Di Dang Tang抵当汤
Resistance Decoction
Ingredients4 herbs
Indications
Severe blood accumulation in the lower burner. Heat has followed the channel inward and bound with blood below; because the fluid pathways are untouched, urination stays normal even as the lower abdomen hardens.
Clinical Manifestations
- Lower-burner blood accumulation with manic behaviour
- Hard, full lower abdomen with normal urination
- Amenorrhoea from severe long-standing stasis
- Jaundice with a stasis pattern, in specialist care
Health Categories
Modern Applications
Common adjustments
- Milder accumulation without derangement — use Tao He Cheng Qi Tang instead — this formula is reserved for the severe case
- Patient too weak for the decoction — the classical answer is the pill form Di Dang Wan, which delivers the same herbs more slowly
- Stasis with underlying blood deficiency — follow the course with a blood-nourishing formula rather than adding tonics to this one
Contraindications
One of the most drastic prescriptions in the classical repertoire and not to be used outside expert supervision. Absolutely contraindicated where there is any active bleeding, peptic ulcer, low platelets or a clotting disorder, and never alongside anticoagulant or antiplatelet medication. Not for a depleted patient, and not for anyone whose lower abdominal pain has not been diagnosed — an acute abdomen is a surgical emergency. It is given for one or two doses, not as a course.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Absolutely contraindicated in pregnancy and while breastfeeding — there is no circumstance in which a pregnant patient should take it. Shui Zhi and are the two most forceful blood-breaking medicinals in the materia medica and Da Huang with Tao Ren adds a purging, blood-moving effect on top; the formula will cause bleeding and loss of the pregnancy. Shui Zhi contains hirudin, a direct thrombin inhibitor, and has documented antithrombotic activity, so the formula must never be combined with warfarin, direct oral anticoagulants, heparins or antiplatelet drugs, and must be stopped well ahead of any surgery.
References
Source Shang Han Lun 《伤寒论》 · Eastern Han
「太阳病六七日，表证仍在，脉微而沉，反不结胸，其人发狂者，以热在下焦，少腹当硬满，小便自利者，下血乃愈。」
- Classical source (public domain) — 《伤寒论·辨太阳病脉证并治》, 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）— discussed as the severe counterpart to 桃核承气汤 in 理血剂 · 活血祛瘀.
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.