Class 11-12 : Herbs and Formulas That Release The Exterior

1. Class 11-12: Herbs and Formulas That Release The Exterior Fayi Wu

2. Mulberry Leaf and Chrysanthemum Decoction (sang ju yin) Ingredients: sang ye, ju hua, lian qiao, bo he, jie geng, xing ren, lu gen, gan cao

3. Actions and indications of the formula • Actions • Releases the exterior wind-heat and stops coughing by facilitating the flow of lung qi. • Indications • Slight fever, cough, slight thirst, a thin white tongue coating, and a floating, rapid pulse.

4. Analysis of Formula • Chief: sang ye, ju hua • Release exterior heat. Sang ye also clears heat from the lungs and stops coughing, ju hua disperses upper burner wind-heat • Deputy: lian qiao, bo he; jie geng, xing ren • Lian qiao, bo he: strengthen exterior-releasing properties • Jie geng, xing ren: facilitate the flow of lung qi and stop cough • Assistant: lu gen • Clears heat and generates fluids • Envoy: gan cao • Harmonizes the actions of the other herbs

5. Modern application and modifications • Modern application: • Disorder of upper respiratory tract infection, influenza, early-stage acute bronchitis, acute tonsillitis, and acute conjunctivitis. • Modifications: • For heat in qi level, add shi gao, zhi mu • For nutritive-level heat with a dark tongue, add xuan shen, xi jiao • For heat entering the blood, omit lu gen, bo he, add mai meng dong, sheng di huang, yu zhu • For wind-heat affecting eyes , add jue ming zi, xia ku cao, bai ji li

6. Honeysuckle and Forsythia Powder (yin qiao san) Ingredients: jin yin hua, lian qiao, jie geng, niu bang zi, bo he, dan dou chi, jing jie, dan zhu ye, xian lu gen, gan cao

7. Actions and indications of the formula • Actions • Disperses wind-heat, clears heat, and relieves toxicity. • Indications • Fever, slight or no chills, headache, thirst, cough, sore throat, a red-tipped tongue, a thin white or thin, yellow tongue coating and a floating rapid pulse.

8. Analysis of Formula • Chief: jin yin hua, lian qiao • Release heat from exterior, clear heat, and relieve toxicity. • Deputy: jie geng, niu bang zi; dan dou chi, bo he • Jie geng, niu bang zi: spread the lung qi and improve the function of the throat • Dan dou chi, bo he: help chief herbs release exterior heat • Assistant: jing jie, dan zhu ye, xian lu gen, gan cao • Jing jie: boosts the exterior-releasing action of the formula without producing dryness • Dan zhu ye, xian lu gen, gan cao: clear heat, generate fluids and alleviates thirst

9. Modern application and modifications • Modern application: • Disorder of upper respiratory tract infection, influenza, acute bronchitis, measles, epidemic parotitis, acute endometritis, and early stage encephalitis or meningitis. • Modifications: • For severe sore throat, add ma bo, xuan shen • For pronounced coughing, add xing ren • For heat entering the interior with scanty urine, add sheng di huang, mai meng dong, huang qin • For early-stage measles with incomplete expression of rash, add chan tui, fu ping

10. Bupleurum and Kudzu Decoction to Release the Muscle Layer (chai ge jie ji tang) Ingredients: chai hu, ge gen, qiang huo, bai zhi, huang qin, shi gao, jie geng, bai shao, gan cao, sheng jiang, da zao

11. Actions and indications of the formula • Actions • Releases pathogenic influences from the muscle layer and clears interior heat. • Indications • An exterior wind-cold presentation characterized by increasing fever and decreasing chills accompanied by headache, stiffness of the extremities, orbital and eye pain, dry nasal passages, irritability, insomnia, thin, yellow tongue coating, and a floating slightly flooding pulse.

12. Analysis of Formula • Chief: chai hu, ge gen • Release the pathogenic influence from the muscle layer while concurrently clearing heat. • Deputy: qiang huo, bai zhi, huang qin, shi gao • Qiang huo, bai zhi: helps the chief ingredients release the exterior and alleviate pain • Huang qing, shi gao: clearing interior heat • Assistant: jie geng, bai shao • Jie geng: facilitates the flow of lung qi and helps scatter the pathogenic influence from the exterior • Bai shao: preserves the yin by preventing the exterior-releasing herbs from causing excessive sweating • Envoy: gan cao, sheng jiang, da zao • Gan cao: harmonizes the actions of the other herbs • Sheng jiang, da zao: regulate the protective and nutritive qi to faciliate the release of the pathogenic influence

13. Modern application and modifications • Modern application: • Disorder as influenza and toothache. • Attentions: • Inappropriate for simple exterior wind-heat disorders • Modifications: • For severe chills without sweating, substitute ma huang for huang qin • For cases without chills or headache, omit qiang huo and bai zhi • For a dry mouth and tongue, add tian hua fen

14. Ligusticum Chuanxiong Powder to be Taken with Green Tea (chuan xiong cha tiao san) Ingredients: chuan xiong, bo he, bai zhi, qiang huo, xi xin, jing jie, fang feng, gan cao

15. Actions and indications of the formula • Actions • Disperses wind and alleviates pain. • Indications • Headache in any part of head accompanied by fever and chills, dizziness, nasal congestion, a thin, white tongue coating and a floating pulse.

