Ephedra Decoction

傷寒論

Taiyang disease, with headache, fever, bodily pain, lumbar pain, bone-joint pain, aversion to wind, no sweating, and wheezing: Ma Huang Tang governs it. (Shang Han Lun (Treatise on Cold Damage)) -- When Taiyang and Yangming combine in disease, with wheezing and chest fullness, one must not purge; Ma Huang Tang is appropriate. (Shang Han Lun (Treatise on Cold Damage)) -- Taiyang disease, ten days have already passed, pulse floating and fine and the patient is fond of lying down: the exterior has already resolved. If there is chest fullness and hypochondriac pain, give Xiao Chai Hu Tang. If the pulse is only floating, give Ma Huang Tang. (Shang Han Lun (Treatise on Cold Damage)) -- Taiyang disease, pulse floating and tight, no sweating, fever, generalized pain, not resolved after eight or nine days, exterior pattern still present: this should be treated by inducing sweating. After taking the medicine, shortly afterward the patient becomes restless and the eyes become dim; in severe cases there will certainly be epistaxis, and with epistaxis there is resolution. The reason for this is that yang qi is replete, so Ma Huang Tang governs it. (Shang Han Lun (Treatise on Cold Damage)) -- If the pulse is floating, the disease is in the exterior; one may induce sweating; Ma Huang Tang is appropriate. (Shang Han Lun (Treatise on Cold Damage)) -- If the pulse is floating and rapid, one may induce sweating; Ma Huang Tang is appropriate. (Shang Han Lun (Treatise on Cold Damage)) -- Cold damage with pulse floating and tight, when sweating is not induced, and epistaxis thereby occurs, Ma Huang Tang governs it. (Shang Han Lun (Treatise on Cold Damage)) -- Yangming disease, pulse floating, no sweating and wheezing: inducing sweating will cure it; Ma Huang Tang governs it. (Shang Han Lun (Treatise on Cold Damage))

Ma Huang 3 liang, Gui Zhi 2 liang, Gancao 1 liang (prepared), Xing Ren 70 pieces. For the four ingredients above, use 9 sheng of water; first boil Ma Huang, reduce by 2 sheng, remove the upper foam, add the other drugs, boil to obtain 2.5 sheng, remove the dregs. Take 8 ge warm. Cover to obtain slight sweating; there is no need to sip congee. The remainder is as in the Gui Zhi method for regulating and resting. (Shang Han Za Bing Lun (Treatise on Cold Damage and Miscellaneous Diseases))

For the four ingredients above, use 9 sheng of water; first boil Ma Huang, reduce by 2 sheng, remove the upper foam, add the other drugs, boil to obtain 2.5 sheng, remove the dregs, take 8 ge warm. Cover to obtain slight sweating; there is no need to sip congee. The remainder is as in the Gui Zhi method for regulating and resting (modern usage: decoct in water and take; cover warmly to obtain slight sweating).

湯劑

Release the exterior by inducing sweat, Diffuse the Lung and calm wheezing.

External contraction of wind-cold exterior excess pattern. Severe aversion to cold, mild fever, headache, bone-joint pain, no sweating and wheezing, thin white coating, floating tight pulse.

For wind-dampness etc. with generalized vexing pain: add Cang Zhu:10, Yi Yi Ren:30. -- For severe nasal congestion and runny nose: add stir-fried Cang Er Zi:10, Xin Yi:10, Bai Zhi:10.

1. This formula is a drastic agent for pungent-warm sweating; therefore, in Shang Han Lun (Treatise on Cold Damage), for “sores”, “strangury”, “epistaxis”, “blood loss”, as well as exogenous disease with exterior deficiency and spontaneous sweating, blood deficiency with a pulse also showing “slow chi position”, and erroneous purgation manifesting “heaviness of body and palpitations”, etc., although there is an exterior cold pattern, all are contraindicated. Although Mahuang Tang has few ingredients, its sweating power is strong and it must not be overused; otherwise, excessive sweating will surely damage the healthy qi. As Ke Qin pointed out: “This is a pure yang formula, excessively dispersing, like a general going straight in single-handedly; when administered appropriately, success is achieved in one battle. When inappropriate, it cannot be restrained and invites disaster. Therefore, when using it to release the exterior, it can be used once but not again.” (Shang Han Lai Su Ji · Shang Han Fu Yi, volume 1) 2. If Ephedra is used at 15g or more, it needs prolonged decoction for at least two hours. 3. Prescriptions containing Ephedra should not be taken after 8 p.m., otherwise it easily causes insomnia. If insomnia still occurs, change to taking after breakfast and lunch.