活血化瘀药 (Blood Activating and Stasis Resolving Herbs)
· Definition
Herbs that primarily promote blood circulation, dispel stasis, and are used to treat blood stasis syndromes are called 活血化瘀药 (huó xuè huà yū yào), or blood activating and stasis resolving herbs, abbreviated as 活血药 (huó xuè yào) or 化瘀药 (huà yū yào). Those with stronger blood activating effects are also referred to as 破血药 (pò xuè yào) or 逐瘀药 (zhú yū yào).
· Characteristics
活血化瘀药 (huó xuè huà yū yào) are generally pungent, bitter, and warm in nature, with some animal-derived herbs being salty, primarily entering the Heart (心, xīn) and Liver (肝, gān) meridians. The pungent flavor disperses and moves, while the bitter flavor promotes drainage, both entering the blood aspect, thus facilitating blood flow and resolving stasis.
· Classification and Indications
活血化瘀药 (huó xuè huà yū yào) can be classified into four categories based on their functional characteristics and clinical applications: blood activating and pain relieving herbs, blood regulating herbs, blood healing herbs, and stasis dispelling herbs.
PART 01
川芎 (Chuanxiong, Ligusticum chuanxiong)
Is the rhizome of the Umbelliferae plant Chuanxiong. It can be used fresh or stir-fried with wine.
This herb is pungent, warm, and enters the Liver (肝, gān), Gallbladder (胆, dǎn), and Pericardium (心包, xīnbāo) meridians. It has the effects of activating blood, promoting Qi (气, qì), and relieving pain. This herb is known as a “Qi herb in the blood” and can treat blood stasis and Qi stagnation pain syndromes. Chuanxiong is effective in regulating menstrual flow and relieving gynecological conditions, as well as treating headaches. It disperses and warms, alleviating wind and pain, and can also treat rheumatic pain.
Dosage: 3-9g.
Use with caution in cases of Yin deficiency with excess heat, excessive sweating, heat syndromes without stasis, and in pregnant women.
PART 02
延胡索 (Yanhusuo, Corydalis yanhusuo)
Is the dried tuber of the Papaveraceae plant Yanhusuo. It is harvested in early summer when the stems and leaves wither, removing the fibrous roots, washing, and boiling until the white core is gone, then drying. It can be sliced thickly or crushed, used fresh or stir-fried with vinegar.
This herb is pungent, bitter, and warm, entering the Liver (肝, gān), Heart (心, xīn), and Spleen (脾, pí) meridians. It has the effects of activating blood, regulating Qi, and relieving pain. It is used for chest and abdominal pain, limb pain, dysmenorrhea, and other symptoms. This herb has a weaker blood activating effect but a strong pain-relieving effect, treating both blood stasis pain and Qi stagnation pain. It can be used alone or combined with other herbs in decoctions for treating pain due to Qi and blood stasis. It is a commonly used pain-relieving herb, applicable for any type of pain syndrome. Dosage: 3-9g, powdered form taken at 1.5-3g per dose.
PART 03
郁金 (Yujin, Curcuma aromatica)
Is the tuber of the Zingiberaceae plant 温郁金 (Wēn yù jīn), turmeric, or Guangxi curcuma. It can be sliced or crushed, used fresh or stir-fried with alum water.
This herb is pungent, bitter, and cold, entering the Liver (肝, gān), Heart (心, xīn), and Lung (肺, fèi) meridians. It has the effects of promoting Qi, resolving stasis, clearing the heart, and relieving depression, as well as benefiting the gallbladder and reducing jaundice. It is used for amenorrhea, dysmenorrhea, chest and abdominal distension and pain, febrile diseases with delirium, epilepsy, and jaundice. It treats chest and flank pain, dysmenorrhea, amenorrhea, and masses due to Qi stagnation and blood stasis. Yujin clears the heart, cools the blood, and can be used for warm diseases with high fever; it clears heat, transforms phlegm, and opens the orifices for treating damp-heat obstructing the orifices, leading to confusion and phlegm-heat mania. This herb can regulate Qi and reduce fire while cooling the blood and stopping bleeding, treating conditions like hemoptysis, hematemesis, hematuria, and uterine bleeding due to blood heat. It is also commonly used for treating damp-heat jaundice and gallstones.
Dosage: 5-12g; powdered form taken at 2-5g.
Avoid with cloves.
PART 04
乳香 (Ruxiang, Boswellia carterii) and 没药 (Moyao, Commiphora molmol)
乳香 (Ruxiang) is the resin exuded from the bark of the olive family plant Boswellia. It is used fresh, often stir-fried. 没药 (Moyao) is the resin exuded from the bark of the Commiphora plant. It is used fresh, often prepared by stir-frying or vinegar frying.
Ruxiang is pungent, bitter, and moist, entering the Heart (心, xīn), Liver (肝, gān), and Spleen (脾, pí) meridians. It has the effects of dispersing blood, promoting Qi, relieving pain, and reducing swelling. It is used for traumatic injuries, sores, and abscesses. Ruxiang is a key herb in trauma treatment and can also be used for pain due to Qi stagnation and blood stasis. Experts believe that Ruxiang contains an unknown antibacterial substance that can kill Helicobacter pylori.
Moyao has similar effects and indications as Ruxiang. It is often used in conjunction with Ruxiang. The difference is that Ruxiang is more focused on promoting Qi and relaxing tendons, while Moyao is more effective in dispersing blood and resolving stasis, particularly for severe stomach pain due to blood stasis and Qi stagnation. Both herbs can be used for early-stage sores, red, swollen, and painful conditions, or for sores that have ulcerated and do not heal, as well as for hard phlegm masses that do not dissipate.
Dosage: 3-10g, preferably stir-fried to remove oil. For external use, apply an appropriate amount, either fresh or stir-fried, and ground for topical application.
Use with caution in those with weak stomachs, and avoid in pregnant women and those without stasis.
PART 05
五灵脂 (Wulingzhi, Excrement of the Three-toothed Rat)
Is the feces of the rodent family animal, the Three-toothed Rat. It can be used fresh or stir-fried with vinegar or wine.
This herb is bitter, salty, sweet, and warm, entering the Liver (肝, gān) meridian. It has the effects of activating blood, relieving pain, and stopping bleeding. It is used for stabbing pain in the chest and flanks, dysmenorrhea, amenorrhea, postpartum blood stasis pain, traumatic swelling and pain, and snake or insect bites. This herb is also effective for bleeding due to blood stasis obstructing the channels and blood not flowing properly.
Dosage: 3-10g, preferably wrapped in a decoction.
Use with caution in cases of blood deficiency without stasis and in pregnant women. According to the “Nineteen Avoidances,” ginseng is incompatible with Wulingzhi and should generally not be used together.