16. Analysis of Formula • Chief: bo he • Disperses wind for the exterior, benefits the head and clears heat. • Deputy: chuan xiong, qiang huo, bai zhi, xi xin: disperse wind and alleviate headache • Chuan xiong: alleviates headache from shao yang channel • Qiang huo: alleviates headache from tai yang channel • bai zhi: alleviates headache from yang ming channel • Xi xin; scatters cold, alleviates pain (shao yang) • Assistant: jing jie, fang feng • Disperse wind from the head and release the exterior • Envoy: gan cao, green tea • harmonizes the actions of the other herbs • Green tea: clears heat and moderates side-effects caused by warm, drying properties of some of the other ingredients

17. Modern application and modifications • Modern application: • Disorder of upper respiratory tract infection, migraine headache, tension headache, neurogenic headache, and acute and chronic rhinitis or sinusitis. • Attentions: • Inappropriate for treating headache from ascendant liver yang due to liver and kidney deficiency and for headache due to qi and blood deficiency • Modifications: • For wind-cold headache, omit bo he, add sheng jiang, su ye • For wind-heat headache, omit qiang huo, xi xin, add man jing zi, ju hua

18. Xanthium Powder (cang er zi san) Ingredients: cang er zi, xin yi hua, bai zhi, bo he

19. Actions and indications of the formula • Actions • Disperses wind, alleviates pain and unblocks the nose. • Indications • Copious, purulent, and foul-smelling nasal discharge, nasal obstruction, dizziness, frontal headache, a normal or yellow tongue coating, and a floating, rapid pulse.

20. Analysis of Formula • Chief: cang er zi, xin yi hua • Unblock the nasal passages and are frequently used in treating profuse nasal discharge. • Deputy: bai zhi, bo he • Bai zhi: releases the exterior and opens up the orifice, disperses wind-dampness, and promotes the discharge of pus • Bo he: releases wind-heat from the exterior and clears the eyes and head

21. Modern application and modifications • Modern application: • Disorders as acute or chronic sinusitis and acute, chronic or allergic rhinitis. • Modifications: • For more pronounced heat in the lungs, add sang bai pi, di gu pi or huang qin • For very copious and purulent nasal discharge, add jin yin hua

22. Kudzu Decoction (ge gen tang) Ingredients: ge gen, ma huang, gui zhi, shao yao, sheng jiang, da zao, gan cao

23. Actions and indications of the formula • Actions • Releases the exterior and muscle layer, and generates fluids. • Indications • Fever and chills without sweating, stiff and rigid neck and upper back, a thin, white tongue coating, a floating, tight pulse.

24. Analysis of Formula • Chief: ge gen • Releases the muscle layer (especially of the upper back and neck) by drawing fluids to the affected area and exterior. • Deputy: ma huang, gui zhi • Ma huang: releases exterior and induce sweating • Gui zhi: releases exterior and relieves the muscle layer • Assistant: bai shao, sheng jiang, da zao • Bai shao: preserve yin • Sheng jiang, da zao: regulate the protective and nutritive qi, harmonize the stomach • Envoy: gan cao • Harmonizes the actions of the other herbs

25. Modern application and modifications • Modern application: • Disorders as upper respiratory tract infection, influenza, stomach flu, acute cervical myositis, tendonitis or bursitis of the shoulder, urticaria, allergic rhinitis, and early-stage polio or encephalitis. • Modifications: • For severe nasal blockage, add chuan xiong, xin yi hua, huang qin, jie geng • For urticaria, add chan tui

26. Ginseng Powder to Overcome Pathogenic Influences (ren shen bai du san) Ingredients: qiang huo, du huo, chuan xiong, chai hu, jie geng, zhi ke, qian hu, ren shen, fu ling, gan cao

27. Actions and indications of the formula • Actions • Releases the exterior, dispels wind and dampness, and augments the qi. • Indications • High fever and severe chills with shivering, absence of sweating, pain and stiffness of the head and neck, soreness and pain of the extremities, focal distention and fullness of the chest, nasal congestion with sonorous breathing, a productive cough, a greasy, white tongue coating, and a floating, soggy pulse.

