The Commonly Used Summer Formula Qing Shu Yiqi Tang

Qing Shu Yiqi Tang (Summerheat-Clearing Qi-Boosting Decoction) belongs to the TCM category of summerheat-dispelling formulas and is a famous TCM formula very suitable for this season. Historically there are two Qing Shu Yiqi Tang: one comes from Piweilun (Treatise on the Spleen and Stomach) by Li Dongyuan, founder of the Spleen-Earth school of the Jin-Yuan period; the other comes from Wenre Jingwei (Simple Primer on Warm-Heat Diseases) by Wang Mengying, a famous warm-disease physician of the Qing dynasty. Li Dongyuan's formula emphasizes boosting qi, while Wang Mengying's emphasizes nourishing yin and clearing heat.

Both formulas treat the summerheat-injury qi-deficiency pattern of the hot season, but each has its own emphasis.

Li Dongyuan's Qing Shu Yiqi Tang, also called the Li-family Qing Shu Yiqi Tang, has the following prescription: astragalus 6g, atractylodes 6g, cimicifuga 6g, ginseng 3g, fried shenqu 3g, tangerine peel 3g, atractylodes macrocephala 3g, ophiopogon 2g, tangshen root 2g, green tangerine peel 1.5g, phellodendron 2g.

Wang Mengying's Qing Shu Yiqi Tang, also called the Wang-family Qing Shu Yiqi Tang, has the following prescription: American ginseng 5g, dendrobium 15g, ophiopogon 9g, coptis 3g, bamboo leaf 6g, lotus stem 6g, anemarrhena 6g, raw licorice 3g, japonica rice 15g, watermelon emerald (i.e., watermelon rind) 30g.

The Li-family Qing Shu Yiqi Tang is suitable for patients who are normally qi-deficient and, after newly contracting summer dampness, present with feverish body and headache, thirst and spontaneous sweating, limp limbs, no desire to eat, fullness in the chest and heaviness of the body, loose stools, scanty dark urine, a yellow greasy tongue coating, and a weak, forceless pulse.

Later, Wang Mengying felt the Li-family formula was insufficient in strength for clearing summerheat and boosting qi, so he created his own Wang-family Qing Shu Yiqi Tang. The Wang-family formula is suitable for patients whose summerheat has damaged fluids; it emphasizes nourishing yin and generating fluids, so it heavily uses dendrobium and ophiopogon and adds watermelon rind. Later generations mostly use the Wang-family formula to treat pediatric patients with summer fever and dual injury of qi and fluids. Clinically, the formula is chosen when the child has feverish body with profuse sweating, thirst and vexation, scanty dark urine, fatigue and shortness of breath, low spirits, and a weak rapid pulse.

Although Li Dongyuan's Qing Shu Yiqi Tang is not as strong as Wang Mengying's in nourishing yin and generating fluids, it is better at fortifying the spleen and drying dampness. So the Li-family formula can be used for patients whose original qi is deficient and who have also been injured by summer dampness. It is especially suitable for cancer patients who, after surgery or chemoradiotherapy during the summer, have poor appetite, feverish body with profuse sweating, and unformed stools, as well as some long-term frail patients with deficient original qi.

Profuse sweating and poor appetite are common symptoms in summer, especially after the dog days, when many people's appetite is very poor. In this season, try to take less medicine (in many places there is a folk tradition of not drinking Chinese medicine during the dog days, but cancer patients in progression who are on TCM treatment had best not stop the medicine altogether, though they should avoid taking decoctions as much as possible), so as not to injure the stomach; reduce activity in high-temperature environments and take heat-prevention measures.

If one does suffer heatstroke with poor appetite and profuse sweating damaging fluids (especially active children, who are prone to heatstroke), one may consider using the above two prescriptions as the main basis, with moderate modifications, according to the patient's specific condition.