What is Qin Jiao Bie Jia San?

Qin Jiao Bie Jia San is a classic Chinese herbal formula. It is one named recipe of about eight herbs, not a mix you build yourself. Its English name is Large Gentian and Soft-Shelled Turtle Shell Powder.

It is used in Chinese medicine for a low fever that creeps up in the late afternoon or at night. The same picture includes night sweats, a dry cough, thirst and slow weight loss.

Old texts tied that pattern to long wasting illness. The formula has been in use for nearly 700 years, but we found no published human trials of the formula itself. A long history of use is not proof that something works, so treat this as traditional, not proven.

How does Qin Jiao Bie Jia San work?

No one has shown how this formula acts in the body.

In Chinese medicine terms, it is said to clear heat that sits deep in the body and to build up yin. Yin means the body's cooling, moist side. Practitioners also say it frees stuck qi, or energy, in the chest and sides.

Lab and animal work on the single herbs shows some fever-lowering and swelling-lowering effects. That work does not tell us what the whole powder does in a person. The mixture itself has not been tested in a good human trial that we could find.

What forms does Qin Jiao Bie Jia San come in?

Most often you will meet it as a loose powder, or as a tea made by boiling the herbs.

Common forms are raw herbs to cook at home, a fine powder stirred into warm water, granules that dissolve, and pills or capsules sold as a patent medicine.

Quality varies a lot. Some imported patent medicines have been found to hold lead, mercury or hidden drug ingredients. Buy only from a seller who tests each batch and will show you the test result.

Where it comes from:

The formula comes from Wei Yi-Lin's book Shi Yi De Xiao Fang, written in 1345 during the Yuan dynasty in China.

It was aimed at 'steaming bone fever', a slow deep fever with night sweats and weight loss. Doctors of that time used it for long illnesses that today would often be called tuberculosis, a lung infection.

It is still taught in Chinese medicine schools and still appears in standard formula textbooks.

What does Qin Jiao Bie Jia San help with?

• Night sweats: This is the classic reason a practitioner would reach for this formula. The evidence is traditional only. If you sweat through your bedclothes most nights, see a doctor first, because that can point to infection, a thyroid problem or a blood disorder.
• Low fever that returns in the afternoon or evening: Chinese medicine calls this a yin-deficient fever and treats it with cooling, moistening herbs like these. No human trial has tested the formula for it. A fever that keeps coming back needs a medical cause found, not just a herb.
• Feeling of heat rising from deep inside (steaming bone fever): This old term describes heat that feels as if it comes from the bones, with sweating and thirst. The formula was written for exactly this picture. It is a traditional match, not a tested treatment.
• Dry cough with tiredness during a long illness: Traditional use covers a dry, tickly cough late in a long illness. We found no trials in people. A cough lasting more than three weeks, or any cough with blood, needs a doctor.
• Weight loss and weakness after a long illness: Classical texts used it during slow recovery from wasting illness. Modern evidence is absent. Unplanned weight loss is a warning sign and should be checked by a doctor before you try any herb.
• Feeling hot, dry and thirsty in the late stage of an infection: Practitioners use it when a fever has mostly passed but heat and dryness linger. This is a traditional pattern match. It has not been compared with a dummy treatment in people.

Which foods are rich in Qin Jiao Bie Jia San?

1. Smoked or salted plum (Wu Mei): the one ingredient also eaten as a food, as a sour preserved fruit in China and Japan

Practical Tips:

No ordinary food contains this formula; the other ingredients are medicines, and one of them is an animal shell, so it is not suitable if you avoid animal products.

What are the side effects of Qin Jiao Bie Jia San?

• Loose stools or diarrhoea
• Nausea or stomach ache
• Loss of appetite
• Skin rash or itching from an allergy
• Easier bruising, or small cuts bleeding for longer
• Dizziness
• Rare liver injury, with yellow skin or eyes (jaundice), dark urine and deep tiredness

Good to know:

Most reported effects are mild and settle when you stop taking it. Stomach upset is the most common.

Two problems are rare but serious. Formulas that contain thorowax root (Chai Hu) have been linked to liver damage, and in Japan to a serious lung reaction in people also taking interferon, a medicine used for hepatitis (liver swelling caused by a virus).

Chinese angelica root can thin the blood. Watch for bruising, nosebleeds or bleeding gums, and stop if they appear.

How much Qin Jiao Bie Jia San should you take?

• Recommended daily: There is no modern tested dose. Classical texts give about 6 to 9 grams of the powder per dose, once or twice a day. As a tea, practitioners use roughly 30 to 60 grams of raw herbs a day, boiled and split into two cups. The right amount depends on your size, your health and the other herbs used. A trained Chinese medicine practitioner should set it after examining you.
• Best time of day: Most practitioners split the day's amount into two doses, morning and early evening. Some give one dose in the late afternoon, just before the time of day the fever tends to rise.
• With or without food: Take it between meals with warm water. If it upsets your stomach, take it just after food instead.
• Time to effect: Traditional teaching suggests a few days to two weeks. There is no trial data behind those numbers, so treat them as custom rather than proof.
• How long to take it: Keep courses short and review them. Traditional use runs one to four weeks, with a check at the two-week mark. Stop and see a doctor if your fever, sweats or cough have not eased in two weeks.