TCM Prescriptions for Treating Carbuncles

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Decoction of Rhubarb Root and Moutan Bark
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Source : Jingui Yaolue ( Synopsis of Prescriptions of the Golden Cabinet).

Ingredients :
No. 1 Dahuang (Radix et Rhizoma Rhei) 12 g;
No. 2 Mudanpi (Cortex Moutan Radicis) 9 g;
No. 3 Taoren ( Semen Persicae) 12 g;
No. 4 Dongguazi ( Semen Benincasae) 30 g;
No. 5 Mangxiao (Natrii Sulphas ) 9 g.
  
Administration:
Decoct the first four ingredients in water; then remove the residue from the decoction and dissolve No. 5 in it. The decoction is to be taken separately.
  
Actions:
Purging away heat and removing blood stasis, dispersing pathogenic accumulation and subduing swelling.

Clinical Application:
This recipe is indicated for intestinal abscess in the early stage, marked by pain and tenderness in the right lower abdomen, or limitation of the right foot to stretch and aggravating pain when stretched, or constant fever, spontaneous perspiration with aversion to cold, thin yellowish and greasy fur, slow and tense or smooth and rapid pulse. It is applicable to acute simple appendicitis that is ascribed to accumulation of dampness-heat, as well as acute pelvic inflammation, infection after ligation of oviduct, and others, which pertain to heat accumulation in xuefen.

In case of excessive heat with high fever, thirst and sharp abdominal pain, add Pugongying (Herba Taraxaci), Jinyinhua (Flos Lonicerae) and Baijiangcao (Herba Patriniae ) to enhance the effect of clearing away heat and toxin. In case of dysentery-like stool with difficulty in defecation, reddened tongue and thready rapid pulse, which are suggestive of yin impairment, it is advisable to subtract No. 5 to reduce the purgative effect and add Xuanshen (Radix Scrophulariae ) and Shengdihuang (Radix Rehmanniae ) to nourish yin and clear away heat.

Elucidation:The syndrome arises when dampnessheat and toxic substances retain in the intestines and lead to stagnation of qi and blood, giving rise to carbuncles.This should be treated by purging away heat and removing blood stasis, dispersing pathogenic accumulation and subduing swelling. No. 1 has the function of purging away intense heat, toxin and dampness-heat from the intestines, while No. 3 possesses the function of promoting blood flow and removing blood stasis, both acting as monarch drugs.

No. 5 is capable of purging away heat and pathogenic accumulation and, when in combination with No. 1, can remove heat of excess type from the intestines. No. 2 is capable of clearing away heat from blood and removingblood stasis, and can promote the function of No. 3.Therefore No. 5 and No. 2 function together as minister drugs. No. 4 is the adjuvant drug in the recipe, which has the function of clearing away heat from the intestines, inducing diuresis and promoting pus discharge.

Cautions:
This recipe should be contraindicated for patients after degeneration, the aged, pregnant women and women after delivery. Besides, it should not be used for severe case of acute suppurative or gangrenous appendicitis, appendicitis complicated with peritonitis, and acute infantile appendicitis.



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