Qing Zao Jiu Fei Tang (清燥救肺汤): Clear Dryness and Rescue the Lungs

The Autumn Dryness Formula

Qing Zao Jiu Fei Tang (清燥救肺汤), “Clear Dryness and Rescue the Lungs Decoction,” is the canonical TCM answer to a specific seasonal complaint: the dry cough that arrives in late summer and autumn. As the weather turns hot and dry — particularly the long, rainless stretch around the start of autumn (处暑 to 秋分) — people develop a tickling, non-productive cough, a raw throat, and a constant thirst. TCM calls this wen zao (温燥, warm dryness), and Qing Zao Jiu Fei Tang is the formula built specifically for it.

It was created by Yu Chang (喻昌, 1585–1664, also known as Yu Jiayan), one of the most original thinkers of the early Qing dynasty, and recorded in his 《医门法律》 (Yi Men Fa Lu, “Principles and Prohibitions of Medicine,” 1658 CE). Yu Chang was unusual among classical authors in that he built whole theories around the idea of zao (dryness) as a distinct pathogen, separate from cold, heat, and dampness. The Huangdi Neijing had listed Six Pathogens — Wind, Cold, Summerheat, Dampness, Dryness, Fire — but clinical practice had largely folded Dryness into either Cold or Heat. Yu Chang argued, persuasively, that dryness deserved its own treatment, and this formula is his demonstration.

The Pattern It Treats

Warm Dryness Damaging the Lungs (温燥伤肺)

The pattern develops when, after a hot summer, the air turns dry and the body’s Lung fluid is evaporated faster than it is replaced. The Lung in TCM is the “tender organ” (娇脏) — it dislikes both cold and dryness, and it is the first internal organ to communicate with the outside air.

Key symptoms:

• Dry, hacking cough with little or no sputum, or sticky sputum hard to expectorate
• Dry, sore throat and dry mouth, with thirst
• Dry nasal passages, sometimes slight nosebleed
• Chest tightness or a feeling of oppression
• Low-grade fever, mild headache, possible dry skin
• Tongue: dry, possibly red at the tip, thin dry coating
• Pulse: thin, rapid, or floating

The crucial diagnostic point: the cough is dry, not wet, and there is no deep Yin-deficiency background (no night sweats, no五心烦热) — the patient was fine until the dry weather set in. This is what separates warm dryness from the deeper Yin depletion patterns.

The Herbs

Qing Zao Jiu Fei Tang has nine ingredients, and its elegance is in the way they support and balance one another:

Herb	Chinese	Role	Action
Sang Ye	桑叶	Chief	Clears Lung heat, disperses dryness
Shi Gao	石膏	Deputy	Clears Lung heat, generates fluid
Mai Men Dong	麦门冬	Deputy	Nourishes Lung Yin, generates fluid
E Jiao	阿胶	Deputy	Nourishes Lung Yin, stops bleeding
Hu Ma Ren	胡麻仁	Assistant	Nourishes Yin, moistens the Lungs
Xing Ren	杏仁	Assistant	Stops cough, directs Lung Qi downward
Pi Pa Ye	枇杷叶	Assistant	Descends Lung Qi, stops cough
Ren Shen	人参	Assistant	Supplements Qi, generates fluid
Gan Cao	甘草	Harmonizer	Harmonizes, moistens the Lungs

How the Formula Works

The formula operates as a layered defense of Lung fluid:

Clear the Dryness at the Source

Sang Ye (Mulberry Leaf) is the chief — light, cooling, and dispersing, it vents the dry heat out of the Lung through the surface. Shi Gao (Gypsum) reinforces this by clearing the internal heat that is drying the fluid. Together they extinguish the cause of the dryness.

Moisten What Has Been Dried

Mai Men Dong, E Jiao, and Hu Ma Ren directly replenish Lung Yin and fluid. E Jiao (donkey-hide gelatin) in particular is a heavy Yin-blood nourisher that also helps with any dry-heat-induced minor bleeding (dry cough with a streak of blood). This trio “rescues” the Lung tissue.

