I. Prescription Source & History

1. Tracing Ancient Records

Sha Shen Mai Dong Tang is from 'An Outline of Warm Febrile Diseases' written by Wu Jutong, a famous warm febrile disease expert in the Qing Dynasty. On the basis of summarizing the experiences of predecessors and combining his own rich clinical practice, Wu Jutong made outstanding contributions to the theory of formulae. 'An Outline of Warm Febrile Diseases' is an important work in the field of warm febrile disease study, systematically expounding the occurrence, development laws and syndrome differentiation and treatment methods of warm febrile diseases. As one of the classic formulas in it, Sha Shen Mai Dong Tang plays an important role in the treatment of the late stage of warm febrile diseases.

In ancient times, the prevalence of warm febrile diseases brought great disasters to people, and many medical experts were committed to studying the treatment methods of warm febrile diseases. On the basis of predecessors, Wu Jutong further improved the syndrome differentiation system of warm febrile diseases and classified warm febrile diseases into upper, middle and lower jiao for syndrome differentiation and treatment. Sha Shen Mai Dong Tang is a formula established for the syndrome of yin injury of the lung and stomach in the late stage of warm febrile diseases.

2. Heritage & Development

Since the publication of 'An Outline of Warm Febrile Diseases', Sha Shen Mai Dong Tang has always been valued and applied by later medical experts. With the development of the times, traditional Chinese medicine has been continuously inherited and innovated, and the application scope of Sha Shen Mai Dong Tang has gradually expanded.

In modern times, many medical experts have conducted in-depth research and exploration on Sha Shen Mai Dong Tang in clinical practice. According to different diseases and patients' constitutions, appropriate additions and subtractions have been made to the formula, making its curative effect more remarkable. The development of modern medicine has also provided new perspectives and methods for the research of Sha Shen Mai Dong Tang. Some scholars have explored the pharmacological action mechanisms of Sha Shen Mai Dong Tang through experimental research, providing a more solid theoretical basis for its clinical application.

II. Composition of Herbs

1. Monarch Herb: Adenophora

Radix Glehniae is divided into Radix Glehniae seu Adenophorae and Radix Glehniae. Generally, Radix Glehniae is used in Sha Shen Mai Dong Tang. Radix Glehniae tastes sweet and slightly bitter, is slightly cold in nature, and belongs to the lung and stomach meridians.

Its main effects are to nourish yin and moisten the lung for relieving cough, and benefit the stomach for promoting the production of body fluid. In the late stage of warm febrile diseases, when the yin fluid of the lung and stomach has been damaged, Radix Glehniae can nourish the lung yin and relieve symptoms such as dry cough due to lung dryness. It is like a loyal guardian, providing the power of moistening and repairing for the damaged lung.

Radix Glehniae is soft and moist in texture and is good at nourishing yin. It has a good conditioning effect on symptoms such as dry throat and mouth, and dry cough with little sputum caused by yin deficiency of the lung and stomach. It can penetrate deep into the lung and stomach meridians to nourish the yin fluid and gradually restore the functions of the lung and stomach to normal.

2. Minister Herb: Ophiopogon

Radix Ophiopogonis tastes sweet and slightly bitter, is slightly cold in nature, and belongs to the heart, lung and stomach meridians.

Ophiopogon japonicus has the effects of nourishing yin and moistening the lungs, promoting the production of fluid to moisten the stomach, and clearing the heart to remove vexation. In the Decoction of Adenophora and Ophiopogon japonicus, it assists Adenophora to enhance the power of nourishing yin and moistening the lungs and promoting the production of fluid to moisten the stomach. At the same time, Ophiopogon japonicus can also clear the heart to remove vexation, and has a certain therapeutic effect on symptoms such as restlessness and insomnia caused by the lingering of residual heat in the later stage of febrile disease.

The yin-nourishing effect of Ophiopogon japonicus is relatively mild and can act synergistically with Adenophora to jointly nourish the yin of the lungs and stomach. It is like a capable assistant, working with Adenophora to comprehensively protect the yin fluid of the lungs and stomach, ensuring sufficient yin fluid in the body and thus alleviating various yin deficiency symptoms.

3. Assistant Herbs

Polygonatum odoratum is sweet in taste, neutral in nature, and belongs to the lung and stomach meridians. It has the functions of nourishing yin and moistening dryness, and promoting the production of fluid to relieve thirst. In the Decoction of Adenophora and Ophiopogon japonicus, Polygonatum odoratum can enhance the effects of Adenophora and Ophiopogon japonicus in nourishing yin and moistening dryness, further nourishing the yin fluid of the lungs and stomach, making the yin-nourishing effect of the formula more comprehensive.

