Herb Formulas Notebook

Ma Huang Fu Zi Gan Cao Tang

Ephedra, Aconite and Licorice Decoction


Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Discussion of Cold Damage (Shang Han Lun, 傷寒論)


Category: Formulas that Release the Exterior

Pattern: Mild Exterior Cold invasion or oedema with pre-existing Yang deficiency

Key Symptoms: Slight fever and chills that is not relieved by wearing more clothing or adding covers or mild oedema with shortness of breath and urinary difficulty, exhaustion with an almost constant desire to sleep

Pulse: Submerged and faint


Ingredients

Ma Huang 6g
Zhi Fu Zi 9g
Gan Cao 6g

Subsitutions:
In the UK almost this entire formula needs to be substituted, Ma Huang being strictly limited, Fu Zi being banned and Xi Xin being available but voluntarily banned by the RCHM. Some substitution suggestions include:
Ma Huang == 1.8g Ma Huang + Jing Jie + Fang Feng + Zi Su Ye
Fu Zi == Gan Jiang + Rou Gui
The dosage restrictions on Ma Haung also mean it should be taken in three 0,6g doses per day.


Preparation: Originally Ma Huang is decocted in 10 cups of water until 8 remain, the froth removed and the other ingredients added until 3 cups remain. The strained decoction is then taken in 3 doses over the course of a day. At present Fu Zi is cooked first for 30-60 minutes until there is no numbing of the tongue upon tasting and then the other ingredients are added to the decoction.


Actions: Assists the Yang, releases the Exterior

Contraindications: Only for use in mild Yang deficiency. Where it is severe and there is undigested food in the stool and the pulse is almost imperceptible it could devastate the Yang.



Notes:
One liang is taken as 3g in modern sources but in Eastern Han times it was equivalent to 13.875g. This means that the dosages in classical formulae could have been more than 4x what is given today making them far higher than recommended safe dosages today but prompts consideration of what an effective dose may be (He, 2013).



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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.