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Da Huang Fu Zi Tang大黄附子汤

Rhubarb and Prepared Aconite Decoction

Purging Downward 泻下剂Warm Purgation 温下

Ingredients3 herbs

大Da Huang大黄9g君 ChiefPurges the accumulation out — its cold nature offset by the warming pair
附Fu Zi附子炮12g君 ChiefWarms the interior and disperses the congealed cold, and blunts Da Huang's coldness
细Xi Xin细辛3g臣 DeputyWarms and penetrates to disperse deep cold and relieve the pain

Indications

Warms the interior and disperses coldPurges the cold accumulationUnblocks the bowel and stops pain

Cold accumulation binding the interior. The obstruction is real and must come out, but the cause is cold rather than heat, so warming and purging are done in one move. Fever here is not heat in the bowel — it is yang blocked and unable to circulate.

Clinical Manifestations

  • Constipation with abdominal pain that is worse for cold
  • One-sided pain below the ribs with fever and cold hands and feet
  • Cold-type chronic constipation in an otherwise robust patient
  • Cold hernia-type painwith a blocked bowel
TonguePale with a white greasy coating
PulseWiry and tight, or deep and wiry

Health Categories

Digestive HealthLiver Health & DetoxUrinary & Bladder Health

Modern Applications

Chronic constipationBiliary colicRenal colicIntestinal obstructionChronic abdominal pain

Common adjustments

  • Severe pain — increase Fu Zi Fu Zi (Zhi) within safe limits and cook it longer
  • Qi weak with the accumulation — add qi tonics such as Ren Shen 人参, moving toward Wen Pi Tang
  • Cold dominant and the stool only sluggish — reduce Da Huang so the warming lead is not lost

Contraindications

Not for constipation from heat, from fluid depletion, or from deficiency without accumulation. Fu Zi is toxic raw and must be the properly prepared form, decocted first and long; Xi Xin is used in small doses only. Both need a practitioner's supervision.

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

Pregnancy

Contraindicated in pregnancy. Da Huang purges downward, and both Fu Zi and Xi Xin are traditionally avoided during pregnancy — Fu Zi because of its toxicity, Xi Xin because of its strong dispersing heat. This formula should not be used at any stage of pregnancy.

References

Source Jin Gui Yao Lue 《金匮要略》 · Eastern Han

「胁下偏痛，发热，其脉紧弦，此寒也，以温药下之，宜大黄附子汤。」
— 《金匮要略·腹满寒疝宿食病脉证治》(classical source, public domain)
  1. 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）— chapter placement, 功用 and 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.