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Source: Shāng Hán Lùn 伤寒论

Alternate Chinese names: 桃仁承气汤

Ingredients:

• Táo rén (桃仁 Persicae Semen, peach kernel) 12g
• Shēng dà huáng (生大黄 Rhei Radix et Rhizoma Crudi, raw rhubarb) 12g
• Máng xiāo (芒硝 Natrii Sulfas , mirabilite) (drenched) 6g
• Guì zhī (桂枝 Cinnamomi Ramulus, cinnamon twig) 10g
• Gān cǎo (甘草 Glycyrrhizae Radix, licorice [root]) (mix–fried) 6g

Action: Precipitates; expels stasis; frees menstruation.

Indication: Binding of heat and static blood with lower abdominal fullness and distension, black stool, heat effusion, and in severe cases delirious or manic raving. Also used for blood-stasis amenorrhea and menstrual pain.

Category: Blood-rectifying formulas / Blood-quickening stasis-transforming formulas

Method: Decoct with water.

Rationale: Táo rén not only quickens the blood and dispels stasis, but also moistens the intestines and frees the stool. Dà huáng boiled for the full length of time quickens the blood and dispels stasis (rather than draining heat and freeing the stool when added near the end). Guì zhī, when combine with a larger amount of cold bitter Dà huáng, descends to the lower body to quicken the blood and free the vessels (rather than resolving the exterior). Máng xiāo helps the Dà huáng to free the stool and drain heat, their action being tempered by the Guì zhī and Gān cǎo.

Variations:

• Severe internal static blood with stabbing pain in the abdomen, dry mouth, heat effusion, and rough pulse: Add Sān qī (三七 Notoginseng Radix, notoginseng [root]) and Chì sháo (赤芍 Paeoniae Radix Rubra, red peony [root]).
• Retention of lochia with painful firm smaller abdomen (lower abdomen): Add Pú huáng (蒲黄 Typhae Pollen, typha pollen) and Wǔ líng zhī (五灵脂 Trogopteri Faeces, squirrel's droppings).
• Nosebleed or bleeding gums due to frenetic movement of hot blood in stasis-heat patterns: Add Shēng dì huáng (生地黄 Rehmanniae Radix Exsiccata seu Recens, dried/fresh rehmannia [root]) and Bái máo gēn (白茅根 Imperatae Rhizoma, imperata [rhizome]).
• Internal blood stasis with abdominal distension and pain due to qì stagnation: Add Xiāng fù (香附 Cyperi Rhizoma, cyperus [rhizome]) and zhike.

Similar: Dà chéng qì tāng (大承气汤 Major Qì-Coordinating Decoction)

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