Niu Xi San - 牛膝散 - Achyranthes Powder

Author: Tai Yi Ju (Imperial Medical Bureau), 太醫局

Year: 1107

Source: Formulary of the Pharmacy Service for Benefiting the People of the Taiping Era (Tai Ping Hui Min He Ji Ju Fang, 太平惠民和劑局方)

Category: Formulas that Regulate Blood

Pattern: Qi and Blood stasis in the lower abdominal region of the Chong Mai

Key Symptoms: Inhibited menstruation with periumbilical or lower abdominal pain

Ingredients

Niu Xi

Gui Zhi

Pinyin: Gui Zhi Chinese: 桂枝 Pharmaceutical: Ramulus Cinnamomi Taxonomy: Cinnamomum cassia English: Cinnamon Twig
Tastes: Pungent, sweet, warm Meridians Entered: Lung, Heart, Kidney, Liver
Actions & Indications: *Releases the Exterior, assists Yang, adjusts the Ying* and Wei and releases the muscle layer** Taiyang Wind Strike (Taiyang Zhongfeng, 太阳中风) - a weak person who catches cold easily with spontaneous sweating, aversion to drafts, fever and chills, nasal congestion, stiff and aching head and muscles Warms the channels and collaterals to relieve pain Wind-Cold-Damp Bi *Unblocks Yang* and transforms Qi and thin mucus Edema due to Cold-Phlegm or Yang Qi Deficiency with urinary dysfunction, dizziness and palpitations Assists Heart Yang and warms and facilitates the flow of Yang Qi in the chest** Palpitations due to Yang Obstruction in the chest due to Stagnation or Deficiency Listless chest Yang with upward movement of Phlegm and thin mucus and disorderly descent of Lung Qi with shortness of breath, chest and back pain and palpitations Heart and Spleen Yang Deficiency Warms and facilitates the flow of Qi through the channels and collaterals and Blood through the vessels Wind-Cold-Damp Bi Blood Stasis due to Cold, causing amenorrhea or dysmenorrhea with or without abdominal masses *Warms the Middle and directs Turbid Yin* downward** Middle Jiao Yang Deficiency Heart and Spleen Yang Deficiency (patient usually craves sweets) Aids fasting Mentioned in the Shen Nong Ben Cao Jing as part of the superior class of herbs which can, with protracted taking, make the body light, prevent forgetfulness, and render the face bright and efflorescent, thus forever looking charming, like a child's face. This may suggest it was part of supplementing the diet when engaging in an "avoiding grain" (Bigu 辟穀) fasting regime to cultivate life (Yangsheng 養生).
Standard Dosage: 3-10g in decoction for exterior conditions, or up to 15g for Bi Syndromes. Cautions: This herb induces heat, damages the yin and moves blood. It is prohibited for those with warm pathogens, yin deficiency with effulgent fire, or reckless movement of the blood due to heat in the blood. Use with caution in pregnant women.

Chi Shao

6-9g

Dang Gui

4-6g

Pinyin: Dang Gui Chinese: 當歸 Pharmaceutical: Radix Angelicae sinensis Taxonomy: Angelica sinensis English: Chinese Angelica Root / Tang-Kuei / Dong Quai Root
Tastes: Sweet, Pungent, Warm Meridians Entered: Heart and Liver
Actions & Indications: Tonifies the Blood and regulates the menses Blood Deficiency, especially when affecting the Heart and Liver with pale, ashen complexion, lusterless nails, tinnitus, blurred vision and palpitations Blood Deficiency associated irregular menstruation, amenorrhea and dysmenorrhea Invigorates and harmonizes the Blood and disperses Cold (stops pain due to Blood Stasis) Blood Stasis causing abdominal pain and carbuncles and pain due to Blood Stasis from traumatic injury, especially when accompanied by Deficiency Cold Postpartum menstruation Pregnancy (use with caution) Blood Deficiency with chronic Wind-Damp-Bi Moistens the Intestines and unblocks the bowels Dry Intestines due to Blood Deficiency Reduces swelling, expels pus, generates flesh and alleviates pain Sores and abscess (Chuang Yung), internally and topically Stops coughing and treats dyspnea Used adjunctively for coughing Tonifies the Blood while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015)
Standard Dosage: 6-12g in decoction. Cautions: It is contraindicated in cases of Damp-Heat stagnating in the Middle, Lung Heat with Phlegm Fire, and Yin deficiency with effulgent Yang because it is warm and sweet in properties. In addition, it should be used with caution in cases of loose stool because it can moisten intestines to smooth stool. Many sources recommend using caution, avoiding or only taking under guidance of a TCM physician during pregnancy as it can cause uterine contractions. However, there are no studies supporting this and the only scientific literature seems to suggest that Z-Ligustilide has anti-spasmodic activities that alleviate dysmenorrhoea by inhibiting uterine contractions (Du et al., 2006; Dietz et al., 2016). Caution is also advised in breast cancer patients due to its oestrogen stimulating activity. This based upon Lau et al (2005) who found it may stimulate breast cancer growth in vitro, however Yue et al, (2019) demonstrated that it is not that stimulatory in breast cancer both in vitro and in vivo through a series of tests, although they suggested it should still be used with caution in estrogen receptor-positive breast cancer. Conversely, a large population study in Taiwan by Wu et al (2014) found it reduced the subsequent risk of endometrial cancer in breast cancer survivors taking tamoxifen, especially in those of reproductive age.

6-9g

6-9g

6-9g

6-9g

6-9g

Preparation: Originally ground into powder and taken in 3g doses with warmed rice wine before meals.

Actions: Invigorates the Blood, disperses stasis, adjusts the menses, relieves pain.

Contraindications: Pregnancy.

Notes:
This is almost identical to Zhe Chong Yin but with Mu Xiang instead of Hong Hua making it slightly more focused on moving Qi than Blood.

Research Links:

American Dragon

TCMWiki

Journal of Chinese Medicine

National Resource Centre for Chinese Materia Medica, China

TCM-ID Integrated Database, East China Normal University

TCM-ID Information Database, National University of Singapore

Pubmed

Science Direct

Google Scholar

Bai Du (Chinese)

A+ Medical Encyclopedia (Chinese)

Reference Notes: (click to display)

These pages are intended to assist clinicians and are not intended for self-diagnosis or treatment for which a qualified professional should be consulted.

Herb Formulas Notebook

牛 膝 散  Niu Xi San

Achyranthes Powder