Xiao Qing Long Tang: A Classic TCM Formula for Cold and Lung Relief
Health Lab- Oct 31, 2024
- 8 min read
Updated: May 9
Xiao Qing Long Tang, a revered Traditional Chinese Medicine (TCM) formula, is a gentle yet effective remedy for relieving wind-cold invasions, clearing phlegm, and supporting lung function.
Originating from Zhang Zhongjing’s Shanghan Lun (Treatise on Febrile Diseases) in the Eastern Han Dynasty, this time-honored prescription addresses respiratory issues caused by cold and fluid retention. Its carefully blended herbs reflect ancient TCM wisdom, offering a natural solution for modern-day colds, coughs, and breathing difficulties.
Origins and Background of Xiao Qing Long Tang
Developed by Zhang Zhongjing, a legendary physician, Xiao Qing Long Tang was crafted to treat “Taiyang syndrome with water retention,” where external cold invades the body, causing chills, cough, and fluid buildup in the lungs.
In an era of harsh climates and frequent respiratory ailments, this formula was a vital tool for restoring balance. Its focus on warming the lungs and expelling cold makes it a versatile remedy for today’s seasonal colds and allergic conditions.
Ingredients and Their Benefits
Xiao Qing Long Tang combines eight herbs, each contributing to its warming and phlegm-clearing effects:
Ephedra (Ma Huang): Warm and pungent, ephedra induces sweating, opens the lungs, and expels wind-cold, relieving chills and congestion.
Cinnamon Twig (Gui Zhi): Warm and spicy, cinnamon twig promotes sweating, warms the body, and supports energy flow to release pathogens.
Dried Ginger (Gan Jiang): Hot and pungent, dried ginger warms the lungs and stomach, disperses cold, and reduces phlegm.
Asarum (Xi Xin): Warm and spicy, asarum clears nasal congestion, warms the lungs, and relieves cough.
Schisandra Berry (Wu Wei Zi): Sour and warm, schisandra secures lung qi, reduces wheezing, and balances the formula’s warming effects.
Peony Root (Bai Shao): Cool and sour, peony nourishes blood, harmonizes the liver, and softens the formula’s intensity.
Pinellia (Ban Xia): Warm and pungent, pinellia dries dampness, clears phlegm, and soothes the stomach to prevent nausea.
Licorice Root (Gan Cao): Sweet and harmonizing, licorice soothes the throat, reduces irritation, and unifies the formula.
Together, these herbs warm the lungs, expel cold, and clear fluid buildup, restoring respiratory health.
Benefits and Conditions Treated
Xiao Qing Long Tang excels at treating wind-cold invasions with fluid retention, known as “Taiyang syndrome with water retention.” It’s ideal for those with chills, cough, and watery phlegm. Its key effects include:
Expelling Wind-Cold: It induces mild sweating to release external pathogens, relieving chills and body aches.
Clearing Phlegm: It dries dampness and resolves watery sputum, easing cough and wheezing.
Warming the Lungs: It supports lung function, improving breathing and reducing chest tightness.
Balancing Fluids: It regulates water metabolism, addressing edema or bloating.
Common Symptoms
This formula is ideal for:
Chills, fever, and no sweating.
Cough with thin, watery phlegm.
Wheezing, chest tightness, or shortness of breath.
Nasal congestion or runny nose with clear mucus.
White, moist tongue coating with a floating, tight pulse.
Practical Applications
Colds with Phlegm: Xiao Qing Long Tang relieves cough, congestion, and chills caused by wind-cold invasions.
Respiratory Issues: It eases wheezing or chest tightness from fluid buildup in the lungs.
Allergic Reactions: It helps with runny nose or breathing issues triggered by cold exposure.
Clinical Uses
Xiao Qing Long Tang is used for:
Acute bronchitis or asthma with watery phlegm.
Common colds or influenza with chills and cough.
Allergic rhinitis or sinusitis triggered by cold.
Chronic obstructive pulmonary disease (COPD) with cold-type symptoms.
Edema or bloating due to fluid retention.
