Hey, this is Nicholas. Today we're talking about herbs that release the exterior, and specifically about the category warm acrid herbs that release the exterior. So we'll do this in three parts.
First, we'll talk about the category as a whole, the basic properties of these herbs, and when we would choose to use them in treatment. This will include some discussion of the Shang Han Lun. Then we'll talk about the individual herbs in detail.
And finally, we'll just do a brief overview of the entire category. The audio portion of this lecture can be downloaded for free at TCMStudy.net under the Herbology 1 tab. There you can also find handouts with photos if you want to follow along.
And there's a practice test that you can take afterwards, so be sure to check that out. But let's go ahead and get started. So the first thing we want to know is, when would we use herbs from this category, herbs that release the exterior?
Well, no surprise, these herbs are used during an external attack, or we could say more specifically, when an external pathogen is lodged in the superficial layers of the body. When we say external pathogen, we're referring to the six evils. Heat, cold, dampness, dryness, wind, and summer heat.
So when one or more of these pathogenic influences attacks the body from the exterior, we use herbs that release the exterior to push it out. So how do these herbs work? What's their method of action?
Well, these herbs work by promoting sweating. In biomedicine, this is called diaphoresis, where we could say that these herbs have a diaphoretic action. So by inducing sweating, we're able to push the pathogen out of the body. And we can do this because the pathogen is still at the surface.
If the pathogen were deeper in the body, we would have to employ other strategies like draining or purging. So how do we know there's a pathogen on the exterior? What kind of evidence or what signs and symptoms are we going to see to let us know that there's an exterior attack? Well, the two main ones are fever and chills and a floating pulse.
So we can just say fever and chills, or we can use the Nigel Weissman terminology, heat effusion and aversion to cold. or aversion to wind. The reason he says heat effusion is because what we're really referring to is the subjective feeling of heat as felt by the patient. So we don't really care what the number on the thermometer is.
What we're really interested in is does the patient feel feverish? And then he says aversion to cold and aversion to wind because this is a literal translation of the Chinese wu han and wu feng. So the idea here is even though the patient feels warm and feverish, they still like to stay covered or bundled up because even slight exposure to a cold draft will cause them to feel chilled. So if you want to be real technical, you can say heat effusion and aversion to cold.
Or if you want to sound like a normal person, you can just say fever and chills. And what we should also emphasize here is that we're talking about simultaneous fever and chills. Alternating fever and chills is something we'll talk about later with Xiaoyang disorder, which is half internal, half external.
But with an external attack, the fever and chills are simultaneous. And the way we explain this is, when a pathogen invades the body, there's a great battle that ensues between the good qi, or the upright qi of the body, and the evil qi that's invading from the outside. So the simultaneous fever and chills are a consequence of this battle.
So besides fever and chills, we're also going to see a floating pulse. We can say floating pulse or superficial pulse. It doesn't matter.
These two words mean the same thing. They're just... different translations of the Chinese Fu Mai. The idea here is because the pathogen is on the exterior, the upright qi of the body rises to the surface to meet it, and that gets reflected in the pulse.
Or to put it more simply, the pathogen is on the exterior near the surface, so we feel the pulse near the surface. So anytime you see these two symptoms, fever and chills, and a floating pulse, that's a pretty good sign that you're dealing with an exterior attack. We generally divide external attacks into two categories. wind cold, and wind heat.
With wind cold, in addition to fever and chills and a floating pulse, you might also see things like headache, stiff neck, and body ache. There might be nasal congestion or thin white phlegm. Now wind heat is still going to present with fever and chills.
It's just going to be more fever and less chills. And the pulse is still going to be floating, indicating the pathogen is on the exterior. It just might be floating and rapid because of the heat. One of the major differentiating factors is going to be a red.
swollen sore throat. If they're slim it's going to be thick yellow and difficult to expect rate and wind heat can also present with eye problems like red itchy eyes or certain skin problems like rash. We'll talk more about wind heat in the next category. For now let's get back to wind cold. So in terms of the Shang Han Lun and the six levels an exterior attack of wind cold is associated with the Tai Yang level.
