TCM Prescriptions for Relieving Exterior Syndromes

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Xiao Qinglong Tang, Small Blue Dragon Decoction
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Decoction 
Source: Shanghan Lun (Treatise on Febrile Diseases).
 
Ingredients:    
No.1  Mahuang (Herba Ephedrae) 9 g
No.2  Shaoyao (Radix Paeoniae) 9 g
No.3  Xixin (Herba Asari) 6 g
No.4  Ganjiang (Rhizoma Zingiberis) 6 g
No.5  Zhigancao (Radix Glycyrrhizae Prozparatae) 6 g
No.6  Guizhi (Ramulus Cinnamomi) 9 g
No.7  Banxia (Rhizoma Pinelliae) 9 g
No.8  Wuweizi (Fructus Schisandrae) 6 g

Administration:
Decoct the above drugs in water for oral use.

Actions:
Relieving the pathogenic factors from the exterior and expelling cold, warming the lung to resolve retained fluid.

Clinical Application:
This recipe is indicated for external cold and interior fluid-retention, marked by aversion to cold, fever without perspiration, headache, cough and asthma with profuse thin sputum, inability to keep horizontal posture if serious, or swollen extremities, smooth whitish fur, and superficial pulse. It is applicable to acute onset of chronic bronchitis, bronchial asthma, and senile pulmonary emphysema, etc., which are marked by aversion to cold, absence of perspiration, cough with profuse sputum and are attributable to exogenous wind-cold and accumulation of cold retention in the lung.
Baishaoyao (Radix Paeoniae Alba) is now often used as ingredient No. 2. In case of not serious exterior-cold syndrome without obvious aversion to cold, sweating and headache, subtract ingredient No. 6, and replace No.1 with honey-prepared one so as to weaken the action of relieving pathogenic factors from the exterior. If complicated with thirst, subtract ingredient No. 7 and add Tianhuafen (Radix Trichosanthis) to clear away heat and promote the production of body fluid. If phlegm retention transforms into heat, manifested as dysphoria, add Shigao (Gypsum Fibrosum) to clear away heat and relieve dysphoria, forming another recipe entitled Xiao Qinglong plus Shigao Tang.
 
Elucidation:
The syndrome is the result of wind-cold attack on the exterior, accumulation of cold fluid retention in the lung, and failure of the lung-qi to descend. The treatment should focus on relieving exterior syndrome to dissipate cold as well as warming the lung and resolving fluid-retention. Ingredients No. 1 and No. 6 both act as monarch drugs, inducing diaphoresis to relieve the exterior and dispersing the lung to relieve asthma. No. 3 and No. 4 serve as minister drugs, capable of warming the lung to remove cold and helping yang remove fluid retention.

Ingredient No. 2 has the effects of nourishing blood and astringing yin, and No. 8 of astringing the lung to relieve asthma. Both prevent such pungent, warm and dry ingredients as No. 1, No. 3 and No. 4 from impairing body fluid and consuming qi, closing amidst opening, astringing amidst dispersing, and eliminating the pathogenic factors without impairment of vital-qi. Ingredient No. 7 acts as adjuvant drug, drying dampness and resolving phlegm, and No. 5 as guiding drug, replenishing qi and mediating drug properties.
 
Cautions:
This recipe is warm and dry in property, and thus not applicable to cases with cough and asthma with yellowish sputum.



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