Ma Xing Gan Shi Tang: A Gentle Remedy for Fever and Cough
Health Lab- Jan 30
- 5 min read
Updated: May 3
Ma Xing Gan Shi Tang, or Ephedra and Almond Decoction, is a time-tested Chinese medicine recipe from Shang Han Lun. Known for clearing lung heat, easing coughs, and relieving asthma, it’s a go-to for respiratory issues caused by colds or infections.
With just four herbs—ephedra, almonds, licorice, and gypsum—it cools the body and supports smooth breathing. In this guide, we’ll explore its ingredients, benefits, modern uses, and precautions in a clear, easy-to-understand way.
What’s in Ma Xing Gan Shi Tang?
This simple yet powerful decoction combines four herbs:
Ephedra: Warm and pungent, it opens the lungs, relieves asthma, and promotes sweating to clear surface pathogens.
Almonds: Bitter and calming, they soothe coughs and ease breathing by directing lung energy downward.
Roasted Licorice: Sweet and neutral, it harmonizes the formula, boosts energy, and hydrates to quench thirst.
Gypsum: Cold and sweet, it clears intense lung heat and produces body fluids to relieve fever.
How They Work Together
Ephedra and gypsum form the core: ephedra opens the lungs to release cold, while gypsum cools internal heat. Almonds calm coughs and asthma, and licorice balances the mix, ensuring the herbs work smoothly without irritating the stomach.
How to Use It
Traditional Method: Boil the herbs in water to make a decoction, then sip warm multiple times daily.
Modern Method: Follow a doctor’s dosage, typically decocting the herbs and drinking warm. Adjust based on symptoms.
What Does It Do?
Ma Xing Gan Shi Tang clears heat and supports lung function, helping with:
Cooling Fever: Reduces persistent body heat and thirst.
Easing Coughs: Soothes coughs with little phlegm and calms rapid breathing.
Relieving Asthma: Opens airways to reduce wheezing and nasal flaring.
Clearing Pathogens: Releases surface cold and internal heat for balanced health.
Common symptoms it addresses:
Ongoing fever or feeling hot
Coughing with shortness of breath
Nasal flaring from rapid breathing
Dry mouth and thirst
Variable sweating (some sweat a lot, others little)
Thin white or yellow tongue coating
Rapid, pulsating pulse
Why Does It Work?
In Chinese medicine, this formula treats conditions where a cold (wind evil) enters the body and turns into heat, clogging the lungs. This heat disrupts the lungs’ ability to regulate breathing, causing coughs, wheezing, and fever.
Ephedra releases the surface cold, gypsum clears lung heat, almonds calm the airways, and licorice supports hydration and balance. Together, they restore the lungs’ natural function, cooling the body and easing respiratory distress.
Who Can Benefit?
Ma Xing Gan Shi Tang is ideal for:
Respiratory Issues: Colds, bronchitis, pneumonia, or asthma with fever and cough.
Infections: Upper respiratory infections or measles with pneumonia.
Skin Conditions: Urticaria (hives) or rosacea driven by heat.
ENT Problems: Sinusitis with heat-related congestion.
Urinary Issues: Urinary tract infections or dysfunction with heat symptoms.
It’s best for those with heat signs (yellow tongue coating, rapid pulse) rather than cold-driven coughs or heavy phlegm.
Modern Uses
Modern research confirms the formula’s effectiveness:
Fever Reduction: Ephedra induces sweating, and gypsum lowers body temperature.
Respiratory Relief: Ephedra relaxes bronchial muscles, almonds calm breathing, and licorice reduces cough and phlegm.
Anti-inflammatory: Gypsum reduces swelling and inflammation, aiding infections or skin issues.
It’s widely used for:
Viral infections like colds or flu
Bronchial asthma or pneumonia
Inflammatory skin conditions
Sinus or urinary infections with heat
Precautions
Not for Cold Coughs: Avoid if you have a cold-driven cough (clear phlegm, chills) or asthma without heat.
Not for Heavy Phlegm: Unsuitable for conditions with thick, sticky phlegm or heat congestion.
