Individual Herbs Notebook

Ma Huang

Translation: Yellow Hemp

Pharmaceutical: Herba Ephedrae
Taxonomy: Ephedra sinica

Other names: Ephedra Stem / Joint Pine / Joint Fir / Mormon Tea / Brigham Tea / Somalata सोमलता

Category: Herbs that Release the Exterior



Properties: Pungent, slightly bitter, warm

Meridans Entered:
Primary: Lung and Bladder
Sinews: Taiyang


Traditional Actions/Indications:
  1. Induces sweating and releases the Exterior
    Taiyang Stage Wind-Cold Invasion of the Lung, with anhidrosis, chills, fever, headache and a tight, floating pulse
  2. Disseminates and facilitates Lung Qi, calms wheezing and stops coughing
    Wind-Cold Obstructs Lung Qi
  3. Promotes urination and reduces oedema
    Externally generated oedema
  4. Warms and disperses Cold pathogens
    Wind-Cold Bi
    Toxic sores without a head

Suggested Daily Dosage: 3-10g in decoction.


Cautions: It is prohibited to be used for patients with deficient dyspnea without blockage of the lung qi and should be used with caution for patients with hypertension and insomnia because ephedrine can stimulate central nervous system and raise blood pressure. The Shang Han Lun recommends removing the nodes and decocting Ma Huang first, scooping the foam from the top of the decoction. It has been argued this is to reduce the "vexing" effects although the efficacy of this is debated and rarely done today.

It should not be used in conjunction with MAOIs, central nervous system stimulants, alkaloids ergotamines and xanthines enhancing their effects by acting as a receptor level agonist.

In the UK the maximum daily dose permitted without prescription is 1.8g daily in three 0.6g doses. This makes it difficult to achieve a pharmacologically active effect and must be complemented with other herbs that release the exterior and expel Wind-Cold such as Gui Zhi, Jing Jie, Fang Feng and Zi Su Ye.

Huang Hua Zi (Sida cordifolia), more common in Ayurveda where it is known as Bala बला, also contains ephedrine at lower concentrations and has no legal restrictions placed on it by the UK MHRA. It is considered more cooling, Heat clearing and Damp draining without Exterior Releasing properties in Chinese medicine so best used as a substitute in Warm Diseases, especially Damp-Warm Disease, or supplemented with increased warm Exterior Releasing herbs like those described above.


Interactions:

  • Medications that can cause an irregular heartbeat (QT interval-prolonging drugs): Ephedra speeds up heart rate which can cause serious side effects if combined with this herb, including increased risk of heart attack.
  • Methylxanthines: May have additive effect causing jitteriness, nervousness, a fast heartbeat, high blood pressure, and anxiety. These include aminophylline, caffeine, and theophylline
  • Stimulant drugs: May have additive effect causing increased heart rate and high blood pressure.
  • Dexamethasone: Ephedra may increase the speed of breakdown reducing its effect.
  • Ergot Derivatives: Both can increase blood pressure.
  • MAOIs: May have additive effect causing fast heartbeat, high blood pressure, seizures, nervousness.
  • Antidiabetes drugs: Ephedra may increase blood sugar requiring adjustment of drugs aimed to lower blood sugar.
  • Anticonvulsants: May decrease their effectiveness.
  • Recommended to stop 24 hours before surgery due to increased risk of autonomic side effects (tachycardia, hypertension, arrhythmia), myocardial infarction, stroke & seizure (Ang-Lee, Moss & Yuan, 2001; Yilmaz & Çifci, 2018).


Notable Constituents:
  1. Ephedrine
    Amphetamine alkaloid with bronchodilatory, anti-hypotensive and CNS stimulant properties.
  2. Pseudoephedrine
    Similar to ephepdrine but with less CNS stimulant properties. Used as a decongestant in many cough, cold and flu remedies.
  3. Phenylpropanolamine
    Similar to ephepdrine, also called norpseudoephedrine, it binds to apha and beta adrenergic receptors in the mucosa of the respiratory tract resulting in vasoconstriction and reduction in swelling of nasal mucous membranes and reduction in tissue hyperemia, edema, and nasal congestion. Also stimulates release of noradrenaline. It also binds to beta-receptors producing tachycardia and increased contractile force of the heart muscle and acts as an appetite suppressant.

Appears in 57 formulae listed on this site: (click to display)
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