Modern research supports its benefits: ephedra and pinellia have bronchodilator and expectorant effects, schisandra reduces wheezing, and cinnamon twig improves circulation, making this formula a potent respiratory aid.
Dietary Support
Pairing Xiao Qing Long Tang with warming recipes can enhance its cold-expelling and phlegm-clearing effects:
Ginger Porridge
Ingredients: 5g dried ginger, 100g rice.
Method: Boil ginger in water for 10 minutes, strain, cook rice in the liquid until soft, serve warm.
Benefits: Warms the lungs and disperses cold.
Cinnamon Twig Tea
Ingredients: 5g cinnamon twig.
Method: Steep in boiling water for 5 minutes, drink warm.
Benefits: Promotes sweating and expels wind-cold.
Green Onion Soup
Ingredients: 2 green onion whites, 5g ginger.
Method: Boil in water for 5 minutes, drink warm.
Benefits: Warms the body and clears nasal congestion.
Pinellia Broth
Ingredients: 5g pinellia (prepared), 1 carrot, sliced.
Method: Boil pinellia and carrot in water until tender, season lightly.
Benefits: Clears phlegm and supports digestion.
Massage Support
Massage can complement Xiao Qing Long Tang by promoting lung function and pathogen release:
Lieque Point: On the wrist, above the thumb side. Massage for 5 minutes to open the lungs and relieve cough.
Fengmen Point: On the upper back, two inches below the second thoracic vertebra. Massage for 5 minutes to expel wind-cold.
Feishu Point: On the upper back, below the third thoracic vertebra. Massage for 5 minutes to strengthen lung qi.
Hegu Point: At the base of the thumb on the hand’s back. Massage for 5 minutes to release external pathogens.
Precautions
Xiao Qing Long Tang is effective but requires caution:
Avoid in Heat Conditions: If you have fever, red tongue, or rapid pulse without chills, consult a practitioner, as it may worsen symptoms.
Pregnant Women: Use only under medical guidance due to ephedra’s strong effects.
Weak Patients: Those with frail constitutions or excessive sweating should avoid it to prevent qi depletion.
Medical Supervision: Always follow a TCM practitioner’s advice for safe use.
Conclusion
Xiao Qing Long Tang is a TCM masterpiece, blending ephedra, pinellia, and schisandra to relieve colds, clear phlegm, and restore lung health. Perfect for cough, wheezing, or chills with watery sputum, this formula delivers targeted relief. Enhance its effects with ginger porridge or cinnamon twig tea, and consult a TCM practitioner for personalized guidance. Let this ancient remedy bring warmth and clarity to your modern life.
Chinese Name | 小青龍湯 |
Phonetic | Xiao Qing Long Tang |
English Name | Minor Green Dragon Decoction |
Classification | Exterior-releasing formulas |
Source | 《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
Combination | Ephedrae Herba (Ma Huang) 3 liang (9g), Paeoniae Radix Alba (Shao Yao) 3 liang (9g), Asari Radix et Rhizoma (Xi Xin) 3 liang (6g), Zingiberis Rhizoma (Gan Jiang) 3 liang (6g), Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao) 3 liang (6g), Cinnamomi Ramulus (Gui Zhi) 3 liang (9g), Pinelliae Rhizoma (Ban Xia) 0.5 sheng (9g), Schisandrae Chinensis Fructus (Wu Wei Zi) 0.5 sheng (6g) |
Method | Prepare Xiao Qing Long Tang as a decoction to be taken warm. 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. |
Action | Releases the exterior, dissipates cold, warms the lung and dissolves rheum (fluid retention). |
Indication | This formula is indicated for the pattern of exterior cold with interior fluid retention. The symptoms are aversion to cold, fever, absence of sweating, labored breathing, cough, copious clear and thin phlegm, stuffiness in chest, dry retching, difficulty in lying back in the supine position, general body aches, edema of the face and extremities. The tongue coating is white and glossy, and the pulse is superficial. |