Constitution Check: Consult a doctor if you have a cold constitution (feeling chilly, weak digestion) or chronic conditions.
Medical Guidance: Essential for pregnant, breastfeeding, or medicated individuals, as ephedra can be stimulating.
Final Thoughts
Ma Xing Gan Shi Tang is a powerful, classic remedy for fever, coughs, and asthma caused by heat and lung congestion. With herbs like ephedra, almonds, and gypsum, it cools the body, opens the airways, and restores smooth breathing.
Whether you’re fighting a stubborn cold, bronchitis, or heat-related discomfort, this formula offers gentle, effective relief. Always consult a doctor before starting to ensure it’s right for you, especially if symptoms persist. Breathe easier and cool down with Ma Xing Gan Shi Tang!
Chinese Name | 麻黃杏仁甘草石膏湯 |
Phonetic | Ma Huang Xing Ren Gan Cao Shi Gao Tang |
English Name | Ephedra, Apricot Kernel, Licorice and Gypsum Decoction |
Classification | Exterior-releasing formulas |
Source | 《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
Combination | Ephedrae Herba (Ma Huang) 4 liang (9g), Armeniacae Semen Amarum (Xing Ren) 50 pieces (9g), Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao) 2 liang (6g), Gypsum Fibrosum (Shi Gao) 0.5 jin (18g) |
Method | Prepare it as a decoction. It should be taken warm. |
Action | Acrid-cool to scatter the exterior, clear heat, and calm labored breathing. |
Indication | This formula is indicated for patterns of externally contracted wind causing pathogenic heat to obstruct the lung. Signs and symptoms include continuous fever, cough with rapid qi counterflow or even flaring of nostrils, thirst, presence or absence of sweat, a thin white or yellowish tongue coating, and a superficial and rapid pulse. |
Pathogenesis | This pattern is caused by exterior pathogens that penetrate the interior and transform into heat. The heat obstructs the lung which then fails to diffuse. When external wind-heat invades the exterior and is not released, thereby constrained, wind-cold transforms into heat that penetrates the interior. Consequently, both the exterior and interior heat up and cause the symptoms of continuous fever, sweating, thirst, yellow tongue coating, and a rapid pulse. With heat obstructing the lung, the lung fails to diffuse and descend. This causes cough, rapid qi counterflow, and even flaring of the nostrils. The absence of sweating, a thin white coating, and a superficial pulse are signs of residual exterior pathogens. The correct treatment method is to use acrid-cool medicinals to vent the pathogen, clear the lung, and calm panting. |
Application | 1. Essential pattern differentiation Ma Xing Gan Shi Tang is used to treat patterns of unresolved external pathogens complicated by pathogenic heat obstructing the lung with labored breathing and cough. Due to the fact that shi gao is double the dosage of ma huang, its action is more on clearing heat and diffusing the lung, and much less on inducing sweat. This clinical pattern is marked by fever, coughing and labored breathing, thin and yellow tongue coating, and rapid pulse 2. Modern applications The formula may be used in the following biomedically defined disorders showing signs and symptoms of unresolved external pathogens complicated by pathogenic heat obstructing the lung: common cold, upper respiratory infection, acute bronchitis, bronchopneumonia, lobar pneumonia, bronchial asthma, and measles complicated by pneumonia. 3. Cautions and contraindications This formula is not appropriate for cough and labored breathing caused by wind-cold with phlegm-heat obstruction. |
Additonal formulae | Yue Bi Tang (Maidservant From Yue Decoction, 越婢湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] ma huang 6 liang (18g), shi gao 0.5 jin (24g), sheng jiang 3 liang (9g), gan cao 2 liang (6g), da zao 15 whole pieces (5 pieces) [Preparation and Administration] Prepare it as a decoction. Ma huang should be decocted first and the foam that collects at the top of the decoction needs to be removed before adding the other medicinals. The decoction should be taken warm. [Actions] Induces sweat and promotes urination. [Applicable Patterns] Wind edema complicated by heat. Symptoms include: aversion to wind, general edema, absence of thirst, spontaneous sweating without a high fever, and a superficial pulse. |
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