【Chinese Name】 |
小青龍湯
|
【Phonetic】 |
Xiao Qing Long Tang
|
【English Name】 |
Minor Green Dragon Decoction |
【Classification】 |
Exterior-releasing formulas |
【Source】 |
《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
【Combination】 |
Ephedrae Herba (Ma Huang) 3 liang (9g), Paeoniae Radix Alba (Shao Yao) 3 liang (9g), Asari Radix et Rhizoma (Xi Xin) 3 liang (6g), Zingiberis Rhizoma (Gan Jiang) 3 liang (6g), Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao) 3 liang (6g), Cinnamomi Ramulus (Gui Zhi) 3 liang (9g), Pinelliae Rhizoma (Ban Xia) 0.5 sheng (9g), Schisandrae Chinensis Fructus (Wu Wei Zi) 0.5 sheng (6g) |
【Method】 |
Prepare Xiao Qing Long Tang as a decoction to be taken warm. Ma huang should be decocted first and the foam that collects at the top of the decoction needs to be removed before adding the other medicinals. |
【Action】 |
Releases the exterior, dissipates cold, warms the lung and dissolves rheum (fluid retention). |
【Indication】 |
This formula is indicated for the pattern of exterior cold with interior fluid retention. The symptoms are aversion to cold, fever, absence of sweating, labored breathing, cough, copious clear and thin phlegm, stuffiness in chest, dry retching, difficulty in lying back in the supine position, general body aches, edema of the face and extremities. The tongue coating is white and glossy, and the pulse is superficial. |
【Pathogenesis】 |
Xiao Qing Long Tang is indicated when an excessive fluid condition is complicated by externally contracted wind-cold. Aversion to cold, fever, absence of sweating and body aches are symptoms of an exterior excess pattern with wind-cold fettering the exterior causing obstruction of the wei yang and constraint of ying yin. When a person who has excessive fluids contracts an external pathogen, the pathological activities of the excessive fluids may be initiated. Cold thin phlegm then invades the lung and causes the lung qi to fail to diffuse and descend which leads to cough, labored breathing and copious thin sputum. Stuffiness in chest is due to fluid retention under the heart blocking the qi movement. Dry retching is caused by lodged fluid that causes ascending counterflow of the stomach qi. General edema and heaviness is due to subcutaneous water retention. And finally, a white and glossy coating and superficial pulse are clear signs of exterior cold with interior fluid retention. In this situation, dispersing external pathogens alone without dissolving fluid retention will not resolve the excessive internal fluids. On the other hand, dissolving fluid retention alone without expelling external pathogens will not release the exterior. Therefore, the correct treatment method is to simultaneously address both the internal and external by relieving the exterior and dissolving fluid retention. |
【Clarification】 |
Why does Xiao Qing Long Tang, an acrid formula, contain astringents wu wei zi and bai shao? Xiao Qing Long Tang is designed for patients with an internal excessive fluid condition who have contracted external wind-cold, triggering abnormal movement of internal fluids. Generally, acrid-warm dispersing medicinals are indicated for externally contracted wind-cold with closed pores and orifices. However, those with internal cold thin phlegm already have deficient spleen and lung. If drastic sweat-inducing therapy is used, it will damage the lung qi and yin fluids. Consequently, the way to make the best of both is to combine both dispersing and astringent medicinals to conserve qi and yin. In this formula, ma huang and gui zhi reinforce each other to induce sweat and expel pathogens. Sheng jiang, xi xin and ban xia warm the lung and transform thin phlegm. These five are all acrid-warm medicinals. To the contrary, wu wei zi astringes the lung and relieves cough while bai shao astringes yin and nourishes blood. By combining these two medicinals with the previous five medicinals that have opposite yet complementary actions, the formula induces sweating with acrid-warm medicinals and prevents qi and yin damage without retaining pathogens. Furthermore, wu wei zi and bai shao are not only used to check and balance other medicinals, they also assist the formula to relieve cough and calm labored breathing. The action of wu wei zi to relieve cough and calm labored breathing is backed by ancient herbal classical literature while bai shao has been proven to alleviate bronchial spasm by modern studies in Chinese medicine pharmacology. It is therefore obvious that these two medicinals will enhance the formula’s action to calm labored breathing. |
【Application】 |
1. Essential pattern differentiation Xiao Qing Long Tang is commonly indicated for the pattern of externally contracted wind-cold with cough and labored breathing due to internal cold thin phlegm. This clinical pattern is marked by aversion to cold, fever, absence of sweating, labored breathing, cough, copious thin phlegm, white and glossy tongue coating, and superficial pulse. 2. Modern applications This formula may be used in biomedically defined disorders such as bronchitis, bronchial asthma, pneumonia, pertussis, pulmonary heart disease, allergic rhinitis, and catarrhal ophthalmic and catarrhal tympanitis when the patient shows signs of external cold and internal fluid retention. 3. Cautions and contraindications Due to the relatively strong acrid-dispersing and warm-resolving effects of the formula, it is only indicated for those who are indeed affected by external cold interacting with internal fluids causing a disorder of the lung system. The dosage needs be determined according to the physical constitution of the patient. It is not applicable for coughs without sputum due to a yin deficiency or internal phlegm-heat pattern. |
【Additonal formulae】 |
She Gan Ma Huang Tang (Belamcanda and Ephedra Decoction, 射干麻黃湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Xiao Qing Long Tang remove gui zhi, gan jiang, bai shao, gan cao, add she gan 3 liang (9g), sheng jiang 4 liang (6g), zi wan 3 liang (6g), kuan dong hua 3 liang (6g), da zao 7 pieces (3 pieces) [Preparation and Administration] Prepare it as a decoction. Ma huang should be decocted first and the foam that collects at the top of the decoction needs to be removed before adding the other medicinals. The decoction should be taken warm. [Actions] Diffuses the lung, dispels phlegm, lowers qi, and relieves cough. [Applicable Patterns] Congested phlegm and fluids complicated with cough and labored breathing. Symptoms include: cough, breathing due to ascending counterflow qi, labored breathing, and a continuous rattling sound in the larynx caused by sputum blockage. |
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