Trichosanthes kirilowii is sweet and slightly bitter in taste, slightly cold in nature, and belongs to the lung and stomach meridians. It can clear heat and purge fire, and promote the production of fluid to relieve thirst. It can assist Adenophora and Ophiopogon japonicus to clear the residual heat in the lungs and stomach, while replenishing body fluids to prevent further consumption of yin fluid.

Dolichos lablab is sweet in taste, slightly warm in nature, and belongs to the spleen and stomach meridians. It can strengthen the spleen and resolve dampness. In the later stage of febrile disease, the function of the spleen and stomach may be affected to a certain extent. Dolichos lablab can play the role of strengthening the spleen and regulating the stomach, preventing the yin-nourishing drugs from being too greasy and hindering the transportation and transformation of the spleen and stomach, making the formula tonifying without stagnation.

4. Guide Herb: Licorice

Licorice is sweet in taste, neutral in nature, and belongs to the heart, lung, spleen and stomach meridians. It has the functions of invigorating the spleen and replenishing qi, moistening the lungs and relieving cough, and coordinating the properties of various drugs.

In the Decoction of Adenophora and Ophiopogon japonicus, Licorice can, on the one hand, coordinate the properties of drugs such as Adenophora and Ophiopogon japonicus, making them act synergistically to achieve the best therapeutic effect; on the other hand, Licorice can also invigorate the spleen and replenish qi, enhance the function of the spleen and stomach, and promote the absorption and transportation of drugs. It is like a coordinator, enabling various drugs in the formula to coexist harmoniously and jointly play a therapeutic role for patients.

III. Pathogenesis, Efficacy and Indications

1. Analysis of Pathogenesis

In the later stage of febrile disease, the pathogenic heat has subsided, but the yin fluid of the lungs and stomach has been consumed. The lung is in charge of qi and respiration, opens into the nose, is externally related to the skin and hair, and prefers moistness and dislikes dryness. During the process of febrile disease, the lung is easily invaded by pathogenic heat, resulting in damage to the yin fluid, presenting symptoms such as dry cough with little sputum, dry throat and dry mouth.

The stomach is the foundation of acquired constitution, responsible for receiving, accommodating, ripening, and digesting food and drink, and it prefers moistness over dryness. In the late stage of febrile diseases, when there is deficiency of stomach yin, symptoms such as thirst and loss of appetite will occur. The yin fluids of the lung and stomach nourish each other, and damage to one often affects the other, thus forming the pathogenesis of injury to both lung and stomach yin.

2. Explanation of Efficacy

The main efficacy of Shashen Maidong Decoction is to nourish the lung and stomach, promote the production of body fluid and moisten dryness. Through the action of yin-nourishing drugs such as Adenophorae Radix and Ophiopogonis Radix, the consumed yin fluids of the lung and stomach are replenished, enabling the lung to regain its moistness and normally perform its functions of diffusing and descending, relieving symptoms such as cough and dry throat.

At the same time, the drugs in the formula can also promote the production of body fluid and moisten dryness, improve the conditions of thirst and loss of appetite caused by deficiency of stomach yin, promote the transportation and transformation functions of the spleen and stomach, enable the body to better absorb nutrients, and restore healthy qi.

3. Indicated Diseases

Shashen Maidong Decoction is mainly used to treat the syndrome of injury to the lung and stomach yin by dryness. The symptoms include dry throat and thirst, dry cough with little sputum, or fever, or dry stools, red tongue with little coating, and thready and rapid pulse.

Clinically, it is commonly seen in the late stage of febrile diseases, such as the late stage of cold, pneumonia, bronchitis, etc., presenting manifestations of injury to lung and stomach yin; it can also be seen in some chronic diseases, such as pulmonary tuberculosis, diabetes, etc. When symptoms of yin deficiency of the lung and stomach appear during the development of the disease, Shashen Maidong Decoction can also be used for conditioning.

IV. Analysis of ShaShen MaiDong Decoction

1. Moistening Dryness with Yin as Main Line

Shashen Maidong Decoction Taking Adenophorae Radix and Ophiopogonis Radix as the core drugs, it has a powerful effect of nourishing yin and moistening dryness. Adenophorae Radix directly nourishes lung yin, and Ophiopogonis Radix not only nourishes the yin of the lung and stomach, but also clears the heart and removes vexation. The two cooperate with each other to provide sufficient yin fluids for the lung and stomach, fundamentally improving the pathological state of yin deficiency of the lung and stomach.