The Tai Yang channel governs the exterior of the body so it's the first to get hit by an exterior attack. When we say Taiyang, we mean the UB and SI channels. So that's why we see things like headache and stiff neck, because these two channels go to the head and neck. Now, Taiyang disease can be further subdivided into two types, excess and deficiency. So the key symptom that differentiates them is presence of sweating or lack of sweating.
So Taiyang excess presents with lack of sweating. The idea here is there's an excess cold pathogen blocking the pores, so the sweat... can't get out. This Taiyang excess pattern is also called Shang Han or cold damage. Taiyang deficiency, on the other hand, is characterized by the presence of sweating.
Here, there's a disharmony of the yin and the wei, meaning the exterior is deficient. It's unable to contain the sweat, so the sweat leaks out, but it does so in a way that's insufficient to expel the pathogen. This pattern is also called Zhong Feng or wind strike.
So our two major herbs for these patterns are ma huang and gui zhi. Ma huang treats tai yang excess, also known as shang han, or cold damage, which is fever and chills without sweating. Gui zhi treats tai yang deficiency, also known as zhong feng, or wind strike, characterized by fever and chills with sweating.
So let's talk about the category warm acrid herbs that release the exterior. Some common characteristics of these herbs, like the name suggests, they're going to be warm and acrid. Warm because we're treating wind cold conditions and acrid because the acrid flavor disperses the pathogen. As far as entering channels, most of these herbs enter the lung channel because the lung governs the exterior and the wei qi and the opening and closing of the pores. Cautions we want to pay attention to.
These herbs are warm, acrid, and dry so use caution in cases of yin deficiency. Also these herbs are very dispersing so use caution with debilitated patients or patients with qi deficiency. Now that doesn't mean that these herbs are necessarily contraindicated. We'll just want to keep that in mind, that we might need to modify the formula to add tonifying or moistening herbs.
And we'll want to be careful not to use these herbs long term. So we just spent a lot of time talking about the category without talking about any of the actual herbs. But this is important because when we understand the category as a whole, that makes it a lot easier to understand the individual herbs.
And as we start building up a large repertoire of hundreds of herbs, the most important thing we'll want to remember is, what category does each herb belong to? So as we go through each herb, we're going to want to pay attention to two things. Number one, within its category function, what is each herb's specialty?
So all of these herbs release the exterior, but what makes each herb stand out, or what makes it different from the rest? Is it better for headache, for stomach problems, or for sinus problems? Does it treat dampness? or summer heat.
And number two, we want to know, besides its category function, what else does this herb do? So besides releasing the exterior, what else are these herbs good for? So let's get into the individual herbs. First is ma huang, ephedra erba.
Ma huang. Ma huang has three main functions. It promotes sweating to release the exterior, it stops cough and wheezing, and it promotes urination to treat edema.
Ma huang is one of our best herbs for opening the pores and releasing the exterior, and it's the representative herb for taiyang excess pattern, that is, fever and chills without sweating. It turns out mahwang is so good at releasing the exterior, we even use it for warm patterns. We just have to combine it with cold herbs like shiogao or huangqin. Mahwang, a federal herbal, also disseminates lung qi to stop cough and wheezing.
When we say disseminate or diffuse lung qi, that just means where restoring the normal movement of qi in the lung, which in this case will treat coughing, panting, or labored breathing. So this is ephedra, and the active ingredient in this herb is ephedrine, which we now make in a synthetic form called pseudoephedrine, or pseudephed. So basically, mahwong is so good at stopping cough and wheezing that we even use it in western medicine for asthma and allergy relief.
And finally, mahwong promotes urination to treat edema. But we have to be careful here. When we say that Mahuang treats edema, we're usually talking about upper body edema, usually edema in the face or acute edema that happens during the course of an external attack. So if a patient has long-standing edema in the legs due to kidney yang deficiency, it's unlikely that we'd use Mahuang in that situation.
Mahuang enters the lung channel, and the lung is in the upper jowl, so Mahuang is for fluid accumulation in the upper body. If anything else, we could say that Mahuang can be used to treat B-syndrome because of its ability to disperse and expel pathogens. But this isn't quite as common as the other functions.
You might see it in one or two formulas for this purpose, or you might see it used in certain external applications. But really, the main things to know are Mahuang releases the exterior to treat taiyang excess. It's one of our best herbs for treating coughing and wheezing, and it promotes urination to treat upper body edema.
