Herbs that clear heat mainly remove interior heat. Generally speaking, interior heat syndrome excludes exterior syndrome due to invasion of exogenous pathogenic factors and heat syndrome caused by retention of food in the interior. Based on the functions and indications of the herbs, herbs that clear interior heat can be classified as follows:
(1)Herbs that clear heat and reduce fire: These herbs are mainly indicated for heat syndromes at the Qi level.
(2)Herbs that clear heat and dispel dampness: These herbs are bitter and dry in property, and are mainly indicated for interior syndromes of excessive heat without consumption of body fluids.
(3)Herbs that cool blood: These herbs cool heat at the blood level.
(4)Herbs that clear heat and remove toxins: These herbs are mainly indicated for syndromes of excessive toxic heat, such as epidemic diseases, toxic dysentery, boils and carbuncles.
(5)Herbs that clear heat caused by deficiency of Yin: These herbs are indicated for syndromes of interior heat due to deficient Yin, such as afternoon tidal fever.
In general, herbs that clear heat are cool and cold in property. Their heat-clearing action may impair the normal function of the spleen and stomach; therefore, they should be used with caution in cases with poor appetite, weakness of the spleen and stomach, or diarrhea. In addition, they serve as auxiliary herbs in combination with toxic herbs, or with herbs that nourish Yin.
Prescriptions chiefly composed of cool and cold herbs, which have the functions of clearing away heat, purging fire, cooling blood and releasing toxins, and are applied in treating interior heat syndromes, are called “heat-clearing Prescriptions.” These prescriptions can be subdivided into seven categories:
(1)Prescriptions for clearing away heat from Qi level: This type of formula promotes the production of body fluids, and relieves dysphoria and thirst. These prescriptions are applicable to the syndrome of excessive heat at Qi level.
(2)Prescriptions for removing heat from Ying level and blood: These prescriptions are chiefly composed of herbs that clear away heat from Ying, nourish Yin, cool blood, and remove stasis. They are utilized against the syndrome of heat accumulation at Ying level and in blood.
(3)Heat-clearing and detoxifying prescriptions: These are chiefly composed of bitter and cool herbs that purge fire, and are used in cases of pestilence and virulent heat pathogens.
(4)Prescriptions for treating carbuncles: These are able to detoxify and reduce swelling.
(5)Prescriptions for removing heat from Zang–Fu organs: Made from herbs aimed at clearing away fire-heat from either Zang or Fu organs, these are applicable to the syndrome of heat dominating a particular Zang or Fu organ.
(6)Prescriptions for clearing deficiency heat: Comprising herbs that remove heat, nourish Yin, and expel pathogenic factors, these prescriptions are applicable to the syndrome of Yin impairment due to excessive heat.
(7)Prescriptions for clearing summer heat: These are applicable to the syndrome caused by the attack of pathogenic summer heat.
The heat-clearing herbs and herbal prescriptions are:
Herbs That Clear Heat
Herbs that Clear Heat and Reduce Fire（清热泻火药）
Herbs that clear heat and reduce fire are mainly indicated for syndromes of heat at the Qi level due to exogenous pathogenic heat invasion, manifested as high fever, sweating, thirst, delirium, irritability, scanty brown urine, a yellow dry tongue coating, a surging forceful pulse, and excessive heat in the lungs, stomach, and heart.
(i) Gypsum (Shi Gao, 
)
Pharmaceutical Name: Gypsum Fibrosum
Part Used: The mineral is ground into powder
Properties: Sweet, pungent, and very cold
Channel Tropism: Lung and stomach
| Functions: | (a) | To clear heat and sedate fire; |
| (b) | To relieve irritability and thirst. |
Applications:
(a)Excessive heat at the Qi level due to invasion of exogenous pathogenic heat, manifested as high fever, irritability, thirst, profuse sweating and surging, and rapid a forceful pulse. Gypsum (Shi Gao, 
) is used with Anemarrhena rhizome (Zhi Mu, 
).
(b)Excessive heat at both the Qi and the blood level due to invasion of exogenous pathogenic heat, manifested as continual high fever and maculopapules. Gypsum (Shi Gao, 
) is used with Scrophularia (Xuan Shen, 
) and Rhinoceros horn (Xi Jiao, 
).
(c)Heat in the lungs manifested as cough and asthma accompanied by fever, thirst, and a desire to drink. Gypsum (Shi Gao, 
) is used with Ephedra (Ma Huang, 
) and Apricot seed (Xing Ren, 
).
(d)Flaring-up of stomach fire manifested as toothache, swollen painful gums, and headache. Gypsum (Shi Gao, 
) is used with Fresh Rehmannia root (Sheng Di Huang, 
) and Anemarrhena rhizome (Zhi Mu, 
).
(e)Eczema, burns, and dermal abscesses, Gypsum (Shi Gao, 
) is used with Natural indigo (Qing Dai, 
) and Phellodendron bark (Huang Bai, 
).
(f)Dosage: 15–60 g.
Cautions and Contraindications: This herb is contraindicated in cases with a weak stomach.
(ii) Anemarrhena rhizome (Zhi Mu, 
)
Pharmaceutical Name: Rhizoma Anemarrhenae
Part Used: Rhizome
Properties: Sweet, bitter, and cold
Channel Tropism: Lung, stomach, and kidney
| Functions: | (a) | To clear heat and reduce fire; |
| (b) | To nourish yin and moisten dryness. |
Applications:
(a)Excessive heat at the Qi level. Anemarrhena rhizome (Zhi Mu, 
) is used with Gypsum (Shi Gao, 
).
(b)Cough due to heat in the lungs or dry cough due to deficient Yin. Anemarrhena rhizome (Zhi Mu, 
) is used with Tendrilled fritillary bulb (Chuan Bei Mu, 
).
(c)Deficient yin of the lungs and kidneys with heat signs, manifested as afternoon fever, night sweats, and a feverish sensation in the palms, soles, and chest. Anemarrhena rhizome (Zhi Mu, 
) is used with Phellodendron bark (Huang Bai, 
).
(d)Diabetes, manifested as extreme thirst and hunger, and profuse urine. Anemarrhena rhizome (Zhi Mu, 
) is used with Trichosanthes root (Tian Hua Fen, 
), Ophiopogon root (Mai Dong, 
), and Pueraria root (Ge Gen, 
).
(e)Dosage: 6–12 g.
Cautions and Contraindications: This herb is contraindicated when there is diarrhea due to weakness of the spleen.
(iii) Reed root (Lu Gen, 
)
Pharmaceutical Name: Rhizoma Phragmitis
Part Used: Rhizome
Properties: Sweet and cold
Channel Tropism: Lung and stomach
| Functions: | (a) | To clear heat and relieve irritability; |
| (b) | To promote the production of body fluids and relieve thirst; | |
| (c) | To stop vomiting. |
Applications:
(a)Febrile disease, manifested as thirst, irritability, and fever. Reed root (Lu Gen, 
) is used with Gypsum (Shi Gao, 
), Ophiopogon root (Mai Dong, 
), and Trichosanthes root (Tian Hua Fen, 
).
(b)Heat in the stomach with vomiting and belching. Reed root (Lu Gen, 
) is used with the juice of Fresh ginger (Sheng Jiang, 
), Bamboo shavings (Zhu Ru, 
), and Loquat leaf (Pi Pa Ye, 
).
(c)Heat in the lungs, manifested as cough, expectoration of thick yellow sputum, and pulmonary abscess. Reed root (Lu Gen, 
) is used with Honeysuckle flower (Jin Yin Hua, 
), Houttuynia (Yu Xing Cao, 
), and Benincasa seed (Dong Gua Ren, 
).
(d)Dosage: 6–12 g.
Cautions and Contraindications: This herb should be used with caution in cases with cold and a deficient spleen and stomach.
(iv) Trichosanthes root (Tian Hua Fen, 
)
Pharmaceutical Name: Radix Trichosanthis Part Used: Root
Properties: Bitter, slightly sweet, and cold
Channel Tropism: Lung and stomach
| Functions: | (a) | To clear heat and promote the production of body fluids; |
| (b) | To reduce swelling and dispel pus. |
Applications:
(a)Thirst in febrile disease. Trichosanthes root (Tian Hua Fen, 
) is used with Glehnia root (Sha Shen, 
), Ophiopogon root (Mai Dong, 
), and Reed root (Lu Gen, 
).
(b)Extreme thirst in diabetes. Trichosanthes root (Tian Hua Fen, 
) is used with Pueraria root (Ge Gen, 
), Schisandra fruit (Wu Wei Zi, 
), and Anemarrhena rhizome (Zhi Mu, 
).
(c)Dry cough due to lung heat. Trichosanthes root (Tian Hua Fen, 
) is used with Mulberry bark (Sang Bai Pi, 
), Tendrilled fritillary bulb (Chuan Bei Mu, 
), and Platycodon root (Jie Geng, 
).
(d)Boils and carbuncles. Trichosanthes root (Tian Hua Fen, 
) is used with Forsythia fruit (Lian Qiao, 
), Dandelion herb (Pu Gong Ying, 
), Tendrilled fritillary bulb (Chuan Bei Mu, 
), and Honeysuckle flower (Jin Yin Hua, 
).
(e)Dosage: 9–15 g.
Cautions and Contraindications: This herb should be used with caution during pregnancy.
