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Da Cheng Qi Tang 大承气汤
Major Order the Qi Decoction


Tradition:
TCM

Source / Author:
Discussion of Cold Induced Disorders (Shang Han Lun) C.220

Herb Name
Da Huang ⼤黄 (Rhubarb root)
Mang Xiao
芒硝 (Mirabilite)
Zhi Shi
枳实 (Unripe Bitter Orange)
Hou Po
厚朴 (Magnolia bark)

Latin
Rheum palmatum
Mirabilitum
Citrus aurantium
Magnolia o
fficinalis

Amount
6–12 grams
9–12 grams
12 grams
12–24 grms


Preparation:
Decoct Citrus Zhi Shi and Magnolia Hou Po in 10 cups of water down to 5 cups, then add the Rhubarb and cook a further 20 minutes, then strain and dissolve in the Mirabilitum Mang Xiao.

Function:
Purge Heat accumulation

Use:
Severe constipation, focal distention, abdominal fullness, dry, yellow tongue coat, or black coat, deep strong pulse. Severe cases may have delirium.
1. Intestinal obstruction
2. Appendicitis

3. Acute pancreatitis
4. Acute cholecystitis


Dose:

a cupful can be taken as a dose. A second cup can be taken after several hours if required. Once diarrhea is induced it is not taken.

Cautions:
1. Not used during pregnancy
2. Not used in cold and weak patients


Modifications:
1. Blood stasis, add Peach kernel Tao Ren
2. High Fever with rapid pulse, add Gypsum Shi Gao
3. Large doses of Magnolia Hou po are used if there is strong focal distention, otherwise less doses are used.
4. In most cases, lower doses of Rhubarb are su
fficient unless there is severe constipation with excess heat, in which case a full dose of 12 grams may be required.


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