Use of Da Huang (rhubarb) in TCM
Please note that you should never self-prescribe TCM ingredients. A TCM ingredient is almost never eaten on its own but as part of a formula containing several ingredients that act together. Please consult a professional TCM practitioner, they will be best able to guide you.
Preparation: Remove the stems and leaves from the rhizome and root, scrape off the rough skin and top buds, slice and dry.
Dosage: 3 - 12 grams
Main actions according to TCM*: Drains Excess Heat and eliminates Dampness, especially when in the Bright Yang stage according to the Six Stages Theory. Cools the Blood and stops bleeding. Invigorates Blood, breaks up Stasis and relieves pain. Clears Heat and toxins from Excess. Applied topically for Hot sores and Blood Stasis.
Primary conditions or symptoms for which Da Huang may be prescribed by TCM doctors*:
Constipation
Fever
Jaundice
Dysentery
Hematemesis
Nosebleed
Conjunctivitis
Appendicitis
Abdominal pain
Sores
Abcesses
Amenorrhea
traumatic bleeding
Traumatic swelling
Burns
Contraindications*: This herb should only be used where there is a definite condition of Heat and Dampness; Rhubarb should be used by nursing mothers with extreme caution.
Common TCM formulas in which Da Huang is used*
Da Huang is a king ingredient in Tao He Cheng Qi Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Tao He Cheng Qi Tang, Da Huang clears pathogenic Heat and purges accumulations.
Read more about Tao He Cheng Qi Tang
Da Huang is a king ingredient in Da Cheng Qi Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Da Cheng Qi Tang, Da Huang , as best described in the classic Divine Husbandman's Classic of the Materia Medica, "breaks up abdominal masses, accumulations, lingering Fluids, and harbored food by flushing them from the Stomach and Intestines, pushing out the old so that the new [can enter], unblocking [the passages for] food and drink, regulating the Middle [Burner so that it can again] transform food and the five Yin Organs are calmed."
Read more about Da Cheng Qi Tang
Da Huang is a king ingredient in Xie Xin Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Xie Xin Tang, Da Huang drains excessive Fire. It also has the purging function that direct the Heat downwards and break up the clumping. Finally, it enters the Blood and stop bleeding, especially in the upper pat of the body.
Read more about Xie Xin Tang
Da Huang is a king ingredient in Zhi Shi Dao Zhi Wan. Like the name indicates, it means it has more power than other ingredients in the formula.
In Zhi Shi Dao Zhi Wan, Da Huang strongly mobilizes the Stomach and Intestines to flush away accumulated obstruction due to Heat from Excess
Read more about Zhi Shi Dao Zhi Wan
Da Huang is a king ingredient in Tiao Wei Cheng Qi Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Tiao Wei Cheng Qi Tang, Da Huang breaks up abdominal masses, accumulations, lingering fluids, and harbored food by flushing them from the Stomach and Intestines
Read more about Tiao Wei Cheng Qi Tang
Da Huang is a king ingredient in Da Chai Hu Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Da Chai Hu Tang, Da Huang enters the Yang Brightness to remove Heat and open the bowels.
Read more about Da Chai Hu Tang
Da Huang is a king ingredient in Wen Pi Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Wen Pi Tang, Da Huang flushes the Intestines and Stomach in order to eliminate Stagnation.
Read more about Wen Pi Tang
Da Huang is a king ingredient in Huang Long Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Huang Long Tang, Da Huang helps to drain Heat and unblock the bowels along with Mirabilite.
Read more about Huang Long Tang
Da Huang is a king ingredient in Chai Hu Jia Long Gu Mu Li Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Chai Hu Jia Long Gu Mu Li Tang, Da Huang resolves Lesser Yang disorders and releases constraint at this level.
Rhubarb also addresses delirious speech and Yang brightness-warp symptoms, by clearing Heat and stools Stagnation from the Intestines.
Read more about Chai Hu Jia Long Gu Mu Li Tang
Da Huang is a king ingredient in Da Huang Zhe Chong Wan. Like the name indicates, it means it has more power than other ingredients in the formula.
In Da Huang Zhe Chong Wan, Da Huang eliminates Blood Stagnation by attacking and purging,
while simultaneously cooling the Blood and clearing Heat.
It has the ability to break up abdominal masses and accumulations, pushing out the Stagnant Blood to allow generation of new blood.
Read more about Da Huang Zhe Chong Wan
Da Huang is a king ingredient in Fang Feng Tong Sheng San. Like the name indicates, it means it has more power than other ingredients in the formula.
In Fang Feng Tong Sheng San, Da Huang expels Heat through the stool.
Treating Rhubarb in wine strengthens its effect on the circulation while mitigating its purgative properties. This is important because too strong of a purgative will cause the Exterior disorder to penetrate more deeply into the body.
