Tao Ren Cheng Qi Tang: A Chinese herbal medicine for Blood Stasis and Heat
Hongji Medical- Feb 10
- 7 min read
Chinese herbal medicine, Tao Ren Cheng Qi Tang, also known as Taohe Chengqi Decoction, is a time-honored herbal formula from the ancient Chinese medical text Treatise on Febrile Diseases by Zhang Zhongjing.
Designed to promote blood circulation, clear heat, and relieve constipation, this prescription targets blood stasis in the lower abdomen. It is commonly used for symptoms like severe lower abdominal pain, dark stools, normal urination, nighttime fever, irritability, delirium, and a heavy, astringent pulse.
Over time, doctors have adapted the formula, applying it to various acute and chronic conditions with impressive results. This article explores the formula’s ingredients, uses, modern applications, and precautions.
Ingredients and Their Roles
Tao Ren Cheng Qi Tang combines five herbs, each with a specific role in addressing blood stasis and heat:
Peach Kernel (King Herb): The primary ingredient, peach kernel, promotes blood circulation, breaks up blood stasis, and lubricates the intestines to ease constipation.
Rhubarb (Assistant Herb): Bitter and cold, rhubarb clears heat, relieves constipation, and helps break up accumulations of blood stasis.
Mirabilite (Assistant Herb): Salty and cold, mirabilite softens hardened masses and enhances the heat-clearing and blood stasis-removing effects.
Cinnamon Twig (Adjuvant Herb): Warm and pungent, cinnamon twig improves blood and qi circulation, warms the meridians, and balances the cold nature of rhubarb and mirabilite. It also prevents blood stasis from affecting the upper body.
Licorice (Guiding Herb): Licorice softens the harsh effects of rhubarb and mirabilite, protects the stomach, and harmonizes the formula.
Together, these herbs work synergistically to break up blood stasis, clear heat, and promote bowel movements.
How Chinese herbal medicine Tao Ren Cheng Qi Tang Works
Tao Ren Cheng Qi Tang addresses a condition where unresolved external pathogens enter the body’s interior, transforming into heat and causing blood to stagnate in the lower abdomen.
This leads to symptoms like tight, painful lumps in the lower abdomen, resistance to pressure, and mental disturbances such as irritability or delirium due to heat affecting the heart. Unlike conditions involving qi stagnation, this formula focuses on blood stasis, leaving bladder function (and urination) unaffected.
Key signs of this condition include:
Lower Abdominal Pain: Tightness, pain, or a lump-like sensation.
Menstrual Issues: Amenorrhea or painful periods due to blood stasis.
Mental Symptoms: Irritability, restlessness, or delirium caused by heat and stasis disturbing the mind.
Postpartum or Traumatic Issues: Retained lochia (postpartum discharge) or localized pain from injuries.
Heavy, Astringent Pulse: A hallmark of blood stasis.
The formula’s approach is to break up blood stasis, clear heat, and promote defecation, targeting the root cause in the lower abdomen.
Therapeutic Effects
Tao Ren Cheng Qi Tang is highly effective for conditions involving blood stasis and heat, particularly in the lower abdomen. Its key actions include:
Removing Blood Stasis: Peach kernel drives the formula’s ability to break up blood stagnation, supported by rhubarb and mirabilite, which clear heat and detoxify.
Clearing Heat and Masses: Rhubarb and mirabilite work together to soften lumps and promote bowel movements, addressing constipation and accumulations.
Warming and Balancing: Cinnamon twig ensures smooth blood and qi flow, preventing cold herbs from harming the stomach.
Harmonizing: Licorice protects the stomach and balances the formula’s strong actions.
This combination makes the formula especially effective for “acute abdominal congestion,” where blood stasis causes pain and tightness in the lower abdomen.
Modern Applications
In modern medicine, Tao Ren Cheng Qi Tang is used to treat conditions caused by blood stasis and heat, including:
Acute Pelvic Inflammatory Disease: Relieves pain and inflammation.
Retained Placenta: Helps clear postpartum blood stasis.
Adnexitis: Reduces inflammation in the fallopian tubes or ovaries.
Intestinal Obstruction: Eases blockages caused by stasis.
Endometriosis: Alleviates pain and stagnation in the pelvic region.
These conditions share the common thread of blood stasis and heat, making the formula a versatile treatment option.
Precautions
While effective, Tao Ren Cheng Qi Tang requires careful use:
Avoid During Pregnancy: Its blood-moving properties can risk miscarriage.
Resolve External Symptoms First: If a patient has signs of an external infection (e.g., fever or chills), treat those before using this formula.
Accurate Diagnosis: Ensure the condition matches the formula’s focus on lower abdominal blood stasis for best results.
Conclusion
Tao Ren Cheng Qi Tang is a powerful and precise herbal formula for treating blood stasis and heat in the lower abdomen. With peach kernel as the star ingredient, supported by rhubarb, mirabilite, cinnamon twig, and licorice, it effectively clears stagnation, relieves pain, and promotes healing.
Widely used in both ancient and modern medicine, it remains a go-to remedy for conditions like pelvic inflammation, endometriosis, and postpartum issues. To ensure safety and effectiveness, use it under proper medical guidance, especially avoiding it during pregnancy and confirming the diagnosis matches its intended purpose.
