Angong Niuhuang Wan (Angong Niuhuang Pill)

What Is Angong Niuhuang Wan

Angong Niuhuang Wan is a classic prescription in traditional Chinese medicine (TCM) used for febrile disease treatment. It first appeared in <Wen Bing Tiao Bian> (Treatise on differentiation and treatment of seasonal warm diseases) written by Wu Jutong in the Qing Dynasty (1,798 AD).

An means “Protect”, Gong means “Palace and Wall, and here it refers to the pericardium”. Angong means “Protecting the pericardium from disturbance by filthy and turbid pathogenic factors”. Niu Huang means “Calculus Bovis”, and Wan means “edible pills”. It is a traditional Chinese medicine prescription mainly composed of calculus bovis.

Angong Niuhuang Wan is an emergency medicine commonly used in ancient Chinese medicine, which is widely used for the rescue of acute and critical illnesses, especially high fever and coma. In ancient times Angong Niuhuang Wan was known as the pill that could rescue the patient immediately and help revive those who were on the brink of death. With the continuous development of modern pharmacology, its pharmacological effects have also been continuously explored and discovered.

In traditional Chinese medicine, it is often used to clear heat and remove toxins, eliminate phlegm and induce resuscitation, and treat high fever, coma, dysphoria, delirium, retraction of the tongue and difficulty in speaking, apoplexia, cerebral infarction, meningitis, cerebral hemorrhage, viral encephalitis, toxic encephalopathy, thermoplegia, leukemia, ichorrhemia, pyemia, viral pneumonia, intractable epilepsy, infantile convulsion, serious hepatitis, abnormal liver function, fat embolism, severe drug eruptions, erythroderma psoriaticum, diabetes, gout, vascular dementia, depression, schizophrenia, sleepwalking, leptospirosis, toxic dysentery, measles, eclampsid gravidarum, lupus brain, pelvic inflammatory diseases, acute bronchiolitis, hand-foot-mouth disease, and delayed encephalopathy after acute carbon monoxide poisoning.

With the development of pharmaceutical technology, it has been improved into pills, capsules, and granules with more standardized dosages. In the market, the common Angong Niuhuang Wan include Angong Niuhuang Pill, Angong Niuhuang Capsules, and Angong Niuhuang Granules.


The medicinal nature of Niu Huang is relatively cool, with a bitter taste. It can clear heart-heat, eliminate phlegm, induce resuscitation and restore consciousness, and treat seasonal febrile disease due to invasion of pericardium by heat, infantile convulsion, epilepsy, coma, delirium, high fever, and dysphoria.

The medicinal nature of Shui Niu Jiao is relatively cold. It can clear heat and cool blood, purge fire and remove toxins, and treat high fever, coma, delirium, and infantile convulsion caused by heat attacking yingfen and xuefen.

The medicinal nature of She Xiang is relatively warm, with a pungent taste. It can induce resuscitation and restore consciousness, treat stroke caused by various symptoms. These three Chinese herbal medicines are the most crucial in this formula. Their combination can better clear heart and induce resuscitation, cool the blood and remove toxins.

The medicinal nature of Huang Lian is relatively cold. It can clear heart-fire and treat high fever, dysphoria, coma, and delirium caused by excessive heat in the heart meridian.

The medicinal nature of Huang Qin is relatively cold. It can clear heat and dry dampness, reduce fire and remove toxins. It is often used in combination with Huang Lian and Niu Huang.

The medicinal nature of Zhi Zi is relatively cold, with a bitter taste. It can purge fire in the tri-jiao and heart, and treat dysphoria caused by febrile diseases. Huang Lian, Huang Qin, and Zhi Zi synergize with Niu Huang and Shui Niu Jiao to help clear heat and remove toxins.

The medicinal nature of Bing Pian is relatively cold, with a bitter taste. It can induce resuscitation and restore consciousness. However, its efficacy is weak, and it is often used with She Xiang to increase the efficacy of She Xiang.

The medicinal nature of Yu Jin is relatively cold, with a bitter taste. It can clear heart-fire, remove depression by regulation of qi, and induce resuscitation, treat coma caused by febrile diseases, and epilepsy. It synergizes with She Xiang to help induce resuscitation.

The medicinal nature of Xiong Huang is relatively warm, with toxicity. It can counteract poison with poison, and help Niu Huang to eliminate phlegm and remove toxins.

The medicinal nature of Zhu Sha is slightly cold. It can clear heart-fire, relieve convulsions and spasms, and treat high fever, dysphoria, coma, delirium, and convulsion caused by invasion of pericardium by heat or phlegm-heat blocking the heart orifices.