Read more about Fang Feng Tong Sheng San
Da Huang is a deputy ingredient in Da Huang Fu Zi Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Da Huang Fu Zi Tang, Da Huang is used here to flush the Intestines and purge Stagnant accumulation. It also enters the Liver Channel at the Blood level where it assists in the treatment of hypochondriac pain and directs the actions of the other herbs into the Intestines.
This is a more subtle and complex action than merely draining Fire through the stool. For this reason, the dosage of this herb is much lower than in formulas in which it serves as the key herb, such as Da Cheng Qi Tang.
Read more about Da Huang Fu Zi Tang
Da Huang is a deputy ingredient in Zhou Che Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Zhou Che Wan, Da Huang purges Heat and water from the Small and Large Intestines. It also interacts synergistically with the Key herbs.
Read more about Zhou Che Wan
Da Huang is a deputy ingredient in Liang Ge San. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Liang Ge San, Da Huang opens the bowel to flush Heat from the Middle Burner.
Read more about Liang Ge San
Da Huang is a deputy ingredient in Hui Chun Dan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Hui Chun Dan, Da Huang clears Heat and drains Fire.
Its purgative action removes accumulation and Stagnation, which enables it to eliminate the accumulation of Phlegm-Heat from the Stomach and Intestines.
Read more about Hui Chun Dan
Da Huang is a deputy ingredient in Di Dang Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Di Dang Tang, Da Huang assists the key herbs in expelling Blood Stagnation.
It also opens the bowels, following the momentum of
the pathology (eg: the downward movement of Heat and its clumping in the Lower Burner) to create a route for the Heat to leave the body.
Read more about Di Dang Tang
Da Huang is a deputy ingredient in Gun Tan Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Gun Tan Wan, Da Huang is bitter and cold. It cleanses Fire from the Upper Burner by descending it through the Large Intestine in the Lower Burner.
Therefore, it unblocks the obstruction of the Yang Organs. Unless the obstruction is removed, there is no clear path for removal of Phlegm-Fire from the body.
It is also good for Dampness and Heat congealing into Phlegm in the Middle and Lower Burners. It expels pathogens to halt their violence, and has a special ability to uproot chaos and restore normality.
The key and deputy herbs thus strongly drive out the Phlegm via the Intestines.
The large dosage of this herb is used to thoroughly transform the root of this disorder. It is also washed in wine in order to direct their action to the Upper Burner from which it can then exert
their downward-directing action via the Middle and Lower Burners.
Read more about Gun Tan Wan
Da Huang is a deputy ingredient in Er Qing Gao. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Er Qing Gao, Da Huang is bitter and cold. It drains Fire, resolves Toxic-Heat, disperses swelling and relives pain. It treats internal clumping due to accumulation of Toxic-Heat.
Read more about Er Qing Gao
Da Huang is a deputy ingredient in Feng Yin Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Feng Yin Tang, Da Huang is bitter and cooling. It moves Qi downwards. It expels Heat through the bowels.
It helps the three cooling mineral substances (Gypsum, Calcitum and Talc) to clear Fire and drain Heat to eliminate the underlying cause of this pattern.
Together, these four herbs counteract the upward-moving momentum of Fire
and thereby effectively treat the root.
Read more about Feng Yin Tang
Da Huang is a deputy ingredient in Xie Qing Wan. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Xie Qing Wan, Da Huang guides the Liver Fire downward to eliminate it via the bowels and urinary tract.
When Fire becomes constrained and clumps in the Liver Channel, the Liver loses its ability to thrust out the body's Qi.
Read more about Xie Qing Wan
Da Huang is a deputy ingredient in Shao Yao Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.
In Shao Yao Tang, Da Huang is bitter and cooling. It drains Toxic-Heat through the stool.
When combined with other Qi-moving herbs in the formula, Rhubarb promotes Qi circulation in case of Stagnation.
It also guides out stagnation.
Read more about Shao Yao Tang
Da Huang is an assistant ingredient in Ba Zheng San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In Ba Zheng San, Da Huang drains Heat from the Triple Burner through the stool.
Read more about Ba Zheng San
Da Huang is an assistant ingredient in Dang Gui Long Hui Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In Dang Gui Long Hui Wan, Da Huang drains Fire from the Yang Brightness and eliminates clumping.
Read more about Dang Gui Long Hui Wan
Da Huang is an assistant ingredient in Yin Chen Hao Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In Yin Chen Hao Tang, Da Huang purges Heat, eliminates stagnated Heat and directs downward
Read more about Yin Chen Hao Tang
Da Huang is an assistant ingredient in Ma Zi Ren Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In Ma Zi Ren Wan, Da Huang is a purgative.
