Zhu Ye Shi Gao Tang

Zhu Ye Shi Gao Tang

From "Shang Han Lun"

[Composition] Zhu Ye 9 grams (two handfuls), Shi Gao 30 grams (one jin), Ban Xia 9 grams, Ren Shen 4.5 grams (two liang), Mai Dong 18 grams (one sheng), Zhigan Cao 3 grams (two liang), Jing Mi 15 grams (half a sheng)

[Usage] First, decoct all herbs, remove the residue, add Jing Mi, and cook until the rice is done, then serve warm.

[Indications] Residual heat that has not yet been cleared.

[Indications] High fever with profuse sweating, dry mouth and a desire to drink, restlessness and insomnia, weakness and little breath, qi rising and wanting to vomit, dry tongue with little coating, and a fine, rapid pulse.

[Functions] Clear heat and relieve frustration, nourish qi and nourish yin.

[Formula Explanation] When residual heat has not yet been cleared, the patient experiences high fever with profuse sweating, dry mouth and a desire to drink, restlessness and insomnia; when qi and yin are both depleted, the patient feels weak and little breath, qi rising and wanting to vomit, dry tongue with little coating, and a fine, rapid pulse. Residual heat often comes with frustration; in this formula, Zhu Ye and Shi Gao clear residual heat and relieve frustration, serving as the primary treatment for the underlying cause. Ren Shen nourishes qi, and Mai Dong nourishes yin—these two herbs work together to nourish qi and yin as complementary treatments. When heat and dryness damage fluids, and the stomach loses its ability to descend, qi rises and wants to vomit; Ban Xia helps to lower the rebellious qi; when heat and dryness damage qi, the spleen and stomach are weakened, Jing Mi helps to harmonize the middle burner—these two herbs serve as complementary treatments. Zhigan Cao harmonizes the herbs as a guiding agent.

[Clinical Additions and Subtractions] This formula is enhanced with Shan Zhi and Dou Chi, whose efficacy in clearing heat and relieving frustration is even greater.

[Reference Materials]

① “Although the major evil has been resolved, the original qi has not yet recovered, and residual heat has not yet been eliminated. When qi is insufficient, phlegm arises; when heat is not cleared, it rises upward, leading to weakness and little breath, and qi rising and wanting to vomit. Zhu Ye Shi Gao Tang is a variation of Bai Hu Tang; because it contains less qi, it adds Ren Shen and Mai Dong’s sweet qualities to nourish qi, and because qi is rising and there is a need to drink, it uses Ban Xia’s pungent properties to lower qi and dispel phlegm. Moreover, it removes the salty coldness of Zhi Mu and adds the sweet, cool properties of Zhu Ye, especially for those with gastric weakness and internal heat.” (Shang Han Guan Zhu Ji)

② “Although the major heat has subsided, residual heat still remains; therefore, the patient feels weak and little breath, and qi rises and wants to vomit—this is a sign of yin deficiency unable to retain yang, and it is also aided by residual heat from external exposure. Thus, in this formula, Zhu Ye and Shi Gao are used to clear heat from external exposure, while Ren Shen and Mai Dong are added to nourish yin deficiency, as the combination of Shi Gao and Ren Shen has a unique synergy, allowing them to restore true yin even when residual heat remains. Ban Xia is used to lower qi and stop vomiting; Zhigan Cao and Jing Mi are used to harmonize stomach qi and ease the impact of Shi Gao’s medicinal properties.” (Medical Zhong Zhong Can Xi Lu)

[Commentary] This formula can be used for tuberculosis, blood disorders, and late-stage fever during influenza. Recently, this formula has also been used in combination with other herbs to treat summer heat in children.