TCM Prescriptions for Relieving Exterior Syndromes

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Yinqiao San, Powder of Lonicera and Forsythis
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Source: Wenbing Tiaobian (Detailed Analysis of Seasonal Febrile Diseases).

Ingredients:
No.1  Jinyinhua (Flos Lonicerae) 30 g;
No.2  Lianqiao (Fructus Forsythiae) 30 g;
No.3  Jiegeng (Radix Platycodi) 18 g;
No.4  Bohe (Herba Menthae) 18 g;
No.5  Niubangzi (Fructus Arctii) 18 g;
No.6  Zhuye (Herba Lophatheri) 12 g;
No.7  Jingjiesui (Spica Schizonepetae) 12 g;
No.8  Dandouchi (Semen Sojae Praeparatum) 15 g;
No.9  Shenggancao (Radix Glycgrrhizae Recens) 15 g.

Administration:
These ingredients are ground into powder, each time 18 g is decocted with Xianlugen (Rhizoma Phragmitis) decoction for oral administration.
  
Actions:
Relieving exogenous pathogenic factors with drugs pungent in flavor and cool in property, clearing away heat and eliminating toxin.

Clinical Application:
This recipe is indicated for seasonal febrile diseases in the early stage and severe syndrome of exterior heat. The usual symptoms are fever without perspiration, or hindered perspiration, slight aversion to wind-cold, headache, thirst, cough, sore throat, red tip of the tongue, thin whitish or yellowish fur, superficial and rapid pulse. It is applicable to flu,acute tonsillitis, measles of early stage, epidemic encephalitis B, epidemic cerebrospinal meningitis, and parotitis, etc. which belong to the exterior syndrome of wind-heat and are marked by fever, sore throat, and no perspiration.

In case of excessive heat marked by high fever with thirst, add Shigao (Gypsum Fibrosum), Huangqin (Radix Scutellariae) and Daqingye (Folium Isatidis ) to clear away heat and purge fire. In the absence of perspiration but marked aching body, add Chantui (Periostracum Cicadae) and Jiangcan (Bombyx Batryticatus ) to enhance the effect of relieving the exterior syndrome by expelling wind.

Elucidation:
Affection by wind-heat leads to stagnation of defensive qi and failure of the lung in purifying and descending function, for which the method of relieving exterior syndrome by expelling wind, clearing away heat and toxin should be adopted. Ingredients No. 1 and No. 2 in larger amount act as monarch drug, capable of clearing away heat and eliminating toxin as well as expelling exterior pathogenic factors. Ingredients No. 4 and No. 5 pungent in flavor and cool in property, No. 7 and No. 8 pungent in flavor and warm in property, act together as minister drug, enhancing the effect of expelling pathogenic factors, and involving no impairment of the body fluid.

Ingredient No. 6 and Lugen (Rhizoma Phragmitis) can clear away heat and promote the production of body fluid, and No. 3 disperses the lung to relieve cough, the three constituting adjuvant drug. The last ingredient acts as guiding drug, capable of clearing away heat and toxin, mediating drug property, and being good at soothing the throat together with No. 3.

Both Sangju Yin and Yinqiao San are commonly used prescriptions in treating exterior syndrome due to wind-heat, and both have the ingredients Lianqiao (Fructus Forsythiae), Jiegeng (Radix Platycodi), Bohe ( Herba Menthae), Lugen (Rhizoma Phragmitis ) and Gancao (Radix Glycyrrhizae). The former has a better effect in terms of dispersing the lung to relieve cough because it also includes Sangye (Folium Mori), Juhua (Flos Chrysanthemi), Xingren (Semen Armeniacae Amarum).

While the latter shows a stronger effect in terms of clearing away heat and relieving the exterior syndrome owing to the ingredients Jinyinhua (Flos Lonicerae), Jingjie (Spica Schizonepetae), Dandouchi (Semen Sojae Praeparatum), Niubangzi (Fructus Arctii), Zhuye (Herba Lophatheri). Thus they can be selected in the light of clinical needs.
     
Cautions:
It is not applicable to exterior syndrome due to wind-heat with aversion to cold, absence of perspiration, but a mild fever without thirst.


 Key words:  feverheadachethirstcoughsore throattonsillitis

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