Dan Dao Pai Shi Tang

Biliary Stone Expulsion Decoction · 胆道排石汤

A modern formula for clearing Damp-Heat from the Liver and Gallbladder, moving Qi to relieve pain, and promoting bile flow to expel gallstones. It is used for acute cholecystitis, biliary colic, common bile duct stones, and residual stones after surgery.

Origin 《中西医结合治疗急腹症》 (Integrated Chinese-Western Medicine Treatment of Acute Abdomen) — Modern (20th century)
Composition 6 herbs
Jin Qian Cao
King
Jin Qian Cao
Yin Chen
King
Yin Chen
Yu Jin
Deputy
Yu Jin
Zhi Ke
Deputy
Zhi Ke
Mu Xiang
Deputy
Mu Xiang
Da Huang
Assistant
Da Huang
Explore composition

Educational content Consult qualified TCM practitioners for diagnosis and treatment

Patterns Addressed

In TCM, symptoms don't appear randomly — they cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Dan Dao Pai Shi Tang is designed to correct these specific patterns.

Why Dan Dao Pai Shi Tang addresses this pattern

This formula directly clears Damp-Heat from the Liver and Gallbladder and expels stones formed by that pathogenic accumulation. Jin Qian Cao and Yin Chen target the Damp-Heat root, while Yu Jin, Zhi Ke, and Mu Xiang address the Qi stagnation that causes pain. Sheng Da Huang purges Damp-Heat through the stool, accelerating the resolution of the acute episode. The entire prescription works to drain Dampness, cool Heat, and restore the free flow of bile.

A practitioner would look for one or more of these signs

Jaundice

Yellowing of the skin and eyes from obstructed bile flow

Nausea

Queasiness due to ascending Damp-Heat disturbing the Stomach

Vomiting

Vomiting from the same upward disturbance

Fever

Fever, often with chills, as Heat stagnates in the gallbladder

Abdominal Pain

Severe, colicky pain in the right upper abdomen radiating to the back or shoulder

Commonly Prescribed For

These conditions can arise from the patterns above. A practitioner would consider Dan Dao Pai Shi Tang when these conditions are specifically caused by those patterns — not for all cases of these conditions.

TCM Interpretation

In TCM, gallstones form when Damp-Heat stagnates in the Liver and Gallbladder over a long period, causing bile to become turbid and condense into solid masses. These stones obstruct the bile duct, leading to severe Qi and Blood stagnation manifested as intense colicky pain. The sudden flare-up often includes fever, jaundice, nausea, and vomiting, which are signs of Damp-Heat surging upward.

Why Dan Dao Pai Shi Tang Helps

Jin Qian Cao and Yin Chen directly clear Damp-Heat and promote bile flow to dissolve and flush out stones. Yu Jin and Mu Xiang break up Qi stagnation, relieving the spasmodic pain. Zhi Ke helps guide the stones downward, and Sheng Da Huang purges Heat and Dampness through the bowels, accelerating stone expulsion. This combination addresses both the acute obstruction and the underlying Damp-Heat.

Also commonly used for

Chronic Cholecystitis

Resolves lingering Damp-Heat and helps prevent stone recurrence

What This Formula Does

Every TCM formula has a specific set of actions — here's what Dan Dao Pai Shi Tang does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Dan Dao Pai Shi Tang is primarily used to support these areas of health:

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Dan Dao Pai Shi Tang performs to restore balance in the body:

How It Addresses the Root Cause

TCM doesn't just suppress symptoms — it aims to resolve the underlying imbalance. Here's how Dan Dao Pai Shi Tang works at the root level.

This formula targets the accumulation of Damp-Heat in the Liver and Gallbladder. Over time, Damp-Heat congeals and obstructs the free flow of bile, leading to the formation of stones. The stagnated Qi and obstructed bile ducts cause severe, colicky pain in the right upper abdomen that may radiate to the back or shoulder. The Damp-Heat steams upward, producing a bitter taste, nausea, vomiting, and jaundice. When the Heat is intense, fever and chills may appear. The underlying disharmony is a mixture of Excess Dampness, Heat, and Qi stagnation in the hepatobiliary system.

Formula Properties

Every formula has an inherent temperature, taste, and affinity for specific organs — these properties determine how it interacts with the body

Overall Temperature

Cold

Taste Profile

Predominantly bitter and acrid — bitter to clear heat and drain dampness, acrid to move Qi and expel stones.