As far as entering channels go, ma huang enters the lung and ubi channels, which makes sense. Ma huang releases the exterior, and both the lung channel and the ubi channel relate to the exterior. The lung controls the opening and closing of the pores, and the ubi is part of the tai yang channel, the most exterior channel.
Also, ma huang is good for cough, so it enters the lung channel, and ma huang promotes urination, so it enters the ubi channel. As for the name of this herb, ma means hemp, like huo ma ren, and Huang means yellow, like the Huangdi Neijing. So Mahuang means hemp yellow.
There's an American version of this plant called Mormon tea, but this is usually referring to a different species called Ephedra nevadensis, which does not contain ephedrine. The one we use is Ephedra sinica, which does contain ephedrine. Next is Guizhi, cinnamomi ramulus or cinnamon twig.
Guizhi. Guizhi releases the exterior. and it's the representative herb for Ta Yang deficiency, or fever and chills with sweating. With Gui Jur, when we say it releases the exterior, we specifically say it releases the muscle layer.
This is implying that the pathogen is at a slightly deeper level than what we would see with Ma Huang. In this situation, we're more likely to see signs like stiff neck, body ache, and muscle soreness, because that's where the pathogen is, in the muscle layer. Besides releasing the exterior, Gui Jur, cinnamomi ramulus, has a strong function of warming and unblocking the yang qi of various parts of the body. It can warm the heart and unblock the yang qi of the chest, treating chest B and palpitations. It can warm the middle jiao, treating abdominal pain due to coldness, as in the formula xiao jian zhong tong.
It can warm the u-bee, treating urinary attention, as in the formula wu leng san. It can warm the channels to treat B syndrome due to cold. And then it can also treat certain conditions of blood stagnation due to cold.
Now, we don't really say that guizhi is a good thing. invigorates blood, but due to its warming yang nature, it can warm the vessels and help with blood stagnation caused by cold. Guizhi enters the lung channel because it releases the exterior, it enters the heart channel because it warms the chest, and it enters the yubi channel because it warms the yubi.
Now you'd think that guizhi would enter the spleen channel as well because it warms the middle jiao and because it releases the muscle layer, and the muscles and flesh are governed by the spleen. But for some reason, we don't say that Guizhi enters the spleen channel. We do, however, say that Guizhi is sweet in flavor. And remember, the sweet flavor is associated with earth, which is in turn associated with the middle jiao and the muscles and flesh. So maybe that's how we can think of the flavors.
Guizhi is acrid because it releases the exterior. And even though Guizhi doesn't really have any tonifying action, we still call it sweet because it treats a pattern of Ta Yong deficiency and because it goes to the muscle layer and the spleen. The zh'er in gui zh'er means twig, so gui zh'er just means cinnamon twig.
And lastly, we can say that ma huang and gui zh'er are very often used together as a dui yao pair. If we wanted to compare them, we could say that ma huang is better at opening the pores and inducing sweating, but gui zh'er is actually warmer in temperature. Ma huang works at a slightly more superficial level to release pathogens right under the skin, while gui zh'er works at a deeper level, releasing pathogens from the muscle layer.
For Taiyang excess, we actually use Mahuang and Guizhi together, and their ability to release the exterior is enhanced. For Taiyang deficiency, we combine Guizhi with other tonifying and harmonizing herbs. Next is Zizuye, Perilla Folium.
Z-zu-ye. Zizuye releases the exterior to treat wind cold, but it's not quite as strong as the previous two. The specialty of Zizuye comes from its second function, which is regulating middle jiaoqi to treat nausea and vomiting. So when we combine these two functions, that makes zitsuje especially useful for flu-like conditions, where we see fever and chills plus stomach issues like abdominal pain, nausea and vomiting. In regulating the middle jowl, zitsuje, perilofolium, can also be used for morning sickness and restless fetus.
And it can also be used for seafood poisoning. In Japanese, this is called shiso, which is often served as a garnish alongside sushi or sashimi. So maybe that can help you remember that zitsuge is good for seafood poisoning or upset stomach. Zizie enters the lung and spleen channels, which should make sense. It enters the lung channel because it releases the exterior, and it enters the spleen channel because it treats nausea and vomiting.
