Throat Pain Like a Razor Blade, Fever That Won’t Drop, Face and Eyes Swollen Shut? Pu Ji Xiao Du Yin (Universal Salvation Toxin-Dispelling Decoction): One Dose Turns the Tide on Heat Toxin

Opening the epidemic-preparedness series: what should a household keep on hand?

The epidemic situation has still been changing at any moment lately. Reading all the discussions online, Doctor Luo Dalun felt that debating back and forth was of little use — he says: we must of course comply with epidemic-prevention policies, but at the same time we should learn a bit more prevention knowledge ourselves, and store a reasonable amount of medicine at home — better to have it and not need it.

💬 Note from Doctor Luo: So starting today, I’m going to talk about a series of formulas — ready-made Chinese medicines related to externally-contracted illnesses. Everyone asks: what should we stock up on, what should we buy? You don’t actually need to hoard anything — but buying one or two boxes and keeping them at home, well, if there really is an emergency, right? It can come in handy. I think talking about this has real practical value.

Who opens the series? Today’s protagonist — Pu Ji Xiao Du Yin, in the old days called Pu Ji Xiao Du Yin Zi (the “Zi” simply meaning “small formula”).

A formula born of plague: Doctor Li Dongyuan’s battle against the Big Head Plague

Whose formula is this? The great Jin-Yuan physician Doctor Li Dongyuan. Doctor Luo says he has told this story before — Doctor Li Dongyuan happened to live through a plague, and this formula was made to treat it.

💬 Note from Doctor Luo: The plague back then was called the Da Tou Wen, the “Big Head Plague.” What was the Big Head Plague? A person would catch the plague and start swelling up — the neck thick and swollen, the head swollen, the eyes so swollen they couldn’t open. This was an externally-contracted plague — heat pathogen invaded the heart and lungs, and then heat toxin attacked upward, which is why the head and eyes swelled up. At that time the Big Head Plague killed a great many people — countless deaths.

When Doctor Li Dongyuan saw this, what could be done? People begged him to treat them, and he created this formula.

💬 Note from Doctor Luo: Once the formula came out, it saved countless lives, with immediate results. People carved it onto stone steles and placed them at crossroads — why crossroads? So that people passing by could copy it down. Everyone said this was an immortal formula and copied it for their own use. Later, the Ming-dynasty physician Doctor Gong Tingxian — in his book, for instance the Wan Bing Hui Chun (The Return of Spring in Ten Thousand Diseases) — when discussing plague, put Pu Ji Xiao Du Yin right at the very beginning; it was the formula for the Big Head Plague.

Heat toxin congesting the upper jiao: swollen face, throat pain like a razor blade

What does this formula treat? Doctor Luo sums it up in one sentence: anything that is heat toxin congesting and binding in the upper jiao — especially the heat-toxin binding that travels upward, to the head and face.

💬 Note from Doctor Luo: As I see it, it’s this: upper-respiratory infection, with the tonsils and throat badly swollen and painful — this formula’s ability to resolve toxin is outstanding, and basically one dose turns the tide. Say my throat is terribly swollen — ordinary people would go get an IV drip, and that’s fine, but with our Pu Ji Xiao Du Yin, basically it clears it right out in one go. Generally one dose lays the foundation for turning things around; two or three doses and it’s no problem at all — definitely no problem.

What does the typical presentation look like? Doctor Luo paints the picture very clearly:

💬 Note from Doctor Luo: It treats a heat pattern — heat toxin congesting within. How does it present? Chills, fever, high temperature; then the face and head are red and swollen, some like mumps with the cheeks swollen up; the throat swollen; even the eyes swollen so they can’t open; the throat is blocked and painful, swallowing saliva hurts badly, the tonsils are inflamed inside — very severe. The tongue is red, the coating yellow, and the pulse feels floating, rapid and forceful.

Why do these signs appear?

💬 Note from Doctor Luo: Heat toxin attacks upward, so the face and head are red and swollen, the eyes swollen. Heat toxin inside injures the fluids and drains the body’s moisture — the fluids within are consumed, so the mouth is dry and there is thirst. Heat toxin binding in the throat area causes throat pain that is especially severe.

Doctor Luo’s practical experience: one dose turns the battle around — and can even feel like a root cure

Doctor Luo uses this formula with personal experience of his own — it is not only for emergencies; for one type of person it can even feel like a “root cure.”

