1. Da Huang Fu Zi Tang from "Jin Gui Yao Lue"

1. Da Huang Fu Zi Tang from "Jin Gui Yao Lue"

[Composition] Rheum palmatum 9 grams (three liang), Aconitum carmichaelii 9 grams (three pieces, processed), Asarum sieboldii 5 grams (two liang).

[Administration] Decocted in water and taken orally.

[Indications] Cold congealing and stagnation.

[Symptoms] Abdominal pain and constipation, epigastric distension, feeling cold and weak, white greasy tongue coating, and a deep, string-like pulse.

[Functions] Disperse cold and remove stagnation.

[Explanation] Cold congealing causes abdominal pain, while stagnation leads to constipation. When cold congealing and stagnation coexist in the middle burner, it results in epigastric distension, and the inability of yang energy to reach the exterior causes a feeling of cold and weakness. In this formula, Aconitum carmichaelii is pungent and hot, primarily to dispel cold congealing. Although Rheum palmatum is a bitter-cold herb, when paired with the highly pungent and hot Aconitum carmichaelii, its cooling nature diminishes, yet its purgative effect remains strong, effectively helping to purge stagnation as a supplementary action.

[Clinical Modifications] ① Add Guizhi and Bai Shao to harmonize ying and relieve pain; add Citrus aurantium and Liu Qu to eliminate stagnation and promote digestion; add Dang Shen and Huang Qi for patients with deficiency of vital energy. ② Add Rou Gui and Xiao Hui Xiang to disperse cold and relieve pain, suitable for cold hernia.

[Reference Materials] ① Aconitum warms to dispel cold, Asarum sieboldii disperses cold and relieves flank pain, and Rheum palmatum is bitterly cold and purgative. However, when paired with the highly pungent and hot Aconitum carmichaelii and Asarum sieboldii, the cold nature dissipates while the purgative effect persists, and the three herbs work synergistically to achieve warm purgation—this is the treatment for deep-seated cold combined with stagnation. (Chinese Academy of Traditional Chinese Medicine: "Translation of Jin Gui Yao Lue") ② "It is because only warmth can disperse cold and only purging can eliminate stagnation, so we use the pungent and hot Aconitum carmichaelii and Asarum sieboldii to search out and disperse the cold, after which Rheum palmatum can act on the stagnation." ("Cheng Fang Bian Du")

[Commentary] ① The dosage of Rheum palmatum should not exceed that of Aconitum carmichaelii; if it does, the warm purgative effect will be lost. ② This formula can be used for chronic dysentery, uremia, and ulcerative colitis.