Ma Huang Lian Qiao Chi Xiao Dou Tang — Ephedra, Forsythia & Adzuki Bean Decoction

On this page

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

Overview

Ma Huang Lian Qiao Chi Xiao Dou Tang — the “Ephedra, Forsythia and Adzuki Bean Decoction” — is from Zhang Zhongjing’s Shang Han Lun. Originally prescribed for jaundice with an exterior pattern still unresolved, the formula combines a Wind-Cold surface-releasing action (Ma Huang) with Damp-Heat clearance (Lian Qiao, Chi Xiao Dou). Modern dermatologists use it widely for acute itchy skin eruptions with both surface obstruction and Damp-Heat — the classical “Wind-Damp-Heat” skin pattern where Heat cannot escape because the surface is closed.

I prescribe Ma Huang Lian Qiao Chi Xiao Dou Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Ma Huang Lian Qiao Chi Xiao Dou Tang is prescribed for Damp-Heat with an unresolved exterior:

• Yang-type jaundice with fever, aversion to cold, no sweat
• Acute itchy red rash, possibly weeping
• Slight oedema, especially of upper body or face
• Dark yellow urine
• Chest oppression, slight cough
• Tongue — red, yellow greasy coat
• Pulse — floating, slippery, rapid

Key herbs

1. Ma Huang — releases the exterior; opens the Lung; promotes urination
2. Lian Qiao — clears Heat and resolves toxin
3. Chi Xiao Dou (adzuki bean) — drains Damp; resolves toxin; reduces oedema
4. Xing Ren — descends Lung Qi; assists Ma Huang
5. Sang Bai Pi — drains Lung Heat and promotes urination
6. Gan Cao — harmonises
7. Sheng Jiang, Da Zao — harmonise the Stomach

Formula actions

1. Releases the exterior
2. Clears Damp-Heat from the interior
3. Promotes urination; reduces jaundice and oedema
4. Resolves Heat-toxin in the skin

Conditions treated

1. Acute hepatitis with Yang-type jaundice and surface symptoms (alongside conventional care)
2. Acute eczema flare with weeping itchy lesions
3. Acute urticaria with Damp-Heat pattern
4. Acute glomerulonephritis with oedema, dark urine, no sweat (with conventional care)
5. Cholestatic itch with jaundice
6. Acute contact dermatitis
7. Acute drug rash with Damp-Heat pattern

Cautions

Contains Ma Huang — contraindicated in hypertension, hyperthyroidism, anxiety, glaucoma, prostatic hypertrophy, and with MAO inhibitors or sympathomimetics.

Acute hepatitis with rising bilirubin or coagulopathy requires urgent hepatology assessment.

Severe widespread skin reactions (Stevens-Johnson, DRESS) require emergency care.

Not appropriate for Yin-deficient patterns, chronic deficiency or pure interior Heat without surface obstruction.

Always consult a qualified Chinese herbalist registered with the RCHM.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.