A high-end "clear the heart, open the orifices, calm the spirit" formula from the Song dynasty, one of the most expensive OTC preparations in Chinese pharmacies, traditionally given as a household "rescue" remedy.
Cultural reference - how this formula has been discussed in Chinese medical tradition. Not medical advice.
Background & origin
Finalized in the Song dynasty "Formulary of the Bureau of Medicine" (《太平惠民和剂局方》) as the imperial-court version of the heart-clearing formula. In Korea it is sold as Uhwang-cheongsim-won (우황청심원) by Kwang Dong as one of the most popular high-end hanbang preparations for stroke-prone middle-aged and elderly patients. In Japan, related heart-clearing formulas are produced by Kracie and Kotaro in the OTC "honjōhō" (rescue remedy) category. The genuine Beijing Tongrentang version is one of the most expensive Chinese medicines in global circulation, often used as a diplomatic gift.
From the source text
This page is cultural documentation, not medical advice.
From the source text · 《局方》卷一·治诸风·牛黄清心丸
Classical text
治诸风，缓纵不随，语言謇涩，心怔健忘，恍惚去来，头目眩冒，胸中烦郁，痰涎壅塞，精神昏愦。又治心气不足，神志不定，惊恐怕怖，悲忧惨戚，虚烦少睡，喜怒无时，或发狂癫，神情昏乱。
Modern Chinese rendering
本方用于"诸风"所致四肢缓纵不遂、语言謇涩、心悸怔忡、健忘、神志恍惚来去不定、头目眩冒、胸中烦郁、痰涎壅塞、精神昏愦；亦用于"心气不足"所致的神志不定、惊恐怕怖、悲忧惨戚、虚烦少睡、喜怒无时，或发狂癫、神情昏乱。这一段方论把牛黄清心丸定位为"清心化痰、镇惊祛风、扶正安神"思路下"风痰阻窍、心神失养"路径的代表方——既以牛黄、麝香、冰片等芳香开窍、清心化痰以治标,又以人参、白术、茯苓、甘草、当归、白芍等扶正益气、养血安神以治本,是"局方"系列里少有的"标本兼治、补泻兼施"大方。
Editorial translation
This formula is used for "various wind" patterns causing the four limbs to be slack and unable to follow through, slurred speech, palpitations and fright-amnesia, vacillation ("恍惚来去"), dizziness, chest oppression and stuffiness, phlegm-drool congestion, and clouded consciousness; it is also used for "heart qi insufficiency" patterns of unsettled spirit, fright and fear, sorrowful grief, vexation and reduced sleep, untimed joy and anger, or even raving epilepsy and clouded mental state. This preface positions Niú Huáng Qīng Xīn Wán as the Formulary-derived "clear the heart and transform phlegm, settle fright and expel wind, support the upright and quiet the spirit" representative formula — the canonical entry for the "wind-phlegm obstructing the orifices, heart-spirit losing nourishment" register; it uses the aromatic orifice-opening, heart-clearing, phlegm-transforming trio (Niú Huáng / Shè Xiāng / Bīng Piàn) to treat the branch while using the qi-tonifying, blood-nourishing, spirit-quieting base (Rén Shēn / Bái Zhú / Fú Líng / Gān Cǎo / Dāng Guī / Bái Sháo) to treat the root — one of the few "treat both branch and root, combine tonifying and draining" major formulas in the Formulary canon.
In tradition
In TCM tradition, associated with "phlegm-heat clouding the heart" patterns in vulnerable populations: sudden dizziness, transient numbness or weakness on one side, slurred speech, irritability, and restlessness, particularly in older adults with underlying circulatory concerns. It is also one of the formulas most often mentioned in the context of the post-stroke recovery period in TCM discussions.
Formula composition
Monarch1
- Calculus bovis (Niú Huáng / 牛黄)
Minister2
- Musk (Shè Xiāng / 麝香)
- Borneol (Bīng Piàn / 冰片)
Assistant11
- Ginseng (Rén Shēn / 人参)
- White atractylodes (Bái Zhú / 白术)
- Poria (Fú Líng / 茯苓)
- Angelica sinensis (Dāng Guī / 当归)
- White peony root (Bái Sháo / 白芍)
- Coptis root (Huáng Lián / 黄连)
- Scutellaria root (Huáng Qín / 黄芩)
- Gardenia fruit (Zhī Zǐ / 栀子)
- Platycodon root (Jié Gěng / 桔梗)
- Saposhnikovia (Fáng Fēng / 防风)
- Bupleurum root (Chái Hú / 柴胡)
Envoy1
- Licorice root (Gān Cǎo / 甘草)
International availability
Taiwan & Hong Kong
- 順天堂OTC牛黃清心丸Niu Huang Qing Xin Wan
Cautions & context
- A "rescue remedy", not for daily use, and not a substitute for emergency medical care in suspected stroke or heart events.
