• Since the dispersing effect of some of the more aromatic herbs in this category depends on their volatile oils, they are often decocted only for a short time (or are infused only).
• Also consider for wind-cold patterns when appropriate: Xi xin, Du Huo, Cang Zhu, Chuan xiong, Huo xiang, Ju hong, Wu gong, Jiang huang, Bai shao, etc.

Nature: acrid, warm

Enters: Lung, Stomach

Actions: Eliminates wind-cold; dries dampness; relieves swelling and drains pus; alleviates pain by eliminating wind; conducts to the Yangming channels; opens the nasal passages.

Indications:
• Wind-cold: frontal headache, nasal congestion, supraorbital pain, toothache, or any other problem due to wind invading the Yangming channels in the head (can be used for heat syndromes when appropriately combined – e.g. for frontal headache due to wind-heat when combined with Shi gao).
• Headache due to sinusitis – key herb (not for headaches due to blood deficiency).
• Carbuncles and surface sores: dissipates swelling before there is pus or drains the pus after it has developed.
• Cold and damp in the lower Jiao: leukorrhea (combined appropriately, can be used for damp-heat also).
• Prevention of colds: increases IgA, IgM in the nose (by smelling it – usually hung in a container around the neck).
• Used in prevention of corneal ulcers secondary to burns.
• Used topically for freckles, maybe acne, hyperpigmentation, other blemishes.
• Liu: the ultimate herb for pus.
• A powder of Bai zhi and Bing pian, when inhaled through the nose, has been effective in treating headache, toothache, trigeminal neuralgia.
HF: A San Du, scattering toxin medicinal, typically found in Gu Zheng (Gu parasites) formulas.
Li Dong Yuan: Upbears Yang Qi.
Eric Brand: We now think of Bai Zhi as being an exterior-resolving agent that is suitable for wind-cold patterns, especially cases that are characterized by sinus congestion and headache. In truth, Bai Zhi’s actions are quite diverse, and it is an important medicinal for both internal and external applications (it relieves itching and is often featured in topical formulas for itching). Its actions of relieving headache and sinus congestion go far beyond the context of external contraction, which is often expressed by the action phrase “dispels wind and relieves pain.” It is indicated for yang ming channel headache, eyebrow bone pain, “head wind” headache, toothache, and deep-source nasal congestion.
Most practitioners remember Bai Zhi’s actions to resolve the exterior, treat headache, and open the nose. However, all too often practitioners forget that Bai Zhi disperses swelling and expels pus; here, it is used for painful swollen sores and welling-abscesses. To disperse swelling before the rupturing stage, combine it with heat-clearing toxin-resolving medicinals such as Jin Yin Hua (Lonicerae Flos) and Tian Hua Fen (Trichosanthis Radix). After pus has formed, combine it with supplementing medicinals such as Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), and Dang Gui (Angelicae Sinensis Radix) to expel pus.
Bai Zhi is aromatic and reaches upward, so it is often used to treat disorders affecting the head (headache, sinus congestion, etc). However, it is also a key medicinal that should not be overlooked for treating vaginal discharge. Bai Zhi is acrid, warm, aromatic and drying, so it is particularly appropriate for cold-damp patterns of vaginal discharge. To treat copious white vaginal discharge due to cold-damp pouring downwards, combine it with medicinals to warm yang, dry dampness, and fortify the spleen, such as Lu Jiao Shuang (Cervi Cornu Degelatinatum), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Shan Yao (Dioscoreae Rhizoma). Although it is warm in nature, it can also be used for yellow or reddish vaginal discharge due to damp-heat when combined with medicinals such as Che Qian Zi (Plantaginis Semen) and Huang Bai (Phellodendri Cortex).
If we look at the indications and historical applications of Bai Zhi, it is obvious that it is an important medicinal that transcends many normal limits of use. It is warm and acrid, so we often combine it with other warm, acrid agents to treat cold patterns. However, we also use it in conjunction with cold herbs to treat hot conditions characterized by swelling and pus, as well as hot patterns of vaginal discharge. It is famous for conditions affecting the head and upper body, but it is also an important medicinal for vaginal discharge and intestinal wind in the lower body. Such paradoxical and wide-ranging indications are very interesting and unusual. If one searches the Chinese formula literature based on Bai Zhi, one will discover that a stunning number of formulas based on Bai Zhi exist (over 30 formulas share the name Bai Zhi San alone). These formulas span a wide range of internal and external conditions and really illustrate its profound spectrum of use.
Bai Zhi is differentiated into two primary sources: Angelica dahuricae (Fisch.) Benth. Et Hook. and Angelica dahurica var. formosana (Boiss.) Yuan et Shan. The latter, called Hang Bai Zhi, is characterized by the presence of square rings that can be seen upon the transverse cross section. The product pictured above is Chuan Bai Zhi, which only has round rings. Hang Bai Zhi has some round and some square rings, whereas Chuan Bai Zhi only has round rings. Hang Bai Zhi is considered to be slightly superior but Chuan Bai Zhi is more abundant on the market (according to some sources, Chuan Bai Zhi accounts for about 70% of the market supply). Both are acceptable forms.
Weng Weiliang, et. al.:
• Anti-bacterial effect: Escherichia coli, Shigella dysenteriae, Proteus vulgaris, Salmonella typhi, Pseudomonas aeruginosa, Vibrio cholerae, and Mycobacterium tuberculosis var. hominis were found to be susceptible to the decoction of Angelica Dahurica.
• Use in ophthalmology: A burn ointment, which included ground Radix A. duhurica has been effective in promoting healing and avoiding deleterious sequelae from corneal ulcers secondary to flash burns.
• Use in otolaryngology: A powder made up of ground Radix A. dahurica and Borneol, when inhaled through the nostrils, has been effective for headache and toothache. It also proved to be of use in trigeminal neuralgia.

