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Ma Huang Xi Xin Fu Zi Tang麻黄细辛附子汤

Ephedra, Asarum and Prepared Aconite Decoction

Releasing the Exterior 解表剂Release the Exterior with Tonification 扶正解表

Ingredients3 herbs

麻Ma Huang麻黄去节6g君 ChiefOpens the surface to release the lodged cold
附Zhi Fu Zi附子炮，去皮，破八片9g臣 DeputyRestores yang at the root so the sweat does not exhaust it
细Xi Xin细辛3g佐 AssistantRuns between exterior and interior, joining Ma Huang's release to Fu Zi's warming

Indications

Warms yang and releases the exteriorScatters cold that has penetrated to the shaoyinRestores the surface without exhausting yang

Exterior cold in a yang-deficient constitution: the fever is slight and the chills are out of all proportion to it, and the pulse sinks rather than floating as an exterior pattern normally would.

Clinical Manifestations

  • Severe chills with only mild fever in a cold-natured patient
  • Overwhelming sleepiness during a cold
  • Sudden loss of voice from cold
  • Cold-triggered pain in a yang-deficient patient
TonguePale with a white moist coating
PulseDeep and faint

Health Categories

Respiratory HealthHeart & CirculationEnergy & FatigueCold & Flu Relief

Modern Applications

Common cold in the elderlyHypothyroid-type fatigueSick sinus bradycardiaLaryngitis with hoarsenessCold-induced pain

Common adjustments

  • Yang deficiency severe with cold limbs — increase Fu Zi, decocting it long, and reduce Ma Huang 麻黄
  • Exterior mild, only a gentle sweat wanted — use Ma Huang Fu Zi Gan Cao Tang instead
  • Cough and thin phlegm with the pattern — add Gan Jiang 干姜 and Wu Wei Zi 五味子

Contraindications

Not for a heat pattern of any kind, and not for yin deficiency with heat signs. Fu Zi is toxic when inadequately prepared or under-decocted: only processed Fu Zi is used, it is decocted first for at least 30–60 minutes, and any numbness of the mouth or tongue, palpitations or nausea means stopping at once and seeking care. The dose belongs entirely to the prescriber.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Contraindicated in pregnancy. It combines Ma Huang with Fu Zi and Xi Xin — the three herbs in this chapter most restricted in pregnancy — and there is no adjustment that makes the combination appropriate.

Related Formulas

References

Source Shang Han Lun 《伤寒论》 · Eastern Han

「少阴病，始得之，反发热，脉沉者，麻黄细辛附子汤主之。」
— 《伤寒论》(classical source, public domain)
  1. Classical source (public domain), cited in the source-quote section.
    2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
    3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.