Bu Yang Huan Wu Tang - 補陽還五湯 - Tonify Yang to Restore Five Tenths 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: Deficiency of Qi and Yang leading to static Blood obstructing the Channels

Key Symptoms: Sequalae to stroke with hemiplegia, paralysis and atrophy of the lower limbs, facial paralysis
Secondary Symptoms: Drooling, slurred speech, dry stools, urinary frequency or incontience

Tongue: Pale, dark body, white coating
Pulse: Moderate

Ingredients

Huang Qi

30-120g

Pinyin: Huang Qi Chinese: 黄芪 Pharmaceutical: Radix Astragali Taxonomy: Astragalus membranaceus English: Astragalus Root / Mongolian Milkvetch Root
Tastes: Sweet, warm Meridians Entered: Lung and Spleen
Actions & Indications: Tonifies Qi and Blood Postpartum fever due to Qi and Blood Deficiency Recovery from severe Blood loss Strengthens the Spleen and raises the Yang Qi of the Spleen and Stomach Spleen Qi Deficiency with anorexia, fatigue and diarrhoea Central Qi Sinking (prolapse) Lung and Spleen Qi Deficiency Qi Failing to contain Blood Qi and Blood Deficiency Fever from Qi Deficiency Tonifies Wei Qi, stabilizes the Exterior and tonifies the Lungs (aids circulation of moisture downward from the face) Wei Qi Deficiency with spontaneous sweating Lung Qi Deficiency with frequent colds or shortness of breath Excessive sweating associated with Qi, Yang or Yin Deficiency Dampness in the head Promotes urination and reduces oedema Spleen Deficiency oedema or superficial oedema with reduced urination (It can be used as a stand-alone herb for this) Promotes the discharge of pus, generates flesh and expels toxins Chronic ulcerations and sores that either have trouble forming pus or have formed pus but are not draining well Generates Body Fluids Wasting and thirsting disorder (消渴 Xiao Ke) Bi Syndrome with numbness of the limbs and paralysis Relieves numbness and pain Numbness and pain due to Deficiency of Qi and Blood Tonifies the Qi while suppressing Parasites Gu Sydnrome (Fruehauf, 1998) Chronic inflammatory disease (Fruehauf, 2015)
Standard Dosage: 10-15g in decoction. Large dosages of up to 30g can be used for severe debilitation, Blood deficiency or unhealing sores (e.g. Dang Gui Bu Xue Tang). Cautions: It is contraindicated in cases of exterior excess with excessive pathogen, internal obstruction, yin deficiency with yang hyperactivity, early stage of sores and ulcers of excessive pathogen and no deficiency of heathy qi, because it can tonify qi, raise yang and strengthen superficial.Caution with patients on immunosuppressents due to its immune modulating effects.

Dang Gui Wei

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.

4.5-6g

Pinyin: Di Long Chinese: 地龙 Pharmaceutical: Pheretima seu Lumbricus Taxonomy: Pheretima seu Lumbricus English: Earthworm
Tastes: Salty, cold Meridians Entered: Liver, Spleen and Bladder
Actions & Indications: Drains Heat, settles convulsions, extinguishes Wind and stops spasms Extreme Heat generating Wind with loss of consciousness, incoherent speech, convulsions and seizures It can be used alone It has recently been used to treat schizophrenia of the hot-manic type Clears Heat and unblocks and promotes movement in the channels and collaterals Hot or Cold Bi (with appropriate herbs) with swollen, painful joints with a reduced range of motion Hemiplegia due to lack of flow in the channels such as the sequelae of Wind-Stroke Clears Heat and calms wheezing Wheezing due to Lung Heat (can be taken alone as a powder, in capsules or decocted with sugar as a syrup) Clears Heat and promotes urination Hot, painful urinary dysfunction, oedema (severe cases), ascites and jaundice Especially useful for Heat clumping in the Bladder with urinary difficulty or inability to urinate (can be used alone) Anchors Liver Yang and lowers Blood pressure Hypertension due to Liver Yang Rising Promotes healing topically Acute parotitis, chronic ulcers of the lower limbs, burns, boils or carbuncles (powder, mix with sugar and apply topically) Removes the Three Worms and Hidden Corpses, Ghost Possession and Gu Toxins White necked earthworms (白頸蚯蚓 Bai Jing Qiu Yin) are said in the Shen Nong Ben Cao Jing to remove the Three Worms (三蟲) and Hidden Corpses (伏尸), Ghost Possession (鬼注) and Gu Toxins (蠱毒) and kills Long Worms (殺長蟲), suggesting their use to treat a number of invisible, supernatural diseases, presumably because of their own worm-like nature and non-toxic nature.
Standard Dosage: 5-10g in decoction. Cautions: Animal products are prohibited from use in the UK under the Medicines Act 1968 ch. 67 which restricts herbalists to the use of plant products only. It is generally substituted with Xi Xian Cao and Gou Teng, although vines like Ji Xue Teng or Ye Jiao Teng could be appropriate too if the principle of worms and vines entering the channels and collaterals wants to be preserved.

Subsitutions:
In UK Di Long must be substituted. Some suggestions include Xi Xian Cao and Gou Teng.

Preparation: Decoction.

Actions: Tonifies the Qi, invigorates the Blood, unblocks the Channels

Contraindications: Acute cerebral haemorrhage, Wind-stroke with a large and forceful, or firm, wiry and forceful pulse, yin deficiency, Blood heat, pregnancy

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

補 陽 還 五 湯  Bu Yang Huan Wu Tang

Tonify Yang to Restore Five Tenths Decoction