Dose: 3-9g

Nature: acrid, bitter, warm, slightly toxic

Enters: Lung

Actions: Opens the nose; eliminates wind-damp, alleviates pain; dispels wind.

Indications:
• Wind-damp/wind-cold-damp: Bi syndrome, sinusitis, congestion, whitish discharge, headache.
• Wind-damp: skin disorders with itching, painful obstruction.
• Eliminates wind (auxiliary herb) for exterior syndromes with splitting headache radiating to back of the neck.
• Topical: local application in sesame oil for chronic rhinitis.
• Im injection for low back pain.
• Bensky/Gamble: eliminate wind-damp category.
Hsu: Antibacterial, decoction cures chronic arthritis and syphilitic neuralgia.
DY: Diffuses the Lung Qi.
• With Xin yi hua to effectively dispel wind, diffuse the Lung Qi, and open the portals of the nose. These two herbs are probably the two most efficient Chinese medicinal substances for all types of rhinitis and sinusitis. For the following indications, use the base formula Cang Er Zi San with these amendments: for wind-cold, add Xi xin, Huo xiang, Ma huang, and subtract Bo he; for wind-heat, add Ju hua, Jin yin hua, Lian qiao; for gallbladder heat, add Yu xing cao, Long dan cao, Huang qin; for Lung-spleen Qi deficiency, add Huang qi, Bai zhu, Dang shen, and subtract Bo he.
– 1. Common cold with headache, nasal congestion, and runny nose due to wind-cold.
– 2. Deep source nasal congestion with headache, nasal congestion, loss of smell, and turbid nasal phlegm.
– 3. Chronic or acute rhinitis, allergic rhinitis, hypertrophic rhinitis, sinusitis, parasinusitis, and frontal sinusitis.
• Cang er zi is incompatible with horse meat or pork.

Dose: 3-9g
Cang Er Cao: the herb (stem and leaves)
• Bitter, acrid, slightly cold, slightly toxic.
• Expels wind; clears heat; eliminates toxicity.
• For wind-damp: Bi syndrome with spasms and pain in the extremities.
• Deep-rooted skin lesions and pruritis.
• Generally used topically.
• Not for long-term internal use, particularly by those who are very weak.
6-15g

Nature: acrid, warm

Enters: Lung, Stomach

Actions: Mildly releases the exterior by promoting sweats; disperses cold and activates Yang; eliminates toxicity, dissolves swellings; conducts Yang to the surface.

Indications:
• Mild wind-cold EPI : especially in the very early stage (often with Dan dou chi).
• Excess cold keeping the Yang on the surface of the body: diarrhea, cold extremities, feeble pulse, abdominal pain and distention, nasal congestion.
• Sores, abscesses, mastitis (often applied externally as a poultice).
• Combining with honey can upset the stomach.
• When decocting, cook only for a short time.
• When there is floating Yang due to deficiency, the use of Cong bai alone could make it collapse – this must be treated with Yang tonics or herbs which warm the interior (e.g. Fu zi, Gan jiang).
DY: Guides the action of other herbs to the Lung channel.

Dose: 2-5 pieces

Nature: acrid, sweet, warm

Enters: Bladder, Liver, Spleen

Actions: Releases the exterior by eliminating wind, cold, and dampness; relives pain; relieves convulsions and tremors; alleviates itching.

Indications:
• Wind-cold-dampness: headache, body ache, aversion to cold or joint pain, muscle spasm in the limbs.
• External wind: tetanus, trembling of the hands and feet.
• Spleen and liver disharmony: intestinal wind – recurrent, painful diarrhea with bright blood in the stool.
• Migraines.
• Deeper effect than Jing jie – Fang feng reaches the muscles and tendons while Jing jie is more for the skin level. Qiang huo which penetrates to the bones and tendons, reaches deeper than Fang feng.
• Analgesic, mild antipyretic.
• Fang feng’s chief function is to disperse wind. Can be combined with Huang qi to prevent wind (e.g. in Jade Wind Screen).
• Not for convulsions due to blood deficiency or Yin deficiency fire.
Liu: May free stagnant liver Qi.
SD: May help antidote arsenic poisoning.
DY: With Huang qi to supplement the defensive Qi without retaining external evils in the body, to drain external evils without damaging correct Qi and without causing perspiration, to secure the exterior, prevent invasion by external evils, and stop perspiration. This combination appears in Yu Ping Feng San for indications such as:
– 1. Spontaneous perspiration due to exterior deficiency.
– 2. Tendency to contract EPIs frequently due to defensive Qi deficiency.
– Yu Ping Feng San should not be used to treat wind affections that are already established. This combination is too astringent once the evil Qi and the defensive Qi are already struggling. Its use might, in this case, retain the external evil inside the body.
– The pair Fang feng and Huang qi, when combined with Zhi ke, yields good results in the treatment of prolapse of the rectum, external hemorrhoids, flatulence, and abdominal distention. For rectal prolapse, the best approach is to add 3g Fang feng and 6g Zhi ke to Bu Zong Yi Qi Tang.