💬 Note from Doctor Luo: If a person always has heat rising — always running fevers, tonsils swelling, the kind who develops tonsillitis at every cold — then taking this formula, I’d say a few doses gives a root-cure sort of feeling. Once that heat toxin is cleared away, later it’s not so easy for this situation to reappear. I’ve really encountered this — the feeling that it never came back, as if the root was cut. So the power of this formula is very great.

So when the epidemic comes, in what situations is it actually used? Doctor Luo’s reminder is very practical:

💬 Note from Doctor Luo: If plague comes and nothing much is wrong with you — for mild cases, don’t use it. Most people with something like Omicron — one city’s statistics even said 90% had no symptoms — just got infected, the body had no real reaction, then there’s nothing to use it for. Who really uses this formula? Someone who, after infection, has throat pain like being cut by a razor blade — this formula is exactly right; and the occasional person whose high fever of 39°C won’t come down can also use it. People who really catch an external infection — sore throat, swollen painful throat, fever and high temperature — in this situation you can use it. Keep it at home; generally three doses prepared is enough — no need to stock more.

Doctor Luo also tells a real example — someone back from Sanya asked him about it: quite a few people there had been infected, but when he himself caught it, it was just sneezing and a few days of coughing; he drank some Chinese-medicine-hospital decoction and recovered — it was lighter than a cold. This kind of mild case naturally has no use for Pu Ji Xiao Du Yin either.

Before using it, sort out cold from heat: if you caught cold, never touch it

This is an iron rule Doctor Luo repeats again and again — Pu Ji Xiao Du Yin is a cold, cooling formula that clears heat and resolves toxin; before using it you absolutely must distinguish cold from heat.

💬 Note from Doctor Luo: Everyone must remember: it is for heat toxin. If you have just been invaded by cold — the whole body feeling chilled, runny nose with clear green mucus, white tongue, fear of cold, none of the signs of heat — then you cannot use it. Without this kind of heat pattern, you cannot use it.

And there’s a particularly vivid reminder — don’t bring out the dragon-slaying blade to kill a chicken:

💬 Note from Doctor Luo: What is Pu Ji Xiao Du Yin? It is a dragon-slaying blade. If your throat is a little sore, you caught a bit of wind, a little external contraction, and you go straight for Pu Ji Xiao Du Yin — that’s killing a chicken with a dragon-slaying blade — no good, it’s too fierce. A formula this cold and cooling should not be casually deployed. Only use it for genuine heat toxin in full blaze — throat swollen, pain very severe, high fever — that’s the situation for it.

Taking the formula apart: huang lian and huang qin lead the charge, a company of herbs drives the heat toxin downward

What’s mainly in the formula? Doctor Luo takes apart the sovereign, minister, assistant and envoy structure.

💬 Note from Doctor Luo: The formula mainly uses huang lian (coptis) and huang qin (scutellaria) to clear heat and drain fire — these are the sovereign and minister herbs. Usually we don’t use huang lian that heavily, but in this formula you can basically use up to 15 g of each. In Li Dongyuan’s day he used wine-fried huang lian and huang qin — the warming nature of the wine carries upward, so it lets the medicinal power attack upward. Of course, if you can get the wine-fried versions, best; if not, ordinary huang lian and huang qin work fine — I often use the ordinary ones, no problem.

What’s added to send the medicinal power upward?

💬 Note from Doctor Luo: Besides wine-frying to make it rise, there’s also chai hu (bupleurum) and sheng ma (cohosh) — the medicinal nature travels upward, lifted and raised, so the detoxifying power goes upward. Why does this formula work so well for sore throat? Because the prescribing is truly precise — I resolve toxin, but I use wine-frying to make it rise, plus chai hu and sheng ma to carry it upward. Where does the medicinal power go? To the head and face, to the throat. This is where the brilliance of Li Dongyuan’s school lay — all of it classic.

