Herbal Formulas Like
Ma Xing Shi Gan Tang (麻杏石甘汤)
In Traditional Chinese Medicine (TCM), herbal formulas for asthma are selected based not just on symptoms but on the nature of the internal pattern—hot or cold, excess or deficiency, exterior or interior. Among the most important classical formulas for asthma with heat and phlegm is Ma Xing Shi Gan Tang (麻杏石甘汤), a time-tested prescription from the Shang Han Lun that continues to serve as a foundation for modern respiratory care in Chinese herbal medicine.
Ma Xing Shi Gan Tang is composed of four key herbs: Ma Huang (麻黄, Ephedra), Xing Ren (杏仁, Apricot kernel), Shi Gao (石膏, Gypsum), and Zhi Gan Cao (炙甘草, Honey-fried Licorice root). The formula’s core function is to disseminate Lung qi, clear interior heat, and calm wheezing through the dual action of opening the surface and draining internal fire.
Ma Huang is acrid and warm, opening the Lung and promoting sweating, but it also descends rebellious qi. In this context, it is used not just for surface release but to help relieve bronchial constriction. Xing Ren is bitter and slightly warm, and works synergistically with Ma Huang to stop cough and downward-direct Lung qi. Shi Gao is a mineral substance that strongly clears heat from the Lung and Stomach, particularly in cases of thick yellow phlegm, fever, and labored breathing. Zhi Gan Cao harmonizes the formula and protects the middle burner.
This formula is particularly indicated for patterns involving external Wind-Heat invasion transforming into Lung heat, with symptoms such as fever, absence of sweating, labored breathing, yellow sticky sputum, and a floating-rapid pulse. It is not appropriate for cold-type asthma or cases with significant qi or yin deficiency.
Modern studies have examined Ma Xing Shi Gan Tang for use in bronchitis, pneumonia, and asthma exacerbations, showing that it may reduce airway inflammation and support bronchodilation. However, its use must be carefully matched to the patient’s pattern to avoid further drying or dispersing in already-deficient individuals.
Many derivative formulas are based on this structure. For example, Da Qing Long Tang (大青龙汤) includes additional surface-releasing herbs for more severe exterior conditions, while Ding Chuan Tang (定喘汤) combines this model with phlegm-resolving and qi-tonifying components for mixed excess-deficiency presentations.
In clinical practice, Ma Xing Shi Gan Tang often serves as a core component of a modified formula tailored to individual presentation. It may be combined with herbs like Huang Qin (黄芩) to enhance heat-clearing or Ban Xia (半夏) to transform phlegm. As always, a clear diagnosis is essential—this formula is powerful but not universally appropriate.
Understanding the nature and lineage of formulas like Ma Xing Shi Gan Tang allows students of Chinese medicine to approach respiratory conditions with a sophisticated and flexible strategy rooted in classical theory and supported by clinical experience.
Vocabulary Guide
- Ma Xing Shi Gan Tang (麻杏石甘汤) – “Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction”; clears Lung heat and stops wheezing
- Ma Huang (麻黄) – Ephedra; disperses Lung qi and opens the exterior
- Xing Ren (杏仁) – Apricot kernel; directs Lung qi downward, stops cough
- Shi Gao (石膏) – Gypsum; strongly clears heat from the Lungs and Stomach
- Zhi Gan Cao (炙甘草) – Honey-fried Licorice root; harmonizes formulas and supports digestion
- Huang Qin (黄芩) – Scutellaria; clears heat and dries dampness
- Ban Xia (半夏) – Pinellia; transforms phlegm and harmonizes the Stomach
- Ding Chuan Tang (定喘汤) – “Calm Wheezing Decoction”; used for mixed phlegm-heat and deficiency patterns
