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:

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
   Cold extremities (Reynaud's disease)
5. 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.

Pinyin: Gui Zhi  Chinese: 桂枝
Pharmaceutical: Ramulus Cinnamomi
Taxonomy: Cinnamomum cassia
English: Cinnamon Twig

Tastes: Pungent, sweet, warm
Meridians Entered: Lung, Heart, Kidney, Liver

Actions & Indications:

1. Releases the Exterior, assists Yang, adjusts the Ying and Wei and releases the muscle layer
   Taiyang Wind Strike (Taiyang Zhongfeng, 太阳中风) - a weak person who catches cold easily with spontaneous sweating, aversion to drafts, fever and chills, nasal congestion, stiff and aching head and muscles
2. Warms the channels and collaterals to relieve pain
   Wind-Cold-Damp Bi
3. Unblocks Yang and transforms Qi and thin mucus
   Edema due to Cold-Phlegm or Yang Qi Deficiency with urinary dysfunction, dizziness and palpitations
4. Assists Heart Yang and warms and facilitates the flow of Yang Qi in the chest
   Palpitations due to Yang Obstruction in the chest due to Stagnation or Deficiency
   Listless chest Yang with upward movement of Phlegm and thin mucus and disorderly descent of Lung Qi with shortness of breath, chest and back pain and palpitations
   Heart and Spleen Yang Deficiency
5. Warms and facilitates the flow of Qi through the channels and collaterals and Blood through the vessels
   Wind-Cold-Damp Bi
   Blood Stasis due to Cold, causing amenorrhea or dysmenorrhea with or without abdominal masses
6. Warms the Middle and directs Turbid Yin downward
   Middle Jiao Yang Deficiency
   Heart and Spleen Yang Deficiency (patient usually craves sweets)
7. 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, prevent forgetfulness, and render the face bright and efflorescent, thus forever looking charming, like a child's face. 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: 3-10g in decoction for exterior conditions, or up to 15g for Bi Syndromes.
Cautions: This herb induces heat, damages the yin and moves blood. It is prohibited for those with warm pathogens, yin deficiency with effulgent fire, or reckless movement of the blood due to heat in the blood. Use with caution in pregnant women.

Pinyin: Gan Jiang  Chinese: 干姜
Pharmaceutical: Rhizoma Zingiberis
Taxonomy: Zingiber officinale
English: Dried Ginger

Tastes: Pungent, hot
Meridians Entered: Spleen, Stomach, Kidney, Heart and Lung

Actions & Indications:

1. Warms the Middle and expels Cold
   External Cold affecting the Spleen and Stomach Spleen and Stomach Yang Deficiencies
2. Dispels Wind-Dampness seeping into the Lower Jiao
   Lower Jiao Wind-Cold-Damp Bi
3. Rescues Devastated Yang and expels Interior Cold
   Devastated Yang with a very weak pulse and cold limbs
4. Warms the Lungs and transforms thin mucus
   Lung Cold with expectoration of thin, watery or white sputum
5. Warms the channels (unblocks the pulse) and stops bleeding
   Haemorrhage due to Deficiency Cold, especially uterine bleeding (only if the bleeding is chronic and pale in colour with cold limbs, ashen white face and a soggy thin pulse)
6. Aids fasting
   Mentioned in the Shen Nong Ben Cao Jing as part of the middle class of herbs which can, with protracted taking, remove foul smell and enable one to communicate withe Spirit Light (Shen Ming 神明). 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: 3-10g in decoction.
Cautions: It is contraindicated for yin deficiency with internal heat and haemorrhage due to blood heat.

