Qinjiao Biejia San for Reducing Fever and Relieving Pain

"Qinjiao Biejia San" comes from the Taiping Huimin Heji Jufang. Its composition is: Jingjie (Schizonepeta, stem removed), Beimu (Fritillary Bulb, core removed), Tianxianteng (Dutchmanspipe Vine), Qianhu (Peucedanum), Qingpi (Green Tangerine Peel, white removed), Chaihu (Bupleurum), Zhi Gancao (honey-fried Licorice), Chenpi (Tangerine Peel, white removed), Qinjiao (Gentiana Macrophylla, Radix Gentianae Macrophyllae), and Biejia (Soft-shelled Turtle Shell, vinegar-fried), each 1 liang (30 g); Gegen (Kudzu Root, Radix Puerariae) 2 liang (60 g, baked); and Baizhi (Angelica Dahurica), Rougui (Cinnamon Bark, Cortex Cinnamomi), and Qianghuo (Notopterygium), each 5 qian (15 g).

Grind all the above into a fine powder. Each time take 2 qian (6 g), add about 150 ml of water and 3 slices of Shengjiang (Fresh Ginger), and decoct together to about 100 ml; take warm, or it may be mixed with yellow wine, regardless of meals. Nowadays one may also directly decoct the ready-cut herbs. If decocting from cut pieces, use the following amounts: Jingjie 6 g, Chuan Beimu 6 g (Zhe Beimu may also be used), Tianxianteng 6 g, Qianhu 6 g, Zhi Gancao 6 g, Chenpi 6 g, Qinjiao 6 g, Biejia 6 g, Gegen 12 g, Baizhi 3 g, Rougui 3 g, and Qianghuo 3 g.

This formula nourishes yin and disperses wind. It is indicated for patients with an inherently yin-deficient constitution who, after contracting an external wind pathogen, fail to recover and present with: fatigue of the limbs, emaciation of the body, vexatious pain in the joints, dizziness and flushed cheeks, withered and haggard limbs, a sallow yellow complexion, parched lips and dry mouth, heat in the five centers (palms, soles, and chest), coughing up phlegm and saliva, dull pain in the lower back, restless alternation between rising and lying down, troubled dreams and unease, a distracted and abstracted spirit, occasional night sweats, a bitter tasteless mouth, and no desire to eat. In the past this formula was mainly used for lingering post-cold symptoms and for the various symptoms appearing after internal-injury fever in orthopedic and trauma patients. It may now be used by cancer patients with bone metastases when they develop cancer fever and cancer pain, to relieve their suffering.

However, when used for cancer patients, the decoction dose should be increased 2-3 fold. If the patient is physically weak, righteous-supporting herbs such as Renshen (Ginseng), Xiyangshen (American Ginseng), Huangqi (Astragalus), or Dangshen (Codonopsis) may be added. For marked internal heat, add Zhimu (Anemarrhena), Tianhuafen (Trichosanthes Root), Sheng Shigao (raw Gypsum), Huangqin (Scutellaria), Huanglian (Coptis), or Huangbai (Phellodendron). For constipation, add Dahuang (Rhubarb), Mangxiao (Mirabilite), Roucongrong (Cistanche), or Huomaren (Cannabis Seed). For severe blood stasis, add Shuizhi (Leech), Tubiechong (Eupolyphaga), Taoren (Peach Kernel), Honghua (Safflower), Ruxiang (Olibanum), Moyao (Myrrh), Yuanhu (Corydalis), Xuejie (Draconis Sanguis), or Ercha (catechu).

In advanced cancer patients, symptoms such as fever and body pain may recur; the medication should be adjusted at any time according to the patient's physical condition to relieve clinical symptoms.