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Let’s explore three H1-receptor blockers. H1-receptor blockers have several function, but we want to remember:

• contract: bronchial airways, GI tract, womb smooth muscles
• dilate:  blood vessels on skin,  capillaries (including those in the nasal passages); exudation and edema follows.
  • that’s why we get hives and catarrhal inflammation.

Just looking at antihistamine drugs, we can somehow make certain connections between the “Lungs” as defined in Chinese Medicine and where the H1 receptor sites are. Ignoring the receptor sites in the GI tract and womb, the rest of them correspond to the physiology and pathology of the Chinese Medicine “Lungs.”

This way, it makes sense to think of 小青龙汤 as an catarrh inflammation antidote, or even as a form of antihistamine treatment, albeit more complex.

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1. Diphenhydramine 本海拉明 (BENADRYL)

Both an antihistamine and an anticholinergic. Most suitable for a person who is:

1. Sneezing and dripping thin mucus from the nose - histamine.
2. Suffering from parkinson’s disease and motion sickness - anti-Ach.
3. An insomniac - drowsiness is a side-effect.

It is a first generation antihistamine. It is also a weaker version of Atropine - 58% of Atropine’s anti-muscarinic power.

2. Chlorphenamine 氯苯那敏 (Actified is made of both this and pseudoephedrine)

Another first generation antihistamine. Not as multi-talented as diphenhydramine, it’s not strong enough as a sedative.

Of Note: Actifed is made up of Chlorpheniramine and Pseudoephedrine. The latter is a decongestant that shrinks blood vessels in the nasal passages, hence reducing nasal congestion. So the combination not only stops the production of histamine (antihistamine) but also reverses the action that existing histamine has caused - blood vessels on skin and in the capillaries dilated, exudate and cause local edema.

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Interesting side-dish: both antihistamines were discovered to be seratonin reuptake inhibitors. Research led to the creation of the first selective seratonin reuptake inhibitor (SSRI) from chlorphenamine - zimelidine. Later on, Prozac was synthesized from diphenhydramine.

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3. Promethazine 异丙嗪

Think of his antihistamine as having some similarities with Chlorpromazine 氯丙嗪, although as an antipsychotic drug, it’s only 1/10th as potent.