Hu Wei Cheng Qi Tang

Stomach-Protecting Qi-Coordinating Decoction · 护胃承气汤

A gentle purgative formula from the Warm Disease school that clears residual Heat from the Stomach and Intestines while nourishing Yin to protect the Stomach. It is used for constipation, dry mouth, and thirst that occur after a feverish illness, when Heat has damaged the body's fluids.

Composition 6 herbs
Da Huang
King
Da Huang
Xuan Shen
Deputy
Xuan Shen
Di Huang
Deputy
Di Huang
Mu Dan Pi
Assistant
Mu Dan Pi
Zhi Mu
Assistant
Zhi Mu
Mai Dong
Assistant
Mai Dong
Explore composition

Educational content Consult qualified TCM practitioners for diagnosis and treatment

Patterns Addressed

In TCM, symptoms don't appear randomly — they cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Hu Wei Cheng Qi Tang is designed to correct these specific patterns.

Why Hu Wei Cheng Qi Tang addresses this pattern

This formula addresses residual Heat accumulation in the Stomach and Intestines, a manifestation of Bright Yang Fire. The Heat consumes fluids and leads to constipation, thirst, and a dry yellow or black tongue coating. Da Huang directly purges this accumulation, while the Yin-nourishing herbs prevent further damage and support the purgative effect.

A practitioner would look for one or more of these signs

Constipation

Hard, dry stools due to Heat accumulation

Dry Mouth

Dry mouth from Heat consuming fluids

Thirst

Thirst with desire for cold drinks

Yellow Tongue Coating

Dry yellow or black tongue coating

Deep Pulse

Deep and forceful pulse

Commonly Prescribed For

These conditions can arise from the patterns above. A practitioner would consider Hu Wei Cheng Qi Tang when these conditions are specifically caused by those patterns — not for all cases of these conditions.

TCM Interpretation

In TCM, constipation can arise from Heat accumulation in the Stomach and Intestines, which dries up fluids and damages Yin, leading to hard, dry stools that are difficult to pass. This pattern often follows a febrile illness where Heat has not been completely cleared.

Why Hu Wei Cheng Qi Tang Helps

Da Huang purges the accumulated Heat and promotes bowel movement, while Xuan Shen, Sheng Di Huang, Mai Dong, and Zhi Mu replenish Stomach Yin and generate fluids, lubricating the Intestines. This dual action addresses both the root (Heat accumulation) and the branch (Yin damage), making it suitable for constipation with Yin deficiency.

Also commonly used for

Gingivitis

Clears Stomach Heat and protects Yin to reduce gum swelling and pain.

Halitosis

Clears Heat accumulation and descends Stomach Qi to alleviate bad breath.

Food Stagnation

Used for pediatric food accumulation with constipation and Heat signs.

Intestinal Obstruction

Helps resolve partial intestinal obstruction by purging Heat and moistening Intestines.

What This Formula Does

Every TCM formula has a specific set of actions — here's what Hu Wei Cheng Qi Tang does in the body, explained in both everyday and TCM terms

Therapeutic focus

In practical terms, Hu Wei Cheng Qi Tang is primarily used to support these areas of health:

TCM Actions

In TCM terminology, these are the specific therapeutic actions that Hu Wei Cheng Qi Tang performs to restore balance in the body:

How It Addresses the Root Cause

TCM doesn't just suppress symptoms — it aims to resolve the underlying imbalance. Here's how Hu Wei Cheng Qi Tang works at the root level.

In the later stages of warm disease, after the main Heat has been cleared, residual Heat may remain in the Stomach and Intestines. This Heat consumes Body Fluids and damages Stomach Yin, leading to dryness and accumulation. The Stomach Qi loses its normal downward direction, resulting in constipation, dry mouth and throat, a dry yellow or black tongue coating, and a deep, forceful pulse. If only purging is used without nourishing Yin, the Stomach Yin will be further damaged; if only Yin is nourished without purging, the accumulated Heat will not be expelled. This formula simultaneously purges the residual Heat accumulation and nourishes Stomach Yin, restoring the Stomach's descending function while protecting the Yin.

Formula Properties

Every formula has an inherent temperature, taste, and affinity for specific organs — these properties determine how it interacts with the body

Overall Temperature

Cold

Taste Profile

Predominantly bitter and sweet — bitter to drain heat and unblock the bowels, sweet to nourish yin and generate fluids.

