Sang Xing Tang (Mulberry Leaf and Apricot Kernel Decoction) sāng xìng tāng · 桑杏汤

Safety. This is the warm-dryness counterpart to Xing Su San, and the pairing is one of the clearer examples of how the traditional framework works: the same symptom, cough, is sorted into two categories by the accompanying signs and the season, and each category has its own formula. That internal logic is worth understanding, but it is a classificatory system, not a diagnostic one. The presentation it describes - dry cough or scanty sticky sputum, dry mouth and nose, thirst, a floating rapid pulse - overlaps with the early phase of a great many respiratory infections, and also with the cough of asthma, of ACE inhibitor therapy, of post-viral cough and of gastro-oesophageal reflux. A cough lasting more than three weeks, blood in the sputum, weight loss, fever, or breathlessness at rest is not a dryness pattern to be moistened; it is a reason to see a clinician. - 杏仁 again carries the strongest signal. Bitter apricot kernel contains amygdalin, a cyanogenic glycoside that can release cyanide, and poisoning from apricot kernels is documented, with children at particular risk. It is processed before use and is not a food. - 沙参 is a name that covers two different articles. 北沙参 is Glehnia littoralis, an apiaceous plant; 南沙参 is Adenophora species, in the bellflower family. They are treated differently in traditional practice and are not interchangeable, so a product labelled only 'sha shen' is ambiguous. Both fall under the classical incompatibility rule that places the various 'shen' roots against 藜芦 (veratrum). - 象贝 is Zhejiang fritillaria. The fritillaria bulbs contain steroidal alkaloids that affect the heart and respiration in preclinical and overdose reports, 浙贝 differs from the more expensive 川贝, and the classical rule puts the fritillarias against the aconite group. - 栀皮 is the peel of gardenia fruit. Gardenia contains geniposide, and geniposide-related liver toxicity has been reported in preclinical studies rather than established as a human harm; the honest framing is that the signal exists and human evidence is limited. - 香豉 is fermented soybean, which means soy allergy applies, and fermented soy products can contain tyramine, so a theoretical interaction with monoamine oxidase inhibitors is mentioned in the literature. - 梨皮 is pear peel, a food item. - Whether this formula shortens an illness or changes any respiratory outcome has not been established by well-conducted controlled trials; it is unproven. - Quantities are for a licensed practitioner to decide, and are deliberately not listed here.