Chapter 4 Formulas for Relieving Exterior Syndrome

The formulas for relieving exterior syndrome refer to those that are chiefly composed of traditional Chinese herbs having the therapeutic effects of inducing diaphoresis, expelling pathogenic factors from the muscles and skin as well as promoting eruption. They are preferred for the treatment of exterior syndrome. Because the exterior syndrome involves the difference between wind-cold type and wind-heat type, the formulas for relieving exterior syndrome are subdivided into the pungent and warm formulas for relieving exterior syndrome, pungent and cool formulas for relieving exterior syndrome, and tonic formulas for relieving exterior syndrome. Section 1 Pungent and Warm Formulas for Relieving Exterior Syndrome This group of formulas is chiefly made up of traditional Chinese herbs pungent in flavor and warm in Property. Possessing the function of dissipating wind-cold, they are usually indicated for the treatment of wind-cold exterior syndrome.

Mahuang Tang( Ephedra Decoction )

Ingredients Ephedra, Herba Ephedrae (with joints removed) 6g Cinnamon twig,Ramulus Cinnamomi 4g Bitter apricot kernel, Semen Armeniacae Amarum (with its skin removed) 9g Prepared licorice root, Radix Glycyrrhizae Praeparata 3g Administration All the herbs should be decocted in water for oral dose. After administration, it is necessary for the taker to stay in warm bed to induce slight perspiration. Functions Inducing sweat to relieve exterior syndrome, facilitating the flow of the lung-qi to relieve asthma. Indications Exterior syndrome of excess type due to exogenous pathogenic wind-cold, manifested as aversion to cold, fever without perspiration and headache, pantalgia, dyspnea, thin and white coating of the tongue as well as superficial and tight pulse, etc. In western medicine, this formula can be modified used in the following diseases, namely cold, influenza and bronchitis, bronchial asthma and other diseases, which are manifested as abovementioned symptoms.

Modern Research In clinical and experimental, it is ascertained that this formula can relieve of the troubles by producing the effects of inducing sweat, removing fever, arresting cough, relieving pain and promoting diuretic. Cautions l. Being warm and pungent, the formula is drastic in its effect of inducing sweat, so it should not be administered for the cases manifested as spontaneous perspiration caused by exterior syndrome of deficiency type, general debility with exogenous diseases, blood deficiency after giving birth, etc. 2. As soon as sweat is induced out and the illness is cured, the administration should be withdrawn immediately. Prolongation of intake is of no benefit.

Guizhi Tang (Cinnamon Twig Decoction)

Ingredients Cinnamon twig, Ramulus Cinnamomi 9g Peony root, Radix Paeoniae 9g Prepared licorice root, Radix Glycyrrhizae Praeparata 6g Fresh ginger, Rhizoma Zingiberis 9g Chinese dates, Fructus Ziziphi Jujubae 4pcs. Administration All the above herbs are decocted together in water for oral administration. After taking the decoction, the patient is required to drink a small quantity of hot water or hot porridge and then lie in warm bed to induce slight perspiration. Functions Expelling pathogenic factors from the muscles and skin and regulating ying and wei to relieve exterior syndrome. Indications Exterior deficiency syndrome due to pathogenic wind and cold, manifested by fever, headache, perspiration with aversion to wind, nasal catarrh, retching, thin and white coating of the tongue, and floating and moderate pulse. Equally, the formula can be modified to deal with the common cold, influenza and others that are attributable to exterior syndrome of deficiency type caused by pathogenic wind and cold, as well as urticaria, cutaneous pruritus, eczema, neuralgia, myalgia, etc. Modern Research Modern researches have proved that the formula possesses the efficacies of inducing sweat, reducing

fever, removing phlegm, relieving convulsion and pain, promoting digestion and absorption, nourishing the body and consolidating the constitution. Cautions l. The formula is not advisable for the exterior syndrome of excess type due to pathogenic wind and cold. 2. Patients with exterior syndrome of wind-heat type marked by aversion to wind, perspiration as well as thirst and rapid pulse are prohibited from taking the formula.