Ingredients

6 herbs

The herbs that make up Dan Dao Pai Shi Tang, organized by their role in the prescription

King — Main ingredient driving the formula
Deputy — Assists and enhances the King
Assistant — Supports or moderates other herbs
Kings — Main ingredient driving the formula
Jin Qian Cao

Jin Qian Cao

Gold Coin Grass

Dosage 30g
Temperature Cool
Taste Sweet (甘 gān), Salty (咸 xián), Bland (淡 dàn)
Organ Affinity Liver, Gallbladder, Kidneys, Urinary Bladder

Role in Dan Dao Pai Shi Tang

Clears Heat, drains Dampness, promotes urination, and specifically dissolves and expels biliary and urinary stones. It is the main stone-expelling herb.
Yin Chen

Yin Chen

Virgate Wormwood Herb

Dosage 15g
Temperature Slightly Cool
Taste Bitter (苦 kǔ), Acrid / Pungent (辛 xīn)
Organ Affinity Spleen, Stomach, Liver, Gallbladder

Role in Dan Dao Pai Shi Tang

Clears Damp-Heat from the Liver and Gallbladder, promotes bile flow, and reduces jaundice. It complements Jin Qian Cao's stone-expelling action with its bile-promoting and jaundice-clearing effects.
Deputies — Assists and enhances the King
Yu Jin

Yu Jin

Turmeric tuber

Dosage 15g
Temperature Cold
Taste Acrid / Pungent (辛 xīn), Bitter (苦 kǔ)
Organ Affinity Heart, Liver, Lungs

Role in Dan Dao Pai Shi Tang

Invigorates Blood, moves Qi, cools Blood, and promotes bile flow. It relieves pain by unblocking stagnant Qi and Blood in the gallbladder region.
Zhi Ke

Zhi Ke

Bitter orange fruit

Dosage 9g
Temperature Slightly Cool
Taste Bitter (苦 kǔ), Acrid / Pungent (辛 xīn), Sour (酸 suān)
Organ Affinity Spleen, Stomach, Large Intestine, Lungs

Role in Dan Dao Pai Shi Tang

Regulates Qi, reduces distension, and helps guide turbid Dampness downward through the bowels. It alleviates epigastric and hypochondriac fullness.
Mu Xiang

Mu Xiang

Costus root

Dosage 9g
Temperature Warm
Taste Acrid / Pungent (辛 xīn), Bitter (苦 kǔ)
Organ Affinity Spleen, Stomach, Large Intestine, San Jiao (Triple Burner), Gallbladder

Role in Dan Dao Pai Shi Tang

Promotes the movement of Qi, especially in the intestines, and stops pain. It relieves the cramping pain caused by Qi stagnation.
Assistant — Supports or moderates other herbs
Da Huang

Da Huang

Rhubarb root and rhizome

Dosage 6 - 9g
Temperature Cold
Taste Bitter (苦 kǔ)
Organ Affinity Spleen, Stomach, Large Intestine, Liver, Pericardium
Preparation Added in the last 5-10 minutes of decoction (后下)

Role in Dan Dao Pai Shi Tang

Raw rhubarb drains Heat and Dampness by promoting bowel movement, clears Heat toxins, and helps expel stones by driving downward. Added near the end of decoction to preserve its purgative action.

Why This Combination Works

How the herbs in Dan Dao Pai Shi Tang complement each other

Overall strategy

This formula combines strong Damp-Heat-clearing herbs with Qi-moving and stone-expelling agents to address the immediate crisis of gallstone obstruction and inflammation. The strategy is to purge Damp-Heat, unblock Qi, and mechanically flush stones from the biliary tract.

King herbs

Jin Qian Cao and Yin Chen jointly serve as the sovereign ingredients. Jin Qian Cao is the primary stone-expelling herb, clearing Heat, promoting urination, and specifically softening and expelling biliary and urinary stones. Yin Chen excels at clearing Damp-Heat from the Liver and Gallbladder, promoting bile secretion, and resolving jaundice. Together they correct the root Damp-Heat while directly targeting the stones.

Deputy herbs

Yu Jin breaks up Qi and Blood stagnation in the gallbladder, alleviates pain, and enhances bile flow. Zhi Ke disperses Qi stagnation in the abdomen and helps guide turbid Dampness downward. Mu Xiang strongly regulates Qi in the intestines, relieving the cramping pain that accompanies biliary colic. These three herbs work synergistically to open the pathways for stone passage.

Assistant herbs

Sheng Da Huang acts as a purgative agent, draining Heat and Dampness through the stool and driving the downward expulsion of stones. Its bitter-cold nature also clears Heat-toxins and reduces inflammation in the gallbladder.

Notable synergies

The combination of Jin Qian Cao and Yin Chen is a classic duo for acute gallbladder disorders: Jin Qian Cao physically dislodges stones while Yin Chen enhances bile production to flush them out. Yu Jin and Mu Xiang pair up to move both Blood and Qi, powerfully relieving the sharp, stabbing pain of stone obstruction.

