Minor Green Dragon Decoction

Minor Green Dragon Decoction

Ephedrae Herba (Ma Huang) 3 liang (9g), Paeoniae Radix Alba (Shao Yao) 3 liang (9g), Asari Radix et Rhizoma (Xi Xin) 3 liang (6g), Zingiberis Rhizoma (Gan Jiang) 3 liang (6g), Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao) 3 liang (6g), Cinnamomi Ramulus (Gui Zhi) 3 liang (9g), Pinelliae Rhizoma (Ban Xia) 0.5 sheng (9g), Schisandrae Chinensis Fructus (Wu Wei Zi) 0.5 sheng (6g)

Prepare Xiao Qing Long Tang as a decoction to be taken warm. Ma huang should be decocted first and the foam that collects at the top of the decoction needs to be removed before adding the other medicinals.

Releases the exterior, dissipates cold, warms the lung and dissolves rheum (fluid retention).

This formula is indicated for the pattern of exterior cold with interior fluid retention. The symptoms are aversion to cold, fever, absence of sweating, labored breathing, cough, copious clear and thin phlegm, stuffiness in chest, dry retching, difficulty in lying back in the supine position, general body aches, edema of the face and extremities. The tongue coating is white and glossy, and the pulse is superficial.

Xiao Qing Long Tang is indicated when an excessive fluid condition is complicated by externally contracted wind-cold. Aversion to cold, fever, absence of sweating and body aches are symptoms of an exterior excess pattern with wind-cold fettering the exterior causing obstruction of the wei yang and constraint of ying yin. When a person who has excessive fluids contracts an external pathogen, the pathological activities of the excessive fluids may be initiated. Cold thin phlegm then invades the lung and causes the lung qi to fail to diffuse and descend which leads to cough, labored breathing and copious thin sputum. Stuffiness in chest is due to fluid retention under the heart blocking the qi movement. Dry retching is caused by lodged fluid that causes ascending counterflow of the stomach qi. General edema and heaviness is due to subcutaneous water retention. And finally, a white and glossy coating and superficial pulse are clear signs of exterior cold with interior fluid retention. In this situation, dispersing external pathogens alone without dissolving fluid retention will not resolve the excessive internal fluids. On the other hand, dissolving fluid retention alone without expelling external pathogens will not release the exterior. Therefore, the correct treatment method is to simultaneously address both the internal and external by relieving the exterior and dissolving fluid retention.

Why does Xiao Qing Long Tang, an acrid formula, contain astringents wu wei zi and bai shao?

1. Essential pattern differentiation Xiao Qing Long Tang is commonly indicated for the pattern of externally contracted wind-cold with cough and labored breathing due to internal cold thin phlegm. This clinical pattern is marked by aversion to cold, fever, absence of sweating, labored breathing, cough, copious thin phlegm, white and glossy tongue coating, and superficial pulse. 2. Modern applications This formula may be used in biomedically defined disorders such as bronchitis, bronchial asthma, pneumonia, pertussis, pulmonary heart disease, allergic rhinitis, and catarrhal ophthalmic and catarrhal tympanitis when the patient shows signs of external cold and internal fluid retention. 3. Cautions and contraindications Due to the relatively strong acrid-dispersing and warm-resolving effects of the formula, it is only indicated for those who are indeed affected by external cold interacting with internal fluids causing a disorder of the lung system. The dosage needs be determined according to the physical constitution of the patient. It is not applicable for coughs without sputum due to a yin deficiency or internal phlegm-heat pattern.

She Gan Ma Huang Tang (Belamcanda and Ephedra Decoction, 射干麻黃湯)