Polygonati Odorati Rhizoma and Trichosanthis Radix further enhance the efficacy of nourishing yin and moistening dryness; Dolichoris Semen strengthens the spleen and resolves dampness, preventing the yin-nourishing drugs from being greasy and obstructing the spleen, ensuring the normal transportation and transformation functions of the spleen and stomach, and enabling the yin-nourishing drugs to better exert their effects. The whole formula revolves around the main line of nourishing yin and moistening dryness, comprehensively regulating the functions of the lung and stomach.

2. Synergistic Effect of Herbs Enhances Efficacy

The various drugs in the formula synergize with each other and play unique roles. Adenophora and Ophiopogon协同nourish the lung and stomach. Polygonatum odoratum and Trichosanthes kirilowii assist in enhancing the power of nourishing yin. Dolichos lablab strengthens the spleen and harmonizes the stomach, enabling the yin-nourishing drugs to be better absorbed and utilized. Licorice调和all the drugs, enabling the drugs in the formula to cooperate with each other and exert the best therapeutic effect.

This synergistic effect makes Shashen Maidong Decoction have a significant curative effect in nourishing the lung and stomach, promoting the production of body fluid and moistening dryness, and can comprehensively and effectively regulate the syndrome of yin injury of the lung and stomach.

3. Medication in Accordance with Lung & Stomach Physiological Features

The lung prefers moistness to dryness, and the stomach prefers moistness to dryness. Most of the drugs selected in Shashen Maidong Decoction have the characteristics of nourishing yin and moistening dryness, meeting the physiological needs of the lung and stomach. By nourishing the yin of the lung and stomach, the lung can maintain moisture and carry out normal respiratory functions; with sufficient stomach yin, it can better receive and ripen grains of food and promote digestion and absorption.

This method of prescribing drugs that conforms to the physiological characteristics of the lung and stomach can fundamentally improve the pathogenesis of yin injury of the lung and stomach and achieve the purpose of treating diseases.

V. Comparison with Other Similar Formulas

1. Comparison with Yiwei Decoction

Yin- Benefiting Decoction also comes from "An Outline of Warm Diseases" and is composed of Adenophora, Ophiopogon, rock sugar, Rehmannia glutinosa, and Polygonatum odoratum. Its main efficacy is nourishing yin and benefiting the stomach, focusing on nourishing stomach yin.

Compared with Yin- Benefiting Decoction, both Shashen Maidong Decoction and Yin- Benefiting Decoction have the effect of nourishing stomach yin. However, Shashen Maidong Decoction focuses more on nourishing the yin of the lung and stomach and also has a certain therapeutic effect on symptoms such as dry cough due to lung dryness; while Yin- Benefiting Decoction is relatively more focused on nourishing stomach yin and is more prominent in treating insufficient stomach yin.

From the perspective of drug composition, in addition to Adenophora, Ophiopogon, and Polygonatum odoratum, Shashen Maidong Decoction also contains Trichosanthes kirilowii, Dolichos lablab, and Licorice, with a richer drug composition and a more comprehensive effect.

2. Comparison with Baihe Gujin Decoction

Lily- Consolidating Metal Decoction It is from 'Shenzhai Yishu' and has the effects of nourishing the lung and kidney, relieving cough and resolving phlegm. Its drug components include lily, raw rehmannia root, prepared rehmannia root, ophiopogon root, scrophularia root, fritillaria cirrhosa, platycodon root, angelica sinensis, peony root, and licorice root.

ShaShen MaiDong Decoction Both ShaShen MaiDong Decoction and Lily Consolidating the Metal Decoction have the effect of nourishing yin and moistening the lung. However, Lily Consolidating the Metal Decoction focuses on nourishing the yin of the lung and kidney, and has a good curative effect on symptoms such as cough and hemoptysis caused by yin deficiency of the lung and kidney; while ShaShen MaiDong Decoction mainly targets the syndrome of yin injury of the lung and stomach, and mainly nourishes the lung and stomach.

In terms of drug composition, Lily Consolidating the Metal Decoction contains drugs such as lily, rehmannia root, and scrophularia root, and its yin-nourishing effect is more extensive, taking into account both the lung and kidney zang-fu organs; ShaShen MaiDong Decoction mainly focuses on drugs such as adenophora root and ophiopogon root, and focuses on nourishing the lung and stomach.