(v) Cape jasmine (Zhi Zi, 
)
Pharmaceutical Name: Fructus Gardeniae
Part Used: Fruit
Properties: Bitter and cold
Channel Tropism: Heart, liver, lung, stomach, and triple Jiao
| Functions: | (a) | To clear heat and reduce fire; |
| (b) | To cool blood and release toxins; | |
| (c) | To eliminate dampness. |
Applications:
(a)Febrile disease with high fever, irritability, delirium, and loss of consciousness. Cape jasmine (Zhi Zi, 
) is used with Prepared soybean (Dou Chi, 
), Forsythia fruit (Lian Qiao, 
), and Scutellaria root (Huang Qin, 
).
(b)Jaundice with fever and dysuria. Cape jasmine (Zhi Zi, 
) is used with Oriental wormwood (Yin Chen Hao, 
), Rhubarb (Da Huang, 
), and Phellodendron bark (Huang Bai, 
).
(c)Heat in the blood, manifested as vomiting blood, epistaxis, and hematuria. Cape jasmine (Zhi Zi, 
) is used with Imperata rhizome (Bai Mao Gen, 
), Fresh Rehmannia root (Sheng Di Huang, 
), and Scutellaria root (Huang Qin, 
).
(d)Boils and carbuncles, Cape jasmine (Zhi Zi, 
) is used with Coptis root (Huang Lian, 
), Scutellaria root (Huang Qin, 
), and Honeysuckle flower (Jin Yin Hua, 
).
(e)Dosage: 3–12 g.
Cautions and Contraindications: The herb is contraindicated in cases with weakness of the spleen and diarrhea.
(vi) Prunella spike (Xia Ku Cao, 
)
Pharmaceutical Name: Spica Prunellae
Part Used: Spike
Properties: Bitter, pungent, and cold
Channel Tropism: Liver and gall bladder
| Functions: | (a) | To clear fire in the liver; |
| (b) | To dissipate accumulation of nodules. |
Applications:
(a)Flaring-up of liver fire, manifested as red, painful, swollen and watery eyes, headache, and dizziness. Prunella spike (Xia Ku Cao, 
) is used with Sea-ear shell (Shi Jue Ming, 
) and Chrysanthemum flower (Ju Hua, 
).
(b)Accumulation of phlegm-fire, manifested as scrofula, lipoma, swollen glands, or goiter. Prunella spike (Xia Ku Cao, 
) is used with Oyster shell (Mu Li, 
), Scrophularia (Xuan Shen, 
), and Laminaria (Kun Bu, 
).
(c)Dosage: 3–10 g.
Cautions and Contraindications: This herb should be used with caution in cases with a weak stomach and spleen.
Herbs That Clear Heat and Dry Dampness （清热燥湿药）
Herbs that clear heat and dry dampness are characterized as bitter and cold. They are indicated in damp-heat disorders manifested as fever, a sticky tongue coating, scanty urine, jaundice, dysentery and diarrhea, furuncles, eczema, abnormal vaginal discharge, and turbid urine. The herbs in this category are likely to weaken the stomach and consume Yin, and should therefore be used with caution in cases with a weakened spleen and stomach, or deficient body fluids. If necessary, the herbs should be combined with herbs that nourish Yin.
(i) Scutellaria root (Huang Qin, 
)
Pharmaceutical Name: Radix Scutellariae
Part Used: Root
Properties: Bitter and cold
Channel Tropism: Lung, gall bladder, stomach, and large intestine
| Functions: | (a) | To clear heat and dry dampness; |
| (b) | To reduce fire and release toxins; | |
| (c) | To stop bleeding and calm the fetus. |
Applications:
(a)Damp-heat syndromes: (1) damp-heat febrile disease — Scutellaria root (Huang Qin, 
) is used with talc (Hua Shi, 
) and Rice paper pith (Tong Cao, 
); (2) jaundice — Scutellaria root (Huang Qin, 
) is used with Cape jasmine (Zhi Zi, 
), Oriental wormwood (Yin Chen Hao, 
), and Bamboo leaf (Zhu Ye, 
); (3) dysentery or diarrhea — Scutellaria root (Huang Qin, 
) is used with Coptis root (Huang Lian, 
); (4) boils, carbuncles, and furuncles — Scutellaria root (Huang Qin, 
) is used with Honeysuckle flower (Jin Yin Hua, 
) and Trichosanthes root (Tian Hua Fen, 
).
(b)Cough due to heat in the lungs. Scutellaria root (Huang Qin, 
) is used with Mulberry bark (Sang Bai Pi, 
) and Anemarrhena rhizome (Zhi Mu, 
).
(c)Hemorrhage due to heat in the blood, manifested as vomiting with blood, epistaxis, hematuria, and uterine bleeding. Carbonized Scutellaria root (Huang Qin, 
) is used with Fresh Rehmannia root (Sheng Di Huang, 
), Imperata rhizome (Bai Mao Gen, 
), and Biota tops (Ce Bai Ye, 
).
(d)Threatened abortion (restless fetus). Scutellaria root (Huang Qin, 
) is used with Chinese Angelica root (Dang Gui, 
) and White Atractylodes (Bai Zhu, 
).
(e)Dosage: 3–10 g.
Cautions and Contraindications: This herb is contraindicated in cases with deficiency cold of the spleen and stomach. The raw herb is used to calm the fetus by clearing heat, the herb stirbaked in wine is used to stop bleeding, and the carbonized herb clears heat in the upper Jiao.
(ii) Coptis root (Huang Lian, 
)
Pharmaceutical Name: Rhizoma Coptidis
Part Used: Five- to seven-year-old root or rhizome
Properties: Bitter and cold
Channel Tropism: Heart, liver, stomach, and large intestine
| Functions: | (a) | To clear heat and dry dampness; |
| (b) | To reduce fire and dispel toxins. |
Applications:
(a)Damp-heat syndromes: (1) damp-heat blocking the middle Jiao manifested as a full sensation in the epigastric region and vomiting — Coptis root (Huang Lian, 
) is used with Scutellaria root (Huang Qin, 
), Pinellia tuber (Ban Xia, 
), and Dried ginger (Gan Jiang, 
); (2) damp-heat accumulated in the intestines manifested as diarrhea or dysentery — Coptis root (Huang Lian, 
) is used with Scutellaria root (Huang Qin, 
) and Pueraria root (Ge Gen, 
); if the resulting manifestation is tenesmus, Coptis root (Huang Lian, ) is used with Costus root (Mu Xiang, 
).
(b)Liver fire attacking the stomach, manifested as vomiting. Coptis root (Huang Lian, 
) is used with Evodia fruit (Wu Zhu Yu, 
). However, when stomach heat causes vomiting, Coptis root (Huang Lian, 
) is used with Bamboo shavings (Zhu Ru, 
).
(c)Febrile disease, manifested as high fever, irritability, loss of consciousness, and delirium. Coptis root (Huang Lian, 
) is used with Gypsum (Shi Gao, 
) and Cape jasmine (Zhi Zi, 
).
(d)Boils, carbuncles, and furuncles. Coptis root (Huang Lian, 
) is used with Scutellaria root (Huang Qin, 
), Honeysuckle flower (Jin Yin Hua, 
), Forsythia fruit (Lian Qiao, 
), and Cape jasmine (Zhi Zi, 
).
(e)Excessive fire in the stomach. If the manifestation is hunger after consumption of sufficient food, Coptis root (Huang Lian, 
) is used with fresh Rehmannia root (Sheng Di Huang, 
) and Trichosanthes root (Tian Hua Fen, 
). If the manifestation is a toothache, Coptis root (Huang Lian, 
) is used with Cimicifuga rhizome (Sheng Ma, 
) and Fresh Rehmannia root (Sheng Di Huang, 
).
(f)Dosage: 1–5 g.
Cautions and Contraindications: This herb should be used with caution; large doses may weaken the stomach.
(iii) Phellodendron bark (Huang Bai, 
)
Pharmaceutical Name: Cortex Phellodendri
Part Used: The bark
Properties: Bitter and cold
Channel Tropism: Kidney, urinary bladder, and large intestine
| Functions: | (a) | To clear heat and dry dampness; |
| (b) | To reduce fire and release toxins. |
Applications:
(a)Damp-heat syndrome: (1) damp-heat accumulated in the intestines manifested as diarrhea and dysentery — Phellodendron bark (Huang Bai, 
) is used with Pulsatilla root (Bai Tou Weng, 
), Coptis root (Huang Lian, 
), and Scutellaria root (Huang Qin, 
); (2) internal accumulation of damp-heat manifested as jaundice — Phellodendron bark (Huang Bai, 
) is used with Cape jasmine (Zhi Zi, 
) and Oriental wormwood (Yin Chen Hao, 
); (3) downward flow of damp-heat, turbid urination, and yellow thick leucorrhea — Phellodendron bark (Huang Bai, 
) is used with Plantain seed (Che Qian Zi, 
), Bamboo leaf (Zhu Ye, 
), and Clematis stem (Mu Tong, 
); (4) boils caused by dampness in the lower part of the body — Phellodendron bark (Huang Bai, 
) is used with Atractylodes rhizome (Cang Zhu, 
).
(b)General boils, carbuncles, furuncles, and eczema. Phellodendron bark (Huang Bai, 
) is used with Scutellaria root (Huang Qin, 
) and Cape jasmine (Zhi Zi, 
) For external use, Phellodendron bark (Huang Bai, 
) is pounded into a powder mixed with Talc (Hua Shi, 
).
