Fever, Sore Throat, Yellow Phlegm and a Yellow Runny Nose? Doctor Luo Dalun: External Cold with Internal Heat — Try Jin Hua Qing Gan Granules (Jinhua Qinggan Granules)

Patient search terms: fever with chills and sore throat / yellow phlegm and yellow runny nose / what to take for external cold with internal heat / Jin Hua Qing Gan Granules (Jinhua Qinggan Granules) / nationally recommended Chinese medicines for COVID / Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction) / Shuang Huang Lian / Lianhua Qingwen alternatives / supporting upright qi while clearing pathogens

Corresponding medical names: wind-heat attacking the lungs (feng re fan fei) · external cold with internal heat (wai han li re) · acute upper respiratory infection with fever, sore throat and productive cough · influenza-like illness

Opening: the rules are relaxing — but first, don’t panic. Look at two sets of real data

Lately many people’s hearts are in their throats: now that the pandemic controls have been lifted, is the virus going to be terrifying? Doctor Luo Dalun starts by calming everyone down — objectively speaking, this is not as serious as it is made out to be.

💬 Note from Doctor Luo: Some self-media used to demonize the virus and paint Omicron as something truly frightening — that was wrong. When foreign countries said the workforce loss was 50%, that lumped several different virus strains together — the ones from three years ago were all counted in, and back then the virus really was more virulent and deadly. Mixing everything together like that just scares people. Now things are slowly opening up, and many people feel panicked, as if their lives were under threat — but look at the actual situation: it is nowhere near that severe.

Doctor Luo cites two sets of real data:

💬 Note from Doctor Luo: When the outbreak hit Tibet, the Tibet Autonomous Region held a press conference and said 90% of people in that round had no symptoms at all; those who did have symptoms needed no medication and recovered on their own in a few days; and among the rest who did need treatment, there were no critical cases. Then look at this round in Guangzhou: 160,000 to 170,000 people were infected, and there were exactly four critical cases — all elderly people who already had health problems. What does this tell us? First, the epidemic is not that severe. Second, because Chinese medicine was used throughout — basically everyone infected in our country is treated with Chinese medicine — the situation is fundamentally different from abroad. Foreigners don’t have these tools. We do.

So at the height of the virus’s virulence, the country really did protect us for three years — work stoppages, lockdowns, at enormous cost, but protect us it did: when America had lost a million people, we were safe. Now that the great waves have become ripples, opening up at this moment is very timely and very wise.

💬 Note from Doctor Luo: We should be grateful. Now it is up to us to face the risk ourselves, but there is no need to be afraid. This is exactly when a little Chinese medicine knowledge pays off — knowing and not knowing are different. People who never learned anything, when they really get a fever — some haven’t had a fever in years, so they panic: the whole family is feverish, what do we do? They have no plan. But friends who understand Chinese medicine, and Chinese medicine enthusiasts, know we have all kinds of ways to handle it. So let me share some knowledge about patent medicines you can use when the time comes. There’s no need to hoard drugs — many of these medicines are in good supply — but it helps to know what you can reach for.

The nationally recommended patent medicines are not just Lianhua Qingwen — today we talk about Jin Hua Qing Gan Granules

Ask anyone about epidemic medicine and most people only know Lianhua Qingwen. Doctor Luo reminds us: several of the national prevention and treatment protocols also recommend Jin Hua Qing Gan Granules — there are actually many patent medicines, and the range to choose from is wide.

💬 Note from Doctor Luo: Don’t just know Lianhua Qingwen — we actually have a great many patent medicines. The Jin Hua Qing Gan Granules I’m talking about today treats wind-heat attacking the lungs — it treats a heat pattern. When an external pathogen first arrives, it is cold; but once it enters the body and the body resists it, and if there was already some fire inside, the struggle becomes a battlefield — the cold quickly transforms into heat, and you get a heat pattern.

What does it treat? — Light external cold, heavy internal heat

Jin Hua Qing Gan Granules treats the situation of external cold with internal heat — light on the outside, heavy on the inside: a full picture of heat, but with a little cold lingering at the body surface.

