Ma Huang Lian Qiao Chi Xiao Dou Tang (麻黄连翘赤小豆汤) — Damp-Heat Jaundice
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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[10]
- Tongue — red, yellow greasy coat
- Pulse — floating, slippery, rapid
Key herbs
- Ma Huang (Hb. Ephedrae, 6-9g) — releases the exterior; opens the Lung; promotes urination
- Lian Qiao (Fr. Forsythiae, 6-15g) — clears Heat and resolves toxin
- Chi Xiao Dou (adzuki bean, 9-30g) — drains Damp; resolves toxin; reduces oedema
- Xing Ren (Sm. Armeniacae, 6-9g) — descends Lung Qi; assists Ma Huang
- Sang Bai Pi ((Cx. Mori, 6-9g), 6-9g) — drains Lung Heat and promotes urination
- Gan Cao (Rx. Glycyrrhizae, 3-6g) — harmonises
- Sheng Jiang (Rz. Zingiberis Recens, 3-6g), Da Zao (Fr. Jujube, 3-6g) — harmonise the Stomach
Formula actions
- Releases the exterior
- Clears Damp-Heat from the interior
- Promotes urination; reduces jaundice and oedema
- Resolves Heat-toxin in the skin
Conditions treated
- Acute hepatitis with Yang-type jaundice and surface symptoms (alongside conventional care)
- Acute eczema flare with weeping itchy lesions
- Acute urticaria with Damp-Heat pattern
- Acute glomerulonephritis with oedema, dark urine, no sweat (with conventional care)
- Cholestatic itch with jaundice
- Acute contact dermatitis
- Acute drug rash with Damp-Heat pattern
Cautions
Contains Ma Huang — contraindicated in hypertension[19], hyperthyroidism[6], anxiety[4], 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.
References
[4] Lin Y, Cai S, Wang T, Zhuang T, Huang T, Yu X, et al. Evaluation of the Safety and Efficacy of Xiao Yao San as a Treatment for Anxiety: A Systematic Review and Meta-Analysis. Evid Based Complement Alternat Med. 2022;2022:1319592. https://doi.org/10.1155/2022/1319592. PMID: 35432568.
[6] Liu Y, Cheng L, Yan G, Gu J, Lyu Z, Ding J. Effectiveness and potential mechanism of Jiawei-Xiaoyao-San for hyperthyroidism: a systematic review. Front Endocrinol (Lausanne). 2023 Sep 18;14:1241962. https://doi.org/10.3389/fendo.2023.1241962. PMID: 37780612.
[10] Lee B, Kwon CY, Suh HW, Kim YJ, Kim KI, Lee BJ, Lee JH. Herbal medicine for the treatment of chronic cough: a systematic review and meta-analysis. Front Pharmacol. 2023 Oct 17;14:1230604. https://doi.org/10.3389/fphar.2023.1230604. PMID: 37920213.
[19] Wang J, Xiong X, Liu W. Tianma Gouteng Yin as Adjunctive Treatment for Essential Hypertension: A Systematic Review of Randomized Controlled Trials. Evid Based Complement Alternat Med. 2013;2013:706125. https://doi.org/10.1155/2013/706125. PMID: 23710230.
