Use of rhubarb (Da Huang) 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 practitionner, 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 Sunlight Yang stage. 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 rhubarb 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 rhubarb are used*:

• For swollen glands combine rhubarb with maral roots (Lou Lu) and forsythia fruits (Lian Qiao).
• For fullness and distension of the abdomen due to Heat accumulation combine rhubarb with goldthread rhizomes (Huang Lian).
• For jaundice with flank pain combine rhubarb with virgate wormwood (Yin Chen) and cape jasmine fruits (Zhi Zi).
• For intestinal abscesses combine rhubarb with mudan peony bark (Mu Dan Pi) and peach kernels (Tao Ren).
• For intestinal abscesses combine rhubarb with wax gourd (Dong Gua) and mudan peony bark (Mu Dan Pi).

Key TCM concepts behind rhubarb (Da Huang)'s properties

In Traditional Chinese Medicine (TCM), rhubarb are plants that belong 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 rhubarb are plants that are Cold in nature. This means that rhubarb typically help 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 rhubarb can help restore a harmonious balance between Yin and Yang.

Rhubarb also taste Bitter. The so-called "five elements" theory in Chinese Medicine states that the taste of TCM ingredients is a key determinant of their action in the body. Bitter ingredients like rhubarb tend 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 rhubarb are 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 fluid 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 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 rhubarb (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 rhubarb (Da Huang) as food

Rhubarb are also eaten as food. It is used as an ingredient in dishes such as Rhubarb pie.