It's acrid because it releases the exterior, and it's aromatic because it's good for the middle jiao. As for the name, zi means purple and ye means leaf. So zizie means purple reviving leaf.
So it's a big leaf that's purple on one side and green on the other. Next we have jingjie. schizonepeta erba, jingjie. Like all the herbs in this category, jingjie releases the exterior, but its specialty is that it's only slightly warm or almost neutral in temperature, so it can be used for both wind heat and wind cold conditions. So we'll see jingjie show up in wind cold formulas like jingfengbaidu san, and we'll see it show up in wind heat formulas like yinchou san.
In releasing the exterior, it's also very useful for venting rashes for things like itchy skin or early stage measles, which is something we might associate more with wind heat rather than wind cold. And also, jingjie, schizonepeta erba, can be used as an auxiliary herb to stop bleeding, usually uterine bleeding or blood in the stool. But for this function, we usually use it in its charred form, called jingjie tan. Jingjie enters the lung channel because it releases the exterior, and it enters the liver channel because it stops bleeding.
Remember, the liver is responsible for storing blood. So herbs that stop bleeding tend to enter the liver channel. Jingjie is just the name of the plant, so it doesn't really translate to anything. But this plant is also known as Japanese catnip.
So maybe you can think that people who are allergic to cats tend to get rashes and be real itchy. And also, cats like to scratch things and cause bleeding. So Jingjie also stops bleeding. Next is fong fong, so poshnikovia radix, or radix. I think both pronunciations are correct.
You might also see this go by the name Lediborelia root. The Chinese name fong fong means guard against wind or protect from wind. So fong fong is the commander of the wind herbs.
It's good for all types of wind. Wind cold, wind heat, internal wind, external wind, wind in the upper body, wind in the lower body, all the wind. It releases the exterior to treat wind cold.
It releases the exterior to vent rashes. It dispels wind cold damp to treat B syndrome, especially when... Wind is predominant. It's used as an auxiliary herb for internal wind, for things like trembling of the hands and feet, or for spasm and contraction, like lockjaw. It can also be used for intestinal wind, treating things like tenesmus or painful diarrhea.
In addition to being acrid, feng feng is also marked sweet in flavor. Now this doesn't really mean it has any tonifying or moistening action. We really just say this because herbs in this category tend to be very drying, and feng feng is the least drying among them. Fangfeng enters the Yubi channel, probably because that's the most exterior channel.
It enters the liver channel because it treats B-syndrome and internal wind, and the liver governs wind. And it enters the spleen channel because it treats muscle cramping and diarrhea. So remember, fangfeng means guard against wind, so it's good for all types of wind. Next is Qianghuo, Nototrygiae Rhizoma Su Radix. Qianghuo?
In releasing the exterior, Qianghuo's spleen. specialty is treating exterior attack with signs of dampness. We should clarify here that with Qiang Huo, when we say dampness, we're specifically referring to dampness in the channels, presenting with things like joint pain, body heaviness, or sleepiness. This is a little different than internal dampness or middle jiao dampness.
Dampness in the middle jiao would be like digestive problems, poor appetite, nausea, vomiting, diarrhea, and that's not really what we're talking about here. Qiang Huo is for dampness in the channels, so we use it for fever and chills plus body ache, stiff neck, heaviness, and joint pain. Qianghuo is also good for B-syndrome because you know B-syndrome has an element of dampness and it's especially for B-syndrome in the upper body.
You can maybe remember this because we have two herbs with huo in the name. Qianghuo, which is better for B-syndrome in the upper body, and duhuo, which is better for B-syndrome in the lower body. Qianghuo is also considered a guiding herb to the Taiyang channel and to the Du channel.
So it can be used to direct other herbs in the formula to these channels. And because of that, we can also say that Qianguo is good for treating taiyang or occipital headache. So Qianguo is acrid because it releases the exterior and then bitter and aromatic to deal with the dampness. It enters the uv and kidney channels and some sources say the liver channel as well.
It enters the uv channel because that's the most exterior channel and it enters the kidney and liver channels because it treats B syndrome. We say it removes wind damp from between the sinews and bones, and those belong to the liver and kidney, respectively. So for Qianghuo, think dampness. When we see Qianghuo in a formula, it's usually because there's wind cold with accompanying signs of dampness. Next is Gaoben, Ligusticae Rhizoma.
