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Ephedra, Ma Huang 麻黄Ma Huang (TCM)
Som Kalapna, Masania, Narom, Soma Kalpa (Unani) Mtshe ldum མཚེ་ལྡུམ (Tibetan) |
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Ephedra spp.
Alpini, P., De plantis exoticis libri duo, 1629
Alpini, P., De plantis exoticis libri duo, 1629
E. distachya
Camerarius, J., Hortus medicus et philosophicus, 1588
Camerarius, J., Hortus medicus et philosophicus, 1588
E. pachyclada
Transactions of the Linnean Society of London, 2nd series: Botany, (1887)
Transactions of the Linnean Society of London, 2nd series: Botany, (1887)
Above: Ephedra growing wild near Urumqi, Xinjiang, China
Right: fresh Wild Ephedra (Adam, 2017) |
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Botanical name:
Ephedra sinica, E. intermedia, E. equisetina (TCM)
E. vulgaris, E. gerardiana, E. intermedia and E. pachyclada have been used from Central Asia to Europe.
In Tibetan Medicine, E. sinica, E. intermedia and E. saxatilis are used
Parts used:
Herb
Temperature & Taste:
Warm, dry. Pungent, slightly Bitter
Classification:
A. Clear Exterior Wind-Cold
Ephedra sinica, E. intermedia, E. equisetina (TCM)
E. vulgaris, E. gerardiana, E. intermedia and E. pachyclada have been used from Central Asia to Europe.
In Tibetan Medicine, E. sinica, E. intermedia and E. saxatilis are used
Parts used:
Herb
Temperature & Taste:
Warm, dry. Pungent, slightly Bitter
Classification:
A. Clear Exterior Wind-Cold
Uses:
1. Clears Wind-Cold, Clears the Exterior:
-wind-cold cold and flu with chills, fever, headache, lack of sweating
-acute and chronic Fever (Tibetan Medicine)
-used in medicinal baths in Tibet
2. Opens the Lungs, Stops Cough and Wheezing:
-Cough and Wheezing from wind-cold
-can be used for Wheezing and Asthma from any cause depending on the medicines it is combined with
3. Clears Cold and Damp, Promotes Urine:
-Edema (especially of an acute nature in TCM)
4. Clears Wind-Cold-Damp, Opens Obstruction, Relieves Pain:
-painful Obstruction of the muscles and joints from Wind, Cold and Damp
-acute muscular and articular Rheumatism
-also toxic sores which don't form a head
-disperses Tumors and Swellings (Tibetan Medicine)
DOSE:
1. Low-moderate doses promote sweat and diffuse the Lungs to stop Cough and Wheezing.
2. Note the froth that forms when boiling should be removed as this part can cause agitation. Some have preboiled Ephedra briefly to remove the froth. This is especially useful when larger doses are used.
3. Large doses of 10–15 grams can be used for Edema and fluid swelling, but expereince shows that large doses are best used with 3 times the amount of raw Gypsum (Shi Gao) to inhibit the diaphoretic effect and promote urine.
In Decoction: 2–9 grams (up to 15 grams as a daily dose)
Of the Powder: 500mg–1 ½ gram
PREPARATION:
1. Removing the Nodes:
Sometimes the nodes are removed; they are said to decrease the diaphoretic effect, so removing them enhances diaphoresis.
2. Hot-water prepared Ephedra:
Steeping in boiling water until the froth rises, then removing the herb and drying lessens agitation, but is slightly weaker to cause sweating.
3. Stir-fried Ephedra:
The herb can be stir-fried with a little water. This reduces the diaphoretic effect, but is better for the Lungs.
4. Honey-fried Ephedra:
This is a way of correcting Ephedra. It is not as dispersing, not as strong to promote sweat, and is milder in effect, but has a secondary strengthening and more prolonged effect on the Lungs.
COMMENT:
1. The raw herb is stronger to promote sweat and disperse the exterior, but is apt to cause agitation and is more prone to cause side effects. Preparing with hot water, stir-frying and especially Honey-frying has the effect of reducing its sweat-promoting effect but is better for the Lungs and because these preparations are milder in effect, have a wider range of use for Cough and Wheezing. The Honey-fried herb is also slightly tonifying to the Lungs, so is better for Cough and Asthma with deficiency, as long as it is combined with suitable tonic medicines.
