HM1-424-Class-9

8/11/2019 HM1-424-Class-9

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Class 9: Herbs and Formulas

That Release The Exterior

Fayi Wu

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Warm-Acrid Release Exterior Herbs

Herba Ephedrae (Ma huang)

Ramulus Cinnamomi (Gui zhi)

Folium Perillae (Zi su ye)

Herba Schizonepetae (Jing jie)

Radix Ledebouriellae (Fang feng)

Radix Notopterygii (Qiang huo)

Radix Angelicae Dahuricae (Bai zhi)

Herba Asari (Xi xin)

Rhizoma Zingiberis Recens (Sheng jiang)

Herba Elsholtziae (Xiang ru)

Flos Magnoliae (Xin yi hua) Bulbus Allii Fistulosi (Cong bai)

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Herba Ephedrae (Ma huang)

Taste and Nature: Pungent, slightly bitter and warm Channel tropism: Lung and bladder

Actions: induces sweating, calms wheezing, promotes urination

Indications: Treat exterior syndrome of wind-cold type.

Facilitate outward flow of lung qi to relieve asthma.

Induce diuresis to treat edema due to affection of wind. Dosage: 6-10g.

Contraindications: Being strong in inducing sweating, this herb is not applicable to patients with

spontaneous sweating due to qi deficiency, especially in the aged, veryyoung patients and those with a weak constitution.

Exciting the central nervous system, it is used carefully in patients withhypertension, insomnia and fidget

When treating chronic cough, it should be given intermittently, otherwise itseffectiveness will be lowered.

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Ramulus Cinnamomi (Gui zhi) Taste and Nature: Pungent, sweet and warm

Channel tropism: Heart, lung and bladder Actions: induces sweating and releases exterior, warms and unblocks the

channels and collaterals, and assists the yang

Indications: Treat exterior syndrome of deficiency type with symptoms of wind-cold type.

Relieve pain by dispersing wind cold from the channels and collaterals, applicable topain or soreness in the shoulder and lumbar region.

Assist yang to promote flow of yang qi and remove obstruction from the collaterals,applicable to phlegm syndrome, abdominal pain due to yang deficiency anddysmenorrhea due to accumulation of cold in the collaterals.

Dosage: 3-9g

Contraindications: Pregnancy, Menorrhagia, Deficiency heat syndrome.

Common compatible herbs: Gui Zhi and Bao Shao: Regulate ying and wei, applicable to exterior syndrome of

deficiency type and insomnia, palpitation, Gui Zhi and Bai Zhu: Promote flow of yang qi to treat retention of water in the bladder

marked by dysuria,

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Folium Perillae (Zi su ye)

Taste and Nature: Pungent, aromatic and warm

Channel tropism: Lung and spleen Actions: releases exterior and disperses cold, promotes the movement of qi

and expands the chest, resolves seafood poisoning

Indications: For wind cold.

Prevention of common cold.

Cool-dry syndrome.

For vomiting caused by stagnation of cold and qi in the stomach.

Prevent miscarriage by promoting flow of qi.

Eliminate Toxin: Applicable to poisoning of crabs or cancers.

Dosage: 3-9 g, not decoct too long.

Comments: Using the stem for chest depression, Su Ye for exterior syndrome.

Being aromatic in taste, it has a strong property of moving about. So, it is speciallyapplicable to vomiting or exterior syndromes with qi stagnation manifestations.

When used for relieving poisoning, its dosage should be up to 30-60 g.

Diabetics should not take the herb at a large dosage, since it can increase theblood sugar level.

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Herba Schizonepetae (Jing jie)

Taste and Property: acrid, slight warm

Meridian Tropism: liver and lung

Actions: releases the exterior and dispels wind, vents rashesand alleviates itching, stops bleeding

Indications: For exterior patterns of either wind-cold or wind-heat. Also for

carbuncles or boils when they first erupt, especially whenaccompanied by chills and fever.

For initial stage of measles and pruritic skin eruptions.

As an auxiliary herb for hemorrhage.

Dosage: 4.5-9g Contraindications: deficiency of the exterior, fully erupted

measles or open sores.

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Radix Ledebouriellae (Fang feng)

Taste and Property: acrid, sweet, slight warm

Meridian Tropism: bladder, liver and spleen

Actions: releases the exterior and expels wind; expels wind-dampnessand alleviates pain; expels wind relives spasm

Indications:

For headache, chills and body aches due to externally-contracted wind-cold. For exterior wind-damp painful obstruction (bi syndrome), especially when

wind predominates, used with qiang huao, dang gui.

