English: Ephedra

Chinese: 麻黄

Parts used: Dried herbaceous stems

TCM category: Warm/Acrid herbs that release the Exterior

TCM nature: Warm

TCM taste(s): BitterPungent

Organ affinity: Bladder Lung

Scientific name: Ephedra sinica

Use of Ma Huang (ephedra) in TCM

Please note that you should never self-prescribe TCM ingredients. A TCM ingredient is almost never eaten on its own but as part of a formula containing several ingredients that act together. Please consult a professional TCM practitioner, they will be best able to guide you.

Preparation: Remove smaller stems, residual roots and impurities, cut into sections and dry.

Dosage: 3 - 9 grams

Main actions according to TCM*: Releases the surface through sweating. Promotes the circulation of Lung Qi and stop wheezing. Promotes urination.

Primary conditions or symptoms for which Ma Huang may be prescribed by TCM doctors*: Common cold Fever Headache Acute nephritis Asthma Edema

Contraindications*: Not for those with high blood pressure, risks of cardiovascular diseases or those with insomnia or spontaneous sweating. Use of this herb for extended periods of time or in large doses is not recommended.

Common TCM formulas in which Ma Huang is used*

Ding Chuan Tang

Source date: 1550 AD

Number of ingredients: 9 herbs

Formula key actions: Clears Lung Heat. Expectorant for asthma.

Conditions targeted*: Chronic bronchitisAsthma and others

Ma Huang is a king ingredient in Ding Chuan Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

In Ding Chuan Tang, Ma Huang unblocks and redirects the Lung Qi, stops wheezing, and releases the Exterior.

Read more about Ding Chuan Tang

Da Qing Long Tang

Source date: 220 AD

Number of ingredients: 7 herbs

Formula key actions: Promotes sweating. Releases the Exterior. Clears Interior Heat.

Conditions targeted*: Upper respiratory tract infectionsInfluenza and others

Ma Huang is a king ingredient in Da Qing Long Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

In Da Qing Long Tang, Ma Huang is a particularly strong diaphoretic that also disseminates the Lung Qi and treats wheezing.

Read more about Da Qing Long Tang

Xiao Qing Long Tang

Source date: 220 AD

Number of ingredients: 8 herbs

Formula key actions: Releases the Exterior. Transforms Phlegm-Fluids. Warms the Lungs. Directs Rebellious Qi downward.

Conditions targeted*: Upper respiratory tract infectionsBronchitis and others

Ma Huang is a king ingredient in Xiao Qing Long Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

In Xiao Qing Long Tang, Ma Huang releases the Exterior, arrests wheezing, and promotes urination.

Read more about Xiao Qing Long Tang

Ma Huang Tang

Source date: 220 AD

Number of ingredients: 4 herbs

Formula key actions: Releases exterior cold. Treats wheezing.

Conditions targeted*: InfluenzaRheumatic fever and others

Ma Huang is a king ingredient in Ma Huang Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

In Ma Huang Tang, Ma Huang is warm and acrid. It is an especially strong diaphoretic which also disperses Lung Qi and treating wheezing.

Read more about Ma Huang Tang

Ma Xing Shi Gan Tang

Source date: 220 AD

Number of ingredients: 4 herbs

Formula key actions: Invigorates Lung Qi. Clears Heat. Calms wheezing by directing rebellious Qi downward.

Ma Huang is a king ingredient in Ma Xing Shi Gan Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

In Ma Xing Shi Gan Tang, Ma Huang invigorates Lung Qi so as to ease wheezing. Due to its warm nature, it must be balanced by the cold herb Gypsum, which is also a key herb of the formula. 

These two ingredients' dosage must be adapted based on specific patient's condition. For example, when the Lung Heat is severe with profuse sweating, Ephedra's dosage should be reduced, while Gypsum's should be increased. If Pernicious Evils haven't left the Exterior completely, Ephedra's dosage should be increased while the Gypsum's should be decrease. 

Read more about Ma Xing Shi Gan Tang

Wu Tou Tang

Source date: 220 AD

Number of ingredients: 6 herbs

Formula key actions: Warms the channels and remove obstruaction. Disperse Cold and Dampness. Warms the joints. Relieve joints pain.

Conditions targeted*: Joint painJoint stiffness and others

Ma Huang is a king ingredient in Wu Tou Tang. Like the name indicates, it means it has more power than other ingredients in the formula.

