Xue Fu Zhu Yu Tang - 血府逐瘀湯 - Drive Out Stasis in the Mansion of Blood Decoction

Author: Wang Qing-Ren, 王清任

Year: 1830

Source: Correction of Errors Among Physicians (Yi Lin Gai Cuo , 醫林改錯)

Category: Formulas that Regulate Blood

Pattern: Blood Stasis in the Chest

Key Symptoms: Pain in the chest and hypochondria, restless sleep, irritability
Secondary Symptoms: Chronic stubborn headache with a fixed piercing quality, chronic incessant hiccup, choking sensation when drinking, dry heaves, loss of visual acuity, low spirits accompanied by a sense of warmth in the chest, palpitations, insomnia, excessive dreaming, unprovoked anger, extreme mood swings, evening fevers that disappear by morning, purplish lips or complexion or sclera

Tongue: Dark red or purplish body, dark purple spots on the sides, visible and distended sublingual vessels
Pulse: Choppy, or wiry and tight, or racing, or irregular

Ingredients

Tao Ren

12g

Hong Hua

Dang Gui

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.

Chuan Xiong

Chi Shao

4.5g

Niu Xi

Chai Hu

Pinyin: Chai Hu Chinese: 柴胡 Pharmaceutical: Radix Bupleuri Taxonomy: Bupleurum chinense (Nan Chai Hu) seu scorzoneraefolium (Bei Chai Hu) English: Hare's Ear Root / Thorowax Root
Tastes: Bitter, pungent, slightly cold Meridians Entered: Liver and Spleen
Actions & Indications: *Resolves Shaoyang* disorders and reduces fever (harmonizes the Exterior and Interior)** Shaoyang Stage with alternating chills and fever, a bitter taste,dizziness, tinnitus, flank pain, irritability, vomiting and a stifling sensation in the chest Deficiency Heat (auxiliary) Gallbladder Fire The Shen Nong Ben Cao Jing says "It weeds out the stale to bring forth the new." Spreads Liver Qi and relieves Stagnation Liver Qi Stagnation with dizziness, vertigo, chest and flank pain, emotional instability and menstrual problems Disharmony between the Liver and Spleen with epigastric and flank pain, a stifling sensation in the chest, abdominal bloating, nausea and indigestion Liver/Gallbladder Disharmony The Shen Nong Ben Cao Jing says "It mainly treats bound qi in the heart, abdomen, intestines, and stomach, food stagnation, cold and heat, and evil qi." Raises Yang Qi (specifically the Clear Qi of the Stomach and Gallbladder) Spleen and Stomach Yang Deficiency, Qi collapse (prolapse) with hemorrhoids, vaginal discharge, bleeding or exhaustion Disperses Wind-Heat and resolves Phlegm and congestion Wind-Heat *Guides herbs to the Shaoyang* aspects of the head** Shaoyang headaches Releases the Exterior and Drives Out Snakes Relieves the symptoms of Gu Sydnrome while suppressing parasites (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015) 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, brighten the eyes and boost the Essence. 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: Up to 3g to raise sinking Qi, 6-9g to relieve Liver Qi stagnation, 12-24g to release the exterior. Cautions: Anyone who has syndromes of yin deficiency with yang hyperactivity, stirring of liver wind, yin deficiency with effulgent fire and qi going upward adversely, this herb should be used with cautions.

Jie Geng

4.5g

Zhi Ke

Sheng Di Huang

Gan Cao

Pinyin: Gan Cao Chinese: 甘草 Pharmaceutical: Radix Glycyrrhizae Taxonomy: Glycyrrhiza uralensis seu glabra seu inflata English: Liquorice Root
Tastes: Sweet, slightly cold Meridians Entered: Heart, Lung and Spleen (and all 12 meridians)
Actions & Indications: Tonifies the Spleen and augments Qi Spleen Qi Deficiency with shortness of breath, lassitude and loose stools Qi and Blood Deficiency with an irregular pulse and/or palpitations Heart Qi Deficiency or Heart Yang Deficiency Moistens the Lungs, resolves Phlegm and stops coughing Lung Heat or Cold Productive or non-productive coughing Moderates spasms and alleviates pain Painful muscle spasms of the abdomen and legs Clears Heat and relieves Fire Toxicity Raw for Toxic Heat with sore throat or carbuncles and sores (Chuang Yung) Antidote for many toxic substances (internal and topical) Poisoning Bites (after washing the wound, chew Gan Cao and apply a thick layer on the bite wound, changing whenever it dries out; Bao Xiang-Ao, 1846, New Compilation of Proven Formulas) Moderates and harmonizes the harsh properties of other herbs and guides the herbs to all twelve channels Often added in small doses to harmonise formulas Tonifies the Qi while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015) 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 and prolong life. 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: Typically 1.5-9g in decoction. Large doses can be up 30g. Cautions: It is contraindicated for combining with Hai Zao, Da Ji, Gan Sui and Yuan Hua because of "eighteen antagonisms". It is also contraindicated in cases of dampness obstruction in middle energizer and edema because it can help dampness obstruct qi, and it is prohibited from long-term usage in large dosage (more than 20g/day) and should be avoided or used with extreme caution in patients with high blood pressure because it may raise aldosterone levels in the blood causing retention of sodium. The NHS recommends avoiding during pregnancy.

Preparation: Decoction.

Actions: Invigorates the Blood, dispels Blood stasis, spreads the Liver Qi, unblocks the Collaterals

Contraindications: Blood stasis associated with deficiency

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

血 府 逐 瘀 湯  Xue Fu Zhu Yu Tang

Drive Out Stasis in the Mansion of Blood Decoction