【Source】

Treatise on Cold Damage Diseases

 【Composition】

Rhubarb, Mirabilite, Euphorbia kansui
(3)

 【Classification】

<Purgatives>: Mirabilite, Rhubarb

<Strong Purgatives and Diuretics>: Euphorbia kansui

【Formula Analysis】

From “Zhong Yi Can Xi”: The symptoms of chest obstruction are characterized by severe fullness and oppression in the chest. This is due to external wind-heat invading internally and combining with pre-existing phlegm and fluid in the chest. Although the rising qi may affect the diaphragm, it is still blocked from ascending. Therefore, herbs that regulate qi, such as Aurantii Fructus Immodus and Magnoliae Officinalis Cortex, are not needed. Only Rhubarb and Mirabilite are used in heavy doses to clear phlegm and heat. However, it is feared that the strong action of Rhubarb and Mirabilite may not be immediately effective, so a small amount of Euphorbia kansui is added. Its nature is to strongly purge and resolve, acting extremely rapidly. When combined with Rhubarb and Mirabilite, this formula can clear and cleanse the empty cavity, removing all obstructions. The creator of this formula used a “thunderbolt” approach.

 【Functions】

Clears heat and expels water, softens hardness and breaks masses.

 【Indications】

Chest obstruction syndrome, characterized by hardness, fullness, and pain from below the xiphoid process to the lower abdomen, which is unbearable to touch. Constipation, mild afternoon fever, or shortness of breath and vexation. Deep, tight, and forceful pulse. Dry tongue, etc. From “Yi Fang”: (1) Treats early stage of wind-cold invading the interior after purgation, with fullness and whip-like pain below the xiphoid process (Wind-Cold Damage, Taiyang Upper Part). (2) May occur without high fever, but with slight sweating on the head, and a deep pulse, indicating water accumulation in the chest (Wind-Cold Damage, Taiyang Upper Part). (3) Taiyang disease, with profuse sweating followed by purgation, inability to defecate for five or six days, dry tongue and thirst, afternoon fever, and whip-like fullness and pain from the chest to the lower abdomen, unbearable to touch (Wind-Cold Damage, Taiyang Upper Part).

 【Clinical Applications】

Pleurisy, digestive system diseases, intestinal obstruction, biliary tract infections, gallstones, acute pancreatitis, and other conditions exhibiting the above symptoms, as well as epidemic hemorrhagic fever, etc.

 【Contraindications】

(1) For those who are habitually weak or cannot tolerate aggressive treatment after illness, beware of the harm of deficiency and deficiency, and avoid this formula. (2) All three are strong purgatives. They should not be used unless the external evil has been completely eliminated and there is an internal accumulation of water and heat.

 【Mnemonic】

The great limit has arrived, and at any time, great death will come (Da Xian, Sui, Da, Mang).

 【Modifications】

(1) If the chest obstruction is severe and accompanied by qi stagnation, add Magnoliae Officinalis Cortex, Aurantii Fructus Immodus, and Aucklandiae Radix to promote qi circulation and strengthen the purgative effect. (2) If the chest obstruction is mild, add Fructus Trichosanthis (Trichosanthes kirilowii) and remove Mirabilite. (3) If there is severe internal heat, add Coptidis Rhizoma to enhance heat clearing. (4) If there is blood stasis, add Spiraea Japonica and Persicae Semen to invigorate blood circulation and resolve stasis. (5) Adding Marrubium vulgare, Armeniacae Semen Amarum, and white honey to this formula creates Da Xian Xiong Wan from “Treatise on Cold Damage Diseases,” which primarily treats chest obstruction syndrome with hardness, fullness, and pain in the chest, and stiff neck resembling tetanus. (6) Removing Mirabilite from this formula and adding Persicae Semen, Spiraea Japonica, Cyathula officinalis, Sichuan Magnoliae Officinalis Cortex, and Aucklandiae Radix creates Gan Sui Tong Jie Tang from “New Interpretation of Formulas for Acute Abdominal Diseases,” which treats intestinal obstruction with significant intestinal fluid accumulation.

 【Pharmacology】

It has diuretic effects, improves symptoms of acute renal failure, and enhances the phagocytic activity of peritoneal macrophages in mice.