[Source]

Collected Essays on Formulas and Their Explanations, Vol. 1.

 [Composition]

Rhubarb, (processed) Aconite, Asarum
(3)

 [Category]

<Purgative>: Rhubarb

<Warming Interior>: Asarum, Aconite

[Analysis of Formula]

Collected Essays on Formulas and Their Explanations: Cold-yin accumulation, localized in one area. Although there is fever, it is also caused by the stagnation of Yang Qi. Therefore, it is not only necessary to warm to disperse the cold, but also to purge to remove the accumulation. Hence, use the pungent and hot nature of Aconite and Asarum to search and disperse, and then use Rhubarb to move the accumulation. This is a representative prescription of the warming-purgative category. The warming-purgative category warms and purges simultaneously. Among the strongly warming herbs like Aconite and Asarum, Rhubarb with purgative effects is combined.

 [Actions]

Warms the channels and dispels cold, promotes bowel movements, and relieves pain.

 [Indications]

Cold accumulation with interior excess syndrome, characterized by abdominal pain and constipation, lateral flank pain, fever, cold extremities, pale and greasy tongue coating, and tight and wiry pulse. The “Classics of the Golden Chamber” states: “Lateral flank pain, fever, and a tight and wiry pulse indicate cold. Use warming herbs to purge. Rhubarb and Aconite Decoction is indicated.” This formula is used for unilateral flank pain (right or left), fever, and tight and wiry pulse. The term “flank pain” here refers to pain extending from the waist to the lower limbs, not necessarily localized. The tight and wiry pulse indicates coldness obstructing the interior.

 [Indications for Use]

Renal failure and uremia, chronic appendicitis, intestinal obstruction, chronic colitis, kidney stones, gallstones, skin diseases, trigeminal neuralgia, intercostal neuralgia, sciatica, etc., presenting with the above symptoms. This formula can be used for biliary colic attacks, ureteral stone colic, sciatica, appendicitis, intercostal neuralgia, inguinal hernia, intestinal colic, etc.

 [Mnemonic]

Formula name + Xi Xin (Asarum).

 [Modifications]

(1) If accompanied by qi stagnation and abdominal distension, add Magnolia Bark and Costus Root to move qi stagnation. (2) If accompanied by qi and blood deficiency, add Codonopsis Root and Angelica Sinensis to tonify qi and nourish blood. (3) If it is cold hernia, add Fructus Meliae Toosendan, Fennel Seed, Semen Citri Reticulatae Imperfectum, and Lindera Root to soothe the liver and move qi. (4) If the accumulation is mild, use processed Rhubarb to reduce the purgative effect.

 [Pharmacology]

Has purgative, anti-hypoxia, and anti-infection effects.