2. In Tibetan medicine it (E. gerardiana) is used for hemorrhage, acute and chronic hot diisorders, and Bile diseases.
CORRECTIVES:
1. Honey, Licorice
2. Tragacanth, Gum Arabic
3. Almonds reduce the drying effect while enhancing the tonic effect on the Lungs. This is enhanced when Licorice is added.
SUBSTITUTES:
1. Hyssop, Adhatoda vasica (Unani)
2. Maidenhair
3. Ficus religiosa bark has been used as a substitute for Ephedra in the Himalayas.
1. Low-moderate doses promote sweat and diffuse the Lungs to stop Cough and Wheezing.
2. Note the froth that forms when boiling should be removed as this part can cause agitation. Some have preboiled Ephedra briefly to remove the froth. This is especially useful when larger doses are used.
3. Large doses of 10–15 grams can be used for Edema and fluid swelling, but expereince shows that large doses are best used with 3 times the amount of raw Gypsum (Shi Gao) to inhibit the diaphoretic effect and promote urine.
In Decoction: 2–9 grams (up to 15 grams as a daily dose)
Of the Powder: 500mg–1 ½ gram
PREPARATION:
1. Removing the Nodes:
Sometimes the nodes are removed; they are said to decrease the diaphoretic effect, so removing them enhances diaphoresis.
2. Hot-water prepared Ephedra:
Steeping in boiling water until the froth rises, then removing the herb and drying lessens agitation, but is slightly weaker to cause sweating.
3. Stir-fried Ephedra:
The herb can be stir-fried with a little water. This reduces the diaphoretic effect, but is better for the Lungs.
4. Honey-fried Ephedra:
This is a way of correcting Ephedra. It is not as dispersing, not as strong to promote sweat, and is milder in effect, but has a secondary strengthening and more prolonged effect on the Lungs.
COMMENT:
1. The raw herb is stronger to promote sweat and disperse the exterior, but is apt to cause agitation and is more prone to cause side effects. Preparing with hot water, stir-frying and especially Honey-frying has the effect of reducing its sweat-promoting effect but is better for the Lungs and because these preparations are milder in effect, have a wider range of use for Cough and Wheezing. The Honey-fried herb is also slightly tonifying to the Lungs, so is better for Cough and Asthma with deficiency, as long as it is combined with suitable tonic medicines.
2. In Tibetan medicine it (E. gerardiana) is used for hemorrhage, acute and chronic hot diisorders, and Bile diseases.
CORRECTIVES:
1. Honey, Licorice
2. Tragacanth, Gum Arabic
3. Almonds reduce the drying effect while enhancing the tonic effect on the Lungs. This is enhanced when Licorice is added.
SUBSTITUTES:
1. Hyssop, Adhatoda vasica (Unani)
2. Maidenhair
3. Ficus religiosa bark has been used as a substitute for Ephedra in the Himalayas.
Main Combinations:
Ephedra & Apricot/Almond kernel
1. Wind-Cold Cold and Flu:
i. Ephedra with Cinnamon twig Gui Zhi (TCM)
ii. Ephedra with Cinnamon, Ginger (Ayurveda)
2. Cough and Wheezing:
i. Ephedra with Bitter Almond / Apricot kernel Xing Ren and Licorice
ii. from Heat, Ephedra with Bitter Almond / Apricot kernel Xing Ren, Gypsum Shi Gao, Licorice (as in Ma Xing Shi Gan Tang)
iii. from Heat, Ephedra, Scutellaria Huang Qin, Anemarrhena Zhi Mu, Licorice
iv. Cough, Asthma, Bronchitis, Ephedra with Licorice, Platycodon Jie Geng, Morus Sang Bai Pi (Mulberry root-bark) (as in Zhen Ke Ning Tang Jiang of the Chinese Pharmacopoeia)
v. acute Heat-Phlegm, Ephedra with Fritillaria Chuan Bei Mu, Platycodon Jie Geng, Arisaema Tian Nan Xing, Bitter Almond (Xing Ren), Scutellaria Huang Qin, Citrus Chen Pi, Licorice (as in Bao Ke Ning Keli of the Chinese Pharmacopoeia)
vi. from Cold, Ephedra with Bitter Almond / Apricot kernel Xing Ren, Cinnamon twig Gui Zhi and Licorice (as in Ma Huang Tang)
vii. from deficiency, Ephedra with Ginseng and Licorice
viii. Lung congestion, allergic Bronchitis or Asthma, Ephedra, Adhatoda, Long Pepper (Ayurveda)
3. Edema, Water retention:
i. Ephedra, Gypsum (Shi Gao), Atractylodes Bai Zhu, Licorice, fresh Ginger, Jujube (Da Zao)
ii. Ephedra, Tribulus, Coriander seed
4. For Wind-Cold-Damp arthritic pain, combine Ephedra with Aconitum Fu Zi
5. Yin-type Abscess (flat, no redness, dark in color), Phlegm nodes and masses:
i. Ephedra, Rehmannia Shu Di Huang, White Mustard seed (Bai Jie Zi), Dang Gui.
ii. Ephedra, Rehmannia Shu Di Huang, White Mustard seed (Bai Jie Zi), Deer horn gelatin (Lu Jiao Jiao), fried Ginger (Pao Jiang), Cinnamon (Rou Gui), Licorice
6. Raynaud's disease, Phlebitis, Ephedra, Rehmannia Shu Di Huang, White Mustard seed (Bai Jie Zi), Cinnamon twig (Gui Zhi), Safflower (Hong Hua), degelatinated Deer horn (Lu Jiao Shuang)
7. Typhoid and other Fevers, Ephedra, Apricot kernel (Xing Ren), Rhubarb, decocted in Snow water and reduced to form a pill mass. (Chinese Materia Medica, Stuauoft)
8. Trauma, Bruising, Pain, Swelling, Fractures, Ephedra with Frankincense, Myrrh, prepared Nux Vomica. (as in Jiu Fen San)
9. Traumatic injury, Sprain, Strain, Bruising, stabbing pain, Dislocation, Fracture, Ephedra with Dang Gui, Ligusticum Chuan Xiong, Frankincense, Myrrh, Dragons Blood, Eupolphaga Tu Bie Chong (Wingless Cockroach) (as in Die Da Wan).
Major Formulas:
Ma Huang Tang
Ma Xing Shi Gan Tang
Xiao Qing Long Tang
Fang Feng Tong Sheng San
Die Da Wan
Jiu Fen San
Feng Shi Ma Qian Pian
Cautions:
1. Toxic in large doses; 30 grams can be toxic to an adult.
2. It can drain the Lung Qi so should be used carefully in those with deficiency. Combining with Licorice and/or Ginseng can correct this.
3. Not used for sweating or night sweats from deficiency.
4. Not used in Hypertension.
DRUG INTERACTION:
Due to Ephedrine content, may interact with:
1. Caffeine and MAO inhibitors, increasing blood pressure
2. Beta-Blockers (reduces efficacy due to opposing action)
3. Ephedrine medication (such as Sudafed), causing ephedrine toxicity, arrhythmia etc.
4. Steroids (dexamethasone), enhancing clearance thereby reducing effectiveness.
Main Preparations used:
1. Toxic in large doses; 30 grams can be toxic to an adult.
2. It can drain the Lung Qi so should be used carefully in those with deficiency. Combining with Licorice and/or Ginseng can correct this.
3. Not used for sweating or night sweats from deficiency.
4. Not used in Hypertension.
DRUG INTERACTION:
Due to Ephedrine content, may interact with:
1. Caffeine and MAO inhibitors, increasing blood pressure
2. Beta-Blockers (reduces efficacy due to opposing action)
3. Ephedrine medication (such as Sudafed), causing ephedrine toxicity, arrhythmia etc.
4. Steroids (dexamethasone), enhancing clearance thereby reducing effectiveness.
Main Preparations used: