1、Chapter 1 Drugs for Relieving Exterior Syndromes,TCM Department of Southern Medical University ZHU CHUAN WU,Concepts:,Drugs with dispersing pathogenic factors from the superficies of the body and relieving exterior syndromes as their main effects are called drugs for relieving exterior syndromes .,E
2、ffect and Indications:,Mainly pungent in flavour for dispersion ,light in quality for lifting and floating effects , and chiefly acting on the lung channel and the superficles of the body,this type of drugs can expel pathogenic factors from the superficies or relieve exterior syndromes by diaphoresi
3、s.They are indicated for exterior syndromes due to affection by exopathogens.With their effects of relieving cough, relieving asthma , inducing diuresis , removing edema , alleviating pain and promoting eruption , etc . , some drugs can be used to treat cough , asthtna , edema , arthralgia , German
4、measles and measles .,Classification:,According to their different properties and indications , drugs for relieving exterior syndromes are divided into two groups : drugs with pungent in flavour and warm in nature for relieving exterior syndromes and drugs with pungent in flavour and cool in nature
5、for relieving exterior syndromes . They should be chosen according to different syndromes , and used in compatibility with drugs for resolving phlegm , relieving cough , promoting the flow of Qi , eliminating fullness , dispersing cold , alleviating pain , inducing diuresis , removing edema , cleari
6、ng heat , removing toxic substances , restoring Qi and strengthening the body resistance according to accompanying syndromes and the patient s constitution .,Drugs which are pungent and dispersing damage Yin and deplete Qi . Therefore , this type of drugs should be used until the patient gets better
7、 . They should not be excessively used in order to avoid damaging vital Qi . In addition , patients with spontaneous perspiration , night sweating , debility after illness , chronic skin and extornal diseases. lingering stranguria and hemorrhage should be careful or prohibited to use drugs for relie
8、ving exterior syndromes .,In addition, Largely aromatic in smell , light in quality and containing volatile oil drugs for relieving exterior syndromes should not be decocted for a long time in order to avoid reducing effective inredients .,Section 1 Drugs Pungent in Flavour and Warm in,Nature for Re
9、lieving Exterior Syndromes Drugs in this section with dispersing pathogenic wind-cold as their main effects have relatively strong potency . They are indicated for exterior syndromes affected by pathogenic wind-cold with symptoms of aversion to cold , anhidrosis , fever , headache , tasteless tongue
10、 with white fur , and floating and tense pulse . Some drugs can also be used to treat wind-cold type of cough , arthralgia due to wind-cold , and edema accompanied by exterior syndrornes ,Ephedra Herba Ephedrae (ma huang),This drug is the herbaceous stem of the herbaceous shrublets Ephedra Sinica St
11、apf . or E . equisetina Bunge . and E . intermidia Schrenk et Mey of family Ephedraceae , mainly produced in Hebei , Shanxi , Inner Mongolia , Gansu , Liaoning , Sichuan and other areas . The herb is collected in the period between the beginning of autumn and winter , dried in the shade , cut into s
12、ections and used in raw , stir-baked with honey or pounded to fine hair .,Ephedra Herba Ephedrae (ma huang),Properties：,Ephedra is pungent and slightly bitter in flavour , warm in nature and acting on the lung and urinary bladder channels . The pungent and the warrn is dispersing cold . Ephedra has
13、main effects of facilitating the circulaton of the lung-qi , relieving exterior syndromes , alleviating asthma and inducing diuresis , with the strongest dispersing power . It is indicated for exterior syndromes of excess type affected by pathogenic wind-cold , dyspnea of excess type due to obstruct
14、ion of the lung-qi , wind edema and anhidrosis .,Effects：,1、Inducing sweating to dispel exopathogens , 2、facilitating the circulation of the lung-Qi to relieve asthma , 3、inducing diuresis to remove edema .,Indications:,1 . For treatment of exterior syndromes of excess type affected by pathogenic wi
15、nd-cold with symptoms of wind-cold type of common cold , aversion to cold ,anhidrosis, fever and headache , the herb is often used in combination with cinnamom twig such as Ephedra Decoction for strengthening the effect of dispersingwind-cold.,2 . Ephedra is often used in combination with apricot ke
16、rnel to strengthen the effects of arresting cough and relieVing asthlna , such as Sanao Decoction , for treatment of dyspnea of excess type due towind-cold attacked on the lung and impairment of ventilatinga and descending function of the lung;with pimellia tuber , dried ginger , asarumh herb and ot
17、her drugs to remove dampness , resolve phlegm , warm the lung and eliminate fluid retention , such as Xiao Qinglong Decoction , for treatmel of cold fluid retention in the lung , stagnaion of phlegm and Qiwith abundant thin sputum ;and with raw gypsum to clear heat from the lung , arrest cough and r
