I. Prescription Source & History

1. Origin Background

Xingsu Powder was first recorded in "Differentiation of Warm Diseases" written by the famous Qing Dynasty physician Wu Jutong. In the medical practice at that time, external cough and other diseases were relatively common, and there were certain limitations in traditional treatment methods. Based on summarizing the experience of predecessors and combining his own rich clinical practice, Wu Jutong created the formula of Xingsu Powder to more effectively treat such diseases.

2. Historical Evolution

Since its appearance, Xingsu Powder has been continuously verified and improved in clinical applications. Physicians of past dynasties have made appropriate adjustments and expanded the application scope of the formula according to the actual situation. With the development of medicine, Xingsu Powder not only plays an important role in treating external cough, but its application scope has gradually expanded to some other diseases related to external pathogens, becoming one of the commonly used formulas in traditional Chinese medicine clinical practice and leaving a remarkable mark in the development of traditional Chinese medicine formula science.

II. Composition Introduction (Monarch, Minister, Assistant, Guide)

1. Monarch Drug

Perilla leaf: Pungent in flavor and warm in nature. It has the effects of inducing sweating to dispel cold and regulating qi to relieve distension. It can disperse wind-cold in the lung meridian and is a key herb for treating cough due to wind-cold. In Xingsu Powder, perilla leaf can quickly dispel the pathogenic cold in the muscle surface, enabling the lung qi to be dredged and laying a foundation for restoring the normal function of the lung.

Apricot kernel: Bitter and warm, entering the lung and large intestine meridians. It has the functions of relieving cough and asthma and moistening the intestine to promote defecation. Apricot kernel is good at descending the lung qi and has a good curative effect on cough and asthma. In the formula, combined with perilla leaf, one dispersing and one descending, they jointly regulate the qi movement of the lung, enabling the functions of dispersing and purging of the lung qi to return to normal, thus achieving the purpose of relieving cough and asthma.

2. Minister Drug

Pinellia ternata: Pungent, warm, and toxic. It enters the spleen, stomach, and lung meridians. It can dry dampness and resolve phlegm, and lower adverse qi and stop vomiting. Pinellia ternata has a strong effect on drying dampness and resolving phlegm, and can remove the pathogenic phlegm-dampness in the lung, having a good therapeutic effect on cough caused by phlegm-dampness blockage. Acting synergistically with apricot kernel and perilla leaf, it enhances the effects of resolving phlegm and relieving cough, regulating qi and relieving fullness in the chest, and helps relieve symptoms such as cough and chest distress.

Poria cocos: Sweet, light, and neutral. It enters the heart, lung, spleen, and kidney meridians. It has the effects of promoting diuresis to eliminate dampness and strengthening the spleen to calm the mind. Poria cocos can strengthen the spleen and promote diuresis to eliminate dampness, enabling the spleen and stomach to function normally in transportation and transformation and cutting off the source of phlegm production. At the same time, its diuretic effect can assist in removing excess water and dampness in the body, reducing the impact of phlegm-dampness on the lung, and creating a good internal environment for restoring the normal physiological function of the lung.

3. Assistant Drug

Fructus Aurantii: Bitter, pungent, sour, and warm. It enters the spleen and stomach meridians. It can regulate qi to relieve distension and promote qi movement to relieve fullness. Fructus Aurantii can enhance the qi-regulating power, assisting herbs such as perilla leaf and apricot kernel to better regulate qi movement, making the ascending and descending of the lung qi smoother. At the same time, it can also relieve discomfort symptoms such as chest distress and abdominal distension caused by qi stagnation, playing a role in regulating the qi movement of the whole body.

Peucedanum praeruptorum Dunn: Bitter, pungent, slightly cold. It belongs to the lung meridian. It can lower qi and resolve phlegm, disperse wind-heat. Peucedanum praeruptorum Dunn can both lower the lung qi to relieve cough and resolve phlegm, and disperse wind-heat. It has a good therapeutic effect on cough with symptoms of exogenous wind-cold complicated by wind-heat. It cooperates with other drugs in the prescription to enhance the comprehensive effects of dispelling exogenous pathogenic factors, resolving phlegm and relieving cough.

