HERB FORMULAS

DA HUANG MU DAN (PI) TANG - 大黄牡丹皮湯 - RHUBARB AND MOUTAN DECOCTION

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 hardness, 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
Perspiration

Irregular or intermittent fever followed by chills and perspiration
May be mass in lower right quadrant of abdomen
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
Rectal prolapse
Urolithiasis
Prostatic hypertrophy
Anorexia
Salpingitis
Enuresis
Puerperal fever
Periappendicular abscess
Vaginal discharge

Acute cholecystitis
Testitis
Peritonitis
Pyelitis
Cystitis
Eczema
Ulcerative enteritis
Gonorrhea
Leukorrhea
Ureteraliths
Iliac fossa abscess
Subdermal abscess
Hepatic abscess
Bacterial dysentery
Mastitis
Osteomyelitis
Blocked uterine tubes
Cerebral thrombosis
Benign prostatic hypertrophy
Suppurative tonsillitis
Colitis
Incarcerated internal hemorrhoids
Abdominal pain
Nausea/Vomiting
Constipation
Diarrhea
Intestinal obstruction
Trichomonas
Ulcerative colitis
Vaginitis
Lower abdominal masses

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 Rubra	Chi Shao	+ Hb. Taraxaci	Pu Gong Ying
+ Hb. Violae	Zi Hua Di Ding	+ Hb. Hedyotis	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
+ Olibanum	Ru Xiang	For high fever:
+ Myrrh	Mo Yao	+ Rz. Coptidis	Huang Lian
or		or
+ Rx. Paeoniae Rubra	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 Rubra	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. Hedyotis	Bai Hua She She Cao	+ Fr. Forsythiae	Lian Qiao
For acute appendicitis with stagnation and accumulation:		+ Rx. Paeoniae Rubra	Chi Shao
		+ Caulis Sargentodoxae	Hong Teng
+ Fr. Toosendan	Chuan Lian Zi	For acute appendicitis with Damp-Heat:
+ Rx. Paeoniae Rubra	Chi Shao	+ Flos Lonicerae	Jin Yin Hua
For acute appendicitis with Toxic Heat:		+ Sm. Coicis	Yi Yi Ren
+ Rz. Coptidis	Huang Lian	For acute appendicitis with toxic sores:
+ Hb. Patriniae	Bai Jiang Cao	+ Rz. Coptidis	Huang Lian
For acute appendicitis with Damp-Heat masses:		+ Rz. Polygoni Cuspidati	Hu Zhang
+ Squama Manitis	Chuan Shan Jia	For chronic appendicitis:
+ Rx. Paeoniae Rubra	Chi Shao	+ Hb. Patriniae	Bai Jiang Cao
For ruptured appendix with peritonitis:		For ruptured appendix with peritonitis with a high fever:
+ Flos Lonicerae	Jin Yin Hua
+ Fr. Toosendan	Chuan Lian Zi	+ Flos Lonicerae	Jin Yin Hua
+ Sm. Persicae	Tao Ren	+ Fr. Toosendan	Chuan Lian Zi
+ Antibiotic drugs		+ Sm. Persicae	Tao Ren
For ruptured appendix with peritonitis with nausea and vomiting:		+ Gypsum Fibrosum	Shi Gao
		+ Rx. Trichosanthis	Tian Hua Fen
+ Flos Lonicerae	Jin Yin Hua	+ Antibiotic drugs
+ Fr. Toosendan	Chuan Lian Zi	For ruptured appendix with peritonitis with severe pain:
