Mahuang Lianqiao Chixiaodou Tang TCM Medical Record

Author: Nan Kaiyang  Editor: Gu Yuxi Translator: Gu Yuxi

Only fill in recent physical conditions, do not include past physical conditions.Gender:

Only fill in recent physical conditions, do not include past physical conditions. Gender: Male Age: 24 Height: 170cm Weight: 70KG Skin flaking: None

●Q: What is the most important physical problem you want to solve right now? Please explain in detail.

●A: Sometimes my body gets very itchy, and when I scratch it, small bumps appear. I went to a pharmacy and the doctor prescribed some medicine, but it had no effect.

(I) Hot and Cold

1. Do you experience aversion to cold, aversion to wind, or aversion to heat?

A: No

2. If yes, which specific body part experiences aversion to cold, aversion to wind, or aversion to heat?

A: No

(II) Sweat

3. Are you able to sweat? If so, is the sweat abundant or scant?

A: Yes, I sweat a lot during exercise.

4. Where does sweating primarily occur?

A: On my face.

(III) Upper Respiratory Tract

5. Do you have a dry mouth all day?

A: No

6. Do you feel like drinking water all day?

A: No

7. Do you prefer warm water or cold water?

A: Cold water.

8. Do you have bad breath?

A: No

9. Do your lip edges appear purplish? Are they dry and peeling?

A: They’re okay.

(IV) Shoulder and Neck

10. Is there stiffness or discomfort in your shoulders and neck?

A: No

(V) Urination and Defecation

11. Is urination frequent?

A: No

12. Is your urine color white or yellow?

A: Yellow.

13. Do you have a bowel movement every day? If not, how often?

A: Approximately once or twice a day.

14. Are your bowel movements smooth?

A: Smooth.

15. Are your stools hard, or soft and loose?

A: Soft.

Here’s the English translation of the provided text, with no omissions:

Only fill in recent physical conditions, do not include past physical conditions. Gender: Male Age: 24 Height: 170cm Weight: 70KG Skin flaking: None

Current Main Physical Problem

Q: What is the most important physical problem you want to solve right now? Please explain in detail. A: Sometimes my body gets very itchy, and when I scratch it, small bumps appear. I went to a pharmacy and the doctor prescribed some medicine, but it had no effect.

(I) Hot and Cold

1. Do you experience aversion to cold, aversion to wind, or aversion to heat? A: No

2. If yes, which specific body part experiences aversion to cold, aversion to wind, or aversion to heat? A: No

(II) Sweat

3. Are you able to sweat? If so, is the sweat abundant or scant? A: Yes, I sweat a lot during exercise.

4. Where does sweating primarily occur? A: On my face.

(III) Upper Respiratory Tract

5. Do you have a dry mouth all day? A: No

6. Do you feel like drinking water all day? A: No

7. Do you prefer warm water or cold water? A: Cold water.

8. Do you have bad breath? A: No

9. Do your lip edges appear purplish? Are they dry and peeling? A: They’re okay.

(IV) Shoulder and Neck

10. Is there stiffness or discomfort in your shoulders and neck? A: No

(V) Urination and Defecation

11. Is urination frequent? A: No

12. Is your urine color white or yellow? A: Yellow.

13. Do you have a bowel movement every day? If not, how often? A: Approximately once or twice a day.

14. Are your bowel movements smooth? A: Smooth.

15. Are your stools hard, or soft and loose? A: Soft.

(VI) Chest and Abdomen

16. Do you have chest tightness? Do your flanks under the armpits hurt?

A: This is an old problem. Since I was about 10 years old, maybe younger, I sometimes couldn’t breathe, but holding my breath for about 1 minute would resolve it. This happens about 4-5 times a year.

17. Do you feel like vomiting?

A: No

18. Is there pain when you press on your epigastrium with moderate force a few times?

A: No

19. Is there any pain when you press on the upper, lower, left, or right areas around your navel with moderate force a few times?

A: No

(VII) Hands and Feet

20. Do your hands and feet feel warm or cold?

A: Warm.

21. Do your limbs have pain or weakness?

A: No

(VIII) Diet

22. How is your appetite recently?

A: It’s okay.

23. Do you eat eggs, dairy, or fruit every day?

A: Yes.

24. Do you prefer warm or cold food?

A: Both are fine, like ice cream, fried chicken.

(IX) Sleep

25. Is it easy to fall asleep?

A: Yes.

