Xiao Cheng Qi Tang - 小承气汤 - Minor Order The Qi Decoction - Minor Rhubarb Combination

English:	Minor Order the Qi Decoction
Also Known As:	Minor Rhubarb Combination Less Drastic Purgative Decoction Minor Purgative Decoction

Herbs And Actions

Pharmaceutical Latin	Pin Yin	Dosage	Actions
Rx. and Rz. Rhei	Da Huang	2-12g	Dispels Blood Stasis, Drains Fire transforms Dampness, Drains Heat, Drains Heat from the Blood, Eliminates Phlegm, Invigorates the Blood, Promotes urination, Purges accumulations, Reduces Fire toxicity.
Fr. Aurantii Immaturus	Zhi Shi	2-15g	Breaks up, Descends stagnant Qi and unblocks bowels, Dissipates clumps, Reduces distention. With Hou Po, assists in moving Qi to expel the stool. With Da Huang, for Food and/or Qi Stagnation with distention and constipation.
Cx. Magnoliae	Hou Po	5-24g	Dries Dampness, Relieves fullness, Spreads and descends Qi, Transforms Phlegm. With Da Huang and Zhi Shi, for constipation due to accumulation and stagnation.

Formula Actions

• Moderately purges Heat accumulation
• Purges the Gallbladder
• Normalizes the flow of Qi at the center
• Eliminates Dampness

Syndromes

• Relatively mild Colon Excess Heat
• Relatively mild Yang Ming Fu
• Relatively mild Wen Bing Qi Stage Intestinal Dry Heat
• Early-stage dysentery
• Moderate Yangming organ syndrome causing constipation (Secondary source)

Clinical Manifestations

Constipation Flatulence Abdominal pain that is not worse with pressure Hemorrhoids Tidal fevers Delirious speech Profuse perspiration from the palms and soles Aversion to Heat Mania Abdominal masses Dry mouth Tenesmus

Epigastric and abdominal distention and pain Irritability Heavy body Fever Dysuria Diarrhea Abdominal and chest distention Abdominal fullness T: Dry with prickles C: Dark yellow and dry or Black and dry P: Deep, Shi and rapid or Tenesmus Slippery and rapid

Treats

Acute uncomplicated appendicitis Acute cholecystitis Acute pancreatitis Uncomplicated Intestinal obstruction Postoperative constipation and distention Roundworms in the bile duct Early-stage dysentery Pneumonia (especially in children) Hypertension Beriberi Epilepsy Food poisoning Ephidrosis Dysentery Intestinal paralysis Chronic gastritis Viral hepatitis Hydrothorax Abdominal pain Hiccups Colitis Ulcerative colitis Abdominal fullness and distention Diverticulitis Mesenteric lymphadenitis Trichomonas Profuse perspiration

Moist fever Typhoid fever Stomach flu Measles Meningitis Tetanus Neurosis Obesity Hemorrhoids Mania Constipation Emotional disorders Food retention Acute simple Intestinal obstruction Absence of peristalsis Acute gastroenteritis Food intoxication Ascites Irritable bowel syndrome Crohn's disease Nausea/Vomiting Abdominal masses Pelvic inflammatory disease Salpingitis Hernia Toothache

Contraindications And Herb/Drug Interactions

Notes

• (Shi/Man/Pi) Treats hardness, fullness and distention, but not dryness (Zao).
• Lacking Mang Xiao, it targets abdominal fullness more and dryness less.
• Compared with Da Cheng Qi Tang: milder; the coat is deep yellow or brown and the pulse slippery rather than deep and full.

Modifications

For generalized weakness and Qi Deficiency:		For generalized weakness and Blood Deficiency:
+ Rx. Astragali	Huang Qi	+ Rx. Angelicae Sinensis	Dang Gui
+ Rx. Ginseng	Ren Shen	+ Rz. Chuanxiong	Chuan Xiong
For irritability and restlessness due to Lung Deficiency:		For tonsillitis:
+ Rx. Ophiopogonis	Mai Men Dong	+ Rx. Sophorae Tonkinensis	Shan Dou Gen
+ Fr. Schisandrae	Wu Wei Zi	+ Rx. Platycodi	Jie Geng
For more severe constipation:		For Intestinal Dryness and general weakness:
+ Natrii Sulfas	Mang Xiao	+ Sm. Armeniacae	Xing Ren
For more severe bloating:		+ Sm. Cannabis	Huo Ma Ren
+ Rx. Aucklandiae	Mu Xiang	+ Rx. Paeoniae Alba	Bai Shao
+ Sm. Arecae	Bing Lang	For delirium:
For Liver tension:		+ Ram. cum Uncis Uncariae	Gou Teng
+ Rx. Bupleuri	Chai Hu	+ Poria	Fu Ling
+ Rx. Scutellariae	Huang Qin	For dysentery:
+ Rx. Paeoniae Alba	Bai Shao	+ Rx. Aucklandiae	Mu Xiang
For peritonitis:		+ Rx. Paeoniae Alba	Bai Shao
+ Rz. Pinelliae Preparatum	Zhi Ban Xia	+ Cx. Phellodendri	Huang Bai
+ Rz. Zingiberis Recens	Sheng Jiang	For acute febrile disease with constipation and bloating:
For uterine carcinoma and pelvic inflammatory disease:		+ Ram. Cinnamomi	Gui Zhi
+ Natrii Sulfas	Mang Xiao	+ Rz. Zingiberis Recens	Sheng Jiang
+ Flos Carthami	Hong Hua	+ Fr. Jujube	Da Zao
+ Rx. Angelicae Sinensis	Dang Gui	+ Rx. Glycyrrhizae	Gan Cao
+ Rx. Glycyrrhizae	Gan Cao	For obesity due to Spleen Qi Deficiency, Stomach Heat and Food Stagnation:
For acute gastroenteritis:
+ Charred Fr. Crataegi	Shan Zha Tan	+ Preserve Harmony Pill Bao He Wan
+ Charred Massa Medicata Fermentata	Shen Qu Tan
For acute gastroenteritis with abdominal pain:
For acute gastroenteritis with fever:		+ Charred Fr. Crataegi	Shan Zha Tan
+ Charred Fr. Crataegi	Shan Zha Tan	+ Charred Massa Medicata Fermentata	Shen Qu Tan
+ Charred Massa Medicata Fermentata	Shen Qu Tan
+ Rx. Aucklandiae	Mu Xiang
+ Fr. Forsythiae	Lian Qiao	For acute gastroenteritis with recurrent nausea and vomiting:
+ Hb. Menthae	Bo He
For viral hepatitis:		+ Charred Fr. Crataegi	Shan Zha Tan
+ Rx. Glycyrrhizae	Gan Cao	+ Charred Massa Medicata Fermentata	Shen Qu Tan
For viral hepatitis with Dampness:
+ Rx. Glycyrrhizae	Gan Cao	+ Fr. Amomi	Sha Ren
+ Rz. Atractylodis	Cang Zhu	+ Rz. Coptidis	Huang Lian
For viral hepatitis with indigestion:		+ Rz. Pinelliae Preparatum	Zhi Ban Xia
+ Rx. Glycyrrhizae	Gan Cao
+ Charred Massa Medicata Fermentata	Shen Qu Tan	For hiccups with constipation:
+ 9-12g Calyx Kaki	Shi Di
+ Charred Endothelium Gigeriae Galli	Ji Ne Jin Tan	+ 9-12g Caulis Bambusae in Taeniam	Zhu Ru