Two Formulas to release the exterior when interior excess is also present

1. Ge Geng Huang Qin Huang Lian Tang (4 herbs) - diarrhea w/ an exterior condition
2. Fang Feng Tong Sheng San (18 herbs) - very strong person with strong Wind Heat pathogen

Ge Geng Huang Qin Huang Lian Tang:

S/S:
Fever, sweat, thirst
foul burning diarrhea
irritibility
wheezing
T; Red, yellow coat

C: Ge Gen - exterior / heat in muscle layer, ascends yang qi to stop diarrhea

D: Huang Qin & Huang Lian - heat in intestines, bitter to dry damp, cold to clear heat

AE: Zhi Gan Cao - moderates and harmonizes


2. Fang Feng Tong Sheng San

S/S:
STrong CHILL & FEVER
dizzy
headache
red eyes, pain
bitter mouth
dry nose
sore throat
difficulty swallowing
nasal congestion / runny
chest congestion - cough and phlegm
constipation (heat)
scanty urine, dark yellow

P: Rapid and Big / Wiry, slippery

HERBS:

Chief:
Fang Feng
Ma Huang

to release w-c

Da Huang
Mang Xiao

to purge interior heat


Deputies (9):

Jing Jie & Bo He: release exterior

Zhi Zi & Hua Shi - clear heat through urination

Shi Gao - clear internal heat

Lian Qiao & Huang Qin: internal heat in intestines

Jie Geng - throat, lung

Chuan Xiong - Tonify

Assistants (3):

Dang Gui
Bai Shao
Bai Zhu

Tonify and move blood, tonifies SP Qi (Bai Zhu)

Envoys (2)

Gan Cao (tonify SP Qi)
Sheng Jiang - relieve exterior

Two formulas to release exterior disorder with interior deficiency

Ren Shen Bai Du San (12 herbs) - deficient patient with WCD
Ma Huang Fu Zi Xi Xin Tang (3 herbs - all in the name) - Kidney Yang deficient with WC

1. Ginseng Powder to overcome pathogenic influences:

Ren Shen Bai Du San

This formula is for someone with Wind Cold Damp who is deficient, or for a child with Wind Cold Damp.

Signs and Symptoms:

STRONG chill and fever
headache
bodyache
NO SWEAT (COLD)
nose congestion (DAMP)
Cough w/ PHLEGM
Full, distended diaphragm

P: Floating and SOFT
T: greasy, white

Ren Shen Bai Du San is NOT a tonification formula, it is for an exterior condition (WCD) in a patient too weak to fight it off.

Chief herbs (2)

Qiang Huo
Du Huo

These relieve exterior WCD in the upper and lower body.

Deputies (3)

Chuan Xiong - acrid and warm, elim WC, reduce headache
Bo He - wind/ sore throat
Chai Hu - sli sweating, muscle layer, reduce heat, fever

Assistants (6):

Zhi Ke - descends - cough , wheeze
Jie Geng - ascends - sore throat

Qian Huo - cough, phlegm
Fu Ling - leach damp, tonify SP
Ren Shen - assists to build to help relieve exterior

Sheng Jiang - relieve exterior W-C

A/Envoy:

Gan Cao - sore throat


Ma Huang Fu Zi Xi Xin Tang:

This patient has a Kidney Yang deficiency, is cold, low energy, low spirit. Plus has Wind Cold. They have chills not relieved by covers and are exhausted. Their pulse is submerged and faint.

C: Ma Huang
D: Fu Zi - aid KD yang, helps Ma Huang
AE: Xi Xin - assists Fu Zi to warm channel, helps Ma Huang relieve exterior

Formulas that treat exterior disorders involving the head and neck (2)

1. Cang Er Zi San
2. *Ge Gen Tang

Cang Er Zi San disperses wind, alleviates pain, and unblocks the nose. It is used for nasal congestion, allergic rhinitis. It contains only four herbs:

Chief (2):

Cang Er Zi - eliminates wind-damp, opens nose, stops head ache, for SINUS and Sinus headache.

Xin Yi Hua - opens the NOSE, disperses Wind - COLD

Deputy (2):

Bai Zhu - Disperses Wind-Cold, relieves yangming headache
Bo He - Acrid and Cold

(two of the herbs are WARM, two are Cold...making this a neutral formula for a stuffy nose.


Ge Gen Tang (Kudzu Decoction)

Ge Gen Tang is used for Wind Cold with significant neck ridgidness because the evil is blocking the taiyang channels in the neck. Qi and Ying cannot reach the neck.

