A method of treatment used to address exterior heat patterns with mild aversion to cold and pronounced heat signs, thirst, red sore pharynx, red tongue with dry thin white fur, and rapid floating pulse. The main medicinals are mint (Menthae Herba, 薄荷bò hé), mulberry leaf (Mori Folium, 桑叶sāng yè), fermented soybean (Sojae Semen Praeparatum, 淡豆豉dàn dòu chǐ), arctium (Arctii Fructus, 牛蒡子niú bàng zǐ), pueraria (Puerariae Radix, 葛根gé gēn), and tamarisk (Tamaricis Cacumen, 柽柳chēng liǔ).
Of these, mint (Menthae Herba, 薄荷bò hé), mulberry leaf (Mori Folium, 桑叶sāng yè), fermented soybean (Sojae Semen Praeparatum, 淡豆豉dàn dòu chǐ), and arctium (Arctii Fructus, 牛蒡子niú bàng zǐ) are the most commonly used. Mint has the strongest sweat-effusing and heat-abating effect of all cool exterior-resolving medicinals. Also, mulberry leaf can clear lung and liver heat and is thus particularly suitable for patterns involving headache, red eyes and cough. Fermented soybean is effective in outthrusting evils and abating heat effusion. Arctium has the additional effect of clearing the throat, promoting lung qì diffusion, and clearing phlegm-heat. Pueraria is suitable for patterns also involving diarrhea and stiffness in the neck and back. Tamarisk may be used to outthrust papules in measles and can also dispel wind-damp. In cool acrid exterior resolution, the emphasis is on cool rather than acrid.
For intense heat patterns, medicinals that clear heat and resolve toxin such as scutellaria (Scutellariae Radix, 黄芩huáng qín), gardenia (Gardeniae Fructus, 山栀子shān zhī zǐ), lonicera (Lonicerae Flos, 金银花jīn yín huā), forsythia (Forsythiae Fructus, 连翘lián qiào), isatis root (Isatidis Radix, 板蓝根bǎn lán gēn), and dandelion (Taraxaci Herba, 蒲公英pú gōng yīng) may also be used.
The use of certain warm exterior-resolving medicinals such as schizonepeta (Schizonepetae Herba, 荆芥jīng jiè), saposhnikovia (Saposhnikoviae Radix, 防风fáng fēng), notopterygium (Notopterygii Rhizoma et Radix, 羌活qiāng huó), and ephedra (Ephedrae Herba, 麻黄má huáng) is not excluded in the treatment of exterior heat patterns when used with large quantities of heat-clearing medicinals. For example, Lonicera and Forsythia Powder (银翘散yín qiào sǎn) includes schizonepeta, and Notopterygium, Arctium, Dandelion, and Mint Decoction (羌蒡蒲薄汤qiāng bàng pú bò tāng) includes notopterygium although both are cool acrid exterior-resolving formulas. Cool acrid exterior-resolving formulas include Lonicera and Forsythia Powder (银翘散yín qiào sǎn), Mulberry Leaf and Chrysanthemum Beverage (桑菊饮sāng jú yǐn), and Notopterygium, Arctium, Dandelion, and Mint Decoction (羌蒡蒲薄汤qiāng bàng pú bò tāng). The most commonly used is Lonicera and Forsythia Powder. Notopterygium, Arctium, Dandelion, and Mint Decoction, a formula tested in modern clinical practice, contains cool and warm acrid medicinals, with the addition of heat-clearing toxin-resolving medicinals. for the treatment of measles, see outthrusting papules.