HERB FORMULAS

DA HUANG MU DAN (PI) TANG

English: Rhubarb and Moutan Decoction
Also Known As: Rhubarb and Moutan Combination
Decoction of Rhubarb and Moutan Bark
Decoction of Rhei and Moutan Radicis

HERBS AND ACTIONS

Pharmaceutical Latin
Pin Yin
Dosage
Actions
Rx. et Rz. Rhei Da Huang 2-12g Drains Heat and breaks up Blood Stasis.
Natrii Sulfas Mang Xiao 4-12g Purges, softens hardnesses, eliminates stagnation, clears Heat and moistens Dryness.
With Da Huang, for constipation due to Stomach and Intestinal Heat.
Cx. Moutan Mu Dan Pi 3-9g Cools Blood, clears Heat and eliminates masses due to Blood Stasis.
With Da Huang, for unsuppurated abdominal abscess with pain, constipation and low grade fever.
Sm. Persicae Tao Ren 4-15g Breaks up Blood Stasis, invigorates Blood, moistens Intestines and unblocks bowels.
With Da Huang, for severe abdominal infection.
With Da Huang and Mang Xiao, for Intestinal Abscess with pain and swelling.
Sm. Benincasae Dong Gua Ren 6-30g Expels pus, eliminates Heat and reduces abscesses, especially in the Intestines.
With Da Huang and Mu Dan Pi, for Intestinal Abscess.

FORMULA ACTIONS

  • Drains Heat
  • Breaks up Blood Stasis
  • Invigorates the Blood
  • Disperses nodules
  • Reduces swelling

SYNDROMES

  • Early Stage Intestinal Abscess
  • Heat and Blood Stagnation

CLINICAL MANIFESTATIONS

  • Lower abdominal distention and pain (usually on right)
  • Pain increases on pressure with rebound tenderness
  • Guarding of the abdominal musculature
  • Groin pain resembling urinary dysfunction without urinary difficulty
  • Groin pain relieved by flexing hip and knee
  • Groin pain intensified by extending hip
  • Irregular or intermittent fever followed by chills and perspiration
  • May be mass in lower right quadrant of abdomen
  • Perspiration
  • Aversion to Cold
  • Hard lumps
  • T: Pink
  • C: Thin, white or yellow and greasy
  • P: Slippery and rapid or Tight or Wiry and tight or Tight and rapid

TREATS

  • Acute uncomplicated appendicitis
  • Mesenteric lymphadenitis
  • Ruptured appendicitis with peritonitis
  • Chronic appendicitis
  • Lochioschesis
  • Pelvic inflammatory disease
  • Infection after vasectomy
  • Adnexitis
  • Periproctitis
  • Colitis
  • Proctitis
  • Hemorrhoids
  • Perimetritis
  • Diverticulitis
  • Renal abscess
  • Pulmonary abscess
  • Pyelonephritis
  • Conjunctivitis
  • Abdominal or lower extremity folliculitis
  • Primary dysmenorrhea
  • Amenorrhea
  • Chronic prostatitis
  • Mesenteric lymphadenitis
  • Rectal prolapse
  • Perimetritis
  • Periappendicular abscess
  • Acute cholecystitis
  • Testitis
  • Peritonitis
  • Pyelitis
  • Cystitis
  • Eczema
  • Ulcerative enteritis
  • Rectal prolapse
  • Gonorrhea
  • Leukorrhea
  • Ureteraliths
  • Iliac fossa abscess
  • Subdermal abscess
  • Hepatic abscess
  • Bacillary dysentery
  • Mastitis
  • Osteomyelitis
  • Blocked uterine tubes
  • Cerebral thrombosis
  • Benign prostatic hypertrophy
  • Suppurative tonsillitis
  • Ulcerative colitis
  • Incarcerated internal hemorrhoids
  • Testitis

CONTRAINDICATIONS AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
  • Contraindicated for those with necrotic appendicitis.
  • Contraindicated for those with appendicitis with peritonitis.
  • Contraindicated for infants with appendicitis.
  • Contraindicated for those with appendicitis due to parasites.
  • Contraindicated during Pregnancy.
  • Use extreme caution in the weak and elderly.
HERB/DRUG INTERACTIONS

NOTES

  • Before pus is formed, the pain is severe with localized hardness and Heat. When fully formed, the Heat and pain diminish, the tissues are more relaxed and the pulse is tight.

MODIFICATIONS

For a palpable mass in the lower abdomen: For intestinal abscess with pus:
+ Rx. Angelicae Sinensis Dang Gui + Flos Lonicerae Jin Yin Hua
+ Rx. Paeoniae Rubrae Chi Shao + Hb. Taraxaci Pu Gong Ying
+ Hb. Violae Zi Hua Di Ding + Hb. Hedyotidis Bai Hua She She Cao
For Blood Deficiency:
For Qi Deficiency:
+ Rx. Angelicae Sinensis Dang Gui + Rx. Pseudostellariae Tai Zi Shen
+ Rx. Salviae Miltiorrhizae Dan Shen
For rough dysenteric diarrhea with a red tongue and a thin, rapid pulse:
For more severe pain:
 - Natrii Sulfas Mang Xiao
+ Rz. Corydalis Yan Hu Suo + Rx. Scrophulariae Xuan Shen
+ Fr. Toosendan Chuan Lian Zi + Rx. Rehmanniae Sheng Di Huang
+ Rx. Aucklandiae Mu Xiang For abdominal fullness:
or
 + Fr. Aurantii Immaturus Zhi Zi
+ Rz. Corydalis Yan Hu Suo + Cx. Magnoliae Hou Po
+ Fr. Toosendan Chuan Lian Zi + Sm. Arecae Bing Lang
+ Olibannum Ru Xiang
For high fever:
+ Myrrh Mo Yao + Rz. Coptidis Huang Lian
or
or
+ Rx. Paeoniae Rubrae Chi Shao + Rz. Coptidis Huang Lian
+ Sm. Persicae Tao Ren + Gypsum Fibrosum Shi Gao
+ Fr. Toosendan Chuan Lian Zi
For a feeling of incomplete evacuation of the stools due to Yin Deficiency:
For a stronger effect:
+ Rx. Scrophulariae Xuan Shen
+ Rz. Coptidis Huang Lian + Rx. Rehmanniae Sheng Di Huang
+ Flos Lonicerae Jin Yin Hua
For Intestinal Abscess without pus or periappendicular abscess:
+ Hb. Taraxaci Pu Gong Ying + Sp. Gleditsiae Zao Jiao Ci
+ Hb. Patriniae Bai Jiang Cao + Rx. Angelicae Dahuricae Bai Zhi
+ Rx. Paeoniae Rubrae Chi Shao
Prior to the formation of pus:
For Heat toxin with a yellowish, dry tongue coat:
+ Flos Lonicerae Jin Yin Hua
+ Hb. Violae Zi Hua Di Ding + Hb. Taraxaci Pu Gong Ying
or
 + Hb. Patriniae Bai Jiang Cao
+ Hb. Hedyotidis Bai Hua She She Cao + Fr. Forsythiae Lian Qiao
  + Rx. Paeoniae Rubrae Chi Shao
    + Caulis Sargentodoxae Hong Teng