Dose: 3-9g

Nature: acrid, warm

Enters: Bladder

Actions: Releases the exterior and alleviates pain by dispersing cold; eliminates wind and damp; guides to the bladder channel and organ; reaches both ends of the Du Mai.

Indications:
• Wind-cold: headache, especially severe parietal headache radiating to the cheek and teeth, occipital headache, or migraine.
• Any wind pattern that presents as pain at the vertex or pain that travels from the vertex down to the cheeks and teeth.
• Wind-cold-damp: Bi syndrome, joint pain.
• Wind-cold: acute lower back pain (the herb reaches both ends of the Du Mai).
• Warm, dry, ascending, dispersing nature.
• Not for headaches due to blood deficiency.
Hsu: Antispasmodic, emmenagogue, antiphlogistic, antifungal.
HF: A San Du, scattering toxin medicinal, typically found in Gu Zheng (Gu parasites) formulas.
Li Dong Yuan: Upbears Yang Qi.

Dose: 3-9g

Nature: acrid, sweet, warm

Enters: Heart, Lung, Bladder, Liver

Actions: Releases the exterior by promoting sweats; warms the channels; activates Yang; disperses cold; promotes blood circulation; frees the bladder channel to promote urination; adjusts the Ying and Wei Qi; warms and facilitates the flow of Yang Qi in the chest.

Indications:
• Wind-cold: fever, aversion to cold, headache, sweating or no sweating.
• Wind-cold-damp: Bi syndrome, sore joints, back, limbs, and especially shoulders.
• Heart and spleen Yang deficiency: retention of phlegm and harmful fluid.
• Heart Yang deficiency or obstructed flow of Yang Qi in the chest (shi or deficiency): chest pain, palpitations, irregular pulse, or angina pectoris.
• Cold obstructing the channels/blood: dysmenorrhea, amenorrhea, masses in the uterus/abdomen.
• Cold-phlegm accumulation or weak movement of Yang Qi: edema.
• To promote sweating, use with Ma huang (Ma huang opens the pores, Gui zhi pushes the sweat out), especially for Yangming stage.
• Wei and Ying imbalance: deficiency patterns where sweating occurs without improvement.
• Diuretic; mild antipyretic (primarily by vasodilation); some antibiotic effects.
• Compared to Ma huang in the treatment of wind-cold: while Ma huang works more directly by opening and disseminating the Lung Qi, Gui zhi works more by aiding the Yang Qi – this gives it the ability to treat either wind-cold excess or deficiency.
• For EPIs, smaller doses are usually used (3-9g) while larger doses (9-15g) are used for dispelling painful obstruction.
Li: Harmonizes the heart and kidneys; warms cold extremities; useful for palpitations.
PFGC: Enters the upper extremities; enters the muscle layer – primary herb to relieve the muscles; opens the energy pathways, raises the ancestral Qi up, descends counterflow of Qi (asthma, coughing), disperses pernicious Qi; keeps the upflaring tendency of liver wood in check; helps collapsed spleen Qi rise and rebellious stomach Qi descend.
• Its pungency disperses while its sweetness tonifies: it is therefore somewhere between dispersing and tonifying.
• By harmonizing the Ying and Wei, it can astringe sweats due to wind injuring the Wei, which in turn cannot attend to the Ying, which becomes weak and cannot secure fluids. it can induce sweating by regulating the Ying, which lets the Wei be harmonious by itself, which then forces sweat out to release the wind.
Hsu: Analgesic (raises pain threshold in brain); alleviates headache due to spasm of blood vessels in the head and relieves abdominal pain due to spasms of smooth muscle of the viscera; stimulates gastric secretions and saliva; markedly inhibits influenza virus.
DY: Promotes perspiration and resolves the exterior without damaging Yin; tropism: the blood division; quickens the network vessels; supplements spleen Yang; relieves the muscles; frees the flow of Yang and promotes urination by stimulating the function of transformation of the bladder.
• Treats edema of the damp type due to deficiency of the transformative function of the bladder.
• With Bai shao to harmonize Yin and Yang, the Qi and the blood, and the constructive and the defensive. This combination drains without damaging Yin, while constraining without retaining evils. They harmonize the vessels, relieve tension and stop pain, as well as support stomach Yin and spleen Yang, while regulating the spleen and stomach. For indications such as:
– 1. Common cold with fever, shivers, slight perspiration, no thirst, headache, thin white tongue fur, and a floating, moderate pulse or, in other words, a wind-cold exterior pattern with disharmony between the constructive and the defensive. (Take Gui Zhi Tang. 10 minutes later, eat very hot rice porridge, and stay well covered in bed to promote perspiration.)
– 2. Spontaneous perspiration and/or night sweats accompanied by fear of wind and cold, a cold feeling in the low back, and frequent catching of colds due to disharmony between the constructive and the defensive. (Use stir-fried Gui zhi.)
– 3. Chest and cardiac area pain due to heart Yang deficiency and disharmony between the Qi and blood. (Use 15-30g Gui zhi. In case of very cold limbs, Fu zi can be added.)
– 4. Abdominal pain with spasms and cramps due to deficiency cold and disharmony between the Qi and blood. (Dose Bai shao:Gui zhi::2:1. Use honey mix-fried Gui zhi and wine mix-fried Bai shao.)
– 5. Pain and/or numbness of the limbs due to disharmony between the Qi and blood. (Use stir-fried Gui zhi and wine mix-fried Bai shao.)
– 6. Vomiting and weakness during pregnancy accompanied by fear of cold, lack of appetite, nausea and a weak pulse in the cubit position due to disharmony of the spleen and stomach and the constructive and defensive. (Use stir-fried Gui zhi and wine mix-fried Bai shao.)
– 7. Weakness in the elderly, during convalescence, postpartum, and post-operatively with fatigue and lack of strength, fear of wind, and slight perspiration due to disharmony between the constructive and the defensive. (Use stir-fried Gui zhi.)
• With Shi gao to clear heat, free the flow of the network vessels, stop pain, and treat heat Bi or impediment. For such indications as rheumatic pain of the heat type with redness, heat, swelling, and severe pain in the joints. (Bai Hu Gui Zhi Tang)
• With Ma huang to mutually reinforce each other’s floating and dispelling characteristics, to effectively open the pores, strongly promote perspiration, resolve the muscle layer, and scatter wind-cold of the excess type. For indications such as:
– 1. Colds, influenza with fever, fear of cold, severe shivering, absence of perspiration, headache, and general body aches caused by wind-cold of the excess type.
– 2. Rheumatic pains due to wind, cold, and dampness. (Ma huang Tang)
– 3. Cough and asthma due to wind-cold obstructing the Lung Qi. (Ma Huang Tang) It is advisable to use honey mix-fried Ma huang for cough and asthma.
– Gui zhi communicates with the constructive division [Ying] where it moves fluids. It brings these fluids to the exterior where Ma huang pushes them outward forcefully.
• The fine twigs (Gui zhi jian or Gui zhi shao) are known for their powerful Qi and are very fragrant. They are more powerful (than Gui zhi) for scattering wind-cold, warming and opening the channels and vessels, and quickening the blood.
• Gui zhi mu, small twigs of cinnamon from which the external bark has been removed, is less powerful than Gui zhi for resolving the exterior and inducing perspiration, but is more powerful for warming the channels and quickening the network vessels. Gui zhi mu is preferred for the treatment of joint pain and stiffness of the sinews.

