1. Ma Huang Tang

1. Ma Huang Tang

"Treatise on Cold Damage"

[Composition] Ma Huang 9 grams (three liang) Gui Zhi 6 grams (two liang) Xing Ren 9 grams (seventy pieces) Zhi Gan Cao 6 grams (one liang)

[Administration] Decoct in water and take warm to induce sweating, aiming for sweat to cover the entire body.

[Indications] Wind-cold exterior excess combined with lung qi stagnation.

[Suitable Conditions] Headache, body pain, fever with chills, no sweating, cough and wheezing, and floating tight pulse.

[Functions] Disperses the exterior and induces sweating, clears the lungs and relieves wheezing.

[Formula Analysis] Wind-cold exterior excess manifests as headache, body pain, fever with chills, no sweating, and a floating tight pulse; lung qi stagnation manifests as cough and wheezing. Wind-cold exterior excess is the primary issue, while lung qi stagnation is the secondary issue. Ma Huang is pungent and warm, with the functions of dispersing the exterior, dispelling cold, and inducing sweating to address the primary issue; it also clears the lungs and relieves wheezing to address the secondary issue, thus treating both primary and secondary issues simultaneously. Gui Zhi warms yang and relaxes muscles, assisting Ma Huang in inducing sweating and driving out wind pathogens, serving as a supplementary function. Xing Ren clears and promotes lung qi, and when paired with Ma Huang, enhances the function of clearing the lungs and relieving wheezing, making it a complementary treatment. Gan Cao harmonizes all the herbs as a guiding force.

[Clinical Adjustments] ① Removing Gui Zhi results in San Ao Tang (from "Harmonized Prescriptions"), specifically for clearing the lungs and stopping cough. ② Adding Bai Zhu results in Ma Huang Jia Zhu Tang (from "Synopsis of Golden Cabinet"), specifically for dispelling wind and removing dampness, used to treat joint pain.

[Reference Materials] According to pharmacological research, Ma Huang contains ephedrine, which can relieve bronchial smooth muscle spasm, as well as ephedra oil, which can promote sweat gland secretion; it also contains pseudoephedrine, which has a significant diuretic effect. In addition, the volatile oils in Ma Huang have a remarkable inhibitory effect on influenza viruses.

[Commentary] This formula is often used for upper respiratory infections, influenza, and acute tracheitis.

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2. Gui Zhi Tang from "Treatise on Cold Damage"

[Composition] Gui Zhi 9 grams (three liang), Bai Shao 9 grams (three liang), Gan Cao 6 grams (two liang), Sheng Jiang 9 grams (three liang), Da Zao 7 pieces (twelve pieces)

[Administration] Decoct in water and take in three divided doses while warm, followed by hot porridge to enhance the medicinal effect.

[Indications] Wind-cold exterior deficiency (disharmony between Ying and Wei).

[Suitable Conditions] Headache, body pain, fever with chills, sweating, and a floating slow pulse.

[Functions] Releases the exterior and relaxes muscles, harmonizes Ying and Wei.

[Formula Analysis] Wind-cold exterior deficiency presents as headache, body pain, fever with chills, sweating, and a floating slow pulse. When wind-cold exterior deficiency occurs, Wei is weak and Ying is strong, leading to sweating—this is what is commonly referred to as disharmony between Ying and Wei. In this formula, Gui Zhi is pungent and warm, primarily working to release the exterior and regulate Wei. Bai Shao gathers yin and regulates Ying, ensuring that Gui Zhi's pungent warmth does not harm yin, thus serving as a supplementary function. The combination of the two herbs addresses both the exterior and interior, jointly achieving the functions of releasing the exterior and harmonizing Ying and Wei. Sheng Jiang helps regulate Wei to assist Gui Zhi, while Da Zao helps regulate Ying to assist Bai Shao; the two herbs strengthen the harmonization of Gui and Bai, serving as a complementary treatment. Gan Cao harmonizes all the herbs as a guiding force.

[Clinical Adjustments] ① Adding Hou Pu and Xing Zi results in Gui Zhi Jia Hou Pu Xing Zi Tang (from "Treatise on Cold Damage"), treating wind-cold combined with wheezing. ② Adding Ge Gen results in Gui Zhi Jia Ge Gen Tang (from "Treatise on Cold Damage"), treating exterior deficiency combined with stiffness in the neck and back. ③ Removing Bai Shao results in Gui Zhi Qu Shao Tang (from "Treatise on Cold Damage"), treating exterior deficiency combined with chest fullness; if there is slight chills, add Fu Zi to this formula, resulting in Gui Zhi Qu Shao Jia Fu Zi Tang (from "Treatise on Cold Damage"). ④ Adding Fu Zi results in Gui Zhi Fu Zi Tang (from "Treatise on Cold Damage"), treating mild stiffness in the limbs that makes it difficult to bend and stretch.

[Reference Materials] ① According to modern experimental research, the volatile oils in Gui Zhi can stimulate sweat glands, causing skin blood vessels to dilate, thus having a sweating effect; they can also stimulate gastrointestinal motility, increasing the secretion of digestive juices, thus having a stomach-strengthening and digestion-assisting effect. Gui Zhi also has a certain inhibitory effect on influenza viruses. ② This formula is the crown of Zhang Zhongjing's group of formulas, being the first formula for nourishing yin and yang, relaxing muscles and inducing sweating, and harmonizing Ying and Wei. Anyone with stroke, cold damage, or miscellaneous symptoms with a floating weak pulse and spontaneous sweating but unresolved exterior symptoms can benefit from it; other cases only need to meet one or two criteria, without needing to fulfill all conditions. ("Discussions on Famous Doctors' Formulas") ③ Patient Li, male, 48 years old. He fell ill yesterday, experiencing chills, fever, headache, slight sweating, chest tightness, nausea, thin white tongue coating, and a slightly rapid pulse with weak pressure. Prescription: Gui Zhi three qian, Bai Shao three qian, Sheng Jiang two qian, Zhi Cao two qian, Da Zao four pieces, Qing Ban Xia three qian. After one dose, he returned for a follow-up visit, his fever subsided, and he felt dizzy but had no appetite. Prescription: Reduce Qing Ban Xia and add Mai Ya three qian, and he recovered after one dose. ("Guangdong Medical Journal," May 21, 1964)

[Commentary] This formula can be used not only for common colds and flu, but also for heart disease, nephritis, neurasthenia, rheumatoid arthritis, and other conditions, with appropriate adjustments.

