ma huang xi xin fu zi tang

Ephedra, Asarum and Prepared Aconite Decoction

About ma huang xi xin fu zi tang

Ma Huang Xi Xin Fu Zi Tang, Ephedra, Asarum and Prepared Aconite Decoction, is those three herbs. The catalogue classes it among the formulas that release an Exterior disorder where the Interior is deficient, and records it as dispersing Wind-Cold while warming the Interior and replenishing Kidney Yang.

Ingredients

Herb	Amount
ma huang	6 g
zhi fu zi	9 g
xi xin	6 g

Actions and indications

Releases the Exterior and disperses Wind-Cold

Wind-Cold invading someone whose Yang is already deficient: Tai Yang and Shao Yin disorders at the same time
Intense chills and a sense of great cold that clothing and covers do not relieve, with slight or no fever
No sweating
Headache from deficiency Cold
Nose congested, sneezing and body aches
Aching joints

Warms the Interior and replenishes Kidney Yang

Exhaustion, fatigue and an almost constant wish to lie down and sleep
Pale face with a weak, quiet voice
Cold hands and feet, and weak limbs
No thirst
Oedema, including oedema from stagnant Wei Qi
Tongue pale and swollen with a slippery white coat; pulse deep and weak, deep even when there is fever

Relieves cough and wheezing

Kidney cough, with pain that goes through to the back
Long-standing wheezing and shortness of breath
Throat sore, painful and obstructed, with a raspy voice
Toothache

Modern uses

Colds in the elderly and weak
Influenza
Headache
Allergic rhinitis
Rhinitis
Sinusitis
Allergies
Acute laryngitis
Chronic laryngitis
Chronic pharyngitis
Sudden dysphonia
Kidney coughing
Bronchitis
Chronic bronchitis
Bronchial asthma
Pertussis
Pneumonia
Viral pneumonia
Emphysema complicated by infection
Chronic obstructive pulmonary disease
Dyspnea
Measles
Skin disorders
Skin Bi
Urticaria
Alopecia
Fibromyalgia
Connective tissue disorders
Arthritis
Arthralgia
Rheumatoid arthritis
Rheumatic arthritis
Sciatica
Trigeminal neuralgia
Facial paralysis
Peripheral neuropathy
Vascular and nerve disorders
Toothache
Sick sinus syndrome
Hypothyroidism
Fatigue
Edema
Nephrotic syndrome
Chronic nephritis, acute flare-up
Chronic glomerulonephritis, acute flare-up
Chronic prostatitis, acute flare-up
Prostatic hypertrophy, acute flare-up
Impotence

Symptoms

Absence of thirst
Anhidrosis
Aversion to cold
Back pain
Chills
Cold limbs
Cold sensation
Cough
Edema
Fatigue
Feeling of a lump in the throat
Headache
Hoarseness
Joint pain
Low-grade fever
Nasal congestion
Pallor
Shortness of breath
Sneezing
Somnolence
Sore throat
Toothache
Weak limbs
Weak voice
Wheezing

Modifications

Heavy body and sore muscles from Damp obstructing the channels: + cang zhu, + du huo
Chronic wheezing from deficiency Cold (combined with Er Chen Tang)
Chronic wheezing from deficiency Cold, alternative: + bai jie zi, + xing ren, + zi su zi
Marked deficiency of Yang and Qi: + huang qi, + ren shen
Severe Cold blocking the Blood, with pain in the limbs and joints: + dang gui, + fang feng, + du huo
Headache from Wind-Cold: + chuan xiong
Headache from Wind-Cold, alternative: + chuan xiong, + sheng jiang
Bi from Wind, Cold and Damp: + qiang huo, + du huo, + wei ling xian, + bai hua she
Chronic bronchitis, or wheezing and breathlessness from Cold: + zhi ban xia, + fu ling, + chen pi, + gan cao
Fibromyalgia from Cold stagnating in and blocking the channels (combined with Yan Nian Ban Xia Tang)
Skin Bi (combined with Xue Fu Zhu Yu Tang): + gui zhi, + qiang huo, + du huo, + wu jia pi, + hai tong pi, + ji xue teng, + chuan xiong, + dang gui
Skin Bi, alternative (combined with Yan Nian Ban Xia Tang and Shi Pi Yin)

