What Tiao Wei Cheng Qi Tang is for
This is the formula for facial redness and heat of the rosacea type, where the skin is hot and reactive rather than pale or depleted, and the Heat behind the flush is congested below rather than sitting on the surface. It clears that Heat from the Stomach and moves it out gently, so the redness settles as the congestion clears.
The skin picture is facial redness and heat: a flush across the cheeks and nose of the rosacea type, hot to the touch and sometimes dotted with small eruptions. The face is where the congestion shows, and the skin is red and reactive rather than pale, dry or weeping. Heat that has built up below rises to the surface, which is why the flush sits on the face while the skin elsewhere is unremarkable. It is the flushed face of Heat rather than the cold, dusky face of stasis.
Da Huang clears the Heat and moves the bowel, Mang Xiao softens and purges gently, and Gan Cao protects the Stomach, which is why the formula regulates rather than attacks. The Heat is drawn off from below, so the flushing eases as the stool moves. It is the mildest of the purgative formulas, used where the congestion is sluggish rather than obstructed, and it is a short course, stopped once the bowel opens.
Because it clears by purging, it is inappropriate for skin that is pale, dry or depleted, and it is excluded in cold deficiency and in pregnancy. It is also not for severe obstruction with abdominal pain. Rosacea needs medical assessment of the diagnosis and management of its triggers, and the redness may persist after the congestion has settled, so the course is brief and the face is reviewed rather than treated indefinitely.
Actions
- Clears Heat from the Stomach and bowel
- Gently purges and moves the stool
- Protects the Stomach
- Relieves heat with constipation
Properties
- Taste and temperature: Predominantly bitter and salty with a sweet note. Bitter clears Heat, salty softens and purges, sweet protects the middle.
- Organs: Stomach, Large Intestine
- Channels: Stomach, Large Intestine
The pattern behind it
The pattern is Heat accumulating in the Stomach and bowel without a severe blockage. The Heat produces the thirst, the dry mouth and the flushing, and the bowel is sluggish but not obstructed. The formula clears the Heat and gently moves the stool, which is why it is the mildest of the purgative formulas.
Composition
The herbs in Tiao Wei Cheng Qi Tang, with their role and dose.
| Role | Herb | Dose | Properties | Why it is there |
|---|---|---|---|---|
| Deputy | Da Huang | 6 to 12 g | Cold, Bitter | Clears Heat and moves the bowel, the main purgative action. |
| Assistant | Mang Xiao | 9 to 15 g | Cold, Salty, bitter | Softens and purges gently, working with Da Huang. |
| Gan Cao | 3 to 6 g | Neutral, Sweet | Protects the Stomach and harmonises, which is why the formula regulates rather than attacks. |
Patterns it treats
Stomach Heat
Facial flushing and heat eruptions of the rosacea type, hot to the touch and reactive while the skin elsewhere stays quiet. The redness eases as the Heat is drawn off from below.
How the formula is built
Two purging herbs and one protecting herb. The protecting herb is the point of the formula: it clears the Heat and moves the bowel without injuring the Stomach, which is why it can be used where the stronger purgatives would be too much.
Skin conditions it is used for
Where this formula appears in the skin conditions of the library.
Preparation and use
Decocted in water and taken warm, in two divided doses, stopping when the bowel moves.
Modifications
- If the constipation is severe, a stronger purgative formula is used.
- If the Heat is marked, more cooling is added.
- If the person is depleted, the formula is reduced or avoided.
- If there is Cold, this formula is not used.
Timing
Taken warm, and stopped as soon as the bowel moves.
Duration
Short course: one to three days, reassessed.
Diet while taking it
Increase fluids; avoid hot spicy and fried food.
Safety
Contraindications
Avoid in cold deficiency, in depleted patients, and in pregnancy. Do not use for more than a few days, and stop once the bowel moves.
Interactions
Da Huang and Mang Xiao can affect electrolytes and interact with diuretics and digoxin. Gan Cao can raise blood pressure and cause potassium loss.
Pregnancy
Contraindicated in pregnancy because the formula contains purgative herbs.
Breastfeeding
Use only under professional guidance.
Children
Used only with professional supervision.
Before you use it
Recorded from the classical record and rewritten in this project's own words. Educational only: not a prescription, and persistent constipation or facial redness needs medical assessment.
General safety references
General references for herbal hepatotoxicity and herb-drug interactions; they are not specific to this formula.
- Review article: Herbal hepatotoxicity - an update on traditional Chinese medicine preparations. Alimentary Pharmacology & Therapeutics, 2014. PMID: 24844799.
- Interactions between herbal medicines and prescribed drugs: an updated systematic review. Drugs, 2009. PMID: 19719333.
- Warfarin and food, herbal or dietary supplement interactions: a systematic review. British Journal of Clinical Pharmacology, 2021. PMID: 32478963.
Origin and history
Shang Han Lun (伤寒论, Treatise on Cold Damage) by Zhang Zhongjing, Eastern Han dynasty, around 220 CE.
Zhang Zhongjing wrote three purgative formulas of increasing strength, and this is the mildest. Its name, regulate the Stomach and order the Qi, describes its gentler purpose: clearing Heat and moving the bowel without the violent purging of the stronger versions.
Classical record
The Treatise on Cold Damage records the decoction as the mildest of the purgative formulas, clearing Stomach Heat and gently moving the bowel while protecting the middle.
Shang Han Lun (伤寒论, Treatise on Cold Damage), Zhang Zhongjing, Eastern Han dynasty.
Evidence note
No controlled trial of this treatment in skin conditions was identified for this entry. What is described here rests on the classical and later materia medica record and on traditional clinical use, not on controlled trial evidence, and it is not a prediction of benefit. Where skin-specific research does exist it is linked above.
Common questions
How is it different from Da Cheng Qi Tang?
It is the mild version. Da Cheng Qi Tang is for severe obstruction with abdominal pain; this is for Heat with a sluggish bowel but no severe blockage.
How long is it used?
One to three days, stopped as soon as the bowel moves.
Can it help rosacea?
Where facial flushing and heat come with a sluggish bowel. Rosacea also needs medical assessment and trigger management.
Who should avoid it?
Depleted patients, anyone with cold deficiency, and pregnant women.