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3. Xiao Qing Long Tang from "Treatise on Cold Damage"

[Composition] Ma Huang 9 grams (three liang), Shao Yao 9 grams (three liang), Gui Zhi 9 grams (three liang), Zhi Gan Cao 9 grams (three liang), Gan Jiang 9 grams (three liang), Wu Wei Zi 9 grams (half liter), Xi Xin 3 grams (three liang), Ban Xia 9 grams (half liter)

[Administration] Decoct in water and take.

[Indications] Wind-cold exterior excess combined with phlegm-dampness.

[Suitable Conditions] Headache, fever with chills, no sweating, wheezing and coughing with reversed breathing, thin and clear phlegm, swollen tongue with white greasy coating, and a floating tight pulse.

[Functions] Disperses the exterior and dispels cold, warms the lungs and transforms phlegm.

[Formula Analysis] Wind-cold exterior excess manifests as headache, fever with chills, no sweating, and a floating tight pulse; when combined with phlegm-dampness, it manifests as wheezing and coughing with reversed breathing, thin and clear phlegm, and a swollen tongue with white greasy coating. This condition is characterized by pre-existing phlegm-dampness, which becomes apparent when exposed to wind-cold, affecting both the exterior and interior. The condition is caused by wind-cold triggering phlegm-dampness, so wind-cold is the primary issue and phlegm-dampness is the secondary issue. Ma Huang and Gui Zhi disperse the exterior and dispel cold to address the primary issue, while Gan Jiang, Xi Xin, Wu Wei Zi, and Ban Xia transform phlegm-dampness to address the secondary issue. All these herbs are pungent, warm, and dry, which often leads to depletion of yin and loss of fluids. To counteract this, Shao Yao is used to gather yin and transform fluids, preventing the depletion of yin, thus serving as a complementary treatment. Gan Cao benefits qi and harmonizes the middle, while also harmonizing all the herbs, serving as a guiding force.

[Clinical Adjustments] ① Adding Shi Gao results in Xiao Qing Long Jia Shi Gao Tang (from "Synopsis of Golden Cabinet"), treating wind-cold exterior combined with internal dampness and internal heat. ② If lung cold and dampness are particularly severe, the amount of Wu Wei Zi should be reduced compared to Gan Jiang and Xi Xin; if accompanied by lung qi deficiency, the amount of Wu Wei Zi should be increased accordingly.

[Reference Materials] ① "Synopsis of Golden Cabinet" uses this formula to treat overflow of fluid and coughing with difficulty lying down, indicating that the focus of this formula is on treating cold-induced dampness and coughing, regardless of whether there is an exterior syndrome or not, it can be used appropriately. ② This formula, along with Wu Ling, is used to treat unresolved exterior conditions with water accumulating under the heart. While Wu Ling treats water accumulation and prevents its flow, thus promoting water drainage and slightly inducing sweating, it is essentially suppressing water accumulation; this formula, on the other hand, treats water movement rather than accumulation, so it prepares pungent and warm remedies to disperse water and uses sour and bitter flavors to calm the lungs and nurture the source of transformation. ("Discussions on Famous Doctors' Formulas") ③ Mr. Jiang ××, male, 64 years old, a cadre, first visited on December 26th, suffering from a cough and asthma for more than ten years, with worsening symptoms during labor. Now he has shortness of breath and coughing, chills and fever, thin and watery phlegm, a whistling sound in the throat, palpitations like springtime, and chest tightness. It seems that the cold has triggered latent dampness, with water accumulating in the heart. Treatment should focus on dispersing the exterior and draining water. Prescription: Pure Ma Huang one qian, Gui Zhi two qian, Bei Xi Xin four fen, Gan Jiang one qian, Jiang Ban Xia three qian, Dan Fu Pian one qian, Sheng Bai Shao three qian, Chao Bai Shao three qian, Ling Ci Shi four qian, Fu Ling four qian, Ju Hong one qian and a half, Su Zi three qian, Wu Wei Zi seven fen. On December 29th, he returned for a follow-up visit, his cough had subsided, the chills and fever were gone, but he still experienced shortness of breath during labor and palpitations and lower back pain. The dampness and external cold have been resolved, but his kidney qi is weak and unable to absorb properly, so he plans to nourish his kidney qi to treat the root cause. Prescription: Dan Fu Pian one qian, Huai Shan Yao three qian, Shan Yu Rou three qian, Ci Shi four qian, Zi Shi Ying four qian, Wu Wei Zi seven fen, Hu Tao Rou four qian, Chen Xiang one qian, Kan Zheng one line. Note: X-ray examination and Western medical diagnosis confirmed emphysema, and after seven doses of medication, all symptoms have subsided. ("Jiangsu Traditional Chinese Medicine Journal," October 22, 1965) ④ When using Xiao Qing Long Tang to treat asthmatic bronchitis, bronchial asthma, and other cold-induced dampness-related coughing and wheezing conditions, some people advocate for heavy use of Xi Xin. They believe that drinking Xi Xin decoction at 12–15 grams, or even taking it continuously for a month, has never shown any adverse effects; however, when taking Xi Xin in powdered form, one must pay attention to the dosage and avoid taking too much to prevent poisoning. ("Shanghai Traditional Chinese Medicine Journal," April 39, 1980)

[Commentary] This formula can be used for bronchial asthma, asthmatic bronchitis, chronic bronchitis, and emphysema.