(c)Deficiency of Yin with heat, manifested as nocturnal emissions and night sweats. Phellodendron bark (Huang Bai, 
) is used with Anemarrhena rhizome (Zhi Mu, 
) and Fresh Rehmannia root (Sheng Di Huang, 
).
(d)Dosage: 3–10 g.
Cautions and Contraindications: This herb is contraindicated in cases with weakness and cold in the spleen and stomach.
(iv) Chinese gentian (Long Dan Cao, 
)
Pharmaceutical Name: Radix gentianae
Part Used: Root or rhizome
Properties: Bitter and cold
Channel Tropism: Liver, gall bladder, and stomach
| Functions: | (a) | To clear heat and dry dampness; |
| (b) | To reduce fire in the liver. |
Applications:
(a)Damp-heat syndrome: (1) damp-heat jaundice — Chinese gentian (Long Dan Cao 
) is used with Oriental wormwood (Yin Chen Hao, 
) and Cape jasmine (Zhi Zi, 
); (2) damp-heat leukorrhea manifested as pain and swelling in the genitals and eczema. Chinese gentian (Long Dan Cao, 
) is used with Phellodendron bark (Huang Bai, 
), Flavescent sophora root (Ku Shen, 
), and Plantain seed (Che Qian Zi, 
).
(b)Upward attack of liver fire, manifested as headache, a feeling of distension in the head, red eyes, deafness, and pain in the costal region. Chinese gentian (Long Dan Cao, 
) is used with Scutellaria root (Huang Qin, 
), Cape jasmine (Zhi Zi, 
), Bupleurum root (Chai Hu, 
), and Clematis stem (Mu Tong, 
).
(c)Fever, spasms, and convulsions. Chinese gentian (Long Dan Cao, 
) is used with Uncaria stem (Gou Teng, 
) and Ox gallstone (Niu Huang, 
).
(d)Dosage: 3–6 g.
Cautions and Contraindications: This herb is contraindicated in cases with weakness and cold in the spleen and stomach.
(v) Flavescent sophora root (Ku Shen, 
)
Pharmaceutical Name: Radix Sophorae Flavescentis
Part Used: Root
Properties: Bitter and cold
Channel Tropism: Heart, liver, stomach, large intestine, and urinary bladder
| Functions: | (a) | To clear heat and dry dampness; |
| (b) | To promote urination; | |
| (c) | To disperse wind and stop itching. |
Applications:
(a)Damp-heat syndrome: (1) damp-heat jaundice — Flavescent sophora root (Ku Shen, 
) is used with Phellodendron bark (Huang Bai, 
), Cape jasmine (Zhi Zi, 
), Chinese gentian (Long Dan Cao, 
), and Oriental wormwood (Yin Chen Hao, 
); (2) damp-heat diarrhea and dysentery — Flavescent sophora root (Ku Shen, 
) is used with Costus root (Mu Xiang, 
) and Licorice root (Gan Cao, 
); (3) damp-heat leukorrhea and eczema of the genitals — Flavescent sophora root (Ku Shen, 
) is used with Phellodendron bark (Huang Bai, 
) and Chinese gentian (Long Dan Cao, 
).
(b)Skin diseases, including itching of the skin, scabies, and impetigo. Flavescent sophora root (Ku Shen, 
) can be used internally and externally. The herb is combined with Chinese Angelica root (Dang Gui, 
) and Red peony (Chi Shao, 
).
(c)Painful urination caused by damp-heat. Flavescent sophora root (Ku Shen, 
) is used with Dandelion herb (Pu Gong Ying, 
) and Pyrrosia leaf (Shi Wei, 
).
(d)Dosage: 3–10 g.
Cautions and Contraindications: This herb should never be used together with the herb Black false hellebore (Li Lu, 
) It is contraindicated with weakness and cold in the spleen and stomach.
Herbs That Clear Heat and Cool Blood （清热凉血药）
Herbs that clear heat and cool blood are indicated in syndromes due to excessive heat at the blood level. The clinical manifestations are shown in various hemorrhagic conditions, including epistaxis, bloody stools and urine, functional uterine bleeding, vomiting or spitting up blood, coughing up blood, and bleeding of the gums. These herbs are also used for fever with loss of consciousness, a deep red tongue, and a rapid pulse. This category of herbs tends to be bitter and sweet–salty in flavor and cold in property.
(i) Rhinoceros horn (Xi Jiao, 
)
Pharmaceutical Name: Cornu Rhinoceri Part Used: Horn
Properties: Bitter, salty, and cold
Channel Tropism: Heart, liver, and stomach
| Functions: | (a) | To clear heat and relieve convulsions; |
| (b) | To cool blood and release toxins. |
Applications:
(a)Hemorrhagic disease due to extravasation of blood by heat, manifested as vomiting with blood, epistaxis, and subcutaneous bleeding. Rhinoceros horn (Xi Jiao, 
) is used with Rehmannia root (Sheng Di Huang, 
), Moutan bark (Mu Dan Pi, 
), and Red peony (Chi Shao, 
).
(b)Fever, unconsciousness, delirium, and convulsions. Rhinoceros horn (Xi Jiao, 
) is used with Isatis leaf (Da Qing Ye, 
), Gypsum (Shi Gao, 
), and Antelope horn (Ling Yang Jiao, 
).
(c)Dosage: 1.5–3 g.
Cautions and Contraindications: Rhinoceros horn should not be mixed with Wild aconite root (Cao Wu, 
) and Monkshood root (Chuan Wu, 
), and must be used with caution during pregnancy.
Note: Although rhinoceros horn is a traditional medicinal substance, its scarcity encourages the common substitution of water buffalo horn.
(ii) Fresh Rehmannia root (Sheng Di Huang, 
)
Pharmaceutical Name: Radix Rehmanniae Part Used: Root
Properties: Sweet, bitter, and cold
Channel Tropism: Heart, liver, and kidney
| Functions: | (a) | To clear heat and cool blood; |
| (b) | To nourish Yin and promote the production of body fluids. |
Applications:
(a)Exogenous heat invading the nutritive and blood levels, manifested as dry mouth and deep-red tongue proper with a scanty coating. It is used with Scrophularia (Xuan Shen, 
), Rhinoceros horn (Xi Jiao, 
), and Ophiopogon root (Mai Dong, 
).
(b)Consumption of yin and body fluids in the late stage of febrile diseases, manifested as a fever without sweating, which occurs at night and subsides in the morning. Fresh Rehmannia root (Sheng Di Huang, 
) is used with Anemarrhena rhizome (Zhi Mu, 
), Sweet wormwood (Qing Hao, 
), and Turtle shell (Bie Jia, 
).
(c)Hemorrhaging due to extravasation of blood by heat, manifested as vomiting with blood, epistaxis, bloody urine, bloody stools, and functional uterine bleeding.
(d)Febrile disease with excessive toxic heat in the blood, epistaxis, and maculopapules. Fresh Rehmannia root (Sheng Di Huang, 
) is used with Rhinoceros horn (Xi Jiao, 
), Moutan bark (Mu Dan Pi, 
), and Red peony (Chi Shao, 
).
(e)Febrile disease with consumption of body fluids, manifested as red tongue proper, dry mouth, thirst, and excessive drinking. Fresh Rehmannia root (Sheng Di Huang, 
) is used with Fragrant solomonseal rhizome (Yu Zhu, 
), Ophiopogon root (Mai Dong, 
), Glehnia root (Sha Shen, 
), and Dendrobium (Shi Hu, 
) If there is constipation, Fresh Rehmannia root (Sheng Di Huang, 
) is used with Scrophularia (Xuan Shen, 
) and Ophiopogon root (Mai Dong, 
).
(f)Dosage: 9–30 g.
Cautions and Contraindications: This herb is contraindicated in cases with deficiency and excessive dampness of the spleen, a full sensation in the abdominal region, or diarrhea.
(iii) Scrophularia (Xuan Shen, 
)
Pharmaceutical Name: Radix Scrophulariae
Part Used: Root
Properties: Bitter, sweet–salty, and cold
Channel Tropism: Lung, stomach, and kidney
| Functions: | (a) | To clear heat and nourish Yin; |
| (b) | To release toxins and nodules. |
Applications:
(a)Sore throat caused by exogenous pathogenic wind. Scrophularia (Xuan Shen, 
) is used with Arctium fruit (Niu Bang Zi, 
), Platycodon root (Jie Geng, 
), and Mentha (Bo He, 
).
(b)Sore throat caused by excessive interior heat. Scrophularia (Xuan Shen, 
) is used with Ophiopogon root (Mai Dong, 
), Platycodon root (Jie Geng, 
), and Licorice root (Gan Cao, 
).
(c)Boils, carbuncles, and furuncles. Scrophularia (Xuan Shen, 
) is used with Honeysuckle flower (Jin Yin Hua, 
) and raw Licorice root (Gan Cao, 
).
(d)Scrofula, goiter, and subcutaneous nodules. Scrophularia (Xuan Shen, 
) is used with Tendrilled fritillary bulb (Chuan Bei Mu, 
) and Oyster shell (Mu Li, 
).
(e)Febrile disease in which pathogenic factors attack the nutritive and blood levels: (1) thirst, fever, insomnia, and deep-red tongue proper with a scanty coating — Scrophularia (Xuan Shen, 
) is used with Fresh Rehmannia root (Sheng Di Huang, 
) and Ophiopogon root (Mai Dong, 
); (2) high fever, unconsciousness, and maculopapules — Scrophularia (Xuan Shen, 
) is used with Anemarrhena rhizome (Zhi Mu, 
) and Gypsum (Shi Gao, 
).
