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Class 9: Herbs and Formulas

That Release The Exterior



Fayi Wu
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Warm-Acrid Release Exterior Herbs
Herba Ephedrae (Ma huang)
Ramulus Cinnamomi (Gui zhi)
Folium Perillae (Zi su ye)
Herba Schizonepetae (Jing jie)
Radix Ledebouriellae (Fang feng)
Radix Notopterygii (Qiang huo)
Radix Angelicae Dahuricae (Bai zhi)
Herba Asari (Xi xin)
Rhizoma Zingiberis Recens (Sheng jiang)
Herba Elsholtziae (Xiang ru)
Flos Magnoliae (Xin yi hua)
Bulbus Allii Fistulosi (Cong bai)
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Herba Ephedrae (Ma huang)
Taste and Nature: Pungent, slightly bitter and warm
Channel tropism: Lung and bladder
Actions: induces sweating, calms wheezing, promotes urination
Indications:
Treat exterior syndrome of wind-cold type.
Facilitate outward flow of lung qi to relieve asthma.
Induce diuresis to treat edema due to affection of wind.
Dosage: 6-10g.
Contraindications:
Being strong in inducing sweating, this herb is not applicable to patients with
spontaneous sweating due to qi deficiency, especially in the aged, very
young patients and those with a weak constitution.
Exciting the central nervous system, it is used carefully in patients with
hypertension, insomnia and fidget
When treating chronic cough, it should be given intermittently, otherwise its
effectiveness will be lowered.
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Ramulus Cinnamomi (Gui zhi)
Taste and Nature: Pungent, sweet and warm
Channel tropism: Heart, lung and bladder
Actions: induces sweating and releases exterior, warms and unblocks the
channels and collaterals, and assists the yang
Indications:
Treat exterior syndrome of deficiency type with symptoms of wind-cold type.
Relieve pain by dispersing wind cold from the channels and collaterals, applicable to
pain or soreness in the shoulder and lumbar region.
Assist yang to promote flow of yang qi and remove obstruction from the collaterals,
applicable to phlegm syndrome, abdominal pain due to yang deficiency and
dysmenorrhea due to accumulation of cold in the collaterals.
Dosage: 3-9g
Contraindications: Pregnancy, Menorrhagia, Deficiency heat syndrome.
Common compatible herbs:
Gui Zhi and Bao Shao: Regulate ying and wei, applicable to exterior syndrome of
deficiency type and insomnia, palpitation,
Gui Zhi and Bai Zhu: Promote flow of yang qi to treat retention of water in the bladder
marked by dysuria,
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Folium Perillae (Zi su ye)
Taste and Nature: Pungent, aromatic and warm
Channel tropism: Lung and spleen
Actions: releases exterior and disperses cold, promotes the movement of qi
and expands the chest, resolves seafood poisoning
Indications:
For wind cold.
Prevention of common cold.
Cool-dry syndrome.
For vomiting caused by stagnation of cold and qi in the stomach.
Prevent miscarriage by promoting flow of qi.
Eliminate Toxin: Applicable to poisoning of crabs or cancers.
Dosage: 3-9 g, not decoct too long.
Comments:
Using the stem for chest depression, Su Ye for exterior syndrome.
Being aromatic in taste, it has a strong property of moving about. So, it is specially
applicable to vomiting or exterior syndromes with qi stagnation manifestations.
When used for relieving poisoning, its dosage should be up to 30-60 g.
Diabetics should not take the herb at a large dosage, since it can increase the
blood sugar level.
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Herba Schizonepetae (Jing jie)
Taste and Property: acrid, slight warm
Meridian Tropism: liver and lung
Actions: releases the exterior and dispels wind, vents rashes
and alleviates itching, stops bleeding
Indications:
For exterior patterns of either wind-cold or wind-heat. Also for
carbuncles or boils when they first erupt, especially when
accompanied by chills and fever.
For initial stage of measles and pruritic skin eruptions.
As an auxiliary herb for hemorrhage.
Dosage: 4.5-9g
Contraindications: deficiency of the exterior, fully erupted
measles or open sores.
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Radix Ledebouriellae (Fang feng)
Taste and Property: acrid, sweet, slight warm
Meridian Tropism: bladder, liver and spleen
Actions: releases the exterior and expels wind; expels wind-dampness
and alleviates pain; expels wind relives spasm
Indications:
For headache, chills and body aches due to externally-contracted wind-cold.