How to Prepare

Traditional preparation instructions for Dan Dao Pai Shi Tang

Soak all herbs except Sheng Da Huang in water for 30 minutes. Bring to a boil, then simmer for 20–30 minutes. Add Sheng Da Huang 5–10 minutes before the end of cooking. Strain. Take one dose per day, divided into two warm servings.

Common Modifications

How practitioners adapt Dan Dao Pai Shi Tang for specific situations

Added
Fu Ling

9-15g, to strengthen the Spleen and drain Dampness without aggravating diarrhea

Removed
Da Huang

Remove raw rhubarb to prevent further purgation

Sheng Da Huang is a strong purgative that can worsen loose stools. Removing it avoids aggravating diarrhea, while Fu Ling gently drains Dampness and supports the Spleen, preserving the formula's damp-clearing function.

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any herbal formula.

Contraindications

Situations where Dan Dao Pai Shi Tang should not be used or requires extra caution

Avoid

Pregnancy — contains Sheng Da Huang (Rhubarb) which may stimulate uterine contractions and Yu Jin (Curcuma) which moves blood.

Avoid

Breastfeeding — Sheng Da Huang may cause diarrhea in infants.

Avoid

Complete biliary obstruction — risk of stone impaction and cholangitis.

Avoid

Acute abdomen with suspected perforation or peritonitis.

Avoid

Severe liver or kidney dysfunction — impaired metabolism and excretion of anthraquinones.

Avoid

Known allergy to any herb in the formula.

Caution

Peptic ulcer — Sheng Da Huang may irritate gastric mucosa.

Caution

Spleen Qi deficiency with loose stools — formula may aggravate diarrhea.

Caution

Children under 12 — strong purgative effect, use only under strict supervision.

Caution

Debilitated or elderly patients — monitor for dehydration.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Contraindicated — contains Sheng Da Huang (Rhubarb) and Yu Jin (Curcuma) which may stimulate uterine contractions and promote blood movement. Not safe during any trimester.

Breastfeeding

Not recommended during breastfeeding. Sheng Da Huang (Rhubarb) may pass into breast milk and cause diarrhea in infants. No specific data on breast milk transfer exists for the other herbs. Avoid use or discontinue breastfeeding while taking this formula.

Children

Not recommended for children under 12 without strict medical supervision. The formula contains Sheng Da Huang, which can cause severe diarrhea and dehydration in children. Dosage must be significantly reduced and tailored to body weight. Use only in acute biliary colic under hospital monitoring. For children over 12, dose reduction to 1/3 to 1/2 of adult dose is suggested, with close monitoring of bowel movements and hydration.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Dan Dao Pai Shi Tang

No well-documented drug interactions exist. However, due to its effects on bile secretion and gastrointestinal motility, caution is advised when used with drugs that have a narrow therapeutic index or are excreted via bile. Consult a healthcare provider before concurrent use with prescription medications.

Usage Guidance

Practical advice for getting the most out of Dan Dao Pai Shi Tang

Best time to take

30 minutes after meals, 2–3 times daily.

Typical duration

Acute use: 7–14 days, or until symptoms subside. For chronic management, may be used in cycles of 2–4 weeks under supervision.

Dietary advice

Avoid greasy, fatty, spicy, and fried foods. Eliminate high-cholesterol foods like egg yolks, organ meats, and full-fat dairy. Avoid alcohol. Consume a light, bland diet with plenty of vegetables, whole grains, and lean proteins. Eat small, frequent meals to avoid gallbladder stimulation. Drink adequate water to aid stone passage.

Dan Dao Pai Shi Tang originates from 《中西医结合治疗急腹症》 (Integrated Chinese-Western Medicine Treatment of Acute Abdomen) Modern (20th century)

Classical Texts

Key passages from the classical Chinese medical texts that first described Dan Dao Pai Shi Tang and its clinical use

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Historical Context

How Dan Dao Pai Shi Tang evolved over the centuries — its origins, lineage, and place in the broader tradition of Chinese medicine

Dan Dao Pai Shi Tang is a modern formula developed in the mid-20th century as part of integrated Chinese-Western medicine efforts to treat acute abdomen conditions. It first appeared in the book 'Zhong Xi Yi Jie He Zhi Liao Ji Fu Zheng' (Integrated Chinese-Western Medicine Treatment of Acute Abdomen). The formula was designed to expel gallstones by clearing heat, draining dampness, and moving Qi, especially for damp-heat patterns in the liver and gallbladder. Variants such as Dan Dao Pai Shi Tang II (with additional herbs like Shuang Hua, Lian Qiao, Huang Qin) were later created for more severe infections. The formula reflects the modern adaptation of TCM principles to surgical emergencies.