Fresh Ginger: Pungent, slightly warm. It belongs to the lung, spleen and stomach meridians. It has the effects of relieving exterior syndrome and dispelling cold, warming the middle-jiao to arrest vomiting, resolving phlegm and relieving cough. Fresh Ginger can enhance the power of Perilla frutescens (L.) Britt. in relieving exterior syndrome and dispelling cold. At the same time, its effect of resolving phlegm and relieving cough helps to relieve cough symptoms. Adding Fresh Ginger when taking medicine can also harmonize the properties of drugs and enhance the transportation and transformation functions of the spleen and stomach, enabling the drugs to exert better curative effects.

Chinese Date: Sweet, warm. It belongs to the spleen, stomach and heart meridians. It can invigorate the spleen and replenish qi, nourish blood and soothe the mind. Chinese Date can invigorate the spleen and replenish qi, enhance the functions of the spleen and stomach, and promote the absorption and transportation of drugs. At the same time, it can also harmonize all drugs and alleviate the drastic nature of the drugs in the prescription, making the properties of the whole prescription milder and suitable for long-term use by patients.

4. Guide Drug

Licorice Root: Sweet, flat. It belongs to the heart, lung, spleen and stomach meridians. It has the effects of invigorating the spleen and replenishing qi, moistening the lung and relieving cough, clearing heat and detoxifying, and harmonizing all drugs. Licorice Root can both moisten the lung and relieve cough to alleviate cough symptoms, and harmonize all drugs, enabling the effects of various drugs to synergize and exert the best therapeutic effects. It can also relieve the stimulation of drugs on the gastrointestinal tract, protect the functions of the spleen and stomach, and ensure the safe and effective exertion of the prescription.

III. Pathogenesis, Efficacy & Indications

1. Pathogenesis

When invaded by pathogenic factors of exogenous cool-dryness, the lung and defensive qi are not properly disseminated, the lung qi fails to descend and disperse, the body fluids are not properly distributed, gather to form phlegm, block the airways, resulting in symptoms such as cough and expectoration. At the same time, the transportation and transformation functions of the spleen and stomach may also be affected, presenting manifestations such as chest distress and nausea.

2. Efficacy

Relieve cool-dryness by dispersing, regulate the lung and resolve phlegm. By dispersing the pathogenic factors of cool-dryness on the muscle surface, restore the dispersing and descending functions of the lung, make the lung qi smooth, and enable the phlegm to be discharged, so as to achieve the purpose of relieving cough and resolving phlegm, and regulating qi movement.

3. Indications

Exogenous cool-dryness syndrome. Symptoms include aversion to cold without sweating, slightly headache, cough with thin sputum, nasal congestion and dry throat, white tongue coating and taut pulse. Aversion to cold without sweating is caused by the failure of the muscle surface to be warmed by the pathogenic factors of exogenous cool-dryness; slightly headache is due to the cold pathogen attacking the clear orifices; cough with thin sputum is due to the failure of the lung to disperse and descend, and the body fluids condense into phlegm; nasal congestion and dry throat are due to the dryness pathogen injuring the body fluids and the lung orifices and throat losing moisture; white tongue coating and taut pulse are manifestations of cool-dryness.

IV. Analysis of Formula Meaning

1. Relieving Exterior & Ventilating Lung

Combined with Armeniaca vulgaris Lam., Perilla frutescens (L.) Britt. disperses and Armeniaca vulgaris Lam. descends, dispersing the pathogenic factors of cool-dryness on the muscle surface, restoring the dispersing function of the lung, and making the lung qi smooth. This is the key link in the treatment of cough due to exogenous cool-dryness. The pungent-warm dispersion of Perilla frutescens (L.) Britt. can disperse the cold pathogen on the muscle surface, and the bitter-warm qi-lowering effect of Armeniaca vulgaris Lam. can make the lung qi descend. The two work synergistically to regulate the qi movement of the lung, creating conditions for subsequent resolving phlegm and relieving cough.

