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formulaRhubarb and Peony Decoction Da Huang Mu Dan Tang
sourceShanghan Zabing Lun
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bubble_chart Preparation and Dosage

Rhubarb Rhizoma (Radix et Rhizoma Rhei) 10gm (4 liǎng)
Peony Bark (Cortex Moutan Radicis) 5gm (1 liǎng)
Peach Kernel (Semen Persicae) 12gm (50)
Waxgourd seed (Semen Benincasae) 20gm (half jīn)
Mirabilite (Natrii Sulfas) 5gm (3 hours)

Take 1200cc (six liters) of water, boil it down to 200cc (one liter), remove the dregs, add Mirabilite, bring to a boil again, and administer it in one draught. If there is pus, it will be expelled; if there is no pus, blood will be expelled.

bubble_chart Efficacy

Draining heat, breaking blood stasis, subduing swelling, and dissipating bind.

bubble_chart Indications

At the onset of an intestinal abscess, there is pain and tenderness in the right lower abdomen, sometimes accompanied by local swelling and fullness, with severe pain upon pressure. Frequent urination resembling strangury may occur, or the right foot may be bent and unable to extend. There may also be intermittent fever, spontaneous sweating, and aversion to cold. If the pulse is slow and tight, pus has not yet formed, and purgation is possible, which may result in the discharge of blood. If the pulse is rapid and large, pus has already formed, and purgation is also possible.

bubble_chart Formula Principles

In the formula, Rhubarb Rhizoma purges heat and removes stasis, detoxifies, and promotes bowel movement; Peony Bark clears heat and cools the blood, disperses stasis, and when used together, these two herbs can more effectively purge heat and stasis; Mirabilite softens hardness and dissipates masses, and assists Rhubarb Rhizoma in eliminating excess heat, promoting the flow of stagnation, and reducing heat intensity; Peach Kernel is effective in breaking blood stasis and assists Peony Bark in invigorating blood and resolving stasis; waxgourd seed clears intestinal dampness and heat, and Pus-Expelling Powder resolves masses; waxgourd seed clears intestinal dampness and heat, and Pus-Expelling Powder resolves abscesses.

bubble_chart Pattern Identification

  1. intestinal abscess (appendicitis).
  2. Pain and tenderness in the right lower abdomen.
  3. Constipation.
  4. Pelvic inflammation.
  5. Yellow and greasy tongue coating.

bubble_chart Formula Modification

  1. For severe abdominal pain, add Lonicera, Dandelion, Red Peony Root, Hedyotis, Corydalis Tuber.
  2. For yin deficiency with a red tongue, add Scrophularia Root, Unprocessed Rehmannia Root.
  3. For blood stasis, add Red Peony Root, Sichuan Lovage Rhizome, Carthamus.
  4. For appendicitis, add Lonicera, Forsythia, Chinese Angelica, Submature Bitter Orange, Patrinia.
  5. If pus has not formed, add Gleditisia Spine, Dahurian Angelica.

bubble_chart Cautions and Contraindications

  1. If appendicitis has progressed to peritonitis, it is necessary to refer to a Western doctor for surgical treatment.
  2. Use with caution in the elderly, pregnant women, and those with weak constitutions.

bubble_chart Modern Application

Promotes bowel movements, improves abdominal blood circulation, and has antibacterial and anti-inflammatory effects. It is mainly used for acute appendicitis, bladder-rectal fossa abscess, uterus-rectal fossa abscess, dysmenorrhea, amenorrhea, salpingo-oophoritis, pelvic inflammation, ovarian cysts, cystitis, urinary tract infections, pyelonephritis, hemorrhoids, proctitis, colitis, etc.

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