【Source】
Shang Han Lun (Treatise on Cold Damage), Jin Gui Yao Lue (Synopsis of Prescriptions of the Golden Chamber)
【Ingredients】
Da Huang (Rhubarb), Zhi Shi (Immature Bitter Orange), Hou Po (Magnolia Bark)
(3)
【Category】
<Regulate Qi>：Zhi Shi (Immature Bitter Orange)
<Purge Downward>：Da Huang (Rhubarb)
<Aromatic Damp-Resolving>：Hou Po (Magnolia Bark)
【Formula Analysis】
《Medical Formulas》: This formula treats Shao Yang and Yang Ming diseases. (1) When evil is in the upper Jiao, there is fullness; in the middle Jiao, there is distention; when the stomach is full, there is tidal fever; when Yang evil attacks the heart, there is mania; when stomach heat dries the lungs, there is panting. (2) Therefore, Zhi Shi and Hou Po are used to remove fullness in the upper Jiao. (3) Da Huang (Rhubarb) is used to remove the substantial heat in the stomach. (4) This formula is for cases where the fullness, distention, dryness, and solidity are not yet complete, so Glauber’s salt is removed to avoid harming the true Yin of the lower Jiao.《Shan Bu》: Ke Qin said: All diseases are caused by Qi, and the failure to eliminate filth is due to the disharmony of Qi. Therefore, formulas that attack accumulation must use herbs that regulate Qi, hence the name “Qi-Regulating Decoction.” The distinction between Major and Minor lies in two aspects: Hou Po is double the amount of Da Huang (Rhubarb), indicating that Qi-regulating herbs are the chief, hence the name Major Qi-Regulating Decoction; Da Huang (Rhubarb) is double the amount of Hou Po, indicating that Qi-regulating herbs are the assistant, hence the name Minor Qi-Regulating Decoction. Many ingredients and strong properties are used in larger doses, aiming for a major downward purge, hence the name “Major”; few ingredients and mild properties are used in smaller doses, aiming to subtly harmonize the stomach Qi, hence the name “Minor.” Moreover, the decoction method has subtle meanings. For Major Qi-Regulating Decoction, one dou of water is used to boil Zhi Shi and Hou Po, extracting five sheng, removing the dregs, adding Da Huang (Rhubarb), and boiling again to extract two sheng, then adding Glauber’s salt. Why? Because raw herbs have a sharp Qi and act first, while cooked herbs have a pure Qi and are mild and harmonious. Zhongjing wants Glauber’s salt to first soften the dry stools, Da Huang (Rhubarb) to then open the intestinal passage, and then Zhi Shi and Hou Po to eliminate the fullness and distention. In Minor Qi-Regulating Decoction, the three ingredients are decocted together without separating the order, using the same Da Huang (Rhubarb), but the decoction method is different, which shows Zhongjing’s intention for subtle harmonization.
【Actions】
Clears and drains heat accumulation, attacks accumulation and drains heat, promotes Qi and eliminates fullness, alleviates fullness and removes distention.
【Indications】
Yang Ming disease, mild Yang Ming fu-organ excess with a tendency towards fullness and distention. Symptoms include delirium, tidal fever, constipation, abdominal fullness, etc.《Medical Formulas》: (1) Shang Han Yang Ming syndrome, delirium, tidal fever, slippery and rapid pulse. (2) Miscellaneous diseases with fullness and obstruction in the upper Jiao. (3) Evil in the stomach, support drink with abdominal distension (Jin Gui Yao Lue, Tan Yin). (4) Tai Yang disease, after vomiting, purging, or sweating, slight vexation, frequent urination, and constipation (Shang Han Lun, Yang Ming chapter).
【Applications】
Chronic gastritis, hepatitis, biliary tract diseases, habitual constipation. Stomach pain, hiccups, biliary ascariasis in children, acute gastroenteritis in children. Intestinal obstruction, gastrointestinal dysfunction after surgery.
【Contraindications】
Pregnant women, postpartum women, menstruating women, the elderly, the weak, those with fluid deficiency after illness, and those with blood loss should use with caution. If necessary, it can be used with both purgative and tonifying properties, and a small dose should be tried. Discontinue use as soon as it takes effect, and do not overdose.
【Mnemonic】
When the melon is ripe, and Da Huang (Rhubarb) is mature (Da Shi Hou), don’t be stingy, please invite everyone to eat.
【Pharmacology】
Antibacterial, liver protection, reduced vascular permeability, etc.