Sweet Wormwood and Turtle Shell Decoction

Sweet Wormwood and Turtle Shell Decoction

Artemisiae Annuae Herba (Qing Hao) 2 qian (9g), Trionycis Carapax (Bie Jie) 5 qian (15g), Rehmanniae Radix (Sheng Di) 4 qian (12g), Anemarrhenae Rhizoma (Zhi Mu) 2 qian (6g), Moutan Cortex (Mu Dan Pi) 3 qian (9g)

Decoct one dose of the formula with five cups of water, and boil it until the volume reduces to two cups. Take one dose, two times per day. (Modern use: use water to decoct the medicinals.)

Nourishes yin and vents heat.

This formula is indicated for patterns where yin has been damaged along with latent pathogens. The symptoms are night fever that abates at dawn, fever that abates without sweating, a red tongue body with a scanty coating, and a thready, rapid pulse.

This pattern is caused by damage to the yin in the later stage of a warm disease, where there is also latent residual heat in the yin level. The wei yang of the human body runs in the exterior during the daytime and goes into the interior at night. Since latent heat has become retained in the yin level, when wei yang moves into the yin level during the night, it adds to the residual heat that is latent in the yin level. There becomes too much yang for the yin to balance, which causes the night fever. When wei yang moves back out of the yin level to the exterior in daytime, the fever abates at dawn. Although the fever may abate at dawn, the latent heat pathogen is still retained in the yin level unable to be released from the exterior. In addition, the residual heat damages yin over time, so there is no fluids for sweat. This results in a fever that abates without sweating. A red tongue with scant coating and a thready, rapid pulse are signs of yin deficiency and heat. The characteristic feature of this pattern’s pathogenesis is damage to yin with latent heat in the yin level of the lower jiao. Therefore, the therapeutic method is to nourish yin and expel pathogens.

1. Essential pattern differentiation Qing Hao Bie Jia Tang is a commonly used formula used to treat yin that has been damaged along with latent pathogens in the later stage of warm disease. This clinical pattern is marked by night fever that abates at dawn, fever that abates without sweating, red tongue body with scanty coating, thready, rapid pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders when the patient shows prolonged low-grade fever caused by yin deficiency and interior heat: idiopathic fever, low-grade fever in the convalescent period of various communicable diseases, chronic pyelonephritis, nephronophthisis, and children’s summer fever. 3. Cautions and contraindications Do not use the formula in patients where the yin deficiency is about to generate wind.

Chinese soft-shelled turtle ( Trionyx sinensis / Pelodiscus sinensis ) is listed as "Vulnerable" in the International Union for the Conservation of Nature and Natural Resources (IUCN) Red List of Threatened Species. Also, it is protected by Hong Kong Wild Animals Protection Ordinance (Cap. 170).