Formulas · Release the Exterior 解表 · Uihak Gangmok (醫學綱目)

Ephedra and Scutellaria Decoction

Mahwanghwanggeum-tang

한글 마황황금탕 · Pinyin Ma Huang Huang Qin Tang

麻黃黃芩湯

The transcription writes 臨卧服; printed here with the corpus glyph 臥. 桂心 is registered to yukgye.

Composition 構成

Mahwang Ma Huang
麻黃 마황 · Ephedra

12 g
Chief 君
Hwanggeum Huang Qin
黃芩 황금 · Scutellaria

8 g
Deputy 臣
Doin Tao Ren
桃仁 도인 · Peach Kernel

—
Deputy 臣

fifteen kernels
Yukgye Rou Gui
肉桂 육계 · Cinnamon Bark

4 g
Assistant 佐
Gamcho Gan Cao
甘草 감초 · Licorice

6 g
Envoy 使

Total 30 g per packet (첩) · representative dosage — verify against source texts. Excludes 1 ingredient measured by count or used as a vehicle, shown as —.

Received this formula from your practitioner? Amounts shown here are classical reference values — granule and prepared products differ. Always follow your prescribed dosage and directions.

Actions 效能

Disperses wind cold lodged within the Blood
Scatters Blood and relaxes the Liver with peach kernel
Draws a night-onset malaria back out to the yang

Indications 主治

Pattern-based

Malaria with onset at night from Blood vacuity
Evil gone deep into the Blood and the yin channels
Liver dryness from Blood having taken an evil

Biomedical correlates

Malaria with nocturnal paroxysms
Relapsing fever with a fixed evening onset

Source text 原文

Donguibogam 東醫寶鑑

治夜發瘧. 麻黃三錢, 黃芩二錢, 甘草一錢半, 桂心一錢, 桃仁十五枚. 右剉, 作一貼, 水煎, 臨臥服. ○桃仁味苦甘辛, 肝者血之海, 血受邪則肝氣燥. 經所謂肝苦急, 急食甘以緩之. 桃仁散血緩肝, 謂邪氣深遠而入血, 故夜發. 乃陰經有邪, 此麻黃黃芩湯乃發散血中風寒之劑也. 《綱目》

Translation

Treats malaria that comes on at night. Ephedra, 3 don; scutellaria, 2 don; licorice, 1 don 5 fun; cinnamon heartwood, 1 don; fifteen peach kernels. Cut up, make one packet, decoct in water, and take at bedtime. ○ Peach kernel is bitter, sweet and acrid in flavour. The Liver is the sea of the Blood, and when the Blood takes an evil the Liver qi turns dry. The Classic says that the Liver suffers from urgency, and that one should urgently eat what is sweet in order to relax it. Peach kernel scatters the Blood and relaxes the Liver. The meaning is that the evil qi has gone deep and far and entered the Blood, and therefore the attack comes at night; it is an evil lodged in the yin channels, and this Mahwanghwanggeum-tang is a formula that disperses wind cold out from within the Blood. — Gangmok 綱目 (Donguibogam · Haehak)

Clinical commentary 臨床

The chapter divides malaria by the hour of onset — qi vacuity brings it by day, Blood vacuity by night — and this is the first of the two night prescriptions. The commentary attached to the leaf is unusually explicit about the reasoning. The evil has gone deep enough to enter the Blood; the Liver, being the sea of Blood, dries when the Blood takes an evil; and the Classic's line that the Liver suffers from urgency and is relaxed by sweetness is quoted to justify the peach kernel. Fifteen peach kernels and a single don of cinnamon heartwood against 3 don of ephedra make this a strongly opening prescription, and the leaf names it exactly: a formula that disperses wind cold out from within the Blood. The bedtime dose is the practical half of the same thought — the medicine is timed to be working at the hour the attack is expected. Ephedra at 3 don is a large dose by any modern reckoning; ephedrine is a cardiovascular stimulant and the herb is restricted or prohibited in many jurisdictions. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.