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Rhubarb (General)

Taste: Bitter. Nature: Cold, Greatly Cold. Toxicity: Non-toxic. Indications: Primarily treats the downward expulsion of blood stasis, amenorrhea due to blood obstruction, alternating chills and fever; breaks up masses and accumulations, clears retained fluid retention and lingering food stagnation; purges the stomach and intestines, pushes out the old to bring forth the new, promotes the free flow of water and grain, harmonizes the middle jiao and transforms food, calms and harmonizes the five zang organs, levels stomach qi and directs it downward, eliminates phlegm-dampness excess, treats heat binding in the intestines, abdominal distension and fullness; for women with cold-blood obstruction and distension, lower abdominal pain, and various types of chronic blood stasis retention and coagulation. Also known as Huangliang. Grows in the valleys of Hexi and Longxi. Roots are harvested in the second and eighth months and dried over fire. (When combined with Baishao (White Peony Root), Huangqin (Scutellaria Root), Muli (Oyster Shell), Xixin (Asarum), and Fuling (Poria), it treats fright, anger, palpitations, and qi stagnation. When combined with Xiaoshi (Niter), Ziyanshi (Purple Quartz), and Taoren (Peach Seed), it treats female blood obstruction. Huangqin acts as its guiding herb, with no incompatibilities or mutual aversions.)

Tao Hongjing stated: Currently, rhubarb collected from Wenshan and the western mountains in northern Yizhou, although not from Hexi or Longxi, those of good quality still exhibit a purple earth brocade color, have a very bitter and astringent taste, and appear dark black. Rhubarb dried in the shade in Sichuan is superior. Those dried in the sun in the north, or fire-dried, have slightly scorched bark and are inferior, but they are resistant to insect damage and preserve well. This herb is potent and sharp; coarse pieces are unsuitable for use and is highly valued by common prescriptions. Daoists often use it to eliminate phlegm disorders, though it is not necessary for nourishing life. The title "General" likely refers to its swift and rapid efficacy. *Tang Bencao* notes: Rhubarb has a moist nature and is prone to spoilage and insect infestation; fire-drying is preferable. In the second and eighth months, the sun is not intense, and if not dried promptly, it becomes unusable. The leaves, seeds, and stems resemble those of *Rumex* (Sheep Sorrel), but are thicker and longer. Fine roots also resemble perennial *Rumex*, while large ones are bowl-sized and two chi long. During processing, stones are heated until hot, the root is cut crosswise into cun segments, placed on the stone to be roasted, dried slightly after one day, then threaded with rope and air-dried until completely dry is best. Rhubarb from Youzhou and Bingzhou gradually becomes finer and lacks the potency of that from Shu. Currently, it is produced in Dangzhou, Liangzhou, Western Qiang, and Shu regions. Its stem tastes sour and can be eaten raw. It can also clear heat, but excessive consumption is detrimental. Tao Hongjing claimed that Shu rhubarb is inferior to Longxi rhubarb, which is incorrect. Current verification according to Chen Cangqi's *Bencao*: When using rhubarb, its potency should be distinguished. If seeking mild, deep-acting effects capable of attacking disease, use the tight, hard pieces resembling ox tongues from Shu. If seeking rapid purgative effects to push out the old and clear heat, use the brocade-patterned rhubarb from Hexi. There are steamed, raw, and cooked forms; they must not be used indiscriminately. Ministers Yu Xi et al. respectfully note according to the *Shu Bencao*: Leaves resemble castor beans. Roots resemble large taro. Fine roots growing laterally resemble burdock; smaller ones resemble *Rumex*. Also, *Tu Jing* records: Height six to seven chi, stems are brittle. *Yaoxing Lun* states: Shu rhubarb removes chills and fever, avoids cold water, tastes bitter and sweet. Digests food, refines the five zang organs, regulates menstruation in women, promotes diuresis for edema, breaks phlegm-excess, treats cold-heat accumulations and lingering food, promotes bowel and bladder movement, applies to heat-toxin swellings, primarily treats pediatric chills-fever epidemic diseases, irritability, heat-induced suppuration, breaks lingering blood. Ri Huazi states: Unblocks all qi, regulates blood vessels, benefits joints, drains stagnant water-qi, treats cold-heat imbalance in four limbs, warm miasma heat diseases, promotes bowel and bladder movement. Applies to all sores, boils, and carbuncles toxins. Those from Machia Gorge in Kuozhou are secondary.

