桃核承气汤

3. Tongue and pulse

• Tongue: Dark purplish tongue, possibly with petechiae or static macules, with a yellow or dry-yellow coating.
• Pulse: Deep and forceful, or deep and choppy.

4. Granule conversion and dose

Calculation of the total raw herb weight in the original formula:

Tao Ren (peach kernel) 12 g + Da Huang (rhubarb) 12 g + Mang Xiao (mirabilite) 6 g + Gui Zhi (cinnamon twig) 6 g + Zhi Gan Cao (prepared licorice root) 6 g = 42 g.

Converted to 5:1 granules:

42 g raw herb ÷ 5 = 8.4 g granules.

Granule dose: Take in 3 doses daily, dissolved in warm water, about 3 g per dose. (This formula is a strong purgative formula and must be used strictly under a practitioner's guidance, discontinuing once the condition resolves.)

5. Cautions and clinical notes

• Contraindications:
  1. This formula has strong action in breaking blood stasis and purging downward, and is therefore absolutely contraindicated in pregnancy.
  2. It should be avoided in those with underlying deficiency and in those without excess stasis-heat pathogen.
  3. If exterior pattern is not yet resolved, the exterior should be released first before attacking the interior.
• Response to the medication: The original method of administration emphasizes that "slight looseness of stool should occur"; that is, mild diarrhea after taking the formula is a sign that stasis-heat is being discharged downward, and indicates that the formula is working.
• Modern applications: This formula is widely used for acute pelvic inflammatory disease, adnexitis, endometriosis, retained lochia after childbirth, acute cerebral hemorrhage, traumatic injury, schizophrenia, and diabetic nephropathy, where the pattern is one of stasis and heat bound together in the lower burner.
• Duration of use: This formula is designed to urgently purge and preserve yin, sharply breaking the course of the disease; it should be discontinued once the condition resolves and not taken for a prolonged period. After the stasis-heat is resolved, further regulation should be carried out according to the individual's condition.