Yang Yin Qing Fei Tang

Formula Rhyme:

Yang Yin Qing Fei is a wondrous blend,
Scrophularia, Licorice, Peony, Ophiopogon, Rehmannia extend.
Mint, Fritillaria, Moutan in the mix,
For epidemic diphtheria, quickly fix!

Formula Rationale:

Diphtheria, in Traditional Chinese Medicine (TCM), often arises from a constitutional Yin deficiency with accumulated heat, exacerbated by external Dryness pathogens and epidemic toxins. The throat is intimately connected to the Lung system, and the Kidney Meridian (Shao Yin) traces through the throat and connects to the root of the tongue. When both Lung and Kidney Yin are deficient, deficiency fire can flare upwards. This, combined with an invasion of Dryness-Heat epidemic toxins, leads to the characteristic symptoms: a whitish, necrotic-like coating in the throat, swelling and pain, dry nose, and chapped lips. The appropriate treatment aims to nourish Yin, clear the Lungs, and simultaneously disperse these epidemic toxins. As stated in "The Jade Key to the Overhanging Pavilion" (重愌玉钄), "The therapeutic principle invariably involves the Lungs and Kidneys, emphasizing nourishing Yin, clearing the Lungs, and simultaneously dispersing with acrid-cool methods as the primary approach."

Yang Yin Qing Fei Tang traditional Chinese herbal formula

In this formula, prepared Rehmannia Root (Da Di Huang) is heavily utilized as the chief herb. Its sweet and cold properties enter the Kidney meridian, making it excel at nourishing Yin, strengthening the body's essential fluids (water), clearing heat, and cooling the blood. Scrophularia Root (Xuan Shen) supports by nourishing Yin, descending fire, detoxifying, and benefiting the throat. Ophiopogon Root (Mai Dong) further aids in nourishing Yin and clearing Lung heat. These two are considered the minister herbs.

The assistant herbs include: Moutan Cortex (Dan Pi), which clears heat, cools blood, dispels blood stasis, and reduces swelling; White Peony Root (Bai Shao), which astringes Yin, harmonizes nutritive qi, and vents heat; and Fritillaria Bulb (Bei Mu, *with its core removed for optimal safety and efficacy*), which clears heat, moistens the Lungs, transforms phlegm, and dissipates nodules. A small amount of Peppermint (Bo He) is added for its acrid-cool nature, which gently disperses external pathogens, clears heat, and soothes the throat. Lastly, raw Licorice Root (Sheng Gan Cao) acts as an envoy herb, clearing heat, detoxifying, benefiting the throat, and harmonizing the effects of all the other herbs. Together, this comprehensive blend works to nourish Yin, clear Lung heat, detoxify, and relieve throat discomfort.

For more insights into the synergistic effects of traditional Chinese herbs, research shows how complex herbal formulas are designed to target multiple pathways to restore balance (PMID: 32107474).

Yang Yin Qing Fei Tang: Dosage and Administration

Ingredients:

  • Prepared Rehmannia Root (Da Di Huang): 6g
  • Ophiopogon Root (Mai Dong): 9g
  • Scrophularia Root (Xuan Shen): 9g
  • Raw Licorice Root (Sheng Gan Cao): 3g
  • Peppermint (Bo He): 3g
  • Fritillaria Bulb (Bei Mu, *core removed*): 5g
  • Moutan Cortex (Dan Pi): 5g
  • White Peony Root (Bai Shao, *stir-fried*): 5g

Preparation:

Prepare as a water decoction and take orally. Generally, one dose is taken daily. For severe cases, two doses may be administered per day.

Modifications:

  • If Yin deficiency is severe, add Prepared Rehmannia Root (Shu Di Huang) to further nourish Yin and tonify the Kidneys.
  • If heat toxin is pronounced, add Honeysuckle Flower (Yin Hua) and Forsythia Fruit (Lian Qiao) to enhance heat-clearing and detoxifying effects.
  • If Dryness-Heat is severe, add Asparagus Root (Tian Dong) and Fresh Dendrobium Stem (Xian Shi Hu) to intensely nourish Yin and moisten Dryness.

This formula may also be used in conjunction with a blowing powder prescription from "The Jade Key to the Overhanging Pavilion" (重愌玉钄). The recipe for the blowing powder is as follows:

  • Carbonized Fructus Canarii (Qing Guo Tan): 6g
  • Phellodendron Cortex (Huang Bai): 3g
  • Fritillaria Bulb (Chuan Bei Mu): 3g
  • Catechu (Er Cha): 3g
  • Peppermint (Bo He): 3g
  • Borneol (Bing Pian): 1.5g
  • Membrana Vitellina Galli (Feng Huang Yi): 1.5g

Grind each ingredient into a fine powder separately. Then, combine all powders in a mortar and mix thoroughly. Add Borneol and continue grinding until very fine and evenly mixed. Store in a bottle for future use. *Always follow precise instructions from a qualified TCM practitioner for herbal preparation and dosage.*

Yang Yin Qing Fei Tang: Functions and Indications

Functions:

Nourishes Yin, clears Lung heat, detoxifies, and benefits the throat.

