Da Huang Zhe Chong Wan大黄䗪虫丸
Rhubarb and Ground Beetle Pill
Ingredients12 herbs
Indications
Internal dry-blood stasis in a depleted patient. Prolonged overwork, injury or illness leaves blood congealed in the interior; nutrition cannot reach the flesh, so the body wastes while the abdomen stays full.
Clinical Manifestations
- Chronic emaciation with abdominal fullness and no appetite
- Rough scaly skinwith darkened eye sockets
- Amenorrhoea from long-standing stasis
- Fixed abdominal masses of long duration
- Chronic hepatic or pelvic stasis patterns, in specialist care
Health Categories
Modern Applications
Common adjustments
- Very weak patient — reduce the dose and alternate with a qi and blood tonic decoction rather than pushing the pill
- Marked yin deficiency with night sweats — pair with a yin-nourishing decoction between courses
- Abdominal mass palpable — consider Bie Jia Jian Wan instead, which supports the middle burner more
Contraindications
Not for anyone with active bleeding, peptic ulcer, low platelets or a known clotting disorder, and not alongside anticoagulant or antiplatelet medication. Not for a patient whose depletion is severe without genuine stasis — the mass-breaking herbs will simply drain them further. Insect medicinals cause allergic reactions in a minority of patients. Any unexplained wasting must be investigated medically before it is treated as dried blood.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Absolutely contraindicated in pregnancy and while breastfeeding. Shui Zhi,, and are the strongest blood-breaking medicinals in the materia medica and Da Huang with Gan Qi adds to the force; the combination will cause bleeding and loss of the pregnancy. Shui Zhi contains hirudin, a direct anticoagulant, and and have documented antithrombotic activity, so this formula must not be combined with warfarin, direct oral anticoagulants, heparins or antiplatelet drugs. Anyone taking it should tell every clinician involved in their care, and it must be stopped well before any surgery or dental procedure.
Related Formulas
References
Source Jin Gui Yao Lue 《金匮要略》 · Eastern Han
「五劳虚极羸瘦，腹满不能饮食……内有干血，肌肤甲错，两目黯黑，缓中补虚，大黄䗪虫丸主之。」
- Classical source (public domain) — 《金匮要略·血痹虚劳病脉证并治》, Eastern Han, Zhang Zhong-jing.
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）— 理血剂 · 活血祛瘀, pattern and 配伍 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.