Heat-Clearing Formulas

麻杏石甘汤 · Má Xìng Shí Gān Tāng

Ma Xing Shi Gan Tang

A classical heat-clearing formula traditionally used in TCM for patterns characterised by Lung Heat with cough and wheezing.

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Last reviewed August 2026

Formula CategoryHeat-Clearing Formulas

Primary PatternLung Heat

Primary FunctionClear Lung Heat

Primary Therapeutic PrincipleDiffuse the lung, clear heat, and calm wheezing

Main HerbsEphedra Herb · Gypsum · Bitter Apricot Kernel · Honey-fried Licorice

Classical SourceShang Han Lun (Zhang Zhongjing, Eastern Han)

Why This Formula?

Traditionally selected when Lung Heat has become more pronounced than the exterior Cold, with fever, thirst and wheezing rather than plain chills — placing far greater emphasis on clearing Heat than Ma Huang Tang, while acting on a deeper, more severe stage than the mild early wind-heat cough addressed by Sang Ju Yin.

Overview

What Is Ma Xing Shi Gan Tang?

1. Classical Literature

Ma Xing Shi Gan Tang (麻杏石甘汤 Ma Huang Xing Ren Gan Cao Shi Gao Tang), also known as Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction, originates from the Shang Han Lun (Treatise on Cold Damage), authored by the renowned Eastern Han physician Zhang Zhongjing. This foundational classical text laid a solid basis for the development of TCM clinical practice and formulary science in subsequent generations. Within the Shang Han Lun, Ma Xing Shi Gan Tang stands out for its distinctive combination approach and reliable therapeutic efficacy, making it one of the key formulas for treating externally contracted heat diseases.

2. Common Cold

Effective for colds with fever, slight aversion to cold, cough, wheezing, and thirst due to wind-heat congesting the lungs. It disperses pathogens, clears lung heat, and promotes rapid symptom relief.

3. Acute Bronchitis

Provides therapeutic results for bronchitis presenting with coughing, wheezing, fever, and thick yellow phlegm. It reduces bronchial inflammation, calms cough, and facilitates expectoration.

Ma Xing Shi Gan Tang: Diffusing Lung, Clearing Heat, Calming Wheeze and Cough | HJMEDICAL

4. Pneumonia (Early/Mid-stage)

Applied in early to middle stage pneumonia with high fever, severe cough, wheezing, and rapid breathing from lung heat. It clears lung heat and improves pulmonary inflammation, often with adjunct therapies.

How It Works

Herb Composition (Sovereign / Minister / Assistant / Envoy)

1. Chief Herb: Mahuang (Ephedra)

Acrid, slightly bitter, and warm, Mahuang governs the formula. It swiftly promotes sweating to release external pathogens and diffuses lung qi, effectively calming wheezing and relieving cough by restoring normal lung function.

2. Deputy Herb: Shigao (Gypsum)

Greatly cold and sweet, Shigao clears internal heat and drains fire, particularly from the lung and stomach channels. It counteracts the potential heat-generating effects of Mahuang, preserving fluids and relieving thirst, thus balancing the formula's warming actions.

3. Adjuvant Herb: Xingren (Apricot Kernel)

Bitter and slightly warm, Xingren directs qi downward to enhance the lung's function of stopping cough and calming wheezing. It also moistens the intestines, promoting smooth bowel movements and aiding the overall qi circulation for recovery.

4. Envoy Herb: Zhigancao (Honey-Fried Licorice)

Sweet and neutral, Zhigancao harmonizes the actions of all other herbs, preventing any single herb's properties from becoming too harsh. It also tonifies the spleen and qi, supporting the body's vital energy to combat pathogens and facilitate recovery.

Symptoms Traditionally Associated

Clinical Presentation in TCM

1. Pathomechanism Analysis

External wind pathogens invade the lung, causing lung qi depression and blockage. The pathogen transforms into heat internally, congesting the lung and establishing the core pathomechanism of heat pathogen congesting the lung.

2. Actions of Ma Xing Shi Gan Tang

Mahuang disperses surface pathogens; Shigao drains internal heat; Xingren descends qi and calms wheezing; Zhigancao harmonises all herbs — together achieving acrid-cooling exterior release and lung-clearing wheeze-calming.

3. Primary Indications

Ma Xing Shi Gan Tang is primarily used to treat fever, coughing, wheezing, thirst, and rapid pulse. Effective for early-to-middle stage respiratory conditions including common cold, influenza, bronchitis, and pneumonia with obvious heat signs.

Formula Analysis

The Mechanism in Classical Theory

1. Mahuang & Shigao: Balanced Action

The core pairing of warm Mahuang and cold Shigao creates a synergistic effect. Mahuang releases the exterior and calms wheezing, while Shigao restrains its warmth, preventing excessive diaphoretic action and protecting vital qi. This combination simultaneously addresses wind-cold and clears internal lung heat.

2. Xingren: Enhancing Lung Function

Xingren works with Mahuang to regulate lung qi; Mahuang diffuses outward, and Xingren directs inward and downward, enhancing wheeze-calming. It also cooperates with Shigao to clear lung-stomach heat and guide depressed heat downwards, reinforcing the formula's efficacy.

