Ephedra (Ma Huang) Cinnamon twigs (Gui Zhi) Apricot seeds (Xing Ren) Liquorice (Gan Cao)

Ma Huang Tang

Chinese: 麻黄汤

Pinyin: Má Huáng tāng

Other names: Ephedra Decoction, Ma Huang Jie Ji Tang

Number of ingredients: 4 herbs

Formula category: Formulas that clear Wind-Cold

Conditions for which it may be prescribed: AsthmaEczemaRhinitis and twenty four other conditions

  1. Releases exterior cold
  2. Treats wheezing

Contraindications: contraindicated for patients with debility and copious urination, and for... contraindicated for patients with debility and copious urination, and for patients who can easily bleed from nose. Patients with hypertension should take particular caution when taking this formula due to its adrenergic effects. Also, the formula should not be use for a long period of time. see more

Source date: 220 AD

Source book: Discussion of Cold Damage

Ma Huang Tang is a 4-ingredient Chinese Medicine formula with Ephedra (Ma Huang) as a principal ingredient.

Invented in 220 AD, it belongs to the category of formulas that clear Wind-Cold. Its main actions are: 1) releases exterior cold and 2) treats wheezing.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Ma Huang Tang is used by TCM practitioners to fight patterns like Wind-Cold invading the Lungs, Greater Yang Attack of Cold or Exterior-Cold. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as influenza, rheumatic fever or pneumonia for instance.

On this page, after a detailed description of each of the four ingredients in Ma Huang Tang, we review the patterns and conditions that Ma Huang Tang helps treat.

The four ingredients in Ma Huang Tang

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.

1. Ephedra (Ma Huang)

Part used: Dried herbaceous stems

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: BladderLung

Category: Warm/Acrid herbs that release the Exterior

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

Learn more about Ephedra (Ma Huang)

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

2. Cinnamon Twigs (Gui Zhi)

Part used: Dried young branches

Nature: Warm

Taste(s): PungentSweet

Meridian affinity: SpleenHeartLung

Category: Warm/Acrid herbs that release the Exterior

Gui Zhi releases the exterior, especially the muscle layer. It also warms and invigorates the flow in the channels. Like the key ingredient Ephedra, It is also a diaphoretic. When the two ingredients are combined, they are very effective in releasing the exterior.

Learn more about Cinnamon Twigs (Gui Zhi)

Xing Ren is an assistant ingredient in Ma Huang Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

3. Apricot Seeds (Xing Ren)

Part used: Dried ripe seeds

Nature: Warm

Taste(s): BitterSweet

Meridian affinity: Large intestineLung

Category: Herbs that relieve coughing and wheezing

Xing Ren is bitter and slightly warm. It assists the chief ingredient Ephedra to treat wheezing and release the Cold Wind Evil by leading the Lung Qi downward. It also protects the Lungs from the acridity of the two main diaphoretic herbs thanks to it oily nature.

Learn more about Apricot Seeds (Xing Ren)

Gan Cao is an envoy ingredient in Ma Huang Tang. This means that it directs the formula towards certain area of the body and/or harmonizes the actions of other ingredients.

4. Liquorice (Gan Cao)

Part used: Dried root and rhizome

Nature: Neutral

Taste(s): Sweet

Meridian affinity: SpleenStomachHeartLung

Category: Tonic herbs for Qi Deficiency

Gan Cao balances the actions of the other herbs by harmonizing the diaphoretic effect of Ephedrae, and counterbalancing the slight toxicity of Apricot seed.

Learn more about Liquorice (Gan Cao)

Conditions and patterns for which Ma Huang Tang may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Ma Huang Tang is used by TCM practitioners to treat four different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Influenza Rheumatic fever Pneumonia Rhinitis Pharyngitis Otitis media Traumatic arthropathy Cervical spine disease Lumbar strain Periarthritis of the shoulder Rheumatoid arthritis Ankylosing spondylitis Raynaud's disease Sciatica Trigeminal neuralgia Migraine Sinusitis Scleroderma Asthma Chronic bronchitis Chronic obstructive pulmonary disease Hay fever Pericardial effusion Eczema Urticaria Chilblains Common cold

Again it wouldn't be correct to say "Ma Huang Tang treats influenza" for instance. Rather, Ma Huang Tang is used to treat patterns that are sometimes the root cause behind influenza.

Now let's look at the four patterns commonly treated with Ma Huang Tang.

The Lungs is a so-called "Zang" Organ. Learn more about the Lungs in Chinese Medicine

Wind-Cold invading the Lungs

Ma Huang Tang is sometimes prescribed by TCM practitioners to treat Wind-Cold invading the Lungs. This pattern leads to symptoms such as chills, lack of sweating, aversion to cold and fever. Patients with Wind-Cold invading the Lungs typically exhibit tight (Jin) or floating (Fu) pulses.

The Defensive Qi layer of the Lungs is invaded by the external Wind-Cold. The battel between these two takes place and gives rise to fever. This is similar to how the immune system reacts to the external bacterial or virus according to the Western Medicine. Please be aware that there aren't always... read more about Wind-Cold invading the Lungs

'Cold' as a body pattern in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Cold pattern in Chinese Medicine

Greater Yang Attack of Cold

Ma Huang Tang is sometimes prescribed by TCM practitioners to treat Greater Yang Attack of Cold. This pattern leads to symptoms such as occipital headaches, aversion to cold, slight fever and absence of sweating. Patients with Greater Yang Attack of Cold typically exhibit tight (Jin) or floating (Fu) pulses.

This is one of the four patterns of the Greater Yang stage, the first stage of the Six Stages theory.

As opposed to Attack of Wind, another pattern of the Greater Yang stage, there is an emphasis on Cold rather than Wind. As such when a key symptom of Attack of Wind is the sweating, in this pattern... read more about Greater Yang Attack of Cold

The Exterior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Exterior in Chinese Medicine

Exterior-Cold

Ma Huang Tang is sometimes prescribed by TCM practitioners to treat Exterior-Cold. This pattern leads to symptoms such as loose stools, clear urination, aversion to cold and fever. Patients with Exterior-Cold typically exhibit tight (Jin) or floating (Fu) pulses.

This pattern is classified as ‘Exterior’ not because it derived from an external pathogenic factor but because its manifestations are located in the ‘Exterior’ of the body (the skin, muscles and channels). 

'Cold' here is an exterior pathogenic factor. Spontaneous 'Fever' and aversion to cold are... read more about Exterior-Cold

The Exterior in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Exterior in Chinese Medicine

Exterior-Full

Pulse type(s): Tight (Jin), Floating (Fu)

Symptoms: Fever No sweat Headaches Body aches Aversion to cold

Ma Huang Tang is sometimes prescribed by TCM practitioners to treat Exterior-Full. This pattern leads to symptoms such as headaches, fever, no sweat and body aches. Patients with Exterior-Full typically exhibit tight (Jin) or floating (Fu) pulses.

An Exterior pattern, by definition, is a Full pattern, because it is characterized by the invasion of an external Pernicious Influence, which then fight with the Body's Defensive Qi. The battle of the two elements gives rise to 'fever', like how our immune system reacts to bacteria and virus... read more about Exterior-Full

Formulas similar to Ma Huang Tang

Ma Xing Shi Gan Tang is 75% similar to Ma Huang Tang

Da Qing Long Tang is 57% similar to Ma Huang Tang

Ling Gui Zhu Gan Tang is 50% similar to Ma Huang Tang

Ge Gen Tang is 43% similar to Ma Huang Tang

Tao He Cheng Qi Tang is 40% similar to Ma Huang Tang

Gui Zhi Tang is 40% similar to Ma Huang Tang