Rhubarb and Cortex Moutan Decoction

Rhubarb and Cortex Moutan Decoction

Rhei Radix et Rhizoma (Da Huang) 4 liang (12g), Moutan Cortex (Mu Dan Pi) 1 liang (3g), Persicae Semen (Tao Ren) 50 pieces (9g), Benincasae Semen (Dong Gua Ren) 0.5 sheng (30g), Natrii Sulfas (Mang Xiao) 3 he (9g)

Decoct the first four medicinals with water and thereafter add máng xiao into the hot decoction.

Drains heat, breaks up stasis, dissipates masses, and relieves swollen sores.

Da Huang Mu Dan Tang is indicated for the initial stage of intestinal abscess caused by the stagnation of dampness, heat, and blood stasis. The symptoms are pain which refuses pressure in the right lesser abdomen (lateral aspects of the lower abdomen), pain that can be as severe as strangury or even accompanied with swollen mass in the right lesser abdomen, bent right foot which cannot stretch otherwise the pain being worsened, normal urination, frequent fever, spontaneous sweating, and aversion to cold. The tongue coating is thin, greasy, and yellow. The pulse is slippery and rapid.

The binding of qi and blood causes this type of intestinal abscess. The pain that refuses pressure, as well as the swollen mass, is generated by damp-heat stagnating and blocking intestinal collaterals. Because the right foot is bent, unable to stretch open without increasing the pain, the disease can be concretized as “contracting foot intestinal abscess”. The pain may be as severe as strangury; yet the urination is normal, which differentiates it from strangury. Frequent fever, spontaneous sweating, and aversion to cold indicate that while there is qi and blood stagnation that has caused the abscess, ying and wei qi have become disharmonious. The greasy yellow tongue coating and rapid slippery pulses are signs of damp-heat. Intestinal abscesses caused by stagnation of dampness, heat, and blood stasis should be treated by draining heat and dampness, breaking up stasis, and dissolving the abscess.

1. Why does this formula use the purgative method to treat intestinal abscesses?

1. Essential pattern differentiation Da Huang Mu Dan Tang is commonly used to treat intestinal abscesses due to the stagnation of damp, heat, and blood stasis. This clinical pattern is marked by pain which refuses pressure in the right lower abdomen, yellow, greasy tongue coating, and rapid, slippery pulse. 2. Modern applications This formula is commonly used to treat acute simple appendicitis, intestinal obstruction, acute biliary tract infection, biliary ascariasis, pancreatitis, acute pelvic inflammation, and infections after oviduct ligation when the patient shows signs and symptoms of stagnation of dampness, heat, and blood stasis. 3. Cautions and contraindications Those whose abdominal abscess has been perforated, the elderly, pregnant, postpartum, or the weak should either not use it or use it with caution.

1. Qing Chang Yin (Intestine Clearing Beverage, 清腸飲)