Qing Wei Wan for Stomach Heat and Fire Uprising

TCM Functions: Clears Stomach Heat, Drains Fire, Clears Heat-Toxins, Cools the Blood, Protects the Yin & Blood.

TCM Diagnosis: Stomach heat and fire uprising.

Presentation: Occasional mouth sores, especially concentrated on the gums and buccal cavity, but may also include sores on the tongue, lips or jaw, bad breath, dry mouth and lips, occasional toothache and occasional frontal headache. May be initiated or exacerbated by excessive consumption of spicy, greasy, hot-natured foods, and areas of discomfort worsened by the topical application of heat and relieved by cold. May be accompanied by red complexion, frequent or indeterminate gnawing hunger, thirst for cold drinks, occasional belching or heartburn, tendency towards slow or dry stools.

Tongue: red, redder in the center, with a dry, yellow coat or a scanty coat

Pulse: slippery, rapid, large in middle positions

Ingredients: Sheng ma/Cimicifuga heracleifolia rhizome 37.1%, Huang lian/Coptis chinensis rhizome 22.1%, Mu dan pi/Paeonia suffruticosa root-bark 19%, Sheng di huang/Rehmannia glutinosa root-raw 10.9%, Dang gui/Angelica sinensis root 10.9%.

Cautions & Contraindications: Use with caution during pregnancy. Contraindicated for conditions without heat, or due to deficient heat. Not appropriate for Kidney deficiency or attack of pathogenic cold causing tooth and gum issues.

Clinical Comments: Qing Wei San was written by Li Dongyuan and published in his classic formula book, Lan Shi Mi Cang/Secrets from the Orchid Chamber, in 1336 A.D. Qing Wei San is indicated for Stomach heat and fire causing occasional toothache, and occasional mouth sores on the tongue and lips.

The Stomach Yangming channel is abundant with Qi and Blood which rises to nourish the head, especially the mouth and teeth. In this pattern, excess heat accumulates in the Stomach channel until it blocks the flow of Qi and eventually gives rise to fire. Stomach fire then rebels upwards to attack the head, particularly the mouth and teeth that the channel runs through. This causes the primary symptoms of occasional toothache that may lead to headache, occasional mouth and tongue sores, dry mouth and lips, and bad breath.

Li Dongyuan attributed this condition to the excessive consumption of hot, tonic herbs, which cause a build-up of Stomach heat. In the modern clinic, we may also see this condition arise due to some combination of overeating, late-night meals, excessive consumption of spicy, heavy, fried, greasy, or oily foods, excessive or unexpressed frustration, anger and stress, and a sedentary lifestyle, resulting in the build-up of Stomach heat.

The chief herb, Huang lian strongly cools and quells Stomach fire, drains the heat from the channel, and clears heat-toxins to deal with the root problem. The deputy, Sheng ma raises and disperses heat and clears heat-toxins from the Yangming channel. Sheng ma works with Huang lian to clear the heat and heat-toxins while also reinforcing the Qi dynamic to ensure that the pure Qi can rise and the turbid Qi can descend, without excessive movement either up (from Sheng ma) or down (from Huang lian). This elegant balance enables the formula to both drain and disperse Stomach fire without harming the Qi dynamic or allowing the excessive rising of pure Qi to fan the flames of the fire. Sheng ma also acts as the envoy to raise the formulas’ focus to the face and mouth. Stomach fire directly damages the Yin and Blood and can attack the collaterals of the Stomach channel running through the gums. Mu dan pi and Sheng di huang work together to cool the Blood and nourish the Yin, and with Dang gui to strongly nourish the Blood, invigorate the flow of Blood to disperse swelling, and alleviate discomfort. Together, the herbs in this formula clear the Stomach heat and cool the Blood, allowing the fire in the upper body to descend and disperse, and protect the Yin and Blood from further damage.

Combinations: For more marked difficulty with stools, combine with Da Huang Jiang Zhi Wan.

References:

1. The Clinical Manual of Chinese Herbal Patent Medicines, 3rd Edition, by Will Maclean with Kathryn Taylor, Pangolin Press, 2016.
2. Chinese Herbal Medicine - Formulas and Strategies, 2nd Edition, by Dan Bensky, Volker Scheid, Andy Ellis and Barolet, Eastland Press, 2009.
3. Chinese Herbal Medicine – Materia Medica, 3nd Edition, by Dan Bensky, Steven Clavey and Erich Stoger, with Gamble, Eastland Press, 2004.
4. Chinese Herbal Formulas and Applications - Pharmacological Effects & Clinical Research, by John Chen & Tina Chen, Art of Medicine Press, 2009.
5. Chinese Medical Herbology and Pharmacology, by John Chen & Tina Chen, Art of Medicine Press, 2004.
6. Essential Chinese Formulas – 225 Classical and Modern Prescriptions, by Jake Fratkin, Shya Publications, 2014.
7. 160 Essential Chinese Herbal Patent Medicines, by Bob Flaws, Blue Poppy Press, 1999.

About the Author

Laura Stropes, L.Ac. is a licensed practitioner of acupuncture and traditional Chinese medicine with a great love of Chinese herbology. She has been in practice since 1998. She has a passion for helping people on their path to achieve balance and wellness. She is a Fellow of the Acupuncture & TCM Board of Reproductive Medicine (ABORM), and specializes in women's health, in helping women, men, and couples optimize fertility, and supporting healthy pregnancies. She also has a strong focus on treating problems that negatively impact everyday health and well-being (sleep, digestion, stress level, pain). Laura worked at Mayway from 1999-2019 as an herbal consultant and project manager. Laura’s projects included the initial Mayway website in 2004 and website redesign in 2012, the Herb ID Kit recreation in 2009, and she coauthored the book “A Practitioner’s Formula Guide: Plum Flower & Minshan Formulas” - Wrinkle, Stropes & Potts, published in 2008. She also worked on product research and development, writing articles, and consulting services for other acupuncturists, chiropractors, veterinarians and medical doctors in choosing suitable TCM herbal treatments for their patients. Laura can be reached at: laura@laurastropes.com.