HERB FORMULAS

DA CHENG QI TANG

English:	Major Order the Qi Decoction
Also Known As:	Major Rhubarb Combination Decoction for Sustaining Qi Major Purgative Decoction Decoction for Potent Purgation

HERBS AND ACTIONS

Pharmaceutical Latin	*Pin Yin*	Dosage	Actions
Rx. et Rz. Rhei	Da Huang	2-12g	Drains Heat, purges accumulations, drains Fire, transforms Dampness, promotes urination, drains Heat from the Blood, invigorates the Blood, dispels Blood Stasis, reduces Fire toxicity and eliminates Phlegm. With Mang Xiao, eliminates obstruction in the Intestines for severe constipation with passage of liquid but no solid stool and abscess, swellings and toxic sores. With Zhi Shi, Mang Xiao and Hou Po, for unremitting high fever, delirious speech, and constipation.
Natrii Sulfas	Mang Xiao	2-12g	Purges, eliminates stagnation, clears Heat, softens hardness, moistens Dryness, drains Fire and reduces swelling . With Da Huang, for constipation due to Heat in the Stomach and Intestines.
Fr. Aurantii Immaturus	Zhi Shi	2-15g	*Dissipates Qi Stagnation, reduces distention, descends Qi,* removes stagnant food, transforms Phlegm, resolves hardenings and unblocks the bowels.** With Da Huang, for Food and for Qi Stagnation with distention and constipation.
Cx. Magnoliae	Hou Po	5-24g	*Promotes the movement of Qi in the Middle Jiao,* resolves Stagnation resolves Food Stagnation, descends Rebellious Qi, reduces Phlegm, dries Dampness and calms wheezing.** With Da Huang and Zhi Shi, for constipation due to accumulation and stagnation. With Zhi Shi, for clumped Qi failing to move, with abdominal distention, wheezing, shortness of breath, nausea and constipation and abdominal or chest distention, focal epigastric distention, wheezing, shortness of breath nausea, rebellious Qi or constipation from Cold, Heat, Dampness or Phlegm as long as clumped Qi is at the root of the problem (use with caution in weaker patients).

FORMULA ACTIONS

Strongly purges Heat accumulation.

SYNDROMES

Colon Excess Heat
Intestinal Abscess
Yang Ming Fu
Wen Bing Qi Stage - Intestinal Dry Heat
Syncope and seizures (closed type Wind-Stroke or Heat Collapse)
San Jiao - Large Intestine Damp-Heat
Internal Blood Stasis with spasms

CLINICAL MANIFESTATIONS

Severe constipation (dry knots)
Flatulence
Focal distention
Abdominal fullness
Abdominal pain - worse with pressure
Tense firm abdomen
Tidal fevers
Delirious speech
Profuse perspiration from the palms and soles
Trembling extremities
Aversion to Heat
Mania
Convulsions
Abdominal masses
Dry mouth
Thirst

Cracked lips
Periumbilical pain
Irritability
Heavy body
Hemorrhoids
Fever
Cold extremities
Perspiration from the head
A hot sensation in the sternum and epigastrium
Scanty, dark urination
Green, watery and foul-smelling diarrhea
Abdominal spasms
T: Pink with prickles or Red
C: Yellow and dry or Black and dry
P: Deep, Excess and rapid or Slippery and rapid

TREATS

Acute uncomplicated appendicitis
Acute cholecystitis
Acute pancreatitis
Uncomplicated intestinal obstruction
Postoperative constipation and distention
Roundworms in the bile duct
Early-stage dysentery
Pneumonia (especially in children)
Hypertension
Beriberi
Mania
Cholecystitis
Acute icteric hepatitis
Stomach flu
Purulent tonsillitis
Asthma
Urolithiasis
Schizophrenia
Habitual constipation
Enteroparalysis
Organophosphorus poisoning

Severe constipation
Postoperative constipation
Food poisoning
Ephidrosis
Moist fever
Typhoid fever
Influenza
Measles
Meningitis
Tetanus
Neurosis
Obesity
Hemorrhoids
Bacterial dysentery
Encephalitis
Lobar pneumonia
Cardiopulmonary disease
Enuresis
Stroke
Acute eczema
Lead poisoning

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS

Contraindicated during pregnancy.
Contraindiciated when a pathogen remains at the protective (Wei) stage or in the Tai Yang level.
Contraindicated when there is hardness in the epigastric area indicating that the pathogen is still above the diaphragm.
Contraindicated when there is a flushed face due to Heat Floating in the Exterior.
Contraindicated for those with Spleen and Stomach Deficiency who eat only small amounts.
Contraindicated for those who stop eating.
Contraindicated for those who vomit frequently due to the pathogen remaining in the Shao Yang.
Contraindicated for those who have Interior Cold with a slow pulse.
Contraindicated for those with spontaneous sweating and normal urination.
Use extreme caution with weak patients, add tonics.

HERB/DRUG INTERACTIONS

NOTES

MODIFICATIONS

*For simultaneous Yang Ming Jing* and Fu syndromes with high fever, pronounced thirst and a forceful, rapid pulse:**		For severe bloating:
+ Rx. Anemarrhenae	Zhi Mu	+ Sm. Raphani	Lai Fu Zi
+ Gypsum Fibrosum	Shi Gao	For Blood Stasis:
*for Yang Ming* disorder with damage to the fluids including dry lips, a burnt, yellow, dry tongue coat and a thin, rapid pulse:**		+ Sm. Persicae	Tao Ren
+ Rx. Rehmanniae	Sheng Di Huang	+ Rx. Paeoniae Rubrae	Chi Shao
+ Rx. Scrophulariae	Xuan Shen	+ Rx. Angelicae Sinensis	Dang Gui
+ Rx. Ophiopogonis	Mai Men Dong	For Qi Deficiency:
For fullness, distention and oppression in the abdomen:		+ Rx. Ginseng	Ren Shen
+ Sm. Raphani	Lai Fu Zi	For dry stools and pain:
Rx. Aucklandiae	Mu Xiang	+ More Natrii Sulfas	Mang Xiao
For hemorrhoids and painful defecation:		+ Sm. Trichosanthis	Gua Lou Ren
+ Rx. Scutellariae	Huang Qin	For ascites:
+ Olibanum	Ru Xiang	+ Rx. Kansui	Gan Sui
For severe Qi and Blood Deficiencies:		+ Flos Genkwa	Yuan Hua
+ Rx. Ginseng	Ren Shen	For mild damage to the Body fluids:
+ Rx. Angelicae Sinensis	Dang Gui	- Natrii Sulfas	Mang Xiao
+ Rx. Glycyrrhizae	Gan Cao	For mild abdominal distention and fullness:
For severe abdominal bloating and pain:		- Cx. Magnoliae	Hou Po
+ Sm. Raphani	Lai Fu Zi	- Fr. Aurantii Immaturus	Zhi Shi
+ Sm. Persicae	Tao Ren	+ Rx. Glycyrrhizae	Gan Cao
+ Rx. Paeoniae Rubrae	Chi Shao	For severe Dryness in the intestines:
		- Cx. Magnoliae	Hou Po
		- Fr. Aurantii Immaturus	Zhi Shi
		+ Rx. Scrophulariae	Xuan Shen
		+ Rx. Ophiopogonis	Mai Men Dong