Ma Huang Fu Zi Xi Xin Tang — Ephedra, Aconite & Asarum Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

What is Ma Huang Fu Zi Xi Xin Tang?

Ma Huang Fu Zi Xi Xin Tang — Ephedra, Aconite and Asarum Decoction — is a classical Shang Han Lun formula for exterior wind-cold occurring in a Yang-deficient (Shao Yin) constitution. In Chinese herbal medicine it is the formula of choice for the “elderly cold” pattern: severe chills with low fever, marked fatigue and a deep pulse instead of the usual floating exterior pulse.

I prescribe Ma Huang Fu Zi Xi Xin Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

Ma Huang Fu Zi Xi Xin Tang TCM pattern

Prescribed for Shao Yin exterior cold (exterior wind-cold in a Yang-deficient constitution): marked chills, low-grade fever, no sweating, severe fatigue and lassitude, somnolence, pallor, cold extremities, a thin white tongue coat with a pale tongue body and a deep, weak or faint pulse.

Key herbs

1. Ma Huang — chief herb; releases the exterior and disperses cold
2. Fu Zi — warms Yang in the Kidney and supports the upright Qi during exterior release
3. Xi Xin — warms the Lung, disperses cold and unblocks the orifices

Formula actions

1. Releases the exterior
2. Warms the interior and assists Yang
3. Disperses cold from the channels

Conditions treated

1. Wind-cold colds in elderly or Yang-deficient patients who cannot sustain robust diaphoresis
2. Cold-induced bronchitis with copious clear sputum and fatigue
3. Allergic rhinitis with copious watery discharge and cold extremities
4. Selected presentations of cold-trigger asthma in deficient constitutions
5. Acute exacerbations of chronic neuralgia (trigeminal, occipital) triggered by cold exposure

Cautions

Contraindicated in pregnancy, hypertension, ischaemic heart disease, arrhythmia, hyperthyroidism and Yin-deficient heat patterns. Fu Zi must be properly processed (typically Heizi/Bai Fu Pian) and prescribed only by a qualified herbalist; raw aconite is highly toxic. Modern Sun Ten granules use fully processed Fu Zi at standardised doses.

Always consult a qualified Chinese herbalist registered with the Register of Chinese Herbal Medicine (RCHM). Online herbal consultations are available.

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