Many people, when they feel "internal heat," buy heat-clearing medicines on their own. Some find them effective, while others become more depleted the more they take them, even developing stomach pain and diarrhea. In traditional Chinese medicine theory, "fire" can be deficient or excess, and its location can be upper or lower; medication must therefore be chosen carefully. Below I introduce three commonly used heat-clearing medicines to help you clarify things and avoid using the wrong one.

1. Huanglian Shangqing Pian: clears heat from the upper burner, heart, and lungs

If you experience dizziness and a heavy-headed feeling, red swollen painful eyes, swollen painful throat, recurrent mouth ulcers, nosebleeds or gum bleeding, accompanied by irritability and insomnia, dry mouth with a desire to drink, these are mostly signs of heart- and lung-fire disturbing the clear orifices.

In traditional Chinese medicine, the heart opens into the tongue, the lung governs the skin and hair and connects with the nasal orifices; fire rises and easily disturbs the clear orifices. Huanglian Shangqing Pian is centered on Huanglian, Huangqin, Zhizi and similar herbs—bitter and cold in nature, it directly counters excess fire in the upper jiao, especially adept at clearing heat from the heart and lungs and improving heat symptoms of the head, face, and sensory organs.

2. Sanhuang Pian: clearing fire in the middle jiao, stomach, and intestines

If you often feel burning in the stomach, get hungry easily after eating, have abdominal bloating or stomach pain, hard stools like sheep droppings, and dark scanty urine, these are most likely signs of accumulated heat in the spleen and stomach and obstruction in the intestines.

San Huang Pian (Three-Yellow Tablets) originates from the Xiaxin Decoction variant in the Jin Kui Yao Lue, primarily using rhubarb, baical skullcap, and coptis; it mainly targets the middle burner to purge excess in the Yangming fu. Its heat-clearing power is relatively strong and it can also promote bowel movements to remove stagnation, suitable for conditions of excessive gastrointestinal heat accumulation, especially for people with a more robust constitution.

3. Niuhuang Jiedu Pian (Bezoar Detoxification Tablets): clears constrained fire in the three burners, detoxifies and reduces swelling

If you not only have dry mouth and throat pain but also accompanying throat or gum swelling and pain, mouth ulcers, hoarseness, even fever with irritability, dark scanty urine, and dry, hard stools, this indicates that pathogenic heat has spread through the upper, middle, and lower burners.

Niuhuang Jiedu Pian chiefly contains artificial bezoar, baical skullcap, gypsum, and others; it is especially good at clearing heat and detoxifying, purging fire and promoting bowel movements. Its heat-clearing range is broader, and it is relatively effective at relieving various inflammations and swellings caused by exuberant heat-toxin.

Real case reference

I once treated a 28-year-old woman who worked late regularly. She repeatedly developed mouth ulcers and a dry, sore throat. After taking Sanhuang pills on her own, her bowel movements became regular, but the ulcers did not heal and she experienced stomach discomfort. Examination showed a red tongue with little coating and a thin, rapid pulse—signs of yin deficiency with exuberant fire and upward-floating deficient heat. After switching to methods that nourish yin and reduce fire, she improved. This case shows that if one does not distinguish between excess and deficiency and blindly clears heat and drains fire, it can easily damage the spleen and stomach and worsen yin deficiency.

Usage reminders:

All three types of these medicines are appropriate for “excess fire” and are not suitable for “deficient fire” (such as long-term low-grade fever, heat in the palms and soles, dry mouth without desire to drink, etc.) or for people with a cold-deficient constitution.

Stop when the illness improves; not suitable for long-term use to avoid damaging the spleen and stomach yang.

During medication, eat light foods; avoid spicy and greasy foods.

If symptoms do not improve after 3 days of medication, stop taking it and consult a doctor.

Conclusion

In short, fire-clearing medicines must not be used blindly or indiscriminately. Only correct syndrome differentiation can make the medicine effective; otherwise it may actually increase the "fire." It is recommended to choose them under the guidance of a doctor or pharmacist. Those who have recurrent "heat" symptoms or other accompanying discomfort should seek medical attention promptly to determine the cause.