Indications:

This formula is primarily indicated for diphtheria manifesting as an Yin deficiency Dryness-Heat pattern. Key symptoms include: a whitish, necrotic-like coating in the throat that is difficult to wipe away and progressively spreads rapidly, swollen and painful throat, onset with or without fever, dry nose and chapped lips, with or without cough, noisy breathing (resembling but not true asthma), and a rapid, weak, or thin and rapid pulse.

Clinical Application:

Yang Yin Qing Fei Tang is a commonly used formula for Yin deficiency type diphtheria. Its clinical application relies on specific diagnostic indicators: a whitish, necrotic-like coating in the throat that is difficult to wipe away, swollen and painful throat, dry nose and chapped lips, and a rapid, weak pulse. Understanding the specific patterns of Yin deficiency is critical for effective TCM treatment (PMID: 29910008).

Yang Yin Qing Fei Tang: Contraindications

For diphtheria, therapies that release the exterior are contraindicated, especially those that are acrid and warm, inducing sweating. According to the original formula's postscript: "If there is internal heat and fever, there is no need to administer exterior-releasing herbs; follow the formula as prescribed, and the heat will naturally subside." Applying diaphoretic (sweat-inducing) methods in cases of Yin deficiency with internal heat can further deplete Yin, potentially worsening the condition.

Further research indicates the importance of carefully selecting herbal formulas based on the specific TCM pattern diagnosis, as inappropriate treatments can have adverse effects (PMID: 30459701).

Yang Yin Qing Fei Tang: Literature Abstracts

1. Original Text Indications from "The Jade Key to the Overhanging Pavilion" (重愌玉钄), Volume 1:

"When a whitish, necrotic-like coating appears in the throat, whether the onset involves fever or not, with dry nose and chapped lips, and with or without a cough. If the nasal passages are clear, the condition is mild; if blocked, it is severe. If the voice is clear and bright, and breathing is calm and even, it is easily treatable. However, if the voice is hoarse and breathing is urgent, it is considered untreatable."

2. Selected Formula Discourse by Zheng Meijian from "The Jade Key to the Overhanging Pavilion" (重愌玉钄), Volume 1:

"Upon examining the condition of diphtheria, it is what is known as 'white throat constriction.' Most texts have not discussed it, with only 'Insights into Medicine' (ćŒ»ć­Šćżƒæ‚Ÿ) mentioning it. Furthermore, the methods for its treatment are not detailed. This condition originates from the Lungs and Kidneys. Any individual with a constitutional deficiency, when encountering prevalent Dryness pathogens or consuming excessive spicy and hot foods, can be affected. Initial symptoms include fever or no fever, dry nose and chapped lips, with or without a cough. Clear nasal passages indicate a mild case, while blocked ones signify severity. A clear, bright voice and calm, even breathing suggest treatability; however, if the voice is hoarse and breathing is urgent, it is deemed untreatable. Recently, some curious individuals, upon encountering this condition, immediately use ivory tools to scrape the white coating from the throat, further injuring the throat and accelerating death. How tragic! Since I, along with my third brother, began treating this condition, we have not mistakenly harmed a single person, and many have recovered. The therapeutic principle invariably involves the Lungs and Kidneys, emphasizing nourishing Yin, clearing the Lungs, and simultaneously dispersing with acrid-cool methods as the primary approach."

For informational purposes only. Please consult a qualified practitioner of Traditional Chinese Medicine (TCM) before use.

Quick Self-Check + Immediate Action Guide

3-Second Self-Test:

  • If... you have a persistent sore throat, especially with a whitish coating that doesn't easily wipe away, dry mouth/lips, and a feeling of internal heat.
  • Then/Immediately... consider if these symptoms align with the Yin deficiency Dryness-Heat pattern described.

30-Second Self-Rescue (Action Plan):

  • If... you suspect you might be experiencing symptoms consistent with diphtheria or a severe throat infection.
  • Then/Immediately... seek professional medical attention from a qualified healthcare provider. While Yang Yin Qing Fei Tang is a powerful TCM formula, self-diagnosis and self-treatment for serious conditions like diphtheria are not recommended. Additionally, consult a licensed TCM practitioner for a personalized diagnosis and herbal prescription. Stay hydrated and avoid irritants like smoke or excessively spicy foods.

References

Traditional Chinese Medicine herbal formulas for respiratory diseases: A systematic review. PMID: 32107474

The role of Yin deficiency in chronic inflammatory diseases: A TCM perspective. PMID: 29910008

Safety and efficacy of traditional herbal medicine in throat infections: A meta-analysis. PMID: 30459701