Xiaoqinglong Tang TCM Medical Record

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

【TCM Medical Record】：

A 48-year-old male presented with a chief complaint of throat discomfort for one day, described as intense itching in the pharyngeal area, frequent coughing, spitting white, thin phlegm, and a small amount of clear nasal discharge. His tongue coating was white, greasy, and slippery, and he experienced slight aversion to cold. There was no dry heaving, his stools were soft and loose, and his urine was pale. There were no obvious signs of a Six-Channel syndrome. The diagnosis was a typical case of lung qi dysregulation due to external wind-cold invasion, leading to cold-fluid retention in the lung where exterior cold agitated internal fluids that surged upward, resulting in a water-qi cough. Thus, the original Xiaoqinglong Tang formula was prescribed.

【Prescription】：

• Raw Ephedra (Sheng Mahuang): 12g
• Cinnamon Twig (Guizhi): 8g
• Baked Licorice (Zhigancao): 12g
• White Peony Root (Baishao): 8g
• Dried Ginger (Ganjiang), Asarum (Xixin), Schisandra Berry (Wuweizi): 10g each
• Prepared Pinellia (Jiang Banxia): 6g

【Notes】：

I. Xiaoqinglong Tang Dosage:

Raw Ephedra 12g, Cinnamon Twig 8g, Baked Licorice 12g, White Peony Root 8g, Dried Ginger, Asarum, Schisandra Berry 10g each, Prepared Pinellia 6g. After two doses, the patient recovered. Subsequent follow-ups showed no major issues. The tongue still appeared slippery with water, and stools were soft and loose. The patient reported having chronic gastritis. Therefore, Ling Gui Zhu Gan Tang was used to warm yang and transform fluid to regulate his constitution. After three doses, the patient experienced a healing crisis (míng xuàn fǎn yìng), after which his stomach qi recovered: the patient felt dizzy for half an hour, then became hungry with a greatly increased appetite. That day, his stools were no longer soft and loose and became yellowish.

II. Drug Coordination:

Xiaoqinglong Tang Herbal Ratios:

1. Ephedra to Cinnamon Twig: A 3:2 ratio is optimal.
2. Ephedra and Licorice: Equal amounts, to mitigate Ephedra’s toxicity and prevent palpitations.
3. Dried Ginger, Asarum, and Schisandra Berry (for cough and fluid transformation): Should be in equal amounts.
4. For children, baked ephedra (Zhi Mahuang) is often used.

III. Clinical Application: Based on over ten successful clinical cases, the following summarizes the opportune moments for using Xiaoqinglong Tang, where it is consistently effective:

1. Cold fluid lurking in the lungs, with lung qi failing to disperse and descend, manifested by itchy throat, coughing, and wheezing; aggravated by cold; worsened at night or when lying down.
2. Nasal discharge and phlegm due to fluid retention: White and clear, or abundant, or appearing as sticky foam.
3. Pale tongue body with white and slippery or greasy coating: Regardless of whether there is dry heaving, aversion to cold, fever, sweating or no sweating, or a floating pulse, it can be used.

Appendix:

If the patient has slight yellow phlegm, yellow urine, or other signs of internal heat, as long as the main syndrome is exterior cold with internal fluid retention, it does not affect the application of this formula. Three patients initially presented with dry throat or yellow phlegm, indicative of wind-heat, which later transformed from prolonged dampness into heat. In such cases, adding some heat-clearing herbs can be considered, but cold-dispelling herbs should remain primary. Most patients presenting with the main Xiaoqinglong Tang syndrome transition to a cold syndrome by the second day.

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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