(f)Constipation due to dryness in the intestines. Scrophularia (Xuan Shen, 
) is used with Fresh Rehmannia root (Sheng Di Huang, 
) and Ophiopogon root (Mai Dong, 
).
(g)Dosage: 9–30 g.
Cautions and Contraindications: Scrophularia (Xuan Shen, 
) is contraindicated in cases with weakness of the spleen and stomach and should not be combined with Black false hellebore (Li Lu, 
).
(iv) Moutan bark (Mu Dan Pi, 
)
Pharmaceutical Name: Cortex Moutan
Part Used: Bark
Properties: Bitter, pungent, and slightly cold
Channel Tropism: Heart, liver, and kidney
| Functions: | (a) | To clear heat and cool blood; |
| (b) | To invigorate blood and resolve blood stagnation. |
Applications:
(a)Febrile disease in which pathogenic heat enters the blood level, manifested as fever, vomiting with blood, epistaxis, blood in the urine, maculopapules and deep-red tongue proper. Moutan bark (Mu Dan Pi, 
) is used with Fresh Rehmannia root (Sheng Di Huang, 
), Rhinoceros horn (Xi Jiao, 
), and Red peony (Chi Shao, 
).
(b)Late stage of febrile diseases with exhaustion of body fluids or yin deficiency, manifested as a fever without sweating which occurs at night and subsides in the morning, red tongue proper with scanty coating, and a thready rapid pulse. Moutan bark (Mu Dan Pi, 
) is used with Anemarrhena rhizome (Zhi Mu, 
), Fresh Rehmannia root (Sheng Di Huang, 
), Turtle shell (Bie Jia, 
), and Sweet wormwood (Qing Hao, 
).
(c)Blood stagnation, manifested as amenorrhea, dysmenorrhea, hard masses, lumps, tumors, and modules. Moutan bark (Mu Dan Pi, 
) is used with Peach seed (Tao Ren, 
), Cinnamon twigs (Gui Zhi, 
), Red peony (Chi Shao, 
) and Poria (Fu Ling, 
).
(d)Boil carbuncles and furuncles. Moutan bark (Mu Dan Pi, 
) is used with Honeysuckle flower (Jin Yin Hua, 
) and Forsythia fruit (Lian Qiao, 
).
(e)Dosage: 6–12 g.
Cautions and Contraindications: Care should be taken when it is used during excessive menstruation or pregnancy.
(v) Red peony (Chi Shao, 
)
Pharmaceutical Name: Radix Paeoniae Rubra
Part Used: Root
Properties: Bitter and slightly cold
Channel Tropism: Liver
| Functions: | (a) | To clear heat and cool blood; |
| (b) | To remove stagnant blood and reduce swelling. |
Applications:
(a)Febrile disease in which exogenous pathogenic heat enters the nutritive and blood levels, manifested as maculopapules, vomiting with blood, epistaxis, and deep-red tongue proper. Red peony (Chi Shao, 
) is used with Fresh Rehmannia root (Sheng Di Huang, 
) and Moutan bark (Mu Dan Pi, 
).
(b)Blood stagnation, manifested as dysmenorrhea, amenorrhea, acute inflammation with red swelling, and pain from external injury. Red peony (Chi Shao, 
) is used with Chuan Xiong rhizome (Chuan Xiong, 
), Chinese Angelica root (Dang Gui, 
), Peach seed (Tao Ren, 
), and Safflower (Hong Hua, 
).
(c)Boils, carbuncles, and furuncles. Red peony (Chi Shao, 
) is used with Honeysuckle flower (Jin Yin Hua, 
) and Forsythia fruit (Lian Qiao, 
).
(d)Dosage: 6–15 g.
Cautions and Contraindications: This herb should not be combined with Black false hellebore (Li Lu, 
).
Herbs That Clear Heat and Release Toxins （清热解毒药）
The category of herbs that clear heat and release toxins is indicated in syndromes caused by excessive toxic heat, including boils, carbuncles, furuncles, maculopapules, erysipelas, sore throat, and dysentery. Some of these herbs may help arrest the growth of cancerous cells and release the poison from snakebites.
(i) Honeysuckle flower (Jin Yin Hua, 
)
Pharmaceutical Name: Flos Lonicerae
Part Used: Bud
Properties: Sweet and cold
Channel Tropism: Lung, stomach, and large intestine
Function: To clear heat and release toxins.
Applications:
(a)Febrile disease: (1) exogenous pathogenic heat at the defensive and Qi levels, manifested as fever, thirst, slight aversion to wind and cold, and sore throat — Honeysuckle flower (Jin Yin Hua, 
) is used with Forsythia fruit (Lian Qiao, 
) and Arctium fruit (Niu Bang Zi, 
); (2) exogenous pathogenic heat at the Qi level, manifested as high fever, extreme thirst, and a large surging pulse — Honeysuckle flower (Jin Yin Hua, 
) is used with Gypsum (Shi Gao, 
) and Anemarrhena rhizome (Zhi Mu, 
); (3) exogenous pathogenic heat at the nutritive and blood levels, manifested as a maculopapule that appears as a dull, deep-red and dry tongue, irritability, and insomnia — Honeysuckle flower (Jin Yin Hua, 
) is used with Moutan bark (Mu Dan Pi, 
) and Fresh Rehmannia root (Sheng Di Huang, 
).
(b)Boils, carbuncles, and furuncles, Honeysuckle flower (Jin Yin Hua, 
) is used alone or is combined with Dandelion herb (Pu Gong Ying, 
), Chrysanthemum flower (Ju Hua, 
), and Forsythia fruit (Lian Qiao, 
).
(c)Toxic heat diarrhea. Honeysuckle flower (Jin Yin Hua, 
) is used with Coptis root (Huang Lian, 
) and Pulsatilla root (Bai Tou Weng, 
).
(d)Dosage: 10–16 g.
Cautions and Contraindications: This herb can be applied externally.
(ii) Forsythia fruit (Lian Qiao, 
)
Pharmaceutical Name: Fructus Forsythiae
Part Used: Green fruit
Properties: Bitter and slightly cold
Channel Tropism: Heart, lung, and gall bladder
| Functions: | (a) | To clear heat and release toxins; |
| (b) | To relieve carbuncles and disperse nodules. |
Applications:
(a)Febrile disease: (1) exogenous pathogenic heat at the defensive Qi level, manifested as headache, fever, thirst, and sore throat — Forsythia fruit (Lian Qiao, 
) is used with Arctium fruit (Niu Bang Zi, 
) and Mentha (Bo He, 
); (2) exogenous pathogenic heat entering the pericardium, manifested as high fever, irritability, and loss of consciousness — Forsythia fruit (Lian Qiao, 
) is used with Rhinoceros horn (Xi Jiao, 
) and Lotus seed (Lian Zi, 
).
(b)Boils, carbuncles, and furuncles. Forsythia fruit (Lian Qiao, 
) is used with Wild chrysanthemum flower (Ye Ju Hua, 
) and Honeysuckle flower (Jin Yin Hua,
).
(c)Scrofula. Forsythia fruit (Lian Qiao, 
) is used with Prunella spike (Xia Ku Cao, 
), Scrophularia (Xuan Shen, 
), and Tendrilled fritillary bulb (Chuan Bei Mu, 
).
(d)Dosage: 6–16 g.
Cautions and Contraindications: This herb is contraindicated in cases of heat in the blood due to deficient Yin, and diarrhea due to weakness of the spleen.
(iii) Isatis leaf (Da Qing Ye, 
)
Pharmaceutical Name: Folium Isatidis
Part Used: Leaf
Properties: Bitter and very cold
Channel Tropism: Heart, lung, and stomach
Functions: To clear heat and release toxins
Applications:
(a)Sore throat, erysipelas, boils, carbuncles, and furuncles. Isatis leaf (Da Qing Ye, 
) is used with Scrophularia (Xuan Shen, 
) and Honeysuckle flower (Jin Yin Hua, 
).
(b)High fever with maculopapules. Isatis leaf (Da Qing Ye, 
) is used with Moutan bark (Mu Dan Pi, 
).
(c)Dosage: 10–16 g.
Cautions and Contra Indications: This herb is contraindicated in cases with weakness and cold in the spleen and stomach.
(iv) Ox gallstone (Niu Huang, 
)
Pharmaceutical Name: Calculus Bovis
Part Used: Gallstone
Properties: Bitter and cool
Channel Tropism: Liver and heart
| Functions: | (a) | To clear heat and release toxins; |
| (b) | To eliminate endogenous wind and stop convulsions; | |
| (c) | To resolve phlegm and promote resuscitation. |
Applications:
(a)Loss of consciousness and convulsions caused by high fever. Ox gallstone (Niu Huang, 
) is used with Coptis root (Huang Lian, 
), Rhinoceros horn (Xi Jiao, 
), and Musk (She Xiang, 
).
(b)Sore throat or ulcers and boils due to accumulation of toxic heat. Ox gallstone (Niu Huang, 
) is used with Natural indigo (Qing Dai, 
) and Honeysuckle flower (Jin Yin Hua, 
).
(c)Dosage: 0.15–0.3 g.
Cautions and Contraindications: This substance is contraindicated during pregnancy.