💬 Note from Doctor Luo: The main signs are fever, headache, sore muscles and bones and joints, and a sore throat — all heat signs; cough with yellow phlegm; yellow nasal discharge, possibly mixed yellow and green. At the same time you still fear wind and cold, which shows a little cold remains at the surface. This situation is generally not the very beginning of an external affliction — it is what happens when you failed to control it at the first stage: the pathogen moves inward, the body resists, and a heat pattern appears.

How do you tell it’s this pattern? — Check the tongue and pulse

💬 Note from Doctor Luo: If you find your tongue is red, the edges of the tongue are red, your pulse is rapid and floats a little at the surface; if you fear wind and cold, have a sore swollen throat, run yellow nasal discharge, cough yellow phlegm, have a headache and aching muscles; and on top of all that you have a fever — then you can use Jin Hua Qing Gan Granules.

Formula breakdown, layer one: Zhang Zhongjing’s Ma Xing Shi Gan Tang as the base

What’s inside Jin Hua Qing Gan Granules? Doctor Luo takes it apart layer by layer. First, you need something to scatter the external cold — honey-fried ma huang (ephedra).

💬 Note from Doctor Luo: Ma huang diffuses the lungs and releases the exterior. Generally, to scatter external cold and remove damp pathogen, you use raw ma huang to induce sweat — it disperses the exterior pathogen and unties the surface cold. But the Jin Hua Qing Gan Granules uses honey-fried ma huang, and I think there are two reasons. First, raw ma huang is a bit forceful — in the Shang Han Lun (Treatise on Cold Damage), when you decoct it you must boil the ma huang first and skim off the foam that rises, and only then add the other herbs; otherwise the strength is too fierce and your heart races. Honey-fried, the herb becomes gentler. Second, honey-fried ma huang is slightly weaker at diffusing the lungs and scattering external cold, but stronger at stopping cough and calming wheeze. When making a patent medicine, you don’t want it to hit that hard, so they use honey-fried ma huang — it still disperses cold and releases the exterior, and at the same time regulates qi, resolves phlegm and stops wheezing.

Next comes sheng shi gao (raw gypsum) — to clear heat; then xing ren (apricot kernel) — to unblock lung qi; and gan cao (licorice) to harmonize. Four herbs together — what is that? Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum and Licorice Decoction).

💬 Note from Doctor Luo: Did you notice? Ma Xing Shi Gan Tang is the base formula for many prescriptions — even today’s Lianhua Qingwen is built on Ma Xing Shi Gan Tang. This is a method Zhang Zhongjing established: on one side ma huang scatters external cold, on the other sheng shi gao clears internal heat. What does xing ren do? It opens the lung qi — an external pathogen first attacks the lungs, and the lungs govern the skin and body hair, so you must regulate the lung qi — and gan cao harmonizes all the herbs. Ma Xing Shi Gan Tang pioneered the approach of “scattering external cold while simultaneously clearing internal heat”; it is a therapeutic method, and all these formulas use it as their foundation.

Formula breakdown, layer two: jin yin hua, huang qin, lian qiao — the Shuang Huang Lian trio enters

With the base of scattering cold and clearing heat in place, you also need to resolve toxins — so add jin yin hua (honeysuckle), huang qin (baical skullcap), and lian qiao (forsythia).

💬 Note from Doctor Luo: Jin yin hua, huang qin and lian qiao all clear heat and resolve toxins. Jin yin hua is also called shuang hua (“double flower”); huang qin, lian qiao — we call these three together “Shuang Huang Lian,” and Shuanghuanglian Oral Liquid is exactly honeysuckle, skullcap and forsythia combined. So in this formula it is as if Ma Xing Shi Gan Tang has been paired with Shuang Huang Lian to clear heat and resolve toxins: when an external pathogen arrives, you must resolve the toxins.

Then a few supporting players: zhe bei mu, zhi mu, niu bang zi, bo he, and qing hao

💬 Note from Doctor Luo: Then come: zhe bei mu (Thunberg fritillary bulb) — clears heat and resolves phlegm; zhi mu (anemarrhena) — clears lung heat; niu bang zi (burdock seed) — resolves the heat-toxin of the throat and soothes the throat; bo he (mint) — acrid, cool, releases the exterior, disperses upward, also acts on the throat, and clears away heat-toxin; and a little qing hao (sweet wormwood) — this is an herb specifically for pushing heat out from deep inside the body to the surface.

