A Commonly Used Formula for Cancer Fever: Qinghao Biejia Decoction
Qinghao Biejia Decoction comes from Wenbing Tiaobian (Systematic Differentiation of Warm Diseases). It has the action of nourishing yin and venting heat, and treats the late stage of warm disease with the syndrome of pathogen latent in the yin phase. Signs include fever at night that clears in the morning, heat withdrawal without sweating, a red tongue with little coating, five-palm heat, and a fine rapid pulse.
This formula may be used for pulmonary tuberculosis, interstitial pneumonia, infantile summer fever, chronic pyelonephritis, renal tuberculosis, bone tuberculosis, low-grade fever persisting after surgery, low-grade fever persisting after viral infection, and pneumonia in those with yin-deficiency fire hyperactivity—all patterns of yin deficiency with internal heat.
Qinghao Biejia Decoction: Qinghao 6g (added later), Biejia 15g (decoct first), Zhimu 6g, Shengdi 12g, Mudanpi 9g.
The Qinghao in this formula does not tolerate long decocting; if cooked too long its active constituents are destroyed, so it should be added later. Add the Qinghao in the last 5-10 minutes before turning off the heat, after the other herbs are done.
The Biejia in this formula should not be decocted for too short a time; too short and the active constituents do not dissolve. So first decoct the Biejia alone for half an hour, then add the other herbs (except Qinghao) and decoct together for 20-30 minutes, then add the Qinghao and decoct for another 5-10 minutes.
There are many ways to resolve cancer fever, and different patients require different formulas. Which formula to choose depends mainly on the patient's clinical symptoms.
Qinghao Biejia Decoction suits patients whose cancer fever comes on at night, clears of its own accord in the early morning, withdraws without sweating, with a red tongue without coating and a fine, relatively rapid pulse. From the TCM perspective, such patients belong to the yin-deficiency internal-heat type, so this formula is needed to nourish yin and vent heat.
Biejia, Shengdi, Zhimu and Mudanpi all nourish yin and cool the blood; Qinghao has the action of clearing deficiency heat and steaming bone. Used together, these herbs achieve the effect of nourishing yin, cooling the blood and reducing fever.
If such a patient with cancer fever also has difficult urination, Liuyi San (Huashi 15g, Sheng Gancao 3g) may be combined; if phlegm-dampness is combined, add Peilan, Huoxiang, Biandou and Yiyiren to transform dampness and resolve phlegm; if there is blood-stasis pain, add Tubiechong, Taoren, Ruxiang, Moyao and Sumu to activate blood, resolve stasis, stop pain and disperse swelling; if there is qi deficiency, add Sheng Huangqi, Dangshen and Baizhu to supplement the middle and boost qi; if heat-toxin is accumulated, add Sheng Shigao, Jinyinhua, Banzhilian and Baihua Sheshicao to clear heat and resolve toxin.
This formula is not suitable for cancer-fever patients whose fever is not of the yin-deficiency type.