Jiuwei Qianghuo Tang (Notopterygium Decoction of Nine Ingredients )

Ingredients Notopterygium root, Rhizoma seu Radix Notopterygii 6g Ledebouriella root, Radix Ledebouriellae 6g Atractylodes rhizome, Rhizoma Atractylodis 6g Asarum herb, Herba Asari 2g Chuanxiong rhizome,Rhizoma Ligustici Chuanxiong 3g Dahurian angelica root, Radix Angelicae Dahuricae 3g Dried rehmannia root, Radix Rehmanniae 3g Scutellaria root, Radix Scutellariae 3g Licorice root, Radix Glycyrrhizae 3g Administration All the above herbs are to be decocted in water for oral use. Functions Relieving exterior syndrome, clearing interior heat and alleviating pain. Indications Syndrome due to the exogenous wind, cold and dampness on the body surface with interior heat, manifested by chill and fever, absence of perspiration, headache with stiff neck, aching pain of the extremities, bitter taste in the mouth with thirst, white and slippery coating of the tongue, floating pulse, etc. The formula can be modified to deal with influenza, lumbago, sciatica rheumatic arthritis that are ascribable to the attack of exogenous wind-cold-dampness on the body surface with interior heat. Modern Researches Modern researches have ascertained that this formula possesses the efficacies in inducing diaphoresis,

bringing down fever, relieving pain and cough, resisting bacteria and viruses, subduing inflammation, etc. Cautions 1.The formula is not advisable for cases ascribable to exterior syndrome caused by exogenous windcold. 2.The formula should not be decocted long in case the effective components are destroyed. 3.Patients with weakness of the vital energy and deficiency of yin are prohibited from taking the formula.

Xiao Qinglong Tang (Decoction of Green Dragon)

Ingredients Ephedra, Herba Ephedrae (with joins removed) 9g Peony root, Radix Paeoniae 9g Asarum herb, Herba asari 3g Dried ginger, Rhizoma Zingiberis 3g Prepared licorice root, Radix Glycyrrhizae Praeparata 6g Cinnamon twig, Ramulus Cinnamomi 6g Pinellia tuber, Rhizoma Pinelliae 9g Schisandra fruit, Fructus Schisandrae 3g Administration All the above ingredients are to be decocted in water for oral administration. Functions Relieving superficial syndrome by means of inducing diaphoresis, removing fluid-retention, arresting cough and relieving asthma. Indications Exterior cold due to cxopathogen, and excessive fluid in the body, marked by chill and fever, absence of perspiration, cough, asthma with watery and copious sputum, or thirst with little predilection for drinks or retching, or dysphagia, or diarrhea, or dysuria, and white and slippery coating of the tongue, and floating and tight pulse. In addition, the formula can be modified to deal with the above symptoms and signs as seen in the common cold, influenza, asthmatic bronchitis, bronchial asthma at its stage of attack, etc.

Modern researches Modern researches have ascertained that this formula possesses the effects of inducing sweat, reducing fever, relieving dyspnea and cough, removing Phlegm, promoting diuresis, relieving allergic reaction and promoting blood circulation. Cautions This formula should not be administered to patients with dry cough, dry mouth and throat accompanied by thick yellow-colored sputum.

Section 2 Pungent and Cool Formulas for Relieving Exterior Syndrome

This group of formulas is chiefly composed of herbs pungent in flavor and cool in property and possesses the therapeutic effect of expelling pathogenic wind-heat. It is preferred for the treatment of exterior syndrome due to exogenous wind-heat.

Yinqiao San (Powder of Lonicera and Forsythis)

Ingredients Forsythia fruit, Fructus Forsythiae 9g Honeysuckle flower, Flos Lonicerae 9g Peppermint, Herba Menthae 6g Schizonepeta spike, Spica Schizonepetae 5g Prepared soybean, Semen Sojae Praeparatum 5g Arctium fruit, Fructus Arctii 9g Platycodon root, Radix Platycodi 6g Licorice root, Radix Glycyrrhizae 5g Lophatherum, Herba Lophatheri 4g Reed rhizome, Rhizoma Phragmitis in proper dosage Administration All the above herbs are to be decocted in water for oral administration. Indications Affection by exogenous wind-heat with superficial syndrome marked by fever with anhidrosis or with disturbed hidrosis, mild chilly sensation, headache, thirst, cough, sore throat, red tip of the tongue with thin white or yellowish coating on it, and floating and rapid pulse. Besides, this formula can be modified to treat such conditions as infection of upper respiratory tract, acute tonsillitis, encephalitis B, epidemic cerebrospinal meningitis, parotitis and so on that pertain to exterior syndrome caused by exogenous wind-heat.