VI. Clinical Applications and Indications

1. Respiratory Diseases

In the late stage of diseases such as cold, pneumonia, and bronchitis, if there are symptoms of yin injury of the lung and stomach such as dry cough with little sputum, dry throat and mouth, and red tongue with little coating, ShaShen MaiDong Decoction can be applied for conditioning. It can nourish the lung yin, relieve cough symptoms, and promote the repair of the respiratory tract.

For patients with chronic bronchitis, during the remission period of the disease, if there are manifestations of yin deficiency of the lung and stomach, taking ShaShen MaiDong Decoction can improve the constitution and reduce the recurrence of the disease.

2. Digestive Diseases

ShaShen MaiDong Decoction can be used to treat digestive system diseases such as chronic gastritis and gastric ulcer. When there are symptoms of yin deficiency of the stomach, such as dull pain in the epigastrium, dry mouth and throat, and dry stools, applying this formula can nourish the yin of the stomach and relieve gastric discomfort.

For diabetic patients, if there are symptoms of yin deficiency of the lung and stomach, such as excessive thirst and polydipsia, polyphagia and easy hunger, and emaciation, ShaShen MaiDong Decoction also has a certain adjuvant therapeutic effect, which can regulate the body's yin-fluid balance and improve symptoms.

3. Other Conditions

During the recovery period of some chronic diseases, such as pulmonary tuberculosis, chronic hepatitis, etc., if there are manifestations of yin injury in the lung and stomach, Shashen Maidong Decoction can be used as a conditioning prescription to help patients restore the healthy qi of the body and promote the recovery of the disease.

In addition, for some symptoms of yin deficiency in the lung and stomach caused by overwork, staying up late, etc., such as dry throat, thirst, fatigue, etc., Shashen Maidong Decoction also has a good conditioning effect.

VII. Modified Shashen Maidong Decoction

1. Those with severe cough

Fritillaria cirrhosa and Armeniaca vulgaris can be added to enhance the effect of relieving cough and resolving phlegm. Fritillaria cirrhosa is sweet, bitter, and slightly cold in nature, and belongs to the lung and heart meridians. It can clear heat and resolve phlegm, moisten the lung and relieve cough. Armeniaca vulgaris is bitter and slightly warm in nature, and belongs to the lung and large intestine meridians. It can lower qi, relieve cough and asthma, and moisten the intestines and promote defecation. When combined with Shashen Maidong Decoction, they can effectively relieve cough symptoms.

2. Those with dry stools

Rheum officinale and Cannabis sativa can be added to moisten the intestines and promote defecation. Rheum officinale is bitter and cold in nature, and belongs to the spleen, stomach, large intestine, liver, and pericardium meridians. It can purge and reduce accumulation, clear heat and purge fire. Cannabis sativa is sweet and neutral in nature, and belongs to the spleen, stomach, and large intestine meridians. It can moisten the intestines and promote defecation. This can improve the condition of dry stools and restore the normal function of the intestines.

3. Those with poor appetite

Medicated leaven and Fructus Hordei Germinatus can be added to promote digestion and harmonize the stomach. Medicated leaven is sweet, pungent, and warm in nature, and belongs to the spleen and stomach meridians. It can promote digestion and harmonize the stomach. Fructus Hordei Germinatus is sweet and neutral in nature, and belongs to the spleen, stomach, and liver meridians. It can promote digestion and strengthen the stomach, and reduce lactation and relieve distension. It helps to enhance the transportation and transformation function of the spleen and stomach and improve appetite.

VIII. Dosage (Traditional and Modern Concentrated Granules)

1. Traditional method

3 qian (9g) of Adenophora stricta, 3 qian (9g) of Ophiopogon japonicus, 2 qian (6g) of Polygonatum odoratum, 2 qian (6g) of Trichosanthes kirilowii, 1 qian and a half (4.5g) of Dolichoos lablab, 1 qian (3g) of Glycyrrhiza uralensis.

Add appropriate amount of water to the above-mentioned herbs, soak for about 30 minutes, then decoct with low heat for 30 - 40 minutes, take the decoction, one dose per day, divided into two doses.

2. Modern concentrated granules

There are also concentrated granules of Shashen Maidong Decoction in the modern market. Its administration method is more convenient. Generally, according to the dosage in the instruction manual, it can be taken by冲服 with boiling water.