The medicinal nature of Zhen Zhu is relatively cold. It can clear heat in the heart and liver, relieve convulsions and spasms, and treat infantile convulsions, high fever, and coma.


  • Clearing heat and removing toxins, eliminating phlegm and inducing resuscitation, and treating high fever, dysphoria, coma, delirium, retraction of the tongue and difficulty in speaking, cold limbs from intense heat, reddish or deep-red tongue, and rapid pulse.
  • Treating high fever and coma caused by acute stroke, severe type of craniocerebral injury, cervical cord injury, heavy infectious diseases, viral encephalitis, severe pneumonia, tumor, or organic phosphorus pesticide poisoning [1].
  • Treating intractable epilepsy, high fever in children, convulsions, and stroke.
  • Treating encephalitis, meningitis, toxic encephalopathy, cerebral infarction, cerebral hemorrhage, and septicemia.
  • It ameliorates cerebral ischemia/reperfusion injury in mice partly by restoring gut microbiota dysbiosis [2].
  • It reduced the blood-brain barrier damage, brain edema, hemorrhagic transformation, and mortality rate and enhanced neurological function in the ischemic stroke rats with t-PA treatment via inhibited peroxynitrite-mediated MMP-9 activation [3].
  • It has anti-atherosclerosis effects on a high-fat diet-induced ApoE-/- mice early and mid-term atherosclerosis model via regulating Th17/Treg balance, inhibiting chronic inflammation, reducing plaque collagen fibers, and reducing inflammatory cells infiltration [4].
  • It can improve the brain dysfunction of septic rats and reduce the expression of pro-inflammatory cytokines in the brain. It is speculated that It can protect the brain function in sepsis by inhibiting the inflammatory reaction in the brain [5].
  • The study found that the addition of Angong Niuhuang Pills on the basis of modern medical routine treatment can better improve consciousness disorder, body temperature, and convulsion of patients with hypxic-Ischemic encephalopathy [6].
  • A clinical study shows that it treatment can effectively promote the postoperative recovery and respiratory nursing outcomes in chronic obstructive pulmonary disease patients following cardiac surgery [7].

How to use it

When using Angong Niuhuang Wan, follow the instructions for the medicine. Angong Niuhuang Wan includes candied pills, capsules, and granules.

When using the ancient Chinese medicine method to make Angong Niuhuang Wan, all the ingredients of the medicine are ground, stir-frying them with honey, make them into pills, wrap them with gold foil, and seal them with wax.

When taking its candied pills, it should be swallowed or chewed. The dosage per administration is 1 pill (about 3g). Take it 1 time a day.

When taking its capsules, you should take it with warm water. The dosage per administration is 2 capsules. Take it 3 times a day.

When taking its granules, it should be taken after stirring and dissolving in warm water. The dosage per administration is 1 sachet (about 1.6g). Take it 1 time a day.

Children should reduce the dosage as prescribed by their doctor before taking it.

Those who are in a coma or have difficulty taking it orally should be administered by nasal feeding under the guidance of a doctor.

Side Effects

Animal experiments have shown that long-term overdose may cause adverse reactions and accumulated poisoning [8].

It may cause hypothermia or allergic reactions in a small percentage of patients taking it.

Generally, the patient’s symptoms will be relieved after taking the medicine. Patients should stop using it when their symptoms have resolved.

Precautions and Warnings

  • This product is for first aid and should not be taken for long periods.
  • During the medication, it is not recommended to drink wine, and eat cold, spicy, and greasy foods.
  • The wax skin, plastic spherical shell, and cellophane should be removed before taking it.
  • People who are allergic to the ingredients in Angong Niuhuang Wan should not take it.
  • It contains cinnabar and realgar, which should not be overdosed or taken for a long time.
  • It should not be taken with nitrates, ferrous salts, nitrites, and sulfates.
  • After taking the medicine, if you have cold limbs, pale complexion, or persistent cold sweat, you should stop the medicine in time and go to the hospital for medical treatment.
  • If you accidentally overdose, you should stop the drug immediately, and drink plenty of water to promote drug metabolism and excretion. At the same time, if you feel unwell, you need to seek medical attention in time.
  • Patients with stroke due to cold should not take it.
  • Pregnant women should not take it.
  • Patients with renal or hepatic insufficiency should not take it.
  • Patients with hematopoietic disorders should not take it.
  • If you are taking other drugs at the same time, you should consult your doctor to prevent interactions between the drugs and affect the efficacy of the drugs.
  • Lactating women, children, and the elderly and infirm should be taken under the guidance of a physician.
  • If symptoms are not relieved on the day after taking the medicine, you should go to the hospital in time.