Experience Using Sheng Ma Tang from Wei Sheng Bao Jian for Headache

Volume 9 of the Wei Sheng Bao Jian contains a formula called Sheng Ma Tang, used to treat Lei Tou Feng (thunder-head wind). Lei Tou Feng refers to brain noise and headache caused by traumatic brain injury or cranial nervous system diseases (such as vascular headache)—i.e., in TCM terms, headache due to upward rushing of damp phlegm: "headache like thunder, or hard nodules on the head and face, with chills and fever, and tightness of the limbs."

Sheng Ma Tang is composed of Sheng Ma (Cimicifgae Rhizoma) and Cang Zhu (Atractylodis Rhizoma), each one liang, and He Ye (Nelumbinis Folium) five qian. These are ground together into a coarse powder; each time take five qian, decoct in water. One liang here converts to about 30 g today, and one qian to about 3 g.

This formula is centered on Sheng Ma. In TCM, Sheng Ma is a wind-heat dispersing herb. It is held to release the exterior and promote rash eruption, clear heat and resolve toxin, and ascend yang and lift prolapse. It is used for wind-heat headache, incomplete rash eruption in measles, heat-toxin sores, erysipelas, mumps, sore throat, mouth and tongue ulcers, warm-toxic macules, and long-standing diarrhea with prolapse due to qi collapse, uterine bleeding, and prolapse of the stomach or uterus. Modern pharmacology shows Sheng Ma has antipyretic, cooling, analgesic, anti-inflammatory, sedative and anticonvulsant actions; it influences immune function, protects the liver, fights pathogens, anticoagulates, stops bleeding, lowers lipids, and relieves spasm.

Judging from this formula, Sheng Ma can treat cranial nervous system diseases; it may be one of the Chinese herbs that can cross the blood-brain barrier. The Cang Zhu in Sheng Ma Tang can reduce cerebral edema, while He Ye and Sheng Ma have the action of awakening the spirit and opening the orifices. Hence the formula has some effect on brain noise and headache.

I have adapted this formula to a decoction using modern prepared herbs, at: Cang Zhu 30 g, Sheng Ma 30 g, He Ye 15 g. I have treated two patients with refractory headache with some effect.

Case 1 was a lung cancer patient with brain metastases who developed intractable headache unrelieved by many methods. I had already tried various common headache treatments without success; after switching to Sheng Ma Tang, the brain noise and headache were greatly relieved.

Case 2 was a post-stroke patient with intractable brain noise and headache, also unresponsive to many methods. After switching to Sheng Ma Tang plus Quan Xie (scorpion) and Wu Gong (centipede), the effect was striking.

Both cases were neurological symptoms arising from intracranial lesions and had failed to respond to multiple Chinese and Western drugs; this formula worked. However, reducing the dose weakens the effect: both Cang Zhu and Sheng Ma should reach 30 g. Fresh lotus leaves can be used in summer; dried leaves the rest of the year. With fresh leaves, one leaf is enough.