3. Zhigancao: Harmonizing & Strengthening

Zhigancao moderates the potent properties of the other herbs, ensuring a balanced medicinal force. It coordinates their actions for synergistic results and strengthens vital qi through its spleen-tonifying effect, enhancing the body's disease resistance and promoting recovery.

How This Formula Compares

Clinical Comparison Table

Compare	Ma Xing Shi Gan Tang	Ma Huang Tang	Sang Ju Yin
Primary Function	Clear Lung Heat	Release exterior Wind-Cold, stop wheezing	Disperse Wind-Heat, stop cough
Formula Category	Heat-Clearing Formulas	Exterior-Releasing Formulas	Exterior-Releasing Formulas
Typical TCM Pattern	Lung Heat	Wind-Cold	Wind-Heat
Main Conditions	Cough, Asthma & Wheezing	Cough, Dry Cough, Fever, Cold Limbs, Nasal Congestion	Cough, Dry Cough, Sore Throat, Fever
Main Herbs	Ephedra Herb · Gypsum · Bitter Apricot Kernel · Honey-fried Licorice	Ephedra Herb · Cinnamon Twig · Bitter Apricot Kernel · Honey-fried Licorice	Mulberry Leaf · Chrysanthemum Flower · Forsythia Fruit · Mentha / Peppermint · Platycodon Root · Bitter Apricot Kernel · Reed Rhizome · Licorice Root
Classical Source	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Wen Bing Tiao Bian (Systematic Differentiation of Warm Pathogen Diseases, Wu Jutong, 1798)

How to tell them apart

Ma Xing Shi Gan Tang, Ma Huang Tang, and Sang Ju Yin all address externally-contracted cough, but differ by pattern: Ma Xing Shi Gan Tang clears lung heat with more pronounced fever and thirst, Ma Huang Tang releases wind-cold with chills and absence of sweating, and Sang Ju Yin disperses wind-heat at a milder, earlier stage.

For educational reference only, based on traditional pattern differentiation — not a substitute for professional advice.

Clinical Modifications

Clinical Modifications for Ma Xing Shi Gan Tang

1. Severe Lung Heat

When lung heat is pronounced, the dose of Shigao can be increased to strengthen the heat-clearing and fire-draining force. A higher Shigao dose more effectively clears and drains the heat pathogen from the lung, relieving high fever and thirst. For example, the original formula's Shigao dose may be appropriately increased to 30–60g based on the clinical presentation to better address more intense lung heat.

2. Cough with Copious Phlegm

For patients with copious phlegm, phlegm-transforming and cough-stopping herbs such as Gualou (Trichosanthes Fruit), Beimu (Fritillaria), and Jiegeng (Platycodon) may be added. Gualou clears heat and transforms phlegm while dispersing chest binds; Beimu clears heat and transforms phlegm while moistening the lung to stop coughing; Jiegeng diffuses the lung to expel phlegm and benefits the throat. Combined with Ma Xing Shi Gan Tang, these herbs reinforce phlegm-transforming and cough-stopping effects, making phlegm easier to expectorate and relieving coughing symptoms.

Modern Research

What the Science Suggests

1. Pharmacological Research

Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum, and Licorice Decoction) is a classic formula in Traditional Chinese Medicine widely used to clear heat in the lungs and relieve symptoms such as sore throat, upper respiratory tract infection, cough with dyspnea, phlegm-heat, and heat-type asthma.

Key components like Ephedrine (Mahuang) stimulate the CNS and relax bronchi, while Shigao acts as an antipyretic. Xingren provides antitussive relief, and Zhigancao offers anti-inflammatory and immune-regulating benefits.

2. Respiratory Disease Treatment

By dispersing lung qi, venting heat, and calming wheezing, this formula effectively addresses the acute manifestations of exterior wind-heat invading the lungs that transform into internal heat (persistent fever), helping patients recover faster from respiratory discomfort. It is particularly suitable when there is fever, thirst, yellow or thick phlegm, and shortness of breath.

Clinical studies validate its effectiveness against colds, bronchitis, and pneumonia. It reduces inflammation, coughing, and wheezing, often shortening the disease course. Combining it with other medicines can further enhance therapeutic outcomes.

3. Immune Modulation

The formula significantly regulates immune function, boosting macrophage activity and overall disease resistance. By balancing cellular and humoral immunity, it helps patients recover and reduces the frequency of recurrent respiratory infections.

Safety

Safety Considerations

1. Precautions

While taking Ma Xing Shi Gan Tang, patients should maintain a light diet and avoid acrid, greasy, and irritating foods, as these may aggravate internal heat pathogens. Adequate rest and sufficient sleep should be ensured to support recovery. After taking the medicine, closely monitor changes in the condition — whether symptoms such as fever and coughing are improving — and seek prompt medical attention if the condition worsens or other discomforts arise.