18、elieve asthma , such as Ma Xing Shi Gan Decoction , for treatment of heat of excess type in the lung , high fever and dyspnea .,Indications:,Indications:,3 . For treatment of initial edema mainly facial,with exopathogenic exterior syndromes, that is，wind edema,the herb is always used in combination
19、with white atractylodes rhizome such as Yuebi Jiazhu Decoction for Strengthening the effect of diuresis to remove edema,Dosage and Administration:,1 . 510 g. Raw herb is strong for inducing sweating , and stir-baked is mild for inducing sweating but better at relieving asthma . 15-30g in concentrate
20、d decoction for emergency treatment of prostration虚脱 syndrome.,Precautions:,Patients with debility , hyperhidrosis and asthma of deficiency type should be prohibited to use Ephedra .,Modern Researches:,Ephedra can induce sweats , clear heat and alleviate spasm of bronchial smooth muscle to relieve a
21、sthma It has the effects of inhibiting bacteria and virus , inducing diuresis , elevating blood pressure and exciting central nerves .,Cinnamom Twig Ramulus Cinnamomi(gui zhi),This drug is the tender twigs of the evergreen tree Cinnamomum cassia Pres1 of family Lauraceae ，mainly produced in Guangdon
22、g , GuangXi and Yunnan provinces .Tender twigs are usually cut off in sping , dried in the sun or in the shade , and cut into slices or sections The drug is called Guizhi ,Guizhi Jian or Nan Guizhi in Chinese ,Cinnamom Twig Ramulus Cinnamomi(gui zhi),Cinnamom Twig Ramulus Cinnamomi(gui zhi),Properti
23、es:,The herb is pungent and sweet in flavour ,warm in nature and acting on heart ,lung and urinary bladder channels . Pungent and warm for disper-sion and sweet for mild potency , without the shortcomings of hyperhidrosis dam- aging Yang , the herb is often used to treat exterior syndromes of both d
24、eficiency and excess types caused by pathogenic wind -cold . In addition , the herb can warm blood , inyigorate pulse , reinforce Yang and promote Qi flow . It is an important herb to treat pains due to cold , deficiency of Yang and water retention .,Effectts:,1、Inducing sweats to dispel exopathogen
25、s , 2、warming the channels to clear obstruction and reinforcing Yang to promote Qi flow .,Indications:,1 . To treat exterior syndromes of deficiency type with symptoms of wind - cold , perspiration ,aversion to wind ,floating and slow pulse ,the herb is used in combination with white peony root , su
26、ch as Guizhi Decoction to regulate Ying and Wei , inducing sweats and expelling pathogenic factors from muscles and skin . To treat exterior syndromes of excess type with symptoms of wind -cold , aversion to cold , anhidrosis and floating and tense pulse , such as in Ephedra Decoction the herb can h
27、elp ephedra induce sweats and dispel exopathogens .,Indications:,2 .The herb is often used in combination with notopterygium root ,ledebouriella root and other herbs for dispelling wind ,dampness ,cold and alleviating pain ,to treat arthralgia and pain in the limbs due to wind cold; with evodia frui
28、t , chuanxiong rhizome , Chinese angelica root and other herbs , such as Wenjing Decoction for warming the channels , dispersing cold , regulating menstruation and alleviating pain , to treat women s illness of cold , irregular menstruation , dys- menorrhea and amenia ; and with unripened bitter ora
29、nge and macrostem onion , such as Zhishi Xiebai Guizhi Decoction for activating Yang , resolving lumps , and a lleviating arthralgia and pain , to treat insufficiency of chest-Yang and chest pain due to Qi blockage .,Indications:,3. 3 . It is used in combination with malt extract , such as Xiao Jian
30、zhong De- coction , for warming the middle -jiao , restoring Qi , dispersing cold and alleviating pain , to treat cold of deficiency type in the middle Jiao , cold pain in the stomach and abdomen , anorexia and loose bowel ; with white atractylodes rhizome and po- ria for warming Yang , promoting Qi
31、 flow , strengthening the spleen and removing fluid retention, to treat deficiency of the spleen -Yang , phlegm retention , dizziness and palpitation ; and with umbellate pore fungus , poria , white atractylodes rhi- zome for reinforcing Yang , promoting Qi flow , inducing diuresis and removing edem
32、a , such as Wuling Powder , to treat deficiency of Yang , disturbance in Qi transformation , water retention , edema and difficulty in urination .,Dosage and Administration:,310g Precautions:Patients with Yin deficiency and excessive fire should be prohbited to use this herb , and women in pregnancy
33、 or with profuse menstruation should be careful to use it .,Modern Researches :,Cinnamon twig has the effects of anti-bacteria,clearing heat , relieving pain , tranquilizing and anti-convulsion . It can relax gastor-intestinal spasm to relieve pain and has the effect of strengthening the digestive f
