Ma Huang Lian Qiao Chi Xiao Dou Tang — Damp-Heat Jaundice

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 (Hb. Ephedrae, 6-9g) — releases the exterior; opens the Lung; promotes urination
2. Lian Qiao (Fr. Forsythiae, 6-15g) — clears Heat and resolves toxin
3. Chi Xiao Dou (adzuki bean, 9-30g) — drains Damp; resolves toxin; reduces oedema
4. Xing Ren (Sm. Armeniacae, 6-9g) — descends Lung Qi; assists Ma Huang
5. Sang Bai Pi ((Cx. Mori, 6-9g), 6-9g) — drains Lung Heat and promotes urination
6. Gan Cao (Rx. Glycyrrhizae, 3-6g) — harmonises
7. Sheng Jiang (Rz. Zingiberis Recens, 3-6g), Da Zao (Fr. Jujube, 3-6g) — 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.

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