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4. Da Qing Long Tang from "Treatise on Cold Damage"

[Composition] Ma Huang 10 grams (six liang), Gui Zhi 6 grams (two liang), Xing Ren 6 grams (forty pieces), Zhi Gan Cao 6 grams (two liang), Sheng Shi Gao 30 grams (the size of an egg), Sheng Jiang 6 grams (three liang), Da Zao 4 pieces (twelve pieces)

[Administration] Boil Ma Huang first, then add the other herbs, remove the residue, and take warm.

[Indications] Exterior excess combined with internal heat.

[Suitable Conditions] Headache, body pain, fever with chills, no sweating but thirst, irritability, and a floating tight pulse.

[Functions] Disperses the exterior and dispels cold, clears heat and relieves irritability.

[Formula Analysis] Exterior excess manifests as headache, body pain, fever with chills, no sweating, and a floating tight pulse; when combined with internal heat, it manifests as thirst and irritability. The condition is caused by wind-cold entering the interior and turning into heat, so treating wind-cold should be the main focus. In this formula, Ma Huang and Gui Zhi are heavily used to induce sweating and disperse the exterior, serving as the primary agents. Shi Gao clears internal heat and also relieves irritability as a supplementary agent. The lungs are connected to the skin and hair, and when wind-cold invades the exterior, the lungs become stagnant and start coughing, so Xing Ren clears the lungs and stops coughing as a complementary treatment; when wind-cold invades the exterior, Ying and Wei become disharmonious, so Sheng Jiang and Da Zao harmonize Ying and Wei as a complementary treatment. Gan Cao harmonizes all the herbs as a guiding force.

[Clinical Adjustments] ① Removing Gui Zhi, Sheng Jiang, and Da Zao results in Ma Xing Gan Shi Tang (from "Treatise on Cold Damage"), a specialized formula for treating wind-heat accumulated in the lungs. ② Adding Che Qian Zi can treat acute conjunctivitis or other external eye inflammations. ③ Removing Xing Ren and Gui Zhi results in Yue Bi Tang (from "Synopsis of Golden Cabinet"), treating water retention and swelling all over the body.

[Reference Materials] ① For sunstroke, with a floating tight pulse, fever with chills, body pain, no sweating but irritability, Da Qing Long Tang is the main treatment. If the pulse is weak and there is sweating but wind, do not take it, as it will lead to convulsions, muscle twitching, and other adverse reactions. ("Treatise on Cold Damage") ② The name "Da Qing Long" means "great dragon rising clouds and rain," so treating wind is mainly done with Gui Zhi, and treating cold is mainly done with Ma Huang. Combining Gui Zhi and Ma Huang into one formula makes it a comprehensive treatment for both cold and wind, with no sweating, so reducing Shao Yao is to avoid its gathering effect, and with irritability, adding Shi Gao to relieve heat. ("Medical Compendium of the Golden Age") ③ Mr. Shi ××, male, 36 years old, first visited on November 3, 1965. He had been sick for three days, with chills, high fever of 39.5°C, no sweating but irritability, pain in head and body, floating rapid pulse, and thin white tongue coating. Prescription: Ma Huang and Gui Zhi each one and a half qian, Xing Ren three qian, Sheng Shi Gao one liang, Sheng Gan Cao one qian, Zhu Ru one qian and a half, Zhu Ye thirty pieces, fresh Lu Gen one chi, all decocted in water. After one dose, the chills and fever subsided, but the cough worsened, so the original prescription removed Ma and Gui, adding Ju Jing and Sang Ye each one and a half qian. After another dose, the illness was cured. ("Traditional Chinese Medicine Journal," March 1966)

[Commentary] This formula is used for severe colds, acute bronchitis, bronchial pneumonia, lobar pneumonia, and respiratory diseases complicated by infection.

5. Renshen Baidu San from "Pediatric Medicinal Evidence Directly Explained"

[Composition] Qiang Huo, Du Huo, Chai Hu, Qian Hu, Zhi Ke, Ju Jing, Chuan Xiong, Fu Ling, Dang Shen each 30 grams, Gan Cao 15 grams

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[Dosage and Administration] Grind the herbs into powder; take 6 grams per dose, 2–3 times daily, decocted in ginger and peppermint water and taken warm. In modern times, it is often used as a decoction, with the dosage reduced to one-fifth of the original amount, adding a small amount of peppermint and ginger.

[Main Indications] Exterior excess combined with dampness.

[Indications] Headache, body pain, fever with chills, no sweating, chest and diaphragm fullness and oppression, joint pain, nasal congestion with heavy nasal discharge, cough with copious phlegm, white greasy tongue coating, floating and tight pulse or with slippery pulse.

[Functions] Dispersing wind-cold and eliminating wind-dampness.

[Formula Analysis] The pattern of exterior excess presents as headache, body pain, fever with chills, no sweating, and a floating and tight pulse; the pattern of dampness adds chest and diaphragm fullness and oppression, heavy nasal discharge, joint pain, cough with copious phlegm, and a slippery pulse. This condition arises from wind-cold combined with dampness invading the body, with both factors contributing to the disease. The formula uses Qianghuo and Duhuo to disperse wind-cold and eliminate wind-dampness simultaneously, addressing both root causes, making them the primary herbs. Dampness tends to be heavy and obstructive, leading to chest and diaphragm fullness, joint pain, and heavy nasal discharge—clinical manifestations of damp obstruction of qi flow. The formula employs Qianhu to descend qi, Jiegeng to lift qi, Chaihu to diffuse qi, and Zhike to disperse qi, integrating the essence of qi-moving herbs. This enhances the ability of Qianghuo and Duhuo to resolve exterior wind-cold and eliminate dampness, thus serving as auxiliary herbs. When pathogenic factors gather, qi must be deficient; the reason wind-cold combined with dampness invades the body is due to qi deficiency. Therefore, Dangshen is added to tonify qi, embodying the principle of reinforcing the righteous qi to dispel the pathogenic qi, which can also be considered a complementary treatment. Chuanxiong promotes blood circulation and dispels wind, while Fuling strengthens the spleen and drains dampness—all serving as complementary treatments. Ginger and peppermint harmonize cold and heat, also acting as complementary treatments. Licorice balances all the herbs and serves as a guiding agent.