The concentrated granule is made from traditional Chinese medicine through processes such as extraction and concentration, which retains the effective components of Chinese medicine. It is convenient to take, saves time, and is suitable for the modern fast-paced lifestyle. However, when choosing concentrated granules, attention should be paid to selecting products with reliable quality and good reputation to ensure the efficacy of the medicine.

IX. Precautions and Taboos

1. Dietary taboos

During the period of taking Shashen Maidong Decoction, it is necessary to avoid eating spicy, greasy, and stimulating foods, such as chili peppers, fried foods, etc. These foods are likely to damage the spleen and stomach, exacerbate internal damp-heat, and are not conducive to the recovery of lung and stomach yin fluids.

At the same time, it is necessary to avoid eating raw and cold foods, such as ice cream, cold drinks, etc., so as to prevent cold pathogens from injuring the stomach and affecting the transportation and transformation functions of the spleen and stomach.

2. Special Populations

Pregnant women and lactating women should consult a doctor before using Shashen Maidong Decoction. Although most of the medicines in Shashen Maidong Decoction are relatively mild, the bodies of pregnant women and lactating women are relatively special, and they need to use medicines with caution.

When children use Shashen Maidong Decoction, the dosage should be appropriately adjusted according to age and constitution. Generally, the doctor should determine the dosage according to the specific situation.

3. Drug Interactions

If taking other medicines, it is necessary to inform the doctor before using Shashen Maidong Decoction to avoid drug interactions. Some medicines may react with the components in Shashen Maidong Decoction, affecting the efficacy of the medicine or causing adverse reactions.

X. Modern Research Progress

1. Pharmacological Research

Modern research shows that Shashen Maidong Decoction has various pharmacological effects. Its medicinal components can regulate the immune function of the body and enhance the body's resistance. Polysaccharide substances in medicines such as Adenophora stricta and Ophiopogon japonicus can promote the proliferation and activity of immune cells and improve the body's immune ability.

This prescription also has an antioxidant effect, which can scavenge free radicals in the body and reduce oxidative damage. Some studies have found that components such as flavonoid compounds in Shashen Maidong Decoction have antioxidant activity, which helps to delay aging and protect cells from oxidative stress damage.

In addition, Shashen Maidong Decoction also has a certain regulatory effect on the digestive system, respiratory system, etc. It can promote gastrointestinal peristalsis and improve digestive function; relieve respiratory tract inflammation and alleviate symptoms such as cough and asthma.

2. Clinical Efficacy Verification

In clinical studies, many studies have confirmed the effectiveness of Shashen Maidong Decoction. For patients with syndrome of yin injury of the lung and stomach, after taking Shashen Maidong Decoction, symptoms such as cough, dry throat, and thirst have been significantly improved, and the functions of the lung and stomach gradually return to normal.

In the adjuvant treatment of some chronic diseases, such as diabetes and chronic bronchitis, Shashen Maidong Decoction also shows certain curative effects. It can improve the symptoms of patients, enhance the quality of life, and reduce the recurrence rate of diseases.

3. Dosage Form Improvement Exploration

With the development of modern technology, continuous exploration has been carried out on the dosage form improvement of Shashen Maidong Decoction. In addition to the traditional decoction and modern concentrated granules, new dosage forms such as capsules and tablets have emerged.

While maintaining the drug efficacy, these new dosage forms are more convenient for patients to take and store. For example, capsules can mask the unpleasant smell of the drug and are easy for patients to accept; tablets have accurate dosages and are convenient to take. The dosage form improvement provides more choices for the clinical application of Shashen Maidong Decoction, which helps to improve the medication compliance of patients.

Summary

Shashen Maidong Decoction is a representative prescription for clearing and nourishing the lung and stomach, nourishing yin and promoting fluid production. It has the functions of moistening the lung and relieving cough, promoting fluid production and moistening dryness, benefiting the stomach and promoting fluid production, and promoting fluid production and quenching thirst. It is applicable to the syndrome of yin deficiency of the lung and stomach and dryness-heat injuring body fluid. All the ingredients in the prescription include Glehnia littoralis, Ophiopogon japonicus, Polygonatum odoratum, Dolichos lablab, Morus alba leaf, Trichosanthes kirilowii root tuber, Citrus reticulata peel, Glycyrrhiza glabra, etc. The medicinal properties are mild. It is often boiled with pork and preserved jujubes. Clinically, it has good curative effects on dry cough without phlegm, thirst, etc. However, it should be used with caution in those with deficiency-cold of the spleen and stomach.