da cheng qi tang

Major Order the Qi Decoction

About da cheng qi tang

Da Cheng Qi Tang, Major Order the Qi Decoction, is Da Huang, Mang Xiao, Zhi Shi and Hou Po. The catalogue classes it among the formulas that drain downward, and records it as purging accumulated Heat vigorously and unblocking the bowels.

Ingredients

Herb	Amount
da huang	12 g
mang xiao	9 g
zhi shi	12 g
hou po	24 g

Actions and indications

Vigorously purges accumulated Heat and unblocks the bowels

Yang Ming organ (Fu) excess: Heat bound up with dry stool in the Intestines
Severe constipation with hard, knotted, dry stool, or foul green watery diarrhea seeping around the retained mass
Firm, tense abdomen with pain around the navel that is worse for pressure
Also given for intestinal abscess, dry Heat in the Intestines at the Qi stage of warm disease, Damp-Heat of the Large Intestine, and internal Blood stasis with spasm
Abdominal masses, abdominal cramps and hemorrhoids

Moves stagnant Qi and relieves fullness and distension

Focal distension and fullness of the epigastrium and abdomen that pressure does not relieve
Flatulence and a heavy body

Clears excess Heat

Tidal fever, worst in the late afternoon, with heavy sweating from the palms and soles and sometimes the head; aversion to heat
Hot feeling over the sternum and epigastrium, dry mouth, thirst, cracked lips, and scant dark urine
Irritability, restlessness, delirious talk, mania or clouded consciousness from Heat disturbing the Stomach and Intestines
Closed-type Wind-stroke or Heat collapse with fainting, convulsions or trembling limbs, and cold hands and feet
Fullness and constipation after a high fever, or with gum and tooth pain from Stomach Fire
Tongue red, or pink with prickles, with a dry yellow, dark yellow or dry black coat; pulse deep, forceful and rapid, or slippery and rapid

Modern uses

Acute uncomplicated appendicitis
Acute cholecystitis
Cholelithiasis
Acute pancreatitis
Simple intestinal obstruction
Enteroparalysis
Postoperative constipation and distension
Severe constipation
Habitual constipation
Biliary ascariasis (roundworm in the bile duct)
Early-stage dysentery
Bacterial dysentery
Enteritis
Stomach flu
Irritable bowel syndrome
Crohn's disease
Diverticulitis
Mesenteric lymphadenitis
Peritoneal tuberculosis
Ascites
Abdominal pain
Abdominal fullness and distension
Abdominal masses
Abdominal spasms
Nausea and vomiting
Diarrhea
Anorexia
Hemorrhoids
Acute icteric hepatitis
Pneumonia, especially in children
Lobar pneumonia
Purulent tonsillitis
Asthma
Influenza
Measles
Typhoid fever
Moist fever
Meningitis
Encephalitis
Tetanus
Heat-excess fainting or seizures
Convulsions
Stroke
Mania
Schizophrenia
Bipolar disorder
Neurosis
Hypertension
Cardiopulmonary disease
Hyperlipoproteinemia
Obesity
Beriberi
Urolithiasis
Oliguria
Enuresis
Profuse sweating (ephidrosis)
Organophosphorus poisoning
Lead poisoning
Food poisoning
Acute eczema
Pelvic inflammatory disease
Salpingitis
Vaginitis
Trichomonas infection
Vaginal discharge
Postpartum abdominal pain

Symptoms

Abdominal distention
Abdominal mass
Abdominal pain
Abdominal rigidity
Abdominal spasms
Altered consciousness
Aversion to heat
Cold limbs
Constipation
Convulsions
Dark urine
Delirium
Diarrhea
Dry lips
Dry mouth
Dry stools
Epigastric distention
Fever
Flatulence
Gum pain
Heat sensation in the chest
Heavy body
Hemorrhoids
Irritability
Mania
Pain aggravated by pressure
Restlessness
Scanty urination
Sweating
Thirst
Tidal fever
Tremor

Modifications

Yang Ming channel and organ patterns together, with high fever, great thirst and a strong rapid pulse: + zhi mu, + shi gao
Severe bloating: + lai fu zi
Blood stasis: + tao ren, + chi shao, + dang gui
Yang Ming disorder injuring fluids (dry lips, parched dry yellow coat, thin rapid pulse): + sheng di huang, + xuan shen, + mai men dong
Qi deficiency: + ren shen
Oppressive fullness and distention of the abdomen: + lai fu zi, + mu xiang
Dry, painful stools: + mang xiao, + gua lou ren
Hemorrhoids with painful bowel movements: + huang qin, + ru xiang
Ascites: + gan sui, + yuan hua
Qi and Blood badly depleted: + ren shen, + dang gui, + gan cao
Mild injury to body fluids: − mang xiao
Slight distention and fullness of abdomen: + gan cao, − hou po, − zhi shi

