Qing Ying Tang

Qing Ying Tang

From “Wen Bing Tiao Bian”

[Composition] Bamboo leaf core: 3 grams; Salvia miltiorrhiza: 6 grams; Rhizoma Bupleuri: 9 grams; Forsythia suspensa: 9 grams; Coptis chinensis: 4.5 grams; Lonicera japonica: 9 grams; Rehmannia glutinosa: 15 grams; Scrophularia ningpoensis: 9 grams; Ophiopogon japonicus: 9 grams

[Administration] Decocted in water and taken orally.

[Indication] Heat entering the heart and blood.

[Indications] Feverish heat, thirst, confusion, delirium, irritability and insomnia, faint red rashes, a red and dark tongue with little coating, and a fine, rapid pulse.

[Function] Clearing the heart and cooling the blood.

[Formula Explanation] When heat enters the heart and blood, it consumes yin and harms the spirit. Symptoms include feverish heat, thirst, confusion, delirium, irritability and insomnia, a red and dark tongue with little coating, and a fine, rapid pulse. As heat enters the blood, it approaches the blood vessels, causing faint red rashes. In the formula, Rhizoma Bupleuri directly enters the blood and blood vessels, effectively clearing the heart and cooling the blood as its primary function. When heat enters the heart and blood, it primarily damages yin and consumes fluids; Rehmannia glutinosa, Scrophularia ningpoensis, and Ophiopogon japonicus help replenish yin and nourish the body, providing support to the formula. As the ancient saying goes, “Dispersion leads to heat; accumulation leads to toxicity,” and when heat becomes toxic, it is especially easy to develop toxicity. Only by combining methods to clear heat and detoxify can we achieve twice the result with half the effort. Forsythia suspensa, Forsythia, Coptis chinensis, and Lonicera japonica are all powerful agents for clearing heat and detoxifying, and when combined with Rhizoma Bupleuri, their effects on clearing heat and detoxifying become even more pronounced, making them useful as adjunct treatments. When heat enters the heart and blood, blood heat may lead to deficiency; Salvia miltiorrhiza enters the blood vessels, helping to nourish and activate blood while also clearing blood. Bamboo leaf clears the internal fire in the heart and relieves irritation, allowing heat to be expelled through urination—this is known as “guiding and harmonizing.”

[Clinical Additions and Subtractions]

① If confusion, delirium, or limb weakness are observed, these symptoms indicate that heat has entered the pericardium. In such cases, the physician may prescribe Niu Huang Wan or Zi Xue Dan alongside the treatment. If convulsions are present, Antelope Horn and Gou Teng can be added, or Zi Xue Dan can be used in conjunction.

② Adding Rhizoma Bupleuri, Paeonia lactiflora, Gou Teng, Licorice, and Earthworms can treat meningitis, scarlet fever, and Japanese encephalitis. If confusion and delirium are severe, An Gong Niu Huang Wan and Zhi Bao Dan can be used in combination.

[References]

① “The ‘Su Wen · Zhi Zhen Yao Da Lun’ states: ‘Heat invades internally; treat it with salty and cold, supporting it with sweet and bitter.’ This formula is based on the principles of treating excessive heat within the body. When warm heat enters the heart and blood, although there is feverish heat and thirst, confusion and delirium, irritability and insomnia, a red and dark tongue with little coating, and a fine, rapid pulse—when heat enters the blood, it approaches the blood vessels, causing faint red rashes. In the formula, Rhizoma Bupleuri directly enters the blood and blood vessels, effectively clearing heat and detoxifying while also cooling the blood and stopping bleeding. Rhizoma Bupleuri possesses a light and agile nature, capable of eliminating pathogenic toxins; Coptis chinensis has a bitter and descending quality, which can dry out dampness. Together, these two herbs serve as essential remedies for treating heat. When heat enters the pericardium, the blood’s yin is scorched, so Rehmannia glutinosa and Scrophularia ningpoensis nourish the kidney water, while Ophiopogon japonicus nourishes the lung metal—and Salvia miltiorrhiza guides the remedy into the heart, enabling it to fulfill its role in replenishing fluids and relieving burning. Forsythia suspensa, Lonicera japonica, and Bamboo leaf all penetrate deeply into the heart while also opening up the exterior, offering a refreshing and cool nature that helps calm the spirit, reduce heat, and allow the pathogenic toxins to dissipate naturally.” (Jiangsu New Medical College: Chinese Medicine Formulaology)

② “For heat-related illness affecting the pericardium, with symptoms like thirst, a red tongue, and feverish heat accompanied by delirium, the heat is often associated with the Fire element. Fire governs the heart, and because the heart is the master of the body, it does not accept external pathogens. What the heart receives is merely the energy of the meridians, but the heart holds the spirit; when pathogenic factors disturb the heart, the spirit cannot rest, leading to delirium. The heart governs blood, and when heat damages the blood vessels, the tongue turns red. Because Metal is afflicted by Fire, there is a strong sense of thirst. Heat is the primary pathogenic factor among the Six Evils, and warmth is an abnormality of the seasons. When these two evils combine, they give rise to heat and warmth—similar to spring and autumn heat, though heat is most likely to affect the heart. Rhizoma Bupleuri and Coptis chinensis both enter the heart to clear fire. Rhizoma Bupleuri has a light and nimble nature, capable of eliminating epidemic toxins; Coptis chinensis has a bitter and descending quality, which can dry out dampness. Together, these two herbs serve as essential remedies for treating heat. When heat attacks the pericardium, the blood’s yin is scorched, so Rehmannia glutinosa and Scrophularia ningpoensis nourish the kidney water, while Ophiopogon japonicus nourishes the lung metal—and Salvia miltiorrhiza guides the remedy into the heart, enabling it to fulfill its role in replenishing fluids and relieving burning. Forsythia suspensa, Lonicera japonica, and Bamboo leaf all penetrate deeply into the heart while also opening up the exterior, offering a refreshing and cool nature that helps calm the spirit, reduce heat, and allow the pathogenic toxins to dissipate naturally.” (Cheng Fang Can Du)

[Commentary] This formula can be used for various acute febrile infectious diseases, such as typhoid fever, trench fever, scarlet fever, meningitis, Japanese encephalitis, and others.