Liu Shen Tong Jie San - 六神通解散 - Six Miracle Powder to Unblock and Release

Author: Zhang Lu-Yu / Shi-Wan

Source: Comprehensive Medicine According to Master Zhang (1695)

Category: Formulas that Release Exterior-Interior Excess

Pattern: Damp-Heat accumulating in the San Jiao with Wind-Cold binding the Exterior due to sudden exposure to Cold during summer months

Key Symptoms: Headache, fever and chills without sweating, a bitter taste in the mouth, reduced urination or blood in the urine, a stifling sensation in the chest, fatigue, aching of the limbs, nausea

Tongue: Yellow greasy coating

Ingredients

Ma Huang

15g

Pinyin: Ma Huang Chinese: 麻黄 Pharmaceutical: Herba Ephedrae Taxonomy: Ephedra sinica seu intermedia seu equisetina English: Ephedra Stem / Joint Pine / Joint Fir / Mormon Tea / Brigham Tea
Tastes: Pungent, slightly bitter, warm Meridians Entered: Lung and Bladder
Actions & Indications: Induces sweating and releases the Exterior Taiyang Stage Wind-Cold Invasion of the Lung, with anhidrosis, chills, fever, headache and a tight, floating pulse Disseminates and facilitates Lung Qi, calms wheezing and stops coughing Wind-Cold Obstructs Lung Qi Promotes urination and reduces oedema Externally generated oedema Warms and disperses Cold pathogens Wind-Cold Bi Cold extremities (Reynaud's disease) *Breaks up concretions, firmness, accumulations and gatherings (Shen Nong Ben Cao Jing)* Yin sores that are firm, deeply rooted and without a head
Standard Dosage: 1.5-9g in decoction to release the exterior, and 10-15g for the treatment of oedema. Maximum dose is 20g. Toxic dose is considered to be 30-45g but side effects and risks are possible at any dosage. 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.

15g

2.4g

4.5g

Pinyin: Hua Shi Chinese: 滑石 Pharmaceutical: Talcum / Magnesium Silicate Taxonomy: Mg₃Si₄O₁₀(OH)₂ English: Talc / Talcum Powder
Tastes: Sweet, bland and cold Meridians Entered: Bladder, Lung and Stomach
Actions & Indications: Promotes urination and drains Heat from the Urinary Bladder (aids the movement of gravel and stones), (expels Damp-Heat) Hot Painful Urinary Dysfunction (Lin Syndrome) with hot, painful urination, dark, painful, burning, scanty urine Damp-Heat diarrhoea Qi Level Heat with Dampness with unremitting fever, heavy feeling in the body, thirst, yellow tongue coat Releases Summeheat and resolves Dampness Summerheat (fever, urinary difficulty, thirst) Absorbs Dampness and clears Heat (topically) Damp skin lesions (eczema, damp sores, prickly heat) Stops bleeding due to Heat Heat type bleeding Nosebleed, vomiting blood (taken internally) Bleeding from wounds and sores (topical) Aids fasting Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of minerals which can, with protracted taking, make the body light, free from hunger and prolong life. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
Standard Dosage: 10-20g in decoction, or applied externally. Cautions: Talc can cause granulomas in the rectum, vagina or wounds and prolonged external use has also been linked to ovarian (Wentzensen & O'Brien, 2021), stomach (Chang et al., 2020) and lung (Chang et al., 2017) cancer but other reviews contradict these findings (Goodman et al., 2020) suggesting this may only be an effect seen in rats (Prueitt et al., 2024). For safety it should therefore not be used for prolonged periods. It should also not be in inhaled as it can cause lung irritation and remain in the body for up to 40 years (Johnson, 2021). Mineral products are prohibited from use in the UK under the Medicines Act 1968 ch. 67 which restricts herbalists to the use of plant products only. It is generally substituted with Chi Fu Ling and Ze Xie.

Gan Cao

1.5g

Pinyin: Gan Cao Chinese: 甘草 Pharmaceutical: Radix Glycyrrhizae Taxonomy: Glycyrrhiza uralensis seu glabra seu inflata English: Liquorice Root
Tastes: Sweet, slightly cold Meridians Entered: Heart, Lung and Spleen (and all 12 meridians)
Actions & Indications: Tonifies the Spleen and augments Qi Spleen Qi Deficiency with shortness of breath, lassitude and loose stools Qi and Blood Deficiency with an irregular pulse and/or palpitations Heart Qi Deficiency or Heart Yang Deficiency Moistens the Lungs, resolves Phlegm and stops coughing Lung Heat or Cold Productive or non-productive coughing Moderates spasms and alleviates pain Painful muscle spasms of the abdomen and legs Clears Heat and relieves Fire Toxicity Raw for Toxic Heat with sore throat or carbuncles and sores (Chuang Yung) Antidote for many toxic substances (internal and topical) Poisoning Bites (after washing the wound, chew Gan Cao and apply a thick layer on the bite wound, changing whenever it dries out; Bao Xiang-Ao, 1846, New Compilation of Proven Formulas) Moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels Often added in small doses to harmonise formulas Tonifies the Qi while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015) Aids fasting Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, make the body light and prolong life. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
Standard Dosage: Typically 1.5-9g in decoction. Large doses can be up 30g. Cautions: It is contraindicated for combining with Hai Zao, Da Ji, Gan Sui and Yuan Hua because of "eighteen antagonisms". It is also contraindicated in cases of dampness obstruction in middle energizer and edema because it can help dampness obstruct qi, and it is prohibited from long-term usage in large dosage (more than 20g/day) and should be avoided or used with extreme caution in patients with high blood pressure because it may raise aldosterone levels in the blood causing retention of sodium. The NHS recommends avoiding during pregnancy.

Dan Dou Chi

Cong Bai

3pcs

Subsitutions:
In the UK several substitutions must be made:
Ma Huang is often substituted for Xiang Ru so this could be done to overcome the maximum daily dose of 1.8g and an maximum single dose of 0.6g in the UK. It may be used at this low dose and complemented with Jing Jie, Fang Feng and Zi Su Ye too.
Shi Gao and Hua Shi may be substituted with Chi Fu Ling and Ze Xie.

Preparation: No preparation instructions are given but was presumably ground into powder in the original but the dosages in Scheid et al. (2008) appear to be for a decoction.

Actions: Disperses Cold in the Exterior clears Heat from the Yangming channel and Upper Jiao, drains Damp

Research Links:

American Dragon

TCMWiki

Journal of Chinese Medicine

National Resource Centre for Chinese Materia Medica, China

TCM-ID Integrated Database, East China Normal University

TCM-ID Information Database, National University of Singapore

Pubmed

Science Direct

Google Scholar

Bai Du (Chinese)

A+ Medical Encyclopedia (Chinese)

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.

Herb Formulas Notebook

六 神 通 解 散  Liu Shen Tong Jie San

Six Miracle Powder to Unblock and Release