Da Huang Zhe Chong Wan (大黄蛰虫丸) — Rhubarb & Earth Beetle Pill

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Da Huang Zhe Chong Wan — the “Rhubarb and Earth Beetle Pill” — is from Zhang Zhongjing’s Jin Gui Yao Lue. It addresses the difficult clinical picture of chronic dry Blood stasis with simultaneous Qi-Blood depletion — long-standing internal stasis where the patient is too depleted to receive a strong Blood-moving formula alone. The formula combines vigorous Blood-moving insect herbs (Zhe Chong/earth beetle, Shui Zhi/leech, Meng Chong/horsefly) with nourishing herbs (Shao Yao, Sheng Di Huang) so the stasis can be broken without further injuring the depleted patient.

I prescribe Da Huang Zhe Chong Wan as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Da Huang Zhe Chong Wan is prescribed for chronic dry Blood stasis with Qi-Blood depletion:

• Long-standing internal abdominal mass or fixed pain
• Dark, dry, scaly skin (“crocodile skin”)
• Dull dark complexion, dark circles under eyes
• Marked emaciation, fatigue^[9]
• Low-grade fever, dry mouth
• Possible amenorrhoea or scant dark menses
• Tongue — dark purple or with stasis spots
• Pulse — thin, choppy

Key herbs

1. Da Huang (Rx. Rhei, 3–9g) — chief; moves Blood and breaks stasis; purges accumulation
2. Zhe Chong (Eupolyphaga, 3–6g) — powerfully breaks Blood stasis; the namesake "earth beetle"
3. Shui Zhi (Hirudo, leech, 3–6g) — very strongly breaks chronic Blood stasis
4. Meng Chong (Tabanus, horsefly, 3–6g) — breaks stubborn Blood stasis
5. Tao Ren (Sm. Persicae, 6–12g), Xing Ren (Sm. Armeniacae, 6–12g) — assist in moving Blood and Qi
6. Qi Cao (Sm. Sesame), Sheng Di Huang (Rx. Rehmanniae, 9–15g), Bai Shao (Rx. Paeoniae Alba, 9–12g) — nourish Yin and Blood; counter the dryness
7. Gan Cao (Rx. Glycyrrhizae, 3–6g) — harmonises
8. Huang Qin (Rx. Scutellariae, 6–9g) — clears Heat
9. Qi Cao (Cao Chong, dried cricket, 3–6g) — moves Blood

Formula actions

1. Powerfully breaks chronic Blood stasis
2. Nourishes Yin and Blood to protect against depletion
3. Reduces internal masses
4. Slowly restores normal circulation in chronic cases

Conditions treated

1. Chronic Blood-stasis abdominal masses (uterine fibroids^[20] in depleted patients)
2. Post-surgical adhesions with chronic pain
3. Liver cirrhosis (early stage) with stasis (adjunctive)
4. Chronic endometriosis with marked depletion and dark skin
5. Post-stroke^[18] recovery with chronic stasis pattern
6. Cardiovascular disease with chronic stasis (adjunctive)

Cautions

Contains Da Huang and multiple insect-based Blood-movers — strictly contraindicated in pregnancy.

Caution in bleeding disorders or with anticoagulant medication — may significantly potentiate bleeding risk.

For longer-term controlled use; not an acute-action formula. Improvement is gradual over months.

Always consult a qualified Chinese herbalist registered with the RCHM.

Prefer to be treated from home? Chinese herbal medicine online consultations are available throughout the UK and worldwide.

References

[9] Wang YY, Li XX, Liu JP, Luo H, Ma LX, Alraek T. Traditional Chinese medicine for chronic fatigue syndrome: a systematic review of randomized clinical trials. Complement Ther Med. 2014 Aug;22(4):826-33. https://doi.org/10.1016/j.ctim.2014.06.004. PMID: 25146086.

[18] Shi YH, Wang Y, Fu H, Xu Z, Zeng H, Zheng GQ. Therapeutic effect of Chinese herbal medicines for post stroke recovery: A traditional and network meta-analysis. Medicine (Baltimore). 2017 Dec;96(49):e9214. https://doi.org/10.1097/MD.0000000000009214. PMID: 29245245.

[20] Chen NN, Han M, Yang H, Yang GY, Wang YY, Wu XK, Liu JP. Chinese herbal medicine Guizhi Fuling Formula for treatment of uterine fibroids: a systematic review of randomised clinical trials. BMC Complement Altern Med. 2014 Jan 2;14:2. https://doi.org/10.1186/1472-6882-14-2. PMID: 24383676.