【Source】
Formulas from *Shang Han Lun* (Treatise on Cold Damage) and *Jin Gui Yao Lue* (Essentials from the Golden Cabinet)
【Ingredients】
Da Huang (Rhubarb), Zhi Shi (Immature Bitter Orange), Hou Po (Magnolia Bark)
(3)
【Category】
<Regulating Qi>：Zhi Shi (Immature Bitter Orange)
<Purging Downward>：Da Huang (Rhubarb)
<Aromatizing and Resolving Dampness>：Hou Po (Magnolia Bark)
【Formula Explanation】
*Yi Fang* (Medical Formulas): This is a Shao Yang and Yang Ming formula. (1) When evil is in the Upper Jiao, there is fullness; in the Middle Jiao, there is distention; when the Stomach is replete, there is tidal fever; when Yang evil attacks the Heart, there is mania; when Stomach heat dries the Lungs, there is wheezing. (2) Therefore, Zhi Shi and Hou Po are used to eliminate fullness and distention in the Upper Jiao. (3) Da Huang (Rhubarb) is used to eliminate replete heat in the Stomach. (4) This formula is for cases where fullness, distention, dryness, and solidity are not fully developed, so Mirabilite (Mang Xiao) is omitted to avoid injuring the true Yin of the Lower Jiao. *Shan Bu* (Supplemented and Revised Texts): Ke Qin said: All diseases originate from Qi, and the failure to eliminate turbid matter is due to the disharmony of Qi. Therefore, purging formulas must use herbs that regulate Qi, hence the name Cheng Qi (Order the Qi) Decoction. The differentiation between Large and Small (Da and Xiao) has two meanings: Hou Po is doubled compared to Da Huang (Rhubarb), making Qi-regulating herbs the chief, hence the name Da Cheng Qi (Large Order the Qi); Da Huang (Rhubarb) is doubled compared to Hou Po, making Qi-regulating herbs the assistant, hence the name Xiao Cheng Qi (Small Order the Qi). The taste is more, the nature is strong, and the dosage is large, aiming for a large downward purging effect, hence the name Da (Large); the taste is fewer, the nature is mild, and the dosage is small, aiming to harmonize the Stomach Qi slightly, hence the name Xiao (Small). Furthermore, the decoction method has profound significance. Da Cheng Qi uses one dou of water to decoct Zhi Shi and Hou Po, obtaining five sheng. The residue is removed, Da Huang (Rhubarb) is added, and the mixture is decocted again to obtain two sheng. Then Mirabilite is added. Why? Because raw herbs are sharp in Qi and act first, while cooked herbs are pure in Qi and gentle. Zhang Zhongjing wanted Mirabilite to soften the dry feces first, and Da Huang (Rhubarb) to then clear the bowels, and then Zhi Shi and Hou Po to eliminate the fullness and distention. In Xiao Cheng Qi, the three ingredients are decocted together without differentiation in order, using the same Da Huang (Rhubarb), but the decoction method is different. This shows Zhang Zhongjing’s intention for mild harmonization.
【Functions】
Clears and drains heat accumulation, purges accumulation and drains heat, promotes Qi and eliminates fullness, reduces stuffiness and resolves distention.
【Indications】
Yang Ming disease, mild Yang Ming Fu (bowel) repletion pattern with a tendency towards fullness and distention. Symptoms include delirium, tidal fever, constipation, abdominal fullness and distention, etc. *Yi Fang* (Medical Formulas): (1) Yang Ming pattern of Cold Damage, delirium, tidal fever, slippery and rapid pulse. (2) Miscellaneous diseases with Upper Jiao fullness and obstruction. (3) Evil in the Stomach, supporting-phlegm with abdominal fullness (Jin Gui Yao Lue, Phlegm and Fluid). (4) Tai Yang disease, after vomiting, purging, or sweating, with slight irritability, frequent urination, and constipation (Shang Han Lun, Yang Ming section).
【Applications】
Chronic gastritis, hepatitis, biliary disorders, habitual constipation. Stomachache, hiccups, biliary ascariasis in children, acute gastroenteritis in children. Intestinal obstruction, postoperative gastrointestinal dysfunction.
【Contraindications】
Pregnant women, postpartum women, women during menstruation, the elderly and weak, those with fluid deficiency after illness, and those with blood loss should all use with caution. If necessary, it can be used with tonifying methods, using small doses to test the effect, and stopping when effective. Do not overdose.
【Mnemonic】
When the fragrant melon is ripe with Da Huang (Rhubarb) (Da Shi Hou), don’t be stingy, please share it with everyone.
【Pharmacology】
Antibacterial, liver protection, reducing vascular permeability, etc.