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Resolving the exterior with coolness and acridity

辛凉解表 〔辛涼解表〕xīn liáng jiě biǎo

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).

Cool Acrid Exterior-Resolving Agents

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.

See also resolving the exterior; wind-heat.

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