Modern researches Modern researches have ascertained that this formula possesses the efficacy of inducing diaphoresis, bringing down fever, relieving pain and cough, resisting bacteria and viruses, subduing inflammation, etc. Cautions 1. The formula is not advisable for cases ascribable to exterior syndrome caused by exogenous windcold. 2. The formula should not be decocted long in case the effective components are destroyed.

Sang Ju Yin ( Decoction of Mulberry Leaf and Chrysanthemum )

Ingredients Mulberry leaf, Folium Mori 7.5g Chrysanthemum flower, flos Chrysanthemi 3g Bitter apricot kernel, Semen Armeniacae Amarum 6g Forsythia fruit, Fructus Forsythiae 5g Peppermint, Herba Menthae 2.5g Platycodon root, Radix Platycodi 6g Licoricc root, Radix Glycyrrhizae 2.5g Reed rhizome, Rhizoma Phragmitis 6g Administrations All the above ingredients are to be decocted in water for oral administration. Functions Relieving the exterior syndrome with herbs pungent in flavor and cool in property, facilitating the flow of the lung-qi to relieve cough. Indications The onset of cough due to wind-heat, marked by cough, mild feverish body,slight thirst, thin and white coating of the tongue and floating pulse. The modification of the above formula can be adopted for the treatment of such diseases as the common cold, influenza, acute bronchitis, bronchial pneumonia and acute tonsillitis that indicate the exterior syndrome due to wind-heat. Modern Researches Clinically and experimentally, it is ascertained that the above formula has the functions of relieving

cough, removing phlegm, resisting bacteria, subduing inflammation as well as inducing mild sweat and allaying fever. Cautions 1. Those with cough due to exogenous wind-cold are prohibited from taking this formula. 2. Since the herbs in the formula are of dispelling effect, they should not be decocted for a long time.

Ma Xing Shi Gan Tang ( Decoction of Ephedra, Apricot Kernel, Gypsum and Licorice)
Ingredients Ephedra, Herba Ephedrae (with joints removed) 6g Bitter apricot kernel, Semen Armeniacae Amarum (with its skin and tip removed) 9g Prepared licorice root, Radix Glycyrrhizae Praeparata 6g Gypsum, Gypsum fibrosum 30g Administrations All the above herbs are to be decocted in water together and then taken orally. Functions Expelling pathogenic heat with pungent and cool herbs, clearing away lung-heat to relieve asthma. Indications Cough and dyspnea due to wind-heat manifested by persistent feverish body with or without sweat, cough with dyspnea or even accompanied by nares flaring, thirst, thin white or thin yellow coating of the tongue, slippery and rapid pulse, etc. The formula can be modified for the treatment of acute bronchitis, bronchial pneumonia, bronchial asthma in the stage of attack and other diseases associated with cough and dyspnea caused by lungheat. Modern researches Clinically and experimentally, it is ascertained that this formula has the efficacies of subduing inflammation, removing phlegm, relieving cough and dyspnea, and resisting viruses. Cautions This formula is only advisable for cases with dyspnea of excess type due to lung-heat, and it is not suitable for those associated with dyspnea of excess type due to wind-cold as well as those with dyspnea of deficient type.

Chai Ge Jieji Tang ( Bupleurum and Pueraria Decoction for Dispelling Pathogens from superficialMuscles )
Ingredients Bupleurum root, Radix Bupleuri 9g Pueraria root, Radix Puerariae 9g Scutellaria root, Radix Scutellariae 9g Licorice root, Radix Glycyrrhizae 3g Peony root, Radix Paeoniae 3g Notopterygium root, Rhizoma seu Radix Notopterygii 3g Dahurian angelica root, Radix Angelicae Dahuricae 3g Platycodon root, Radix Platycodi 3g Gypsum, Gypsum Fibrosum 9g Fresh ginger, Rhizoma Zingiberis 3 slices Chinese dates, Fructus Ziziphi jujubae 2 pcs. Administrations All the above herbs are to be decocted in water for oral administration. Functions Expelling pathogenic factors from the muscles and skin and reducing fever. Indications Affection due to exogenous pathogenic wind-cold with heat in the interior resulting from stagnated pathogens manifested as slight aversion to cold, high fever, headache, soreness and pain in the extremities, eye pain, dry nose, orbit pain, restlessness, insomnia, thin and yellowish coating of the tongue, and superficial and slightly full pulse. Besides, other cases ascribed to the above syndrome such as the common cold, influenza, bronchitis and toothache can be deal with the modified formula. Modern researches

Modern researches have proved that this formula possesses the efficacies in inducing sweat, allaying fever, resisting bacteria and viruses, subduing inflammation, alleviating pain, tranquilizing the mind and Cautions 1. The formula is contraindication in patients with symptoms of exterior wind-cold but without interior heat. 2. The formula should not be administered for cases associated with yangming fu-organ disease marked by abdominal pain and constipation. so on.

