Drain Downward

Question 1

What is the main action of herbs in the downward draining category?

Answer 1

To facilitate the expulsion of stool.

Purgatives: primarily are cold natured herbs. Used to pass stool due to heat accumulation in the colon. Interior excess cases.

Moist laxatives: mostly consist of nuts/seeds. They lubricate the intestine and are best for the elderly or weekend patients after febrile disease or childbirth.

Cathartics: strong drugs that induce diarrhea. Used for water retention in the upper body.

Question 2

How can you turn a cold purgative herb into a warm pergative herb?

Answer 2

Add fu zi - aconite to the formula. You will need to use the same amount or more of aconite as what you used for the purgative herb for it to get warm enough.

Question 3

What are the three main actions of Da Huang - rhubarb?

Answer 3

1. Clear heat accumulation
2. Clear other forms of heat (excess heat, damp heat, toxic heat, blood heat)
3. Moves blood

Bitter, cold
HT, LV, LI, ST 3-15g

NOTE: is a strong purgative by driving out stasis and increasing bowel peristalsis

Question 4

What are the 3 main actions of mang xiao - sodium sulfate?

Answer 4

1. Cleat heat accumulation
2. Moistens dryness and softens hardness.
3. Can be used externally for breast abcess.

acrid, bitter, salty, very cold
ST, LI 6-18g

NOTE: is an osmotic agent that softens the stool by drawing in more water into the bowel to facilitate movement of stool

Question 5

What is the main action of Fan xie ye - senna?

Answer 5

1. Clear heat accumulation

sweet, bitter, cold
LI

Question 6

What are the main actions of Lu hui - aloe?

Answer 6

1. Clear heat accumulation
2. Clear heat and cool the liver (helpful for constipation accompanied by insomnia and irritability)
3. Kill parasite and strengthen the stomach

Bitter, cold
LI, LV, ST

Question 7

What are the main contraindications for the purgative herbs in this category?

Answer 7

ST/SP weakness due to cold
Pregnancy
Lactation (da huang)

Question 8

What are the 3 main actions of huo ma ren - hemp seed?

Answer 8

1. Nourish and moisten the intestines
2. Nourish yin
3. Clear heat and promote healing of sores

Sweet, neutral temp
LI, SP, ST
9-15g

Question 9

The excessive combination of downward-draining herbs and pharmaceutical laxatives/diuretics may cause or exaggerate:
A. diarrhea
B. dehydration
C. electrolyte imbalance
D. all of the above

Answer 9

D. all of the above

Question 10

Which Dui-Yao (herb pair) is most suitable for constipation due to cold accumulation?
A. Da Huang + Mang Xiao
B. Da Huang + Fu Zi

Answer 10

B. Da Huang - rhubarb + Fu Zi - aconite

Question 11

How would you cook Da Huang (Rhei Radix et Rhizoma) for a strong purgative effect?
A. Use wine-treated Da Huang
B. Cook additional 30 minutes longer
C. Add near the end
D. Cook with small fire for longer time

Answer 11

C. Add near the end of the

Question 12

Purgatives strongly induce defecation and eliminate excess accumulation. COLD purgatives treat heat accumulation;
WARM purgatives treat cold accumulation. Which herb does NOT belong to COLD purgatives?
A. Ba Dou
B. Mang Xiao
C. Da Huang
D. Lu Hui

Answer 12

A. Ba Dou - crotonius fructus

Question 13

Da Huang (Rhei Radix et Rhizoma) has a bitter and cold property with a strong downward-directing action. In the Shang Han Lun, which stage does it treat?
A. Yang Brightness Channel stage
B. Yang Brightness Organ stage

Question 14

Which herb passes through the breast milk, may turn yellow, and causes diarrhea in infants?
A. Da Huang
B. Mang Xiao
C. Fan Xie Ye
D. Lu Hui

Answer 14

A. Da Huang

Question 15

In Ba Zheng San (Eight-herb powder for rectification), the action of Da Huang (Rhei Radix et Rhizoma):
A. is purgative
B. drains fire toxin
C. clears heat and transform dampness
D. invigorates the blood

Answer 15

C. clears heat and transform dampness

Question 16

Da Huang (Rhei Radix et Rhizoma) and Mang Xiao (Natrii Sulfas) are commonly prescribed together to treat
excess-type constipation caused by heat. From the pharmacological perspective, they work synergistically increasing
intestinal peristalsis with _____________ and increasing bowel fluid content with _____________.
A. Da Huang, Mang Xiao
B. Mang Xiao, Da Huang