Pathogenesis | Xiao Qing Long Tang is indicated when an excessive fluid condition is complicated by externally contracted wind-cold. Aversion to cold, fever, absence of sweating and body aches are symptoms of an exterior excess pattern with wind-cold fettering the exterior causing obstruction of the wei yang and constraint of ying yin. When a person who has excessive fluids contracts an external pathogen, the pathological activities of the excessive fluids may be initiated. Cold thin phlegm then invades the lung and causes the lung qi to fail to diffuse and descend which leads to cough, labored breathing and copious thin sputum. Stuffiness in chest is due to fluid retention under the heart blocking the qi movement. Dry retching is caused by lodged fluid that causes ascending counterflow of the stomach qi. General edema and heaviness is due to subcutaneous water retention. And finally, a white and glossy coating and superficial pulse are clear signs of exterior cold with interior fluid retention. In this situation, dispersing external pathogens alone without dissolving fluid retention will not resolve the excessive internal fluids. On the other hand, dissolving fluid retention alone without expelling external pathogens will not release the exterior. Therefore, the correct treatment method is to simultaneously address both the internal and external by relieving the exterior and dissolving fluid retention. |
Clarification | Why does Xiao Qing Long Tang, an acrid formula, contain astringents wu wei zi and bai shao? Xiao Qing Long Tang is designed for patients with an internal excessive fluid condition who have contracted external wind-cold, triggering abnormal movement of internal fluids. Generally, acrid-warm dispersing medicinals are indicated for externally contracted wind-cold with closed pores and orifices. However, those with internal cold thin phlegm already have deficient spleen and lung. If drastic sweat-inducing therapy is used, it will damage the lung qi and yin fluids. Consequently, the way to make the best of both is to combine both dispersing and astringent medicinals to conserve qi and yin. In this formula, ma huang and gui zhi reinforce each other to induce sweat and expel pathogens. Sheng jiang, xi xin and ban xia warm the lung and transform thin phlegm. These five are all acrid-warm medicinals. To the contrary, wu wei zi astringes the lung and relieves cough while bai shao astringes yin and nourishes blood. By combining these two medicinals with the previous five medicinals that have opposite yet complementary actions, the formula induces sweating with acrid-warm medicinals and prevents qi and yin damage without retaining pathogens. Furthermore, wu wei zi and bai shao are not only used to check and balance other medicinals, they also assist the formula to relieve cough and calm labored breathing. The action of wu wei zi to relieve cough and calm labored breathing is backed by ancient herbal classical literature while bai shao has been proven to alleviate bronchial spasm by modern studies in Chinese medicine pharmacology. It is therefore obvious that these two medicinals will enhance the formula’s action to calm labored breathing. |
Application | 1. Essential pattern differentiation Xiao Qing Long Tang is commonly indicated for the pattern of externally contracted wind-cold with cough and labored breathing due to internal cold thin phlegm. This clinical pattern is marked by aversion to cold, fever, absence of sweating, labored breathing, cough, copious thin phlegm, white and glossy tongue coating, and superficial pulse. 2. Modern applications This formula may be used in biomedically defined disorders such as bronchitis, bronchial asthma, pneumonia, pertussis, pulmonary heart disease, allergic rhinitis, and catarrhal ophthalmic and catarrhal tympanitis when the patient shows signs of external cold and internal fluid retention. 3. Cautions and contraindications Due to the relatively strong acrid-dispersing and warm-resolving effects of the formula, it is only indicated for those who are indeed affected by external cold interacting with internal fluids causing a disorder of the lung system. The dosage needs be determined according to the physical constitution of the patient. It is not applicable for coughs without sputum due to a yin deficiency or internal phlegm-heat pattern. |
Additonal formulae | She Gan Ma Huang Tang (Belamcanda and Ephedra Decoction, 射干麻黃湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Xiao Qing Long Tang remove gui zhi, gan jiang, bai shao, gan cao, add she gan 3 liang (9g), sheng jiang 4 liang (6g), zi wan 3 liang (6g), kuan dong hua 3 liang (6g), da zao 7 pieces (3 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] Diffuses the lung, dispels phlegm, lowers qi, and relieves cough. [Applicable Patterns] Congested phlegm and fluids complicated with cough and labored breathing. Symptoms include: cough, breathing due to ascending counterflow qi, labored breathing, and a continuous rattling sound in the larynx caused by sputum blockage. |
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