Herb Formulas Notebook

Ma Huang Jia Bai Zhu Tang

Ephedra plus Atractylodes Decoction


Author: Zhang Zhong-Jing, 張仲景

Year: c. 220

Source: Essentials from the Golden Cabinet (Jin Gui Yao Lue, 金匱要略)


Category: Formulas that Release the Exterior

Pattern: Damp-Cold in the Exterior or invasion of Wind-Dampness with chronic Spleen Qi deficiency and Internal Damp

Key Symptoms: Pronounced body aches with irritability
Secondary Symptoms: Cough, wheezing, headaches, simultaneous fever and chills, aversion to cold with absence of sweating

Tongue: White coating


Ingredients

Ma Huang 6-9g
Bai Zhu 6-12g
Gui Zhi 4-6g
Xing Ren 6-9g
Zhi Gan Cao 3g

Subsitutions:
In the UK the maximum legal dose of Ma Huang allowed without prescription is 1.8g per day, and a maximum of 0.6g per administration. This makes it difficult to get the effects required. If necessary it can be substituted with Zi Su Ye, Jing Jie and Fang Feng or Wei Ling Xian.


Preparation: Decoction. Do not cook for more than 20 minutes.


Actions: Releases the Exterior, expels Wind, resolves Dampness, strengthens the Spleen

Contraindications: Recent blood loss, patients prone to bleeding (especially nosebleeds), hypertension, anxiety and restlessness in patients who tend to be overstimulated



Notes:
In order to mitigate the agitation causing effects of Ma Huang it may be fried in honey first and when decocted the froth removed from the surface with a spoon.

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