Answer 16

A. Da Huang, Mang Xiao

Question 17

Da Cheng Qi Tang (Major order the Qi decoction) strongly purges heat accumulation for Yangming organ syndrome.
What is the indication of Mang Xiao (Natrii Sulfas)?
A. Hardness
B. Dryness
C. Objective fullness
D. Subjective distention

Answer 17

B. Dryness

Question 18

Which of the following Cheng Qi Tang (Order the qi decoction) does NOT include Mang Xiao (Natrii Sulfas)?
A. Tao He Cheng Qi Tang
B. Da Cheng Qi Tang
C. Xiao Cheng Qi Tang
D. Tiao Wei Cheng Qi Tang

Answer 18

C. Xiao Cheng Qi Tang

Question 19

When used TOPICALLY, which herb treats the early stages of breast abscess and promotes lactation?
A. Pu Gong Ying
B. Si Gua Lou
C. Wang Bu Liu Xing
D. Mang Xiao

Answer 19

D. Mang Xiao

Question 20

Which herb is usually steeped in hot water for no more than 15 minutes and consumed as tea?
A. Da Huang
B. Mang Xiao
C. Fan Xie Ye
D. Lu Hui

Answer 20

C. Fan Xie Ye - senna

Question 21

Overdose or long-term use of Fan Xie Ye (Sennae Folium) is associated with toxic side effects. Symptoms include:
A. nausea, vomiting, abdominal colic, retention of urine
B. low blood pressure, hypotonic shock
C. severe damage to the large intestine and liver
D. substantial loss of electrolytes (specifically hypokalemia)
E. all of the above

Answer 21

E. all of the above

Question 22

Which purgative herb clears liver fire and kills parasites?
A. Da Huang
B. Mang Xiao
C. Fan Xie Ye
D. Lu Hui

Answer 22

D. Lu Hui - aloe

Question 23

Lu Hui (Aloe) is used for excess liver fire characterized by headache, hypochondriac pain, red eyes, dizziness,
irritability, and constipation. Which of the following herbs can be combined?
A. Long Dan Cao / Zhi Zi / Qing Dai
B. Shi Gao / Huang Lian / Mai Men Dong
C. Da Ji / Yuan Hua / Gan Sui
D. Sang Bai Pi / Di Gu Pi / Huang Qin

Answer 23

B. Shi Gao / Huang Lian / Mai Men Dong

Question 24

Downward-draining herbs either stimulate or lubricate the gastrointestinal tract to facilitate the expulsion of stool. They are divided into three major classes. Which category is most appropriate for the debilitated, elderly, and those who are weakened from either a febrile disease or from childbirth?
A. Purgative
B. Moist laxatives
C. Harsh expellants
D. Cathartics

Answer 24

B. Moist laxatives

Question 25

_____________ and _____________ should be used with extreme caution for the elderly, menstruating/
pregnant/postpartum women, and patients with Qi, Blood, Yin, or Yang deficiencies.
A. Purgatives, Cathartics
B. Purgatives, Laxatives
C. Laxatives, Cathartics

Answer 25

A. Purgatives, Cathartics

Question 26

Which downward-draining category promotes both bowel movement and urination?
A. Purgative
B. Moist laxatives
C. Cathartics

Answer 26

C. Cathartics

Question 27

Which of the following is INCORRECT regarding the “Cathartics” category?
A. Most herbs in this category are sweet seeds that contain a significant amount of lipids to moisten the bowels
and relieve constipation.
B. Because these herbs are extremely harsh and toxic, they are reserved for strong patients who are able to
tolerate such approaches.
C. Clinical applications include severe constipation and water accumulation such as ascites and pleurisy.
D. It is recommended that a small quantity of tonic herbs be combined in the formula to prevent damage to the
body.

Answer 27

A. Most herbs in this category are sweet seeds that contain a significant amount of lipids to moisten the bowels

Question 28

Which herb is incompatible with Da Ji (Knoxiae/Euphorbiae Radix), Yuan Hua (Genkwa Flos), and Gan Sui (Kansui
Radix)?
A. Da Zao
B. Gan Cao
C. Wu Tou
D. Li Lu

Answer 28

B. Gan Cao - licorice