26. Do you wake up easily after falling asleep?

A: No.

27. Do you dream a lot?

A: No.

28. Do you need to get up to urinate at night after falling asleep? If so, how many times a night?

A: No.

(X) Other

29. Are there any other discomforts in your body? Please explain in detail.

A: Rashes. They don’t itch, but they hurt when rubbed.

30. What medications have you taken for this condition before, and what was the effect?

A: Jianpi Lizhong Wan (Spleen-Invigorating and Middle-Regulating Pill).

Appendix: Do you have a bitter taste in your mouth or other unusual tastes?

A: No.

TCM Medical Case Summary：

A 24-year-old male presented with a chief complaint of widespread skin rashes and itching. The symptoms flared up in hot weather and included block-like blisters on the thighs, which were painful but not itchy during outbreaks. The diagnosis was damp-heat on the exterior with obstruction of the couli (pores), where internal dampness could not be transformed and combined with heat. The reasons are as follows:

1. The rashes being painful but not itchy indicates an exterior repletion syndrome where the superficial qi is obstructed and not flowing smoothly. This has a direct correlation with herbs like Ephedra and Fresh Ginger. Here, the intermittent chest tightness is not a repletion syndrome of shortness of breath due to internal water retention, nor is it a deficiency syndrome of Shenqi Wan. It is more akin to heat stagnation internally, where strong fire consumes qi leading to obstructed qi passages.

2. Long-term yellow urine, overweight with a preference for cold drinks, no fatigue, and worsening rashes with spicy foods, all fall within the category of internal heat. The soft stools and absence of undigested food in stools rule out Chengqi Tang (Purgative Decoction) type formulas. No red eyes or vexation rule out Huanglian (Coptis). No axillary sweating but head sweating indicates a tendency towards Shaoyang level gallbladder heat ascending and invading, but since the Shaoyang issue is not prominent, formulas like Chaihu are unnecessary. The patient’s constitution is not weak, rather robust, so there is no reason to use Guizhi Tang type formulas. Absence of symptoms like body swelling, spontaneous sweating, and dark complexion (indicating overflow of kidney water) rules out Yuebi Tang. The soft stools, white and greasy tongue coating, plus the inability to sweat, lead to the inference that the skin pores are blocked, preventing the discharge of water qi through sweating, thus causing it to stagnate on the exterior. This combines with internal stagnant heat. The damp-heat has not reached the level of steaming the liver and gallbladder to cause jaundice, which is why when body temperature rises, the heat has nowhere to dissipate, combining with dampness to cause widespread rashes but without the signs of Yang Jaundice. This belongs to a Taiyang-Yangming concurrent syndrome. Additionally, there is clear damp-heat descending. Thus, this formula was prescribed.

Prescription：

Mahuang Lianqiao Chixiaodou Tang (Ephedra, Forsythia, and Adzuki Bean Decoction) combined with Ermiao Wan (Two Marvels Pill):

• Ephedra (Mahuang), Baked Licorice (Zhigancao), Forsythia Fruit Shell (Lianqiao Ke): 8g each
• Apricot Kernel (Xingren): 16g
• Adzuki Bean (Chixiaodou): 20g
• Cortex Pseudolaricis (Zibai Pi), Prepared Pinellia (Jiang Banxia): 12g each
• Fresh Ginger (Shengjiang): 3 slices
• Jujube (Dazao): 3 pieces (pitted)

Six doses, one dose taken three times a day. Avoid exposure to wind and cold, overeating, and irritating foods.

Follow-up：

After taking three doses, the patient’s newly erupted rashes largely disappeared, and there was no longer any itching on the body. The patient felt hot all over after taking the medicine but did not sweat. Upon inquiry, it was learned that urination increased and was initially very yellow, then gradually became lighter in color. This is considered the primary basis for Ephedra promoting urination. Eighteen days after finishing all the medication, a follow-up visit showed no recurrence, and the blisters on the inner thighs had completely resolved. No recurrence was observed during a one-year follow-up.

Disclaimer:​

The experiences and insights shared above represent the author’s personal usage and understanding, and are provided for reference only as part of academic exchange. Please do not blindly replicate or apply them; any consequences arising from such actions are solely your responsibility. As individual constitutions vary, medication should be tailored accordingly. It is advisable to use such treatments under the guidance of a qualified physician. If you have additional experiences to share, comments and submissions are welcome.​
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