All combinations of herbs that nourish and replenish blood, used to treat blood deficiency syndromes, are collectively referred to as buxue ji (blood nourishing agents).
This type of formula is suitable for symptoms such as dizziness, blurred vision, pale complexion without luster; pale lips, brittle nails; palpitations, insomnia; dry stools; women with irregular menstruation, scanty and pale menstrual flow; thin and rapid or thin and choppy pulse, pale red tongue, slippery and scanty coating, etc.
These formulas often include main components such as Shu Di Huang (Rehmannia Root), Dang Gui (Angelica Sinensis), Bai Shao (White Peony), and A Jiao (Donkey-hide Gelatin), with representative formulas like Si Wu Tang (Four Substance Decoction), Gui Pi Tang (Restore the Spleen Decoction), and Dang Gui Bu Xue Tang (Dang Gui Blood Supplement Decoction).
1. Si Wu Tang (Four Substance Decoction)《太平惠民和剂局方》
Composition: Dang Gui (10g) prepared with wine and stir-fried, Chuan Xiong (8g), Bai Shao (12g), Shu Di Huang (12g) prepared with wine and steamed (Shu Di Huang is already a finished product, while Gan Di Huang is fresh Rehmannia dried, using 12g) in equal parts.
Dosage: Grind into coarse powder, take 3 qian (9g) each time, with 1.5 cups of water, decoct until reduced to 80%, strain and take warm on an empty stomach before meals. If there is instability in pregnancy with bleeding, add 10 leaves of Ai Ye (Mugwort) and 1 slice of A Jiao, decoct as before.
For blood cold and excessive bleeding, also add A Jiao and Ai Ye for decoction (modern usage: as a soup, decoct three times, take on an empty stomach in the morning, noon, and evening).
Function: Nourishes and regulates blood.
Indications: Deficiency of Chong and Ren channels. Irregular menstruation, abdominal pain, excessive bleeding. Blood stasis with hard masses causing intermittent pain. Instability in pregnancy with continuous bleeding, and postpartum lochia not expelling, leading to hard masses in the lower abdomen with intermittent cold and heat.
Formula Explanation: This formula is the main prescription for nourishing blood and regulating menstruation, derived from Qiong Gui Jiao Ai Tang in the Jin Kui Yao Lue (Essentials of the Golden Chamber) by removing A Jiao, Ai Ye, and Gan Cao (Licorice). It serves as a foundational formula for various blood deficiency syndromes, adjusted according to symptoms.
Chong is the sea of blood, and Ren governs the uterus. If the Chong pulse is deficient, women may experience scanty menstrual flow, pale color, and delayed periods.
If there is cold stagnation in the lower jiao, abdominal pain may occur. If the spleen is deficient and cannot hold blood, or if the kidney is deficient and the Chong and Ren are unstable, symptoms such as excessive bleeding may follow.
Additionally, if there is liver cold and blood stagnation, blood flow may be obstructed, leading to hard masses and pain in the lower abdomen and around the navel.
This formula uses Dang Gui to nourish and invigorate blood; Shu Di Huang primarily nourishes blood; Chuan Xiong regulates the qi in the blood; Bai Shao nourishes blood and astringes yin. Thus, the entire formula belongs to blood-nourishing herbs. However, the combination is appropriate, nourishing blood without causing stagnation, moving blood without breaking it, and balancing nourishment and dispersal, forming a key formula for treating blood.
Modification Methods:
1. If there is blood cold with abdominal pain during menstruation, consider adding Pao Jiang (dried ginger), Gui Zhi (cinnamon twig), Wu Yu (evodia), Zhi Ke (bitter orange), Xiang Fu (cyperus), Sang Ji Sheng (mulberry mistletoe), and Xu Duan (dipsacus) to warm cold, regulate qi, move blood, and relieve pain.
2. If there is instability in pregnancy with bleeding, add A Jiao, stir-fried Ai Ye, and roasted Gan Cao to create Xiong Gui Jiao Ai Tang.
3. If there is blood stasis, add Dan Shen (salvia), Tao Ren (peach kernel), and Hong Hua (safflower) to promote blood circulation and eliminate stasis.
4. If there is blood deficiency with heat, add Huang Qin (scutellaria) and Dan Pi (moutan root).
5. If there is qi deficiency unable to hold blood, add Lu Dang Shen (codonopsis), Huang Qi (astragalus), and Bai Zhu (white atractylodes).
