Qing Wei San (Stomach-Clearing Powder) for Toothache and Headache Caused by Stomach Fire Flaring Upward

Qing Wei San is recorded in Lanshi Micang (Secrets of the Orchid Chamber). It is composed of "Danggui Shen (Angelicae body) two qian, Huanglian (Coptidis Rhizoma) one and a half qian, Shengdihuang (Rehmanniae Radix recens, prepared with yellow wine) four qian, Mudanpi (Moutan Cortex) two qian, Shengma (Cimicifugae Rhizoma) two qian." Converted into modern measures this is approximately: Danggui Shen 6 g, Huanglian 5 g, Shengdihuang 12 g, Mudanpi 6 g, Shengma 6 g. Modern use: decoct in water, one package daily, taken morning and evening.

Qing Wei San treats toothache caused by accumulated heat in the stomach with stomach fire flaring upward, even radiating to headache, with warmth in the cheek, teeth preferring cold and disliking heat, or bleeding, redness, swelling and ulceration of the gums; swelling and pain of the lips, tongue, and cheeks; hot foul breath; dry mouth and tongue; a red tongue with yellow coating; dark urine; anal burning during bowel movements; and a slippery rapid pulse. Today Qing Wei San is commonly used for stomatitis, oral ulcers, periodontitis, and other common conditions. In the author's experience, this formula has some effect on the range of symptoms caused by Helicobacter pylori, though it may not eradicate H. pylori. Adding Pugongying (Taraxaci Herba) 15–30 g and Jinyinhua (Lonicerae Flos) 15–30 g to the base formula works better for the stomach-fire-flaring-up symptoms caused by H. pylori.

The version of Qing Wei San collected in Yifang Jijie additionally contains Sheng Shigao (Gypsum fibrosum recens; usual dose 15–30 g, to be decocted first for half an hour), making its stomach-fire-clearing action stronger than that of the Lanshi Micang version. In Chen Shigong's Waike Zhengzong (Orthodox External Medicine, Ming Dynasty), the Qing Wei San not only adds Sheng Shigao but also replaces Danggui with Huangqin (Scutellariae Radix); Chen Shigong used it for swollen, painful, and bleeding gums caused by stomach fire flaring upward. If the patient has constipation and scanty dark urine, Huangbo (Phellodendri Cortex) 6 g, Zhizi (Gardeniae Fructus) 6–12 g, and Dahuang 6–30 g should be added (Dahuang is added late, boiled only the last five minutes). With Zhizi, Huangqin, Huangbo, and Dahuang added, the formula forms a combination with Huanglian Jiedu Tang, and the stomach-fire-clearing effect is even more pronounced.