(v) Pulsatilla root (Bai Tou Weng, 
)
Pharmaceutical Name: Radix Pulsatillae
Part Used: Root
Properties: Bitter and cold
Channel Tropism: Large intestine
| Functions: | (a) | To clear heat and release toxins; |
| (b) | To cool the blood and stop dysentery. |
Applications:
(a)Dysentery, manifested as fever, abdominal pain, bloody pus-like stools and tenesmus. Pulsatilla root (Bai Tou Weng, 
) is used with Phellodendron bark (Huang Bai, 
) and Coptis root (Huang Lian, 
) in a formula such as Bai Tou Weng Tang.
(b)Dosage: 6–15 g.
(vi) Green chiretta (Chuan Xin Lian, 
)
Pharmaceutical Name: Herba Andrographitis
Part Used: Aerial parts
Properties: Bitter and cold
Channel Tropism: Lung, stomach, large and small intestines
| Functions: | (a) | To clear heat and release toxins; |
| (b) | To dry dampness. |
Applications:
(a)The beginning of warm febrile disease, manifested as fever, headache, and sore throat. Green chiretta (Chuan Xin Lian, 
) is used with Honeysuckle flower (Jin Yin Hua, 
), Platycodon root (Jie Geng, 
), and Arctium fruit (Niu Bang Zi, 
).
(b)Heat in the lungs, manifested as cough and asthma or cough with yellow sputum. Green chiretta (Chuan Xin Lian, 
) is used with Houttuynia (Yu Xing Cao, 
), Platycodon root (Jie Geng, 
), and Trichosanthes fruit (Gua Lou, 
).
(c)Dysentery due to dampness and heat. Green chiretta (Chuan Xin Lian, 
) is used with Portulaca (Ma Chi Xian, 
).
(d)Dosage: 9–15 g.
Cautions and Contraindications: Prolonged overdosing of this herb may impair Stomach-Qi.
Herbs That Clear Heat Caused by Yin Deficiency （清虚热药）
These herbs are indicated in deficiency of Yin with heat syndrome, manifested as fever, afternoon fever, a feverish sensation in the palms, soles and chest, night sweats, red tongue proper with a scanty coating, and a thready rapid pulse. They are often combined with herbs that nourish Yin to strengthen the function of clearing empty heat caused by Yin deficiency. In addition, some of these herbs are indicated in the late stage of febrile diseases caused by invasion of exogenous pathogenic heat, in which Yin and body fluids are damaged and pathogenic factors remain inside. The most commonly seen manifestations are low-grade fever, fever at night, and fever subsiding in the morning without the presence of sweating.
In general, these herbs are not suitable for fever due to the common cold and cases of deficiency of Yin and blood without heat signs.
(i) Sweet wormwood (Qing Hao, 
)
Pharmaceutical Name: Herba artemisiae annuae
Part Used: The entire plant
Properties: Bitter, pungent, and cold
Channel Tropism: Liver, gall bladder, and kidney
| Functions: | (a) | To reduce heat caused by deficient Yin; |
| (b) | To cool the blood and release summer heat; | |
| (c) | To relieve malaria. |
Applications:
(a)Malaria. Sweet wormwood (Qing Hao,
) is used alone or with Scutellaria root (Huang Qin, 
) and Pinellia tuber (Ban Xia, 
).
(b)Late stage of febrile diseases, with pathogenic heat damaging Yin and body fluids, manifested as fever, a fever without sweating which occurs at night and subsides in the morning, red tongue proper with a scanty coating, and a thready rapid pulse. Sweet wormwood (Qing Hao, 
) is used with Turtle shell (Bie Jia, 
), Moutan bark (Mu Dan Pi, 
) and Fresh Rehmannia root (Sheng Di Huang, 
).
(c)Heat signs due to deficient Yin, manifested as afternoon fever and night sweats. Sweet wormwood (Qing Hao, 
) is used with Large-leaf gentian root (Qin Jiao, 
), Turtle shell (Bie Jia, 
), and Anemarrhena rhizome (Zhi Mu, 
).
(d)Invasion of summer heat, manifested as fever, dizziness, and headache. Sweet wormwood (Qing Hao, 
) is used with Mung bean (Lu Dou, 
) and Lotus leaf (He Ye, 
).
(e)Dosage: 3–9 g.
Cautions and contraindications: This herb should not be boiled for a long time.
(ii) Swallow wort root (Bai Wei, 
)
Pharmaceutical Name: Radix Cynanchi
Part Used: Roots or rhizome
Properties: Bitter, salty, and cold
Channel Tropism: Stomach and liver
| Functions: | (a) | To clear heat and cool blood; |
| (b) | To benefit urination and relieve urinary tract infection. |
Applications:
(a)Internal heat and deficient yin, manifested as afternoon fever and night sweats or as febrile disease due to exogenous pathogenic heat at the nutritive and blood levels and accompanied by sustained fever. Swallow wort root (Bai Wei, 
) is used with Wolfberry bark (Di Gu Pi, 
) and Fresh Rehmannia root (Sheng Di Huang, 
).
(b)Postpartum fever caused by deficient yin. Swallow wort root (Bai Wei, 
) is used with Ginseng (Ren Shen, 
) and Chinese Angelica root (Dang Gui, 
).
(c)Urinary tract infection, manifested as heat syndrome or bloody urine. Swallow wort root (Bai Wei, 
) is used with Clematis stem (Mu Tong, 
).
(d)Boils, carbuncles, sore throat, and snakebite. Swallow wort root (Bai Wei, 
) is used externally and internally.
(e)Dosage: 3–9 g.
(iii) Wolfberry bark (Di Gu Pi, 
)
Pharmaceutical Name: Cortex Lycii
Part Used: Bark of the roots
Properties: Sweet or flavorless and cold
Channel Tropism: Lung and kidney
| Functions: | (a) | To cool blood; |
| (b) | To clear heat in the lungs. |
Applications:
(a)Heat in the blood and deficient Yin, manifested as afternoon fever and night sweats. It is used with Anemarrhena rhizome (Zhi Mu, 
) and Turtle shell (Bie Jia, 
).
(b)Heat in the lungs and deficient Yin, manifested as cough, asthma, and cough with blood. It is used with Imperata rhizome (Bai Mao Gen, 
) and Biota tops (Ce Bai Ye, 
).
(c)Dosage: 6–12 g.
Cautions and Contraindications: This herb is contraindicated in cases with fever due to the common cold or weakness of the spleen accompanied by diarrhea.
Herbal Prescriptions That Clear Heat
Prescriptions for Clearing Away Heat from Qi Level （清气分热剂）
(i) Baihu Tang 
(White Tiger Decoction)
| Composition: | Gypsum (Shi Gao,  ) |
30 g |
Licorice (Gan Cao,  ) |
3 g | |
Anemarrhena rhizome (Zhi Mu,  ) |
9 g | |
Rice (Jing Mi,  ) |
9 g |
Administration: Decoct the above herbs until the rice is well done; remove the residue and take the decoction several times.
Functions: To clear away heat and promote the production of body fluids.
Indications: Excessive heat in the Yangming Meridian or in the Qi system, marked by high fever, a flushed face, polydipsia, profuse perspiration, thirst with a preference for cold drinks, aversion to heat, and a full forceful pulse.
Formula Analysis: This syndrome is the result of excessive heat at the Qi level scorching the body fluid. It should be treated by clearing the heat and promoting the production of body fluids. Shi Gao 
with pungent, sweet, and extremely cold properties, the chief herb, is capable of purging heat without impairing body fluid, and expelling pathogenic factors from the muscle to remove heat. It is the important herb for clearing and purging sthenic heat from the Qi phase. Zhi Mu 
, the assistant herb with bitter, cold, and moist properties, clears heat and generates body fluid. Shi Gao 
and Zhi Mu 
enhance each other to powerfully clear heat. Jing Mi 
and Gan Cao 
function as adjuvant herbs that not only reinforce the stomach and protect body fluid, but also protect the stomach-Qi against injury by the extreme cold of Shi Gao 
Gan Cao 
also mediates the herbs’ properties and plays the role of guiding herb. The four herbs used together mainly clear heat from the Qi phase with acrid and cool herbs, help generate body fluid, and benefit the stomach to remove heat and restore body fluid.
Applications in Bio-medicine: Febrile or infectious diseases, and diabetes, where the four characteristics — high fever, polydipsia, profuse perspiration, and a full large pulse — of this syndrome are manifested.
Modifications:
(a)In cases of a large but weak pulse, and thirst that is not quenched by drinking, add Ginseng (Ren Shen, 
). This mixture becomes the formula Baihu Jia Ren Shen Tang.
(b)For arthritis with swelling and painful joints, add Atractylodes rhizome (Cang Zhu, 
) to create the formula Baihu Jia Cang Zhu Tang.
(c)In cases of excess heat causing the stirring up of wind accompanied by spasms of the limbs, add Uncaria stem (Gou Teng, 
), Earthworm (Di Long, 
), and Antelope horn (Ling Yang Jiao, 
).
Prescriptions for Removing Heat from Zang–Fu Organs （清脏腑热）
(i) Daochi San 
(Redness-Removing Powder)
| Composition: | Fresh Rehmannia root (Sheng Di Huang,  ) |
10 g |
Clematis stem (Mu Tong,  ) |
10 g | |
Licorice (Gan Cao,  ) |
10 g | |
Bamboo leaf (Zhu Ye,  ) |
10 g |
Administration: The herbs are ground into powder. 9 g of the power are administered orally for each dosage.
Functions: To remove heart fire and promote urination.
