Da Huang
StarRheum palmatum L., Rheum tanguticum Maxim. ex Balf., Rheum officinale Baill.
Traditionally used for
- Digestion
- Bowel health
- Skin
- Liver & jaundice
Cautions & contraindications
- Heart conditions
☯ TCM Properties
Purges Heat and Unblocks the Bowels; Clears Heat and Drains Fire; Cools the Blood and Resolves Toxicity; Invigorates Blood and Dispels Stasis; Clears Damp-Heat and Resolves Jaundice
Traditional Chinese Uses
Da Huang (rhubarb root and rhizome) is a cold, bitter herb with a powerful purging action on the Large Intestine, making it one of the most important laxative herbs in Chinese medicine. It evacuates heat-type constipation, drains Damp-Heat from the Stomach and Intestines for dysentery and jaundice, cools the Blood to stop bleeding and clear sores, and invigorates Blood to address stasis. Raw rhubarb has a stronger action; wine-processed rhubarb has a reduced purging action but enhanced Blood-moving properties.
Western Herbalism Properties
Used In Formulas (17)
Relationships
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Botanical Description
Rheum palmatum, Chinese or Turkish rhubarb, is a large perennial herbaceous plant in the family Polygonaceae, native to the cool mountainous regions of western China, Tibet, and Mongolia. It grows from a thick, branching, woody rhizome with deep yellow internal flesh and stout, fleshy roots. Basal leaves are very large, up to 90 cm across, broadly cordate, and deeply palmately lobed into 5-7 acute, pinnately cut segments borne on long, stout, reddish petioles. A robust hollow flowering stem rises 1.5-3 meters and bears a large terminal panicle of small, six-tepalled, greenish-white to deep red flowers. Fruit is a three-winged reddish-brown achene. Da Huang refers to the dried rhizome and root.
Active Constituents
Sennosides (A and B)
Dianthrone glycosidesConcentration: Principal purgative constituents
The main stimulant-laxative principles. After bacterial cleavage in the colon to rhein-anthrone, they stimulate colonic motility and inhibit water/electrolyte absorption, producing the purgative action ('purges Heat and unblocks the bowels'). Their bulk is lost with prolonged decoction, so Da Huang is added late (hou xia) when purgation is intended.
Rhein
AnthraquinoneConcentration: Major free/bound anthraquinone
A key bioactive anthraquinone with anti-inflammatory, antibacterial, lipid-regulating and antifibrotic activity; inhibits TGF-β1-driven fibrosis and is studied for renal protection in chronic kidney disease.
Emodin
AnthraquinoneConcentration: Major free/bound anthraquinone
A broadly studied anthraquinone with anti-inflammatory, immunomodulatory, antimicrobial, hepatoprotective and anticancer activity; contributes to the blood-cooling and toxicity-resolving actions.
Aloe-emodin
AnthraquinoneConcentration: Minor anthraquinone
Anthraquinone with antibacterial, antiviral and cytotoxic/anticancer activity; part of the free-anthraquinone fraction.
Chrysophanol
AnthraquinoneConcentration: Major free anthraquinone
A prominent free anthraquinone with anti-inflammatory and antimicrobial activity; a Pharmacopoeia marker for identity and assay of rhubarb.
Physcion (emodin monomethyl ether)
AnthraquinoneConcentration: Minor-to-moderate anthraquinone
Contributes to antimicrobial and antioxidant activity within the anthraquinone complex; another Pharmacopoeia identity marker.
Gallotannins / catechin
Hydrolyzable and condensed tanninsConcentration: Large non-anthraquinone fraction
Astringent polyphenols (including catechin and galloyl-glucoses) that counterbalance the purgative action; in small doses they can produce a secondary constipating/astringent and hemostatic effect and contribute antioxidant and hepatoprotective activity.
Stilbenes (e.g., rhaponticin)
Stilbene glycosidesConcentration: Minor
Antioxidant and lipid-modulating stilbene glycosides characteristic of Rheum species.
⚠ Drug Interactions
Digoxin and other cardiac glycosides
As a stimulant (anthraquinone) laxative, chronic or excessive Da Huang use can cause potassium loss; the resulting hypokalemia sensitizes the myocardium to cardiac glycosides and increases the risk of digoxin toxicity and arrhythmia. This is a well-established class effect of stimulant laxatives.