Chinese Name | 桃核承氣湯 |
Phonetic | Tao He Cheng Qi Tang |
English Name | Peach Kernel Qi-Guiding Decoction |
Classification | Blood-regulating formulas |
Source | 《Treatise on Cold Damage》Shang Han Lun《傷寒論》 |
Combination | Persicae Semen (Tao Ren) 50 pieces (12g), Rhei Radix et Rhizoma (Da Huang) 4 liang (12g), Cinnamomi Ramulus (Gui Zhi) 2 liang (6g), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gan Cao) 2 liang (6g), Natrii Sulfas (Mang Xiao) 2 liang (6g) |
Method | Decoct the first four medicinals with water. Take the decoction after mixing in the mang xiao. |
Action | Breaks up blood and expels stasis through purgation. |
Indication | Tao He Cheng Qi Tang is indicated for patterns of blood amassment in the lower jiao. The symptoms are distension and spasmodic pain in the lower abdomen, normal urination, fever at night, menstrual block due to blood stasis, and painful menstruation; there may even be delirium, dysphoria, and mania. The pulse will be deep and excessive or choppy. |
Pathogenesis | This formula is used to treat blood retention in the lower jiao caused by an unresolved taiyang pattern that travels along the taiyang channel and enters the taiyang fu-organ, which then transforms into heat and finally binds with blood. The binding of stasis and heat in the lower jiao leads to distension and spasmodic pain in the lower abdomen. The location of this disease is in the blood level instead of the qi level, which therefore bears no effect on the bladder qi transformation leaving the urination normal while there is fever during night. The heart governs the blood vessels and stores the spirit, which is disturbed by rising heat caused by stasis. As a result, there may be vexation, agitation, delirium, dysphoria, and mania. This is a pattern of binding stasis and heat. Therefore, the therapeutic principle is to break up and expel blood stasis through purgation in order to eliminate the blood retention from the lower jiao. |
Application | 1. Essential pattern differentiation Tao He Cheng Qi Tang is commonly used to treat blood amassment in the lower jiao due to binding of blood stasis and heat. This clinical pattern is marked by distension and spasmodic pain in lower abdomen, normal urination, deep, excessive or choppy pulse. 2. Modern applications This formula may be used in the following biomedically defined disorders, when the patient shows signs of binding of stasis and heat in the lower jiao: acute pelvic inflammatory disease, retained placenta, annex inflammation, intestinal obstruction, and endometriosis. 3. Cautions and contraindications If the patient has an unresolved exterior syndrome, first release the exterior pattern and thereafter use this formula to eliminate stasis. Tao He Cheng Qi Tang is not applicable for pregnant women because of its drastic effect in breaking up blood and expelling stasis through purgation. |
Additonal formulae | 1. Xia Yu Xue Tang (Blood Stasis Decoction 下瘀血湯) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Da huang 2 liang (6g), tao ren 20 pcs (12g), zhe chong 20 pcs (9g) [Preparation and Administration] Grind these medicinals into a fine powder. Form into four honey pills, add 1 sheng of wine, make one pill, take 8 he at once, then the new refreshed blood will flow immediately. [Actions] Drains heat and expels stasis. [Applicable Patterns] Heat pattern due to blood stasis, patterns of combined heat and stasis. Symptoms include: painful lower abdomen that is worse with pressure following childbirth, gelosis felt upon pressure, inhibited lochia, dry mouth, dry stool, dry and scaly skin, a purple red tongue body with ecchymosis, a dry yellow coating, and a deep, choppy and strong pulse. It also treats scanty menstruation due to blood stasis. 2. Da Huang Zhe Chong Wan (Rhubarb and Eupolyphaga Pill 大黃蟅蟲丸) [Source]《Essentials from the Golden Cabinet》Jin Gui Yao Lue《金匱要略》 [Ingredients] Da huang 10 fen (75g), huang qin 2 liang (60g), gan cao 3 liang (90g), tao ren 1 sheng (60g), xing ren 1 sheng (60g), shao yao 4 liang (120g), gan di huang 10 liang (300g), gan qi 1 liang (30g), meng chong 1 sheng (60g), shui zhi 100 pieces (60g), qi cao 1 sheng (60g), tu bie chong 0.5 sheng (30g) [Preparation and Administration] Grind all of the medicinals into a fine powder. Form them into honey pills as big as a bean. Take five pills (3g) with wine, three times a day. (Modern use: skewer qi cao separately, mash tao ren and xing ren separately. Pulverize the rest and sift them. Mix all of the medicinals and make them into a fine powder. Add honey to make pills, 3g for each pill, and seal with wax. Take 1 pill at a time with warm water or wine.) [Actions] Dispels blood stasis and regenerates new blood. [Applicable Patterns] Da Huang Zhe Chong Wan is indicated for severe deficiency due to exhaustion or lesions from the five labors, and the retention of dried blood due to internal deficiency-heat. The symptoms and signs are marked by emaciation, contractions or spasms in the lower abdomen, abdominal pain which is worse with pressure or the pain which cannot be relieved by pressure, fullness of the stomach and poor appetite, scaly skin, dull and lusterless eyes, dark eyes, a tongue body with ecchymosis, and a pulse that is deep, choppy or wiry. |