Indications: Fire and heat syndrome in the Heart Meridian, manifested as irritability, a feverish sensation in the chest, thirst, a flushed face, preference for cold drinks, oral ulceration; or dark urine with difficult and painful urination, a red tongue with a thin yellowish coating, and a rapid pulse.
Formula Analysis: This is the common formula for flaring up of heart fire due to the accumulation of heat in the Heart Meridian or heat in the heart invading the small intestine. The syndrome should be treated by clearing heat and fire from the heart, nourishing Yin, and promoting diuresis. Functioning as the chief herb, Mu Tong 
acting on the small intestine removes fire from the heart meridian and purges heat from the small intestine. Sheng Di Huang 
, serving as the assistant herb, acts on the heart and kidney meridians, clears heat from the heart, nourishes the kidney-Yin, and promotes the production of body fluid, when combined with Mu Tong 
, it prevents impairment of Yin. Zhu Ye 
plays the part of adjuvant herb, reducing heat from the heart and dysphoria, relieving restlessness, and inducing heat downward. Sheng Gan Cao 
, the guiding herb, clears heat, removes toxin, relieves painful urination, and coordinates the actions of the other herbs in the formula. The formula not only descends heat, but also nourishes Yin without lingering pathogenic factors, and induces diuresis without consuming Yin.
Applications in Bio-medicine: Stomatitis, thrush, infantile night crying and infantile urinary infection, which pertain to domination of heat in the Heart Meridian.
Modifications:
(a)For severe ulceration of the mouth and tongue, add Coptis root (Huang Lian, 
).
(b)For severe urinary tract infection, add Small thistle (Xiao Ji, 
), Cape jasmine fruit (Zhi Zi, 
), and Plantain seed (Che Qian Zi, 
).
Cautions: This formula is contraindicated in patients with exuberant heat in any other meridian than the heart or in patients with renal insufficiency.
(ii) Longdan Xiegan Tang
(Gentian Liver-Draining Decoction)
| Composition: | Chinese gentian (Long Dan Cao,  ) |
6 g |
Scutellaria root (Huang Qin,  ) |
9 g | |
Cape jasmine fruit (Zhi Zi  ) |
9 g | |
Alismatis rhizome (Ze Xie,  ) |
12 g | |
Clematis stem (Mu Tong,  ) |
9 g | |
Plantain seed (Che Qian Zi,  ) |
9 g | |
Chinese Angelica root (Dang Gui,  ) |
3 g | |
Fresh Rehmannia root (Sheng Di Huang,  ) |
9 g | |
Bupleurum root (Chai Hu,  ) |
6 g | |
Licorice (Gan Cao,  ) |
6 g |
Administration: The herbs are cooked by decoction.
| Functions: | (a) | To clear excessive fire in the liver and gallbladder; |
| (b) | To clear damp-heat in the lower Jiao. |
Indications: Flaring up of fire in the liver and gall bladder, or damp-heat in the lower Jiao, marked by headache, conjunctival congestion, hypochondriac pain, a bitter flavor in the mouth, deafness, and pain and swelling of the middle ear. Other symptoms include stranguria with turbid urine, pruritus and swelling of the vulva, and leukorrhagia, a red tongue with a thick yellowish coating, and a taut rapid pulse.
Formula Analysis: This is the commonly used formula for treating sthenic fire flaming up, and downward flow of dampness and heat of the liver and gall bladder. The syndrome should be treated by purging sthenic fire of the liver and gall bladder, and removing dampness and heat of the lower Jiao. Acting as the chief herb, Long Dan Cao 
purges excess fire in the liver and gall bladder and clears dampness and heat in the lower Jiao. Huang Qin 
and Zhi Zi 
are used in combination to reinforce the effect of Long Dan Cao 
, and together play the role of assistant herbs. Functioning together as adjuvant herbs, Che Qian Zi 
, Mu Tong 
, and Ze Xie 
remove heat and induce diuresis to dispel damp-heat, while Dang Gui 
and Sheng Di Huang 
, nourishing Yin and blood, expel dampness without consuming Yin, and Chai Hu 
regulates the function of liver-Qi, and guides the herb to enter the liver and gall bladder meridians. Gan Cao 
works as the guiding herb clearing heat and coordinating the effects of the other herbs. Additionally, Gan Cao 
protects the stomach against the bitter and cold properties of the other herbs. All the herbs used together possess tonification within purgation, nourishing within promoting, and ascension with descension. These methods descend fire, clear heat, and remove dampness. Diseases occurring along the meridians may all be cured.
Formula Analysis: This is the commonly used formula for treating sthenic fire flaming up, and downward flow of dampness and heat of the liver and gall bladder. The syndrome should be treated by purging sthenic fire of the liver and gall bladder, and removing dampness and heat of the lower Jiao. Acting as the chief herb, Long Dan Cao purges excess fire in the liver and gall bladder and clears dampness and heat in the lower Jiao. Huang Qin and Zhi Zi are used in combination to reinforce the effect of Long Dan Cao , and together play the role of assistant herbs. Functioning together as adjuvant herbs, Che Qian Zi , Mu Tong , and Ze Xie remove heat and induce diuresis to dispel damp-heat, while Dang Gui and Sheng Di Huang , nourishing Yin and blood, expel dampness without consuming Yin, and Chai Hu regulates the function of liver-Qi, and guides the herb to enter the liver and gall bladder meridians. Gan Cao works as the guiding herb clearing heat and coordinating the effects of the other herbs. Additionally, Gan Cao protects the stomach against the bitter and cold properties of the other herbs. All the herbs used together possess tonification within purgation, nourishing within promoting, and ascension with descension. These methods descend fire, clear heat, and remove dampness. Diseases occurring along the meridians may all be cured.
Applications in Bio-medicine: Acute conjunctivitis, acute media otitis, acute icteric hepatitis, acute cholecystitis, hypertension, acute urethritis, acute prostatitis, orchitis, acute pelvic inflammation, and swollen genital organs, all of which pertain to excess fire in the Liver Meridian or damp-heat syndrome in the lower Jiao.
Modifications: In the case of icteric hepatitis, replace Che Qian Zi 
and Ze Xie 
with Oriental wormwood (Yin Chen Hao, 
).
Cautions: It is contraindicated in a patient having a red tongue with a scanty coating.
(iii) Qingwei San 
(Stomach-Clearing Powder)
| Composition: | Fresh Rehmannia root (Sheng Di Huang,  ) |
12 g |
Chinese Angelica root (Dang Gui,  ) |
6 g | |
Moutan bark (Mu Dan Pi,  ) |
9 g | |
Coptis (Huang Lian,  ) |
3–5 g | |
Cimicifuga (Sheng Ma,  ) |
6 g |
Administration: The herbs are ground into powder.
| Functions: | (a) | To clear heat in the stomach; |
| (b) | To cool the blood. |
Indications: Toothache due to fire in the stomach, marked by a headache arising from toothache, feverish cheeks, aversion to heat with a preference for cold, gingival bleeding or ulceration of the gums, or swelling and soreness of the tongue, lips and cheeks, or hot and foul breath, dryness of the mouth and tongue, a red tongue with a yellowish coating, and a smooth rapid pulse.
Formula Analysis: This is the commonly used formula for the syndrome due to the upward attack by stomach heat along the Yangming Meridian of the foot. The syndrome should be treated by clearing stomach heat and cooling and activating the blood to eliminate swelling. Huang Lian 
is used as the chief herb to clear fire in the stomach. Sheng Di Huang 
and Mu Dan Pi 
are the assistant herbs, which cool the blood and nourish Yin and purge heat. Dang Gui 
, the adjuvant herb, nourishes the blood and promotes blood circulation, reduces swelling, and alleviates pain. Sheng Ma 
, with acrid and cold properties, functioning as the guiding herb, dispels fire and removes toxins, disperses the depressed heat accumulation, and leads the other herbs directly to the Yangming Meridian. All herbs in the formula clear the stomach heat with the appendant method of cooling blood for the purpose of simultaneous treatment of Qi and blood.
Applications in Bio-medicine: Stomatitis, periodontitis, trigeminal neuralgia, and other illnesses where the chief symptoms are toothache and gingival swelling due to the flaring-up of stomach fire.
Modifications:
(a)For bleeding gums, add Cyathula root (Niu Xi, 
).
(b)For severely swollen gums, add Honeysuckle flower (Jin Yin Hua, 
).
(iv) Yunu Jian 
(Jade Lady Decoction)
| Composition: | Gypsum (Shi Gao,  ) |
15–30 g |
Prepared Rehmannia root (Shu Di Huang,  ) |
9–30 g | |
Ophiopogon root (Mai Dong,  ) |
6 g | |
Anemarrhena rhizome (Zhi Mu,  ) |
4.5 g | |
Achyranthes (Niu Xi,  ) |
4.5 g |
Administration: Decoct the above herbs for drinking.
Functions: To clear stomach heat and replenish Yin.
Indications: Yin deficiency due to the stomach heat, manifested as toothache, odontoseisis, dysphoria with thirst, or diabetes, polyorexia, a dry red tongue with a dry yellowish coating, and a thready rapid pulse.
