Rhubarb (Da Huang) Mirabilites (Mang Xiao) Immature Bitter Oranges (Zhi Shi) Houpu Magnolia bark (Hou Pu)

Da Cheng Qi Tang

Chinese: 大承气汤

Pinyin: Dà Chéng Qì Tāng

Other names: Major Order the Qi Decoction, Major Rhubarb Combination

Number of ingredients: 4 herbs

Formula category: Formulas that purge Heat accumulation

Conditions for which it may be prescribed: AsthmaStrokeEnuresis and fourteen other conditions

  1. Purges Heat from the Stomach and Intestines
  2. Relieves constipation

Contraindications: Contradicted for conditions where a Pathogen remains in the protective level... Contradicted for conditions where a Pathogen remains in the protective level and Exterior. This is indicated by aversion to Cold and by urine that remains normal in both color and amount. Contradicted for treating hardness in the epigastric area, indicating that the Pathogen remains above the diaphragm and has not yet penetrated into the Intestines. Contradicted if the is a flushed face. It indicates that Heat is not yet bound in the Interior but still floats in the Exterior. Contradicted for patients who habitually eat only small amounts, indicating Deficiency of Spleen and Stomach Qi. In such cases, constipation requires tonification. Contradicted for patients who stop eating as the disorder develops. This means there is nothing to produce stools with which the Heat may bind. Contradicted for the case of frequent vomiting. It indicates that the disorder remains at the lesser Yang warp. Contradicted for the case of a slow pulse, which indicates Cold in the Interior. Contradicted in case of spontaneous sweating and normal urination, indicating that the Fluids in the interior are expended. Contradicted during pregnancy. see more

Source date: 220 AD

Source book: Discussion of Cold Damage

Da Cheng Qi Tang is a 4-ingredient Chinese Medicine formula with Rhubarb (Da Huang) as a principal ingredient.

Invented in 220 AD, it belongs to the category of formulas that purge Heat accumulation. Its main actions are: 1) purges Heat from the Stomach and Intestines and 2) relieves constipation.

In Chinese Medicine health conditions are thought to arise due to "disharmonies" in the body as a system. These disharmonies are called "patterns" and the very purpose of herbal formulas is to fight them in order to restore the body's harmony.

In this case Da Cheng Qi Tang is used by TCM practitioners to fight patterns like Yang Excess or Heat in Yang brightness Organs. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as pancreatis, appendicitis or cholecystitis for instance.

On this page, after a detailed description of each of the four ingredients in Da Cheng Qi Tang, we review the patterns and conditions that Da Cheng Qi Tang helps treat.

The four ingredients in Da 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.

1. Rhubarb (Da Huang)

Part used: Dried root and rhizome

Nature: Cold

Taste(s): Bitter

Meridian affinity: SpleenStomachLarge intestineLiverPericardium

Category: Purgative herbs that drain downward

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."

Learn more about Rhubarb (Da Huang)

Mang Xiao is a deputy ingredient in Da Cheng Qi Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

2. Mirabilites (Mang Xiao)

Part used: The rock crushed as a powder

Nature: Cold

Taste(s): BitterSalty

Meridian affinity: StomachLarge intestine

Category: Purgative herbs that drain downward

Mang Xiao has stool-softening properties that helps the key herb (Rhubarb) in its purgative action. Together they moisten Dryness as they drain downward.

Learn more about Mirabilites (Mang Xiao)

Zhi Shi is an assistant ingredient in Da Cheng Qi Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

3. Immature Bitter Oranges (Zhi Shi)

Part used: Dried unripe fruit

Nature: Cool

Taste(s): BitterPungentSour

Meridian affinity: SpleenStomachLarge intestine

Category: Herbs that regulate Qi

In general Zhi Shi's main actions are as follows: "Regulates the flow of Qi in the Middle Burner and reduces Food Stagnation. Moves Qi downward and helps constipation. Reduces Stagnant Phlegm and lessens distention and pain. For prolapse of organs when used with the appropriate herbs."

In the context of Da Cheng Qi Tang, it is used because it dissipates clumps and reduces focal distention.

Learn more about Immature Bitter Oranges (Zhi Shi)

Hou Pu is an assistant ingredient in Da Cheng Qi Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. Houpu Magnolia Bark (Hou Pu)

Part used: Dried stem bark, root bark or branch bark

Nature: Warm

Taste(s): BitterPungent

Meridian affinity: SpleenStomachLung

Category: Aromatic herbs that transform Dampness

Hou Pu disseminates the Qi and relieves the sensation of fullness. Together with Immature bitter orange (Zhi Shi), the other assistant, they assists in the expulsion of stool by moving the Qi. Even though the root of the condition is Heat, the resultant clumping leads to severe Qi Stagnation. Moving the Qi is thus an important aspect of the formula.

Learn more about Houpu Magnolia Bark (Hou Pu)

Conditions and patterns for which Da Cheng Qi Tang may be prescribed

It's important to remember that herbal formulas are meant to treat patterns, not "diseases" as understood in Western Medicine. According to Chinese Medicine patterns, which are disruptions to the body as a system, are the underlying root cause for diseases and conditions.

As such Da Cheng Qi Tang is used by TCM practitioners to treat two different patterns which we describe below.

But before we delve into these patterns here is an overview of the Western conditions they're commonly associated with:

Pancreatis Appendicitis Cholecystitis Bacterial dysentery Icteric hepatitis Encephalitis Influenza Lobar pneumonia Purulent tonsillitis Cardiopulmonary disease Asthma Enuresis Urinary stones Hemorrhoids Stroke Hypertension Schizophrenia

Again it wouldn't be correct to say "Da Cheng Qi Tang treats pancreatis" for instance. Rather, Da Cheng Qi Tang is used to treat patterns that are sometimes the root cause behind pancreatis.

Now let's look at the two patterns commonly treated with Da Cheng Qi Tang.

'Excess' as a body pattern in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Excess / Full in Chinese Medicine

Yang Excess

Pulse type(s): Rapid (Shu), Full (Shi)

Tongue coating: Sticky coating, Yellow coating

Tongue color: Red

Symptoms: Fever Thirst Red face Irritability Restlnessness Scanty dark urination Yellow vaginal discharge

Da Cheng Qi Tang is sometimes prescribed by TCM practitioners to treat Yang Excess. This pattern leads to symptoms such as fever, thirst, red face and restlnessness. Patients with Yang Excess typically exhibit rapid (Shu) or full (Shi) pulses as well as a red tongue with sticky coating, yellow coating.

Yang Excess is a Full Yang state and its symptoms are similar to those are caused by the Heat Pernicious invasion. Yang is associated with Heat, activity and Dryness and these are the general symptoms when patients have Excess Yang. However, they become more specific depending on the Organ... read more about Yang Excess

'Heat' as a body pattern in Chinese Medicine is one of the so-called "Eight Principles". Learn more about Heat pattern in Chinese Medicine

Heat in Yang brightness Organs

Pulse type(s): Full (Shi)

Tongue coating: Grey or black coating, Yellow coating

Symptoms: Flatulence Focal distention Abdominal fullness Severe constipation Tense and firm abdomen Abdominal pain that increases upon pressure

Da Cheng Qi Tang is sometimes prescribed by TCM practitioners to treat Heat in Yang brightness Organs. This pattern leads to symptoms such as severe constipation, flatulence, focal distention and abdominal fullness. Patients with Heat in Yang brightness Organs typically exhibit full (Shi) pulses as well as a tongue with grey or black coating, yellow coating.

Learn more about Heat in Yang brightness Organs

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