the same formula.
Pills or capsules from Chinese patent medicine makers.
Custom versions where a herbalist adds or drops herbs to fit one person.
Buy only from sellers who test for heavy metals such as lead and for hidden drugs added to the product. Never buy any version that claims to hold real rhinoceros horn.
Where it comes from:
The formula is credited to Sun Simiao and appears in his Tang dynasty work Bei Ji Qian Jin Yao Fang, from around the seventh century. It is also carried in later fever texts, including works of the warm disease school in the Qing dynasty.
It became one of the standard answers for fever with bleeding in Chinese medicine, and it is still taught in schools today.
The rhino horn in the original name is history, not practice. Trade in rhino horn is illegal worldwide, and water buffalo horn has been the accepted stand-in for decades.
If this is an emergency
Some reactions to Xi Jiao Di Huang 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 Xi Jiao Di Huang Tang?
- Never buy or use any product that claims to contain real rhinoceros horn. The trade is illegal worldwide and the animal is critically endangered.
- Do not use if you are bleeding heavily, vomiting blood, passing black or bloody stools, or confused with a high fever. Call emergency services instead.
- Do not use if you are pregnant or trying to get pregnant, because red peony root and tree peony bark are traditionally avoided in pregnancy.
- Do not use if you are breastfeeding, as no one knows whether the herbs pass into breast milk.
- Do not use if you take warfarin, heparin, apixaban, rivaroxaban or any other blood thinner (a medicine that stops blood from clotting).
- Do not use if you take aspirin, clopidogrel or another antiplatelet drug (a medicine that stops blood cells sticking together to form clots).
- Do not use if you have a bleeding disorder such as haemophilia (an inherited problem where blood does not clot properly) or a low platelet count, unless a doctor is guiding your care.
- Do not use if you have surgery or dental work booked in the next two weeks. Stop at least 14 days beforehand.
- Do not use if you have long-term loose stools, poor appetite or feel cold easily, because this cooling formula can make those worse.
- Do not use if you are giving it to a child, unless a qualified doctor or herbalist has prescribed it and set the dose.
- Do not use if you have kidney or liver disease without telling your doctor first, as these organs handle what you swallow.
When should you see a doctor?
Get emergency help now if you vomit blood, pass black or bloody stools, bleed from the nose or gums and cannot stop it, or if someone with a high fever becomes confused, very drowsy or hard to wake.
Call your doctor the same day if you notice new purple spots or bruises, a rash that spreads quickly, blood in your urine, or a fever above 39C that will not come down.
Stop the formula and get advice if you bleed or bruise more easily than usual, if you get a rash or swelling after taking it, or if diarrhoea lasts more than two days.
If you take any prescription medicine, especially a blood thinner or diabetes medicine, talk to your doctor or pharmacist before you start.
Evidence grades and traditional-use labels are explained in our methodology. Nothing here is medical advice.
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