【Name Origin】
Golden Mirror: All diseases originate from Qi. The inability to eliminate waste is due to the Qi not flowing smoothly. Therefore, purgative formulas must use Qi-regulating herbs, hence the name ‘Chengqi’ (Order the Qi). Chinese Dictionary: Chengqi means to regulate the Qi, ensuring its smooth flow, to treat abdominal distension and constipation.
【Source】
Shang Han Lun (Treatise on Cold Damage), Jin Gui Yao Lue (Essentials from the Golden Cabinet)
【Composition】
Da Huang (Rhubarb), Hou Po (Magnolia Bark), Zhi Shi (Immature Bitter Orange), Mang Xiao (Sodium Sulfate)
(4)
【Category】
<Regulating Qi>：Zhi Shi (Immature Bitter Orange)
<Purgatives>：Mang Xiao (Sodium Sulfate), Da Huang (Rhubarb)
<Aromatic Damp-Resolving>：Hou Po (Magnolia Bark)
【Formula Explanation】
Medical Formulas: This is a formula for Yangming diseases. (1) Heat excess internally should be treated with salty and cold herbs; hardening due to Qi stagnation should be softened with salty herbs; heat excess should be eliminated with cold herbs. (2) Therefore, Mang Xiao’s salty and cold nature moistens dryness and softens hardness. (3) Da Huang’s bitter and cold nature drains heat, removes blood stasis, descends dryness and hardness, and drains stomach excess. (4) Zhi Shi and Hou Po’s bitter descending action drains fullness and distention. (5) As the classics say, ‘Deplete what is stagnant in the earth element.’ However, it should not be used lightly unless there is significant fullness and distention, for fear of cold attacking the middle burner leading to binding chest and Qi stagnation. Chinese Dictionary: This is a representative formula for Yangming diseases…Hou Po and Zhi Shi can treat abdominal tightness and distention; Da Huang and Mang Xiao have anti-inflammatory and purgative effects. Therefore, even for those with abdominal distension and constipation, it is still contraindicated if the pulse is weak. For example, if abdominal distention is caused by ascites or peritonitis, there is almost no chance of using this formula.
【Functions】
Strongly purge heat accumulation, eliminate fullness and distention, moisten dryness and attack hardness.
【Indications】
(1) Yangming Excess Heat Syndrome: fullness and distention in the epigastrium and abdomen, abdominal pain and tenderness, hard on palpation, dry and hard stools, constipation, frequent passing of gas, or even tidal fever, delirium, sweaty hands and feet, thick yellow tongue coating, dry and thorny, or scorched black and cracked, deep and forceful pulse. (2) Heat accumulation causing diarrhea of clear watery fluid, abnormally foul odor, abdominal distension and umbilical abdominal pain unrelieved, hard masses on palpation, dry mouth and tongue, slippery and rapid pulse. (3) Heat syncope, spasm disorders, or mania due to internal excess heat syndrome. Medical Formulas: (1) Cold damage Yangming Fu (bowel) syndrome, Yang evil enters the interior, stomach excess without bowel movement, fever, delirium, spontaneous sweating, aversion to heat, fullness, distention, dryness, hardness, and impaction all present (Cold Damage, Yangming chapter). (2) Miscellaneous diseases with triple burner excess heat, deep and forceful pulse (miscellaneous diseases, dry and hard stools). (3) Also treats Yangming rigid spasms (Golden Cabinet, spasm disorders). (4) Yangming disease, after purging, with irritability and vexation in the heart, dry stool in the stomach (Cold Damage, Yangming chapter). Deleted and Supplemented: Yangming disease with tidal fever, sweaty hands and feet, delirium, profuse sweating, dry stomach with delusional speech as if seeing ghosts, shortness of breath, unable to lie down, abdominal fullness and pain, slippery and forceful pulse. Also, unclear vision, uncoordinated eyes, or dry mouth and throat in initial stages of Shaoyin disease. Diarrhea with clear watery fluid, pure green color, pain below the heart, dry mouth and tongue. Abdominal distension and constipation after six or seven days.
【Adaptation】
Acute pneumonia, enteric fever, intestinal obstruction, appendicitis, acute cholecystitis, acute pancreatitis, acute infectious hepatitis, hypertension, habitual constipation, postoperative abdominal distension and pain, psychosis, mania, severe trauma respiratory distress syndrome, obesity.
【Contraindications】
(1) Although internal excess is present, external symptoms are unresolved; spleen and stomach deficiency cold, kidney yang deficiency, and pregnancy are all contraindications. (2) Cold damage with frequent vomiting, even with Yangming symptoms, should not be purged; (3) Yangming disease with hard fullness below the heart should not be purged; (4) Yangming disease with a red face should not be purged; (5) Yangming disease with a slow pulse, profuse sweating, fever and aversion to cold, the exterior is unresolved, and the fever is not tidal, Da Chengqi Tang should not be used; (6) Yangming disease with tidal fever but no hard stool should not be given Da Chengqi Tang. (7) When typhoid fever is about to bleed, there is also abdominal pain and tenderness; (8) Peritonitis Fu Zi Geng Mi Tang syndrome, with pain so severe that hands cannot approach, are all prohibited from purging; (9) If the disease is initially accompanied by diarrhea and weakness, this formula should not be used recklessly.
【Mnemonic】
Laughing uncontrollably (Da Huang, Mang Xiao, Hou Po, Zhi Shi) can bear the full stomach of foul Qi.
【Modifications】
(1) If also with blood stasis, add Tao Ren (Peach Kernel), Hong Hua (Safflower), Chi Shao (Red Peony Root) to activate blood and remove blood stasis. (2) If also with Qi deficiency, add Ren Shen (Ginseng) to tonify Qi and prevent Qi collapse from purging. (3) If also with insufficient Yin fluids, add Xuan Shen (Scrophularia Root), Sheng Di (Rehmannia Root) to nourish Yin and moisten dryness. (4) If heat excess has become toxic, add Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Zhi Zi (Gardenia Fruit), Lian Qiao (Forsythia Fruit) to clear heat and resolve toxicity.
【Pharmacology】
Excites the intestinal tract, increases gastrointestinal propulsion function, increases intestinal volume and intestinal blood flow, anti-inflammatory, antibacterial, detoxifying, enhances smooth muscle electrical excitability, increases motilin release, inhibits calcium influx in obstructed colonic smooth muscle, reduces plasma norepinephrine (NA) levels in patients with intestinal obstruction, promotes experimental lung damage repair, increases serum zinc concentration and superoxide dismutase activity.