*TU Jing* states: Rhubarb grows in the valleys of Hexi and Longxi; currently found in Sichuan, Hedong, and Shaanxi prefectures, with brocade-patterned Sichuan rhubarb being the best. Next are those from Qin and Long, called Tubo Rhubarb. Green leaves emerge in the first month, resembling castor beans, large ones fan-shaped. Roots resemble taro, large ones bowl-sized, one to two chi long. Lateral fine roots resemble burdock, small ones like taro. Yellow flowers bloom in the fourth month, some green-red resembling buckwheat flowers. Stems are green-purple, bamboo-like. Roots harvested in the second and eighth months, black skin removed, fire-dried. Those from Jianghuai are called Earth Rhubarb, flowering in the second month with fine fruits. Dingzhou produces a type of Rumex Rhubarb, very effective for scabies. Initial seedlings resemble *Rumex*; after years of growth, leaves resemble *Phytolacca* but narrower and pointed. Spires emerge on branches in the fourth month, five to seven stems together, flowers and leaves same color. Fruits resemble buckwheat but lighter and smaller, yellow when ripe in the fifth month, also called Golden Buckwheat. Seedlings harvested in the third month, fruits in the fifth month, both shade-dried. Roots harvested in the ninth month, split open showing brocade patterns, sun-dried. Also called Earth Rhubarb. Regarding collection methods, Su Gong said: Process by heating stones, cutting crosswise, roasting on stones, drying slightly after one day, threading with rope until dry. Current Tubo rhubarb is often made into cross-slices, previously exposed to fire and explosion. Shu rhubarb is made into tight slices resembling ox tongues, called Ox Tongue Rhubarb. Both are equally effective. *Ben Jing* states: Rhubarb pushes out the old to bring forth the new, its effect is most miraculous. Thus, ancient formulas frequently use it for expelling stagnation. Zhang Zhongjing uses it particularly often for treating Taiyang disease. There is also Sanwu Beiji Wan. Sima Pei Xiu prepared it as a powder to treat various heart and abdominal diseases and sudden acute illnesses. The formula uses Rhubarb, Dried Ginger, and Croton Seed, each one liang, requiring refined, fresh, and good quality material. Pound and sieve, mix with honey, pound another thousand times, form pills the size of small beans. Take three pills, adjusting for age and constitution. Powder form is inferior to pill form. If suffering from evil invasion or guest strangulation, with abdominal distension, sudden pain like awl or knife stabbing, shortness of breath, locked jaw, or sudden death from corpse-possession, administer with warm water or wine. If not expelled, lift the head and pour down the throat; improvement follows shortly. If ineffective, give three more pills; abdominal rumbling will occur, leading to vomiting and purging, resulting in cure. If the jaw is locked, teeth must be pried open to administer; upon entering the throat, improvement occurs. Cui Zhiti treats pediatric innocent flash-pi, scrofula, or dry yellow hair standing up, or intermittent dysentery and recovery, with multiple symptoms, primarily using Rhubarb decoction. Nine liang of Rhubarb, fresh and solid with brocade patterns; if slightly rotten, it is unusable. Scrape off the gray skin, weigh, pound and sieve into powder. Mix with three sheng of high-quality rice vinegar, place in a copper bowl, float in a large pot over boiling water, cook with charcoal fire gently, stir with bamboo/wood spatula until suitable for pill formation, store in small porcelain jars. For three-year-old children, take seven pills the size of wu-tzu seeds, twice daily, until green-red pus is discharged. If pus is not discharged or discharge is scant, gradually increase the number of pills. If discharge is excessive, reduce the number of pills. Severe cases may require seven or eight doses to eradicate the root. Adjust dosage for adults and children according to judgment. This medicine only discharges pus and old accumulation, does not cause diarrhea. Must avoid toxic foods. Nursing mothers and infants consuming milk must observe the same taboos. Cui Yuanliang's *Haishang Fang*: Treats cold wind qi in waist and legs. Two da liang of Rhubarb, cut like chess pieces, stir-fried with a little ghee until ghee is absorbed into the medicine. Do not let it turn yellow or scorched, or it loses potency. Pound and sieve into powder. Each day, on an empty stomach, take two qian of Rhubarb powder mixed with ginger soup (prepared by boiling two coin-sized slices of fresh ginger in three he of water for ten boils, removing ginger). Drink immediately on an empty stomach. If there is remaining ginger soup, sip slowly until finished. Cold pus and foul matter should be discharged, and the illness will cease. Ancients used toxic medicines to attack disease, always adjusting according to the patient's deficiency or excess, not using indiscriminately. Yao Sengyuan, early in his career, Emperor Wu of Liang desired to take Rhubarb due to fever. Sengyuan said: Rhubarb is a rapid/purgative medicine; Your Majesty is advanced in age, do not use it lightly. The Emperor did not follow this advice and nearly became prostrate. Emperor Yuan often suffered from heart and abdominal ailments. All physicians suggested using mild medicines to gradually promote circulation. Sengyuan said: The pulse is surging and excess; this indicates lingering obstruction. Without Rhubarb, there is no correct treatment principle. The Emperor followed this and recovered. From this, we see that modern physicians use one toxic medicine to attack many diseases; if it occasionally hits the mark, they call the formula miraculous; if it fails, they do not speak of the error in medication usage. There are many such cases; how can one not beware?