Signs and Symptoms:

Wind-Cold
NO SWEAT
Upper back / Neck rigidness

All of Gui Zhi Tang is in this formula, plus Ma Huang and Ge Gen

HERBS:

Chief:
Ge Gen: releases muscle layer, mild sweating action, relieves Wind Cold, generates fluids, relaxes tendons, raises yang qi

Deputies (2) to promote sweat

Ma Huang
Gui Zhi

Assistants to nourish ying and relieve exterior:

Bai Shao
Da Zao
Sheng Jiang

Plus Zhi Gan Cao.

This formula can also treat diarrhea by raising the yang qi (I think this is the action of Ge Gen).

Formulas that Release Exterior Wind-heat (4)

1. Sang Ju Yin
2. Yin Qiao San
3. Chai Ge Jie Ji Tang
4. Sheng Ma Ge Gen Tang

#1. Sang Ju Yin (8 herbs)

For superficial wind-heat, disperses wind, clears heat, disseminates Lung Qi, stops cough. More fever than chills.

Thirst
Cough
Sore Throat

T: no change
P: floating, slightly rapid

Chief herbs:

Sang Ye
Ju Hua

These clear heat and benefit the head and eyes.

Duputies:

Bo He - releases wind heat from exterior
Lian Qiao - clears heat from qi level

Jie Geng - travels up to relieve rebellious lung qi, cough, breaks up Lung stagnation
Xing Ren - travels down to relieve cough

Assistants:

Lu Gen - sweet, cold, clears yangming heat, stops thirst, generates fluids
Sheng Gan Cao - clears heat, generates fluids, detox


#2. Yin Qiao San (honeysuckle / forsythia) - TEN herbs

Similar to Sang Ju Yin, but much stronger. Sang Ju Yin works to relieve exterior Wind-heat. It is acrid and cold and vents the evil from the superficial level. It clears heat and detoxicates. For use when the warm febrile disease is in the wei level.

Signs and symptoms:

FEVER, mild or no chill
Headache
Thirst
Cough/ sore throat
T: Red tipped, twc or tyc
P: floating, rapid

Chief herbs (2):

Jin Yin Hua - sweet and cold, clears heat, detoxes, vents evil by fragrantly dispersing (NOT sweating/pore opening)
Lian Qiao - acrid, bitter, cold - clears heat, detoxes, relieves exterior by dispersing (stronger than jin yin hua), also NOT through sweating

For Upper Burner Heat.

Deputies (5):

Jing Jie Sui - acrid and sli. WARM, used to relieve the exterior through dispersing
Bo He - vents exterior Wind heat, benefits head, sore throat, headache

Jie Geng - goes to lung to benefit throat and stop cough

Niu Bang Zi - acrid bitter cold - disperses W-H, benefits throat, vents rashes

Assistants / Envoys (3):

Dan Zhu Ye - sweet (doesn't injure yin), bland (promotes urination), cold (clears heat, removes irritibility), it generates fluids

Lu Gen - sweet and cold, goes into to the LUng, STomach to clear heat and generate fluids

Sheng Gan Cao - clears heat, detox


Comparing Sang Ju Yin to Yin Qiao San:

They have five herbs in common (Lian Qiao, Bo He, Jie Geng, Lu Gen, Sheng Gan Cao). Sang Ju Yin stops cough more (Sang Ye, Xing Ren) and the W-H attack gives more cough but not so high a fever. Yin Qiao San is stronger at relieving exterior W-H, stronger at clearing a sore throat, and the addition of Dan Zhu Ye (plus Lu Gen) decreases irritibility more.


#3. Chai Ge Jie Ji Tang (Bupleurum and Kudzu to release muscle layer)

For a taiyang and yangming combination. Chai Ge Jie Ji Tang is used when W-Cold has lodged in the muscle layer awhile and becomes severe heat causing a high fever - Taiyang has become yangming. It is NOT shaoyang (no alternating between chills and fever).

