Da Cheng Qi Tang大承气汤

Major Order the Qi Decoction (Major Rhubarb Combination)

Purging Downward 泻下剂Cold Purgation 寒下

Ingredients4 herbs

HerbDosageRoleWhat it does in this formula

大Da Huang大黄酒洗Rhei Radix et Rhizoma12g君 ChiefDrains heat and breaks the dry accumulation out through the bowel 厚Hou Po厚朴去皮，炙Magnoliae Officinalis Cortex24g佐 AssistantThe largest dose in the formula: moves qi downward and relieves the distension 枳Zhi Shi枳实炙Aurantii Fructus Immaturus12g佐 AssistantBreaks up the focal fullness and drives the qi downward with Hou Po 芒Mang Xiao芒硝Natrii Sulfas9g臣 DeputySalty and cold, it softens the hardened stool so Da Huang can move it

Indications

Vigorously purges heat accumulationMoves qi and relieves abdominal distension

Yangming fu excess: interior heat has dried the intestinal fluids and bound the stool, so the qi cannot descend. Distension, fullness, dryness and hardness present together, with fever and mental restlessness making the interior heat plain.

Clinical Manifestations

Constipation with hard dry stool and marked abdominal distension
Tidal fever with profuse sweating and delirious speech
Abdominal pain that refuses pressure
Acute abdominal presentations treated by draining the interior
Foul watery discharge passing around a dry blockage

TongueYellow, dry or scorched coating with raised prickles

PulseDeep, excess and forceful

Health Categories

Digestive HealthCognitive & Memory SupportCold & Flu Relief

Modern Applications

Acute intestinal obstruction Severe constipation Paralytic ileus High fever with delirium Acute appendicitis (traditional adjunctive use)

Common adjustments

Fluids already damaged (dry mouth, cracked tongue) — add Sheng Di Huang 生地黄 and Xuan Shen 玄参 — the Zeng Ye Cheng Qi Zeng Ye Cheng Qi Tang direction
Qi deficiency alongside the excess — add Ren Shen 人参 and support the middle while purging
Milder accumulation without true dryness — use the lighter Xiao Cheng Qi Tang 小承气汤 or Tiao Wei Cheng Qi Tang 调胃承气汤 instead

Contraindications

A short-course emergency strategy, never a laxative for habitual constipation. Withhold where an exterior pattern is unresolved, in qi deficiency, yin depletion, old age or general debility, and stop the moment the stool passes — continuing damages the fluids and the stomach qi. Contraindicated in pregnancy. Acute severe abdominal pain requires medical assessment first; this formula is used within a diagnosis, not in place of one.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Contraindicated in pregnancy — this is a vigorous downward-driving purgative. It is likewise unsuitable while breastfeeding without practitioner supervision.

Related Formulas

References

Source Shang Han Lun 《伤寒论》 · Eastern Han

「腹满不减，减不足言，当下之，宜大承气汤。」
— 《伤寒论》(classical source, public domain)

Classical source (public domain), cited in the source-quote section.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— pattern analysis cross-checked.

Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.