*Tang Bencao* states: Leaves resemble castor beans, roots resemble large taro, lateral fine roots resemble burdock. *Tu Jing* states: Height six to seven chi, stems brittle, taste sour,醒酒 (sobering)... Steam seven times thus. Sun-dry, then sprinkle thin honey water and steam again for one fu period. The rhubarb splits like black paste. Sun-dry for use is excellent. *Shenghui Fang*: Treats epidemic pea-sores. Use half liang of Chuan Rhubarb, slightly stir-fried. Decoct in one large cup of water until reduced to 70%, remove dregs, divide into two doses. Another formula: For heat disease delirium and various jaundices. Use five liang of Chuan Rhubarb, chopped and stir-fried until slightly red, pound into powder. Decoct in five sheng of snow water collected in the twelfth lunar month until it becomes a paste. Take half a spoonful mixed with cold water at any time. *Waitai Miyao*: Formula for pi-masses: Ten liang of Rhubarb, pound and sieve. Mix with three sheng of vinegar and two spoons of white honey, boil until pills the size of wu-tzu seeds can be formed. Take thirty pills swallowed with ginger tea, stop when bowels move; reduce dose for children. *Qianjin Fang*: Treats postpartum evil blood rushing to the heart, retained placenta, abdominal blood masses, etc. Use one liang of Brocade Rhubarb, pound and sieve into powder. Boil with half sheng of first pressing vinegar into a paste, form pills the size of wu-tzu seeds. Patient dissolves five pills in seven fen cups of warm vinegar and takes them; stool passes after a while. Also treats internal injury from horse falls. *Qianjin Yi* treats women's blood-pi pain. Three liang of Rhubarb, pound and sieve. Decoct in two sheng of wine for ten boils, take in one dose. *Jingyan Houfang*: Resolves wind-heat, unblocks accumulated wind-stagnation, digests food, transforms qi, guides blood, greatly resolves stagnation. Four liang of Rhubarb, four liang of Qian Niu Zi (Morning Glory Seed), half raw half cooked, pound into powder, refine honey to form pills the size of wu-tzu seeds. Take ten pills with tea per dose; if mild movement is desired, take fifteen pills. Most suitable in winter months, does not disturb the person. *Meishi Fang*: Treats sudden unilateral swelling and pain of external testicles. Apply Rhubarb powder mixed with vinegar; change when dry. *Doumen Fang* treats lower back pain. Use half liang of Rhubarb plus half liang of fresh ginger, cut together the size of small beans, stir-fry in a pot until yellow, add two bowls of water, drink suddenly at dawn, pass material at daybreak. Evil blood substances from the waist collected in a basin resemble chicken liver; pain stops. *Jianyao Jizhong*: Treats hematemesis. One liang of Chuan Rhubarb, pound and sieve into powder. Take one qian per dose. Decoct with one he of fresh Rehmannia juice and half a cup of water for three to five boils; take at any time. *Guangli Fang*: Treats joint heat, gradual emaciation and jaundice. Four fen of Rhubarb, decoct in five da he of urine from an uncircumcised boy until reduced to four he, remove dregs, divide into two doses on an empty stomach; take again after walking four or five li. *Shanghan Leiyao*: Treats acute jaundice. Coarsely chop two liang of Rhubarb, soak in three and a half sheng of water overnight. At dawn, decoct and squeeze out one and a half sheng of juice, add two liang of Mangxiao (Mirabilite), squeeze and take. Rapid purging should occur shortly. Yao Hezhong treats pediatric brain heat with constant eye closure. One fen of Rhubarb, coarsely chopped, soaked in three he of water overnight. Give half he daily to a one-year-old child; apply remaining liquid to the top of the head, reapply when dry. Bieshuo states: Carefully note that during harvest, rhubarb is always dried by heating stones. To sell quickly, there are no raw ones left; usage requires no further processing like steaming or boiling.

*Yanyi* states: Rhubarb, benefits and drawbacks, are detailed in previous books. Zhongjing treats insufficient heart qi, hematemesis, and epistaxis. Xiexin Tang uses Rhubarb, Huangqin, and Huanglian. This is for cases requiring vomiting or nosebleeds. This is pathogenic heat invading due to insufficiency, hence bleeding. Using bitter properties to drain the heat thereby supplements the heart, achieving both goals. Effective for those with these indications. Most suitable for excess-deficiency differentiation.