Signs and Symptoms:

Fever increases while aversion to cold / chills decrease
NO sweat
headache
orbital eye pain
very dry, hot nose
Increased irritability, can't sleep

P: Floating, slightly flooding
T: Red with yellow coat

HERBS (11):

Chief (2):

Chai Hu - cool, acrid: releases muscle layer, clears heat, reduces fever
Ge Gen - sweet, acrid, cool - Yangming (ST and SP), releases evil from muscle layer

Deputies (4):

Qiang Huo - acrid and warm, taiyang - releases W-C, eliminates pain
Bai Zhi - acrid and warm, yangming - releases W-C, eliminates pain

Huang Qin - clears heat in yangming, bitter
Shi Gao - clears heat in yangming, sweet, very cold

Assistants (4):

Jie Geng - for sore throat, disseminates Lung Qi
Bai Shao - balances out acrid herbs, tonifies blood, astringes yin

Sheng Jiang - harmonizes ying and wei
Da Zao - tonifies qi ying, blood in middle

Envoy (1):

Gan Cao


#4. Sheng Ma Ge Gen Tang (4 herbs)

Sheng Ma Ge Gen Tang is for kids with measles. Evil is lodged in the muscle layer (wind-heat) and it vents rashes. For early stage measles / rashes.

Signs/ Symptoms:
FEVER, chills
lacrimation
sneezing, runny nose
sore throat
cough
headache
bodyache

HERBS (4):

Chief:

Sheng Ma - cool, acrid, release exterior - vents rashes from muscle to skin

Deputy:

Ge Gen: sweet, acrid, cool - very light and dispersing, opens interstices, causes sweating

Assistants:

Chi Shao - invigorates and cools blood heat

Zhi Gan Cao - helps to nourish qi, blood, yin, yang

CI: Sheng Ma Ge Gen Tang is not to be used if the rash is fully expressed, or if it has turned inward.

Formulas that release Exterior Cold

1. Ma Huang Tang - Ephedra Decoction (W-C excess)

2. Gui Zhi Tang - Cinnamon Twig Decoction (W-C deficient)

3. Xiao Qing Long Tang - Minor Bluegreen Dragon Decoction (chronic bronchitis with W-C, damp in the middle, lots of clear copious phlegm)

4. Jiu Wei Qiang Huo Tang - Nine Herb Decoction with Notopterygium (wind, cold, damp w/ internal heat)

5. Xiang Ru San - Mosla Powder (a W-C in the summertime)

#1. Ma Huang Tang

Ma Huang Tang contains four ingredients: Ma Huang, Gui Zhi, Xing Ren, and Gan Cao.
Actions: Induces Sweat to Relieve exterior wind cold; stops cough and wheeze

Signs and Symptoms of someone who could use Ma Huang Tang:
Chills, fever (more chills than fever)
No sweating
Headache
Bodyaches
Cough and/or Wheeze

Tongue: no change
Pulse: floating and TIGHT

Functions of the herbs:

Chief: Ma Huang: acrid and warm, it releases the exterior (kicks out the evil) and disperses/relieves Lung qi in order to stop the cough and wheezing. It is not strong enough to open the pores by itself (the pore opening is what relieves the cough, by freeing up the Lung qi), so it needs its Deputy, Gui Zhi.

Deputy: Gui Zhi: Significantly increases the sweating action to release the exterior and relieve the cough/wheeze.

Assistant: Xing Ren: Descends Lung Qi to directly stop cough/wheeze.

The Envoy, Zhi Gan Cao, harmonizes the formula, and moderates the action.

Notes:

Ma Huang Tang is an exterior, excess condition (the excess is COLD). The purpose is to provide an even, minor sweat. It is contraindicated for a patient who is weak (post-partum, elderly, deficient), or tends to get skin diseases (boils/furuncles) because they have a heat toxin in the body, someone who has damp heat int the lower burner (a recurrent lin condition - UTI), someone with heat in the blood or lung - nosebleeds, other bleeding tendencies, is already sweating and wei qi deficient, as deep, slow Kidney pulses (a severe blood deficiency), high blood pressure, or is yin deficient.

#2. Gui Zhi Tang


Gui Zhi Tang includes Gui Zhi, Bai Shao, Sheng Jiang, Da Zao, and Zhi Gan Cao. It serves to relieve the muscle layer to treat the exterior and it harmonizes the ying and wei.

A patient needing Gui Zhi Tang has Exterior Wind Cold and is Wei Qi deficient. Their signs and symptoms would be:

Chills, Fever (more chills)
body ache
head ache
and SOME sweating (but the evil is not be relieved by this sweat)

The sweating is injuring the qi and ying, and with the ying being deficient, the evil cannot be pushed out with the sweat. So, Gui Zhi Tang harmonies the ying and wei.

Chief: Gui Zhi: Acrid and warm, Gui Zhi acts to push the evil out from the muscle layer (not to open the pores at skin level). It has a mild sweating action.