Clinical note: Avoid prolonged or high-dose use with digoxin; monitor serum potassium.
Potassium-depleting diuretics and corticosteroids
Additive potassium loss when the stimulant-laxative action of Da Huang is combined with thiazide/loop diuretics or corticosteroids, potentiating hypokalemia.
Clinical note: Monitor electrolytes with concurrent long-term use; limit duration of laxative dosing.
Oral medications (general absorption effect)
Accelerated intestinal transit from the purgative effect, and tannin binding, can reduce the absorption of some concurrently taken oral drugs.
Clinical note: Separate administration of important oral medicines from purgative doses of Da Huang.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction, or powder/pills | 3–15 g | Daily | — | — | 中国药典 2020 【用法与用量】3～15g；用于泻下不宜久煎。外用适量， 研末敷于患处。 【注意】孕妇及月经期、哺乳期慎用。 【性味与归经】苦，寒。归脾、胃、大肠、肝、心包经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Preparation Methods
Raw rhubarb added late to decoction (Sheng Da Huang, hou xia)
Parts: dried root and rhizome
For strong purgation the raw herb (typical dose 3-15 g) is added in the last few minutes of decoction, because prolonged boiling destroys the sennosides and greatly weakens the laxative effect. This form most strongly purges Heat and unblocks the bowels.
Wine-processed rhubarb (Jiu Da Huang)
Parts: dried root and rhizome
Stir-processing with wine moderates the purgative action and directs the herb upward, favoring clearing of Heat in the upper body and invigorating the Blood to dispel stasis rather than draining the bowels.
Charred rhubarb (Da Huang Tan)
Parts: dried root and rhizome
Carbonizing the herb largely abolishes the purgative action and emphasizes the astringent/hemostatic effect, used to cool the Blood and stop bleeding.
Steamed rhubarb (Shu Da Huang)
Parts: dried root and rhizome
Steaming (often repeatedly with wine) gives a milder preparation with reduced purgative harshness, suitable for weaker patients where gentler clearing of Heat is desired.
Dui Yao — Herb Pairs
The classical two-herb combinations this herb appears in, each with an action neither herb has alone.
Drastic expulsion of fluid combined with purging of heat, together driving out water and heat bound in the chest and epigastrium.
Major chest binding (da jie xiong) with water and heat. Toxic, drastic purgative; for robust patients only, stop once effect is achieved, contraindicated in pregnancy.
Core pair of a classical formula — Da Xian Xiong Tang, Shang Han Lun (Zhang Zhongjing)
Together they drain fire and purge heat from the Heart and Stomach, relieving focal distention and bleeding caused by heat.
Core pair of a classical formula — Da Huang Huang Lian Xie Xin Tang, Shang Han Lun (Zhang Zhongjing)
Moistening the intestines combined with gentle purging of heat, which moves dry stool while limiting injury to fluids.
Heat-dryness constipation with frequent urination (spleen-binding pattern), taken as pills for a mild action.
Core pair of a classical formula — Ma Zi Ren Wan, Shang Han Lun (Zhang Zhongjing)
Bitter-cold purging combined with salty softening: together they break up hardened dry stool and drain accumulated heat from the Yang Ming organ far more forcefully than either alone.
Yang Ming fu-organ excess with dry hard stool, abdominal fullness and pain. Contraindicated in pregnancy and in deficiency.
Core pair of a classical formula — Da Cheng Qi Tang, Shang Han Lun (Zhang Zhongjing)
Forcefully attacks and expels stubborn phlegm while purging heat downward through the bowels, opening an exit for phlegm-fire.
Excess phlegm-fire with mania, palpitations or stubborn phlegm; harsh, not for deficiency or pregnancy.
Core pair of a classical formula — Meng Shi Gun Tan Wan, Tai Ding Yang Sheng Zhu Lun (Wang Yinjun)
Purging downward combines with cooling and moving the blood, so heat and static blood are drained together and a hot, congealed mass is dispersed.
Classic for intestinal abscess in its early, not-yet-suppurated stage with lower abdominal pain. Contraindicated in pregnancy.
Core pair of a classical formula — Da Huang Mu Dan Tang, Jin Gui Yao Lue (Zhang Zhongjing)
Purging downward together with breaking blood stasis: the pair drives static blood and heat out through the bowels.