Show all 53 modifications

Bloating with severe belly pain: + lai fu zi, + tao ren, + chi shao
Severe intestinal dryness: + xuan shen, + mai men dong, − hou po, − zhi shi
High fever: + shi gao
Severe pain: + mu xiang, + qing pi
Severe abdominal cramps: + yan hu suo, + bai shao, + zhi gan cao
Thirst: + xuan shen, + mai men dong
Yin deficiency: + sheng di huang, + shi hu
Intestinal obstruction: + lai fu zi, + huang qin
Cholecystitis: + pu gong ying, + jin qian cao, + san qi
Cholecystitis, Qi stagnation: + pu gong ying, + jin qian cao, + san qi, + xiang fu, + yu jin
Cholecystitis, Excess Heat: + pu gong ying, + jin qian cao, + san qi, + jin yin hua, + lian qiao
Cholecystitis, Damp-Heat: + pu gong ying, + jin qian cao, + san qi, + yin chen, + zhi zi
Acute appendicitis: + zhi ke, + bai jiang cao, + bai hua she she cao, + hong teng, + hu zhang, + dan shen, + tao ren, − mang xiao, − zhi shi
Acute pancreatitis: + huang qin, + huang bai, + chai hu
Acute pancreatitis, Yang Ming Excess Heat: + huang qin, + huang bai, + chai hu, + jin yin hua, + lian qiao
Acute pancreatitis, Damp-Heat jaundice: + huang qin, + huang bai, + chai hu, + yin chen, + zhi zi
Acute pancreatitis, biliary roundworms: + huang qin, + huang bai, + chai hu, + ku lian pi, + bing lang, + xi xin
Acute pancreatitis, no constipation: + huang qin, + huang bai, + chai hu, − da huang, − mang xiao
Mild tetanus: + chan tui
Urinary stones: + hai jin sha, + jin qian cao
Acute eczema: + chan tui, + chi shao, + jin yin hua
Acute eczema, intense itch: + chan tui, + chi shao, + jin yin hua, + bai xian pi, + ku shen
Acute eczema, loose stools: + chan tui, + chi shao, + jin yin hua, + shan yao, − mang xiao
Acute eczema, weeping: + chan tui, + chi shao, + jin yin hua, + pu gong ying, + cang zhu
Acute eczema, fever: + chan tui, + chi shao, + jin yin hua, + di long
Lead poisoning, sudden severe abdominal pain: + yan hu suo, + wu yao
Lead poisoning, chronic constipation: + qian niu zi, + yu li ren
Lead poisoning, poor appetite: + shan zha, + lai fu zi, + ji nei jin
Lead poisoning, Qi and Blood deficiency: + ren shen, + huang qi, + dang gui, + bai shao
Biliary ascariasis from worm Heat: + bing lang, + shi jun zi, + jin qian cao, + wu mei
Biliary ascariasis from worm Heat, jaundice: + bing lang, + shi jun zi, + jin qian cao, + wu mei, + yin chen hao
High fever injuring Yin: + sheng di huang, + xuan shen, + mai men dong
High fever, scant dark urine: + fu ling, + che qian zi, + yi yi ren
Acute pancreatitis, cholecystitis, appendicitis or bowel obstruction with badly injured fluids: + xuan shen, + sheng di huang, + mai men dong, − hou po, − zhi shi
Acute pancreatitis, cholecystitis, appendicitis or bowel obstruction with Heat in the Small Intestine (painful, frequent urination): + chi shao, + sheng di huang, + huang bai, + huang lian
Hyperlipoproteinemia: + huang qin, + hu huang lian, + shi chang pu, + zhi mu, + shan zha, + gan cao, − mang xiao
Hyperlipoproteinemia, Damp-Heat: + huang qin, + hu huang lian, + shi chang pu, + zhi mu, + shan zha, + gan cao, + hu zhang, + yu jin, − mang xiao
Hyperlipoproteinemia, injured Yin: + huang qin, + hu huang lian, + shi chang pu, + zhi mu, + shan zha, + gan cao, + yu zhu, + he shou wu, − mang xiao
Hyperlipoproteinemia, Liver Qi stagnation: + huang qin, + hu huang lian, + shi chang pu, + zhi mu, + shan zha, + gan cao, + yu jin, − mang xiao
Hyperlipoproteinemia, Qi deficiency: + huang qin, + hu huang lian, + shi chang pu, + zhi mu, + shan zha, + gan cao, + ling zhi, + ren shen, − mang xiao
Hyperlipoproteinemia, Blood deficiency: + huang qin, + hu huang lian, + shi chang pu, + zhi mu, + shan zha, + gan cao, + he shou wu, + dang gui, − mang xiao

Cautions

pregnancy Do not use in pregnancy: its strong downward purging and Blood-moving action is considered unsafe
contraindication Pathogen still at the Wei (defensive) level or the Tai Yang stage
contraindication Hardness in the epigastrium, showing the pathogen has not yet descended below the diaphragm
contraindication Flushed face from Heat floating at the exterior
contraindication Deficient Spleen and Stomach with very little appetite, or a patient who has stopped eating
contraindication Frequent vomiting while the pathogen is still in the Shao Yang
contraindication Slow pulse from Cold in the interior
contraindication Spontaneous sweating with normal urination
contraindication Deficiency of Qi, Blood, Yin or Yang, frailty, old age, or no true excess: it can harm Stomach and Spleen Qi and use up fluids
contraindication Not an all-purpose laxative: unsuitable for ordinary or long-term constipation where no Heat has accumulated
caution In weak patients use with great care and add tonifying herbs
caution For short use only; stop once the stool has passed and the excess has resolved
caution The forceful purge can cause diarrhea, vomiting or abdominal cramps
caution Appendicitis, intestinal obstruction, cholecystitis and pancreatitis are medical or surgical emergencies that need hospital assessment; a strong purgative given for an undiagnosed acute abdomen can be dangerous

Preparation

Decoction in a fixed order: Hou Po and Zhi Shi first, Da Huang added near the end for a brief boil, and Mang Xiao dissolved into the strained liquid off the heat

Names

Pinyin	da cheng qi tang
English Name	Major Order the Qi Decoction

Classification

Category: Drain Downward