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 Shen Yaozi 
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formulaRhubarb and Aconite Decoction Da Huang Fu Zi Tang
sourceShanghan Zabing Lun
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bubble_chart Preparation and Dosage

Rhubarb Rhizoma (Radix et Rhizoma Rhei) 9gm (3 liǎng)
Aconite Lateral Root (Radix Aconiti Lateralis Praeparata) prepared 10gm (3 pieces)
Asarum (Herba Asari) 3gm (2 liǎng)

Boil five liters (1000cc) of water down to two liters (600cc), and take it warm in three doses; for stronger individuals, boil it down to two and a half liters (500cc), and take it warm in three doses. After taking the dose, wait for the time it takes to walk four or five miles before taking the next dose.

bubble_chart Efficacy

Warming the meridians and dissipating cold, relieving stagnation and alleviating pain.

bubble_chart Indications

Pain in the hypochondrium, fever, and a tight, wiry pulse.

bubble_chart Formula Principles

The syndrome treated by this formula is described as pain in the hypochondrium, but it is not necessarily limited to the hypochondrium or to one-sided pain. It can be applied to cases where there is severe pain from the hypochondrium to the lower abdomen or waist and legs, accompanied by a heat sensation and a tight, wiry pulse. This condition belongs to cold accumulation, which is a syndrome of cold evil internal binding. It cannot be resolved without warm herbs to dispel the cold, nor without purgation to expel the binding. Therefore, the method of warm purgation is used. This formula is a representative formula for warm purgation. The ingredients in the formula, such as Aconite Lateral RootAsarum, are pungent and warm in nature, capable of warming the meridians, relieving stuffy orifices, dispelling wind, and dispersing cold, thus treating cold abdominal pain and bi pain. Rhubarb Rhizoma has a purging and downward-draining effect. Although it is bitter and cold in nature, when combined with Aconite and Asarum, its cold nature is reduced while its purging properties are retained. The combination of these three herbs achieves the effect of warm purgation.

bubble_chart Pattern Identification

  1. Severe pain in the flanks, waist, and feet.
  2. Lean and cold constitution.
  3. Weak abdomen.
  4. Presence of heat symptoms.
  5. Tight and wiry pulse.

bubble_chart Formula Modification

  1. Severe pain with preference for warmth: add Cinnamon Twig, Peony Root.
  2. Abdominal pain: add Immature Orange Fruit, Medicated Leaven.
  3. Physical weakness: add Tangshen, Astragalus Root.
  4. Cold abdominal colic and lumbago: add fennel, Cassia Bark.

bubble_chart Cautions and Contraindications

Non-cold constitution, use with caution.

bubble_chart Modern Application

Stomach and intestinal cramps, kidney stones, gallstones, intercostal neuralgia, sciatica, migraine, scrotal hernia pain, hernia, intervertebral disc herniation, floating kidney.

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