34、unction. In addition , it also has the effects of inhibiting influenza virus , arresting cough and inducing diuresis , etc .,Asartum Herb Herba Asari(xi xin),This drug is the whole plant of the perennial herbaceous plants Asarurn het- erotropoides Fr . Schmidt var . mandshuricum ( MaXirn . ）Kitag ,
35、A . sieboldii Miq . Var . seoulense Nakai or A . sieboldii Miq of family Aristolochiaceae . The first two are known as Liao Xixin , mainly produced in Liaoning and Jilin Provinces ; and the last as Hua Xixin ,mainly produced in Shaanxi Province . The herb is collected in summer and autumn when the f
36、ruit is ripe or in early autumn , cleared of mud and sand , dried in the shade , cut into sections and used in raw .,Asartum Herb Herba Asari(xi xin),Asartum Herb Herba Asari(xi xin),Properties:,The herb is pungent in flavour , warm in nature and acts on the heart , lung and kidney channels . Pungen
37、t for dispersion , warm for removing blockage , aromatic for moving from exterior to interior , it can disperse cold from exterior , dispel cold from interior , warm the lung , clear passages and relieve pain with good effect . It is an important herb for treatment of Yang insufficiency caused by ex
38、opathogens , headache due to pathogenic wind , cold fluid retention , cough and asthma .,Effects:,1、Expelling wind , 2、dispersing cold , 3、clearing passages , 4、relieving pain , 5、warming the lung and removing fluid retention .,Indications:,1.Asarum can be used in combination with prepared aconite r
39、oot,such as Mahuang Fuzi Xixin Decoction for reinforcing Yang and dispelling exopathogens, to treat Yang deficiency caused by exopathogens with symptoms of wind-cold , aversion to cold , anhidrosis , and ectopic radial and deep pulse ; and with ledebouriella root , notopterygium root and other herbs
40、 , such as Jiuwei Qianghuo Decoction , to treat wind-cold type of common cold , headache and nasal obstruction .,Indications:,2.To treat headache due to rhinorrhea with turbid discharge and nasal obstruction , asarum is often used in combination with magnolia flower , peppermint and other herbs .,In
41、dications:,3.To treat cold fluid retention in the lung and cough with abundant white and thin phlegm , the drug can be used in combination with dried ginger , pinellia tuber and other herbs , such as Xiao Qinglong Decoction for warming the lung and removing fluid retention . In addition , asarum can
42、 also be used to treat arthralgia due to wind-cold , headache caused by wind , toothache due to wind and fire , and other syndromes .,Dosage and Administration:,l 一3g.,Precautions:,Asarum antagonizes veratrum root . There is an old saying : “More than one Qian of asarum should never be used . “ Ther
43、efore , it should not be used in excessive dosage .,Modern Researches :,Hua Xixin extract with water or alcohol can blockade impulse conduction of sciatic nerve in the frog , and has the effect of infiltration anesthesia in tests on the dermic cumulus of the guinea plg .The volatile oi1 has the effe
44、cts of superficial anesthesia , clearing heat and alleviating pain in tests on animals , directly inhibiting cardiac muscle and smooth muscle . Its decoction has an effect of arresting cough .,Purple Perilla Leaf Folium Perillae （zisu）,This drug is the leaf of the annual herbaceous plants Perilla fr
45、utescens ( L . ) Britt. var Crispa ( Tunb . ) Hand-Mazz . and P . frutescens ( L . ) Brill var acuta (thunxb . ) Kudo of family Labiatea , produced in South and North China . The herb is collected in summer and autumn , dried in the shade and used in raw .,Purple Perilla Leaf Folium Perillae （zisu）,
46、Purple Perilla Leaf Folium Perillae （zisu）,Properties:,The herb is pungent in flavour , warm in nature and acts on the lung , spleen and stomach channels . Pungent and warm for dispersion and aromatic for enlivening the spleen , it can disperse pathogenic wind-cold from the lung channel , disperse t
47、he lung to arrest cough , and promote the Qi flow in the spleen and stomach to regulate the function of the middle Jiao and arrest vomiting . It is often used to treat wind-cold type of common cold . It is particularly suitable to treat common cold accompanied by cough or stagnation of Qi.,Effects:,
48、1、Inducing sweat to dispel exopathogens , 2、promoting the Qi flow to alleviate stagnation in the middle Jiao , 3、detoxifying fish and crab .,Indications:,1 . The herb is used in combination with apricot kernel and peucedanum root , such as Xiang Su Powder , for dispelling exopathogens , dispersing c
49、old , resolving phlegm , arresting cough , to treat wind-cold due to exopathogens , aversion to cold and fever , or accompanied by cough ; and with cyperus tuber and tangerine peel , such as Xiang Su Powder , for promoting the circulation of Qi , relieving exterior syndrornes , to treat exterior syndromes of wind-cold affected by exopathogens accompanied by Qi stagnation , distention and fullness in the interior .,Indications:,2 . It can be used in combination with pinellia tuber , tangerine peel and other herbs for prornoting