Section 3 Formulas for Strengthening the Body Resistance , and Relieving Exterior Syndrome
This group of formulas is mainly composed of diaphoretics and tonifying herbs possessing the effect of strengthening the body resistance and relieving exterior syndrome and indicated in the treatment of exterior syndrome due to general debility and attack of exopathogens.

Baidu San ( Antiphlogistic Powder )

Ingredients Bupleuruum root, Radix Bupleuri 30g Root of purple-flowered Peucedanum, Radix Peucedani Peucedanum root 30g Chuanxiong rhizome, Rhizoma Ligustici Chuangxiong 30g Fruit of citron or trifoliate orange, Fructus Aurantii 30g Notopterygium root, Rhizoma seu Radix Notopterygii 30g Pubescent angelica root, Radix Angelicae Pubescentis 30g Poria, Poria 30g Platycodon root, Radix Platycodi (parched) 30g Ginseng, ginseng 30g Licorice root, Radix Glycyrrhizae 15g Administrations All the above herbs are to be ground into powder and administered 6g each time for one dosage, to be decocted in water with a small amount of fresh ginger and peppermint for oral dose. Functions Relieving the exterior syndrome by re-plenishing qi and dispelling pathogenic wind and dampness. Indications Exopathic diseases caused by weakened body resistance and pathogenic wind-cold-dampness, manifested as loathing of cold with high fever, headache and stiffness of the neck, soreness of the extremities, absence of perspiration, stuffy nose with low speaking voice, fullness and stuffiness in the chest, white and greasy coating of the tongue, floating and soft pulse which turns faint on hard pressure, etc. The modified formula can be adapted for the treatment of the common cold, influenza, epidemic parotitis, bronchitis, chronic rheumatic arthritis, urticaria, eczema and pyesis in its primary stage and other diseases that belong to the type of deficiency of genuine energy and attack of exogenous windcold-dampness on the body surface.

Modern Researches Clinically and experimentally, it has been confirmed that the formula is effective for inducing sweat, allaying fever, alleviating pain, reducing sputum, relieving cough, promoting urination and blood circulation, subduing inflammation, resisting bacteria and viruses and so on. Cautions On account of its being warm and dry in property, the formula is indicated for cases affected by exogenous wind-cold-dampness complicated with general deficiency, but it is not fit for those whose pathogens are dampness-heat.

Jiajian Weirui Tang ( Moditfied Decoction of Fragrant Solomonseal Rhizome)

Ingredients Fragrant solomonseal rhizome, Rhiconia Poygonati Odorati 6g Chinese green onion, Bulbus Allii fistulosi 6g Platycodon root, Radix Platycodi 5g Swallowwort root, Radix Cynanchi Atrati 3g Prepared soybean, Semen Sojae Praeparatum 9g Peppermint, Herba Menthae 5g Prepared licorice root, Radix Glycyrrhizae Praeparata 2g Chinese dates, Fructus Zizifhi jujubae 2pcs. Administrations All the above herbs are to be decocted in water and the decoction is to be taken warm and in separate portions. Functions Nourishing yin and clearing away heat, induing sweat to relieve exterior syndrome. Indications Original yin-deficiency with re-affaciion due to exopathogen, manifested by headache, fever, light aversion to wind-cold, dry throat with cough, sputum too. viscous to be coughed out. absence of sweat or little sweat ,thirst and restlessness, reddened tongue and rapid pulse. Moreover, the formula can be modified to deal with the common cold, influenza. bronchitis and others that indicate exopathic diseases due to yin deficiency with re-affection by exopathogens after giving birth or bleeding. Modern Researches Modern studies have confirmed that this formula is qualified as tonics for consolidating the constitution and curative one for inducing sweat, bringing down fever subduing inflammation, relieving cough, expelling phlegm, etc.

Cautions This formula is only advisable for exogenous diseases with yin deficiency, it is contraindicated in cases without yin deficiency.