In summary, this formula can be modified according to symptoms to address various blood conditions.
2. Sheng Yu Tang (Holy Recovery Decoction)《医宗金鉴》
Composition: Shu Di Huang (20g), Bai Shao (15g) mixed with wine, Chuan Xiong (8g), Ren Shen (20g, generally using Lu Dang Shen), Dang Gui (15g) washed with wine, Huang Qi (18g).
Take with water decoction.
Function: Benefits qi, nourishes blood, and holds blood.
Indications: Early menstruation with heavy and pale flow, fatigue in limbs, and general weakness. This syndrome is due to qi and blood deficiency, unable to hold blood, hence Si Wu Tang is used to nourish and regulate blood, supplemented with Ren Shen and Huang Qi to benefit qi and hold blood.
3. Tao Hong Si Wu Tang (Peach Blossom Four Substance Decoction)《医宗金鉴》
Composition: Shu Di Huang (15g or use Gan Di Huang 15g), Chuan Xiong (8g), Bai Shao (10g) stir-fried, Dang Gui (12g), Tao Ren (6g), Hong Hua (4g).
Decoct and take three times a day, finishing in one day.
Function: Nourishes blood, invigorates blood, and eliminates stasis.
Indications: Women with early menstruation, heavy flow, purple color, thick consistency, or clots, with abdominal pain and distension.
This formula nourishes and invigorates blood with Si Wu Tang and adds Tao Ren and Hong Hua to promote blood circulation and eliminate stasis. When blood flows smoothly, abdominal pain and distension will subside. However, this formula is strong in its action to break blood stasis, so it should not be taken excessively, as overuse may lead to excessive bleeding or heavy menstrual flow.
4. Dang Gui Bu Xue Tang (Dang Gui Blood Supplement Decoction)《内外伤辨惑论》
Composition: Huang Qi (30g), Dang Gui (6g) washed with wine.
Dosage: Grind into a single dose, decoct until one cup, strain and take warm on an empty stomach before meals (modern usage: decoct three times, take on an empty stomach in the morning, noon, and evening).
Function: Tonifies qi and generates blood.
Indications: Internal injury from overwork, qi weakness, blood deficiency, floating yang. Symptoms include hot skin, red face, thirst, desire to drink, and a large but weak pulse, as well as women with menstrual issues and postpartum blood deficiency with fever and headache. Also for non-healing sores after ulceration.
Formula Explanation: This formula addresses internal injury from overwork, insufficient original qi affecting yin and blood, leading to floating yang. Symptoms include hot skin, red face, thirst, and a large but weak pulse. Therefore, it uses a formula to tonify qi and generate blood.
Since tangible blood is generated from intangible qi, this formula emphasizes Huang Qi to greatly tonify spleen and lung qi, thus enriching the source of blood; it also uses Dang Gui to nourish blood and harmonize the nutrients, allowing yang to generate yin and qi to promote blood generation.
As Wu He Gao stated, “Tangible blood cannot generate itself; it is generated from intangible qi” (from Ming Yi Fang Lun), which serves as the theoretical basis for this formula.
For women with menstrual issues, postpartum blood deficiency with fever and headache, this formula benefits qi and nourishes blood to reduce fever. For non-healing sores after ulceration, this formula nourishes qi and blood, promoting tissue regeneration and healing.
The symptoms presented by this formula are quite similar to those of Bai Hu Tang (White Tiger Decoction) with a large pulse, thirst, fever, and red face, but upon careful examination, there are strict distinctions between the two.
The pulse in Bai Hu syndrome is large and full, with great thirst and a preference for cold drinks, high fever, and profuse sweating, which are the characteristics of the “Four Greats” of Bai Hu syndrome. In contrast, the pulse in Dang Gui Bu Xue syndrome is large but weak, with thirst and a preference for warm drinks, and while the body is hot, it is not excessively high, with no profuse sweating.
Therefore, when using this formula, it is essential to distinguish between the two aspects of heat in the Yangming channel and qi weakness with blood deficiency, as well as floating yang. If the diagnosis is unclear, using this formula may not only be ineffective but may also lead to adverse effects of “false deficiency” or “false excess”.
5. Gui Pi Tang (Restore the Spleen Decoction)《济生方》
Composition: Bai Zhu (30g), Fu Shen (30g) without wood, Huang Qi (30g) without reed, Long Yan Rou (30g), Suan Zao Ren (30g) stir-fried, Ren Shen (15g), Mu Xiang (15g) without fire, Gan Cao (8g) stir-fried, Dang Gui (3g), Yuan Zhi (3g) honey-fried (both Dang Gui and Yuan Zhi are added from Jiao Zhu Fu Ren Liang Fang).
