Herb Formulas Notebook

Ma Huang Tang

Ephedra Decoction

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Source: Discussion of Cold Damage (c. 220)
Author: Zhang Ji / Zhong-Jing

Category: Formulas that Release the Exterior

Pattern: Wind-Cold attacking the Exterior, Taiyang Cold Damage, disharmony of Yang Wei Mai without sweating.

Key Symptoms: Fever and chills (chills predominate), aversion to cold, absence of sweating, generalised body aches or pain
Secondary Symptoms: Cough or wheezing, headaches, painful obstruction (due to Wind-Cold-Dampness), runny nose or nasal obstruction

Tongue: Thin, white coating
Pulse: Floating, tight

Ma Huang 6-9g
Gui Zhi 4-6g
Xing Ren 6-9g
Zhi Gan Cao 3g

In the UK the maximum legal dose of Ma Huang allowed without prescription is 1.8g per day, and a maximum of 0.6g per administration. This makes it difficult to get the effects required. If necessary it can be substituted with Zi Su Ye, Jing Jie and Fang Feng.

Preparation: Decoction. Do not cook for more than 20 minutes.

Actions: Releases Wind-Cold from the Exterior, arrests wheezing

Contraindications: Weak patients, recent blood loss, patients prone to bleeding (especially nosebleeds), hypertension, anxiety and restlessness in patients who tend to be overstimulated

In order to mitigate the agitation causing effects of Ma Huang it may be fried in honey first and when decocted the froth removed from the surface with a spoon.


Although designed for acute Wind-Cold disorders it can be used whenever the presenting symptoms match the core pattern. For example, in skin disorders or gynaecological problems caused by Cold obstruction where there are signs of heat, aggravation by cold and an absence of sweating.


Extraordinary Vessel attributions come from Li Shi-Zhen's (1577-8) Exposition on the Eight Extraordinary Vessels (Qi Jing Ba Mai Kao), trans. Chace & Shima (2009).


Ploberger (2017), in Westliche und traditionell chinesische Heilkräuter, offers the following alternative using western herbs:

Rhizoma Zingiberis recens(Fresh Ginger)5g(Emperor)
Ramulus Cinnamomi(Cinnamon bark)6g(Minster)
Radix Glycyrrhizae(Licorice root)3g(Envoy)
Radix Paeonia rubra(Red Peony)4g(Assistant)

This essentially makes it a variation of Gui Zhi Tang with fresh ginger increased to the level of Emperor herb and Bai Shao changed to Chi Shao to mitigate the heat.

Research Links:
Science Direct
Google Scholar
Journal of Chinese Medicine
American Dragon

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.