Formulas · Purge Downward 瀉下 · Bogam (寶鑑)

Bitter Orange and Rhubarb Decoction

Jisildaehwang-tang

한글 지실대황탕 · Pinyin Zhi Shi Da Huang Tang

枳實大黃湯

Made into one packet, decocted in water and taken on an empty stomach. The chapter records the case of a stout official whose leg qi swelling and pain were so severe the hand could not approach; a single dose of Danggwiyeomtong-tang halved the pain and a second removed the swelling entirely, with three-edged needling at the nail tips drawing much black blood; when the pain returned days later after eating wheat, this formula was given. Note on modern practice: rhubarb is a stimulant purgative; short courses only.

Composition 構成

Daehwang Da Huang
大黃 대황 · Rhubarb

12 g
Chief 君 wine-roasted
Ganghwal Qiang Huo
羌活 강활 · Notopterygium

6 g
Deputy 臣
Danggui Dang Gui
當歸 당귀 · Korean Angelica

4 g
Deputy 臣
Jisil Zhi Shi
枳實 지실 · Immature Bitter Orange

2 g
Assistant 佐

Total 24 g per packet (첩) · representative dosage — verify against source texts.

Received this formula from your practitioner? Amounts shown here are classical reference values — granule and prepared products differ. Always follow your prescribed dosage and directions.

Actions 效能

Opens the bowel in damp heat leg qi swelling
Answers a flare brought on by rich food

Indications 主治

Pattern-based

Damp heat leg qi with swelling and pain (治濕熱脚氣腫痛)
Recurrence after eating wheat or rich food
Leg swelling with bowel stagnation

Biomedical correlates

Leg swelling with dietary trigger
Recurrent inflammatory leg swelling
Short-course purgative therapy

Source text 原文

Donguibogam 東醫寶鑑

治濕熱脚氣腫痛. 大黃(酒煨) 三錢, 羌活一錢半, 當歸一錢, 枳實五分. 右作一貼, 水煎, 空心服. 《寶鑑》

Translation

Treats damp heat leg qi with swelling and pain. Wine-roasted rhubarb 3 don; notopterygium 1 don 5 fun; Korean angelica 1 don; unripe bitter orange 5 fun. Make into one packet, decoct in water, and take on an empty stomach. — Bogam 寶鑑 (Donguibogam · Jok)

Clinical commentary 臨床

Four herbs, and the case attached to it is the useful part: the swelling had been cleared, then returned after a wheat meal, and *this* is what was given for the recurrence. That makes it the chapter's formula for a dietary flare rather than a first presentation — which is a distinction worth having, since the trigger tells you the bowel is involved. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.