Channels Entered

Ingredients

6 herbs

The herbs that make up Hu Wei Cheng Qi Tang, organized by their role in the prescription

King — Main ingredient driving the formula
Deputy — Assists and enhances the King
Assistant — Supports or moderates other herbs
King — Main ingredient driving the formula
Da Huang

Da Huang

Rhubarb root and rhizome

Dosage 9g
Temperature Cold
Taste Bitter (苦 kǔ)
Organ Affinity Spleen, Stomach, Large Intestine, Liver, Pericardium

Role in Hu Wei Cheng Qi Tang

Purges Heat and unblocks the bowels to eliminate accumulated Heat in the Stomach and Intestines.
Deputies — Assists and enhances the King
Xuan Shen

Xuan Shen

Figwort root

Dosage 9g
Temperature Cold
Taste Sweet (甘 gān), Bitter (苦 kǔ), Salty (咸 xián)
Organ Affinity Lungs, Stomach, Kidneys

Role in Hu Wei Cheng Qi Tang

Nourishes Yin and clears Heat, protecting Stomach Yin while supporting the purgative action.
Di Huang

Di Huang

Rehmannia root

Dosage 9g
Temperature Cold
Taste Sweet (甘 gān), Bitter (苦 kǔ)
Organ Affinity Heart, Liver, Kidneys

Role in Hu Wei Cheng Qi Tang

Cools Blood and nourishes Yin, moistening dryness and protecting Stomach Yin.
Assistants — Supports or moderates other herbs
Mu Dan Pi

Mu Dan Pi

Tree peony root bark

Dosage 6g
Temperature Slightly Cool
Taste Bitter (苦 kǔ), Acrid / Pungent (辛 xīn)
Organ Affinity Heart, Liver, Kidneys

Role in Hu Wei Cheng Qi Tang

Clears Heat and cools Blood, addressing residual Heat in the Blood level and preventing further Yin damage.
Zhi Mu

Zhi Mu

Anemarrhena rhizome

Dosage 6g
Temperature Cold
Taste Bitter (苦 kǔ), Sweet (甘 gān)
Organ Affinity Lungs, Stomach, Kidneys

Role in Hu Wei Cheng Qi Tang

Clears Heat and nourishes Yin, moistens dryness and generates fluids to protect Stomach Yin.
Mai Dong

Mai Dong

Ophiopogon root

Dosage 9g
Temperature Slightly Cool
Taste Sweet (甘 gān), Bitter (苦 kǔ)
Organ Affinity Heart, Lungs, Stomach

Role in Hu Wei Cheng Qi Tang

Nourishes Yin and generates fluids, especially for Stomach Yin deficiency with dry mouth and throat.

Why This Combination Works

How the herbs in Hu Wei Cheng Qi Tang complement each other

Overall strategy

This formula combines purging with nourishing Yin, using the "bitter-sweet method" to simultaneously eliminate residual Heat accumulation in the Stomach and Intestines while protecting and restoring Stomach Yin, thereby restoring the Stomach's descending function.

King herbs

Da Huang (Rhubarb) is the King herb. It is bitter, cold, and descending, powerfully purging Heat and unblocking the bowels. It directly addresses the retained Heat accumulation in the Stomach and Intestines, the primary pathomechanism.

Deputy herbs

Xuan Shen (Scrophularia) and Sheng Di Huang (Rehmannia) are Deputies. Both are sweet, cold, and moistening. They nourish Yin, cool Blood, and generate fluids, protecting the Stomach Yin from further damage by the purgative action and helping to moisten the Intestines to facilitate bowel movement.

Assistant herbs

Mu Dan Pi (Moutan) clears Heat and cools Blood, addressing any residual Heat in the Blood level that may have been stirred. Zhi Mu (Anemarrhena) clears Heat and nourishes Yin, moistening dryness and supporting fluid generation. Mai Dong (Ophiopogon) strongly nourishes Yin and generates fluids, especially for the Stomach, alleviating dry mouth and throat. These three herbs reinforce the Yin-nourishing and Heat-clearing actions from different angles.

Envoy herbs

There is no specific Envoy herb; the formula's combination of herbs naturally directs the action to the Stomach and Intestines.

Notable synergies

The pairing of Sheng Di Huang and Xuan Shen powerfully nourishes Yin and cools Blood, a classic duo for Yin deficiency with Heat. Zhi Mu and Mai Dong together enhance fluid generation and moisten the Stomach. The combination of Da Huang with these Yin-nourishing herbs ensures that purgation occurs without damaging Yin, a key feature of this formula.

How to Prepare

Traditional preparation instructions for Hu Wei Cheng Qi Tang

Soak the six herbs in 5 cups of water (approx. 750 ml) for about 30 minutes. Decoct until reduced to about 2 cups (approx. 300 ml). Divide into two equal portions. Take one portion (approx. 150 ml) first. If bowel movement occurs, stop; if not, take the remaining portion later. If still no bowel movement, the remaining dose may be repeated. Take warm once daily.