28. Analysis of Formula • Chief: qiang huo, du huo • Dispels wind cold from the exterior, dispel dampness and alleviate pain. • Deputy: chuan xiong, chai hu, bo he • Chuan xiong: relieves the exterior, moves the blood, dispels wind, alleviates pain • Chai hu, bo he, relieve exterior, reduce fever, and expel the pathogenic influences • Assistant: jie geng, zhi ke, qian hu, fu ling, sheng jiang, ren shen • Jie geng, zhi ke: regulate qi in the chest • Qian hu: expels phlegm and stops cough • Fu ling: transforms phlegm and strengthens the spleen • Sheng jiang: releases exterior and harmonizes middle jiao • Ren shen: tonifies qi • Envoy: gan cao • Tonifies qi and harmonizes the actions of the other herbs

29. Modern application and modifications • Modern application: • Disorders as upper respiratory tract infection, influenza, early-stage dysentery, early-stage measles, and surgical infection. • Attentions: • contraindicated for cases with heat • Modifications: • For malarial disorders, increase the dosage of chai hu, add huang qin and bing lang

30. Ephedra, Asarum, and Prepared Aconite Decoction (ma huang xi xin fu zi tang) Ingredients: ma huang, fu zi, xi xin

31. Actions and indications of the formula • Actions • Assists yang and releases the exterior. • Indications • Sensation of extreme cold and severe chills (relieved by wearing more clothing or adding covers), a slight fever without sweating, exhaustion, a white, slippery tongue coating, and a submerged faint pulse.

32. Analysis of Formula • Chief: ma huang • Releases the exterior and dispels externally-contracted cold. • Deputy: fu zi • Stimulates yang and warms both interior and the channels • Assistant: xi xin • Releases exterior and scatters interior cold

33. Modern application and modifications • Attentions: • If the deficiency is more severe, this formula is contraindicated • Modifications: • For wind-cold headache, add chuan xiong, sheng jiang • For chronic wheezing due to cold deficiency, take with er chen tang

34. Modified Polygonatum Odoratum Decoction (jia jian wei rui tang) Ingredients: yu zhu, cong bai, jie geng, dan dou chi, bo he, bai wei, zhi gan cao, da zao

35. Actions and indications of the formula • Actions • Nourishes yin, clears heat, induces sweating, and releases the exterior. • Indications • Fever and slight chills, little or no sweating, headache, dry throat, cough, sputum which is difficult to expectorate, thirst, irritability, a dark-red tongue, and a rapid pulse.

36. Analysis of Formula • Chief: yu zhu • Nourishes the yin of the lungs and stomach, clears heat, and generates the fluids. • Deputy: cong bai, dan dou chi, bo he • Releases exterior and dispel wind heat • Assistant: bai wei, jie geng • Bai wei, cools the blood and clears heat without injuring yin • Jie geng: disseminates the lung qi to stop cough and expel phlegm • Envoy: gan cao, da zao • Assist the chief herb in moistening dryness and harmonizing the actions of the other ingredients

37. Modifications • Modifications: • For more severe exterior disorders, add fang feng, ge gen • For cough, dry throat, and sputum which is difficult to expectorate, add niu bang zi, gua lou pi

38. Ledebouriella Powder that Sagely Unblocks (fang feng tong sheng san) Ingredients: fang feng, ma huang, jiu da huang, mang xiao, jing jie, bo he, zhi zi, hua shi, shi gao, lian qiao, huang qin, jie geng, chuan xiong, dang gui, bai shao, bai zhu, gan cao

39. Actions and indications of the formula • Actions • Disperses wind, releases the exterior, drains heat, and unblocks the bowels. • Indications • Strong fever and chills, dizziness, red and sore eyes, difficulty in swallowing, sticky nasal discharge and saliva, a bitter taste in the mouth, dry mouth, focal distention with a stifling sensation in the chest and diaphragm, constipation, dark urination, a yellow greasy tongue coating, and a flooding rapid or wiry slippery pulse.

40. Analysis of Formula • Chief: fang feng, ma huang, jiu da huang, mang xiao • Fang feng, ma huang: disperse wind and release the exterior by inducing sweating. • Da huang, mang xiao: expel heat through stool • Deputy: jing jie, bo he, zhi zi, hua shi, shi gao, lian qiao, huang qin, jie geng • Jing jie, bo he: release exterior • Zhi zi, hua shi: drain heat through urine • Shi gao, jie geng, lian qiao: clear heat in the stomach and lungs • Assistant: chuan xiong, dang gui, bai shao, bai zhu • Chuan xiong, dang dui, bai shao: harmonize the blood and help to disperse wind • Bai zhu: strengthens the spleen • Envoy: gan cao, • Protects the spleen and harmonizes the actions of the other ingredients

41. Modern application and modifications • Modern application: • Disorders as influenza, erysipelas, food poisoning, carbuncles, urticaria, dermatitis, and acne. • Modifications: • For cases without strong chills, omit ma huang • For cases without constipation, omit da huang, mang xiao