Gao-ben. Gaoben is an interesting one because it enters the dew channel. We just don't see a lot of herbs entering the extraordinary channels, so that kind of makes it stand out.
In releasing the exterior, it's good for headache, especially occipital headache and vertex headache, because that's where the dew channel goes. And it's also good for B syndrome, especially acute low back pain due to wind cold. Because, again, that's where the dew channel goes.
Next is Bi-Jur, Angelica de Huracay Radix. Bi-Jur. Bi-Jur releases the exterior, and its specialties are opening the nasal orifices and treating Yang Ming headache. It's also good for certain skin conditions, like swelling and pus.
And it's good for dampness, especially vaginal discharge. So it enters the lung channel. because it releases the exterior and opens the nose, and it enters the spleen and stomach channels because of dampness and pus.
Herbs that discharge pus tend to enter the stomach channel. As for the name, Bai means white, and Zhe is just the name of the plant, Angelica. So this is just white Angelica.
So maybe you can think of an angelic person with headache and a stuffy nose and vaginal discharge. Next is Xi Xin, Asari radix at rhizoma. Xi Xin.
This is a very warming and very acrid herb. In fact, the name Xixin means thin acrid because the shape is thin and it's an intensely acrid herb. It's very good at warming the channels and dispersing cold. So it's commonly used for body ache and body pain. This can be pain anywhere in the body, but especially headache, toothache, or B syndrome.
Xixin is also very good for warming the lung, for cough with copious, thin, clear phlegm. And pay attention to the dosage. Xishin is slightly toxic, so its dosage is smaller than average, 1 to 3 grams. The leaves are especially toxic, so that's why we only use the root and the rhizome. And for those parts, most of the toxicity is reduced through boiling.
So you really want to be careful if you use this herb in its raw form, like in pills or powders. And again, xi means thin, like ximai is the thin pulse. And xin means acrid, like with the five flavors.
So Xi Xin is a very acrid herb. Sheng Jiang is fresh ginger root. Sheng Jiang. Like all herbs here, Sheng Jiang is warm and acrid, and it releases the exterior. But it's also good for warming the middle jiao to alleviate nausea and vomiting.
You can maybe remember this because even people who don't study Chinese medicine know that ginger tea is good for an upset stomach. But we just need to be careful to remember that Sheng Jiang is specifically for rebellious stomach qi due to cold. It is possible to have heat pattern nausea and vomiting, but shengjiang is only for cold. And then shengjiang is another herb that warms the lung for cough with thin, copious, clear white phlegm.
It also detoxifies other herbs like fucin bancha or for seafood poisoning. As for the name, sheng means raw or unprepared and jiang just means ginger. We can also use the peel of ginger root called sheng zhang pi.
Pi means skin or peel. Sheng zhang pi is similar to sheng zhang except that it's cooler in temperature and its specialty is promoting urination to treat superficial edema. So sheng zhang pi makes you pee.
And this is the skin of the root so it treats edema under the skin. And then we have another food herb, zhong bai, aliphistulose bulbus, which is scallion or green onion. Zhong bai. Tong Bai releases the exterior, and it's usually used for a mild or early stage wind-cold attack.
So in America, if you're just starting to get sick, people might tell you to eat chicken noodle soup to feel better. Well, in Asia, it might be something more like miso soup, something with ginger and scallion in it to mildly promote sweating to release the exterior. Tong Bai can also warm the stomach to treat abdominal pain due to coldness, and it can be applied externally as a poultice to treat abscesses and sores. The name just means scallion white. Next is xiang ru, mossle erba.
Xiang ru. For xiang ru, think summer heat. So it releases the exterior to treat summer heat and summer heat dampness.
And it also treats wind cold attacks that occur during the warm summer months. The idea here is when it's hot during the summertime, if a person seeks out cold places or drinks a lot of cold beverages, they may contract wind cold even though the weather is warm. So xiang ru.
treats this wind-cold attack that occurs during the summertime. And then Xiangru also promotes urination to treat edema. As for the name, the xiang in xiangru means aromatic, so it's especially useful for when there's accompanying signs of dampness.