Accumulation of blood and heat in the lower burner (blood amassment). Contraindicated in pregnancy.
Core pair of a classical formula — Tao He Cheng Qi Tang, Shang Han Lun (Zhang Zhongjing)
Together they purge and break up long-standing blood stasis, dissolving dry blood and masses.
Consumptive disorder with dry blood: emaciation, abdominal fullness, rough scaly skin, dark eyes. Contraindicated in pregnancy.
Core pair of a classical formula — Da Huang Zhe Chong Wan, Jin Gui Yao Lue (Zhang Zhongjing)
Clearing damp-heat and resolving jaundice while opening a downward exit through the bowels, so damp-heat leaves via both stool and urine.
Yang-type damp-heat jaundice with bright yellow skin and constipation.
Core pair of a classical formula — Yin Chen Hao Tang, Shang Han Lun (Zhang Zhongjing)
Hot acrid warming paired with cold purging: the combination expels cold accumulation from the interior while the heat of the aconite overrides the cold nature of rhubarb (warm purgation).
Cold accumulation constipation with hypochondriac or abdominal pain and cold limbs. Aconite is toxic; use processed root only, properly decocted; contraindicated in pregnancy.
Core pair of a classical formula — Da Huang Fu Zi Tang, Jin Gui Yao Lue (Zhang Zhongjing)
Evidence Tier
Strong evidence · 2 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
2
2 verified · 0 unverified
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
0
In vitro / animal
0
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Clinical effect of rhubarb on the treatment of chronic renal failure: A meta-analysis
Meta-analysis of 34 controlled trials (2,786 patients) found that rhubarb-based therapy significantly reduced serum creatinine, blood urea nitrogen and uric acid and improved creatinine clearance and overall symptom response in chronic renal failure, though it showed no significant benefit for hemoglobin; the authors cautioned that more rigorous trials are needed.
Botany, Traditional Use, Phytochemistry, Pharmacology and Clinical Applications of Rhubarb (Rhei Radix et Rhizoma): A Systematic Review
Systematic review cataloguing the anthraquinones, stilbenes, tannins and other constituents of rhubarb and summarizing purgative, anti-inflammatory, antibacterial, hepato-renal protective, hypolipidemic and antitumor pharmacology together with clinical applications and toxicology.
⚠ Rule-Based Cautions
These entries come from the deterministic rule tables that gate Verscienta's formula tools — classical pair prohibitions, pregnancy and lactation contraindications, and dose ceilings.
Pregnancy
Avoid strong purgative (anthraquinones)
Breastfeeding
Avoid anthraquinones pass into milk → infant diarrhoea
Continuous use
Not beyond 7 days at a time — “Not to be used for more than 1 week.”
Adolescents over 12, adults and elderly; contraindicated under 12 (EMA). Source: EMA/HMPC/113700/2019 — European Union herbal monograph on Rheum palmatum L. and Rheum officinale Baillon, radix (Final – Revision 1, adopted 6 May 2020), §4.2 Duration of use. §4.4: use for more than a brief period of treatment may lead to impaired function of the intestine and dependence on laxatives.
A patient's own days on this herb are counted on their patient page (practitioners only).
Historical Texts
Shennong Bencao Jing (Divine Husbandman's Classic of Materia Medica)
Han dynasty (c. 200 CE)Shanghan Lun / Jin Gui Yao Lue, Zhang Zhongjing
Eastern Han (c. 200 CE)Bencao Gangmu (Compendium of Materia Medica), Li Shizhen
Ming dynasty (1578)References
- Huang W, Rao Y, Li L, Li C, An Y. Clinical effect of rhubarb on the treatment of chronic renal failure: A meta-analysis . Frontiers in Pharmacology (2023) [DOI]
- Xu H, Wang W, Li X, Li Y, Jiang Y, Deng C, Song X, Zhang D. Botany, Traditional Use, Phytochemistry, Pharmacology and Clinical Applications of Rhubarb (Rhei Radix et Rhizoma): A Systematic Review . American Journal of Chinese Medicine (2024) [DOI]
- Chinese Pharmacopoeia Commission. Pharmacopoeia of the People's Republic of China (2020 Edition), Volume I — Da Huang (Rhei Radix et Rhizoma) . China Medical Science Press (2020) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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