2. Resolving Phlegm & Regulating Qi

Pinellia ternata dries dampness and resolves phlegm; Poria cocos strengthens the spleen and eliminates dampness to prevent the source of phlegm production; Citrus aurantium regulates qi and relieves chest tightness; Peucedanum praeruptorum lowers qi and resolves phlegm. These herbs work together to target the pathogenesis of phlegm and dampness obstructing the airways. Through their phlegm-resolving and qi-regulating effects, they eliminate phlegm, clear the airways, relieve symptoms such as cough and chest tightness, and gradually restore lung function to normal.

3. Harmonizing Spleen & Stomach

Ginger, Jujube, and Licorice have the function of regulating the spleen and stomach. Ginger can relieve exterior syndrome and dispel cold, warm the middle-jiao to arrest vomiting. Jujube can invigorate the spleen and replenish qi, nourish the blood and soothe the mind. Licorice can invigorate the spleen and replenish qi, harmonize various herbs. They help to enhance the transportation and transformation function of the spleen and stomach, enable the herbs to be better absorbed and utilized, and at the same time reduce the stimulation of the herbs on the spleen and stomach, ensuring the safety and effectiveness of the prescription.

4. Overall Conditioning

Through the synergistic effects of various herbs in the entire formula, from relieving exterior syndrome, dispersing the lung qi, resolving phlegm, regulating qi movement to harmonizing the spleen and stomach, it comprehensively regulates various pathological changes in the human body caused by exogenous cool dryness, restores the normal functions of the lungs, spleen and stomach and other zang-fu organs, and achieves the purpose of treating the syndrome of exogenous cool dryness.

V. Comparison with Other Similar Formulas

1. Comparison with Sangxing Decoction

Mulberry and Apricot Decoction It is mainly used to treat the syndrome of exogenous warm dryness, manifested as mild fever, thirst, dry throat and nose, dry cough without sputum or scanty and sticky sputum, red tongue, thin white and dry tongue coating, floating and rapid pulse. Its drug composition focuses on dispersing pathogenic factors of warm dryness and moistening the lung to arrest cough, such as Mulberry Leaf, Apricot Kernel, Glehnia littoralis, Fritillaria thunbergii, Sojae semen preparatum, Gardenia jasminoides Ellis, Pyrus pyrifolia, etc. Compared with Apricot Kernel and Perilla Decoction, Mulberry and Apricot Decoction focuses on treating pathogenic factors of warm dryness, and the drugs are inclined to clear heat and moisten dryness; while Apricot Kernel and Perilla Decoction mainly targets pathogenic factors of cool dryness, and the drugs are inclined to relieve exterior cold, resolve phlegm and regulate qi.

2. Comparison with Zhisou Powder

Cough-Suppressing Powder   is primarily used to treat wind-cold invading the lungs, characterized by cough, itchy throat, difficulty expectorating phlegm, or slight aversion to wind and fever, thin white tongue coating, and a floating and slow pulse. Its medicinal components include...Platycodon grandiflorum、Schizonepeta tenuifolia、Aster tataricus、Stemona japonica、Rhizoma Cynanchi Stauntonii、Licorice、Pericarpium Citri Reticulatae Viride. Cough-Suppressing Powder's main function is to relieve wind and stop coughing. It has a mild effect and is used for various types of coughs without obvious signs of chills or fever. Apricot Kernel and Perilla Decoction For exogenous cool dryness, there is a clear cause of cool dryness, and it has a more prominent effect in relieving exterior cold and resolving phlegm to stop cough.

VI. Clinical Applications and Indications

1. Respiratory Diseases

Post - cold cough: After the patient has a cold, the symptom of aversion to cold is not obvious, but there are still cough, expectoration, the sputum is clear and thin, accompanied by nasal congestion, dry throat and other symptoms, which conform to the manifestation of exogenous cool dryness syndrome. Xingsu Powder can be selected for treatment. By dispersing the pathogenic factor of cool dryness and regulating the lung qi, the cough symptom can be relieved.