Putting it together: scattering external cold and clearing internal heat at the same time

💬 Note from Doctor Luo: What does the whole formula do together? It scatters external cold on one side and clears internal heat on the other; it regulates lung qi on one side and soothes the throat on the other. Sore swollen throat — it clears the throat and benefits the voice; internal heat with high fever starting — sheng shi gao brings the fever down; cold still at the surface — ma huang scatters it. The overall effect is summed up as “dispel wind, diffuse the lungs, clear heat and resolve toxins.”

So the timing is clear: you caught an external affliction, failed to seal it off at the first stage, the pathogen moved inward, and heat signs appeared inside — the phlegm turned yellow, the body started to run a fever, joints ache, head hurts, throat hurts — that’s when you use Jin Hua Qing Gan Granules.

Flexible use one: keep some perilla leaf at home and brew it into water to take with the granules

The one thing Doctor Luo finds slightly regrettable about Jin Hua Qing Gan Granules is that it is, after all, a fixed patent medicine.

💬 Note from Doctor Luo: The patent medicine uses honey-fried ma huang. To help it scatter the external pathogen more thoroughly, I suggest keeping some zi su ye (perilla leaf) at home — the dried kind. When you take the medicine, brew a few leaves into water, and use that perilla water to wash down the Jin Hua Qing Gan Granules. The perilla leaf’s surface-scattering, cold-dispersing action reinforces the honey-fried ma huang — after all, once ephedra is honey-fried its surface-releasing power is a little insufficient, so the perilla water helps strengthen the sweat-inducing effect. If you feel the wind-and-cold aversion at the surface is quite obvious, this is how you use it.

Flexible use two: sweat at the slightest movement? Pair it with Gui Zhi Granules or Xiao Chai Hu

There is another type of person who should add a “supporting upright qi” ingredient when using Jin Hua Qing Gan Granules.

💬 Note from Doctor Luo: Some people sweat at the slightest movement — sweating on slight exertion means insufficient upright qi and a fairly obvious insecure exterior. What to do? You can add some Gui Zhi Granules (Cinnamon Twig Granules) to the mix, or take a little Xiao Chai Hu (Minor Bupleurum). This formula is basically cooling, and it is missing a bit of support from above. Gui Zhi is a qi-supporting herb, and Xiao Chai Hu contains ren shen (ginseng), which is also qi-supporting. If you feel your upright qi is clearly insufficient and you’re weak, adding a little qi-supporting medicine alongside is perfectly fine.

Doctor Luo’s method: clearing pathogens alone is not enough — support upright qi and expel pathogens together

Having explained the patent medicine, Doctor Luo also opens up his own prescription method — and this is the most important sentence in the whole talk:

💬 Note from Doctor Luo: I used to like formulas like Jin Hua Qing Gan Granules too, but later I realized they only resolve toxins — and resolving toxins alone is not enough. Why? Because the reason an external pathogen gets in and you can’t beat it is that your upright qi is insufficient. So when I write formulas of this kind, I always add dang shen (codonopsis), ren shen (ginseng), or huai shan yao (Huai yam) — I always add something that supports upright qi. Once your upright qi is a little stronger, clearing the pathogen works much better. So after explaining the patent medicine, everyone can apply it flexibly: if the external cold is obvious, pair it with perilla leaf; if you really feel weak and depleted, while taking it also brew some yam slices into water to drink, or hold a few slices of ginseng in your mouth — that will absolutely help the body gather strength and drive out the external pathogen.

Supporting upright qi and expelling pathogens together is the better way to use it — formulas like Jin Hua Qing Gan Granules are basically pathogen-expelling, and their qi-supporting power is insufficient on its own.

💬 Note from Doctor Luo: If you feel weak and your body is a bit depleted, then combine it with qi support and the effect will be better; if you’re full of energy right now and just have a slightly uncomfortable throat, then using it alone is fine — no need to add anything. That is the rule for using this medicine. Over the next few days I’ll keep introducing the patent medicines from the nationally recommended protocols, one by one. See you tomorrow!

Compiled from Doctor Luo Dalun’s health lecture (external affliction prevention and treatment · the nationally recommended Chinese patent medicines series).