The house specialty herbs for clearing the throat and resolving toxin include a few more:

💬 Note from Doctor Luo: Bai jiang can (white stiff silkworm) — the silkworm that got infected by a fungus, turned white and died — this thing is excellent at resolving toxin, especially for clearing the throat. In the Sheng Jiang San (Ascending-Descending Powder) we discussed for treating plague, bai jiang can is in there. For throat disease, bai jiang can is an especially commonly used herb. Ma bo (puffball) — puffball is a fungus, with an outer skin and something like a pink mushroom inside; once dried, touch it and a puff of spore powder bursts out. Ma bo resolves toxin and clears the throat excellently — but it stains your hands black when you’re weighing it out, so many pharmacies don’t stock it. If you encounter this, the other herbs in the formula can basically all be obtained — the one you often can’t get is ma bo. Niu bang zi (burdock seed) and xuan shen (scrophularia) — these too resolve toxin and clear the throat. Then match with bo he (mint) to expel the pathogen outward, release the exterior and push out the evil qi; ban lan gen (isatis root) and lian qiao (forsythia) to clear heat and resolve toxin. And what does ju hong (dried tangerine peel) do? It diffuses the lungs — regulates the congestion of lung qi. The qi is congested and the evil toxin sits above, so I use ju hong to open the lung qi; once the lung qi opens, you won’t let all the heat accumulate above — you can bring it down and clear it out.

The original doses were extremely light — the ancients drank half and dissolved half in the mouth

The original formula has a distinctive feature — the doses are extremely light.

💬 Note from Doctor Luo: Using this formula nowadays, to be honest, there is one issue: the amounts are very light. Huang lian and huang qin are used boldly, 15 g each; the rest of the herbs are used very lightly — ju hong, xuan shen, gan cao, chai hu, jie geng, 6 g each, that is, two qian; niu bang zi, ma bo, ban lan gen and such, one qian each — one qian is 3 g; bai jiang can and lian qiao were also 3 g back then; sheng ma used five fen — not even a full qian. So the dosage is very small.

How was it taken in those days?

💬 Note from Doctor Luo: Back then it was ground into powder — after grinding, half was simmered briefly in boiling water and steeped, sipped slowly; the other half was made into honey pills to be held in the mouth and dissolved, and that’s how the heat toxin was resolved. That’s how they used it then. For us now, making it as a decoction to drink also works.

For a modern decoction, the doses can be adjusted like this

Doctor Luo gives reference doses for modern decoction:

💬 Note from Doctor Luo: Huang lian and huang qin — for truly severe cases you can go up to 15 g; for an ordinary external contraction, 9 to 12 g is enough; I generally use around 9 g. The other detoxifying herbs — xuan shen, lian qiao, ban lan gen, bai jiang can — can be used at 9 g. The detoxifying portion should be sufficient. Then chen pi, gan cao, chai hu, jie geng, ma bo and bo he, I use 6 g each; sometimes ma bo up to 9 g; sheng ma, 3 g is enough. We can raise this dosage a little.

On additions and subtractions, Doctor Luo also has his opinions:

💬 Note from Doctor Luo: Doctor Li Dongyuan’s original formula had no ren shen (ginseng) in it. But by the time it reached Doctor Luo Tianyi — his disciple — the formula in his book had ren shen; and in Doctor Gong Tingxian’s book there’s also ren shen — three qian, which is 9 g. My personal view: if you have high fever and severely swollen painful throat, you can skip the ren shen — at that point the priority is clearing heat and resolving toxin; with heat toxin in full blaze, no ren shen needed. If the person is genuinely rather deficient, with insufficient upright qi, and on top of that there’s local heat toxin in full blaze — then you can add ren shen. Doctor Gong Tingxian also added one herb, chuan xiong (cnidium), and in my view you don’t need it — Doctor Li Dongyuan’s original formula is already perfectly classic. If the stool is dry, add a little da huang (rhubarb) — that’s acceptable.

While taking it, watch your diet — and if you feel chilled afterward, top up your yang

Doctor Gong Tingxian’s book also recorded the taboos to observe while taking the medicine:

💬 Note from Doctor Luo: What Doctor Gong Tingxian said — avoid sour and cold: don’t eat very sour things, because sour astringes; very cold things won’t do either — the medicine itself is cooling, and if you also eat cold food, you may not be able to take it. Lamb, chicken, fish — these provoking foods (fa wu) must also be avoided. And especially avoid sexual activity — your throat is swollen and painful, your head is swollen big, why would you be doing that?

After recovery, there’s one more step of aftercare:

💬 Note from Doctor Luo: After the illness is cured, if you feel a bit cold, a bit of cold in the belly, fear of cold — for those who are indeed yang-deficient, the medicine resolved the toxin but the yang qi took a little injury. At that point take Fu Zi Li Zhong Wan (Aconite Center-Regulating Pill) for a few days to restore the yang. That’s the usage of Pu Ji Xiao Du Yin.

