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Exterior-resolving formulas
解表剂 〔解表劑〕 jiě biǎo jì
Medicinal formulas that resolve the exterior, mostly using exterior-resolving agents to treat exterior patterns presenting with aversion to cold, heat effusion, headache, generalized pain, a white or yellow tongue fur, and a floating pulse. See also resolving the exterior
Exterior-resolving formulas have the actions of promoting sweating, resolving the flesh, and outthrusting papules. They correspond to sweating
among the eight methods.
They are used when externally contracted disease evils assail the exterior and affect the lung and defense qì. In such cases, the evil has not penetrated deeply, so the conditions are mild, allowing them to be treated by acrid dispersing and light diffusing medicinals that expel the disease evil from the fleshy exterior. Sù Wèn (Chapter 5) states, When it is in the skin, promote sweating to effuse it.
If appropriate treatment is not given or the treatment fails to achieve its intended aims, and the disease evil is not resolved in the exterior, it will penetrate the body, giving rise to other patterns. Hence the Sù Wèn, Chapter 5, says,
This emphasizes that in the initial stages of exterior contractions, timely use of exterior-resolving formulas is important.
Exterior-resolving formulas treat exterior patterns caused by wind-cold or initial-stage warm evils, including conditions such as initial stages of measles, sore3s, water swelling, malarial disease, and dysentery presenting with aversion to cold, heat effusion, headache, generalized pain, a white or yellow tongue fur, and a floating pulse.
Disease evils that cause exterior patterns differ in nature, including both cold and heat. Depending on the patient, there may be exterior repletion or exterior vacuity. For these reasons, formulas are divided into three categories, namely warm acrid exterior-resolving formulas, cool acrid exterior-resolving formulas, and right-supporting exterior-resolving formulas to treat cold patterns, heat patterns, and vacuity patterns respectively. See Subcategories below.
Cautions
Exterior-resolving formulas are composed of acrid dispersing and light diffusing agents, which should not be subjected to excessively long dedication if they are to retain their medicinal strength.
They should be taken warm to help promote sweating. The aim is to achieve a gentle generalized sweat. Sweating has to be sufficient to resolve the disease evils but not so much as to damage yīn.
If the exterior evil is not eliminated and interior patterns start to develop, the principle of treatment is to first resolve the exterior and then treat the interior.
If exterior and interior are equally urgent, then dual resolution of exterior and interior is called for.
Exterior-resolving formulas should not be used if the disease evil has already penetrated the interior and in conditions where measles papules have already erupted, sores have already burst, or vacuity water swelling is present.
Subcategories
- Cool acrid exterior-resolving formulas
- Warm acrid exterior-resolving formulas
- Right-supporting exterior-resolving formulas
1. Warm Acrid Exterior-Resolving Formulas
Warm acrid exterior-resolving formulas treat exterior patterns due to External contraction of wind-cold with signs including aversion to cold with heat effusion, headache and stiff nape,
Main agents
Má huáng (麻黄 Ephedrae Herba, ephedra) Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig) Qiāng huó (羌活 Notopterygii Rhizoma et Radix, notopterygium)
Given that wind-cold assailing the exterior often affects lung qì diffusion, formulas often include medicinals that diffuse the lung and rectify qì and ones that relieve cough and transform phlegm.
Representative formulas
Má huáng tāng ( 麻黃湯 Ephedra Decoction)Guì zhī tāng ( 桂枝湯 Cinnamon Twig Decoction)Jiǔ wèi qiāng huó tāng ( 九味羌活汤 Nine-Ingredient Notopterygium Decoction)Xiǎo qīng lóng tāng (小青龙汤 Minor Black Dragon Decoction) Xiāng rú sǎn1 (香薷散1 Mosla Powder1)
2. Cool Acrid Exterior-Resolving Formulas
Cool acrid exterior-resolving formulas course and disperse wind-heat in the treatment of initial-stage exterior patterns caused by externally contracted wind-heat or warm disease, manifesting in heat effusion, sweating slight aversion to cold, thirst, painful pharynx, cough, a thin white or slightly yellow tongue fur and a pulse that is floating and rapid.