Dose: 3-15g

Nature: acrid, slightly warm

Enters: Lung, Liver

Actions: Releases the exterior by eliminating wind; stops bleeding (charred); promotes expression of rashes, alleviates itching.

Indications:
• Wind-cold or wind-heat: headache, fever, aversion to cold, lack of sweats (combine appropriately for heat or cold).
• Wind: itching, urticaria, slow skin eruption in measles.
• Has a superficial effect (to skin level).
• Carbuncles and boils when they first erupt, especially when accompanied by chills and fever.
• Liu: special for skin problems, the upper body, sore throat, headache, aversion to cold.
• Diaphoretic, increases subcutaneous circulation.
• Bensky/Gamble: can be used whether the disorder is hot or cold.
• Short cook.
Li: [contrary to Liu] this is a warm herb – caution with sore throat, can worsen it (Li removes Jing jie from Yin Qiao San when there is a sore throat). [My limited clinical experience seems to corroborate this idea. -PLB]
• With Fang feng – vital for opening the chest for persistent lung obstruction.
MLT: Antispasmodic, useful for rheumatism, facial paralysis, stroke symptoms, stiff neck and spine.

Dose: 3-9g
Jie Dui Tan: charred form
• Stops bleeding, promotes blood circulation, dispels blood stasis.
• For bleeding, helps the liver store blood and the spleen hold blood.
• Epistaxis, hemafecia, uterine bleeding.

Nature: acrid, warm

Enters: Lung, Bladder

Actions: Promotes sweating (opens the pores); relieves asthma; promotes urination; disperses/moves Lung Qi and encourages it to descend.

Indications:

• Wind-cold invasion: aversion to cold, no sweats, etc. – specifically Taiyang.
• Wind-cold in the Lung obstructs Qi: cough, asthma.
• Edema with exterior syndrome (heat or cold).
• For externally-contracted or internally-generated wheezing.
• Ma huang opens the pores, but does not supply the sweat (combine with Gui zhi, which reaches the heart, the mother of sweat).
• Beneficial for urinary retention due to Lung Qi deficiency, where the Lungs lack the energy to descend fluids to the bladder.
• To mitigate its diaphoretic function, combine with astringent herbs, Qi tonics, or cool herbs.
• Anti-viral (influenzas); bronchodilator; vasoconstrictor, raises blood pressure (mild but prolonged).
• Not for breathing problems due to failure of the kidneys to grasp Lung Qi.
• Traditionally prepared by decocting it first and removing the foam on the surface of the water before adding other ingredients.
• American species (Mormon Tea / Brigham Tea) may be decent, though weaker, substitutes.
MLT: Of the world’s ephedra species, Chinese has the most ephedrine and pseudoephedrine, especially between the joints of the stem. The best quality Ma huang has the joints removed.
PFGC: Shen Nung says it can break up masses and accumulations; it can reach the surface and also penetrate deeply into pockets of accumulated phlegm and coagulated blood, especially in combination with materials to eliminate masses and transform stasis
• By its entry into the Taiyang bladder, it can also enter the Shaoyin kidney and treat Shaoyin syndrome.
• Can treat pustules, skin ulcerations, stubborn skin disorders of the Yin (cold) type.
• The foam that collects on the water when Ma huang is cooked is too intense a diaphoretic and should be removed.
• People in cold areas with thick skin and muscles may need a larger dose to induce sweating.
DY: This is one of six medicinals which have been traditionally aged for the purpose of reducing secondary effects and reinforcing their therapeutic actions. Generally, the longer it is kept, the more efficient.
• The nodes of the stem (Ma huang jie) have an anti-diaphoretic action (like the root). For most effective diaphoresis, the knots should be removed.
• With Gui zhi to mutually reinforce each other’s floating and dispelling characteristics, to effectively open the pores, strongly promote perspiration, resolve the muscle layer, and scatter wind-cold of the excess type. Gui zhi communicates with the constructive division [Ying] where it moves fluids. It brings these fluids to the exterior where Ma huang pushes them outward forcefully. See Gui zhi in this category for specific indications of this combination.
CHA: (Karen S. Vaughan) Honey fried Ma huang: The high heat in frying releases the essential oils in the joints of the Ma huang which would otherwise prevent sweating. (Smashing the joints and allowing the oils to escape would have a similar effect, but without honey’s properties.) Honey frying makes Ma huang less warming (which may seem counterintuitive) because the oils are freed. (The Shang Han Lun suggests using node-free Ma huang to promote sweating.)
K&R: Sympathomimetic, diaphoretic, vasoconstrictor, bronchodilator, adrenal medulla stimulant, volumetric diuretic.
Wood, fire, metal, and water deficiency, water excess.
Also for cardiac disorders – hypotension, bradycardia.
FDA: Contraindicated in heart disease, hypertension, thyroid disease, diabetes mellitus, difficult urination with enlarged prostate, or with antidepressants
Yoga: Somalata: K-; P+; V+ (in excess)
• Powerful Kapha reducer; lymph cleanser.
• Rajasic – can overstimulate the adrenals and burn out the nerves.
IBIS: Affinities: respiratory tract, urinary tract.
• Actions: Sympathomimetic, Bronchodilator, Decongestant, Central stimulant, Hypertensive, Diuretic, Sudorific, Anti-rheumatic.
• [Western] dosage: Tincture : (1:4) 2.5 ml T.I.D.; Decoction of Dried herb : 600 mg – 1500 mg per cup, 3 cups per day; Maximum Recommended Doses: UK: (Schedule III restricted): 600 mg herb single dose. USA: (FDA recommended) 8 mg single dose, 24 mg total daily as ephedrine alkaloid. Commission E: 15-30 mg single dose as ephedra alkaloid up to max. 300 mg daily as ephedrine alkaloid. Children – Not recommended under 13 years. 2 mg alkaloid /Kg body weight maximum dose.
• Internal: Asthma, hay fever, urticaria, hives, emphysema, nocturnal eneuresis, narcolepsy, febrifuge, rheumatism, myasthenia gravis, edema, rheumatic conditions.
• External: Allergic skin irritations, insect bites and stings.
• Specific Indications: Allergic rhinitis, congestion due to sinusitis, coryza or asthma.
Pharmacology:
• Ephedra is indirectly sympathomimetic, causing epinephrine release and thus non specific adrenergic receptor agonism. Ephedrine is predominantly alpha adrenergic, pseudoephedrine is predominantly beta adrenergic (Mills, 1991). Ephedrine is well absorbed by the oral route, crosses the blood brain barrier easily, and has a half life much longer than epinephrine being resistant to MAO and COMT degradation; excretion is urinary. The whole herb is not identical to isolated ephedrine because of the pharmacodynamics of pseudoephedrine and other components; in addition there are pharmacokinetic differences between the whole herb and isolated ephedrine (Mills, 1991; White, 1997; Gurley, 1998).
• Alpha and beta adrenomimetic effects: peripheral vasoconstriction, skeletal muscle vasodilation, positive inotropism, potentially hypertensive, sudorific, tachycardic, bronchodilator, mydriatic, urogenital tract stimulant and relaxant, decreases visceral muscle motility, increases viceral sphincter tone lipolytic, thermogenetic, hyperglycemic, diuretic.
• Central stimulation: Increases arousal and wakefulness.
• Motor end plate actions: Ephedrine modulates skeletal muscle motor end plate activity in rat models of myasthenia gravis (Sieb, 1993., Molenaar, 1993)
• Complement inhibition: Aqueous extracts of Ephedra inhibit complement activation at C2 and C9 (Ling, 1995).
• Inhibition of 3’5’cAMP Phosphodiesterase: Whole Ephedra extracts inhibit PDE in vitro, but isolated ephedrine did not inhibit PDE. (Nikaido, 1990, 1992).
• Reports of Ephedra whole herb toxicity in therapeutic dose ranges are absent from the medical literature. Numerous references to ephedrine (isolated alkaloid) toxicity exist. Ma Huang OTC supplements are often cited in toxicity reports without analysis of dose or alkaloid content. Ephedra is not used as an isolated herb or supplement by clinical herbalists of Western or Traditional Chinese schools, but is always used in combination with other herbs.
• Excessive consumption of ephedrine causes typical side effects of sympathetic hyperstimulation including headaches, nausea, dizziness, vomiting, palpitations, tachycardia, insomnia, tremor, anxiety. These effects are less noticable in consumption of the whole herb, and it has been suggested that the other constituents may modify the effects of the ephedrine alkaloids (Mills, 1991) .
• Nephrolithiasis has recently been associated with both ephedrine and Ma Huang usage (Powell,1998) .
• Contraindicated in hypertension due to vasoconstrictive and inotropic actions. Hypertensive effects of ephedrine in whole herb modulated by pseudoephedrine beta adrenergic effects causing muscle bed vasodilation.
• Contraindicated in hyperthyroidism: due to sympathetic induced increase in metabolic rate.
• Contraindicated in anxiety states: due to central stimulatory effects.
• Contraindicated in pregnancy: due to uterine stimulatory action of ephedrine and potential mutagenicity of byproducts.
• Contraindicated in Benign Prostatic Hypertrophy: due to net adrenergic effects on bladder causing urinary retention.
Drug interactions:
• Sympathomimetic effects could interact with MAOI therapy to cause potentially harmful elevation of catecholamine levels.
• Increased norepinephrine levels may reduce effectiveness of beta-blocker therapy.
• Ephedrine containing preparations are banned by Olympic and other sporting authorities.
Notes:
• Related Species: E. sinica is the principal herb of commerce; the related species E. equisitina, E. intermedia, E. distachya, E. geradiana all contain ephedra alkaloids, in varying distribution profiles (Zhang,1989). Several species of Ephedra are native to the South Western USA, including E. nevadensis, E. viridis. These species, commonly known as Mormon Tea or Mexican Tea have either insignificant traces or no detectable alkaloids (Moore, 1993).
• Traditional Chinese Medicinal Uses: Ma Huang has been used for over 5000 years in China. Ma Huang is never given alone in Chinese medicine, but always used in formulae combined with other herbs that modulate its stimulant effects without altering its actions on the lungs and kidneys. The crude herb may also be treated before use (by boiling in water or cooking with honey) to change its characteristics. Its principal uses in TCM are to disperse external wind, and aid movement of Lung qi. It is also taken for chills, fevers and coughs, and in combination with Rehemannia glutinosa as a kidney yin deficiency tonic. In Chinese medicine, the root is also used – its therapeutic effects being almost opposite to the stem e.g. hypotensive as opposed to hypertensive (Hikono,1983).
• Ephedra and its alkaloids have gained widespread popularity among the sports and body-building communities for weight reduction. The combination of ephedrine with caffeine (E.C.), and of both with aspirin (E.C.A.) is used by body builders in combination with caloric restriction to “cut” fat. This practice and popular OTC “weight loss” and “natural speed” products, based either on Ephedra herb or more usually on isolated ephedrine alkaloids have attracted considerable bad press in recent years. The FDA responded by issuing ultra-conservative dosage guidelines for Ephedra herbal products, expressed in terms of total ephedrine alkaloid maximum recommended doses. (Since then, this herb and its derivatives have been essentially banned, due to their use in the manufacture of crystal methamphetamine. Even pseudoephedrine products are now controlled.) The retail and MLM market is still replete with products purporting to be legal or natural speed and “natural” weight loss agents that contain variable amounts of Ephedra alkaloids or synthetic ephedrine and which will likely continue to be subject to consumer abuse and potential adverse reactions.

