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Ephedrae Herba (Mahuang, 麻黄)

Bitter, warm, slightly warm, non-toxic. It primarily treats headache caused by wind-stroke and cold damage (Shanghan), warm malaria, releases the exterior and induces sweating, eliminates pathogenic heat qi, stops cough with rebellious qi, removes chills and fever, breaks up masses and accumulations, relieves urgency caused by pathogenic qi in the five zang organs, treats wind-related hypochondriac pain, postpartum residual ailments, stops excessive salivation, unifies the interstices (Couli), disperses cold damage headache, resolves the muscle layer, vents evil qi, and reduces red-black spot toxins. It should not be taken in large doses, as it may cause deficiency. Also known as Beixiang, Longsha, or Beiyans. Grows in Jin region and Hedong. Stems are harvested after the Start of Autumn and dried in shade until green. (Paeoniae Radix Rubra (Ganzao) acts as an assistant; Ephedra is incompatible with Magnoliae Flos (Xinyi) and Phyllanthi Herba (Shiwei).)

Tao Hongjing states: The best quality comes from Qingzhou, Pengcheng, Xingyang, and Zhongmu, characterized by a green color and abundant foam. There is also production in Shu, but the quality is inferior. When used, the nodes must be broken off and removed because nodes stop sweating. Boil for one or two boils first, remove the foam on top, as the foam causes mental restlessness. The roots also stop sweating and are mixed with powder for use in summer months. Commonly used to treat cold damage, it is the premier herb for resolving the muscle layer. *Tang Ben Zhu* notes: There is an abundance in Lutai, Zhengzhou, and the sandy banks of the He River in Guanzhong. Those from Qing and Xu regions are no longer used. Tongzhou's Shayuan produces the most. Current annotations and usage consider those from Zhongmu superior, which are annually presented as tribute to Kaifeng Prefecture. Minister Yuxi et al. carefully note according to *Yao Xing Lun*: Mahuang is the sovereign herb, sweet in taste, neutral. It can treat toxic wind-damp bi syndrome on the body, insensitivity of skin and flesh, primarily treats high fever, resolves the muscle layer and induces sweating, treats warm malaria, and treats warm epidemics. Roots and nodes stop sweating. Prescription method: Pound old bamboo fans into powder and apply. Alternatively, equal parts of Oyster Shell Powder (Muli Fen), Millet Powder (Su Fen), and root powder are placed in a raw silk bag; when night sweats occur, apply and massage with hands. Duan Chengshi's *Youyang Zazu* states: Mahuang flowers at the stem tips; flowers are small and yellow, growing in clusters. The fruit resembles a raspberry and is edible. Ri Huazi states: It opens the nine orifices, regulates blood vessels, opens pores and skin, expels wind, breaks up masses and accumulations, drives out pathogenic qi from the five zang organs, reduces fever, and guards against mountain miasma and malarial air.

*TU Jing* states: Mahuang grows in Jin region and Hedong; it is now common near the capital, with those from Xingyang and Zhongmu being superior. Seedlings sprout in spring and grow to about one chi long by the fifth month of summer. Yellow flowers appear at the tips, bearing fruits resembling lily petals but smaller, similar to soap bean pods, sweet in taste, with a slight Mahuang aroma, red outer skin, and black inner seeds. Roots are purple-red. Folklore suggests there are male and female varieties: females flower in March-April and bear fruit in June; males do not flower nor bear fruit. After the Start of Autumn, stems are harvested and dried in shade until green. Zhang Zhongjing uses Mahuang in Mahuang Decoction (Mahuang Tang) and Da/Small Green Dragon Decoctions (Da/Xiao Qinglong Tang) to treat cold damage. For lung萎 (Fei Wei) with rebellious qi, he uses Belamcanda and Mahuang Decoction (Shegan Mahuang Tang) and Pueraria and Mahuang Decoction (Nongpu Mahuang Tang), both major formulas. In ancient decoction prescriptions using Mahuang, it was always boiled first to remove foam before adding other herbs. This is not done for modern pills and powders. *Bi Xiao Fang* treats epidemic diseases in their first one or two days: Take one da liang of Mahuang, remove nodes, boil in four sheng of water to remove foam, reduce to two sheng, strain, add one spoonful of rice and fermented soybeans to make a thin porridge, obtain one qiang of liquid, first bathe the head with hot water over one hundred bowls, then drink the porridge, cover thickly to induce sweating, best taken at night. *Qian Jin Fang*: To treat cold damage, Snow Decoction uses ten jin of Mahuang (nodes removed), four sheng of Apricot Seeds (Xingren) (remove two kernels, tips, skins, stir-fried), one jin thirteen liang of golden Rhubarb (Dahuang). Soak Mahuang in five shuo four dou of snow water in a cauldron facing east on the stove for three nights, then add Rhubarb and stir well, boil with mulberry firewood until two shuo of juice remains, strain, return to cauldron, add pounded Apricot Seeds, boil again until six or seven dou remain, strain, place in copper vessel. Add three dou of snow water and continue boiling until two shuo four sheng remains. Form into pills like bullet seeds. For patients, dissolve one pill in five he of boiling white water, take at appropriate temperature to induce immediate sweating; if not cured, take another pill, seal the medicine to prevent leakage.

Lei Gong says: When using, remove nodes and foam. If not thoroughly removed, ingestion causes chest stuffiness. Use shears to cut off nodes and tips, finely chop with a copper knife on a locust wood cutting board, boil for thirty to forty boils, skim off all foam with a bamboo strip, drain, dry, and use. *Shanghan Lei Yao*, Zhang Zhongjing's *Shanghan Lun* states: For jaundice disease, Mahuang Alcohol Decoction (Mahuang Chunjie Tang) is the primary treatment. Take one ba of Mahuang (nodes removed), wrap in silk, boil in five sheng of fine wine until half a sheng remains, strain, take in one dose. It also treats cold damage with exterior heat leading to jaundice; inducing sweat cures it. In winter, use wine; in spring, boiling with water is effective. *Zimu Milu* treats postpartum abdominal pain and incomplete expulsion of blood. Take Mahuang (nodes removed), pound into powder, take one fang cun bi with wine, two to three times a day, stop when blood expulsion is complete. Taking Zelan Decoction is also excellent.

*Yan Yi* states: Mahuang from Zhengzhou is superior. Cut off nodes, take half liang, stir-fry with one spoonful of honey for a while, boil in half a sheng of water, wait for boiling, remove foam, boil further until one-third is reduced, discard dregs. For patients with inverted black sores, drink while hot, avoid wind, wait for sores to reappear. Another method uses ash-free wine for decoction. However, it is difficult for children who cannot drink alcohol, though its effect is faster. This indicates this herb enters the exterior level.