As an auxiliary herb to alleviate trembling of the hand and feet and tetany.

Dosage: 4.5-9g

Contraindications: exuberant fire from yin deficiency, spasm fromblood deficiency

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Radix Notopterygii (Qiang huo)

Taste and Property: acrid, bitter, aromatic, warm

Meridian Tropism: bladder, kidney

Actions: releases the exterior and expels wind, cold, dampness;unblocks painful obstruction and alleviates pain

Indications: For headache, chills and body aches due to externally-contracted

wind-cold.

For wind-cold-damp painful obstruction, especially in upper limbsand back.

Dosage: 3-9g Contraindications: for blood deficiency painful obstruction

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Bulbus Allii Fistulosi (Cong bai)

Taste and Nature: Acrid, warm

Channel tropism: Lung and stomach

Actions: releases exterior and induces sweating; disperses coldand unblocks the yang, resolves toxicity and disperses clumps

Indications: For exterior syndrome of wind cold, especially in the very early

stages, used with dan dou chi, i.e. cong chi tang

For either abdominal pain and distention or nasal congestion dueto blockage of yang qi by cold, i.e. bai tong tang

For sores and abscesses, externally as a poultice

Dosage: 3-9g. Contraindications: profuse sweating from exterior deficiency,

can’t taken with honey

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Scallion and Prepared Soybean

Decoction (cong chi tang)

Ingredients: cong bai, dan dou chi

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Actions and indications of the formula

Actions

Unblocks the yang qi in the exterior and induces

sweating

Indications Mild fever and slight chills without sweating,

headache, stuffy nose, a thin white tongue coating

and a floating pulse.

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Analysis of Formula

Cong bai:

A warm, acrid herb that unblocks the flow of yang

qi in the exterior and induces sweating

Dan dou chi: Releases externally contracted disorders from the

exterior as well as interior constraint

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Modern application and modifications

Modern application: Disorder of upper respiratory tract infection

Modifications:

For pronounced chills and headache, add qiang huo, fangfeng, jing jie

For pronounced cold with abdominal pain, add sheng jiang,brown sugar

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Ephedra Decoction (ma

huang tang)

Ingredients: ma huang, gui zi, xing ren,

gan cao

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Actions

Releases exterior cold and arrests wheezing.

Indications

Fever and chills (chills predominant) without

sweating, headache, generalized body aches,

wheezing, a thin white tongue coating, and

floating tight pulse .

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Analysis of Formula

Chief: Ma huang Disseminates the lung qi and treats wheezing.

Deputy: Gui zhi Releases the exterior (especially the muscle layer) and

warms and facilitates the flow in the channels. Combinedwith chief herb, it strengthens the diaphoretic effect.

Assistant: Xing ren Unblocks the flow of lung qi and helps the chief ingredient

arrest wheezing and expel the pathogenic influence .

Envoy: Gan cao Harmonizes the actions of the other herbs and moderates

the diaphoretic action of ma huang

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Modern application: Disorder of upper respiratory tract infection, influenza,

acute bronchitis, bronchial asthma, lobar pneumonia andacute glomerulonephritis.

Attentions: Contraindicated for patients with debility and copious

urination, and for patients who are prone to bleeding, usedwith caution in cases with hypertension.

Modifications: For exterior cold with interior heat, add shi gao For sore throat, reduce the dosage of gui zhi, add tian hua

fen, she gan.

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Cinnamon Twig Decoction

(gui zhi tang)

Ingredients: gui zhi, shao yao, sheng

jiang, da zao, gan cao

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Actions

Releases pathogenic influences from the muscle layer and

regulates the nutritive and protective qi.

Indications Fever and chills unrelieved by sweating, headache,

aversion to wind, stiff neck, nasal congestion, dry heaves,

no particular thirst, a thin white tongue coating, and floating

pulse that is either moderate or frail. May also be used for a

similar presentation in patients recovering from seriousillness or after childbirth.

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Analysis of Formula

Chief: Gui zhi

Releases externally-contracted wind-cold from the muscle layer.

Deputy: bai shao yao

Benefits the yin and contains the weak nutritive qi. Combinedwith chief herb, enhance protective qi to dispel pathogenicinfluences while strengthening the nutritive qi.

