Mahuang Lianyao Chixiaodou Tang – Nan Kaiyang

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

Original Text:

Shanghan Lun 262: When cold damage accumulates heat internally, the body will certainly turn yellow; Ma Huang Lian Qiao Chi Xiao Dou Tang (Ephedra, Forsythia, and Red Bean Decoction) is indicated.

Pathogenesis:

Damp-heat is on the exterior, obstructing the striae and cutis.

Herbal Pairings:

• Ma Huang (Ephedra) & Xing Ren (Apricot Kernel): One disperses, one descends; this allows lung qi to disperse, regulating and unblocking the water passages to aid in the expulsion of damp evil from the body.
• Ma Huang (Ephedra) & Sheng Jiang (Fresh Ginger): Both herbs act on the exterior, resolving obstruction and opening the striae and cutis to vent heat outwardly.
• Zhi Gan Cao (Prepared Licorice Root) & Da Zao (Jujube): Tonify the middle-jiao and augment qi, harmonize the middle-jiao, and strengthen the Spleen.
• Chi Xiao Dou (Red Bean), Lian Qiao (Forsythia), & Sheng Zi Bai Pi (Fresh Catalpa Bark): Clear damp-heat internally.
• Ma Huang (Ephedra), Xing Ren (Apricot Kernel), & Sheng Jiang (Fresh Ginger): Disperse damp-heat externally.
• Zhi Gan Cao (Prepared Licorice Root) & Da Zao (Jujube): These herbs counterbalance the internal and external actions, moderate the potent effects of the other herbs, and support upright qi, ensuring that upright qi remains strong and evil cannot invade.

Summary:

From the perspective of damp-heat progression:

First Stage:

Damp-heat is on the exterior, at the initial onset. It steams and fumes the Liver and Gallbladder, affecting their dredging and dispersing functions, leading to the overflow of bile, manifesting as jaundice. Ma Huang Lian Qiao Chi Xiao Dou Tang is indicated.

Second Stage:

Damp-heat enters the interior. The dampness is heavy and obstructs the striae and cutis, preventing external venting of internal heat. This manifests as obvious fever, with progressive worsening of the jaundice. Zhi Zi Bai Pi Tang (Gardenia and Phellodendron Bark Decoction) is then used.

Third Stage:

Damp-heat is in the interior. This manifests as difficult urination and slight abdominal fullness, potentially affecting the internal organs’ functions and leading to abnormal transport of waste by the organ water passages. Dampness cannot be expelled through urine, and heat is difficult to resolve through stool. At this point, the damp-heat is severe, and the jaundice is even more pronounced, manifesting as “body like an orange-yellow color.” Yin Chen Hao Tang (Artemisia Capillaris Decoction) is then used.

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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