Major Chest Draining Decoction

Major Chest Draining Decoction

Rhei Radix et Rhizoma (Da Huang) 6 liang (10g), Natrii Sulfas (Mang Xiao) 1 Sheng (10g), Kansui Radix (Gan Sui) 1 qian bi (1g)

Da huang is first decocted with water and then after, infuse mang xiao and gan sui power with it.

Drains heat and expels water through purgation.

Da Xian Xiong Tang is indicated for thoracic accumulation caused by the binding of water and heat. The symptoms are pain that refuses pressure below heart, hardness in the diseased location, or there is a full, hard, and painful region below the heart and above the lesser abdomen and touching is not tolerated. Other accompanying symptoms are shortness of breath, vexation, constipation, and mild tidal fever in the afternoon. The tongue is red with a yellow greasy or watery coating, and the pulse is deep and tight or deep, slow, and powerful.

This pattern is an excessive pattern caused by the binding of pathogenic heat with retained fluids. These two pathogens stagnate and form a hard, painful mass that refuses pressure below heart. The hard and painful region may even extend to a wider area from below the heart to above the lesser abdomen, and no touching is tolerated. When water and heat bind in the stomach and intestines, it leads to constipation, mild tidal fever in the afternoon, or short breath and vexation. The bind also prevents the body fluids from spreading upward, so there is dry mouth and thirst. The red tongue with a yellow greasy coating and deep tight powerful pulses are signs of the water and heat bind in the interior. Draining heat and expelling water should treat this type of syndrome.

What is the purpose for da huang being decocted ahead of the other ingredients?

1. Essential pattern differentiation Da Xian Xiong Tang is the most common formula used for major chest bind syndrome. This clinical pattern is marked by hardness and fullness below the heart, pain with tenderness, constipation, dry tongue with a yellow tongue coating, and a deep, powerful pulse. 2. Modern applications This formula is usually applied for acute pancreatitis, acute ileus, pyogenic liver abscess, exudative pleurisy, and cholecystitis and cholelithiasis due to binding of water and heat. 3. Cautions and contraindications Do not use this formula for those who have a weak constitution or weakness after illness. It should not be overused in order to prevent it from harming the zheng qi.