Disclaimer For educational purposes only. Do not use as medical advice
AboutChinese MedicineCaution/Notes
| Health Benefits |
| For: Early stage dysentery • Cholecystitis • Appendicitis • Pancreatitis |
| Atributes: |
| Products |
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Tablets |
Pills |
Capsules |
Granules |
| Other Names: |
| Category: Drain Downward ⌕ |
| Subcategory: Purge Heat Accumulation Source: Shang Han Lun |
| Actions: Vigorously purges heat accumulation [31] • Relief constipation Yang Ming organ syndrome causing constipation or diarrhea. Relief excess internal heat causing heat collapse [42]
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| Diagnosis |
| Tongue: dry yellow or black coat with fissures Pulse: excessive, deep, forceful Other: |
| Patterns: Abdominal Pain Yang Ming Heat, Constipation, Stomach and Large Intestine Excess Heat |
| Indications: Yangming organ syndrome causing severe constipation or diarrhea. Re Jue. [35] • Syndrome of heat accumulation with watery discharge：Diarrhea with greenish foul water, abdominal pain with hardness, dry mouth and tongue, slippery excessive pulse; True heat with false cold.[31] • Severe flatulence, Abdominal pain that worsens with applied pressure, abdominal focal distention and fullness, severe constipation, excessive sweating from the hands and the feet, Delirious speech, Low grade fever[31] • Green watery diarrhea[42]
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| Contraindications: Elderly patients • Pregnancy • Yin Deficiency • Weak body constitution • Stop after symptoms are controlled |
| Description |
| Name Variations: Da Cheng Qi Tang, 大承气汤, Major Order the Qi Decoction, |
| Herb List: Da Huang(K, 12g) • Mang Xiao(M, 9-12g) • Hou Po(A, 24g) • Zhi Shi(A, 12-15g) |
| Commentary: Da Cheng Qi Tang - constipation with abdominal pain that WORSENS with pressure.
Xiao Cheng Qi Tang - constipation with abdominal pain that DOES NOT worsen with pressure.
Tiao Wei Cheng Qi Tang - mild constipation, no abdominal pain.
Zeng Ye Cheng Qi Tang - constipation with dryness (cannot be expelled with purgative alone).
Tao He Cheng Qi Tang - for blood stasis [21] • Da Cheng Qi Tang is like Bai Hu Tang for heat in Yang Ming Channel, this is for heat in Yang Ming organ. When heat is only in the Qi channel level there is no constipation, but when it gets into the organ, then there is constipation. Da Huang/Mang Xiao – purging; Zhi Shi – must have something to regulate Qi; HouPo–to push the Qi down. (Xiao Chen Qi Tang just without the Mang Xiao). This formula is designed for pure excess. |
| Related Formulas: Da Cheng Qi Tang, Xiao Cheng Qi Tang, Ma Zi Ren Wan, Huang Long Tang, Tao He Cheng Qi Tang, Tiao Wei Cheng Qi Tang
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| NCCAOM: The 3 NCCAOM formulas for constipation from Yang Ming Heat are Xiǎo Chéng Qì Tāng, Dà Chéng Qì Tāng, and Tiào Wèi Chéng Qì Tāng. • Da Cheng Qi Tang is for severe constipation, abdominal pain that WORSENS with pressure, abdominal focal distention and fullness, severe flatulence, and excessive sweating. • Xiao Cheng Qi Tang is for beginning of dysentery, abdominal distention pain NOT WORSEN with pressure, tenesmus and mild constipation due to heat in ST and intestines. • Tiao Wei Cheng Qi Tang is for mild symptoms like mild constipation, thirst, NO abdominal distention or pain, swollen gums, nosebleed, and petechiae from the ST and intestine heat. |
| Herbs |
Cat/Dosage |
Actions |
Attributes |
| Hou Po |
Aromatic Transform Damp |
Transform spleen dampness • Transform stomach dampness • Clear food stagnation • Transform Phlegm • Clear Qi stagnation moving downwardPairs with Cang Zhu |
GABA-ergic • Sedative • Cannabimimetic • Antioxidant • Anticoagulant • Antidepressant • Anti-inflammatory • Antibiotic • Antispasmodic • Antitumor • Antimicrobial |
| Da Huang |
Downward Draining |
Strongly purges heat accumulations (yangming organ heat, treats “shi” aka hardness) • Drain damp heat • Invigorate and cool blood • Promote menstruation • Promote urination • Stop bleeding • Clear heat, reduce toxicity (used topically for fire toxin sores, hot skin lesions, carbuncles, boils and burns)
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Anti-inflammatory • Antibiotic • Antipyretic • Choleretic • Cholagogic • Hemostatic • Immunity booster • Laxative • Nephroprotective |
| Zhi Shi • Immature Bitter Orange • 枳实 |
Regulate Qi |
Breaks up Qi stagnation, move Qi downward, clear accumulation, resolve phlegm obstruction, unblock bowelsFor moving Qi: from epigastric all the way to the abdominal area - Zhi Shi and Zhi Ke |
hypertensive, acidic, enhances circulation, diuretic, increase intestinal peristalsis, uterine stimulant |
| Mang Xiao • Sodium Sulfate • 芒硝 |
Downward Draining |
Moisten dryness • Soften clumping in the intestine • Purge accumulations • Drain fire • Clear phlegm • Reduce swelling • Clear stagnation • Clear heat • Promote or inhibit lactationThis material attracts water from the body into the intestine and bulks up stool • May be impacting the osmotic pressure in the intestinal peristosis |
Laxative |
| ♠ King/Chief ♥ Minister/Deputy ♣ Assistant ♦ Envoy |
| Directions: Decoct Zhi Shi, Hou Po first, add Da Huang in the last 5 minutes, infuse Mang Xiao [31]
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| Caution |
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ALERT: Contraindications of each herb - use with caution under these conditions:
Hou Po: Anticoagulant drugs • Antidepressant drugs
Da Huang: Qi deficiency • Blood deficiency • Stomach deficiency cold • Spleen deficiency cold • Normal or loose stool • Normal blood flow • Postpartum • Caution with pregnancy, lactation, menstruation [21]
Zhi Shi: pregnancy, Spleen and Stomach deficiencies, gastric or duodenal peptic ulcers[18]
Mang Xiao: Pregnancy • Spleen and Stomach deficiency cold |
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