What is Pu Ji Xiao Du Yin?

Pu Ji Xiao Du Yin is a Chinese herbal formula. It is a single drug (TCM formula), made from a set mix of about 14 herbs. It is also known as Universal Benefit Decoction to Eliminate Toxin.

It is used in Chinese medicine for a hot, red, swollen head or neck. That means sore throat, swollen neck glands, mumps, and hot red skin on the face. It is meant for short, sudden bouts of illness, not for daily use.

The proof is thin. The formula has a long record of use in China, but we could not find good human trials that test it. A long record of use is not proof that a remedy works, and that holds for every use listed on this page.

How does Pu Ji Xiao Du Yin work?

No one has shown how this formula acts in the body. Most lab work looks at single herbs, not at the whole mix.

In Chinese medicine terms, it is said to clear "heat" and "toxin" from the head and neck. It is also said to move stuck qi so swelling can drain. These are ideas from tradition, not measured facts.

In test tubes and in animals, some of these herbs slow the growth of germs and calm swelling. Lab work does not tell you what happens in a person who drinks the tea.

What forms does Pu Ji Xiao Du Yin come in?

The oldest form is a decoction. You simmer the raw dried herbs in water and drink the strained liquid.

Today it is sold more often as granules that you stir into hot water, as small pills, or as a dried powder. Some shops sell it as a ready-made liquid.

Strength varies a lot from brand to brand. Chinese herb mixes have also been found with added drugs or heavy metals, so buy only from a seller who tests each batch.

Where it comes from:

The formula comes from Li Dongyuan, a Chinese doctor of the Jin-Yuan era, around the 1200s. It is written up in his collected formulas.

The story goes that it was made for an outbreak of "big head" fever, in which people had a swollen, red head and neck. It has stayed in use in China ever since and is taught in most Chinese medicine schools.

So it is a staple of one tradition with a long record. It has never been tested well in modern trials.

What does Pu Ji Xiao Du Yin help with?

• Mumps (a viral illness with swollen cheek glands): This is the classic use. Chinese doctors have given the formula for swollen cheek and jaw glands for centuries. We could not find a well-run human trial that supports it. Mumps can harm the ears, brain and testicles, so see a doctor rather than treating it at home.
• Sore throat and tonsillitis: Tradition uses it for a red, burning throat that comes on fast with a fever. Human proof is lacking. A throat that is bad enough to stop you swallowing, or that comes with a high fever, needs a doctor. Strep throat needs antibiotics, and this formula is not a stand-in for them.
• Swollen, tender glands in the neck: The formula is aimed at heat and swelling in the head and neck, so swollen glands fit the old picture of use. There are no good trials. A lump or gland that does not settle in two weeks, or that keeps growing, must be checked by a doctor.
• Erysipelas (a red, hot skin infection of the face): Older Chinese texts list hot, spreading redness of the face among its uses. This is a bacterial infection. It can spread fast and needs antibiotics from a doctor. Use of herbs alone here is not safe.
• Early fever with a red, hot, swollen face or head: In Chinese medicine this is the pattern the formula was built for: fever, chills, a red swollen head, thirst and a sore throat. The match is a tradition-based one, not a tested one. The formula is aimed at short bouts only and is not meant for a long, low-grade illness.

Which foods are rich in Pu Ji Xiao Du Yin?

1. Licorice root: the same plant as the Gan Cao in this mix, so licorice sweets add to the blood pressure and potassium risk
2. Mint tea: Bo He is mint, though the amount in food is small
3. Dried tangerine peel: Chen Pi is used in Chinese cooking as well as in medicine
4. Burdock: the seed is used here; the root is eaten as a vegetable in Japan

Practical Tips:

You cannot get this formula from food. If you take it, cut back on licorice sweets and licorice tea while you do.

What are the side effects of Pu Ji Xiao Du Yin?

• Loose stools or diarrhoea
• Nausea and stomach ache
• Poor appetite
• A strong bitter taste that some people cannot tolerate
• Rash or itching from an allergy to one of the herbs
• Puffy ankles, higher blood pressure and low potassium (a salt your heart needs) with long use, from the licorice
• Jaundice (yellow skin and eyes) in newborn babies, from the coptis in the mix

Good to know:

Most reported problems are mild gut upset, and they stop when you stop the herbs. Good safety data is lacking, so the true rate is unknown.

The serious risks come from two parts of the mix. Licorice taken for weeks can push up blood pressure and pull down potassium, which can upset the heartbeat. Coptis can cause jaundice in a newborn.

Report any swelling, muscle weakness, a fast or odd heartbeat, or yellow skin to a doctor straight away.

How much Pu Ji Xiao Du Yin should you take?

• Recommended daily: No dose has been set by human trials. What follows is common practice, not proven advice. As a decoction, a day's mix is usually 50 g to 90 g of dried herbs in total, simmered in water and split into two or three drinks. As granules or pills, follow the label, which is often 3 g to 6 g twice a day. A trained Chinese medicine practitioner sets the amounts for you and often changes the herb list to match your case. Do not raise the dose on your own.
• Best time of day: Split the day's amount into two or three drinks, spread out morning, afternoon and evening. Take it warm.
• With or without food: Take it between meals. The herbs are bitter and cold in nature, and some people feel sick on an empty stomach. If that happens, take it shortly after food.
• Time to effect: Not known from trials. In traditional use, any change is looked for within 1 to 3 days.
• How long to take it: This is a short-course formula. Most practitioners give it for 3 to 7 days. If you are no better after 3 days, or you get worse at any point, stop and see a doctor. Long use is a real risk here, because the licorice in the mix can raise blood pressure and drop potassium over weeks.