Ying Level Heat-Clearing Decoction

Ying Level Heat-Clearing Decoction

Bubali Cornu (Shui Niu Jiao) 3 qian (30g), Rehmanniae Radix (Sheng Di) 5 qian (15g), Scrophulariae Radix (Xuan Shen) 3 qian (9g), Lophatheri Herba (Zhu Ye Xin) 1 qian (3g), Ophiopogonis Radix (Mai Dong) 3 qian (9g), Salviae Miltiorrhizae Radix et Rhizoma (Dan Shen) 2 qian (6g), Coptidis Rhizoma (Huang Lian) 1 qian 5 fen (5g), Lonicerae Japonicae Flos (Jin Yin Hua) 3 qian (9g), Forsythiae Fructus (Lian Qiao) 2 qian (6g)

Use 8 cups of water for each dose of the formula. Boil the decoction down to 3 cups of water. Take one dose per day divided into three servings. (Modern application: use water to decoct the medicinals.)

Clears heat from the ying level, resolves toxins, vents heat from the ying level, and nourishes yin.

This formula is indicated for the heat in the ying level. The symptoms are fever aggravated at night, vexation and sleeplessness, occasional delirious speech, thirst or not, inconspicuous macules and papules, crimson colored, dry tongue, and a thready, rapid pulse.

This is the initial stage of pathogenic heat entering the ying level. In this stage pathogenic heat enters the ying level and lingers to produce a fever that is aggravated at night. The heat harasses the heart spirit, which causes vexation, sleeplessness, and occasional delirious speech. Once the pathogenic heat enters the ying level, if the heat distills ying-yin upward to the mouth, patients will show no sign of thirst, and if the residual heat in the qi level consumes yin of the lung and stomach, patients will have a fever, thirst, and a dry, crimson colored tongue. The heat burns the blood vessels and forces the blood to flow out of them, which creates inconspicuous macules and papules. The heat consumes ying-yin and leads to the dry, crimson colored tongue and the thready, rapid pulse. The characteristic feature of this pattern pathogenesis is the consumption of yin by the heat in the ying level, and the harassment of the heart and blood vessels by heat.

As a formula indicated for heat in the ying level, why are medicinals used for treating disease in the qi level like jin yin hua, lian qiao, and zhu ye included in Qing Ying Tang?

1. Essential pattern differentiation Qing Ying Tang is a commonly used formula for treating the initial stage of heat entering the ying level. This clinical pattern is marked by fever aggravated at night, vexation and sleeplessness, occasional delirious speech, dry, crimson colored tongue, and a thready, rapid pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows signs of heat entering the ying level, or blazing of both qi and ying: epidemic type B encephalitis, epidemic cerebrospinal meningitis, septicemia, typhus abdominalis, and other diseases characterized by fever. 3. Cautions and contraindications Stop taking this formula when patients show symptoms of dampness trapping hidden heat such as a crimson colored tongue with a glossy, white coating. According to the source text of Qing Ying Tang, “do not give the formula to those with a glossy, white tongue coating”. The reason is “a glossy, white tongue coating indicates excessive heat and dampness, and a pattern with excessive dampness should not be treated with yin-nourishing medicinals”. Otherwise the yin-nourishing medicinals may add to the dampness and complicate the illness.

Qing Ging Tang (Palace-Clearing Decoction, 清宮湯)

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