+ Sm. Persicae	Tao Ren
+ Caulis Bambusae in Taeniam	Zhu Ru
		+ Flos Lonicerae	Jin Yin Hua
		+ Fr. Toosendan	Chuan Lian Zi
+ Rz. Phragmitis	Lu Gen	+ Sm. Persicae	Tao Ren
+ Antibiotic drugs		+ Olibanum	Ru Xiang
For ruptured appendix with peritonitis with abscess and swelling:		+ Myrrh	Mo Yao
		+ Rz. Corydalis	Yan Hu Suo
+ Flos Lonicerae	Jin Yin Hua	+ Antibiotic drugs
+ Fr. Toosendan	Chuan Lian Zi	For Periappendicular abscess:
+ Sm. Persicae	Tao Ren	+ Antibiotic drugs
+ Borneolum	Bing Pian	For Periappendicular abscess with stagnation and accumulation:
+ Natrii Sulfas	Mang Xiao	+ Rz. Corydalis	Yan Hu Suo
+ Antibiotic drugs		+ Rx. Paeoniae Rubra	Chi Shao
For Periappendicular abscess with Excess Heat:		+ Antibiotic drugs
+ Flos Lonicerae	Jin Yin Hua	For pelvic inflammatory disease:
+ Fr. Gardeniae	Zhi Zi	+ Flos Lonicerae	Jin Yin Hua
+ Hb. Taraxaci	Pu Gong Ying	+ Fr. Forsythiae	Lian Qiao
+ Antibiotic drugs		+ Cx. Phellodendri	Huang Bai
For chronic prostatitis with frequent, painful urination (rectal installation):		+ Hb. Taraxaci	Pu Gong Ying
+ Hb. Polygoni Avicularis	Bian Xu	+ Rx. Rehmanniae	Sheng Di Huang
+ Hb. Dianthi	Qu Mai	+ Hb. Patriniae	Bai Jiang Cao
For chronic prostatitis with testicular pain (rectal installation):		+ Rx. Glycyrrhizae	Gan Cao
		+ Antibiotic drugs
+ Fr. Toosendan	Chuan Lian Zi	For chronic prostatitis with lower abdominal pain (rectal installation):
+ Rz. Corydalis	Yan Hu Suo
For chronic prostatitis with nodules and hardening of the prostate (rectal installation):		+ Cx. Eucommiae	Du Zhong
		+ Rx. Dipsaci	Xu Duan
+ Squama Manitis	Chuan Shan Jia	For chronic prostatitis with presence of red or white blood cells in the seminal fluids (rectal installation):
+ Rz. Curcumae	E Zhu
For suppurated tonsillitis:		+ Hb. Taraxaci	Pu Gong Ying
+ Fr. Forsythiae	Lian Qiao	+ Hb. Ecliptae	Mo Han Lian
+ Rz. Coptidis	Huang Lian	For suppurated tonsillitis with seizures:
+ Flos Lonicerae	Jin Yin Hua	+ Fr. Forsythiae	Lian Qiao
+ Rx. Glycyrrhizae	Gan Cao	+ Rz. Coptidis	Huang Lian
For suppurated tonsillitis with abdominal pain:		+ Flos Lonicerae	Jin Yin Hua
+ Fr. Forsythiae	Lian Qiao	+ Rx. Glycyrrhizae	Gan Cao
+ Rz. Coptidis	Huang Lian	+ Ram. Uncariae cum Uncis	Gou Teng
+ Flos Lonicerae	Jin Yin Hua	+ Ram. Uncariae cum Uncis	Gou Teng
+ Rx. Glycyrrhizae	Gan Cao	+ Scorpio	Quan Xie
+ Rx. Aucklandiae	Mu Xiang	For suppurated tonsillitis with submandibular lymphadenitis:
+ Rz. Corydalis	Yan Hu Suo
For incarcerated Internal hemorrhoids:		+ Fr. Forsythiae	Lian Qiao
+ 9g Natrii Sulfas	Mang Xiao	+ Rz. Coptidis	Huang Lian
+ 30g Hb. Taraxaci	Pu Gong Ying	+ Flos Lonicerae	Jin Yin Hua
+ 10g Flos Carthami	Hong Hua	+ Rx. Glycyrrhizae	Gan Cao