For exterior wind-damp painful obstruction (bi syndrome), especially when
wind predominates, used with qiang huao, dang gui.
As an auxiliary herb to alleviate trembling of the hand and feet and tetany.
Dosage: 4.5-9g
Contraindications: exuberant fire from yin deficiency, spasm from
blood deficiency
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Radix Notopterygii (Qiang huo)
Taste and Property: acrid, bitter, aromatic, warm
Meridian Tropism: bladder, kidney
Actions: releases the exterior and expels wind, cold, dampness;
unblocks painful obstruction and alleviates pain
Indications:
For headache, chills and body aches due to externally-contracted
wind-cold.
For wind-cold-damp painful obstruction, especially in upper limbs
and back.
Dosage: 3-9g
Contraindications: for blood deficiency painful obstruction
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Bulbus Allii Fistulosi (Cong bai)
Taste and Nature: Acrid, warm
Channel tropism: Lung and stomach
Actions: releases exterior and induces sweating; disperses cold
and unblocks the yang, resolves toxicity and disperses clumps
Indications:
For exterior syndrome of wind cold, especially in the very early
stages, used with dan dou chi, i.e. cong chi tang
For either abdominal pain and distention or nasal congestion due
to blockage of yang qi by cold, i.e. bai tong tang
For sores and abscesses, externally as a poultice
Dosage: 3-9g.
Contraindications: profuse sweating from exterior deficiency,
cant taken with honey
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Scallion and Prepared Soybean
Decoction (cong chi tang)
Ingredients: cong bai, dan dou chi
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Actions and indications of the formula
Actions
Unblocks the yang qi in the exterior and induces
sweating
Indications
Mild fever and slight chills without sweating,
headache, stuffy nose, a thin white tongue coating
and a floating pulse.
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Analysis of Formula
Cong bai:
A warm, acrid herb that unblocks the flow of yang
qi in the exterior and induces sweating
Dan dou chi:
Releases externally contracted disorders from the
exterior as well as interior constraint
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Modern application and modifications
Modern application:
Disorder of upper respiratory tract infection
Modifications:
For pronounced chills and headache, add qiang huo, fang
feng, jing jie
For pronounced cold with abdominal pain, add sheng jiang,
brown sugar
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Ephedra Decoction (ma
huang tang)
Ingredients: ma huang, gui zi, xing ren,
gan cao
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Actions and indications of the formula
Actions
Releases exterior cold and arrests wheezing.
Indications
Fever and chills (chills predominant) without
sweating, headache, generalized body aches,
wheezing, a thin white tongue coating, and
floating tight pulse .
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Analysis of Formula
Chief: Ma huang
Disseminates the lung qi and treats wheezing.
Deputy: Gui zhi
Releases the exterior (especially the muscle layer) and
warms and facilitates the flow in the channels. Combined
with chief herb, it strengthens the diaphoretic effect.
Assistant: Xing ren
Unblocks the flow of lung qi and helps the chief ingredient
arrest wheezing and expel the pathogenic influence .
Envoy: Gan cao
Harmonizes the actions of the other herbs and moderates
the diaphoretic action of ma huang
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Modern application and modifications
Modern application:
Disorder of upper respiratory tract infection, influenza,
acute bronchitis, bronchial asthma, lobar pneumonia and
acute glomerulonephritis.
Attentions:
Contraindicated for patients with debility and copious
urination, and for patients who are prone to bleeding, used
with caution in cases with hypertension.
Modifications:
For exterior cold with interior heat, add shi gao
For sore throat, reduce the dosage of gui zhi, add tian hua
fen, she gan.
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Cinnamon Twig Decoction
(gui zhi tang)
Ingredients: gui zhi, shao yao, sheng
jiang, da zao, gan cao
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Actions and indications of the formula
Actions
Releases pathogenic influences from the muscle layer and
regulates the nutritive and protective qi.
Indications
Fever and chills unrelieved by sweating, headache,
aversion to wind, stiff neck, nasal congestion, dry heaves,
no particular thirst, a thin white tongue coating, and floating
pulse that is either moderate or frail. May also be used for a
similar presentation in patients recovering from serious
illness or after childbirth.
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Analysis of Formula
Chief: Gui zhi
Releases externally-contracted wind-cold from the muscle layer.
Deputy: bai shao yao
Benefits the yin and contains the weak nutritive qi. Combined
with chief herb, enhance protective qi to dispel pathogenic
influences while strengthening the nutritive qi.