Dose: 3-9g

Nature: acrid, bitter, warm

Enters: Bladder, Kidney

Actions: Releases the exterior and dispersing cold; eliminates wind; powerfully eliminates (external) dampness; unblocks obstruction to alleviate pain; guides to the Taiyang and Du Mai.

Indications:
• Exterior obstruction (especially with dampness) causing pain, aversion to cold, fever, aches over the body and head, general feeling of heaviness, sleepiness, headache at the vertex or occiput.
• Wind-cold-damp: soreness and pain (Bi) over the limbs (especially upper limbs), shoulders, back.
• Reaches deeper than Jing jie and Fang feng: penetrates to bones and tendons.
• Compared to Du huo, Qiang huo is used more for the upper body while Du huo is used more for the lower body.
• Warm, dry, ascending, dispersing nature.
DY: Powerful in action; tropism: the upper part of the body, occiput, nape of the neck, shoulders, upper limbs, and Taiyang.
• Qiang huo has a more powerful action than Du huo. Its nature is upbearing, draining, and vigorous. The ancients said that Qiang huo has a “masculine dispersing Qi.”
• With Du huo to dispel wind, cold, dampness, and treat Bi over the whole body. For indications such as:
– 1. Moving rheumatic pains all over the body. (Juan Bi Tang)
– 2. Common cold with fever, back pain, and joint pain due to wind, cold, and dampness. (Qiang Huo Sheng Shi Tang)
– 3. Joint running wind due to wind, cold, and dampness penetrating the channels and network vessels. Li jie feng or joint running wind refers to acute arthralgia which is severe and movable with loss of joint mobility, swelling, and intense joint pain which is worse at night. This affection can transform itself into heat and then cause redness, pain, swelling, and heat.

Dose: 6-15g

Nature: acrid, slightly warm

Enters: Lung, Spleen, Stomach

Actions: Releases exterior syndromes by promoting sweats; stops vomiting by warming the middle Jiao; stops coughing by warming the Lungs; eliminates or reduces toxicity from crabs, fish, shrimp, and some herbs; adjusts Ying and Wei Qi.