+ 12g Rx. Sanguisorbae	Di Yu	+ Squama Manitis	Chuan Shan Jia
15g Fr. Aurantii	Zhi Shi	+ Sp. Prunellae	Xia Ku Cao
For Crohn's disease:		*For Crohn's disease with Heat damaging the Yin:*
+ 15g Rz. Corydalis	Yan Hu Suo	+ 15g Rz. Corydalis	Yan Hu Suo
+ 15g Flos Lonicerae	Jin Yin Hua	+ 15g Flos Lonicerae	Jin Yin Hua
+ 15g Caulis Sargentodoxae	Hong Teng	+ 15g Caulis Sargentodoxae	Hong Teng
+ 9g Hb. Patriniae	Bai Jiang Cao	+ 9g Hb. Patriniae	Bai Jiang Cao
+ 9g Fr. Forsythiae	Lian Qiao	+ 9g Fr. Forsythiae	Lian Qiao
+ 6g Olibanum	Ru Xiang	+ 6g Olibanum	Ru Xiang
+ 6g Myrrh	Mo Yao	+ 6g Myrrh	Mo Yao
For Crohn's disease with severe abdominal distention:		+ 12g Rx. Rehmanniae	Sheng Di Huang
For Crohn's disease with severe abdominal distention:		+ 12g Hb. Dendrobii	Shi Hu
+ 15g Rz. Corydalis	Yan Hu Suo	For enhancing the accumulation clearing effect:
+ 15g Flos Lonicerae	Jin Yin Hua	+ 30g Caulis Sargentodoxae	Hong Teng
+ 15g Caulis Sargentodoxae	Hong Teng	+ 30g Caulis Sargentodoxae	Hong Teng
+ 15g Caulis Sargentodoxae	Hong Teng	+ 30g Hb. Patriniae	Bai Jiang Cao
+ 9g Hb. Patriniae	Bai Jiang Cao	For Intestinal Abscess or diverticulitis with Qi Stagnation predominant:
+ 9g Fr. Forsythiae	Lian Qiao
+ 6g Olibanum	Ru Xiang	+ 9-12g Per. Citri Reticulatae Viride	Qing Pi
+ 6g Myrrh	Mo Yao	+ 9-12g Per. Citri Reticulatae Viride	Qing Pi
+ 9g Cx. Magnoliae Officinalis	Hou Po	+ 9-12g Rx. Linderae	Wu Yao
+ 9g Cx. Magnoliae Officinalis	Hou Po	For Intestinal Abscess or diverticulitis with Blood Stagnation predominant:
+ 9gEx. Aucklandiae	Mu Xiang
For Intestinal Abscess or diverticulitis with an obvious palpable mass:		+ 18- 30g Rx. Salviae Miltiorrhizae	Dan Shen
+ 9-12g Rz. Curcumae	E Zhu	For Intestinal Abscess or diverticulitis with severe abdominal distention:
+ 9-12g Rz. Sparganii	San Leng
For Intestinal Abscess or diverticulitis with severe pain:		+ 9-12g Fr. Aurantii Immaturus	Zhi Shi
+ 9-12g Rz. Corydalis	Yan Hu Suo	+ 18-24g Fr. Trichosanthis	Gua Lou
+ 9-12g Fr. Toosendan	Chuan Lian Zi	+ 18-24g Fr. Trichosanthis	Gua Lou
+ 6-9g Rx. Aucklandiae	Mu Xiang	For Intestinal Abscess or diverticulitis with External signs and symptoms:
For Intestinal Abscess or diverticulitis with nausea:
For Intestinal Abscess or diverticulitis with nausea:		+ 9-12g Fol. Perillae	Zi Su Ye
12-15g Caulis Bambusae in Taeniam	Zhu Ru	For Intestinal Abscess or diverticulitis with developing Internal Heat:
12-15g Caulis Bambusae in Taeniam	Zhu Ru
For subacute Intestinal abscess:		+ 15-30g Hb. Taraxaci	Pu Gong Ying
+ Less Rx. et Rz. Rhei	Da Huang	+ 9-12g Fr. Forsythiae	Lian Qiao
+ Less Natrii Sulfas	Mang Xiao	+ 15-30g Flos Lonicerae	Jin Yin Hua