INDIVIDUAL HERBS

NAME: DA HUANG - 大簧 - RADIX ET RHIZOMA RHEI - RHUBARB ROOT

Pharmaceutical Latin: Radix et Rhizoma Rhei
Common English: Rhubarb Root and Rhizome

CATEGORY

Downward-Draining Herbs: Purgatives

PROPERTIES

Taste Temperature Entering Meridians Dosage
Bitter
Cold
Heart
Large Intestine
Liver
Stomach
( Pericardium)
(Spleen)
3-15g
Severe cases: 15-20g
Tincture: 2-4ml

ACTIONS AND INDICATIONS

Actions Indications/Syndromes

Drains Heat and purges accumulations

Intestinal Heat Excess, with high fever, profuse sweating, thirst, constipation, abdominal distention and pain, delirium, a yellow tongue coat and a full pulse

Yang-Ming Fu Stage

Qi Level Heat in the Intestines

Drains Fire

Fire from Excess with intense fever, sore throat, and painful eyes and constipation

Fire toxin sores due to Xue Level Heat, especially with constipation

Clears Heat, transforms Dampness and promotes urination

Damp-Heat with edema, jaundice, painful urinary dysfunction and acute, hot dysenteric disorders

Drains Heat from the Blood

Bloody stool either from hemorrhoids or Heat in the Intestines

Chaotic movement of hot Blood with hemoptysis or epistaxis with constipation

It can be powdered and administered orally for bleeding in the upper digestive tract

Invigorates the Blood and dispels Blood Stasis

Blood Stasis with amenorrhea, fixed abdominal masses or fixed pain

Blood Stasis due to traumatic injury

Intestinal abscess

Clears Heat and reduces Fire toxicity

Topically or internally for burns or skin lesions (Chuang Yung) due to Heat

Clears Heat and eliminates Phlegm

Chronic Accumulation of Phlegm-Heat with cough, dyspnea, mania, disorientation and other symptoms of Phlegm Misting the Heart

CONTRAINDICATIONS, INCOMPATIBILITIES AND HERB/DRUG INTERACTIONS

CONTRAINDICATIONS
  • Contraindicated in those with Qi or Blood Deficiency who do not have significant accumulation or Blood Stasis.
  • Contraindicated in those with weak Stomach Qi.
  • Contraindicated in those with External invasion.
  • Contraindicated in those with Spleen and Stomach Deficiency Cold.
  • Contraindicated in those with no Heat and Fire symptoms.
  • Contraindicated in those with Intestinal obstruction.
  • Contraindicated in those with nephritis and/or renal stones. Caution with nursing mothers.
  • Contraindicated in those with abdominal pain of unknown origin.
  • Contraindicated in those with gout.
  • Contraindicated in those with hemorrhoids.
  • Extreme caution during pregnancy, menstruation or postpartum.
  • Caution with children under 12.
  • Caution in those with dehydration.
  • Caution in those with electrolyte imbalance.
INCOMPATIBILITIES
HERB/DRUG INTERACTIONS
  • Prolonged use of Da Huang may cause loss of potassium, leading to increased toxicity of cardiac glycosides such as digoxin (Lanoxin)

MAJOR COMBINATIONS

Natrii Sulfas
Mang Xiao
Cx. Magnoliae Officinalis
Hou Po
Fr. Aurantii Immaturus
Zhi Shi

Sm. Cannabis
Huo Ma Ren
Sm. Armeniacae
Xing Ren

Rx. Aconiti Lateralis Preparata
Zhi Fu Zi

Unremitting high fever, delirious speech and constipation.

Moderate constipation.

Habitual constipation with Deficiency.

Constipation due to Cold accumulation.

Cx. Cinnamomi
Rou Gui

Rz. Coptidis
Huang Lian

 

Rz. Coptidis
Huang Lian
Rx. Scutellariae
Huang Qin

Chronic constipation.

A feeling of fullness and distention due to Heat Accumulation.

Distention, Heart palpitations, mental distress with facial congestion and epilepsy due to Excess Heat.

Hematemesis or epistaxis due to Blood Heat.

Whole body Damp-Heat.

Fr. Gardeniae
Zhi Zi
Rx. Scutellariae
Huang Qin
Fr. Forsythiae
Lian Qiao
(Natrii Sulfas)
(Mang Xiao)

Rx. Gentianae
Long Dan Cao
Spica Prunellae
Xia Ku Cao
(Fr. Gardeniae)
(Zhi Zi)

Rx. Kansui
Gan Sui

 

Strong pathogenic Heat in the Upper and Middle Jiaos.