2. Contraindications

Ma Xing Shi Gan Tang is contraindicated in those with a wind-cold exterior pattern without sweating. This formula treats external wind-pathogen invasion with heat congesting the lung; for patients with a wind-cold exterior pattern and absence of sweating, using this formula will not only fail to release the exterior and scatter cold but will actually damage yang qi through its cold-natured herbs, worsening the condition. In addition, those with spleen-stomach cold deficiency and loose stools should use the formula with caution, as the cold nature of the medicines may injure spleen-stomach yang qi, causing abdominal pain, diarrhoea, and other adverse reactions.

Available Products

Where to Get It

Nong's Ma Xing Gan Shi Tang Extract Granules

HJMEDICAL Nong's Ma Xing Gan Shi Tang (Ephedra, Apricot, Licorice & Gypsum) 5:1 Concentrated Granules $35.90

Hoi Tin Ma Xing Shi Gan Tang Extract Granules

HJMEDICAL Hoi Tin Ma Xing Shi Gan Tang (Ephedra, Apricot Kernel, Gypsum & Licorice Decoction) 5:1 Concentrated Granules $17.90

FAQ

Questions About Ma Xing Shi Gan Tang

Q1: What are the actions of Ma Xing Shi Gan Tang?

Ma Xing Shi Gan Tang has the actions of diffusing the lung and clearing heat, stopping cough and calming wheezing, and relieving lung heat. It is primarily used for symptoms caused by exuberant lung heat, including coughing, wheezing, chest tightness, yellow phlegm, and fever.

Q2: Which modern diseases is Ma Xing Shi Gan Tang suited to?

Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within exuberant lung heat, including Acute Bronchitis, Bronchial Asthma, viral upper respiratory infection, and Post-Infectious Cough.

Q3: Is Ma Xing Shi Gan Tang suitable for improving cough and wheezing?

For presentations of frequent coughing, thick yellow phlegm, rapid breathing, wheezing, chest tightness, and fever — in those whose pattern differentiation confirms exuberant lung heat — TCM commonly applies Ma Xing Shi Gan Tang as an adjunct. It cannot replace standard medical treatment.

Q4: Who should not take Ma Xing Shi Gan Tang?

Those with wind-cold cough, chronic cough due to lung deficiency, non-febrile cough and wheeze, thin white watery phlegm, or constitutionally weak individuals are generally not suitable. Use should be assessed by a qualified TCM physician based on individual constitution and pattern differentiation.

FAQ

General Questions

How do I choose the right formula?

TCM formulas are traditionally selected according to individual pattern differentiation rather than by symptom alone. If you're not sure which formula fits your presentation, take our AI Assessment below for a personalized starting point, then confirm with a qualified TCM practitioner.

What are concentrated herbal granules?

Concentrated herbal granules are made by decocting raw herbs, then extracting and concentrating the resulting liquid into a fine granule or powder form. This preserves the same active compounds as a traditional decoction while making the herbs far easier to store, measure, and prepare.

How should I take these products?

Dissolve the recommended amount of granules in hot water, stir until fully dissolved, and drink while warm — following the dosage and frequency advised by your TCM practitioner or as stated on the product packaging.

Are concentrated herbal granules equivalent to traditional decoctions?

Concentrated granules are produced from the same herbs and processed to retain their active compounds, so they are traditionally regarded as a convenient alternative to decoctions rather than a different remedy. Some practitioners note subtle differences in strength or absorption between the two forms, so your TCM practitioner may adjust dosage accordingly.

Are your products authentic?

Yes. HJMEDICAL sources its concentrated granules exclusively from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry, with GMP compliance stated directly on their packaging.

Are HJMEDICAL products manufactured under GMP standards?

HJMEDICAL sources its concentrated granules from established, reputable manufacturers such as Nong's and Hoi Tin, both long-standing names in the TCM granules industry. GMP compliance for these products is stated directly on their packaging.

Do you ship internationally?

Yes — we ship worldwide! Every order goes out via Hong Kong Post, and your exact shipping cost and estimated delivery time for your address are calculated and shown right at checkout, so there are never any surprises. We also offer free shipping once your order reaches our free-shipping threshold, so it's easy to stock up on your favorite formulas and save.

Can I take more than one formula at the same time?

Some formulas are traditionally combined, while others overlap or counteract each other. We recommend checking with a qualified TCM practitioner before combining formulas, especially if you are already taking other medication.

Are these products suitable during pregnancy or breastfeeding?

Some TCM formulas are not suitable during pregnancy or breastfeeding. Please consult a qualified TCM practitioner or your doctor before use if you are pregnant, trying to conceive, or nursing.

Do these products replace medical treatment?

No. These products are traditional herbal supplements intended to support wellbeing according to TCM principles — they are not a replacement for professional medical diagnosis or treatment. Please consult a qualified TCM practitioner or licensed healthcare provider before starting, stopping, or combining any treatment, especially if you have a chronic condition.

Medical Disclaimer

For general TCM education only — not medical advice. Consult a qualified TCM practitioner or licensed healthcare provider before use, especially if pregnant, nursing, on medication, or managing a chronic condition.

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