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Source: Shāng Hán Lùn 伤寒论

Alternate Chinese names: 麻杏石甘汤

Ingredients:

• Má huáng (麻黄 Ephedrae Herba, ephedra) 10g
• Xìng rén (杏仁 Armeniacae Semen, apricot kernel) 10g
• Shí gāo (石膏 Gypsum Fibrosum, gypsum) 30g
• Gān cǎo (甘草 Glycyrrhizae Radix, licorice [root]) 6g

Action: Clears heat; diffuses the lung; calms panting.

Indication: Evil heat congesting the lung with sweating or absence of sweating, cough, panting with flaring of the nostrils in serious cases, vexation and agitation, and thirst. Tongue fur: Thin and white. Pulse: Slippery and rapid.

Category: Exterior-resolving formulas / Cool acrid exterior-resolving formulas

Method: Decoct with water.

Rationale: Shí gāo is a cold sweet acrid agent that clears lung heat, eliminating the source of the condition. Má huáng is warm, acrid, and bitter, but combined with cold acrid Shí gāo, its sweating-promoting action is curbed, while its lung-diffusing and heat-outthrusting action is enhanced; it therefore helps the heat to escape. These two agents together thus diffuse the lung and drain the heat. One is cold and acrid while the other is warm and acrid, but in this formula the emphasis is on the cold nature of Shí gāo. Xìng rén is downbearing and thus helps the Má huáng to calm panting and relieve cough. Zhì gān cǎo harmonizes the center and protects the stomach.

Variations:

• Panting and sweating (heat congesting the lung); increase the Shí gāo (石膏 Gypsum Fibrosum, gypsum) to 5 times the weight of Má huáng (麻黄 Ephedrae Herba, ephedra).
• Panting with absence of sweating (heat blocked in the lung): Increase the Shí gāo (石膏 Gypsum Fibrosum, gypsum) to 3 times the weight of Má huáng (麻黄 Ephedrae Herba, ephedra).
• Severe panting: Add Zǐ sū zǐ (紫苏子 Perillae Fructus, perilla fruit), Tíng lì zǐ (葶苈子 Lepidii/Descurainiae Semen, lepidium/descurainia), Sāng bái pí (桑白皮 Mori Cortex, mulberry bark), and Lóng gǔ (龙骨 Mastodi Ossis Fossilia, dragon bone).
• Cough with thick phlegm: Add Guā lóu pí (瓜蒌皮 Trichosanthis Pericarpium, trichosanthes rind), Zhè bèi mǔ (浙贝母 Fritillariae Thunbergii Bulbus, Zhèjiāng fritillaria [bulb]), and Tiān zhú huáng (天竺黄 Bambusae Concretio Silicea%#%, bamboo sugar).
• Blood-streaked phlegm: Add Bái máo gēn (白茅根 Imperatae Rhizoma, imperata [rhizome]) and Cè bǎi yè (侧柏叶 Platycladi Cacumen, arborvitae leaf).

Notes: Originally called 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).

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