Upward Flaring of Heat attacking the head.

Liver Fire leading to headache and anger with constipation.

Accumulation of pathogenic Heat and Fluids in the chest and upper abdomen.

Hb. Artemisiae Scopariae
Yin Chen Hao
Fr. Gardeniae
Zhi Zi

Sm. Plantaginis
Che Qian Zi
Hb. Polygoni Avicularis
Bian Xu

or

Caul. Akebiae
Mu Tong
 Sm. Plantaginis
Che Qian Zi
 Fr. Gardeniae
Zhi Zi

Cx. Moutan
Mu Dan Pi
Sm. Persicae
Tao Ren
(Natrii Sulfas)
(Mang Xiao)
(Caulis Sargentodoxae)
(Hong Teng)

Jaundice with flank pain.

Hot, painful urinary dysfunction.

Intestinal abscess.

Ram. Cinnamomi
Gui Zhi

Rx. Angelicae Sinensis
Dang Gui

Hirudo
Shui Zhi
Tabanus
Meng Chong

Blood Stasis. (removes Stasis and unblocks the flow of Qi)

Combined Interior/Exterior conditions with chills, headache, fever, sweating and abdominal fullness and pain.

Abdominal fullness and pain as a result of purging an Exterior condition too soon.

Blood Stasis.

Purges intense Blood Stasis.

Calcined Gypsum
Shi Gao

Natrii Sulfas
Mang Xiao

Rx. Rehmanniae
Sheng Di Huang

Topically as a plaster for burns.

Eliminates obstruction in the Intestines for severe constipation with passage of liquid but no solid stool.

Abscesses, swellings and toxic sores.

Blazing Heart and Stomach Fire with epistaxis and hemoptysis.

Deficiency Fire.

Parched, dry stools with damaged Yin.

Hb. Artemisiae Scopariae
Yin Chen Hao

Rx. Paeoniae Rubra
Chi Shao

Rx. Ginseng
Ren Shen
Rx. Angelicae Sinensis
Dang Gui

Early-Stage Damp-Heat Jaundice when Heat is stronger than Dampness.

Biliary ascariasis.

Chronic accumulation in the abdomen, blockage of urine, constipation, Qi rushing upward to the Heart, abdominal distention and rebellious damage from food and drink.

Yang Ming Stage with Qi and Blood Deficiency.

Rx. Ophiopogonis
Mai Men Dong
 Rx. Rehmanniae
Sheng Di Huang
Rx. Scrophulariae
Xuan Shen

Rx. Ginseng
Ren Shen
 Rx. Glycyrrhizae
Gan Cao

Rz. Coptidis
Huang Lian
Rx. Scutellariae
Huang Qin
Rx. Paeoniae Alba
Bai Shao

Constipation with Heat consuming Body Fluids.

Constipation with Spleen Yang Deficiency and Accumulation of Cold

Dysentery with Excess Damp-Heat.

Rx. Aconiti Lateralis Preparata
Zhi Fu Zi
Rz. Zingiberis
Gan Jiang

Anti-Parasitics

Rx. Angelicae Dahuricae
Bai Zhi

Chronic dysentery with accumulation of Damp-Heat and Spleen Yang Deficiency.

Enhances the expulsion of parasites.

Cellulitis on the back with constipation and a forceful pulse.

Sm. Persicae
Tao Ren
Flos Carthami
Hong Hua
 Rx. Angelicae Sinensis
Dang Gui
 Rz. Chuanxiong
Chuan Xiong

Rx. Stephaniae Tetrandrae
Han Fang Ji
Sm. Descuraniae/Lepidii
Ting Li Zi

Rx. Ginseng
Ren Shen
 Colla Corii Asini
E Jiao

Moderate Blood Stasis.

Water Accumulation with edema and abdominal fullness.

Chronic Blood Stasis with Qi and Blood Deficiency.

Tabanus
Meng Chong
Eupolyphaga
Tu Bie Chong

Rz. Pinelliae Preparatum
Zhi Ban Xia
Poria
Fu Ling

Sm. Persicae
Tao Ren
Cx. Moutan
Mu Dan Pi

Amenorrhea.

Reduces the side effects of nausea and vomiting when the formula is used in high dosages.

Acute appendicitis.

Fr. Forsythiae
Lian Qiao
Hb. Lonicerae
Jin Yin Hua
Gypsum Fibrosum
Shi Gao

Rz. Bletillae
Bai Ji

Rx. Glycyrrhizae
Gan Cao

Topically, for aphthous ulcers, carbuncles, furuncles, cervical erosion, micotic vaginitis, toothache and small or medium sized burns.