Indications:
• Cold in the stomach: vomiting.
• Wind-cold: fever, aversion to cold, headache, nasal congestion.
• Wind-cold or chronic Lung phlegm disorder: cough.
• Cook with brown sugar for mild wind-cold in children.
• Good for motion sickness, helps the nausea of chemotherapy.
• Beneficial in acute bacillary dysentery.
• Weaker than Zi su ye at releasing the exterior/promoting sweating.
• This herb is mainly used to assist.
• Topical: slices over affected testicle in acute orchitis (when no lesions).
• Spasms, sprains, pain: apply ginger tea
• Raises blood pressure (an average of 11.2/14 in adults in one study).
• Ayurvedic uses: see dry ginger – Gan jiang.
• The skin of the ginger rhizome – Sheng jiang pi – additionally can promote urination and reduce edema.
• Anti-emetic effect: there are many studies, most of which find that ginger, in doses ranging from 3-20 grams per day, alleviates nausea. Much of the research has focused specifically on nausea induced by chemotherapy, with some studies looking at motion sickness and morning sickness. While I have included this comment under “fresh ginger,” many studies used dry ginger in capsules.
• Anti-inflammatory: ginger contains anti-inflammatory compounds, particularly gingerols, which have been shown in studies to mildly reduce the pain of osteoarthritis. Gingerols don’t appear to be especially potent, especially compared to pharmaceutical anti-inflammatories, but may be more effective in synergy with other anti-inflammatory herbs.
• Gingerols have demonstrated anti-cancer properties against many different cancers, though research has been mainly in vitro, and we’re not yet at a practical application of ginger for cancer.
• Ginger may produce side effects in some people, and especially at higher doses: heartburn, dizziness, diarrhea, headache, and possibly even nausea.
K&R: (fresh and/or dry – not indicated) Eupeptic, carminative, febrifuge, stimulant, antiphlogistic, antiprostaglandin, sudorific, stimulates circulation and sympathetic nervous system, increases salivary and gastric secretions, strengthens peristalsis of stomach and intestines, accelerates transport through alimentary canal and has general calming effect, stimulates appetite, slight detoxifying effect, anti-ulcerative, especially for ulcers from excess HCl.
• Metal, water, and earth deficiency.
• Metal: respiratory infection, bronchitis, flu, bronchorrhea, pulmonary congestion, fever.
• Earth: anorexia, glairy diarrhea, immune deficiency, leukopenia.
• Water: impotence, UTI, glomerulonephritis.
• Also for hiccups, abdominal pain, diarrhea, gas, amenorrhea from insufficient circulation.
• For motion sickness: can work as well as or better than Dramamine.
DY: “Sheng jiang” refers not simply to raw ginger – it must be fresh and young.
• With Ban xia to transform phlegm, downbear counterflow, harmonize the stomach, and stop vomiting. For such indications as:
– 1. Nausea, vomiting with not thirst and slimy tongue fur due to phlegm-dampness stagnating in the middle burner. (Xiao Ban Xia Tang) Ginger-processed Ban xia should be used.
– 2. Enduring cough with white, watery, and profuse phlegm. Use lime-processed Ban xia.
• Sheng jiang is renowned for effectively treating vomiting. It can be used for all types of vomiting, even in the case of stomach heat, if it is combined with other medicinals related to the nature of the imbalance. It is traditionally said, “Sheng jiang is a sagelike medicinal for vomiting.”
• Use it with bitter medicinals when these would otherwise cause nausea. In these cases, Sheng jiang is directly integrated into the decoction or chewed immediately after swallowing the liquid. This often is sufficient to calm the most stubborn patient.
• With Da zao to move the defensive Qi, nourish the constructive Qi, harmonize the constructive and defensive, fortify the spleen, and harmonize the middle burner. For indications such as:
– 1. Perspiration, fear of wind, and fever due to disharmony between the constructive and defensive Qi. (Gui Zhi Tang)
– 2. Fatigue, lack of strength, abdominal pain, and lack of appetite due to disharmony between the constructive and defensive Qi. (Xiao Jian Zhong Tang)
– This pair helps insure the proper assimilation of the active principles of other medicinal substances. These are the two main harmonizing herbs in Chinese medicine.

Dose: 3-9g

Nature: acrid, slightly warm

Enters: Lung, Stomach

Actions: Releases exterior syndromes by promoting sweating (strong); expels summer-heat; adjusts function of the stomach to resolve dampness; promotes urination, relieves edema; reduces swelling.

Indications:
• Wind-cold or summer-heat with dampness: fever, aversion to cold, headache, abdominal pain, vomiting, lack of sweats, chills, body aches, diarrhea.
• Edema with scanty urination, urinary difficulty, especially when associated with an exterior pattern.
• Simultaneously expels summer-heat from the exterior and transforms turbid dampness in the interior.
• Mainly used in summer.
• For exterior disorders, cook only a short time.
• For edema, cook a long time into a concentrated decoction.
• So effective for summer-heat with dampness that it is sometimes called the “summertime Ma huang.”
• May cause vomiting if taken hot. Take at a room temperature or add Huang qin or Huang lian to reduce this effect.

Dose: 3-9g

Nature: acrid, warm

Enters: Lung, Stomach

Actions: Disperses wind-cold; opens the nose.