Chronic bronchitis: For patients with chronic bronchitis, if the cough is aggravated due to exogenous cool dryness, presenting symptoms such as expectoration of clear and thin sputum, aversion to cold, etc., Xingsu Powder can be used as an adjunctive treatment formula. Its effect of resolving phlegm and regulating qi helps to improve respiratory symptoms and reduce the inflammatory reaction.

2. Otorhinolaryngological Diseases

Allergic rhinitis: Some patients with allergic rhinitis, after being stimulated by the cool dry qi in autumn and winter, present symptoms such as clear nasal discharge, nasal congestion, sneezing, etc., accompanied by cough, dry throat and other manifestations. Xingsu Powder can regulate the qi mechanism of the body, disperse cool dryness, and relieve nasal and respiratory symptoms, and has a certain therapeutic effect on such allergic rhinitis.

Dry throat and sore throat: For dry throat and sore throat caused by exogenous cool dryness, in addition to dry throat and sore throat, the patient is also accompanied by cough, expectoration, aversion to cold and other symptoms. Xingsu Powder can relieve the symptoms by dispersing the lung and dryness and relieving sore throat.

VII. Modified Xingsu Powder

1. Severe exterior syndrome of wind-cold

Ephedra and Ramulus Cinnamomi can be added to enhance the power of relieving exterior cold. Ephedra is pungent and warm, capable of inducing sweating to relieve the exterior, dispersing the lung qi and relieving asthma. Ramulus Cinnamomi is pungent, sweet and warm, capable of relieving the exterior by dispelling wind, warming and dredging the channels. The synergistic effect of these two herbs with Folium Perillae and other herbs can more effectively disperse the wind - cold pathogen and relieve symptoms such as aversion to cold and absence of sweating.

2. Those with severe phlegm-dampness

Magnolia officinalis and Atractylodes lancea can be added to dry dampness and resolve phlegm. Magnolia officinalis is bitter, pungent and warm in nature, capable of drying dampness, eliminating phlegm, descending qi and relieving fullness. Atractylodes lancea is pungent, bitter and warm, able to dry dampness and strengthen the spleen, dispel wind and dissipate cold. Adding these two herbs can enhance the phlegm-resolving effect of the prescription and better deal with the situation of heavier phlegm-dampness.

3. With Severe Qi Stagnation

Aucklandia lappa and Cyperus rotundus can be added to promote qi circulation and relieve pain. Aucklandia lappa is pungent, bitter and warm, capable of promoting qi circulation to relieve pain, strengthening the spleen and promoting digestion. Cyperus rotundus is pungent, slightly bitter, sweet and neutral, able to soothe the liver, regulate qi and relieve pain during menstruation. They can enhance the qi-promoting effect of herbs such as Fructus Aurantii Immaturus and relieve discomfort symptoms such as chest distress and distending pain caused by qi stagnation.

VIII. Dosage (Traditional and Modern)

1. Traditional Methods

Decoct the following herbs in water for oral administration: Folium Perillae (9g), Pinelliae Rhizoma (9g), Poria (9g), Peucedani Radix (9g), Platycodonis Radix (6g), Fructus Aurantii Immaturus (6g), Glycyrrhizae Radix (3g), Zingiberis Rhizoma Recens (3 slices), Jujubae Fructus (3 pieces), Armeniacae Semen Amarum (9g). Add appropriate amount of water to the above herbs, soak them and then decoct. Take the decoction in two warm doses.

2. Modern Concentrated Granules

Currently, there is a modern concentrated granule dosage form of Apricot Kernel and Perilla Powder on the market. Its administration method is more convenient. Generally, it can be taken by taking it orally with warm water according to the dosage specified in the instructions. For example, a certain brand of concentrated granule of Apricot Kernel and Perilla Powder is equivalent to 10g of crude drug per dose. Usually, it is taken once a day in two divided doses by taking it orally with warm water. The modern concentrated granule dosage form retains the efficacy of the traditional prescription and is convenient to take, suitable for the modern fast-paced lifestyle.

