Chinese herbal medicine often combines two or more drugs for better efficacy, which is called compatibility. What are the commonly used combinations with Ephedra?
I. Ephedra and Cinnamon Twig
Compatibility Mechanism:
Ephedra and Cinnamon Twig are both warm and pungent in nature and enter the Taiyang meridian. The combination of the two drugs was first created by Zhang Zhongjing in the "Treatise on Febrile Diseases". Ephedra is good at dispersing the protective qi and opening the pores, making it an important herb for inducing sweating and dispersing cold to relieve the surface. Its diaphoretic effect is the strongest among warm and pungent herbs for relieving the surface. Cinnamon Twig can warm the meridians, promote yang energy, penetrate the nutrient and protective qi, and relieve muscles and promote the surface, but its diaphoretic effect is weak. When the two drugs are used together, they can warm and disperse cold, and pungently relieve closure. Ephedra is assisted by Cinnamon Twig, and its diaphoretic effect is particularly strong. Cinnamon Twig can also expel pathogenic factors from the nutrient and protective qi to the muscles and surface, and there is a mutual need and use, forming a strong diaphoretic and surface-relieving combination.
Clinical Applications:
1. Exterior syndrome due to wind-cold. Symptoms include aversion to cold, fever, no sweating, headache, and body aches.
2. Cough and asthma caused by wind-cold constricting the lungs and failure of the lungs to spread and descend.
3. Wind-cold with dampness obstructing the muscles and surface, causing general body soreness and difficulty turning over in bed.
4. Prolonged cold with weakened pathogenic factors, red face, itchy body, no sweating or slight sweating, and pathogenic factors not receding.
Dosage and Administration:
Ephedra: 3-9g; Cinnamon Twig: 3-9g.
Precautions:
When clinically used, the dosage ratio of the two drugs should be determined based on the specific condition of the patient to avoid excessive sweating and damage to the body's vitality or ineffective sweating. If a stronger diaphoretic effect is needed, double the amount of Ephedra to Cinnamon Twig. If the amount of Ephedra is slightly larger than or equal to Cinnamon Twig, only slight sweating or obvious sweating will occur. This is suitable for the elderly and the weak, or those who already have phlegm, or those who have aversion to cold, fever, and sweating and need to relieve the surface but should not sweat excessively. It should be avoided in cases where excessive sweating is contraindicated, such as spontaneous sweating due to deficiency, external wind-heat, and deficient constitution with external pathogenic factors.
II. Ephedra and Apricot Kernel
Compatibility Mechanism:
Ephedra can disperse the lung qi, scatter cold, relieve wheezing, and stop coughing. Apricot Kernel can warm the lungs, descend qi, relieve wheezing, and transform phlegm. Both Ephedra and Apricot Kernel have antitussive effects, but Ephedra is mainly used to disperse and promote lung qi, while Apricot Kernel is mainly used to suppress and descend lung qi. Since the lungs have the physiological characteristics of both dispersing and suppressing, Ephedra and Apricot Kernel complement each other. Ephedra disperses lung qi and Apricot Kernel suppresses lung qi, promoting the movement of lung qi both upwards and downwards, achieving a harmonious balance. Therefore, the treatment of lung qi imbalance should focus on both promoting and suppressing lung qi in order to achieve the best therapeutic effect.
Clinical Applications:
Exterior syndrome with wind-cold invading the body, internal retention of cold fluids resulting in aversion to cold, fever, wheezing, coughing, and thin and watery phlegm, or wheezing and coughing due to phlegm retention.
Dosage and Administration:
Ephedra: 3-10g; Apricot Kernel: 4.5-9g. Ephedra is better when roasted, and Apricot Kernel is better when the tip is removed.
Precautions:
Ephedra is warm and dispersing, and can consume qi. It should not be used or should be used with caution in cases of deficiency with wheezing. For some patients with chronic obstructive pulmonary disease and wheezing, especially those with deficiency and excess, combining with tonifying herbs to eliminate disadvantages and use advantages can still achieve good therapeutic effects. "Don't be confined to the theory of 'prohibiting the use of tonics for deficiency syndrome'."
III. Ephedra and Gypsum
Compatibility Mechanism:
Ephedra can promote the dispersion of lung qi, induce sweating, and relieve the surface, and can also resolve lung heat through sweating. Gypsum can clear and purge internal heat. When used together with Ephedra, it can disperse and purge lung qi without assisting in heat generation, clear and purge lung heat without causing cold stagnation, and achieve a mutually beneficial effect. It is especially effective in treating lung heat accumulation.
Clinical Applications:
Febrile cough and asthma syndrome. Symptoms include fever with or without sweating, cough with rapid and urgent breathing, and in severe cases, flaring of the nostrils, thirst, thin white or yellow tongue coating, and floating and rapid pulse.
Dosage and Administration:
Ephedra: 3-9g; Gypsum: 15-60g. Gypsum should be used raw for clearing heat and reducing fire, and should be decocted before internal use.
Precautions:
Ephedra and Gypsum are suitable for asthma and cough caused by excessive heat in the lungs. They should not be used for asthma and cough caused by wind-cold and deficiency.
IV. Ephedra and Floatingheart
Compatibility Mechanism:
Both drugs enter the lung meridian, can promote lung qi, open the pores, and facilitate urination, and have diaphoretic and diuretic effects. They can be used to treat fever, lack of sweating, difficult urination, and edema. However, Ephedra is pungent and warm, suitable for exterior wind-cold with no sweating, while Floatingheart is pungent and cold, suitable for exterior wind-heat with no sweating, difficult urination, or various conditions of warmth and heat. When the two drugs are used together, their natures of one warm and one cold balance each other, and they mutually assist and enhance their dispersing and diffusing effects. Therefore, they are good at dispersing external pathogenic factors, opening the pores, and are considered pungent and dispersing herbs for relieving the surface, inducing sweating, and promoting urination.
Clinical Applications:
1. Edema. Symptoms include severe swelling above the waist, no sweating on the surface, difficult urination, and concurrent exterior syndrome.
2. Contact dermatitis caused by wind toxins.
3. Chronic urticaria with itching of the skin.
Dosage and Administration:
Ephedra: 3-6g; Floatingheart: 3-6g, up to 18-30g for fresh herbs.
Precautions:
Do not use for spontaneous sweating due to deficiency. Due to the strong diaphoretic effect of the combination, it is contraindicated in cases of blood deficiency with dry skin and wind pain due to qi deficiency.