Restore the Movement of Lung Qi

Xing Ren and Pi Pa Ye descend Lung Qi — they stop the cough by restoring the downward direction the Lung Qi should flow. Pi Pa Ye, made from loquat leaves, is itself a famous dry-cough herb.

Protect the Spleen and Qi

Ren Shen (ginseng) is the thoughtful inclusion. Heavy Yin-nourishing herbs can burden the digestion and generate dampness. A small amount of ginseng supports the Spleen so the formula can be absorbed, and it also helps generate fluid (Qi generates fluid in TCM theory). Gan Cao harmonizes and adds its own moistening quality.

Clinical Applications

1. Autumn Dry Cough

The textbook use. A patient develops a dry cough as the weather dries out, with thirst and a raw throat. The formula typically resolves the cough within several days.

2. Post-Infection Dry Cough

After a viral respiratory infection clears, a lingering dry, ticklish cough often persists for weeks. Qing Zao Jiu Fei Tang is well-suited here because the pathogen has left residual heat and dryness in the Lung even though the infection is gone.

3. Dry Environment and Occupational Cough

Patients exposed to dry, dusty, or heated environments — desert climates, air-conditioned offices, welding or grinding work — who develop a dry cough respond well, since the trigger is environmental dryness rather than infection.

4. Chronic Pharyngitis with Dryness

For the dry, scratchy throat with occasional dry cough that comes from chronic Lung dryness, a modified version of this formula is a common prescription.

Comparison with Related Formulas

Feature	Qing Zao Jiu Fei Tang	Bai He Gu Jin Tang	Sang Xing Tang
Pattern	Warm-dryness damaging Lungs	Lung-Kidney Yin deficiency	Mild warm-dryness (early stage)
Depth	Lung surface	Deep — Lung + Kidney	Lung surface, lighter
Acute or chronic	Acute / subacute	Chronic	Acute, early
Distinguishing sign	Dry cough, thirst, fever	Dry cough, night sweats, blood	Mild dry cough, slight thirst
Kidney involvement	None	Strong	None

Sang Xing Tang (桑杏汤) is the lighter, earlier-stage version of warm-dryness treatment; Qing Zao Jiu Fei Tang is for when the dryness has progressed further and damaged more fluid.

Forms and Administration

Form	Best For
Decoction	Active symptoms — most effective
Patent pills / granules	Convenience, milder cases

The decoction is taken warm, in divided doses, 2–3 times daily. The Pi Pa Ye should be wrapped and the down brushed off the leaf before decocting. For dry cough, adding a small amount of honey or pear can enhance the moistening effect.

Precautions

• Phlegm-damp cough — do not use when the cough is wet with copious white or clear phlegm; the moistening herbs will worsen the dampness
• Spleen deficiency with loose stools — the Yin-nourishing ingredients (especially E Jiao and Hu Ma Ren) can cause diarrhea in weak digestions; reduce dose or add Spleen-supporting herbs
• Cold-dryness (凉燥) — a separate pattern with chills, no thirst, and clear watery phlegm, treated with Xing Su San, not this formula

Why This Formula Matters

Yu Chang’s contribution was not just a recipe — it was an argument that dryness deserves to be treated on its own terms, with light, moistening, fluid-generating herbs rather than the cold, bitter heat-clearers that doctors had been reaching for by default. Every autumn, millions of people develop exactly the pattern he described: the dry, persistent cough that lingers as the air loses its moisture. Qing Zao Jiu Fei Tang is the most direct and well-designed answer Chinese medicine has for it.

Related Reading

• Bai He Gu Jin Tang: Lily Bulb for Deep Yin Deficiency
• Sang Ye: Mulberry Leaf
• Mai Men Dong: Ophiopogon for Yin
• TCM Autumn Health Guide