What is Qing Ying Tang?
Qing Ying Tang is a classic Chinese herb mix. The name is often put into English as Clear the Nutritive Level Decoction. In Chinese medicine it is used for a very high fever that is worse at night, with a dry mouth, a faint red rash, poor sleep and confused speech.
It is a set recipe of about nine herbs, and this page treats it as a single drug (TCM formula). The herbs are boiled into a strong tea, or taken as granules. A Chinese medicine doctor picks it for a set pattern of signs, not for any named germ.
Here is the short verdict. It has a long record in one tradition, but good human trials are missing, so we cannot say it works. Long use is not proof of effect, and that point is not repeated below.
How does Qing Ying Tang work?
The idea behind it is cooling. In Chinese medicine, this mix is for heat that has sunk deep into the body. The old texts call that deep layer the nutritive level (ying fen), the place where blood and body fluids are said to sit.
The herbs are meant to cool that heat, feed dried up fluids, and push the heat back out to the surface. That is a way of sorting signs, not a body process that has been measured.
Some single herbs in it have been looked at in labs. Berberine, from Chinese goldthread, can slow the growth of some germs in a dish. Dan shen can make blood cells less sticky.
None of that shows that the whole mix helps a sick person, and it has not been tested that way.
What forms does Qing Ying Tang come in?
Most people meet it as a decoction. That means raw herbs boiled in water into a strong, bitter tea.
You may also see it as granules that melt in hot water, as a syrup, or as pills. In China it is sometimes given in hospital next to normal drug care, not instead of it.
There is no standard strength across brands. Granule makers use different herb to powder ratios, so one brand's scoop is not the same as another's.
Where it comes from:
The recipe comes from a 1798 book by Wu Ju-tong, the Systematic Differentiation of Warm Diseases. That book set out the warm disease school, a way of treating fevers that spread fast.
Qing Ying Tang is one of the best known formulas in that school. It is still taught in Chinese medical schools today as the model answer for deep heat with a rash and confused speech.
If this is an emergency
Some reactions to Qing Ying Tang need urgent care. Call your local emergency number or go to an emergency department straight away — do not wait to see whether it passes.
Who should avoid Qing Ying Tang?
- Do not use if you are pregnant or trying to get pregnant, as the herbs are strongly cooling and berberine is not considered safe in pregnancy
- Do not use if you are breastfeeding, because berberine can pass to the baby
- Do not use if you are giving it to a newborn or a baby, as berberine can worsen jaundice (yellow skin and eyes) and in rare cases harm the brain
- Do not use if you take warfarin, heparin, apixaban, rivaroxaban or any other blood thinner
- Do not use if you take aspirin or clopidogrel to stop blood cells sticking together
- Do not use if you have a bleeding disorder, such as haemophilia (a condition where blood does not clot properly)
- Do not use if you have surgery or dental work booked in the next two weeks
- Do not use if you have G6PD deficiency (an inherited blood problem that makes red cells break down easily)
- Do not use if you have long term loose stools, a cold stomach or weak digestion, as this mix is very cold and will make it worse
- Do not use if you take digoxin, ciclosporin or another drug with a narrow safe blood level, unless your doctor checks it first
- Do not use if you have had a rash or swelling after any of the herbs in it
- Do not use if you see rhinoceros horn (xi jiao) on the label, because that product is illegal and comes from an animal close to dying out
- Do not use if you are treating yourself for a high fever instead of getting medical care
When should you see a doctor?
Call emergency services now if someone with a fever is confused, very drowsy, hard to wake, has a stiff neck, is short of breath, or has a rash that does not fade when you press a glass on it. These can be signs of blood poisoning or meningitis (an infection around the brain).
Get urgent medical help for a fever in a baby under three months, a fever above 39.4 C (103 F), a fit or seizure, or a fever that lasts more than two days.
Stop the herbs and see a doctor if you bruise easily, bleed from the nose or gums, pass black stools, turn yellow in the eyes or skin, or come out in a rash after taking them.
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