Formula Analysis: The syndrome results from the flaring-up of stomach fire due to deficiency of kidney-Yin, and should be treated by purging the fire from the stomach and nourishing the kidney-Yin. Shi Gao 
, the chief herb, clears heat from the stomach. Shu Di Huang 
, the assistant herb, invigorates kidney-Yin. When combined, these two herbs have the effect of clearing fire and nourishing body fluids. Zhi Mu 
, with bitter and cold properties, reinforces the effect of Shi Gao 
in purging fire and heat from the stomach, and also assists Shu Di Huang 
in nourishing kidney-Yin. Mai Dong 
helps Shu Di Huang 
to nourish kidney-Yin and benefits the stomach. Niu Xi 
leads the heat and blood downward, and tonifies the liver and kidney. The above three herbs serve as adjuvant herbs. The five herbs used together remove the stomach heat, strengthen the kidney, and cure the diseases.
Applications in Bio-medicine: Periodontitis, acute stomatitis and diabetes, and other related diseases, which belong to the syndromes of stomach heat and Yin deficiency.
Modifications: For severe gingival swelling, bleeding, and ulceration, replace Shu Di Huang 
with Fresh Rehmannia root (Sheng Di Huang, 
), Moutan bark (Mu Dan Pi, 
), and Scrophularia (Xuan Shen, 
).
Prescriptions for Removing Heat from Ying Level and Blood （清营凉血）
(i) Qingying Tang 
(Nutrient-Clearing Decoction)
| Composition: | Rhinoceros horn (Xi Jiao,  ) |
30 g |
Fresh Rehmannia root (Sheng Di Huang,  ) |
15 g | |
Red sage root (Dan Shen,  ) |
6 g | |
Coptis (Huang Lian,  ) |
5 g | |
Honeysuckle flower (Jin Yin Hua,  ) |
9 g | |
Ophiopogon root (Mai Dong,  ) |
9 g | |
Scrophularia (Xuan Shen,  ) |
9 g | |
Bamboo leaf (Zhu Ye,  ) |
3 g | |
Forsythia fruit (Lian Qiao,  ) |
6 g |
Administration: Decoct these herbs for drinking.
| Functions: | (a) | To clear away heat and toxins; |
| (b) | To expel heat and nourish Yin. |
Indications: Syndrome of pathogenic heat entering the Ying level at the early stage, marked by a feverish body which becomes more so at night, intermittent delirium, thirst or absence of thirst, indistinct skin rashes, a deep red dry tongue, and a thready rapid pulse.
Formula Analysis: This syndrome is the result of pathogenic heat invading the Ying level, scorching Ying Yin, and injuring blood vessels. To appropriately deal with it, heat and toxins must be cleared, and Yin must be nourished. Xi Jiao 
, the chief herb, is used for clearing away heat from the Ying level and removes toxic substances. Sheng Di Huang 
, Xuan Shen 
, and Mai Dong 
act as the assistant herbs, which not only help the chief herb to purge heat but also nourish Yin, promote the production of body fluids, and prevent consumption of Yin of the Ying phase. Jin Yin Hua 
and Lian Qiao 
, both mild herbs, clear heat from the Ying level and eliminate toxins, and expel heat from Qi when combined with the above herbs. In conjunction with Huang Lian 
, they also strengthen the heat-clearing and detoxifying action of the chief herb. Dan Shen 
cools and promotes the flow of blood so as to prevent complications of heat with blood. Dan Shen 
, Jin Yin Hua 
, Lian Qiao 
, and Huang Lian 
are adjuvant herbs. Zhu Ye 
plays the role of guiding herb, which not only clears heat from the heart but also guides the other herbs to the heart. Herbs in the formula clear heat from the Ying phase, strengthen Yin of the Ying phase, and cure the disease.
Applications in Bio-medicine: Epidemic encephalitis B, epidemic cerebrospinal meningitis, hematosepsis, ileotyphus, or other epidemic diseases that are attributable to pathogenic heat invading the Ying level in TCM.
Modifications:
(a)For phlegm, add Bamboo juice (Zhu Li, 
).
(b)In cases of coma, add Antelope horn (Ling Yang Jiao, 
) and Earthworm (Di Long, 
), or take Purple Snowy Powder (Zixue Dan), Ox Gallstone Resurrection Pills (Angong Niu Huang, Wan) or Zibao Dan with this decoction.
Cautions: The formula is contraindicated for a person having a deep-red tongue with a glossy whitish coating. These symptoms are attributable to syndromes of retained heat due to blockage of dampness.
Prescriptions for Heat-Clearing and Detoxifying （清热解毒）
(i) Huang Lian Jiedu Tang 
(Coptis Detoxification Decoction)
| Composition: | Coptis (Huang Lian,  ) |
9 g |
Scutellaria root (Huang Qin,  ) |
6 g | |
Phellodendron bark (Huang Bai ) |
6 g | |
Cape jasmine fruit (Zhi Zi,  ) |
9 g |
Administration: Decoct for drinking.
Functions: To purge pathogenic fire and release toxins.
Indications: Excessive heat, fire, and toxicity of the triple Jiao, marked by high fever, restlessness, thirst, delirium, insomnia, or jaundice due to dampness and heat or dysentery with fever, or sores and carbuncles, a red tongue with a yellowish coating, and a rapid forceful pulse.
Formula Analysis: This is the commonly used formula for fire, heat, and toxins accumulating in the triple Jiao, and the syndrome should be treated with extremely cold herbs that are capable of purging fire and toxins. Huang Lian 
, acting as the chief herb, specializes in purging heart fire, and fire in the middle Jiao. Huang Qin 
and Huang Bai 
both purge fire and heat respectively in the upper Jiao and lower Jiao, and serve as the assistant. Zhi Zi 
, serving as adjuvant herb, clears and purges fire of the triple Jiao and drives pathogenic heat out via urination.
Applications in Bio-medicine: Acute enteritis, acute dysentery, acute icteric hepatitis, septicemia, acute cholecystitis, acute pelvic inflammation, erysipelas, boils and carbuncles, and other infectious diseases which are attributable to syndromes of intense fire and toxins.
Modifications:
(a)For jaundice, add Oriental wormwood (Yin Chen Hao, 
) and Rhubarb (DaHuang, 
).
(b)For vomiting blood and epistaxis, add Imperata rhizome (Bai Mao Gen, 
) and Biota tops (Ce Bai Ye, 
).
(c)For severe macula, add Moutan bark (Mu Dan Pi, 
) and Fresh Rehmannia root (Sheng Di Huang, 
).
(d)In cases with a red peeled tongue, add Scrophularia (Xuan Shen, 
), Fresh Rehmannia root (Sheng Di Huang, 
), and Ophiopogon root (Mai Dong, 
).
Cautions: This formula is extremely cold in nature and should be discontinued once the expected results have been achieved. It is contraindicated for patients suffering from a serious impairment of Yin with a deep-red peeled tongue.
(ii) Puji Xiaodu Yin 
(Universal Anti-Toxin Decoction)
| Composition: | Scutellaria root (Huang Qin,  ) |
15 g |
Coptis (Huang Lian,  ) |
15 g | |
Citrus Peel (Ju Pi,  ) |
6 g | |
Licorice (Gan Cao,  ) |
6 g | |
Scrophularia (Xuan Shen,  ) |
6 g | |
Bupleurum root (Chai Hu,  ) |
6 g | |
Isatis root (Ban Lan Gen,  ) |
3 g | |
Platycodon root (Jie Geng,  ) |
6 g | |
Forsythia fruit (Lian Qiao,  ) |
3 g | |
Puffball (Ma Bo,  ) |
3 g | |
Arctium fruit (Niu Bang Zi,  ) |
3 g | |
Mentha (Bo He,  ) |
3 g | |
White stiff silkworm (Jiang Can,  ) |
2 g | |
Cimicifuga (Sheng Ma,  ) |
2 g |
Administration: The herbs are cooked by decoction.
| Functions: | (a) | To dispel wind and other pathogenic factors; |
| (b) | To clear heat and release toxins. |
Indications: Epidemic febrile disease with flushed swollen face and head due to invasion of exogenous pathogenic heat and toxic factors. The Manifestations are chills, fever, swollen face and head, sore throat, a red tongue with a white or yellow coating, and a superficial rapid forceful pulse.
Formula Analysis: This is the commonly used formula for the exogenous wind-heat and seasonal pathogenic factors accumulating in the upper Jiao and further affecting the head and face. All the disorders should be treated by clearing heat and toxins and dispelling wind and other pathogenic factors. Huang Qin 
and Huang Lian 
, of notably larger amounts and prepared with wine, play the role of chief herbs, with the effect of dispelling heat-toxins from the upper Jiao. Niu Bang Zi 
, Lian Qiao 
, Bo He 
, and Jiang Can 
act together as assistant herbs, dispelling wind-heat affecting the head and face, removing toxins, and resolving masses. Xuan Shen 
, Ma Bo 
, Ban Lan Gen 
, Jie Geng 
, and Gan Cao 
all remove heat and toxins from the throat, while Ju Pi 
regulates Qi to remove obstructions and subdue swelling. These six herbs all act as adjuvants. Sheng Ma 
and Chai Hu 
play the part of guiding herbs to dispel pathogenic wind-heat and to assist other herbs in reaching the face and head to remove pathogenic heat. All the herbs making up the formula clear heat and expel accumulation, but focus on clearing heat and removing toxins.
Applications in Bio-medicine: Carbuncles, furuncles, boils, and swelling on the face and head, epidemic parotitis, acute tonsillitis, and acute submaxillary lymphadenitis due to wind-heat and toxins, chiefly manifested as flushed swelling of the face and head and a superficial rapid pulse.
Modifications:
(a)For constipation, add wine-prepared Rhubarb (Da Huang, 
).
