Jie Biao Ji
Generally speaking, exterior-relieving formulas include medicinals which can relieve or resolve exterior patterns. Typically, theyexpel external evils by promoting mild sweating. This diaphoresis out-thrusts and expels the pathogens. In addition, they resolve themuscles and promote the eruption of rashes or pox. They may also be used for the treatment of sores in the exterior and recent onsetedema if either are accompanied by aversion to cold, fever, and other exterior pattern signs and symptoms. Exterior patterns are due toexternal invasion of the six environmental excesses. These include wind, cold, summerheat, dampness, dryness, and fire. Thedistinguishing characteristics of an exterior pattern are aversion to cold and wind, fever, headache, muscular aches and pains, and afloating pulse.There are two main types of exterior patterns: hot and cold. Because the causative factors and the body's reaction to disease isdifferent, these two types of exterior patterns require treatment with different medicinals. In exterior cold patterns, aversion to cold ispronounced; there is slight fever, no particular thirst, either no sore throat or just a tickle in the throat, a clear nasal discharge, afloating, tight pulse, and a thin, white tongue coating. In an exterior heat pattern, there is less aversion to cold and wind, more extremefever, definite thirst, definite sore throat, yellow, sticky nasal mucus, a floating, rapid pulse, and a red tongue tip with a yellowcoating. Based on these two main types of exterior patterns, exterior-relieving formulas are divided into two main subcategories: 1)acrid, warm, exterior-relieving formulas and 2) acrid, cool, exterior-relieving formulas.There is, however, a third category of exterior-relieving formulas. These are called supporting the righteous and relieving the exteriorformulas. They are used when the body is vacuous but has been invaded by external evils manifesting as exterior patterns. In this case,it is still necessary to relieve the exterior. However, because the righteous is vacuous, one must use medicinals which supplement andboost (qi) and assist yang combined with exterior-relieving medicinals. These types of formulas are good for the treatment of childrenwhose source qi is not full. They can also be used on postpartum women or after major disease when there is bodily vacuity andweakness and invasion of wind, cold, damp evils manifesting as an exterior pattern.
Method of Preparation & Administration:
Acrid medicines are light and windy in nature and easily spread outward and upward. Therefore, they should not be cooked forlengthy periods as this will disperse their therapeutic effect. They should only be decocted for from 20-30 minutes maximum. Oncethe water is boiling, decoct for a further 5-10 minutes with a large fire (
, high heat). Exterior-relieving medicinals should be takenwhile still warm and away from cold and drafts. The patient should be instructed to put on more clothes.
Cautions in Using Exterior-relieving Medicinals:
The right degree of perspiration induced by exterior-relieving medicinals is a mild perspiration over the entire body. If perspiration istoo much, righteous qi will be damaged. This is especially so in children and the aged. Excessive perspiration will also damage fluidsand humors.Patients may exhibit both exterior and interior patterns. In such cases, first relieve the exterior and then treat the interior. However, if both exterior and interior are affected to the same degree, treat both simultaneously.
The Five Contraindications of Exterior-relieving Formulas:
Do not relieve the exterior once exterior patterns have transmuted into interior patterns.2.
Do not relieve the exterior once pox and rashes have erupted.3.
Do not relieve the exterior once sores have ulcerated.4.
Do not relieve the exterior for the treatment of edema due to vacuity.5.
Do not relieve the exterior if there is dehydration due to vomiting and diarrhea.
Xin Wen Jie Biao Ji
(Acrid, warm, exterior-relieving formulas).Representative formulas:
A. Ma Huang Tang (Ephedra Decoction)
Herba Ephedrae (
), remove the joints 6g2.
Ramulus Cinnamomi (
Semen Pruni Armeniacae (
) remove the skin and tips 9g