Xie Qing Wan — Drain the Green Pill

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Comparisons with related formulas
7. Modifications
8. Cautions

Overview

Xie Qing Wan — “Drain the Green Pill” — is a Song-dynasty pediatric formula from Qian Yi’s Xiao Er Yao Zheng Zhi Jue (c. 1119). “Green” (qing) corresponds in the Five Element framework to Wood and the Liver; the formula drains accumulated Liver Fire.

Qian Yi designed this formula for the classical pediatric pattern of Liver Fire generating Wind: a feverish, irritable, restless child with red eyes, headache, possibly febrile convulsions. The same pattern occurs in adults today, particularly with stress-driven Liver Fire causing migraine, irritability and sleep disturbance.

The formula is unusual in combining cooling, Heat-clearing herbs (Long Dan Cao, Zhi Zi, Da Huang) with wind-dispelling herbs (Qiang Huo, Fang Feng) and Blood-nourishing herbs (Dang Gui, Chuan Xiong). This addresses the classical principle that Liver Fire often arises against a backdrop of Liver Blood deficiency, so pure cooling without nourishing leaves the underlying weakness.

Note on safety: Some historical versions of this formula listed Chuan Mu Tong, which has been associated with Guan Mu Tong substitution and aristolochic acid toxicity. Modern reformulations and pharmaceutical-grade granules from regulated suppliers use either safe Mu Tong species or substitute Tong Cao. We use only safe, modern reformulations.

I prescribe Xie Qing Wan as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Xie Qing Wan is prescribed for Liver Fire generating Wind, particularly in children:

• Red, painful eyes with photophobia
• Throbbing temporal or vertex headache
• Irritability, restlessness, anger
• Acute high fever with convulsions (classical pediatric indication)
• Restless sleep with crying out
• Bitter taste in the mouth
• Dry mouth, particularly at night
• Constipation with hard, dry stools
• Dark, scanty urine
• Twitching or muscle spasms in chronic cases
• Tongue — red, particularly red sides; possibly thin yellow coat
• Pulse — wiry, rapid, possibly forceful

Key herbs

1. Long Dan Cao (Gentiana scabra) — powerfully drains Liver Fire; chief herb
2. Zhi Zi (Gardenia jasminoides) — drains Triple Burner Heat
3. Da Huang (Rheum palmatum) — drains Heat through the bowel
4. Qiang Huo (Notopterygium incisum) — releases Wind from the upper body; ascends to the head
5. Fang Feng (Saposhnikovia divaricata) — disperses Wind
6. Dang Gui — nourishes Liver Blood (the substrate for healthy Liver function)
7. Chuan Xiong — moves Liver Qi and Blood; resolves headache
8. Tong Cao (or Mu Tong, modern substitution) — drains Damp-Heat through urine
9. Gan Cao — harmonises
10. Bo He (peppermint, decocted last) — disperses Wind-Heat from the head

Formula actions

1. Drains Liver Fire
2. Disperses Wind from the head and eyes
3. Nourishes Liver Blood
4. Clears Heat through the bowel and urine
5. Stops convulsions and tremor

Conditions treated

1. Pediatric high fever with convulsions — the classical indication; ideally alongside conventional medical care
2. Red, painful eyes from Liver Fire
3. Acute conjunctivitis with intense redness and photophobia
4. Migraine and tension headaches with throbbing temporal pain, particularly stress-triggered
5. Hypertension with red face, irritability, headache (alongside conventional management)
6. Sleep terrors in children with restless sleep and crying out
7. ADHD-like presentations with prominent irritability, hyperactivity and impulsivity — see Chinese medicine for ADHD
8. Tourette’s syndrome and tic disorders with Liver Fire pattern
9. Restless legs syndrome with Liver Heat pattern — see restless legs
10. Acute trigeminal neuralgia flare with throbbing red pain — see trigeminal neuralgia

Comparisons with related formulas

• Long Dan Xie Gan Tang — more powerful Liver-Gallbladder Fire draining for adults with Damp-Heat in the lower burner. Both share Long Dan Cao but Long Dan Xie Gan Tang targets lower body symptoms.
• Tian Ma Gou Teng Yin — for Liver Yang rising with hypertension; uses calming, anchoring herbs rather than draining.
• Zhen Gan Xi Feng Tang — for severe Liver Yang rising with risk of stroke.
• Yi Gan San — gentler Liver-soothing formula for irritability and Wind in children and adults; less draining.

Modifications

• For prominent convulsions, add Gou Teng and Tian Ma
• For severe red eyes, add Ju Hua and Mi Meng Hua
• For migraine, add Bai Zhi and Man Jing Zi
• For hypertension, combine with Tian Ma Gou Teng Yin principles
• For chronic Liver Blood deficiency overlay, increase Dang Gui and add Bai Shao and Shu Di
• For sleep terrors and restless sleep, add Long Gu and Mu Li

Cautions

Acute febrile convulsions in children are a medical emergency; this formula is used in TCM hospital settings alongside conventional care and not as a substitute for emergency medical attention. Call 999 if a child has a first febrile convulsion or any convulsion lasting more than 5 minutes.

Not appropriate for cold, deficient or Yin-deficient patterns. The cold, draining herbs will damage the digestion and deplete Yin if used incorrectly.

Not appropriate in pregnancy — contains Da Huang and strong cold herbs.

Use cautiously in children with weak digestion; short courses only.

Confirm with your supplier that the formula does not contain Guan Mu Tong (aristolochic acid). Reputable pharmacies use only Tong Cao or safe Mu Tong species.

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.