(b)In cases of complicated testitis due to parotitis, add Sichuan chinaberry (Chuan Lian Zi, 
) and Chinese gentian (Long Dan Cao, 
)
Prescriptions for Treating Carbuncles （治疡剂）
Prescriptions for treating carbuncles are able to detoxify and reduce swelling. They promote the evacuation of pus and regeneration of tissues for the treatment of carbuncles, cellulitis, sores, and furuncles. Carbuncles, cellulitis, sores, and furuncles may appear as external carbuncles or internal ones. This group of prescriptions is accordingly subdivided into two categories: prescriptions for external carbuncles and prescriptions for internal carbuncles.
Xianfang Huoming Yin 
(Immortal Formula Life-Giving Decoction)
| Composition: | Angelica (Bai Zhi,  ) |
3 g |
Fritillary bulb (Bei Mu,  ) |
3 g | |
Ledebouriella root (Fang Feng,  ) |
3 g | |
Red peony (Chi Shao,  ) |
3 g | |
Trichosanthes root (Tian Hua Fen,  ) |
3 g | |
Fresh Chinese Angelica root (Sheng Dang Gui,  ) |
3 g | |
Mastic (Ru Xiang,  ) |
3 g | |
Honeysuckle flower (Jin Yin Hua,  ) |
9 g | |
Licorice (Gan Cao,  ) |
3 g | |
Gleditsia spine (Zao Jiao Ci,  ) |
3 g | |
Anteater scales (Chuan Shan Jia,  ) |
3 g | |
Citrus peel (Ju Pi,  ) |
9 g | |
Myrrh (Mo Yao,  ) |
3 g |
Administration: The herbs are decocted in water or in a mixture of equal amounts of water and wine for oral use.
| Functions: | (a) | To clear heat and release toxins; |
| (b) | To reduce swelling and nodules; | |
| (c) | To promote the circulation of blood and relieve pain. |
Indications: Initial stage of boils, carbuncles, and swelling due to excess toxic heat and the stagnation of Qi and blood, marked by local redness, swelling, pyrexia and pain, pus on the verge of being formed or already formed, or a feverish body with a slight aversion to cold, a thin whitish or yellowish tongue coating, and a rapid forceful pulse.
Formula Analysis: The syndrome is caused by the excessive accumulation of heat and toxins internally, leading to Qi stagnation, blood stasis, and stagnation of phlegm. It should be treated by clearing heat and toxins, reducing swelling and resolving masses, promoting blood circulation and relieving pain. Jin Yin Hua 
was called the “holy herb for carbuncles.” It functions as the chief herb in this formula, and is used in heavy dosage to clear heat and disperse swelling. Dang Gui 
, Chi Shao 
, Ru Xiang 
, Mo Yao 
, and Ju Pi 
have the function of promoting the flow of Qi, removing obstruction from the meridians, promoting blood circulation, and resolving stasis so as to subdue swelling; all play the role of assistant herb. Bai Zhi 
and Fang Feng 
expel wind and heat; Chuan Shan Jia 
and Zao Jiao Ci 
ensure the smooth flow of Qi in the meridians and collaterals, promote the discharge of pus. Tian Hua Fen 
and Bei Mu 
clear heat, remove phlegm, resolve masses, and subdue swelling, thus resolving pus before it can be formed. These six herbs act as the adjuvant herbs. Gan Cao 
is the guiding herb with the action of clearing heat and toxins as well as mediating the properties of other herbs. The option of including wine is for enhancing the potency of the formula. It smoothes the circulation of blood so that all the herbs can quickly reach their target. All the herbs in combination could dispel toxins, eliminate stasis, and disperse swelling.
Applications in Bio-medicine: Carbuncles, furuncles, boils, mastitis, phlegmon, and other purulent inflammations, which pertain to Yang syndrome and excess syndrome.
Modifications:
(a)For mild pain, omit Ru Xiang 
and Mo Yao 
.
(b)For severe swelling and pain, replace Fang Feng 
and Ju Pi 
with Dandelion (Pu Gong Ying, 
) and Forsythia fruit (Lian Qiao, 
).
(c)In cases of constipation, add Rhubarb (Da Huang, 
).
Cautions: This formula is contraindicated in the Yin type of boils or ulcers.
(ii) Yanghe Tang 
(Yang-Harmonizing Decoction)
| Composition: | Prepared Rehmannia root (Shu Di Huang,  ) |
30 g |
Cinnamon bark (Rou Gui,  ) |
3 g | |
Ephedra (Ma Huang,  ) |
2 g | |
Deer antler gelatin (Lu Jiao Jiao,  ) |
9 g | |
White mustard seed (Bai Jie Zi,  ) |
6 g | |
Baked ginger (Pao Jiang,  ) |
2 g | |
Licorice (Gan Cao,  ) |
3 g |
Administration: The herbs are cooked with water by decoction.
| Functions: | (a) | To warm Yang and tonify blood; |
| (b) | To dispel cold and remove stagnation. |
Indications: Yin-type carbuncles due to blood deficiency and cold congealment, marked by local diffuse swelling, unchanged skin color, soreness without pyrexia, absence of thirst, a pale tongue with a whitish coating, and a deep thready or slow thready pulse.
Formula Analysis: This is the commonly used formula for treating insufficient blood due to ongoing deficiency of Yang and attack by exogenous cold, leading to the accumulation of cold and phlegm, which are retained in the tissue, tendons, blood vessels, and joints. The syndrome is treated by warming yang and enriching the blood, dispelling cold, and clearing phlegm to remove stagnation and subdue swelling. The large dosage of Shu Di Huang 
is meant to nourish the blood, Yin, essence, and marrow. Lu Jiao Jiao 
replenishes essence, activates the kidney-Yang, and engenders essence and blood to strengthen tendons and bone. Both deal with the root cause of the disease by nourishing blood and Yang, and thus function as the chief herbs. Pao Jiang 
and Rou Gui 
warm the interior to dispel cold, as well as ensuring the smooth circulation of blood. They are the assistant herbs. Used as the adjuvant herbs, Ma Huang 
removes obstruction from the meridians and collaterals, and Bai Jie Zi 
eliminates stagnation of phlegm from the muscular striae, tendons, and vessels. Both promote the flow of blood and Qi, while supporting the tonic action of the chief herbs and preventing stagnation. Gan Cao 
is the guiding herb, and removes toxins and mediates the properties of other herbs. All the herb ingredients in combination warm Yang and supplement blood to dispel cold and free stagnation.
Applications in Bio-medicine: Thromboangiitis, rheumatoid arthritis, boils, and bone tuberculosis, and other conditions which are ascribed to the syndrome of cold accumulation due to insufficient blood.
Modifications:
(a)In cases of Qi deficiency, add Ginseng (Ren Shen, 
) and Astragalus root (Huang Qi, 
).
(b)For excess cold, add prepared aconite root (Fu Zi, 
).
Cautions: The formula is contraindicated for patients with yang syndrome external carbuncles.
(iii) Wei Jing Tang 
(Phragmites Stem Decoction)
| Composition: | Phragmites stem (Wei Jing,  ) |
30 g |
Coix seed (Yi Yi Ren,  ) |
30 g | |
Benicasa seed (Dong Gua Zi,  ) |
24 g | |
Peach seed (Tao Ren,  ) |
9 g |
Administration: The herbs are cooked by decoction.
| Functions: | (a) | To clear away heat from the lung and resolve phlegm; |
| (b) | To remove stasis and promote the discharge of pus. |
Indications: Lung abscess, marked by cough with yellow bloody odorous sputum, a vague pain in the chest which is aggravated by coughing, a reddened tongue with a greasy yellow coating, and a smooth rapid pulse.
Formula Analysis: This is the commonly used formula to treat pulmonary welling abscess due to phlegm and heat jamming in the lung. The syndrome should be treated by clearing heat from the lung, eliminating phlegm, dispelling stasis, and expelling pus. Wei Jing 
, which is always considered the primary herb for treating carbuncles, has the function of clearing heat from the lung and acts as the chief herb. Dong Gua Zi 
eliminates heat and phlegm in order to discharge pus, while Yi Yi Ren 
clears heat and induces diuresis to promote pus discharge. Both are used as assistant herbs. Tao Ren 
promotes blood circulation and removes stasis, in addition to moistening the lung and loosening the bowels. It is the adjuvant herb and, in combination with Dong Gua Zi 
, directs the accumulated phlegm downward so that phlegm is removed and carbuncles are subdued. All the herbs in combination clear lung heat, eliminate phlegm, dispel stasis, and expel pus.
Applications in Bio-medicine: Lung abscess, lobar pneumonia, bronchitis, and bronchiectasis, which have the chief manifestations of chest pain, cough, foul smelling expectoration or pus and blood, a reddened tongue with a greasy yellowish coating, and which pertain to the accumulation of heat and phlegm in the lung.
Modifications:
(a)For severe heat, add Scutellaria root (Huang Qin, 
), Cape jasmine fruit (Zhi Zi,
), Houttuynia (Yu Xing Cao, 
), and Honeysuckle flower (Jin Yin Hua, 
).
(b)If cough with profuse sputum is present, add Platycodon root (Jie Geng, 
), Apricot seed (Xing Ren, 
), and Fritillary bulb (Bei Mu, 
).
(c)For severe cough with bloody sputum, add Imperata rhizome (Bai Mao Gen, 
) and Lotus node (Ou Jie, 
).