Ch3: Formulas that are Cold and Purging Flashcards
What are the ingredients of Da Cheng Qi Tang?
- Da Huang (Rhubarb root)
- Mang Xiao (Mirabilite)
- Zhi Shi (Unripe bitter orange)
- Hou Po (Magnolia bark)
What are the functions of Da Cheng Qi Tang?
- Strongly purge the bowels
- Clear internal stagnated heat
What are the indications for DCQT?
- Yangming Fu Excess syndrome
- Heat retention with watery discharge
- Heat syncope, convulsive disease, mania due to internal excess heat
Key symptoms for choosing Da Cheng Qi Tang?
- Fever (or afternoon fever)
- Constipation
- Thirst
- Red tongue
- Yellow thick dry coating
- Rapid, strong pulse
Pathogenesis of heat and fire in the intestines causes which manifestations?
- Abdominal pain
- Constipation
- Distention and fullness
- Fever
- Pain aggravated by pressure
Pathogenesis of heat consuming body fluids leading to lack of nourishment of tendons and eyes causes which symptoms?
- Blurred vision
- Convulsions
- Dry mouth and tongue
- Yellow, thick, dry coating
Mind being disturbed by heat causes which symptoms?
- Delirium
- Irritability
Cold limbs are caused by what pathogenesis?
Accumulation of heat which hinders yang qi reaching the limbs.
Excess pathogenic factors in the interior manifests in what way in the pulse?
Deep rolling and rapid pulse
or
Deep excess and forceful pulse
Yangming Fu Exces Syndrome:
Describe Pi vs Man symptoms. Which is objective vs subjective?
Pi - subjective feeling of fullness in the chest or abdomen
Man - objective distention and fullness that is resistant to palpation
Yangming Fu Excess Syndrome:
What does Zao refer to in the symptom cluster?
Dryness that refers to dry stool, dry mouth, dry tongue, dry coating
Yangming Fu Excess Syndrome:
What does Shi refer to in the symptom cluster?
Excess:
- Constipation and abdominal pain worse with pressure
- Forceful pulse
What is the unique and counterinutuitive manifestation for heat retention with watery discharge? How does Da Cheng Qi Tang help?
Liquid stool or watery discharge!
This is very smelly. This “diarrhea” is a false sign as the real culprit is a stuck, hard, dry stool blocking the passage.
DCQT is used to purge the dry stool so the “diarrhea” can be stopped.
What are the manifestations and pathogenesis unique to heat syncope?
Excess heat inside hinders yang qi reaching the limbs which leaves them feeling cold. This is true heat with false cold.
Still have the other signs of internal excess heat such as abdominal pain worse with pressure, constipation, dry mouth, thirst, slippery excess pulse.
Why is Da Cheng Qi Tang considered to “treat cold with cold”?
Da Cheng Qi Tang clears true heat with purging which allows the qi movement to normalize and limbs to warm with the arrival of Yang Qi.
Treats cold limbs with cold purgation.
Actions of Da Huang?
King herb
- Bitter and cold to sedate heat
- Purge bowels
- Remove stagnation
Actions of Mang Xiao?
Deputy herb
- Salty to soften hardness
- Cold to clear heat
- Moisten the bowel and remove constipation
Actions of Hou Po and Zhi Shi?
Assistants
- Promote qi circulation
- Promote bowel movement
- Relieve distention and fullness
What are the characteristics of the combination of herbs for DCQT?
Purging and regulating qi combination.
Regulate qi to assist purging, purge to assist in regulating qi.
What are the precautions for DCQT?
- Colon cancer
- Deficiency syndrome
- Exterior syndrome
- Pregnancy
What is DCQT applicable to?
- Acute abdominal pain with high fever
- Appendicitis
- Intestinal obstructions
What are the cooking methods for DCQT?
- Cook Zhi Shi and Hou Po first
- Cook Da Huang later - long cooking reduces the purging function
- Do NOT cook Mang Xiao, dissolve into decoction
What is the modification of DCQT to gently purge bowel and relieve bloating?
Xiao Cheng Qi Tang
Remove Mang Xiao from DCQT
This means the Zao dryness symptoms are less because we do not have the moistening of Mang Xiao.
What is the modification of DCQT to slowly purge the bowel and clear heat? Which symptoms are less?
Tiao Wei Cheng Qi Tang
Remove Zhi Shi and Hou Po. This means the fullness and distention are less so we do not need these herbs.
Add Gan Cao