Pinyin: Xi Xin  Chinese: 细辛
Pharmaceutical: Herba cum Radix Asari
Taxonomy: Asarum sieboldii
English: Chinese Wild Ginger

Tastes: Pungent, warm, slightly toxic
Meridians Entered: Lung, Kidney and Heart

Actions & Indications:

1. Releases Exterior Wind and Cold
   As an adjunctive for any exterior Wind-Cold especially with Dampness in Lung or underlying Yang Deficiency
   Frequently used for Wind-Cold when the dominant symptoms are head and body aches
2. Disperses Wind-Cold and Internal Cold and alleviates pain
   Pain due to Wind and/or Cold anywhere in the body, particularly headache, painful obstruction, abdominal pain or headache due to obstruction of Fluids and Blood by Cold, often with anhydrous Wind-Cold-Damp Bipain
3. Warms the Lungs and transforms Phlegm and Thin Mucus (circulates water)
   Cough and Qi which surges upward and fullness in the chest in the chest with continuous cough from clumped Qi in the chest and diaphragm marked by copious, watery sputum due to Phlegm-Damp or Wind-Cold with congested fluids
4. Disperses and unblocks the Qi of the nasal orifices (clears the orifices of the head)
   Nasal congestion
   Oral pathology
   Loss of consciousness
5. Promotes healing of oral ulcerations
   Oral lesions or ulcerations
6. Relieves toothache
   Toothache
7. 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: 1-3g in decoction.
Cautions: Traditionally contraindicated for headache due to hyperactivity of yang caused by yin deficiency and dry cough caused by lung dryness hurting yin. It is incompatible with Li Lu.

While not prohibited in the UK, the RCHM has enacted a voluntary ban by use due to possible fears of aristolochic acid. It is usually substituted with Gui Zhi and Qiang Huo for channel problems, Zi Su Ye and Bai Qian for lung issues, Gao Ban and Bai Zhi for treating the head and Cong Bai and Bai Zhi for the sinuses.

Pinyin: Wu Wei Zi  Chinese: 五味子
Pharmaceutical: Fructus Schisandrae
Taxonomy: Schisandra chinensis
English: Schisandra Fruit / Chinese Magnolia-vine Fruit

Tastes: Sour, sweet, warm
Meridians Entered: Lung, Heart and Kidney

Actions & Indications:

1. Astringes the leakage of Lung Qi and stops coughing
   Chronic cough and wheezing due to Lung Qi Deficiency
   Lung and Kidney Deficiency patterns
2. Tonifies the Kidneys, binds up Essence (astringes Jing) and stops diarrhoea and spermatorrhea
   Kidney Deficiency with nocturnal emissions, spermatorrhea, vaginal discharge and urinary frequency
   Spleen and Kidney Deficiency with daybreak diarrhoea
3. Astringes sweat and generates fluids
   Excessive sweating. especially when accompanied by thirst or a dry throat
   In combination, it is used for spontaneous sweating, night sweats and wasting and thirsting disorder
4. Quiets the Spirit and calms and contains Heart Qi
   Heart and Kidney Blood and Yin Deficiency, with irritability, palpitations, dream-disturbed sleep and insomnia
5. Tonifies Qi
   Heart and Spleen Qi Deficiency

Standard Dosage: 3-6g in decoction. 1-3g as powder.
Cautions: It is contraindicated in cases of external pathogen existence, internal excess heat, acute cough, early stage of measles.

Pinyin: Bai Shao  Chinese: 白芍
Pharmaceutical: Radix Paeoniae Alba
Taxonomy: Paeonia lactiflora
English: White Peony Root

Tastes: Bitter, sour, sweet, slightly cold
Meridians Entered: Spleen and Liver

Actions & Indications:

1. Nourishes the Blood and regulates menstruation
   Liver Blood Deficiency with menstrual dysfunction, vaginal discharge and uterine bleeding accompanied by a pale face, a lusterless complexion and dull, lusterless nails
   Anemia
   Breast distention and premenstrual syndrome
2. Astringes Yin and adjusts the Ying and Wei
   Yin Deficiency sweating Sweating due to Yin Collapse
   Disharmony between the Liver and Spleen
   Disharmony between the Ying and Wei with non-productive sweating
3. Calms Liver Yang and Liver Wind and alleviates pain
   Liver Qi Stagnation with Liver Yang Rising
   Liver Wind with Yin and Blood Deficiency
   Bi syndrome due to Blood Deficiency with pain and spasms
4. Softens the Liver and relieves pain
   Diarrhoea, borborygmus and abdominal pain
   Dysenteric disorders with tenesmus
5. Tonifies the Blood while suppressing Parasites
   Gu Sydnrome (Fruehauf, 1998)
   Chronic inflammatory disease (Fruehauf, 2015)

Standard Dosage: 10-30g in decoction.
Cautions: Caution with anticoagulants as it may slow clotting time. May also slow the absorption of phenytoin.

