Rhubarb (Da Huang) Mirabilites (Mang Xiao) Mudan peony bark (Mu Dan Pi) Wax gourd seeds (Dong Gua Zi)

Da Huang Mu Dan Pi Tang

Chinese: 大黄牡丹皮汤

Pinyin: Dà Huáng Mǔ Dān Pí Tāng

Other names: Rhubarb and Moutan Decoction

Number of ingredients: 5 herbs

Formula category: Formulas that clear internal abscesses and sores

Conditions for which it may be prescribed: MastitisAppendicitisFolliculitis and ten other conditions

  1. Clears Stagnant Heat in the intestines
  2. Reduces swelling and disperses lumps

Contraindications: Contraindicated for necrotic appendicitis, appendicitis with peritonitis,... Contraindicated for necrotic appendicitis, appendicitis with peritonitis, appendicitis in infants, appendicitis during pregnancy, or appendicitis due to parasites. It should be used with extreme caution in the weak and elderly. see more

Source date: 220 AD

Source book: Essentials from the Golden Cabinet

Da Huang Mu Dan Pi Tang is a 5-ingredient Chinese Medicine formula with Rhubarb (Da Huang) as a principal ingredient.

Invented in 220 AD, it belongs to the category of formulas that clear internal abscesses and sores. Its main actions are: 1) clears Stagnant Heat in the intestines and 2) reduces swelling and disperses lumps.

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 Huang Mu Dan Pi Tang is used by TCM practitioners to fight patterns like Blood Stagnation or Blood Stagnation with Heat. From a Western Medicine standpoint, such patterns can give rise to a range of conditions such as appendicitis, pelvic inflammatory disease or iliac fossa abscess for instance.

On this page, after a detailed description of each of the five ingredients in Da Huang Mu Dan Pi Tang, we review the patterns and conditions that Da Huang Mu Dan Pi Tang helps treat.

The five ingredients in Da Huang Mu Dan Pi Tang

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.

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

In general Da Huang's main actions are as follows: "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."

In the context of Da Huang Mu Dan Pi Tang, it is used because it drains Heat and breaks up Blood Stagnation.

Learn more about Rhubarb (Da Huang)

Mang Xiao is a deputy ingredient in Da Huang Mu Dan Pi 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

In general Mang Xiao's main actions are as follows: "Purges Stagnation in the Intestines caused by Heat and Dryness, Cools Heat and abates swelling"

In the context of Da Huang Mu Dan Pi Tang, it is used because it softens the stools and aids in draining Heat downward, thereby unclogging the Intestines.

Learn more about Mirabilites (Mang Xiao)

Mu Dan Pi is a deputy ingredient in Da Huang Mu Dan Pi Tang. This means it helps the king ingredient(s) treat the main pattern or it serves to treat a coexisting pattern.

3. Mudan Peony Bark (Mu Dan Pi)

Part used: Root barks

Nature: Cool

Taste(s): BitterPungent

Meridian affinity: HeartKidneyLiver

Category: Herbs that cool the Blood

In general Mu Dan Pi's main actions are as follows: "Cools the Blood, activates Blood circulation and resolves Blood stasis."

In the context of Da Huang Mu Dan Pi Tang, it is used because it cools the Blood and eliminates masses due to Blood Stagnation.

Learn more about Mudan Peony Bark (Mu Dan Pi)

Dong Gua Zi is an assistant ingredient in Da Huang Mu Dan Pi Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

4. Wax Gourd Seeds (Dong Gua Zi)

Part used: The seeds, dried

Nature: Cold

Taste(s): Sweet

Meridian affinity: StomachLarge intestineLungSmall intestine

Category: Herbs that drain Dampness

In general Dong Gua Zi's main actions are as follows: "Clears Heat, expels Phlegm, expels pus and moistens the Lungs. Clears Heat and drains Dampness."

In the context of Da Huang Mu Dan Pi Tang, it is used because it expels pus, eliminates Heat and reduces abscesses, especially in the Intestines.

Learn more about Wax Gourd Seeds (Dong Gua Zi)

Tao Ren is an assistant ingredient in Da Huang Mu Dan Pi Tang. This means that it either serves to reinforces the effect of other ingredients or it moderates their toxicity.

5. Peach Kernels (Tao Ren)

Part used: Dried ripe seed

Nature: Neutral

Taste(s): BitterSweet

Meridian affinity: HeartLarge intestineLiver

Category: Herbs that invigorate the Blood

In general Tao Ren's main actions are as follows: "Moves Blood and breaks up Stasis. Moistens the Intestines. Relieves coughing."

In the context of Da Huang Mu Dan Pi Tang, it is used because it breaks up Blood Stagnation and has a mild moistening and laxative effect.

Learn more about Peach Kernels (Tao Ren)

Conditions and patterns for which Da Huang Mu Dan Pi 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 Huang Mu Dan Pi 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:

Appendicitis Pelvic inflammatory disease Iliac fossa abscess Subdermal abscess Renal abscess Hepatic abscess Pulmonary abscess Bacillary dysentery Pyelonephritis Mastitis Osteomyelitis Conjunctivitis Folliculitis

Again it wouldn't be correct to say "Da Huang Mu Dan Pi Tang treats appendicitis" for instance. Rather, Da Huang Mu Dan Pi Tang is used to treat patterns that are sometimes the root cause behind appendicitis.

Now let's look at the two patterns commonly treated with Da Huang Mu Dan Pi Tang.

Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine

Blood Stagnation

Da Huang Mu Dan Pi Tang is sometimes prescribed by TCM practitioners to treat Blood Stagnation. This pattern leads to symptoms such as stabbing pain, abdominal masses, purple nails and painful period. Patients with Blood Stagnation typically exhibit choppy (Se), wiry (Xian) or firm (Lao) pulses as well as a reddish-purple tongue.

Blood Stagnation - also often referred to as "Blood Stasis" - is where the Blood flow is heavily restricted in all or parts of the body. It is one of the most important diagnostic conditions in Chinese Medicine because it is frequently the cause of intractable pain syndromes anywhere in the... read more about Blood Stagnation

Blood (Xue) is one of Chinese Medicine's vital subtances. Learn more about Blood in Chinese Medicine

Blood Stagnation with Heat

Pulse type(s): Rapid (Shu), Slippery (Hua)

Tongue coating: Yellow coating

Tongue color: Pale

Symptoms: Pain in the groin Alternating fever and chills Guarding of the abdominal musculature Lower abdominal distension and pain that increases with pressure

Da Huang Mu Dan Pi Tang is sometimes prescribed by TCM practitioners to treat Blood Stagnation with Heat. This pattern leads to symptoms such as lower abdominal distension and pain that increases with pressure, guarding of the abdominal musculature, pain in the groin and alternating fever and chills. Patients with Blood Stagnation with Heat typically exhibit rapid (Shu) or slippery (Hua) pulses as well as a pale tongue with yellow coating.

Learn more about Blood Stagnation with Heat

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