English: Rhubarb
Chinese: 大黄
Parts used: Dried root and rhizome
TCM category: Purgative herbs that drain downward
TCM nature: Cold
TCM taste(s): Bitter
Organ affinity: Spleen Stomach Large intestine Liver Pericardium
Scientific name: Rheum palmatum, Rheum tanguticum or Rheum officinale
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*
Tao He Cheng Qi Tang
Source date: 220 AD
Number of ingredients: 5 herbs
Formula key actions: Dispels Heat and. Eliminates Blood Stagnation.
Conditions targeted*: LeiomyomaRetained placenta and others
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.
Da Huang Mu Dan Pi Tang
Source date: 220 AD
Number of ingredients: 5 herbs
Formula key actions: Clears Stagnant Heat in the intestines. Reduces swelling and disperses lumps.
Conditions targeted*: AppendicitisPelvic inflammatory disease and others
Da Huang is a king ingredient in Da Huang Mu Dan Pi Tang. Like the name indicates, it means it has more power than other ingredients in the formula.
In Da Huang Mu Dan Pi Tang, Da Huang drains Heat and breaks up Blood Stagnation.
Da Cheng Qi Tang
Source date: 220 AD
Number of ingredients: 4 herbs
Formula key actions: Purges Heat from the Stomach and Intestines. Relieves constipation.
Conditions targeted*: PancreatisAppendicitis and others
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."
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.