What Bi Xie Fen Qing Yin is for
Bi Xie Fen Qing Yin is for damp, itchy skin of the lower body with a cold quality, where the tissue looks pale, sodden and slow to dry rather than red and angry. The formula warms what has gone cold and drains the turbid fluid that keeps the skin wet.
The skin is pale rather than red, and it looks waterlogged: soft, white and sodden in the folds, macerated where surfaces meet, and itchy in a way that is worse in cold damp weather. The surface may weep a thin clear fluid rather than pus, and it does not have the heat of an active inflammation. This is Dampness on a cold base, so the tissue looks underpowered as well as wet. It collects in the lower body because Dampness is heavy, and the Kidney that should sort clear fluid from turbid has lost its warmth.
Bi Xie drains the turbid Dampness out, and Yi Zhi Ren warms the Kidney and holds the clear Essence in, so the good fluid is kept while the turbid leaves. Wu Yao warms and moves Qi in the lower body, which helps the cold damp stagnation shift, and Shi Chang Pu transforms the turbidity so it does not settle again. The formula is warming and draining at once, which is why it fits damp skin on a cold base rather than the hot, red, weeping type.
It is not for Damp-Heat. Where the skin is red, the fluid yellow and the coat greasy yellow, cooling and draining is needed instead. It is also not a treatment for dry skin, because its warming and draining action would leave dry tissue drier. The cold, damp picture with pale sodden skin is the one it fits, and it is taken for a defined course and then reviewed.
Actions
- Warms the Kidney and dispels Cold
- Drains Dampness and separates the clear from the turbid
- Secures the Essence
- Relieves turbid discharge and dampness in the lower body
Properties
- Taste and temperature: Predominantly bitter and pungent with a warming quality. Bitter drains Dampness, pungent warms and moves Qi, warm supports the Kidney.
- Organs: Kidney, Bladder, Spleen
- Channels: Kidney, Bladder, Spleen
The pattern behind it
The pattern is Kidney Yang deficiency with turbid Dampness settling in the lower body. When the Kidney is cold it cannot separate the clear from the turbid, so discharge and cloudy urine result and the lower-body skin becomes damp and itchy. Warming the Kidney and draining the turbidity addresses both the cause and what has collected.
Composition
The herbs in Bi Xie Fen Qing Yin, with their role and dose.
| Role | Herb | Dose | Properties | Why it is there |
|---|---|---|---|---|
| Deputy | Bi Xie | 9 to 12 g | Neutral, Bitter | Drains turbid Dampness from the lower body, the key herb for separating the turbid. |
| King | Yi Zhi Ren | 9 to 12 g | Warm, Pungent | Warms the Kidney and secures the Essence, so the clear is retained while the turbid drains. |
| Wu Yao | 9 to 12 g | Warm, Pungent | Warms and moves Qi in the lower body, easing the cold damp stagnation. | |
| Shi Chang Pu | 9 to 12 g | Warm, Pungent | Transforms turbidity and opens the orifices, addressing the cloudy quality. |
Patterns it treats
Kidney Yang Deficiency with Water overflowing
Lower-body skin that is pale, sodden and itchy, macerated in the folds and worse in cold damp weather. Cold has weakened the Kidney's ability to separate clear fluid from turbid, so dampness settles in the tissue and keeps it wet.
How the formula is built
Two herbs drain and two warm and secure. Bi Xie drains the turbid Dampness while Yi Zhi Ren holds in the Essence, and Wu Yao with Shi Chang Pu warms and moves the lower body so the Dampness does not settle again. That balance of draining and retaining is why the formula is described as separating the clear from the turbid.
Skin conditions it is used for
Where this formula appears in the skin conditions of the library.
Preparation and use
Decocted in water and taken warm, in two divided doses, classically with a little salt.
Modifications
- If Cold is marked, more warming herbs are added.
- If the discharge is heavy, draining herbs are increased.
- If Heat appears with a yellow greasy coat, cooling herbs are used instead.
- If the Kidney deficiency is marked, the securing herbs are increased.
Timing
Taken warm in two divided doses, classically with a little salt.
Duration
Two to four weeks for an acute episode, then reassessed; longer for chronic recurrent patterns.
Diet while taking it
Avoid cold and raw food and excess dampening food such as dairy and sugar.
Safety
Contraindications
Avoid in Damp-Heat of the lower body, where the discharge is yellow and the tongue coat greasy yellow. Avoid in Yin deficiency with Heat.
Interactions
No major interaction is recorded in the reference beyond the general caution of warming herbs in Heat patterns.
Pregnancy
Use with caution in pregnancy. Wu Yao moves Qi and has a mild warming, mobilising action.
Breastfeeding
Use only under professional guidance.
Children
Used only with professional supervision.
Before you use it
Recorded from the classical record and rewritten in this project's own words. Educational only: not a prescription, and discharge or genital itch needs medical diagnosis.
General safety references
General references for herbal hepatotoxicity and herb-drug interactions; they are not specific to this formula.
- Review article: Herbal hepatotoxicity - an update on traditional Chinese medicine preparations. Alimentary Pharmacology & Therapeutics, 2014. PMID: 24844799.
- Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs, 2009. PMID: 19719333.
- Warfarin and food, herbal or dietary supplement interactions: a systematic review. British Journal of Clinical Pharmacology, 2021. PMID: 32478963.
Selected PubMed records
Real PubMed records for the modern, non-TCM discussion of this formula. They are references, not a claim that the formula is proven for any skin condition.
- Bi Xie Fen Qing Yin decoction alleviates potassium oxonate and adenine induced-hyperuricemic nephropathy in mice by modulating gut microbiota and intestinal metabolites.. Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2024. PMID: 38147734.
Origin and history
Yang Shi Jia Cang Fang (杨氏家藏方, The Yang Family's Collected Formulas) by Yang Ti, Song dynasty, 1178.
The formula comes from the Yang family formulary of 1178, where it treated turbid urine and discharge on a cold deficient base. Its principle of separating the clear from the turbid is a distinctive idea in the tradition, and the same logic carries over to damp skin problems of the lower body when the quality is cold rather than hot.
Evidence note
No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.
Common questions
How is it different from Bi Xie Shen Shi Tang?
Bi Xie Shen Shi Tang is cooling and clears Damp-Heat. Bi Xie Fen Qing Yin is warming and is used for cold dampness, with a pale wet tongue rather than a yellow greasy one.
Can it help itchy skin?
Only the damp, cold, lower-body pattern. Itchy skin from heat or dryness needs a different formula.
What does separating the clear from the turbid mean?
It means restoring the Kidney's ability to keep what should be retained and pass what should not. That is why the formula both drains turbidity and secures the Essence.
Should genital itch be assessed?
Yes. Persistent itch or discharge needs medical diagnosis before herbal treatment.