course f - chapter 6 purgative formulas

8/3/2019 Course F - Chapter 6 Purgative Formulas

1/10

Chapter 6 Purgative Formulas

Purgative Formulas are mainly composed of purgative herbs with the therapeutic effects of relieving

constipation, evacuating gastrointestinal retention, clearing away heat of excess type, purging away

excessive fluid and accumulation of cold type. They are indicated for the treatment of interior

syndrome of excess type.

Interior syndrome of excess varies with the accumulation of heat, cold, dryness and fluid, the

constitution of the human body differs with the strong and the weak, the old and the young, the

excessive and the deficient. Purgative formulas, therefore, can be further divided into five types:

purgative formulas of cold nature, purgative formulas of warm nature, emollient formulas for causing

laxation, formulas of eliminating retained fluid and formulas for both reinforcement and elimination.

Section 1 Purgative formulas of Cold Nature

This group of formulas chiefly consists of cold-natured cathartics with the effects of purging away heatand relieving constipation. It is associated with the treatment of excess syndrome of internal heat.

Da Chengqi Tang (Major Decoction for Purging Down Digestive Qi )

Ingredients

Rhubarb, Radix et Rhizoma Rhei 12g

Magnolia bark, Cortex Magnoliae Officinalis 15g

Immature bitter orange, Fructus Aurantii Immaturus 12g

Mirabilite, Natrii Sulphas 9g

Administrations

The above herbs should be decocted in water for oral administration. Magnolia bark and Immature

bitter orange are to be decocted prior to Rhubarb. The decoction is to be taken after Mirabilite is

infused in it.

Functions

Expelling pathogenic heat and loosening the bowels, promoting the circulation of qi to purge

accumulation in the bowels.

Indications

l. Excessive-heat syndrome of yangming-fu organ, manifested as constipation, frequent wind through

the anus, feeling of fullness in the abdomen, abdominal pain with tenderness and guarding, tidal

fever, delirium, polyhidrosis of hands and feet, prickled tongue with yellow dry fur or dry black tongue

coating with fissures, deep and forceful pu1se.


2/10

2. Syndrome of fecal impaction due to heat with watery discharge, manifested as watery discharge of

terribly foul odor accompanied by abdominal distension and pain with tenderness and guarding, dry

mouth and tongue, smooth and forceful pulse.

3. Cold limbs due to excess of heat convulsion, mania and other symptoms belonging to excess

syndrome of interior heat .

Equally, this formula can be modified to deal with infectious or non-infectious febrile diseases in their

climax marked by accumulation of heat type, and in the treatment of paralytic, simple and obliterative

intestinal obstructions.

Modern researches

Modern researches have ascertained that this formula has the functions of relieving inflammation,

resisting bacteria, promoting blood circulation of intestines, stimulating intestinal peristalsis, purging

stool, tranquilizing the mind, bringing down fever, etc.

Cautions

l. Being a drastic formula, it must be administered with great care to those of general asthenia, or to

those whose external syndrome has not yet been relieved or to those with absence of dry stool in

gastrointestinal tract.

2. The drastic effect of this formula is harmful to the stomach-qi. So, immediate withdrawal is

indicated once the effect attained. Over-administration is Prohibited.

3. Never is it administered for pregnant women.

Xiao Chengqi Tang ( Minor Decoction for Purging Down Digestive Qi )

Ingredients

Rhubarb, Radix et Rhizorma Rhei 12g

Magnolia bark, Cortex Magnoliae officinalis 6g

Immature biter orange, Fructus Aurantii Immaturus 9g

Administrations

All the herbs except Rhubarb which is to beadded later should be decocted in water for oral

administration.

Functions

Relieving heat accumulation by mild effect.


3/10

Indications

Mild cases of excess syndrome of yang-ming fu organ, manifested as delirium, tidal fever,

constipation, distension and fullness in the chest and abdomen, yellow shriveled tongue coating,

smooth and swift pulse as well as the onset of dysentery with distending abdominal pain or epigastric

fullness, tenemus and so on.

Tiaowei Chengqi Tang

( Purgative Decoction for Coordinating the Function of stomach )

Ingredients


Liquorice, Radix Glycyrrhizae 6g


AdministrationsThe above herbs are decocted in water with the exception of Mirabilite which is infused in the

decoction just before the oral dose.

Functions

Purging pathogenic heat accumulated in the gastrointestinal tract by laxative action.

Indications

Yangming disease marked by gastrointestinal dryness and heat, manifested by of obstruction of

defecation, thirst and vexation, fever like steaming, abdominal distension and fullness,delirium, yellow

tongue coating, slippery and rapid pulse as well as eruption, hematenesis, epistaxis, painful swelling of

mouth, teeth and throat caused by domination of heat in the intestine and stomach. It can also be

indicated for the cases with mild abdominal fullness.

Da Xianxiong Tang ( Major Decoction for Removing Phlegm-heat from Chest )

Ingredients



Kansui root, Radix Euphorbiae Kansui lg

Administrations

Rhubarb is decocted in water priorly, and Mirabilite is dissolved posteriorly. The decoction is to be

taken after Kansui root is ground into fine powder and is infused in boiling water or in the decoction.

Functions

Purging heat and removing water retention by hydragogue.


4/10

Indications

Syndrome due to accumulation of pathogenic heat with stagnancy of fluid or phlegm in the chest,

manifested as fullness, pain and tenderness of the area from the epigastrium to the lower abdomen

where the patient may feel too painful to be touched, constipation, mild tidal fever as well as

restlessness and shortness of breath. thirst and dryness of the tongue, sunken, tense and forceful

Pulse.

Equally, this formula can be modified to deal with inflammatory hydrothorax and ascites, acute

edematous pancreatitis or severe cases of intestinal`obstruction and others which pertain to the

accumulation of pathogenic heat with stagnancy of fluid or phlegm in the chest.

Modern Researches

Clinically and experimentally, it is ascertained that this Formula has the efficacies of purgation,

diuresis, antiinflammation and antisepsis.

Cautions

1. The administration should be withdrawn immediately after thorough purgation is achieved, The

secondary administration is necessary for those without thorough purgation. Since the formula is

indicated for the treatment of acute diseases, the prescribed dosage should be strictly observed to

avoid impairment of the vital qi, but the pathogens should be purged promptly so, as to prevent the

persistence in the body .

2. The administration is prohibited for those with weak constitution or those who have just recovered

from the illness and can not bear the drastic effect of the formula.

Section 2 Purgative Formulas of Warm Nature

This kind of Formulas, composed of purgatives together with herbs of warm nature, has the effects of

warming and relaxing the bowels and expelling the accumulation of cold nature. It is preferred for the

treatment of syndrome of interior excess due to the accumulation of pathogenic cold.

Daihuang Fuzi Tang (Decoction of Rhnbarb and Aconite)

Ingredients


Prepared aconite root, Radix Aconiti Praeparata 9g

Asarum herb, Herba Asari 3g

Administrations

All the above herbs are to be decocted in water for oral administration.


5/10

Functions

Warming yang and dispelling pathogenic cold, relieving constipation and promoting the circulation of

qi.

Indications

Syndrome of interior excess due to the accumulation of pathogenic cold, manifested as abdominal

pain, constipation, hypochondriac pain, fever, cold limbs white and greasy coating on the tongue, taut

and tense pulse.

Besides, this formula can be modified to deal with such cases as acute or chronic constipation

accompanied with accumulation of pathogenic cold, acute appendicitis, intestinal obstruction

ascribable to insufficient-cold type.

Modern Researches

Modern researches have proved that this formula possesses the efficacies of promoting metabolismand blood circulation as well as cardiac stimulant, analgesia and purgation.

Cautions

1. Generally, the dosage of rhubarb should not exceed that of prepared aconite root.

2. If the administration of this formula results in the relief of constipation, the patient can be

pronounced to be out of danger, but if the patient does not respond well to the formula marked by

constipation, vomiting, cold limbs and thready Pulse, it indicates that the patient is still in danger.

Wenpi Tang (Decoction for warming spleen )

Ingredients


Prepared aconite root, Radix Aconiti Praeparata 9g

Dried ginger, Rhizoma Zingiberis 6g

Ginseng, Radix Ginseng 9g


Administrations

All herbs are to be decocted in water with Rhubarb decocted later so as to preserve its available

composition. The decoction is for oral administration.

Functions

Warming and invigorating the spleen-yang and eliminating cold accumulation.

Indications

Constipation caused by accumulation of cold due to hypofunction of the spleen, marked by

periumbilical cold-pain which will be alleviated with a warm hand on the region, also may be used to


6/10

treat protracted diarrhea accompanied by abdominal pain, epigastric fullness, cold extremities, white

tongue fur, deep and taut pulse.

Equally, the formula can also be modified to treat the following cases, constipation due to insufficiency

of yang as seen in chronic gastritis, enteritis and other chronic illness, or chronic diarrhea due to

insufficiency of yang as seen in the cases or chronic dysentery, chronic ulcerative colitis intestinal

tuberculosis, etc.

Modern researches

Modern researches have verified that this is a popular formula for anti-inflammation, antisepsis,

promoting circulation, increasing physiologic function, stimulating peristalsis, exciting nervous center,

promoting digestion and absorption, stimulating heart functions, etc.

Cautions

Prepared aconite root should be decocted for 30 to 60 minutes in water prior to other ingredients soas to lessen its toxicity, while rhubarb should be added into the decoction posterior to all other

ingredients lest its Purgative action should be reduced.

Section 3 Emollient Formulas for Causing Laxation

The formulas of this kind are chiefly made up of emollient cathartics and have the function of causing

laxation. They are indicated in constipation due to intestinal dryness resulting from insufficiency of

body fluid.

Maziren Wan (Hemp Seed Pill )

Ingredients

Hemp seed, Fructus Cannabis 500g

White peony root, Radix Paeoniae Alba 250g

Fruit of immature citron, Fructus Aurantii Immaturus 250g


Magnolia bark, Cortex Magnoliae officinalis 250g

Bitter apricot kernel, Semen Armeniacae Amarum 250g

Administrations

The above herbs are ground into fine powder and then boluses are made out of powdered medicines

mixed with honey, just the same size as a parasol seed. Nine grams is taken each time orally with

warm boiled water, one or two times a day. This formula may be decocted for internal administration,

but the dosage must be reduced in proportion to that of the original formula.


7/10

Functions

Moistening the intestines to relieve constipation.

Indications

Syndrome of constipation due to intestinal dryness, manifested as frequency of urination, dry stool, or

constipation due to dehydration after febrile diseases, and habitual constipation.

This formula can equally be adapted for the treatment of constipation caused by intestinal dryness due

to over-sweating in the febrile diseases, habitual constipation marked by rabbit-stool-like feces.

Modern researches

Modern researches have confirmed that this formula has the functions of moistening the intestine and

softening stool.

Cautions1. The formula should be administered with great care for the aged and the weak or those with

constipation caused by exhaustion of body fluid and blood dryness without pathogenic heat.

2. It is not advisable for the pregnant women.

Section 4 Formulas for Eliminating Retained Fluid

This group of formulas consists of drastic purgatives and functions in eliminating excessive retained

fluid. It is used in the treatment of hydrothorax, ascites and edema of excess type.

Shizao Tang ( Ten Chinese-dates Decoction )

Ingredients

Parched genkwa, Flos Genkwa

Kansui root, Radix Euphorbiae Kansui

Knoxia root, Radix Knoxiae

All the above herbs should be equal in dosage.

Administrations

The above herbs, mixed and ground into fine powder or then put into capsules, are taken 0.5-1g each

time, once a day, with the decoction of 10 Chinese-dates.

When the patient has drastic watery diarrhea, it is recommended that a diet of porridge be taken to

benefit recovery.


8/10

Functions

Drastically expelling the excessive fluid.

Indications

Pleural effusion and edema, manifested by pain in the chest and hypochondrium when coughing or

spitting, hardness and stuffiness in the epigastrium, retching, shortness of breath, headache with

halo, difficult respiration due to pain in the thorax and back, slippery coating on the tongue, sunken

and taut pulse, or edema which is more serious in the lower part of the body, abdominal fullness,

dyspnea, difficulty in urination and defecation.

Moreover, the modified formula is also used to treat hydrothorax, ascitcs and edema caused by

exudative pleurisy, hepatic cirrhosis, acute pancreatitis, chronic nephritis and nephrotic syndrome,

etc.; or simple intestinal obstruction, acute gastric dilatation and others that are ascribed to strong

body resistance with exuberance of Pathogenic factors.

Modern researches

Modern researches have confirmed that this formula can produce drastic effect of purgation and

obvious effect of diuresis by stimulating the intestinal mucosa to Produce inflammatory congestion and

violent peristalsis.

Cautions

1. This formula is advisable only to those who have excessive fluid and are in stout constitution. When

the rapid purgation occurs, the administration must be withdrawn. If the purgation is not thorough,

which suggests incomplete re-moval of fluid retention, the administration may be continued depending

on the health condition.

2. If the purgation is required for patients with excessiveness of pathogen and general debility, there

are several methods available in accordance with the patient's condition, such as the method of

administering medicines to drive out the pathogenic factors first and then give tonics for recuperation,

the method of administering tonics first to improve the patient's general condition and then give

drastic herbs to drive out pathogens, and the method of administering medicines to drive out invading

pathogens and give tonics to reinforce the body resistance at the same time. When the patient's

general condition takes a favourable turn, the treatment should be aimed at warming and replenishing

the kidney-qi and recuperating the spleen and stomach.

3. It is never administered for pregnant women and the patients with weak health condition without

excessiveness of pathogens.

Section 5 Formulas for Both Reinforcement and Elimination


9/10

This kind of formulas is chiefly made up of purgatives and tonifying herbs and possesses double

properties of reinforcement and elimination. They are usually indicated for the treatment of syndrome

of interior excess due to accumulation of pathogens with interior deficiency of the vital qi.

Xinjia Huanglong Tang ( Decoction of Yellow Dragon with Supplements )

Ingredients

Slim dried rehmannia root, Radix Rehmanniae 15g


Ginseng, Radix Ginseng 4.5g



Scrophularia root, RaJix Scrophulariae 15g

Ophiopogon root, Radix Ophiopogonis 15g

Chinese angelica root, Radix Angelicae Sinensis 4.5gSea cucumber 2 pieces

Ginger juice 6 spoonfuls

Administrations

The above herbs should be decocted in water for oral administration.

Functions

Nourishing yin, replenishing the vital qi and purging the accumulation of pathogenic heat.

Indications

Syndrome of the accumulation of heat accompanied by weakened body resistance with such

symptoms as constipation, abdominal fullness and distension mental fatigue, shortness of breath,

dryness of the mouth and throat, parched or chapped lips with fissures on the tongue, dry scorched

yellow or black tongue fur.

Equally, this formula can be modified to treat paralytic, simple and obliterative intestinal obstruction,

habitual constipation, epidemic or non-epidemic febrile diseases in their climax marked by interior

excess and accumulation of heat, and effective for those with deficiency of the vital qi and massive

loss of yin and blood.

Modern researches

Modern researches have confirmed that this formula has the efficacies of relieving inflammation,

resisting bacteria, improving intestinal blood circulation and intestinal Peristalsis, increasing the

activity of gastrointestinal tract, loosing the bowels, tranquilizing the mind and bringing down fever.


10/10

Cautions

Ginseng should be decocted alone, and then poured into the decoction of other ingredients before

intake.

course f - chapter 6 purgative formulas

Documents