Ma huang sheng ma tang
ma huang 18 sheng ma 9 dang gui 9 bai shao 3 gui zhi 3 zhi mu 6 huang qin 6 wei rui 6
tian men dong 3 fu ling 3 bai zhu 3 shi gao 3 gan jiang 3 zhi gan cao 3
In cold damage that has lasted six or seven days, after great purgation, when the cun pulse is deep and slow, and there is reversal cold of hands and feet, while the lower division pulse fails to arrive, and the throat is inhibited, with spitting of pus and blood, and incessant downpour diarrhea, then this is hard to treat, and ma huang sheng ma tang governs.
It treats a tai yang wind cold pattern and heat in the interior with cold extremities, spitting of blood and pus, and incessant diarrhea. This pattern started out as an exterior cold pattern and due to mistreatment the cold has collapsed inward. There is now stagnation in the lungs causing heat and cold in tai yin causing diarrhea.
Ma huang, Ephedrae herba is bitter descending of the lung. It is pungent dispersing of the imperial and ministerial fire. It enters the lung and bladder channel, it opens the surface, and dispels the cold on the surface. Further it dissipates lung qi and pacifies panting through opening the closed lung qi.
Ma huang opens the pores of the surface that were congealed by external cold, and promotes the excretion of stagnant fluids by promoting the dispersion of tai yang and tai yin.
Sheng ma, Cimicifugae rhizome is pungent dispersing of liver blood and the ministerial fire in the san jiao. It is bitter draining of damp and heat in the liver, gall bladder, san jiao and the surface. It frees the movement of Wood wind and supports Earth and Metal.
Sheng ma disperses congested fire by raising and dispersing clear yang.
Dang gui, Angelicae sinensis radix is sweet tonifying and nourishing of liver blood and the ministerial fire. It is pungent dispersing of the liver blood and ministerial fire.
Dang gui nourishes jue yin blood and moves blood which cools heat. Dang gui also supports yang qi with its warm nature.
Bai shao, Paeoniae radix lactiflora is sour, bitter and cool. It is sour collecting of yin fluids and blood. It is bitter descending of heat. It nourishes dryness in yang ming and the jue yin. It descends Earth and Metal and calms Wood wind.
Replenishes the nutritive ying qi layer and clears deficient heat while moistening.
Gui zhi, Cinnamomi cassiae ramulus is pungent sweet and warm dispersing of the imperial and ministerial fire. It warms and tonifies the shao yin and jue yin. In doing so it warms and tonifies the whole body.
Wind is a yang climatic qi and as such dries the yin on the surface leading to a loss of anchoring of yang. The yin of bai shao, zhi mu, dang gui is needed to replenish the yin but the yang must be replaced with gui zhi to restore the balance of yang in yin.
Zhi mu, Anemarrhenae rhizome is bitter draining of heat in the stomach and lungs. It is sweet nourishing of fluids of the stomach, lungs, kidneys, and heart. It clears deficiency heat to preserve the yin blood of liver and heart, for only when yin blood is sufficient can the yang mind be controlled and pacified. It clears the heat in the jue yin liver and pericardium channels.
Zhi mu clears stagnant heat from the nutritive blood layer due to stagnation heat.
Clears stomach heat and lubricates exhausted fluids. Often used together with shi gao in patterns of empty heat due to its moistening nature.
Huang qin, Scutellaria radix is bitter draining and cooling of heat in the san jiao, stomach domain, lungs, liver, gall bladder, and bladder.
Cold and bitter it is the great cleaner. It clears heat and dampness, in all three burners, and in yang ming, tai yin, shao yang, and jue yin.
In clearing heat it cools blood which when hot gives way to excessive bleeding or flaring of ministerial fire. This prevents the heat from further damaging the tissues by cooling the ministerial fire in all three burners.
Wei rui, Polygomati yuzhu rhizoma is sweet tonifying and nourishing of the lungs. It is slightly cool and it nourishes yin, moistens dryness, moistens the lungs, extinguishes wind, nourishes the stomach and generates fluids.
Tian men dong, Asparagi radix is sweet nourishing of heart and lung yin. It is bitter draining of heat. It mildly clears fire and tonifies heart and lung yin. It enters the lung and nourishes upper burner yin fluids and qi.
Sweet bitter and cold, it mildly clears fire and tonifies heart and lung yin.
Fu ling, Poria is sweet and neutral. It drains fluids but is not bitter. Fu ling is tonifying the stomach domain, spleen, kidney and bladder to move excess fluids. It moves more than it tonifies.
Fu ling drains fluids through the tai yang bladder and restores the water metabolism. The movement of fluids is the start of movement for blood. By moving water we move blood. Dampness is a form of yin and we move the yin with the fu ling to restore the transformation and transport aspect of tai yin. Tai yin is also the post heaven source of clear qi and yin and blood.
Bai zhu, Atractylodis macrocephalae rhizome is sweet tonifying of the stomach domain and spleen. Bai zhu is bitter draining of excess fluids in the stomach domain, spleen, lungs and bladder.
It tonifies the spleen qi along with the promotion of the spleen’s transforming and transporting actions.
Fu ling bai zhu work together to clear dampness in the stomach and lung.
Shi gao, Gypsum is pungent dispersing of heat in the stomach domain and lung. It is sweet nourishing of the stomach, spleen, and lung. It is pungent cold dispersing of the yang channels: tai yang, yang ming, shao yang. It saves yin and blood by clearing heat.
Shi gao clears yang ming channel heat which in Fire school terms is the qi layer. In zang fu terms is lung and stomach. Shi gao is cool, sweet and pungent. It clears heat without drying fluids.
Ma huang and shi gao are working together to disperses the cold and heat on the surface.
Gan jiang, Zingiberis rhizoma, dried is warm (or hot) pungent and astringent. Gan jiang is the main herb to warm the tai yin level and treat excessive dampness by introducing yang ming dryness in tai yin dampness.
Gan jiang warms the interior and tai yin and warms the fluids in the lungs and spleen, while assisting in dispersing cold on the body surface.
Zhi gan cao, Glycyrrhizae radix prep is sweet tonifying and nourishing of all organs but especially the heart.
Zhi gan cao is sweet and mildly warm tonifying and nourishing of yin fluids. It nourishes yin fluids in the tai yin and shao yin. It calms wind in the jue yin.
It balances the pungent ma huang, gui zhi, dang gui, and sheng ma with its sweet moderation and nourishing.
We see the three common actions of clearing the surface in this formula. There is pungent dispersing which clears cold and heat. We see yin and blood nourishing to anchor yang once again. We see warming and moving of the ministerial fire to warm the yang circulation.
When we see ma huang, gui zhi and bai shao in a formula we know that there is cold closure, cold ministerial fire and nutritive nourishing. The surface is half way closed and half way open. There will be a strong feeling of cold, sweating and heat effusion all at the same time.