In closing: a plague formula this famous truly deserves approval as a ready-made medicine

At the end, Doctor Luo speaks from the heart:

💬 Note from Doctor Luo: This formula is truly this classic — it has been handed down for a thousand years, and it was made specifically for plague. Our country really should produce it and keep it available as a standard plague-prevention formula. But I went online and looked — to my regret, everything is privately made and sold online; what quality those are, we can’t know — I won’t say more about that. Buying the herbs from your own pharmacy may be more reliable. Three years into the epidemic, our country really should approve a batch of medicines like this. Ancient China has far too many of these plague-treating formulas — they truly should be prepared, truly should be approved as ready-made Chinese medicines. You say Chinese people use them — but foreigners have so many infections too; foreigners can use them as well — Chinese medicine belongs to the whole world. So it is a great pity, some of these drug-approval policies are a great pity.

One last word from Doctor Luo about this formula: a household can make some preparation — write the formula down and keep it at hand; when the epidemic comes you’ll be ready. Especially when an ordinary external contraction reaches this level — as long as your throat is swollen and painful, this is absolutely better than going for an IV drip — and it truly resolves the toxin.

💬 Note from Doctor Luo: Pu Ji Xiao Du Yin, called by later generations Pu Ji Xiao Du San (the Powder form). If you can make it into powder, simmer it briefly in boiling water and drink it; drinking it as a decoction like we do also works. This is a formula for household emergencies. But for an ordinary throat that’s a little sore, a little external contraction, not yet at the level of heat toxin in full blaze — don’t use it for everything. This formula is a dragon-slaying blade; don’t kill a chicken with a dragon-slaying blade — remember this analogy.

Lately, every day Doctor Luo will introduce formulas from the ready-made-medicine repertoire — some are patent medicines, some are classic formulas — so that everyone knows in their hearts what to choose, and facing all the changes ahead, no one has to panic.

What to take away

One dose turns the tide for heat-toxin throat problems. For upper-respiratory infections with severe tonsil/throat swelling — heat toxin attacking upward — Pu Ji Xiao Du Yin (Universal Salvation Toxin-Dispelling Decoction) is the classic plague-era formula created by Doctor Li Dongyuan of the Jin-Yuan period: one dose establishes the turnaround, two or three settle it, and for people who develop tonsillitis at every cold, a few doses can even feel like a root cure.
Sort out cold from heat first — this is an iron rule. It is a cold, cooling formula: use it only for heat toxin (red swollen face and throat, razor-blade throat pain, high fever, red tongue, yellow coating, floating-rapid-forceful pulse). If you just caught cold — chills, green runny nose, white tongue — never touch it. And mild cases need nothing at all: in some cities’ statistics up to 90% of Omicron infections were symptomless.
The structure in brief: huang lian and huang qin (wine-fried in the original) clear heat and drain fire as sovereign and minister; chai hu and sheng ma lift the power upward; bai jiang can, ma bo, niu bang zi and xuan shen resolve toxin and clear the throat; bo he releases the exterior; ban lan gen and lian qiao clear heat and resolve toxin; ju hong diffuses the lungs so the heat toxin comes down instead of piling up above.
Modern reference doses: huang lian and huang qin 9–12 g (15 g for severe); xuan shen, lian qiao, ban lan gen, bai jiang can 9 g; chen pi, gan cao, chai hu, jie geng, ma bo, bo he 6 g (ma bo up to 9 g); sheng ma 3 g. Add da huang for dry stool; add ren shen for the genuinely deficient. While taking it: avoid sour and cold food, lamb/chicken/fish, and sexual activity; if you feel chilled afterward, a few days of Fu Zi Li Zhong Wan restores the yang.
Don’t kill a chicken with a dragon-slaying blade. For a minor sore throat or an ordinary cold, don’t reach for this. Keep the formula written down at home for genuine emergencies — for serious heat-toxin throat pain it is better than an IV drip.

Compiled from Doctor Luo Dalun’s lecture series on preventing and treating externally-contracted illnesses. Pu Ji Xiao Du Yin comes from the Jin-dynasty physician Doctor Li Dongyuan (Li Gao), and was later recorded in his Dong Yuan Shi Xiao Fang (Dongyuan’s Proven Formulas).