Da Cheng Qi Tang
Classical TCM Formula Profile
Part of the HJMEDICAL TCM Discovery Center
大承气汤 · Dà Chéng Qì Tāng
The strongest classical purgative formula for Yang Ming excess Heat with severe constipation, abdominal fullness and hardness, tidal fever and delirium. Attacks hardness, drains fullness and moistens dryness.
Read the complete guide →Quick Facts
- Formula Category
- Purgative Formulas
- Primary Pattern
- Stomach Heat
- Primary Function
- Strongly purge Heat accumulation and constipation
- Primary Therapeutic Principle
- Strongly purge Heat accumulation, eliminate fullness and moisten dryness
- Classical Source
- Shang Han Lun (Zhang Zhongjing, Eastern Han)
- Available as Granules
- Yes
Formula Overview
The strongest classical purgative formula for Yang Ming excess Heat with severe constipation, abdominal fullness and hardness, tidal fever and delirium. Attacks hardness, drains fullness and moistens dryness.
Therapeutic Principle
Traditionally selected for severe Yang Ming fu excess — hard constipation, abdominal fullness with tenderness and high fever — the strongest of the Cheng Qi family, well beyond the milder Xiao Cheng Qi Tang, and without the Blood-invigorating action that defines Tao He Cheng Qi Tang.
Composition: Sovereign, Minister, Assistant, Envoy
Every herb in the formula, grouped by the job it does in the classical hierarchy.
君SovereignTreats the main pattern
臣MinisterReinforces the sovereign
佐/使Assistant & EnvoyTreats accompanying patterns, harmonises the whole
Classical Composition
- Rhei Radix et Rhizoma (Da Huang) 4 liang (12g)
- Magnoliae Officinalis Cortex (Hou Po) 0.5 jin (24g)
- Aurantii Fructus Immaturus (Zhi Shi) 5 pieces (12g)
- Natrii Sulfas (Mang Xiao) 3 he (9g)
Dosages follow the classical source and are shown for study, not as a prescription.
Related Conditions
Related Health Topics
Actions
- Drastically purges heat accumulation.
Indications
- 1.
- Excess heat in the yangming fu-organs.
- The symptoms are constipation with frequent flatulence, gastric stuffiness and abdominal fullness, abdominal pain that feels worse with pressure, and the abdomen is tense and firm when pressed.
- In severe cases, there may be tidal fever, delirious speech, and profuse sweating from the palms and soles.
- Heat retention with watery discharge.
- The symptoms are watery green, foul-smelling diarrhea, umbilical and abdominal pain, hardness with clumps felt when pressing the abdomen, and a dry mouth and tongue.
- Internal excess heat.
- The symptoms are heat inversion (heat syncope), convulsive disease, and mania.
Tongue & pulseThe tongue coating is dry and yellow with prickles, or dry and parched black with cracks. The pulse is deep and excessive. 2. The pulse is slippery and excessive. 3.
Traditional Pathogenesis
Cause & mechanism
- The pathogenesis of this pattern is exuberant yangming heat that consumes fluids and dries the stool.
- Pathogenic heat binds with dry stool to form an excess pattern, which obstructs the qi of the fu-organ.
- Therefore, the characteristics of this pathomechanism may be simplified as “stuffiness, fullness, dryness, and excess”.
- Stuffiness refers to the sensation of oppression, obstruction, and heaviness focused in the chest and epigastrium.
- Fullness refers to distention and fullness of the epigastrium and abdomen that is resistant to palpation.
- Dryness refers to dry bound stool that accumulates in the intestines causing difficult defecation.
- When there is watery diarrhea, neither the abdominal fullness nor pain is relieved.
- When qi stagnation constrains the distribution of yang qi throughout the four limbs, it leads to a pattern called heat inversion.
- Exuberant heat damages and dries the fluids which causes spasms of tendons and vessels because of the loss of nourishment, which is referred to as convulsive disease.
- Pathogenic yangming heat rises to disturb the spirit of heart, located above the yangming domain, causing mania.
- Although all of these manifestations are different, they have the same pathomechanism of severe heat accumulation.
Clinical presentation
- Excess refers to the accumulation of heat that has taken form, abdominal pain that is resistant to pressure, constipation, tidal fever, delirious speech, and an excess pulse.
Treatment strategy
- It should be treated by drastically purging the heat accumulation in order to prevent the depletion of fluids.
- This treatment method is described as extracting the firewood from under the cauldron.
How does this formula compare?
Clinical Perspective
Da Cheng Qi Tang is for severe Yang Ming fu excess. Tao He Cheng Qi Tang adds Blood-invigorating action for stasis with Heat. Wu Ling San drains fluid rather than solid accumulation. Milder relatives include Xiao Cheng Qi Tang and Tiao Wei Cheng Qi Tang.
Clinical Differentiation
- Da Cheng Qi Tang is the basic formula used to treat yangming bowel excess and the representative formula of cold purgation.
- This clinical pattern is marked by pi, fullness dryness, excess, red tongue with a yellow coating and deep excess pulse.
Safety notes: It is not applicable for patients diagnosed with qi and yin deficiency, slight dryness and stagnation, or for those who are aged and weak. It is forbidden to use for pregnant women. Avoid taking a high dose in order to prevent the zheng qi from being damaged.
For educational reference only, based on traditional pattern differentiation — not a substitute for professional advice.
Frequently Asked Questions
What are the actions of Da Cheng Qi Tang?
Da Cheng Qi Tang has the actions of drastically purging Heat accumulation and unblocking the bowels. It is primarily used for Yang Ming Fu excess patterns with severe constipation, abdominal fullness and hardness, and interior Heat.
Which modern diseases is Da Cheng Qi Tang suited to?
Modern TCM clinical practice commonly applies it (under close professional supervision) to individuals whose pattern differentiation falls within Yang Ming Fu excess, including acute simple intestinal obstruction, acute cholecystitis, acute pancreatitis, and severe Heat-type constipation with abdominal hardness.
Is Da Cheng Qi Tang suitable for severe constipation with abdominal pain?
For presentations of severe constipation, abdominal fullness and pain that rejects pressure, a hard abdomen, tidal fever, thick dry yellow or black tongue coating, and a deep excess pulse — in those whose pattern differentiation confirms Yang Ming Fu excess — TCM may apply Da Cheng Qi Tang as an acute adjunct. It cannot replace standard medical treatment.
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Medical Disclaimer
For general TCM education only — not medical advice. Consult a qualified TCM practitioner or licensed healthcare provider before use, especially if pregnant, nursing, on medication, or managing a chronic condition.