Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction)

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Indications

Western Uses:

• What conditions is Ma Xing Shi Gan Tang used for in modern practice?

  Ma Xing Shi Gan Tang clears heat trapped in the Lungs (cough/wheeze with fever and thick sputum), so it is referenced for febrile respiratory conditions: upper respiratory tract infections, lobar and bronchial pneumonia, bronchial asthma, measles pneumonitis, bronchiolitis, whooping cough (pertussis), and diphtheria.

  It is chosen for the Lung-heat pattern, not for a diagnosis. Pneumonia, diphtheria, whooping cough, and measles complications are serious — several are vaccine-preventable and some are medical emergencies — and require prompt medical care; a severe asthma attack is life-threatening. This formula appears in integrative practice alongside, not instead of, that care. Traditional-use correlates only, not a treatment claim.

  Source: Sacred Lotus sources & references (pattern) + Bensky & Barolet, Formulas & Strategies; biomedical correlates as reference only. Not medical advice.

Originally Appeared In:

• On Cold Damage (Shang Han Lun)

Notes:

• How does Ma Xing Shi Gan Tang differ from related formulas?

  Ma Xing Shi Gan Tang is a purely heat-clearing, Lung-diffusing formula — it carries no warming exterior-release herb, which is exactly what sets it apart from its closest relatives.

  • vs Ma Huang Tang: as above — Gui Zhi versus Shi Gao is the defining swap; Ma Huang Tang warms and releases a cold exterior with no sweating, Ma Xing Shi Gan Tang clears Lung heat with or without sweating.
  • vs Da Qing Long Tang: this formula combines Ma Huang Tang’s full exterior-releasing action (including Gui Zhi) with a smaller dose of Shi Gao, treating a strong wind-cold exterior with no sweating alongside interior heat and restlessness; Ma Xing Shi Gan Tang has no Gui Zhi and is used once the exterior is minimal and Lung heat wheezing predominates, without needing a vigorous sweat.
  • vs Ding Chuan Tang: Ding Chuan Tang also uses Ma Huang for wheezing but adds Bai Guo and several phlegm-transforming herbs for wheezing complicated by phlegm accumulation; Ma Xing Shi Gan Tang is comparatively simple and purely heat-clearing.

  Classical source: from the Shang Han Lun (Treatise on Cold Damage), Zhang Zhongjing, where it appears twice — after improper sweating and after improper purgation — both times for “fever and panting, without great [exterior] heat,” a phrase classically understood as the absence of a pronounced exterior fever pattern rather than an absence of heat altogether, since heat has by then relocated to the Lung.

  Source: Shang Han Lun (Treatise on Cold Damage); Bensky & Barolet, Formulas & Strategies (formula comparisons); cross-referenced against multiple online sources. Traditional-use framing; not medical advice.

Clinical Studies & Research:

• Is there modern research on Ma Xing Shi Gan Tang?

  Yes — a substantial body of preclinical work explores antiviral, antibacterial, and anti-inflammatory mechanisms relevant to its traditional use for Lung-heat cough and wheeze, alongside some clinical use in respiratory disease. Much of the mechanistic evidence comes from cell and animal models rather than large randomized trials of the formula itself.

  • Influenza entry inhibition: the decoction blocked influenza A virus attachment and penetration into host cells in vitro (EC50 0.83 ± 0.41 mg/mL against H1N1; attachment IC50 0.58 ± 0.07 mg/mL, penetration IC50 0.47 ± 0.08 mg/mL), with broad-spectrum activity including oseltamivir-resistant strains, via disruption of the viral envelope and suppression of PI3K/AKT signaling (PMID 22710290, Journal of Ethnopharmacology, 2012).
  • Pneumococcal virulence: the formula inhibited oligomerization of pneumolysin, a key toxin of Streptococcus pneumoniae, protecting human lung cells from toxin-mediated damage and improving outcomes in infected mice, without directly killing the bacteria (PMID 33892068, Journal of Ethnopharmacology, 2021).
  • Acute lung injury (rat model): post-treatment after LPS challenge reduced lung microvessel hyperpermeability, leukocyte adhesion, and inflammatory signaling (ICAM-1, TLR4, NF-κB), and improved survival (PMID 24809727, Microcirculation, 2014).
  • Clinical case series (chronic bronchitis): a modified combination with Er Chen Tang was reported in a small clinical series for chronic bronchitis (PMID 15119160, Journal of Traditional Chinese Medicine, 2004).

  Sources: PubMed 22710290; PubMed 33892068; PubMed 24809727; PubMed 15119160. Research context, not a therapeutic claim; robust randomized clinical trial evidence for the formula itself remains limited.