[Clinical Modifications] ① Remove Dangshen, add Yinhuahua and Lianqiao, forming Yinqiao Baidu San (from "Yifang Jijie"). Used for early-stage carbuncles and boils with redness, swelling, pain, and exterior syndrome. ② Remove Dangshen, add Jingjie and Fangfeng, forming Jingfang Baidu San (from "Yixue Zhengchuan"), a general remedy for treating wind-cold common cold.

[References] ① It is suitable for treating infections caused by seasonal pathogens, including severe chills and high fever, as well as typhoid, wind-cold, dampness-related illnesses, epidemic diseases, malaria, and early-stage dysentery when the exterior syndrome has not yet resolved. All seasonal pathogens and epidemic diseases are caused by abnormal qi in the heavens and earth, which attack people when their qi is weak. Therefore, the formula first uses Ren Shen to tonify the righteous qi and expel the pathogenic qi, then Qianghuo disperses the wandering pathogenic qi on the surface, Duhuo clears the hidden pathogenic qi within the body, Chaihu and Jiegeng dissipate heat and elevate clear qi, Zhike and Qianhu eliminate phlegm and lower qi, Chuanxiong diffuses fragrance to move qi in the blood, Fuling lightly drains dampness to facilitate qi movement, and Licorice harmonizes all the herbs so they do not conflict with each other. Ginger purifies impurities and expels pathogenic qi, ensuring there is no stagnation. Thus, each herb plays its role to achieve comprehensive efficacy, all under the powerful control of Ren Shen. As for using this formula to treat dysentery, it follows Yu Jiayan’s method of reversing the current to pull the boat upstream, allowing the pathogenic qi to exit from the interior to the exterior. ("Cheng Fangbian Du") ② Two cases of dysentery treated with Renshen Baidu San showed symptoms such as severe chills and high fever, no sweating but headache, abdominal pain and diarrhea with alternating red and white stools, tenesmus, and frequent bowel movements—20–30 times a day—along with a white, slippery tongue coating and a floating and tight pulse. These were all cases of summer-dampness and wind-cold invading externally, coupled with internal accumulation of raw and cold food. After taking one dose of this formula, profuse sweating occurred, the exterior syndrome completely resolved, and the frequency of diarrhea decreased. After two more doses, the patients recovered. ("Jiangsu Zhongyi," August 1962)

[Notes] ① This formula is particularly effective for early-stage dysentery with exterior syndrome. Yu Jiayan described this formula as a “reverse-water-pulling” method for treating dysentery. ② The nature of this formula is mainly pungent, warm, and drying, making it suitable for exterior wind-cold combined with dampness. If dampness is accompanied by heat, it is not appropriate. ③ This formula can be used for colds, influenza, surgical infections, and dysentery, with modifications as needed.

6. Nine-Ingredient Qianghuo Decoction ("This Matter Is Hard to Know")

[Composition] Qianghuo 10 grams, Fangfeng 10 grams, Xixin 3 grams, Cangzhu 6 grams, Baizhi 3 grams, Chuanxiong 3 grams, Huangqin 6 grams, Shengdi 10 grams, Gancao 3 grams

[Dosage and Administration] Add two slices of ginger and three inches of white onion, then decoct in water and take.

[Main Indications] Exterior excess combined with dampness and internal heat.

[Indications] Headache, body pain, fever with chills, no sweating, joint pain, slight thirst and irritability, thin white but greasy tongue coating, floating and tight pulse, or slippery pulse.

[Functions] Dispelling wind-cold and clearing dampness while reducing heat.

[Formula Analysis] Wind-cold invading the exterior causes headache, body pain, fever with chills, and a floating and tight pulse; dampness leads to bone and joint pain, a white and greasy tongue coating, and a slippery pulse; if internal heat is also present, there is slight thirst and irritability. These symptoms arise from wind-cold combined with dampness invading the exterior and transforming into internal heat. Qianghuo and Fangfeng primarily dispel wind-cold on the surface. Baizhi eliminates dampness in the Yangming meridian, Cangzhu eliminates dampness in the Taiyin meridian, and Xixin eliminates dampness in the Shaoyin meridian, serving as auxiliary herbs. Huangqin specifically clears internal heat as well.

New Compilation of Traditional Chinese Medicine Formulas

[Clinical Modifications] ① For cough, add Xingren and Sangpi; for phlegm, add Banxia; for headache, add Chuanxiong and Baizhi; for wind-cold with spontaneous sweating, add Guizhi and Fangfeng; for typhoid without sweating, add Mahuang and Ganjiang; for nasal congestion and dizziness, add Qianghuo and Jingjie; for epigastric pain, add Yuanhu. ② Add white onion and fermented soybeans, forming Xiangsu Congchi Tang (from "Popular Treatise on Cold Damage"), which has a stronger effect on inducing perspiration and dispersing wind on the surface than this formula.

[References] Perilla disperses exterior qi and dissipates external cold, Xiangfu moves defensive qi and eliminates internal stagnation, JuHong facilitates the flow of qi between the exterior and interior to assist, and Licorice harmonizes the herbs and also helps to disperse wind on the surface. ("Yifang Jijie")

[Notes] ① This formula is often used for gastrointestinal-type colds. For example, if there is stomach distension, add Houpu and Zhike to relieve qi, expand the middle burner, and eliminate bloating and fullness; if food is not digested, add Jinei Jin and fried Liuqu to aid digestion and remove stagnation. ② In recent years, some have been cured of neurasthenia, hysteria, and urticaria by using this formula.

8. Ma Huang Fu Zi Xi Xin Tang ("Treatise on Cold Damage")

[Composition] Ma Huang 6 grams (two liang), Fupian 6 grams (one piece), Xixin 3 grams (two liang)

[Dosage and Administration] First boil Ma Huang in water to remove the foam, then add the other herbs, strain out the residue, and take warm.

[Main Indications] Yang deficiency combined with exterior cold.

[Indications] Headache, fever with chills, no sweating, and a deep, fine pulse.

[Functions] Tonifying yang and dispersing wind on the surface.

[Formula Analysis] People with heart-kidney yang deficiency who suddenly contract wind-cold, although exhibiting exterior symptoms, have a pulse that is not floating but rather deep and fine. This condition arises from the combination of yang deficiency and exterior cold. According to "The Plain Questions: Discussion on Febrile Diseases," "Wherever pathogenic factors gather, qi must be deficient." This indicates that exterior cold is the manifestation, while yang deficiency is the root cause; the manifestation is urgent, the root cause is secondary, so treating the manifestation is the priority, and treating the root cause is supplementary. Ma Huang acts on the surface to disperse wind-cold, serving as the primary herb. Fupian enters the interior to warm the meridians and tonify yang, serving as the auxiliary herb. Xixin both assists Ma Huang in dispersing wind on the surface and helps Fupian in tonifying yang, making it a complementary treatment.

[Clinical Modifications] ① Remove Xixin and add Zhigancao, forming Ma Huang Fu Zi Gancao Tang (from "Treatise on Cold Damage"). The effect is similar to this formula, but the ability to disperse wind-cold is weaker. ② Add Fangfeng and Chuanxiong to treat those who usually suffer from headaches and fear the cold.

[References] ① Yu Jiayan said, "A deep pulse indicates an internal condition. In the Shaoyin meridian, there should not be external heat. If there is fever, it is due to the Sun meridian's exterior pathogenic factor, which requires methods to disperse the exterior." However, the methods for treating the three Yin meridians are different from those for the three Yang meridians. The three Yin meridians must use warming herbs to treat the exterior, and the Shaoyin meridian is especially critical. Therefore, Ma Huang and Fupian are used together to allow the Sun meridian's exterior pathogenic factor to exit while preserving the true yang of the Shaoyin meridian. ("Shanglun Pian") ② A case of loss of voice: a 38-year-old female patient with a history of pulmonary tuberculosis. She initially had a cold but did not receive treatment. Suddenly, she developed chills and fever, her voice became hoarse, her speech was muffled, she had throat pain and coughed up phlegm, fearing that her old illness might be triggered. On April 25, 1974, she sought medical attention. Her tongue was pale with little coating, and her pulse was deep, slow, and weak. This was due to untreated cold, with wind-cold invading the Shaoyin meridian. The prescription was Ma Huang Fu Zi Xi Xin Tang combined with Erchen Wan with added ingredients. The prescription included Ma Huang three qian, Fupian three qian, Xixin five fen, Shichangpu half qian, Fa Banxia three qian, and two doses to be decocted and taken. Two days later, the patient reported that after finishing the two doses, her voice improved and the pain subsided. Subsequently, she sought treatment for tuberculosis and was prescribed a formula to tonify the lungs and benefit the stomach, instructing her to take it regularly. ("New Chinese Medicine," March 1975, issue 25)

[Notes] This formula is often used for chronic bronchitis and edema associated with acute and chronic nephritis.

II. Pungent-Cool Dispelling Wind on the Surface

This formula is designed for wind-heat exterior syndrome. According to "The Plain Questions: Great Treatise on the Supreme Truth," "Pungent and sweet flavors disperse yang." Therefore, dispersing wind should primarily rely on pungent herbs. It also states, "Heat should be cooled," meaning that treating wind-heat exterior syndrome requires not only pungent herbs but also a cooling nature. Hence, formulas for treating wind-heat exterior syndrome are called pungent-cool dispelling wind on the surface formulas. Clinical manifestations of wind-heat exterior syndrome include headache, fever with chills (more heat than cold), thirst, dry throat, and a floating, rapid pulse—as previously mentioned.

1. Sangju Yin ("Differential Diagnosis of Warm Diseases")

[Composition] Sangye 9 grams, Juhua 9 grams, Xingren 9 grams, Lianqiao 9 grams, Bohe 3 grams, Jiegeng 9 grams, Lugen 12 grams, Gancao 3 grams

[Dosage and Administration] Decoct in water and take.

[Main Indications] Wind-heat exterior syndrome combined with cough.

[Indications] Headache, fever with chills (more heat than cold), thirst, dry throat, cough, and a floating, rapid pulse.

[Functions] Dispersing wind-heat and soothing the lungs to stop cough.

[Formula Analysis] Wind-heat invading the exterior most easily brings along cough. Ye Tianshi said, "Warm pathogens first attack the lungs." If lung qi is not dispersed, cough will occur. Sangye and Juhua primarily disperse wind-heat to address the root cause. Xingren soothes the lungs and stops cough, serving as a supplementary herb. The lungs belong to the Metal element and are easily overcome by Fire. With wind-heat attacking the lungs, it is imperative to clear lung fire, so Lianqiao and Bohe are used to clear heat and detoxify, serving as complementary treatments. Fire easily damages yin and consumes body fluids, so Lugen nourishes yin and generates fluids. The lungs store phlegm, and if lung qi is not dispersed, phlegm will form. Jiegeng removes phlegm and stops cough, also serving as a complementary treatment. Licorice harmonizes all the herbs and serves as a guiding agent.

[Clinical Modifications] ① For severe heat, add Shigao and Zhimu; for a dark tongue and severe night-time heat, indicating heat entering the blood, add Xuanshen, Xijiao, Shengdi, and Danpi; for severe lung heat, add Huangqin; for extreme thirst, add Tianhuafen. ② Add Ma Xing Gan Shi Tang to treat pediatric pneumonia. ③ Add Bai Zili, Juemingzi, and Xia Ku Cao to treat epidemic conjunctivitis.

[References] ① This formula combines pungent and sweet flavors to disperse wind, with a slightly bitter and cool taste. Since the lungs are a pure and empty organ, a slight bitterness can help reduce excess, while a cool taste can balance things out. This formula avoids overly pungent and warm flavors. ("Differential Diagnosis of Warm Diseases") ② Using this formula to treat 50 cases of influenza, all presented with fever, chills, headache, runny nose, cough, and poor appetite, achieved an efficacy rate of 86.5%. After two days of medication, the fever completely subsided, but symptoms like nasal congestion and cough took longer to disappear. ("Guangdong Zhongyi," February 1959)

[Notes] This formula is often used for influenza, acute pharyngitis, acute bronchitis, and bronchopneumonia.

2. Yinqiao San ("Differential Diagnosis of Warm Diseases")

[Composition] Jingjie Sui 12 grams, Jiegeng 18 grams, Yinhuahua 30 grams, Lianqiao 30 grams, Bohe 18 grams, Zhuye 12 grams, Dan Dou Chi 15 grams, Niubangzi 18 grams, Gancao 15 grams

[Dosage and Administration] Grind all ingredients into powder; take 18 grams per dose, decoct fresh Lugen soup until fragrant, then take immediately—do not over-decoct. "The upper burner is like a feather; it cannot be lifted without lightness." Over-decocting this formula makes the flavor too strong and shifts it to the middle burner. For severe cases, take three doses during the day and one at night; for mild cases, take two during the day and one at night. Modern usage: make it into a decoction, decoct in water, and adjust the dosage according to the original formula.

[Main Indications] Wind-heat exterior syndrome combined with sore throat.

[Indications] Headache, fever with chills (equal amounts of heat and cold), thirst, dry throat, sore throat, and a floating, rapid pulse.

[Functions] Dispersing wind-heat and clearing heat and detoxifying.

[Formula Analysis] Wind-heat exterior syndrome manifests as headache, fever with chills (more heat than cold), dry throat, thirst, and a floating, rapid pulse; when wind-heat becomes intense and accumulates into toxicity, sore throat occurs. The two flowers and Lianqiao both disperse 【References】 ① This formula strictly follows the principles in the "Inner Canon": when wind invades internally, treat with pungent-cool herbs and supplement with bitter-sweet ones; when heat invades internally, treat with salty-cold herbs and supplement with sweet-bitter ones. ("Differential Diagnosis of Warm Diseases") ② This formula is from Wu's "Differential Diagnosis of Warm Diseases," where the warm diseases treated differ from epidemic warm diseases and also from latent pathogenic warm diseases. This refers only to warm pathogenic factors that invade the surface and lodge in the lungs, so a pungent-cool formula is used to gently relieve the upper burner... Wu specifically opened a new avenue for treating guest warm diseases, something previous scholars had never done. ("Cheng Fangbian Du") ③ Yinqiao San has treated 1,150 cases of wind-heat colds, using coarse powder of this formula, 18 grams per dose. After taking one dose, the fever generally decreases, and mild cases can recover; for severe fevers, it takes longer to bring down the temperature, but other symptoms can be quickly alleviated, usually recovering in 2–4 days, averaging 2–7 days. ("Guangdong Zhongyi," May 1962)

【Notes】 This formula is often used for acute suppurative tonsillitis, acute bronchitis, and bronchopneumonia.

3. Ma Huang Xingren Gancao Shigao Tang ("Treatise on Cold Damage")

[Composition] Ma Huang 9 grams (four liang), Xingren 9 grams (fifty pieces), Zhigancao 6 grams (two liang), Sheng Shigao 25 grams (half jin)

[Dosage and Administration] Boil Ma Huang in water to remove the foam, then add the other herbs, strain out the residue, and take warm.

[Main Indications] Wind-heat invading the lungs, causing lung qi to be undispersed.

[Indications] Headache, fever, thirst, cough with wheezing and shortness of breath, and a floating, rapid pulse.

[Functions] Dispelling wind and clearing the lungs, stopping cough and relieving wheezing.

[Formula Analysis] When wind-heat invades the lungs, lung qi cannot be dispersed. Symptoms of wind-heat include headache, fever, thirst, and a floating, rapid pulse; when lung qi is undispersed, cough and wheezing occur. Although Ma Huang is pungent-warm, when paired with the large dose of Shigao, which is pungent-cool, the overall effect becomes pungent-cool. The two herbs work together, jointly undertaking the major task of dispersing wind and clearing the lungs, serving as the primary herbs. Xingren stops cough and relieves wheezing, helping lung qi to be dispersed, serving as a supplementary herb. Gancao harmonizes the herbs and benefits qi, embodying the principle of reinforcing the righteous qi, which can be considered a complementary treatment; it also harmonizes all the herbs to serve as a guiding agent.

[Clinical Modifications] ① Add Sangbai Pi, Digu Pi, Tingli Zi, and Da Zao to treat pediatric pneumonia. ② Remove Sheng Shigao, add Yi Ren, forming Ma Huang Xingren Yi Ren Gancao Tang (from "Jin Gui Yao Lue"). Used to treat rheumatism with whole-body pain, fever, and worsening symptoms in the afternoon. ③ Remove Sheng Shigao, forming San Ao Tang (from "He Ji Ju Fang"). Used to treat colds caused by wind-pathogens, nasal congestion and heaviness, inability to speak, or wind-cold injuries, headache, dizziness, limb stiffness, and excessive phlegm.