Next is sang-artsa, xanthiae fructus. Sang-artsa disperses wind and opens the nasal orifices, treating something we call deep-source nasal congestion. It can also be used to treat B-syndrome, or for wind-damp-related skin problems like itchiness and rash. Song artsa is slightly toxic. A large dose may cause digestive problems like nausea and vomiting, but it's usually safe to use in the normal dosage range.
You can also use the dry fried version, chao song artsa, to reduce its toxicity. As for the name, zong refers to the color. It means like deep green. Ar means ear, and zz means seed. So this is green ear seed.
So maybe it looks like an ear of corn, but I think it looks more like something that you would stick up your nose. It's got those nice spiky things on it, so you could really use it to dig out that deep source nasal congestion. Xinyi or xinyihua is magnolia flower. Xin-yi-hua.
Pretty much the only thing this one does is it opens the nasal orifices. So now we have three herbs that open the nasal orifices. Cang-ar-zi, Bai-zhi, and xinyihua.
And it turns out they're all used together in a formula called Cang-ar-zi-san. So this is the formula for... opening the nose or for deep source nasal congestion.
The only other thing we need to know about xinyi hua is this herb is very fuzzy so you should wrap it in cheesecloth or put it in a tea bag before you cook it. Otherwise those fuzzies will come out in the decoction and may cause some throat irritation. So maybe remember hua means flower and xinyi hua is magnolia flower so you can think about smelling the flowers to open your nose.
So finally let's just do a quick review. of all the herbs. Mahuang, ephedra erba, releases the exterior, especially for taiyang excess, which is fever and chills with no sweating.
It's one of our best herbs for coughing and wheezing, and it promotes urination to treat windwater facial edema. Guizhi, cinnamomi ramulus, releases the exterior or releases the muscle layer, especially for taiyang deficiency, which is fever and chills with sweating. It's also a warming herb. It warms the middle jiao, especially for abdominal pain due to coldness, warms the chest for chest B and palpitation, warms the UB for urinary retention, warms the channels for pain and B syndrome, and because it's warm, it can treat blood stagnation due to cold. Zizie, Perilofolium, releases the exterior and it moves middle jiao qi to treat nausea, vomiting, and morning sickness.
So it's especially useful when we have an external attack with concurrent stomach problems. Jingjie, Schizonopeta erba, releases the exterior. for both wind heat and wind cold. It's especially good at venting rashes and it can be used in its charred form to stop bleeding. Fong Fong, Sopochnicovia radix or Lead Varelia root, is the commander of all wind herbs.
It treats all the wind. Wind heat, wind cold, internal wind, and external wind. Qiang Huo, Nototorygiae Rhizoma Suradix, releases the exterior, especially when dampness is present, with signs like headache, body ache, body heaviness, and joint pain.
It's also useful for B-syndrome in the upper body. Remember, Qianguo treats upper body B, Duhuo treats lower body B. Gaoben, logusticae rhizoma, goes to the Dhu channel, so it's good for vertex headache and acute low back pain. Baijer, angelica dehuricae radix, releases the exterior, especially for Yangming headache and nasal congestion.
It's also good for dampness and pus. Xixin, a saruradix at rhizoma, is very acrid and very good at warming the body. It warms the channels for pain due to cold and warms the lung for copious clear phlegm.
It's toxic, so it has a smaller dosage. Shengjiang is fresh ginger. It promotes sweating to release the exterior and it warms the middle for upset stomach. The peel, Shengjiangpi, promotes urination to treat edema under the skin.
Congbai, scallion, mildly releases the exterior for early stage wind cold. Xiangru, mausolea erba, is for summer heat or for wind cold attacks that occur during the summer months. Sang-artsa and qin-yi-hua open the nasal orifices.
Sang-artsa is slightly toxic and qin-yi-hua is fuzzy, so put it in a tea bag before you cook it. So that's it for warm acrid herbs that release the exterior. I hope it was helpful.
Be sure to head over to the website tcmstudy.net and take the practice test. And before we go... Special thank you to the Patreon members for supporting this channel and supporting the website. If you enjoy this content and get value out of it, consider supporting the site by joining the Patreon. Just head over to TCMStudy.net and click the Patreon link at the top.
But that's all for today. Hope you enjoyed it. Thanks and see you next time.