Herb Formulas Notebook

Da Xian Xiong Tang

Major Decoction [for pathogens] Stuck in the Chest

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Source: Discussion of Cold Damage (c. 220)
Author: Zhang Ji / Zhong-Jing

Category: Formulas that Drain Downward

Pattern: Heat and fluids clumping in the chest

Key Symptoms: Fullness and hardness of the epigastrium or entire abdomen with severe pain that becomes unbearable under pressure, tidal fever at dusk, severe constipation, thirst
Secondary Symptoms: Shortness of breath, irritability

Tongue: Very dry coating
Pulse: Submerged, tight and forceful
Abdomen: Distended, hard and painful in the epigastrium or entire abdomen

Gan Sui 0.3-0.6g (currently usually 1-1.5g)
Da Huang 18g (currently usually 9-12g)
Mang Xiao 9-12g

In the UK two of these ingredients will have to be substituted. Mang Xiao is usually substituted for Yu Li Ren but Gan Sui is such a toxic that forcefully expels water from the body making it difficult to replace without changing the formula entirely.

Yuan Hua has a similar action but is also likely to impossible to source or illegal to use. Zhi Shi could purge the bowel which makes it more or less the same as Da Cheng Qi Tang which focuses on the stool rather than water. Qian Niu Zi and/or Ting Li Zi or some or all of Wu Ling San could be added to drain water downwards via the urine instead of the bowel. Neither entirely copy the function of this formula suggesting that this presentation is hard to treat in the UK and the formula mainly for reference.

Preparation: Decoction. Da Huang is cooked separately with Mang Xiao added at the end and then taken warm with powdered Gan Sui.

Actions: Drains Heat and drives out water by flushing downwards

Contraindications: Due to the strength and toxicity of this formula it is only used for acute conditions, stopped as soon as results are obtained and never taken for more than a few doses. Contraindicated completely in pregnancy or in debilitated patients.

Research Links:
Science Direct
Google Scholar
Journal of Chinese Medicine
American Dragon

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.