[References] ① After sweating, do not administer Guizhi Tang again. If you sweat and still experience wheezing but no high fever, you can use Ma Huang Xingren Gancao Shigao Tang. ("Treatise on Cold Damage") ② Preliminary report on treating pediatric cough and wheezing with Ma Xing Shi Gan Tang: the selected cases include infants, toddlers, and children of all ages, regardless of how long they have been ill, with cough and wheezing as the main symptoms, and a history of recurrent attacks. Sometimes there is fever, sometimes not; coughing episodes come in waves, with wheezing and roaring sounds, lighter during the day and heavier at night; the tip of the tongue is red, the tongue coating is thin and white, with thick, greasy coating in the middle or root area; the pulse is weak, fine, and rapid. All patients have undergone chest X-rays to rule out any substantive lung lesions. After taking this formula, all patients stopped taking other medications and received regular outpatient treatment. Generally, three doses alleviate symptoms, and six doses eliminate them. The maximum number of doses taken was 23, and the minimum was 2. The prescription includes Ma Huang one qian, Sheng Shigao five qian (the first two ingredients are decocted first), Xingren three qian, Gancao one qian, Tianli Zi one and a half qian, Da Zao three qian, and Zhibanxia two qian. The formula is decocted twice, divided into four doses to be taken throughout the day. In addition, Shan Cigu one qian is ground into powder, divided into three portions, and taken three times a day. ("Jiangsu Zhongyi," November 1965, issue 15)

[Notes] This formula is often used for acute tracheitis, lobar pneumonia, and pediatric bronchopneumonia; it can also be used for scarlet fever, urticaria, acute conjunctivitis, chronic tracheitis, bronchial asthma, and sinusitis.

4. Jia Jian Wei Rui Tang ("Popular Treatise on Cold Damage")

[Composition] Wei Rui 9 grams, Bai Wei 3 grams, White Onion Three Inches, Dan Dou Chi 10 grams, Jiegeng 4 grams, Da Zao Two Pieces, Zhigancao 2 grams, Bohe 4 grams

[Dosage and Administration] Decoct in water and take.

[Main Indications] Lung and kidney yin deficiency combined with exterior heat.

[Indications] Five-heart vexation and heat, cough with phlegm, sticky phlegm that is hard to expel; headache, fever with chills, thirst and dry throat, and a floating, rapid pulse.

[Functions] Nourishing yin and dispelling wind on the surface.

[Formula Analysis] Those with lung and kidney yin deficiency who encounter wind-heat will develop these symptoms. Lung and kidney yin deficiency leads to five-heart vexation, cough with phlegm, and sticky phlegm that is hard to expel; external wind-heat causes headache, fever with chills, thirst and dry throat, and a floating, rapid pulse. With lung and kidney yin deficiency, sweat sources are depleted, and without sweat, exterior heat cannot be dissipated, so nourishing yin should be prioritized. Wei Rui nourishes the yin of the lungs and kidneys, opening up sweat sources, serving as the primary herb. Dan Dou Chi and Bohe disperse wind-heat, serving as auxiliary herbs. When wind-heat is on the surface, lung qi is not conducive to dispersion, so Jiegeng soothes the lungs and stops cough; heat easily harms yin, so Bai Wei clears heat and nourishes yin; white onion promotes yang qi, ensuring that yin-nourishing herbs do not leave room for pathogenic factors; Da Zao strengthens the spleen and supports the righteous qi, all serving as complementary treatments. Licorice harmonizes all the herbs to serve as a guiding agent.

[Clinical Modifications] ① For more severe exterior symptoms, add Fangfeng and Ge Gen; for sticky phlegm, add Niubangzi and Gualou Pi; for heart vexation and thirst, add Zhuye and Tianhuafen. ② Remove white onion, dan dou chi, bohe, jiegeng, and da zao from this formula, add Ma Huang, Du Huo, Xingren, Chuanxiong, Qingmu Xiang, and Shigao, forming Qianjin Wei Rui Tang (from "Qianjin Fang"), used to treat wind-heat invading the lungs combined with yin deficiency (wind warmth).

[References] The formula uses Sheng Yuzhu to nourish yin and moisten dryness as the principal herb, with onion, dan dou chi, bohe, and jiegeng as assistants to disperse wind and dissipate heat, supplemented by Bai Wei's bitter-salty properties to lower and release heat, and with Licorice and Da Zao providing sweetness and moisture to enhance Yuzhu's nourishing and moisturizing effects. It is an excellent formula for colds caused by yin deficiency, as well as winter colds with cough and dry phlegm. ("Popular Treatise on Cold Damage")

[Notes] This formula can be used for pulmonary tuberculosis combined with upper respiratory infection; it can also be used for early-stage external infections with yin deficiency. If there is no yin deficiency, it is not recommended.

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5. Shengma Gegen Tang ("True Secrets of Pediatric Medicinal Formulas")

[Composition] Shengma, Gegen, Shaoyao, Zhigancao, each in equal parts

[Dosage and Administration] Grind the herbs into coarse powder; take 12 grams per dose, decoct in water and take. In modern times, it is made into a decoction, following the original formula proportions, with adjustments based on individual needs, and decocted in water.

[Main Indications] Wind-heat rash.

[Indications] Headache, fever with chills (more heat than cold), thirst, dry throat, initial appearance of pimples, and a floating, rapid pulse.

[Functions] Dispersing wind-heat and detoxifying to promote rash eruption.