Main agents
Bò hé (薄荷 Menthae Herba, mint) Niú bàng zǐ (牛蒡子 Arctii Fructus, arctium) Sāng yè (桑叶 Mori Folium, mulberry leaf) Jú huā (菊花 Chrysanthemi Flos, chrysanthemum) Gé gēn (葛根 Puerariae Radix, pueraria)
Diseases caused by warm-heat evils develop and change rapidly, and often involve congestion of toxin. Furthermore, warm evil affects the upper body, first invading the lung, usually affecting lung qì diffusion. For these reasons, cool acrid exterior-resolving formulas usually include heat-clearing toxin-resolving medicinals or agents that diffuse the lung and disinhibit the pharynx.
Representative formulas
Yín qiào sǎn (银翘散 Lonicera and Forsythia Powder) Sāng jú yǐn (桑菊饮 Mulberry Leaf and Chrysanthemum Beverage) Má huáng xìng rén gān cǎo shí gāo tāng (麻黄杏仁甘草石膏汤 Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction)
3. Right-Supporting Exterior-Resolving Formulas
Formulas that support right and resolve the exterior treat exterior patterns in people with vacuity constitutions. For such patients, exterior-resolving treatment to achieve adequate effusing and dispersing action due to the vacuity of right qì, while supplementing treatment alone can prevent the evil from being expelled.
Because vacuity can take different forms, formulas for such patients can include qì-boosting, yáng-assisting, yīn-enriching, or blood-nourishing medicinals.
Representative formulas
Bài dú sǎn (败毒散 Toxin-Vanquishing Powder) Zài zào sǎn (再造散 Renewal Powder) Shēn sū yǐn (参苏饮 Ginseng and Perilla Beverage) Jiā jiǎn wēi ruí tāng (加减葳蕤汤 Solomon’s Seal Variant Decoction)
Exterior-Resolving Formulas
Warm Acrid Exterior-Resolving Formulas
- Má huáng tāng (麻黄汤 Ephedra Decoction)
- Dà qīng lóng tāng (大青龙汤 Major Black Dragon Decoction)
- Huá gài sǎn (华盖散 Florid Canopy Powder)
- Guì zhī tāng (桂枝汤 Cinnamon Twig Decoction)
- Gé gēn tāng (葛根汤 Pueraria Decoction)
- Dà qiāng huó tāng (大羌活汤 Major Notopterygium Decoction)
- Xiāng sū sǎn (香苏散 Cyperus and Perilla Powder)
- Xiǎo qīng lóng tāng (小青龙汤 Minor Black Dragon Decoction)
- Shè gān má huáng tāng (射干麻黄汤 Belamcanda and Ephedra Decoction)
Cool Acrid Exterior-Resolving Formulas
- Sāng jú yǐn (桑菊饮 Mulberry Leaf and Chrysanthemum Beverage)
- Yín qiào sǎn (银翘散 Lonicera and Forsythia Powder)
- Má xìng gān shí tāng (麻杏甘石汤 Ephedra, Apricot Kernel, Licorice, and Gypsum Decoction)
- Yuè bì tāng (越婢汤 Spleen-Effusing Decoction)
- Yuè bì jiā zhú tāng (越婢加朮汤 Spleen-Effusing Decoction Plus White Atractylodes)
- Chái gé jiě jī tāng1 (柴葛解肌汤1 Bupleurum and Pueraria Flesh-Resolving Decoction1)
- Yī wù chái gé jiě jī tāng (医悟柴葛解肌汤 Medical Insights Bupleurum and Pueraria Flesh-Resolving Decoction)
- Shēng má gé gēn tāng (升麻葛根汤 Cimicifuga and Pueraria Decoction)
- Xuān dú fā biǎo tāng (宣毒发表汤 Toxin-Diffusing Exterior-Effusing Decoction)
- Zhú yè liǔ bàng tāng (竹叶柳蒡汤 Lophatherum, Tamarisk, and Arctium Decoction)
Right-Supporting Exterior-Resolving Formulas
- Bài dú sǎn (败毒散 Toxin-Vanquishing Powder)
- Rén shēn bài dú sǎn (人参败毒散 Ginseng Toxin-Vanquishing Powder)
- Jīng fáng bài dú sǎn (荆防败毒散 Schizonepeta and Saposhnikovia Toxin-Vanquishing Powder)
- Shēn sū yǐn (参苏饮 Ginseng and Perilla Beverage)
- Zài zào sǎn (再造散 Renewal Powder)
- Má huáng fù zǐ xì xīn tāng (麻黄附子细辛汤 Ephedra, Aconite, and Asarum Decoction)
- Cōng bái qī wèi yǐn (葱白七味饮 Scallion White Seven-Ingredient Beverage)