Read more about Ma Zi Ren Wan
Da Huang is an assistant ingredient in San Wu Bei Ji Wan. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In San Wu Bei Ji Wan, Da Huang flushes the Intestines and Stomach. It also moderates the hot, toxic and acrid characters of the Croton fruit.
Read more about San Wu Bei Ji Wan
Da Huang is an assistant ingredient in Zeng Ye Cheng Qi Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In Zeng Ye Cheng Qi Tang, Da Huang softens hardness, drains the Heat, and cleans the Stomach and Intestines.
Read more about Zeng Ye Cheng Qi Tang
Da Huang is an assistant ingredient in Shi Hui San. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In Shi Hui San, Da Huang drains Heat via the urine while Rhubarb via the stool.
In this manner, the thrust of the upward rebellion is reversed, enabling the Qi and Fire to descend, the Liver to properly store the Blood, and the Blood to stay within its normal Channels.
Read more about Shi Hui San
Da Huang is an assistant ingredient in Qing Xin Li Ge Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.
In Qing Xin Li Ge Tang, Da Huang drains Fire by unblocking the stool. In this way, pathogenic Heat is dredged from the Exterior and cleared from the Interior, the clumped Heat is dispersed and drained, and the throat is cleared.
Read more about Qing Xin Li Ge Tang
Key TCM concepts behind Da Huang's properties
In Traditional Chinese Medicine (TCM), Da Huang belongs to the 'Purgative herbs that drain downward' category. The herbs in this category are those whose main purpose is to treat constipation. The fact they're 'purgative' means that they do so by removing Excess Heat in the Intestines and/or Stomach. As such all herbs in this category are Cold in nature, in order to cool the Heat.
Furthermore Da Huang is Cold in nature. This means that Da Huang typically helps people who have too much 'Heat' in their body. Balance between Yin and Yang is a key health concept in TCM. Those who have too much Heat in their body are said to either have a Yang Excess (because Yang is Hot in nature) or a Yin deficiency (Yin is Cold in Nature). Depending on your condition Da Huang can help restore a harmonious balance between Yin and Yang.
Da Huang also tastes Bitter. The so-called 'Five Phases' theory in Chinese Medicine states that the taste of TCM ingredients is a key determinant of their action in the body. Bitter ingredients like Da Huang tends to have a cleansing action on the body by clearing Heat, drying Dampness and promoting elimination via urination or bowel movements.
The tastes of ingredients in TCM also determine what Organs and Meridians they target. As such Da Huang is thought to target the Spleen, the Stomach, the Large intestine, the Liver and the Pericardium. In TCM the Spleen assists with digestion, Blood coagulation and Fluids metabolism in the body. The Stomach on the other hand is responsible for receiving and ripening ingested food and fluids. It is also tasked with descending the digested elements downwards to the Small Intestine. The Large Intestine receives the "impure" parts of the digested food from the Small Intestine, absorbs the remaining fluids and excrete the remainder as feces. The Liver is often referred as the body's "general" because it is in charge of regulating the movements of Qi and the Body Fluids. It also takes a leading role in balancing our emotions. The Pericardium is also called the "heart protector". It is the first line of defence for the Heart against external pathogenic influences
Research on Da Huang
Combination of early enteral nutrition and rhubarb significantly improved the gastrointestinal function, inhibited systemic inflammation and disease severity and mitigated the disease-related damages of liver and kidney function in severe acute pancreatitis patients.1
Rhubarb is an effective herb in alleviating symptoms of primary dysmenorrhoea.2
The rhubarb stalk fiber is effective in lowering serum cholesterol concentrations, especially low-density lipoprotein cholesterol, in hypercholesterolemic men.3
Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.4
Sources:
1. Wan B, Fu H, Yin J, Xu F. (2014). Efficacy of rhubarb combined with early enteral nutrition for the treatment of severe acute pancreatitis: a randomized controlled trial. Scand J Gastroenterol. , 49(11):1375-84. doi: 10.3109/00365521.2014.958523.
2. Rehman H, Begum W, Anjum F, Tabasum H, Zahid S. (2015). Effect of rhubarb (Rheum emodi) in primary dysmenorrhoea: a single-blind randomized controlled trial. J Complement Integr Med. , 12(1):61-9. doi: 10.1515/jcim-2014-0004.
3. Goel V, Ooraikul B, Basu TK. (1997). Cholesterol lowering effects of rhubarb stalk fiber in hypercholesterolemic men. J Am Coll Nutr. , 16(6):600-604.
4. Cai J, Xuan ZR, Wei YP, Yang HB, Wang H. (2005). Effects of perioperative administration of Rhubarb on acute inflammatory response in patients with gastric cancer. Zhong Xi Yi Jie He Xue Bao. , 3(3):195-8.
Use of Da Huang as food
Da Huang is also eaten as food. It is used as an ingredient in dishes such as Rhubarb pie.