- Contains musk and borneol, strong aromatic stimulants; not appropriate during pregnancy.
- People on anticoagulants (warfarin, clopidogrel, etc.) should consult a physician before use, some ingredients have documented antiplatelet effects.
- Sudden neurological symptoms (one-sided weakness, slurred speech, visual loss) require immediate emergency medical evaluation before any herbal remedy is considered.
Related formulas
Other formulas from this text· "Formulary of the Bureau of Medicine"
Other formulas by this contributor· Imperial Medical Bureau (Song)
Related concerns
Concern · stress
Stress & Mood
Everyday tension, low mood, irritability, the sense of being "wound up but tired". The cluster of complaints that brings many Chinese adults to the family 中成药 drawer before they ever see a doctor.
Concern · sleep
Sleep
Difficulty falling asleep, light sleep, dream-disturbed sleep, and the "tired but cannot switch off" pattern that follows overwork or worry.
Editorial note
Compiled from "Formulary of the Bureau of Medicine" (1078).
Last reviewed: July 18, 2026
Three layers of evidence
Classical source
≈ 900 years · "Formulary of the Bureau of Medicine" (1078)
Pharmacopoeia indication
"Clear the heart and resolve phlegm, settle fright and expel wind. Used for wind-phlegm obstructing the orifices: dizziness, epilepsy, clouded consciousness, and infantile fright-wind with spasms; also used for post-stroke sequelae with hemiplegia."
Modern research status
As of 2026-07-18, a PubMed search using the formula name and the Latin / Korean / Japanese transliterations together with "systematic review" and "meta-analysis" did not identify a dedicated systematic review for this formula. Any clinical evidence that does exist is fragmented across small individual trials or covered in broad herbal-medicine umbrella reviews, which do not allow a per-formula evidence assessment; the absence of a dedicated SR is itself the relevant editorial fact here.
References
References reviewed on July 18, 2026 · PubMed search on 2026-07-18
- 01ClassicalChen Shiwen (陈师文) et al. (eds.), 《太平惠民和剂局方》 (Tài Píng Huì Mín Hé Jì Jú Fāng / Formulary of the Bureau of Medicine), Song dynasty, compiled 1078, vol. 1, the "treating various wind" (治诸风) section, the entry for Niú Huáng Qīng Xīn Wán (牛黄清心丸), the imperial-court version of the heart-clearing formula; the original Formulary text presents a 26-flavor preparation, the modern "small" Niú Huáng Qīng Xīn Wán widely sold in Chinese pharmacies today is a later simplified derivative and is not the Formulary original.
- 02TextbookDuan Fuqin (段富津) et al. (eds.), 《方剂学》 (Fāngjìxué / Science of Formulas), 2nd edition, Shanghai Scientific and Technical Publishers, 2011, the standard modern university-level formula textbook in mainland China, with Niú Huáng Qīng Xīn Wán analysed as the representative "clear the heart and transform phlegm, settle fright and expel wind, support the upright and quiet the spirit" (清心化痰，镇惊祛风，扶正安神) formula, the canonical entry for the "wind-phlegm obstructing the orifices, heart-spirit losing nourishment" register; noted in modern pharmacology as one of the few "treat both branch and root, combine tonifying and draining" major formulas.
- 03TextbookKwang Dong Pharmaceutical (광동제약), Uhwang-cheongsim-won (우황청심원 / 牛黄清心丸) product documentation, Korea's leading hanbang manufacturer, one of the most popular high-end Korean hanbang preparations for stroke-prone middle-aged and elderly patients, sold in Korea as both a daily-use hanbang tonic and a high-end gift item, listed in the Korean MFDS (식약처) Korean Pharmacopoeia-style monograph as a standard heart-clearing rescue remedy.
- 04PharmacopoeiaPharmacopoeia Commission of the PRC, 《中华人民共和国药典》 2020 edition, vol. 1 (Zhōnghuá Rénmín Gònghéguó Yàodiǎn, Pharmacopoeia of the People's Republic of China, 2020 ed., vol. 1), China Medical Science Press, 2020, the official national monograph for Niú Huáng Qīng Xīn Wán (局方版), "functional indication" reads "clear the heart and resolve phlegm, settle fright and expel wind, used for wind-phlegm obstructing the orifices causing dizziness, epilepsy, clouded consciousness, and infantile fright-wind with spasms; also used for post-stroke sequelae with hemiplegia".