Common Modifications

How practitioners adapt Hu Wei Cheng Qi Tang for specific situations

Added
Mang Xiao

3-6g, added at end of decoction

Mang Xiao softens hardness and purges Heat, enhancing the purgative effect for stubborn constipation.

Educational content — always consult a qualified healthcare provider or TCM practitioner before using any herbal formula.

Contraindications

Situations where Hu Wei Cheng Qi Tang should not be used or requires extra caution

Avoid

Deficiency-cold constipation (虚寒便秘) — the formula's cold purgative nature will worsen cold patterns and damage Spleen Yang.

Caution

Spleen and Stomach deficiency cold with loose stools or diarrhea — use with caution as the formula is cold and may aggravate digestive weakness.

Special Populations

Important considerations for pregnancy, breastfeeding, and pediatric use

Pregnancy

Contraindicated during pregnancy. Contains Sheng Da Huang (生大黄, Rhubarb) which strongly purges and may stimulate uterine contractions, and Dan Pi (丹皮, Moutan) which moves Blood. Do not use during pregnancy.

Breastfeeding

No specific data on safety during breastfeeding. Caution is advised as purgative herbs may affect the infant's digestion. Consult a healthcare provider before use.

Children

Can be used in children at appropriately reduced doses. Reported in pediatric acute gastroenteritis and food accumulation constipation. Dosage must be adjusted by a qualified practitioner based on age and weight.

Drug Interactions

If you are taking pharmaceutical medications, be aware of these potential interactions with Hu Wei Cheng Qi Tang

No well-documented drug interactions. Caution is advised when combined with other purgatives or diuretics, as they may increase fluid loss and electrolyte imbalance. Consult a healthcare provider before concurrent use with prescription medications.

Usage Guidance

Practical advice for getting the most out of Hu Wei Cheng Qi Tang

Best time to take

Take on an empty stomach in the morning for best purgative effect, or as directed by a practitioner.

Typical duration

Short-term use only; discontinue once bowel movement occurs. Usually taken for 1–3 days.

Dietary advice

Avoid cold, raw, and greasy foods while taking this formula. These foods can counteract the formula's action or further weaken the Spleen and Stomach. Light, warm, easily digestible foods are recommended.

Hu Wei Cheng Qi Tang originates from 《温病条辨》(Wen Bing Tiao Bian) Qing dynasty (清代), 1798 CE

Classical Texts

Key passages from the classical Chinese medical texts that first described Hu Wei Cheng Qi Tang and its clinical use

From 《温病条辨》 (Wen Bing Tiao Bian):

“护胃承气汤方,苦甘法,生大黄三钱,元参三钱,细生地三钱,丹皮二钱,知母二钱,麦冬三钱,连心水五杯,煮取二杯,先服一杯,得结粪,止后服,不便,再服。”
"Hu Wei Cheng Qi Tang formula, bitter-sweet method: Sheng Da Huang 3 qian, Yuan Shen 3 qian, Xi Sheng Di 3 qian, Dan Pi 2 qian, Zhi Mu 2 qian, Mai Dong 3 qian. Decoct with 5 cups of water to 2 cups; first take one cup. If dry stool passes, stop; if not, take the second cup."

“承气者,承胃气也。承气汤通胃结,救胃阴,仍系胃腑本来下降之气。”
"'Cheng Qi' means to support the stomach Qi. Cheng Qi Tang unblocks stomach bind, rescues stomach yin, and restores the stomach's original descending Qi."

Historical Context

How Hu Wei Cheng Qi Tang evolved over the centuries — its origins, lineage, and place in the broader tradition of Chinese medicine

Hu Wei Cheng Qi Tang was created by the Qing dynasty warm disease expert Wu Jutong (吴鞠通) and recorded in his seminal work 《温病条辨》 (Wen Bing Tiao Bian, Systematic Differentiation of Warm Diseases, 1798). It was designed as a gentle purgative for late-stage warm disease when pathogenic heat has damaged stomach yin and caused constipation. The formula adapts the concept of Zhang Zhongjing's Da Cheng Qi Tang from the 《伤寒论》 (Shang Han Lun) but replaces the harsh purgatives with yin-nourishing herbs to protect the stomach. The name "Hu Wei" (护胃) means "protecting the stomach," reflecting its emphasis on preserving stomach yin while clearing heat and unblocking the bowels. It exemplifies the warm disease school's approach of simultaneously attacking pathogens and supporting upright Qi.