Bleeding peptic ulcer.

Vomiting immediately after eating.

Liquid vomit.

Stomatitis, topically.

Rx. Aconiti Lateralis Preparata
Zhi Fu Zi
Hb. cum Rx. Asari
Xi Xin

 

 

Cold Accumulation with constipation.

The elderly with Internal Cold.

Nephritis, Kidney failure, edema, uremia.

 

 

NOTES

  1. This is an important herb for treating both recent and long term Blood Stasis because it can eliminate extravasated Blood through the bowels and eliminate Heat from Stasis.
  2. This is a good herb for treating Blood Stasis due to traumatic injury.
  3. This herb powdered and mixed with sesame oil is used to treat burns.
  4. This herb is secreted by mother’s milk and is therefore contraindicated for nursing mothers.
  5. It may cause Blood Stasis in the pelvis and is therefore not suitable during menstruation or pregnancy.
  6. This herb occurs in most purgative formulas and many Blood Stasis formulas.
  7. Cooked with grain-based liquor, it can be used for dysentery.
  8. It is the most commonly used fast-acting purgative in the Chinese pharmacopia.
  9. People with irritable bowels may experience diarrhea and cramping if given any attacking purgative.
  10. Raw it can rescue the dying.
  11. It inhibits the growth of cancer cells.
  12. Used alone, it treats upper gastrointestinal tract bleeding.
  13. It stops bleeding without causing Stagnation.
  14. It can be used alone or in combination for Blood Stasis.
  15. Thia herb lowers serum cholesterol.
  16. It is good for cardiovascular diseases.
  17. For brain bleeding with constipation, use 9g. in 15-20 ml hot water several times/ day using a stomach tube, or enema 1 time/day using 9g. in 200 ml water.
  18. For tuberculosis patients with bronchiectasis, use 1.5g. Da Huang powder 1-2 times/ day.
  19. Tao Huang San (Da Huang + Shi Hui {Calcium Oxide} + Ming Fan (Alumen) and water may promote blood clot formation.
  20. For hepatitis with jaundice, fresh Da Huang may lower transaminase level and relieve jaundice.
  21. Do not use high dose for an extended period.
  22. It is said to benefit the Gallbladder and to eliminate Food Stagnation.
  23. It strongly mobilizes and directly reaches the Lower Jiao.
  24. It enters the Jue Yin to clear Blood Heat and eliminate Blood Stasis.
  25. It can be used to expel Phlegm-Heat through the Intestines.
  26. Both Da Huang and Fr. Crotonis Ba Dou are purgatives, drive out the old to bring in the new, reduce accumulation and harmonize the middle. Da Huang is cold and is used for Heat buildup in the Yang organs, has a low toxicity, breaks up Blood Stasis, clears Damp-Heat and relieves toxicity. Ba Dou is Hot, is used when Cold accumulates internally in the Yin organs and is very toxic.
  27. Both Da Huang and Natrii Sulfas (Mirabilitum) Mang Xiao drain accumulated to treat clumped Heat in the Large Intestine leading to constipation. Da Huang is bitter and cold, drains Qi Level Heat in Yang Ming disorders, cools the Blood, resolves toxicity and breaks up static accumulations and is used to treat epistaxis, hemoptysis, red, swollen, painful eyes and gynecological abdominal masses. Mang Xiao clears the Large Intestine and softens hardness to treat constipation.
  28. Steamed Rhubarb Shu Da Huang has moderated downward-draining and cooling properties and is more appropriate for weaker patients. Some sources say that it clears Damp-Heat.
  29. Wine-washed Rhubarb Jiu Xi Da Huang cools upper Jiao Fire and directs it downward to treat Large Intestine Heat toxin with red eyes, toothache, mouth ulcers and restless Heat in the chest.
  30. Vinegar Rhubarb Cu Da Huang enables the herb's action to enter the Liver, break up Blood Stasis and Drain Excess Heat form the Blood Level.
  31. Charred Rhubarb Da Huang Tan reduces the herb's ability to drain downward and break up Blood Stasis, but enables it to stop bleeding to treat hemafecia due to Heat in the Intestines.
  32. Slices of Pure Tranquility Qing Ning Pian is sold as a prepared medicine and is used for those who cannot tolerate a strong purgative.
  33. Prepared Rhubarb Zhi Da Huang drains Damp-Heat and clears Heat through the stool.
  34. This herb is uncommon in that it is used in three major medical traditions, Chinese, Ayurvedic and Greek/Western.
  35. This herb may be used as a substitute for rhinoceros horn Xi Jiao and water buffalo horn Shui Niu Jiao.