She Gan Ma Huang Tang (射干麻黄汤) — Belamcanda & Ephedra Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Comparisons with related formulas
7. Cautions

Overview

She Gan Ma Huang Tang — Belamcanda and Ephedra Decoction — is from Zhang Zhongjing’s Jin Gui Yao Lue. It addresses cold-Phlegm causing wheezing with audible rattling in the throat — the picture of asthma^[13]-like wheezing with copious thin clear sputum and a feeling of a froggy or rasping noise on breathing.

The chief herb She Gan (Belamcanda chinensis rhizome) clears throat Phlegm-Heat; Ma Huang disperses the Lung; Xi Xin and Sheng Jiang warm and disperse cold-Phlegm; Wu Wei Zi astringes the Lung; Ban Xia and Da Zao support the middle. The combination simultaneously warms cold-Phlegm and clears the throat — a sophisticated balance for a specific clinical picture.

I prescribe She Gan Ma Huang Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

She Gan Ma Huang Tang is prescribed for cold-Phlegm in the Lung with throat rattling and wheeze:

• Wheezing with audible Phlegm rattling in the throat — the cardinal sign
• Cough with copious thin clear or white sputum
• Sensation of obstruction in the throat
• Worse with cold exposure
• Shortness of breath
• Chest tightness
• Tongue — pale, white slippery coat
• Pulse — floating, tight, possibly slippery

Key herbs

1. She Gan (Belamcanda chinensis, 6-9g) — chief; clears throat Phlegm
2. Ma Huang (Hb. Ephedrae, 6-12g) — disperses Lung Qi
3. Xi Xin (Hb. cum Rx. Asari, 3-9g) — warms Lung and disperses Cold-Phlegm
4. Sheng Jiang (Rz. Zingiberis Recens, 3-12g) — warms and disperses
5. Zi Wan (aster root, 6-9g) — stops cough^[10]
6. Kuan Dong Hua (coltsfoot, 6-9g) — stops cough
7. Ban Xia (Rz. Pinelliae Preparatum, 6-9g) — transforms Phlegm
8. Wu Wei Zi (Fr. Schisandrae, 3-9g) — astringes Lung
9. Da Zao (Fr. Jujube, 6-10g) — harmonises

Formula actions

1. Disperses Cold and dissolves Phlegm in the Lung
2. Descends Lung Qi to stop wheeze
3. Clears Phlegm from the throat

Conditions treated

1. Acute asthma exacerbation with cold-Phlegm pattern (alongside conventional care) — see asthma
2. Chronic bronchitis with audible Phlegm rattle
3. Cough-variant asthma
4. Whooping cough (alongside conventional care)
5. Allergic rhinitis with post-nasal drip and wheeze
6. COPD exacerbation with cold-Phlegm pattern

Comparisons with related formulas

• Xiao Qing Long Tang — for Wind-Cold with internal water-Phlegm; stronger surface-releasing component.
• Ma Xing Shi Gan Tang — for Lung Heat wheeze with yellow phlegm; opposite indication.
• Ding Chuan Tang — for mixed Cold-Heat wheeze.
• Su Zi Jiang Qi Tang — for chronic wheeze with Kidney deficiency.

Cautions

Contains Ma Huang — not appropriate in pregnancy, hypertension^[19], hyperthyroidism^[6], cardiac arrhythmias or with stimulants.

Contains Xi Xin — use at proper dose; the herb contains small amounts of aristolochic acid in its aerial parts but the prepared root and rhizome at correct doses are considered safe in modern pharmacopoeia. Use only pharmaceutical-grade preparations.

Not appropriate for Heat-pattern wheeze with yellow phlegm.

Acute severe asthma is a medical emergency — this is a complementary formula, not a substitute for inhalers, oxygen and hospital care.

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

[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.

[13] Shergis JL, Wu L, Zhang AL, Guo X, Lu C, Xue CC. Herbal medicine for adults with asthma: A systematic review. J Asthma. 2016 Aug;53(6):650-9. https://doi.org/10.3109/02770903.2015.1101132. PMID: 27172294.

[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.