Novel Formulas for Releasing the Exterior: 2024

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Article updated January 16, 2024

Recent reports suggest that the “triple threat” is surging in the US right now. This includes the largest global surge in daily Covid infections with nearly 2 million new infections per day estimated by the CDC in the US alone. This is the highest infection rate since the advent of Omicron in late fall of 2021. Since testing is no longer being conducted by healthcare facilities and is mainly (if at all) being accomplished by at-home tests, the CDC is basing its estimates by wastewater analysis. The CDC expects that one person in three in the US will contract an upper respiratory illness this winter. Fortunately, hospitalizations and deaths are fewer than in months past, although the number is expected to rise. Increased immunity from effective vaccines (for every species of the” triple threat”) and past exposure plus more effective therapies are credited with this relative success.

Traditional Chinese medicine herbalists are being increasingly asked to assist their patients in combating the symptoms associated with exposure. Practitioners inquiring at Mayway’s Consultation Desk (consult@mayway.com or 510-208-3113) often want to know, “What do you have for COVID or RSV or influenza?” I am compelled to remind those asking that as a company that markets dietary supplements (herbs), Mayway cannot hold out that our products “diagnose, treat, mitigate, or cure disease”. What I can do is help order their thinking about their TCM differential diagnosis. The correct syndrome opens an entire world of possibilities. Remember, many would assert that Chinese herbology was developed in response to “Evil Qi” causing pestilence in ancient times. Humankind’s need to combat exogenous pathogenic influences has always been present and will be required in the future.

Since a patient’s response to any disease can vary widely, the syndrome that a patient exhibits is more precise than any named disease. This is the basis of traditional Chinese medicine herbology. This results in a patient-centered approach rather than a named disease-based one. In TCM, we follow the maxim: “One disease many syndromes, one syndrome many diseases.” (一病多證, 一證多病 Yī bìng duō zhèng, yī zhèng duō bìng). Once the syndrome has been defined, then an herbal formula can be selected or created and then the formula can be tailored (jiājiǎn加減) to encompass all symptoms and any concomitant constitutional issues.

In addition to our classic formulas for Releasing the Exterior, such as Gui Zhi Wan (MW# 3316), Gan Mao Ling (MW#3955), and Yin Qiao Jie Du Wan (MW# 3166, 3166C, 3167. 3168), et al., here at Mayway Herbs we have created templates focused on common prescriptive themes based on information coming from China. Although these formulas are comprised mostly of well-known herbs, they are unique in that they do not exactly correspond to classical formulas. These templates for practitioners are listed here in our online Dispensary service. (Note: Access to the Mayway Prescription System requires a Licensed Practitioner account and you must be logged in to our website for the links to the formulas to function.) Importantly, we can quickly ship these prescriptions directly to your patients at no additional cost to you.

Although we know there are numerous sources of information, these templates are primarily derived from three sources. The details regarding these formulas are explained in the links to the source materials cited below and are focused on prevention and early onset of symptoms. More advanced conditions (i.e., requiring hospitalization) are unlikely to be treated by acupuncturists, but, of course, one can always make a custom prescription, if desired. In all cases, notice the source’s staging or TCM differential diagnosis that is appropriate to your patient’s presentation.

Nearly all herbs in these formulas are available in whole herb form from Mayway Herbs with the exceptions of Ma Huang /Ephedra sinesis Herba, Xi Xin/ Asari Herba, Bing Lang/ Areca nut, and Da Fu Pi/ Areca peel, which are prohibited from importation by FDA, and Qing Pi/ Citri reticulatae peel, for which we have recommended Fo Shou/ Citri medica fruit instead. Potential viable substitutions for certain herbs were discussed in Dr. John K. Chen’s seminar at Pacific College (see link below). He suggested the combinations of Di long / Pheretima aspergillum 12g, Xing ren (Ku) / Prunus armeniaca seed 9g, and Zi su zi / Perilla frutescens fruit 9g for Ma Huang and Qiang huo/ Notopterygium incisum root & rhizome 9g, Fang feng/ Saposhnikovia divaricata root 9g, Bai jie zi/ Sinapis alba seed 9g, and Gan jiang/ Zingiber officinale rhizome 9g for Xi xin. These recommended substitutes are not included in the templates but if a practitioner wants to add them to the template, they can save the template as a custom formula and add them to the formula at that point. If an extract powder formula is desired, check out our helpful how-to video: Converting Your Prescription Type. Keep in mind the dosage of extract powders will vary based on age, weight, severity of symptoms, and other factors. (Mayway’s standard dosage recommendation is 3 g, 3x/day.)