Deputy: Bai Shao: Strengthens the ying and yin. Bai Shao tonifies the blood, and astringes yin/sweat. It gives strength so that Gui Zhi can push the evil out.

Assistants:
Sheng Jiang: acrid and warm, it helps to disperse
Da Zao: helps to build qi, ying/yin to tonify the middle

Sheng Jiang and Da Zao serve as a secondary pair to Gui Zhi and Bai Shao.

Envoy: Gan Cao: Assists in the middle to build qi, blood, yin, yang, and harmonizes the actions of the other herbs.

Gui Zhi Tang is a mild sweating formula (vs. Ma Huang Tang - strong sweating), and treats a deficient person who has wind cold.


#3. Xiao Qing Long Tang (Minor Bluegreen Dragon Decoction)

Xiao Qing Long Tang includes Ma Huang and Gui Zhi (the chief herbs), deputies Gan Jiang and Xi Xin, three assistants Wu Wei Zi, Bai Shao, and Ban Xia, and the ever present Zhi Gan Cao, for a total of eight herbs.

It is an acrid and warm formula that relieves exterior wind cold, but also serves to eliminate fluid in the epigastric region due to Spleen qi deficiency. This formula is for someone is has chronic bronchitis as well as wind cold.

Signs and Symptoms:

Chills, fever
headache
body ache
cough/wheeze
and...
copious diluted phlegm coming out of the lungs
difficulty breathing

Xiao Qing Long Tang helps the fluid to descend. Specifically, here's what the herbs are doing:

Chiefs: Ma Huang & Gui Zhi - releasing the exterior, causing sweating
Deputies: Gan Jiang and Xi Xin - dispersing fluids up (gan jiang), and down (Xi Xin) through urination, thereby relieving cough and wheeze & edema.
Assistants:
Ban Xia is drying the damp, moving qi down, eliminating the phlegm
while Wu Wei Zi and Bai Shao are protecting by tonifying the blood and astringing the yin to protect the body from the acrid, dispersing herbs.

Xiao Qing Long Tang is used to relieve the exterior. Once a sweat is induced, stop taking it.

#4. Jiu Wei Qiang Huo Tang: Nine Herb Decoction with Qiang Huo

I cannot find a picture of the Nine herb decoction...a formula which induces sweating to relieve wind, cold, AND damp as well as draining interior heat (Huang Qin and Sheng Di do this). This is for someone who already has an interior heat condition and then catches a cold (W-C-D), therefore they need a lot of different herbs (Jiu - nine) to address the dual nature of what is happening.

The signs and symptoms of someone with this somewhat complex condition are:

Exterior W-C-Damp:
chills, fever
BODY ACHE
Head ache
RIGID NECK
MUSCLE, JOINT PAIN
(cough and phlegm are not so marked in this condition)

Internal Heat Signs:
Thirst
Bitter taste

T: Red with yellow coat, reflecting the internal heat

Herbs:

Chief: Qiang Huo (relieves exterior, acrid, relieves pain, goes to UB/KD, eliminates damp, occipital headache)

Deputies (5):
Fang Feng (ext. w-c-d, pain)
Cang Zhu (relieves w-c-d)
Xi Xin (relieves W-C-D)
Chuan Xiong (disperse Wind Cold, temporal headache)
Bai Zhi (frontal headache, elim damp, stop pain, ST channel)

Assistants (2 - for internal heat):
Huang Qin - elim heat in qi aspect, dries damp
Sheng Di - elim heat in blood aspect

Envoy: Gan Cao


and finally, Xiang Ru San

#5. Xiang Ru San

This formula is for when you catch Wind-Cold in the summertime, (or for interior Damp-Cold). There is no heat present and this is NOT summerheat.

Just three herbs:

Chief: Xiang Ru (frankincense - the Ma Huang for the summer): it is acrid, warm, fragrant, releases exterior Wind Cold, transforms damp, and promotes urine. It has a sweating action.

Deputy: Bai Bian Dou: addresses internal damp cold. It is slightly warm.

Assistant: Hou Po - dries damp, moves qi, it is acrid, bitter, warm.

This patient will have:

chills, fever
bodyache
headache
NO sweat
can have signs of damp in the interior:
Fatigue
n/v, diarrhea
chest fullness
abdominal pain

P: floating
T: white greasy coat

A cold, plus too much cold food (ice cream, etc.).

On to formulas for Wind-heat!