Dosage: Grind and take 4 qian (12g) each time, with 1.5 cups of water, 5 slices of ginger, and 1 date, decoct until reduced to 70%, strain and take warm, without time restrictions.
Modern Usage: Add 6g of fresh ginger and 3-5 dates, decoct and take. Alternatively, adjust the dosage ratio to make honey pills, each pill weighing about 15g, taken on an empty stomach, with warm water, three times a day).
Function: Benefits qi, nourishes blood, strengthens the spleen, and nourishes the heart.
Indications:
1. Deficiency of both heart and spleen. Excessive thinking and worry injure the heart and spleen, leading to insufficient qi and blood. Symptoms include palpitations, forgetfulness, insomnia, night sweats, weakness, poor appetite, pale yellow complexion, pale tongue, thin white coating, and weak pulse.
2. Spleen not governing blood. Symptoms include blood in stools, excessive menstrual flow, or prolonged menstrual bleeding, or leukorrhea.
Formula Explanation: This formula primarily treats deficiency of both heart and spleen.
The heart houses the spirit and governs blood, while the spleen governs thought and controls blood. Excessive thinking and worry injure the heart and spleen, leading to spleen qi deficiency, resulting in fatigue, poor appetite, and heat; heart blood depletion leads to palpitations, forgetfulness, insomnia, and night sweats; pale yellow complexion, pale tongue, thin white coating, and weak pulse are all signs of insufficient qi and blood.
The treatment should focus on benefiting qi and nourishing blood, strengthening the spleen, and nourishing the heart.
The formula includes Ren Shen, Huang Qi, Bai Zhu, Gan Cao, Ginger, and Jujube to warm and tonify the spleen and benefit qi; Dang Gui nourishes the liver and generates heart blood; Fu Shen, Suan Zao Ren, and Long Yan Rou calm the heart and nourish the spirit; Yuan Zhi connects the heart and kidney to calm the mind; Mu Xiang regulates qi and awakens the spleen to prevent the tonifying herbs from causing stagnation, which would hinder the spleen and stomach’s function.
Thus, this formula simultaneously nourishes the heart and strengthens the spleen, integrating qi tonification and blood nourishment.
The spleen governs blood and holds it; if spleen qi is deficient, it cannot control blood, leading to blood in stools; in women, this results in instability of the blood sea, causing excessive menstrual flow or prolonged bleeding; if the spleen is deficient and cannot transport dampness, it leads to leukorrhea.
This formula can benefit spleen qi, support spleen yang, and nourish liver blood, thus treating the aforementioned symptoms of blood in stools, excessive menstrual flow, and leukorrhea.
Modern applications of this formula include treating neurasthenia, heart disease, anemia, functional uterine bleeding, and thrombocytopenic purpura, as long as the diagnosis is heart and spleen deficiency, with modifications based on symptoms, it has shown significant efficacy.
Gui Pi Tang was first recorded in the Song Dynasty by Yan Yonghe in Ji Sheng Fang, used to treat excessive thinking and worry injuring the heart and spleen, leading to forgetfulness and palpitations.
In the Yuan Dynasty, Wei Yilin expanded on this formula in Shi Yi De Xiao Fang, which not only recorded the original indications but also supplemented treatments for spleen not governing blood, leading to bleeding.
In the Ming Dynasty, Xue Lizhai added Dang Gui and Yuan Zhi to the original formula, which has been used ever since.
In the Qing Dynasty, Wang Ren’an expanded its application range in Yi Fang Ji Jie, subsequently using it for palpitations, night sweats, poor appetite, women’s leukorrhea, and intestinal wind bleeding. These adaptations were gradually perfected by later physicians through clinical practice.
This formula shares the qi tonifying function with Buxin Yi Qi Tang, but the differences lie in:
First, the composition differs; this formula combines qi tonification and spleen strengthening with heart nourishing and calming, aiming to strengthen the spleen and nourish the heart, restoring its function of governing blood and generating blood; while Buxin Yi Qi Tang combines qi tonification and spleen strengthening with uplifting sinking yang, aiming to tonify qi and elevate, restoring its function of clearing and descending.
