Ma Huang Fu Zi Xi Xin Tang

Classical TCM Formula Profile

Part of the HJMEDICAL TCM Discovery Center

麻黄附子细辛汤 · Má Huáng Fù Zǐ Xì Xīn Tāng

A Shang Han Lun formula for exterior cold attack on a background of Yang deficiency. It presents with fever, deep pulse, marked chills and cold limbs — exterior excess combined with interior Yang deficiency.

Formula CategoryExterior-Releasing Formulas Primary PatternYang Deficiency Respiratory Care

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Quick Facts

Formula Category: Exterior-Releasing Formulas
Primary Pattern: Yang Deficiency
Primary Function: Release exterior, warm Yang, disperse cold
Primary Therapeutic Principle: Warm the channels, assist Yang and release the exterior
Classical Source: Shang Han Lun (Zhang Zhongjing, Eastern Han)
Available as Granules: Yes

Formula Overview

Therapeutic Principle

Traditionally selected when exterior cold is clear but the pulse is deep and Yang deficiency is evident — a key formula for “cold exterior with deficient Yang,” not for pure excess exterior patterns.

Composition: Sovereign, Minister, Assistant, Envoy

Every herb in the formula, grouped by the job it does in the classical hierarchy.

君SovereignTreats the main pattern

麻黃Ma Huang6g

Ephedra Herb

induces sweating
diffuses the lung and calms wheezing

Serves as the chief medicinal that sets the formula's direction.

臣MinisterReinforces the sovereign

附子Fu Zi9g

Prepared Aconite Root

restores devastated yang
warms the interior and channels

Assists the sovereign in the principal treatment strategy.

佐/使Assistant & EnvoyTreats accompanying patterns, harmonises the whole

細辛Xi Xin3g

Asarum / Wild Ginger

warms the channels
releases the exterior and opens the orifices

Treats accompanying patterns and supports the chief medicinals.

Classical Composition

Herba Ephedrae (Ma Huang) 6g
Radix Aconiti Lateralis Praeparata (Fu Zi) 9g
Herba Asari (Xi Xin) 3g

Dosages follow the classical source and are shown for study, not as a prescription.

Related Conditions

Actions

Releases the exterior
warms the channels
and treats taiyang-shaoyin combination patterns.

Indications

This formula is indicated for a taiyang exterior pattern on a background of shaoyin yang deficiency.
Signs and symptoms include fever with a deep pulse, severe aversion to cold, and a desire to curl up.
Sweating is absent or scant.

Traditional Pathogenesis

Cause & mechanism

This pattern arises from deficient yang that fails to warm and activate the interior.
Without yang warmth, cold collects in the middle or lower jiao, causing cold pain, loose stools, cold limbs and a preference for warmth.

Clinical presentation

A taiyang exterior pattern superimposed on pre-existing shaoyin yang deficiency produces fever with a deep pulse and severe cold.

Treatment strategy

The correct method is to warm yang, dispel cold, and restore interior activation.
In this formula the emphasis is to warm the channels, assist Yang and release the exterior.

How does this formula compare?

Compare	Ma Huang Fu Zi Xi Xin Tang	Ma Huang Tang	Shen Su Yin
Primary Function	Release exterior, warm Yang, disperse cold	Release exterior Wind-Cold, stop wheezing	Tonify Qi, release exterior, resolve phlegm
Formula Category	Exterior-Releasing Formulas	Exterior-Releasing Formulas	Exterior-Releasing Formulas
Typical TCM Pattern	Yang Deficiency	Wind-Cold	Qi Deficiency
Main Conditions	Fever·Cold Limbs·Fatigue & Low Energy·Nasal Congestion	Cough·Dry Cough·Fever·Cold Limbs	Cough·Nasal Congestion·Fever·Fatigue & Low Energy
Main Herbs	Ephedra Herb·Prepared Aconite Root·Asarum / Wild Ginger	Ephedra Herb·Cinnamon Twig·Bitter Apricot Kernel·Honey-fried Licorice	Ginseng Root·Perilla Leaf·Kudzu Root·Peucedanum Root·Pinellia Rhizome
Classical Source	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Shang Han Lun (Zhang Zhongjing, Eastern Han)	Tai Ping Hui Min He Ji Ju Fang (Song dynasty)

Clinical Perspective

Ma Huang Fu Zi Xi Xin Tang releases exterior cold while warming Yang. Ma Huang Tang is pure exterior excess Wind-Cold without Yang deficiency. Gui Zhi Jia Fu Zi Tang addresses exterior deficiency with Yang damage and continuous sweating. Shen Su Yin tonifies Qi while releasing the exterior for Qi-deficient patients with external cold.

Clinical Differentiation

Ma Huang Fu Zi Xi Xin Tang is used for a taiyang exterior pattern on a shaoyin yang-deficiency background.
It is distinguished from Ma Huang Tang (exterior excess in a robust patient) and from Si Ni Tang (pure shaoyin interior cold without an exterior layer).

Tongue & pulseThe key marker is fever with a deep pulse and severe cold.

Safety notes: Ma Huang and Fu Zi are acrid and hot. This formula is not appropriate for yin-deficiency heat or for robust exterior-excess wind-cold without shaoyin cold.

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

Frequently Asked Questions

What are the actions of Ma Huang Fu Zi Xi Xin Tang?

Ma Huang Fu Zi Xi Xin Tang has the actions of assisting Yang and releasing the exterior, warming the channels, and dispersing Cold. It simultaneously warms interior Yang while gently expelling exterior Wind-Cold, making it suitable for Yang-deficient patients who contract Cold.

Which modern diseases is Ma Huang Fu Zi Xi Xin Tang suited to?

Modern TCM clinical practice commonly applies it to individuals whose pattern differentiation falls within Yang deficiency with exterior Cold, including common cold or influenza in the elderly or Yang-deficient patients, allergic rhinitis with clear watery discharge and cold intolerance, cold-type bronchitis or asthma, certain cases of bradycardia or sick sinus syndrome, and cold-triggered neuralgia or joint pain.

Is Ma Huang Fu Zi Xi Xin Tang suitable for improving severe chills with mild fever and a deep pulse?

For presentations of severe aversion to cold, mild or paradoxical fever, no sweating, fatigue, desire to sleep, cold extremities, a pale tongue with thin white coating, and a deep (rather than floating) pulse — in those whose pattern differentiation confirms Yang deficiency complicated by exterior Wind-Cold — TCM commonly applies Ma Huang Fu Zi Xi Xin Tang as an adjunct. It cannot replace standard medical treatment.

Read the complete guide →

Ma Huang Fu Zi Xi Xin Tang: Classic TCM Formula for Exterior Cold with Yang Deficiency

Ma Huang Tang: Classic TCM Formula for Exterior Wind-Cold Excess & No Sweating

Shen Su Yin: Classic TCM Formula for Exterior Wind-Cold with Qi Deficiency & Phlegm

Browse all classical formulas →

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.