Show all 36 modifications

Hair loss from Spleen Yang deficiency (combined with Gui Zhi Ren Shen Tang)
Hair loss from Kidney Yang deficiency (combined with Yang He Tang)
Rheumatic arthritis: + qiang huo, + du huo, + wei ling xian
Rheumatic arthritis with wandering pain: + qiang huo, + du huo, + wei ling xian, + fang feng, + bai zhi, + qin jiao, + hai feng teng
Rheumatic arthritis with extreme pain: + qiang huo, + du huo, + wei ling xian, + gan jiang, + rou gui
Rheumatic arthritis with fixed pain: + qiang huo, + du huo, + wei ling xian, + yi yi ren, + cang zhu
Rheumatic arthritis of the Heat type: + qiang huo, + du huo, + wei ling xian, + jin yin hua, + lian qiao
Stubborn rheumatic arthritis: + qiang huo, + du huo, + wei ling xian, + di long, + quan xie
Long-standing rheumatic arthritis with deficiency: + qiang huo, + du huo, + wei ling xian, + sang ji sheng, + du zhong
Chest Bi: + gua lou, + xie bai
Sciatica: + huai niu xi, + mu gua
Sudden difficulty passing urine: + huai niu xi, + che qian zi
Loose or watery stools: + rou gui, + pao jiang
Toothache: + bu gu zhi, + qiang huo
Toothache with dislike of cold: + bu gu zhi, + qiang huo, + wu zhu yu, + rou gui
Toothache with excess saliva: + bu gu zhi, + qiang huo, + yi zhi ren, + sang piao xiao
Toothache with low back pain: + bu gu zhi, + qiang huo, + xu duan, + sang ji sheng
Toothache with impotence: + bu gu zhi, + qiang huo, + dang gui, + yin yang huo
Peripheral neuritis: + ren shen, + bai zhu
Peripheral neuritis with heavier Cold-Damp: + ren shen, + bai zhu, + cang zhu
Peripheral neuritis with cold limbs and sweating: + ren shen, + bai zhu, + huang qi, − ma huang
Sick sinus syndrome: + gui zhi, + zhi gan cao, + dang gui, + yin yang huo
Sick sinus syndrome with cold, painful lower back and knees: + gui zhi, + zhi gan cao, + dang gui, + yin yang huo, + bu gu zhi, + ling yang jiao, + ba ji tian
Oedema in sick sinus syndrome: + gui zhi, + zhi gan cao, + dang gui, + yin yang huo, + fu ling, + bai zhu, + xiang jia pi

Cautions

contraindication A robust exterior excess without underlying Yang deficiency, which calls for a plain exterior-releasing formula; suited only to mild Yang deficiency
contraindication Severe or collapsing Yang deficiency (profound exhaustion, icy limbs, a very faint pulse), which needs pure warming and rescue rather than a formula that also makes the patient sweat
contraindication Excess Heat or Dryness
contraindication Yin deficiency
pregnancy Contraindicated in pregnancy
lactation Contraindicated while breastfeeding
caution The ephedrine-type alkaloids in Ma Huang act on the heart and circulation, and many countries regulate or restrict ephedra products
caution Fu Zi is toxic when raw: only properly processed Fu Zi is used, and aconite-containing formulas are for a licensed practitioner, not self-treatment
caution Xi Xin is subject to dose limits in modern pharmacopoeias
caution With antibiotics: reported to settle fever from bacterial infection in elderly patients who did not respond to ofloxacin, and suggested as an option when fever persists after three days of antibiotics

Preparation

Decoction: Ma Huang is simmered first and skimmed, then Xi Xin and Fu Zi are added; prepared Fu Zi is usually given a longer, separate simmer to reduce residual toxicity

Names

Pinyin	ma huang xi xin fu zi tang
English Name	Ephedra, Asarum and Prepared Aconite Decoction

Classification

Category: Formulas that Release Exterior Disorders with Interior Deficiency