Assistant: sheng jiang, da zao

Sheng jiang: helps the chief herb release the exterior whilealso treating the nausea and vomiting

Da zao: helps deputy nourish and harmonize the nutritive qiand blood

Envoy: Gan cao

Tonifies middle burner and harmonizes the actions of the otherherb

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Modern application: Disorder of upper respiratory tract infection, influenza, post

partum fever, allergic rhinitis, angioedema, cerebrovascularspasm, eczema and urticaria.

Attentions: Contraindicated in cases with exterior cold and interior heat.

Modifications: For marked nasal congestion with sneezing, add fang feng, xin yi

hua

For shortness of breath and rough breathing, add hou po, xing

ren For severe vomiting, increase the dosage of sheng jiang and bai

shao, add chen pi, hou po

For joint pain in the extremities accompanied by fatigue, addqiang huo and fang feng

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Minor Bluegreen Dragon

Decoction (xiao qing long tang)

Ingredients: ma huang, gui zhi, gan

jiang, xi xin, wu wei zi, bai shao, ban

xia, zhi gan cao

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Actions

Releases the exterior, transforms congested fluids, warms

the lungs, and directs rebellious qi downward.

Indications

Fever and chills (chills predominant) without sweating,

coughing, wheezing, sputum that is copious, white, stringy,

and difficult to expectorate, a stifling sensation in the chest,

a generalized sensation of heaviness and body aches, no

particular thirst, a moist tongue coating, and a floating, tightpulse. In severe case, there may be edema or considerable

difficulty in breathing when lying down

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Analysis of Formula

Chief: ma huang, gui zhi Ma huang: releases exterior, arrests wheezing and moves water by

facilitating the flow of lung qi

Gui zhi: works with ma huang to release the exterior

Deputy: gan jiang, xi xin Warm the interior, transform congested fluids, and help the chief herbs

release the exterior. Gan jiang also can warm spleen, xi xin also stops thecough by facilitating the flow of qi through the body

Assistant: wu wei zi, bai shao, ban xia

Wu wei zi: prevents the leakage of lung qi

Bai shao: nourishes the blood and nutritive qi

Ban xia: transforms congested fluids and harmonizes the

stomach Envoy: Gan cao

Augment the qi and harmonizes the interaction of the acrid and sour herb

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Modern application: Acute bronchitis, acute exacerbation of chronic bronchitis,

bronchial asthma, and influenza.

Attentions:

Should not be used long-tern, nor for conditions with heat,coughing of blood, or coughing due to yin deficiency. Use withcaution in cases with hypertension

Modifications: For severe exterior cold disorders, increase the dosage of

ma huang, gui zhi For pronounced nasal congestion, runny nose, and

headache, substitute sheng jiang for gan jiang, add fangfeng, jing jie

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Nine-Herb Decoction with

Notopterygium (jiu wei qiang

huo tang)Ingredients: qiang huo, fang feng, cang zhu,

xi xin, chuan xiong, bai zhi, huang qin, sheng

di huang, gan cao

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Actions

Releases the exterior dampness and clears

interior heat.

Indications Fever and chills (chills predominant) without

sweating, headache, stiff neck, generalized aches

and pain, slight thirst, a bitter taste in the mouth, a

white tongue coating, and a floating pulse.

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Analysis of Formula

Chief: qiang huo

Disperses exterior wind-cold-dampness

Deputy: fang feng, cang zhu, xi xin, chuan xiong, bai zhi

Fang feng, cang zhu: assist the chief herb in releasing theexterior and eliminating dampness

Xi xin, chuan xiong, bai zhi: assist the chief herb in releasing the

exterior and treating the head and body aches Assistant: huang qin, sheng di huang

Clear qi and blood level interior heat respectively, treat the thirstand bitter taste in the mouth and also prevent the dry nature ofthe other herbs from injuring the fluids

Envoy: Gan cao Harmonizes the middle burner and the actions of the other herbs

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Modern application: Disorder of upper respiratory tract infection, influenza,

sinusitis, acute lower back sprain, and rheumatic fever.

Modifications: For upper back and shoulder pain, add qin jiao

For pronounced thirst and irritability, add shi gao,zhi mu

Where there is no thirst or bitter taste in themouth, omit huang qin, sheng di huang

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HM1-424-Class-9