This group of formula templates is extracted from Guidance for Corona Virus Disease 2019, edited by the National Health Commission of the Peoples Republic of China. The English language version of this 138-page book can be downloaded here. (Google will translate the document into English.) These formulas, and those from Hubei Provincial Hospital and Wuhan Union Hospital are discussed in some detail in the PRC NHC book and in the presentation by Dr. John K Chen from a seminar entitled “Coronavirus (Covid-19) Treatment with TCM in China”. This seminar, sponsored by Pacific College of Health and Science, is available on Pacific College's Website. You can also download a PDF of the slide presentation on the same page.

The formula templates from the National Health Commission are designated by the prefix “PRC” before the formula name. Those from Hubei Provincial Hospital are preceded by the prefix “Hubei” and those from Wuhan Union Hospital are indicated by the prefix “Wuhan”.

First, let us talk about prevention. In traditional Chinese herbal medicine, this is often accomplished by Tonifying the Wei (Defensive) Qi. The classic formula for this purpose is Yu Ping Feng San/ Jade Windscreen Powder. Mayway offers this formula as Plum Flower Jade Screen Teapills (MW# 3357), Bamboo Pharmacy Immune System Support (MW# 83357), and Yu Ping Feng San extract powder (MW# 3357C). Additionally, there are two augmented versions of Yu Ping Feng San among the templates:
(Note: The links to the templates require that you have a Practitioner account and that you are logged into your account to function.)

• Hubei Tonify Wei Qi to Prevent Evil
• Wuhan Prevention

TThe Wei Qi roughly corresponds to barrier immunity. In cases where the patient may have pre-existing conditions or is at greater risk of experiencing a serious outcome, augmenting the templates with herbs that tonify the Yin, Yang, Qi, and/or Blood (as appropriate) may be prudent.

The other formula templates, discussed in the cited materials along with differential diagnostic criteria, are:
(Note: The links to the templates require that you have a Practitioner account and that you are logged into your account to function.)

PRC Qing Fei Pai Du Tang (one of the most discussed formulas) See “Lung Clearing and Detoxifying Soup for Troubling Times”, an in-depth examination of this formula in Mayway's newsletter written by Mark Frost, L.Ac., Former Chair of the Herbal Medicine Department at ACTCM at CIIS.

The other pertinent formula templates (in no particular order) are:

• PRC Cold Dampness Stagnating LU
• PRC Damp Heat Accumulation in LU
• PRC Damp Poison Stagnating LU
• PRC Cold Dampness Obstructing LU
• PRC LU Blocked by Epidemic Toxin
• Hubei Ge Gen Tang
• Hubei Yin Qiao San + Qing Wen Bai Du San
• Hubei Damp Cold in the LU

Finally, we want to remind you that the option to drop-ship formulas, herbal products, and prescriptions may be especially helpful, since many patients in these challenging times are experiencing a lot of stress and sleep challenges that can be diagnosed and treated by herbs prescribed remotely.  It is more important than ever that we tonify any deficiencies, especially the Wei Qi. This could be a focus not only for your patients but for your friends and family. Please know that Mayway Herbs is here to help you determine the appropriate formula, and to be a resource in these challenging times.

About the Author

Skye Sturgeon, DAOM is the Quality Assurance Manager and Special Consultant for Mayway, USA. Skye was the former Chair of Acupuncture & East Asian Medicine and core faculty member at Bastyr University, core faculty member and Faculty Council Chair at the American College of Traditional Chinese Medicine, and President and Senior Professor of the Acupuncture & Integrative Medicine College, Berkeley. Before making Chinese medicine his career choice, Skye held various positions in the Natural Foods Industry for 12 years and prior to that was a clinical biochemist and toxicologist.