This is a modern empirical formula that is based on the following classical formulas:

• Cang Er Zi San (Xanthium Powder-Formula), from ‘Formulas to Benefit Life’ (ji sheng fang), by Yan Yong-he, 1253.
• Yin Qiao San (Lonicara and Forsythia Powder-Formula) from the ‘Analysis of Warm Diseases’ (wen bing tiao bian), by Wu Ju-tong (a.k.a. Wu Tang), 1798
• Jing Fang Bai Du San (Scizonepeta and Saposhnikovia Powder-Formula to Overcome Toxin) from ‘Key to the Therapeutics of Children’s Diseases (xiao er zheng zi jue), by Qian Yi, 1119.
• Huang lian Jie Du Tang (Decoction Formula with Coptis to Resolve Toxin) from ‘Medical Secrets of an Official’ (wai tai mi yao), by Wang Tao, 752.

This formula covers the major pathodynamic factors underlying an episode of infective sinusitis, which may occur as an acute condition or an acute on chronic condition. The key clinical features for which this formula is indicated are all related to the activity of pathogenic factors, i.e. an excess syndrome:

• Nasal discharge with purulent (yellow or greenish) discharge
• Strong pain over the sinuses
• Full pulse
• Substantial tongue coat

It should be noted that in chronic conditions with an acute flare up, the pulse may be thready and the tongue may not have a thick coat, due to the underlying pattern of deficiency.

TCM ACTIONS
Releases exterior Wind, clears Heat Toxin and unblocks the nasal passages.

TCM SYNDROMES

• Wind-Heat invasion Lung (nasal passages)
• Localised Heat Toxin (in the nasal passages)

INDICATIONS
Infective sinusitis (acute or acute on chronic)

SIGNS & SYMPTOMS
(Key clinical features in bold)

• Frontal headache
• Tenderness over the sinuses
• Nasal discharge ‐ yellow or green
• Anosmia
• Sore throat
• Red tongue that may also have a thick, greasy or dry yellow coat
• Rapid pulse that may also be full