Assistant: sheng jiang, da zao
Sheng jiang: helps the chief herb release the exterior while
also treating the nausea and vomiting
Da zao: helps deputy nourish and harmonize the nutritive qi
and blood
Envoy: Gan cao
Tonifies middle burner and harmonizes the actions of the other
herb
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Modern application and modifications
Modern application:
Disorder of upper respiratory tract infection, influenza, post
partum fever, allergic rhinitis, angioedema, cerebrovascular
spasm, eczema and urticaria.
Attentions:
Contraindicated in cases with exterior cold and interior heat.
Modifications:
For marked nasal congestion with sneezing, add fang feng, xin yi
hua
For shortness of breath and rough breathing, add hou po, xing
ren
For severe vomiting, increase the dosage of sheng jiang and bai
shao, add chen pi, hou po
For joint pain in the extremities accompanied by fatigue, add
qiang huo and fang feng
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Minor Bluegreen Dragon
Decoction (xiao qing long tang)
Ingredients: ma huang, gui zhi, gan
jiang, xi xin, wu wei zi, bai shao, ban
xia, zhi gan cao
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Actions and indications of the formula
Actions
Releases the exterior, transforms congested fluids, warms
the lungs, and directs rebellious qi downward.
Indications
Fever and chills (chills predominant) without sweating,
coughing, wheezing, sputum that is copious, white, stringy,
and difficult to expectorate, a stifling sensation in the chest,
a generalized sensation of heaviness and body aches, no
particular thirst, a moist tongue coating, and a floating, tight
pulse. In severe case, there may be edema or considerable
difficulty in breathing when lying down
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Analysis of Formula
Chief: ma huang, gui zhi
Ma huang: releases exterior, arrests wheezing and moves water by
facilitating the flow of lung qi
Gui zhi: works with ma huang to release the exterior
Deputy: gan jiang, xi xin
Warm the interior, transform congested fluids, and help the chief herbs
release the exterior. Gan jiang also can warm spleen, xi xin also stops the
cough by facilitating the flow of qi through the body
Assistant: wu wei zi, bai shao, ban xia
Wu wei zi: prevents the leakage of lung qi
Bai shao: nourishes the blood and nutritive qi
Ban xia: transforms congested fluids and harmonizes the
stomach
Envoy: Gan cao
Augment the qi and harmonizes the interaction of the acrid and sour herb
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Modern application and modifications
Modern application:
Acute bronchitis, acute exacerbation of chronic bronchitis,
bronchial asthma, and influenza.
Attentions:
Should not be used long-tern, nor for conditions with heat,
coughing of blood, or coughing due to yin deficiency. Use with
caution in cases with hypertension
Modifications:
For severe exterior cold disorders, increase the dosage of
ma huang, gui zhi
For pronounced nasal congestion, runny nose, and
headache, substitute sheng jiang for gan jiang, add fang
feng, jing jie
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Nine-Herb Decoction with
Notopterygium (jiu wei qiang
huo tang)
Ingredients: qiang huo, fang feng, cang zhu,
xi xin, chuan xiong, bai zhi, huang qin, sheng
di huang, gan cao
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Actions and indications of the formula
Actions
Releases the exterior dampness and clears
interior heat.
Indications
Fever and chills (chills predominant) without
sweating, headache, stiff neck, generalized aches
and pain, slight thirst, a bitter taste in the mouth, a
white tongue coating, and a floating pulse.
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Analysis of Formula
Chief: qiang huo
Disperses exterior wind-cold-dampness
Deputy: fang feng, cang zhu, xi xin, chuan xiong, bai zhi
Fang feng, cang zhu: assist the chief herb in releasing the
exterior and eliminating dampness
Xi xin, chuan xiong, bai zhi: assist the chief herb in releasing the
exterior and treating the head and body aches
Assistant: huang qin, sheng di huang
Clear qi and blood level interior heat respectively, treat the thirst
and bitter taste in the mouth and also prevent the dry nature of
the other herbs from injuring the fluids
Envoy: Gan cao
Harmonizes the middle burner and the actions of the other herbs
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Modern application and modifications
Modern application:
Disorder of upper respiratory tract infection, influenza,
sinusitis, acute lower back sprain, and rheumatic fever.
Modifications:
For upper back and shoulder pain, add qin jiao
For pronounced thirst and irritability, add shi gao,
zhi mu
Where there is no thirst or bitter taste in the
mouth, omit huang qin, sheng di huang