Second, the indications differ; this formula primarily treats heart and spleen deficiency and spleen not governing blood, with symptoms of palpitations, forgetfulness, poor appetite, and blood in stools; while Buxin Yi Qi Tang primarily treats spleen and stomach qi deficiency with symptoms of fever, fatigue, shortness of breath, and sinking.
6. Zhi Gan Cao Tang (Honey-Fried Licorice Decoction)《伤寒论》
Composition: Gan Cao (12g), honey-fried Sheng Jiang (9g), sliced, Ren Shen (6g), Sheng Di Huang (30g), peeled Gui Zhi (9g), A Jiao (6g), Mai Men Dong (10g), without heart, Ma Ren (10g), Da Zao (5-10 pieces).
Dosage: Combine the nine ingredients with 7 sheng of clear wine and 8 sheng of water, first boil the eight ingredients, take three sheng, strain, and dissolve the A Jiao, take one sheng warm, three times a day.
Modern Usage: Retain A Jiao, mix the other herbs, decoct, and pour out the juice, adding 10ml of clear wine. Separately, slightly boil A Jiao with a little water to dissolve, then mix into the herbal juice and take in three doses. One dose is decocted three times, finishing in one day).
Function: Benefits qi, nourishes yin, supplements blood, and restores pulse.
Indications:
1. Qi deficiency and blood weakness. Symptoms include pulse showing knots or intermittent beats, palpitations, weakness, shortness of breath, pale tongue, and scanty fluids.
2. Deficiency labor lung atrophy. Symptoms include dry cough without phlegm, or phlegm not much with blood streaks, thin body, shortness of breath, insomnia, spontaneous sweating or night sweats, dry throat, and constipation, or heat during deficiency.
Formula Explanation: This formula is used in Shang Han Lun for treating “pulse knots and palpitations.” The clinical manifestation of pulse knots is as described in Bin Hu Mai Xue: “Knotted pulse, slow and intermittent; intermittent pulse, moves and then stops, unable to return, and then moves again.”
This syndrome is caused by yang deficiency unable to circulate pulse qi, and yin deficiency unable to nourish heart blood. Symptoms of restlessness and insomnia, pale tongue, and scanty fluids are also due to insufficient yin blood.
Therefore, the formula uses honey-fried licorice, Ren Shen, and Da Zao to benefit qi and nourish the heart and spleen; Sheng Di Huang, Mai Men Dong, A Jiao, and Ma Ren sweetly moisten and nourish yin, nourish the heart, and generate fluids.
Ginger, Gui Zhi, and wine are all warm in nature, with the function of warming yang and restoring pulse, and when combined with qi and yin nourishing herbs, they can warm without drying, and also promote the flow of qi and blood, ensuring the pulse is smooth. Together, they achieve the effects of benefiting qi, restoring pulse, nourishing yin, and supplementing blood.
For symptoms of qi and yin deficiency, such as dry cough, the use of this formula is beneficial for nourishing qi and yin to support the lungs, but for significant yin deficiency with lung dryness, the warming herbs should be used cautiously or avoided, as warming herbs can deplete yin fluids.
7. Jia Jian Fu Mai Tang (Modified Restore Pulse Decoction)《温病条辨》
Composition: Zhi Gan Cao (5g), Gan Di Huang (20g), Bai Shao (18g), Mai Men Dong (15g), without heart, A Jiao (10g), Ma Ren (10g).
Use 8 cups of water, boil to 8 parts, take 3 cups, divided into three doses.
If severe, increase Gan Cao to 30g, Gan Di Huang and Bai Shao to 24g, Mai Men Dong to 21g, take three times a day, one at night.
Modern Usage: Decoct three times a day, take on an empty stomach in the morning, noon, and evening. The decoction method for A Jiao is the same as for Zhi Gan Cao Tang.
This formula is derived from Zhi Gan Cao Tang by removing Ren Shen, Gui Zhi, Ginger, Da Zao, and Wine, and adding Bai Shao.
Function: Nourishes blood, astringes yin, generates fluids, and moistens dryness.
Indications: Yangming organ excess syndrome, after purging, the excess heat has been removed, but yin fluids are still deficient, presenting with “weak pulse, heat in the palms and soles more than on the back of the hands and feet.”
Thus, the formula takes the meaning of Zhi Gan Cao Tang but removes the warming and pungent ingredients, adding Bai Shao to create a purely yin and moistening formula.
Note: The above is for reference only; please adjust under the guidance of a physician.
Source: Content reproduced from the internet. If there is any infringement, please contact for deletion.