In Wu Tou Tang, Ma Huang is warm and slightly bitter. It enters the Lungs and Bladder channels and invigorate Qi there so as to remove Stagnation in the Lungs. It can disperse Wind Cold through the Exterior

Read more about Wu Tou Tang

Gui Zhi Shao Yao Zhi Mu Tang

Source date: 220 AD

Number of ingredients: 9 herbs

Formula key actions: Clears Heat and inflammations. Unblocks the flow of Yang Qi and promotes movement (in areas with painful obstruction). Clears Wind and Damp. Relieves pain.

Conditions targeted*: Rheumatoid arthritisConnective tissue disorders and others

Ma Huang is a deputy ingredient in Gui Zhi Shao Yao Zhi Mu Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

In Gui Zhi Shao Yao Zhi Mu Tang, Ma Huang strengthens the warming effect of Cinnamon twigs (the key herb here) and relieves relatively superficial swellings.

Read more about Gui Zhi Shao Yao Zhi Mu Tang

Ge Gen Tang

Source date: 220 AD

Number of ingredients: 7 herbs

Formula key actions: Releases the Exterior and muscle layer. Forms Body Fluids.

Conditions targeted*: Common coldCervical spine disease and others

Ma Huang is a deputy ingredient in Ge Gen Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

In Ge Gen Tang, Ma Huang encourages sweating. It is very powerful in releasing excessive Cold from the Exterior. 

Read more about Ge Gen Tang

Key TCM concepts behind Ma Huang's properties

In Traditional Chinese Medicine (TCM), Ma Huang belongs to the 'Warm/Acrid herbs that release the Exterior' category. Herbs that release the Exterior aim to to treat the early stages of diseases that affect the upper respiratory tract, the eyes, the ears, the nose, the throat or the skin. TCM believes that External diseases such as colds or allergies can only invade the body if the External environment overwhelms our Wei Qi (the TCM version of the immune system). In order to counteract this invasion Warm/Acrid herbs aim to induce sweating by increasing the flow of sweat to our capillary pores. The belief is that this will expel the disease from the body and stop it from invading further.

As suggested by its category Ma Huang is Warm in nature. This means that Ma Huang tends to help people who have too much 'Cold' in their body, although with less effect than a plant that would be Hot in nature. Balance between Yin and Yang is a key health concept in TCM. Those who have too much Cold in their body are said to either have a Yin Excess (because Yin is Cold in nature) or a Yang Deficiency (Yang is Hot in Nature). Depending on your condition Ma Huang can help restore a harmonious balance between Yin and Yang.

Ma Huang also tastes Bitter and Pungent. The so-called 'Five Phases' theory in Chinese Medicine states that the taste of TCM ingredients is a key determinant of their action in the body. Bitter ingredients like Ma Huang tends to have a cleansing action on the body by clearing Heat, drying Dampness and promoting elimination via urination or bowel movements. On the other hand Pungent ingredients tend to promote the circulations of Qi and Body Fluids. That's why for instance someone tends to sweat a lot when they eat spicy/pungent food.

The tastes of ingredients in TCM also determine what Organs and Meridians they target. As such Ma Huang is thought to target the Bladder and the Lung. In TCM the impure water collected by the Kidneys that cannot be used by the body is sent to the Bladder for storage and excretion as urine. In addition to performing respiration, the Lungs are thought in TCM to be a key part of the production chain for Qi and the Body Fluids that nourish the body.

Research on Ma Huang

A dietary supplement containing a low potency ephedra/caffeine mixture appeared safe and effective in causing loss of weight and body fat, and improving several metabolic parameters.1

Ingestion of ephedra dry extract acutely and chronically affects autonomic nervous activity by tilting the sympathovagal balance toward increased sympathetic activity.2

Sources:

1. Hackman RM, Havel PJ, Schwartz HJ, Rutledge JC, Watnik MR, Noceti EM, Stohs SJ, Stern JS, Keen CL. (2006). Multinutrient supplement containing ephedra and caffeine causes weight loss and improves metabolic risk factors in obese women: a randomized controlled trial. Int J Obes (Lond). 30(10):1545-56.

2. Chen WL, Tsai TH, Yang CC, Kuo TB. (2010). Effects of ephedra on autonomic nervous modulation in healthy young adults. J Ethnopharmacol. , 130(3):563-8. doi: 10.1016/j.jep.2010.05.056.