Rhubarb 12 gm (washed with wine), Magnolia Bark 15 gm (peeled), Immature Bitter Orange 12 gm (roasted), Mirabilite 9 gm.

bubble_chart Preparation and Dosage

Take the above 4 ingredients, add 1 liter of water, first boil Magnolia Bark and Bitter Orange, take 500 ml, remove the dregs, add Rhubarb, then decoct to 200 ml, remove the dregs, add Mirabilite, and then simmer over low heat for one or two boils. Divide into two doses and administer while warm. If there is a bowel movement, do not take the remaining dose.

bubble_chart Efficacy

Drastic purgation heat accumulation.

bubble_chart Indications

Yangming Fu-Organ Pattern. Tidal fever with delirious speech, sweating from hands and feet, frequent flatus, constipation, abdominal distension and fullness with pain and tenderness, tongue coating that is scorched yellow with thorns or scorched black and dry with cracks, pulse that is deep and slippery or deep and slow but forceful; heat retention with watery discharge, diarrhea with clear water that is foul-smelling, pain around the navel and abdomen that feels hard and lumpy upon pressing; heat reversal, high fever with unconsciousness, flailing of limbs, irritability and desire for cold drinks, constipation; convulsive disease, locked jaw, convulsions in hands and feet, opisthotonos, lockjaw with teeth grinding. Currently used for acute simple intestinal obstruction, adhesive intestinal obstruction, ascaris intestinal obstruction, acute cholecystitis, acute appendicitis, and certain high fever diseases presenting with Yangming Fu-Organ Pattern.

bubble_chart Formula Principles

In the formula, Rhubarb Rhizoma purges heat and promotes bowel movement, Magnolia Bark moves qi and disperses fullness, Immature Orange Fruit breaks stagnant qi and disperses masses, and Mirabilite moistens dryness and softens hardness. The combination of these four herbs has the effect of drastic purgation to eliminate heat accumulation.

1. Enhances gastrointestinal propulsion and intestinal volume ("Tianjin Medical Journal" 1965(10): 790～791). After oral administration to mice, Major Purgative Decoction significantly increased the propulsive movement of the digestive tract, with noticeable effects within 10 minutes of administration. However, in the intravenous administration group, there was no observed enhancement in the propulsion distance of charcoal in the gastrointestinal tract. Oral administration of Major Purgative Decoction also significantly increased intestinal volume.
2. Promotes the reduction of intussusception and relieves obstruction ("Tianjin Medical Journal" 1965(10): 792～793). Experiments observing the general mechanism of Major Purgative Decoction in relieving intestinal obstruction showed that in the administered group, all 10 rabbits (with artificial intussusception) were completely reduced, with an average reduction time of 15 minutes and 30 seconds, and a reduction rate of 100%. In the control group, only 3 rabbits were reduced. The experiment also suggested that the effect of Major Purgative Decoction on the intestines is primarily local.