IX. Precautions and Taboos

Dietary Taboos and Preferences

During the medication period, raw and cold, greasy foods such as cold drinks and fried foods should be avoided. Raw and cold foods are likely to damage the yang qi of the spleen and stomach, affect the transportation and transformation functions of the spleen and stomach, and are not conducive to the absorption of drugs and the recovery of the disease. Greasy foods may increase the burden on the spleen and stomach, leading to the generation of endogenous phlegm-dampness and aggravating symptoms such as cough.

2. Special Populations

Use with caution during pregnancy. Although most of the herbs in Apricot Kernel and Perilla Powder are relatively mild, Pinelliae Rhizoma and other herbs have certain toxicity. Pregnant women should use drugs with caution and should be used under the guidance of a doctor.

For those with deficiency-cold of the spleen and stomach, if symptoms such as discomfort in the epigastrium, abdominal pain, and diarrhea occur after taking the medicine, the medicine should be stopped immediately and a doctor should be consulted for adjusting the prescription. Because the spleen and stomach functions of those with deficiency-cold of the spleen and stomach are inherently weak, the drugs in this prescription may further impair the yang qi of the spleen and stomach.

X. Modern Research Progress

1. Pharmacological Research

Modern research shows that some drugs in Xingsu Powder have multiple pharmacological effects. Perilla leaf has antibacterial, antiviral, anti-allergic effects, and its volatile oil components may be the material basis for exerting these effects. Amygdalin in almonds has antitussive and antiasthmatic effects, which can inhibit the cough center and reduce the frequency of coughing. Pinellia ternata can inhibit the vomiting center and play an antiemetic role. At the same time, the alkaloids and other components it contains may have the effects of resolving phlegm and anti-inflammation. Poria cocos has immunomodulatory, diuretic and other effects, which helps to enhance the body's immunity and promote the metabolism of body fluids.

2. Clinical Efficacy Verification

Multiple clinical studies have confirmed the effectiveness of Xingsu Powder in treating related diseases such as exogenous cough. For example, for patients with cough after a cold, after using Xingsu Powder for treatment, the cough symptoms are significantly reduced, the amount of expectoration is decreased, and the overall symptoms of the patients are improved. In some patients with acute exacerbation of chronic bronchitis, adding Xingsu Powder for adjuvant treatment can shorten the course of disease, reduce the inflammatory reaction, and improve the quality of life of the patients. These research results further prove the value of Xingsu Powder in clinical application and provide a strong basis for its popularization and application in modern medicine.

Summary

Xingsu Powder is from 'Treatise on Febrile Diseases Differentiation and Treatment'. It is a representative formula for treating cough with thin sputum caused by exogenous dryness-cold. It has the functions of dispersing the lung to arrest cough and resolve phlegm, moistening dryness, regulating qi and strengthening the spleen to resolve phlegm. It is applicable to respiratory and tracheal diseases such as colds and bronchitis. Patients often have nasal congestion, dry throat, aversion to cold without sweating, and slight headache. The key points for syndrome differentiation lie in the resolution of the exterior syndrome and the coordinated ascending and descending. In the formula, perilla leaf is pungent-warm, almond is bitter-warm, Peucedanum praeruptorum is used to disperse wind and lower qi, Platycodon grandiflorum, Aurantii Fructus Immaturus, Citrus reticulata Blanco, Pinellia ternata, Poria cocos, Glycyrrhiza glabra, etc. are used with bitter-warm and pungent-sweet herbs. The adjuvant drug Glycyrrhiza glabra harmonizes nutrient qi and defensive qi. Clinically, it is often used together with Zingiber officinale, Citrus reticulata Blanco, and Ziziphus jujuba Mill., and has a good curative effect on dryness-cold syndrome.