Indications:
• Any nasal or sinus conditions: nasal congestion or obstruction, nasal discharge, loss of sense of smell, related headache.
• Wind-cold or wind-heat: key herb (first choice) for sinusitis and rhinitis.
• Stronger than Cang er zi to open the nose.
• Antifungal.
• The hairs can irritate the throat (use a tea bag or grind to a powder).
• This herb has also been prepared as an ointment and an aerosol for local application: when applied to nasal mucosa, Xin yi hua causes a reduction in secretions.
DY: Often combined with Cang er zi. See Cang er zi in this category for the properties and indications of this combination.

Dose: 3-9g

Nature: acrid, warm

Enters: Lung, Spleen

Actions: Releases exterior syndromes by dispersing cold (mild); eases distention of the chest and epigastrium; promotes Qi circulation, expands the chest; alleviates seafood poisoning; calms a restless fetus, alleviates morning sickness.

Indications:

• Wind-cold: fever, aversion to cold, headache, nasal congestion, cough, chest discomfort or stifling sensation in the chest.
• Spleen and stomach Qi stagnation: distended chest, vomiting, morning sickness, poor appetite, nausea, bloating.
• Seafood poisoning: abdominal pain, vomiting, diarrhea.
• Morning sickness: best to use the stem (Zi su geng) rather than the leaf.
• Its ability to release the exterior is mild compared to Ma huang and Gui zhi, but it is stronger than Jing jie and Fang feng at dispersing cold.
• Excellent for treating turbidity.
• Short cook.
Hsu: Extract prolongs duration of sleep.
HF: A San Du, scattering toxin medicinal, typically found in Gu Zheng (Gu parasites) formulas (key herb in Su He Tang).
Li Dong Yuan: Upbears Yang Qi.
DY: Zi su (the leaves [Zi su ye] and stems [Zi su geng] of Perilla) can be combined with Huang lian to clear stomach heat, dry dampness, rectify the Qi, and stop vomiting. For the following indications, ginger mix-fried Huang lian should be used:
– 1. Vomiting and nausea due to stomach heat or damp-heat in the middle burner along with Qi stagnation in the middle burner.
– 2. Vomiting during pregnancy due to heat or damp-heat along with Qi stagnation in the middle burner.
• Zi su geng (the stem) moves the Qi, opens the center, rectifies the Qi, quiets the fetus, and particularly treats vomiting due to pregnancy, threatened miscarriage, and epigastric or abdominal distention.
• Zi su ye and Zi su geng are often combined and added to formulas to treat plum pit sensation or wind-cold attacks with food stagnation or vomiting.
BF: The contemporary standard description of Perilla is that it is acrid and warm, it enters the Lungs and spleen, and its functions are to effuse the exterior, scatter cold, rectify the Qi, and harmonize the constructive. It treats wind-cold flu, aversion to cold, emission of heat, cough, qi panting, chest and abdominal distention and fullness, and restless stirring of the fetus.
While all the sources quoted in the Zhong Yao Da Ci Dian (Large Dictionary of Chinese Medicinals) say that this medicinal is acrid and warm, the Ben Cao Yan Yi (Amplified Meaning Materia Medica) says that Perilla is only slightly acrid and also sweet. The Ben Cao Jing Shu (Oversights in the Materia Medica Classic) says its enters the hand Shaoyin and Taiyin and the foot Yangming, while the Ben Cao Jing Jie (Explaining the Materia Medica Classic) says it enters the foot Jueyin and hand Taiyin. In terms of functions and indications, the Ri Hua Zi Ben Cao (Ri Hua-zi’s Materia Medica) says it supplements the center and boosts the Qi as well as frees the flow of the large and small intestines. The Ben Cao Tu Jing (Illustrated Materia Medica Classic) says it frees the flow of the heart channel and boosts the spleen and stomach. These other historical opinions suggest there is more to Perilla than its just resolving the exterior and downbearing upwardly counterflowing Lung and stomach Qi.
Restless fetal stirring refers to lower abdominal pain with leakage of blood from the vaginal meatus and low back pain during pregnancy. These are symptoms of threatened miscarriage. Most threatened and/or unstoppable miscarriages in my practice are due to insufficient production of progesterone. This usually goes hand in hand with a luteal phase deficiency and is, in my opinion, commonly due to autoimmune ovaritis. Such luteal phase deficiencies and progesterone insufficiencies in 35-50 year old Western women are overwhelmingly accompanied by signs and symptoms of spleen Qi-kidney Yang vacuity complicated by liver depression and possible damp heat, depressive heat, and/or blood stasis, and it is very interesting to me that Perilla is accepted as an empirically effective Chinese medicinal for quieting the fetus – something one would not expect from an exterior-resolving herb.
The Ben Cao Tong Xuan (The Mystery-penetrating Materia Medica) says that Perilla may discharge (drain) a person’s true Qi if administered for a long period of time. Resolving the exterior means to promote sweating and sweating always results in a loss of true Yin and Yang Qi.
However, when combined with Mume, this medicinal’s negative effects of discharging and draining are counterbalanced. As an exterior-resolving medicinal, Perilla is contraindicated in Yin vacuity patterns for fear of further damaging Yin fluids, but Mume engenders fluids. Likewise, over-effusing and out-thrusting can damage the Yang qi, but Mume’s astringing and securing of the Lung Qi prevents this.

Dose: 3-9g