[Formula Analysis] When wind-heat invades the surface, headache, fever with chills, thirst, dry throat, and a floating, rapid pulse appear; when pimples first appear, it indicates that heat-toxin has entered the Yangming meridian and is directly attacking the blood. Shengma and Gegen are both pungent-cool herbs, capable of dispersing wind-heat on the surface and detoxifying to promote rash eruption internally, serving as the primary herbs. Treating wind comes before treating blood; when blood flows, wind naturally disappears. Shaoyao nourishes and activates blood, facilitating wind dispersion; it also aids in rash eruption (activating blood to promote rash) as a supplementary herb. Licorice benefits qi and harmonizes the herbs, serving as a complementary treatment; harmonizing all the herbs can serve as a guiding agent.

[Clinical Modifications] ① Add Bohe, Jingjie, Chan Tui, Niubangzi, and Yinhuahua for initial measles outbreaks; remove Shaoyao, add Chi Shao, Xuan Shen, Dan Pi, Zi Cao, and Da Qing Ye to treat measles that has not fully erupted. ② For those with throat pain, add Jiegeng, Xuan Shen, and Mabo.

[References] ① Treats Yangming-related typhoid and stroke, with headache, body pain, fever with chills, no sweating but thirst, eye pain and dry nose, inability to lie down, as well as Yangming-related rashes that are about to erupt but haven't yet, occasional greetings and interactions, and widespread epidemics. ("Cheng Fang Qie Yong") ② Once measles has already shown red spots, do not take this formula. Yangming is the inner part of the surface, and Shengma is the main medicine for Yangming. Whenever rashes are about to erupt but haven't yet, it is advisable to take this soup to help detoxify them. Do not arbitrarily use cold medicines to attack the heat, nor induce sweating or purging to weaken the qi of the surface and interior. ("Yifang Jijie")

[Notes] ① This formula is most commonly used for initial measles outbreaks, capable of both penetrating outward and lifting upward. If the measles has already fully erupted, use with caution. ② Acute pharyngitis, acute bacillary dysentery, and other conditions can also be treated with modifications to this formula.

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6. Cang’erzi San ("Three Causes Formula")

[Composition] Cang’erzi 60 grams, Bohe 15 grams, Xinyi 15 grams, Baizhi 30 grams

[Dosage and Administration] Grind all ingredients into powder; take 6 grams per dose, mixed with scallions and tea-infused water. Recently, it is often made into a decoction, using one-tenth of the original dosage, decocted in water.

[Main Indications] Wind-heat combined with dampness.

[Indications] Headache, fever with chills, dry mouth, nasal congestion with thick, turbid discharge, slow disease progression, and a floating, rapid pulse with a slippery component.

[Functions] Dispersing wind-heat and treating dampness to clear the nose.

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[Explanation] For wind-heat patterns, symptoms include headache, fever with chills, dry mouth, and a floating, rapid pulse; for dampness-coexisting patterns, symptoms include nasal congestion with thick, turbid discharge, and a slow disease course (due to the sticky nature of dampness, which is not easily eliminated quickly). Although Xanthium seed is a pungent-warm herb, when combined with the pungent-cool peppermint, they work together to disperse wind-heat and primarily treat dampness while clearing the nose. Since dampness is heavy and tends to obstruct the flow of qi, Magnolia bark is used as an auxiliary ingredient due to its aromatic properties that open the orifices. When the flow of qi is blocked, headache becomes severe; since only wind can reach the crown of the head, Angelica dahurica is employed as a wind-dispelling agent to ascend and relieve pain, thus achieving a dual therapeutic effect. Scallions and tea warm yang and clear the upper burner, guiding the herbs upward as a facilitating agent.

[Clinical Modifications] For severe headaches, add Chuanxiong and Fangfeng; for yellow nasal discharge, add Lonicera japonica, Forsythia suspensa, and Scutellaria baicalensis; for hearing loss and tinnitus, add Pueraria lobata and Vitex negundo.

[Reference Material] According to "Cheng Fang Bian Du," the primary herb in this formula is Angelica dahurica, with the largest dosage, stating: "Although the illness is entirely caused by heat, once the clear substances transform into turbid ones, the disease resides in the upper burner, necessitating the use of pungent-aromatic herbs that ascend to disperse it. If one solely relies on bitter-cold purgatives, not only will the turbidity fail to transform, but even the upper heat cannot be swiftly eliminated. Therefore, Angelica dahurica, being pungent-warm and drying, enters the Yangming meridian to dispel pathogenic factors and overcome dampness, serves as the principal herb."

[Commentary] This formula can be applied to various types of chronic rhinitis and sinusitis; further modifications of this formula can also treat rheumatoid arthritis, bacillary dysentery, acute and chronic enteritis, epilepsy, and leprosy, among others.

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Chapter 2: Purgative Formulas

The "Plain Questions" in the "Yellow Emperor's Classic of Internal Medicine," specifically the "Three Parts and Nine Channels Theory," states: "When there is excess, purge it." For syndromes of internal excess, the method of purgation should be employed. Any formula with purgative effects is called a purgative formula. These formulas typically have the functions of promoting bowel movements, eliminating accumulated heat, and expelling water retention, all of which fall under the category of downward treatment. Clinically, internal excess syndromes are classified into four types: ① Internal accumulation of real heat, treated with cold purgation; ② Cold accumulation and stagnation, treated with warm purgation; ③ Dryness leading to constipation, treated with moist purgation; ④ Deficiency of vital energy combined with internal accumulation, treated with tonifying purgation.

Accordingly, purgative formulas are divided into four types: cold purgation, warm purgation, moist purgation, and tonifying purgation.

When using purgative formulas, the following points should be noted: ① If exterior pathogens have not yet been resolved and internal excess is mild, first resolve the exterior; only after the exterior symptoms are cleared can purgation be administered. ② If the exterior remains unresolved but internal excess has already become severe, a simultaneous treatment of both exterior and interior may be employed. ③ If internal excess has become severe and vital energy is deficient, a combined approach of purging and tonifying may be used. ④ Purgative formulas tend to deplete stomach qi; once efficacy is achieved, stop immediately—do not overuse them.