Pinyin: Ban Xia  Chinese: 半夏
Pharmaceutical: Rhizoma Pinelliae
Taxonomy: Pinellia ternata
English: Pinellia Rhizome

Tastes: Pungent, warm, toxic
Meridians Entered: Lung, Spleen and Stomach

Actions & Indications:

1. Dries Dampness and transforms Phlegm
   Cold-Phlegm in the Lungs (cough with copious sputum)
   Especially effective for Damp-Phlegm of the Spleen (Cold-Damp Stagnation)
2. Descends Rebellious Qi and stops vomiting (harmonizes the Stomach)
   Vomiting due to Phlegm-Damp in the Stomach (Tan Yin), Cold thin mucus, Stomach Deficiency, Stomach Heat or pregnancy
3. Dissipates nodules and reduces Stagnation (clumps)
   Phlegm in the chest (nodules, pressure, distention, pain)
   Phlegm nodules in the neck (goiter, scrofula)
   Focal distension in the chest and epigastrium
   Obstruction caused by Phlegm anywhere in the body
4. Treats sores, skin ulcerations and carbuncles and reduces swelling (external)
   Topically as a powder for sores, skin ulcerations and carbuncles

Standard Dosage: 3-10g in decoction.
Cautions: Contraindicated to Wu Tou. Use with cautions during gestation.

Must be processed before use as raw Ban Xia is toxic. Ingesting the raw form can cause severe irritation of the mouth, pharynx, and gastrointestinal tracts, and has toxic effects on the nervous system. Symptoms of toxicity include a dry mouth, numbness of the tongue, gastric discomfort, burning sensations and swelling of the mouth, tongue, throat and salivation. In serious cases ingesting Ban Xia can result in hoarseness, spasms, dyspnoea and asphyxia.

Processing can be done with ginger and alum (Jiang Ban Xia) to make a warming herb best suited for Cold-Damp and thin Phlegm conditions, or with liquorice (Fa Ban Xia) to make a more neutral herb that is less drying and can be used for Damp-Heat conditions too.

Pinyin: Shi Gao  Chinese: 石膏
Pharmaceutical: Gypsum Fibrosum / Calcium Sulphate
Taxonomy: CaSO₄
English: Gypsum / Plaster of Paris

Tastes: Pungent, sweet, cold
Meridians Entered: Lung and Stomach

Actions & Indications:

1. Clears Heat in the Qi Stage, drains Fire, relieves irritability and quenches thirst
   Heat in the Qi Stage or Yangming Heat with high fever, no chills, irritability, intense thirst, profuse sweating, restlessness, encephalitis, a flooding, big pulse and a red tongue with a yellow coat
2. Clears Excess Heat from the Lungs
   Lung Heat with cough, wheezing, fever and a thick viscous sputum
3. Clears Blazing Stomach Fire
   Stomach Fire with headache, toothache or swollen gums
4. Heals eczema, burns and ulcerated sores and wounds
   Sores and wounds (topically or internally)

Standard Dosage: 15-60g in decoction.
Cautions: 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.

Conventional replacements include Huang Lian and Zhi Mu but its actions are difficult to substitute in many cases and the patient may have to rely on OTC mineral based antacids from the pharmacy such as sodium bicarbonate and calcium carbonate which have a similar effect of binding and neutralising the stomach acid, then using herbal medicines as an adjunctive treatment. Another possibility would be to use sodium alginate that is often found in antacid medications and extracted from seaweed.