Xuanbai Chengqi Tang, to Reduce Fever, Loosen the Bowels and Stop Wheezing

"Xuanbai Chengqi Tang" (White-Diffusing Qi-Coordinating Decoction) is a classic formula of the TCM Warm-Disease school, from the warm-disease classic Systematized Identification of Warm Diseases (Wenbing Tiaobian). Its composition is: raw shigao (Gypsum Fibrosum) 5 qian (15 g), raw dahuang (Rhei Radix et Rhizoma) 3 qian (9 g), xingren powder (Armeniacae Semen) 2 qian (6 g), and gualoupí (Trichosanthis Pericarpium) 1 qian 5 fen (4.5 g). Decoct in 1 sheng of water down to about 400 ml and strain. First take 200 ml; if the fever has resolved, the bowels move, and wheezing stops, do not take the remaining 200 ml. If the effect is not marked, drink the remaining 200 ml after 4–8 hours.

This formula clears heat and diffuses the lung, and moistens the intestines to free the bowels. It is indicated for Yangming warm disease where purgation has not moved the bowels, with panting and restlessness, phlegm and saliva congesting, stool bound up, and a forceful, large pulse at the right cun position—the pattern being failure of lung qi to downbear. These symptoms usually appear after an acute respiratory infection: whether from a viral or bacterial infection, the patient develops restless panting, bound stool, fever and dry mouth, copious phlegm and saliva, with or without sweating. The condition is often critical; treatment should use raw shigao to urgently clear interior heat, raw dahuang to unblock the fu organs and expel excess, xingren to stop cough and calm wheezing, and gualoupí to scour phlegm and broaden the chest. Only thus can the patient's symptoms be comprehensively relieved and suffering eased; once the righteous qi returns, the pathogen is expelled and the patient settles.

If the patient also has scanty, dark urine, add zhizi (Gardeniae Fructus) 6 g to clear heat from the lower burner; for severe, urgent panting, add huangqin (Scutellariae Radix) 6 g, sangbaipi (Mori Cortex) 12 g, and digupi (Lycii Cortex) 12 g; if there is pleural effusion, add tinglizi (Descurainiae Semen) 15 g; for incessant cough, add pipaye (Eriobotryae Folium) 6 g, jinqiaomai (Fagopyri Cymosi Rhizoma) 15–30 g, and chuanbeimu powder (Fritillariae Cirrhosae Bulbus) 6 g (taken in two divided doses). Adding pugongying (Taraxaci Herba) 30 g, daqingye (Isatidis Folium) 15 g, banlangen (Isatidis Radix) 15 g, and shuiniujiao (Bubali Cornu) 30 g, and dosing xianhecao (Agrimoniae Herba) heavily up to 100 g, the formula may also be used for acute leukemia patients with severe symptoms such as high fever, constipation, breathing difficulty and purpura.

Note: if the patient's bowels have already moved but residual heat remains, do not continue this formula; switch to Baihu Tang, Renshen Baihu Tang, Lianqiao San, Sangju Yin or similar to continue treatment.