The condition of xue yu zheng (blood stasis syndrome) is broader than that of yu xue zheng (stasis blood syndrome). The symptoms caused by blood circulation obstruction are referred to as xue yu zheng. Yu xue zheng specifically refers to blood that has left the meridians, or has overflowed from the meridians or is lodged in the skin or exuded from the skin. It is a more specific syndrome. In gynecology, for example, symptoms like dark menstrual blood and dysmenorrhea indicate yu xue zheng. Within yu xue zheng, there are several classifications, which we also refer to as the three generations of activating blood and resolving stasis. The naming is flexible, and one can choose any name they prefer.
First Generation of Activating Blood and Resolving Stasis Herbs:
Dan Shen (Salvia miltiorrhiza) 30g, Chi Shao (Red Peony Root) 10g, Ze Lan (Lycopus lucidus) 10g, Ji Xue Teng (Spatholobus suberectus) 40g, Shen Jin Cao (Herba Asari) 10g, Lu Lu Tong (Liquidambaris Fructus) 10g.
In the first generation of activating blood and resolving stasis herbs, we have Dan Shen 30g, Chi Shao 10g, Ze Lan 10g, Ji Xue Teng 40g, Shen Jin Cao 10g, and Lu Lu Tong 10g.
Dan Shen is generally used at 30g. Some people ask me, “Teacher Han, if this person has a lot of bleeding, I am afraid to use 30g of Dan Shen, can I use 10g instead?” Yes, you can use a smaller amount, or if you are concerned about bleeding, you can omit it.
Chi Shao 10g: It has the effect of activating blood, resolving stasis, and alleviating pain. Additionally, Chi Shao can lower transaminases. When liver function is poor and transaminases are elevated, Chi Shao should be used, and the dosage can be increased to 20g or 30g, which is very effective for liver diseases. However, Chi Shao is slightly sour, so if the patient experiences acid reflux, it should be used in smaller amounts. If there is no acid reflux, Chi Shao can be used in larger amounts, such as 20g. It can also help reduce transaminases in cases of jaundice; if transaminases are very high, then Chi Shao can be used in larger quantities.
Ze Lan: Ze Lan has the effects of activating blood, resolving stasis, and promoting urination. It is especially effective in treating gynecological diseases, as Ze Lan can activate blood, resolve stasis, and open the meridians. Additionally, Ze Lan can treat angina when blood stasis occurs in the heart.
Ji Xue Teng 10g: Ji Xue Teng has nourishing blood and invigorating blood effects.
Shen Jin Cao 10g: Shen Jin Cao can also navigate through fine meridians. It is particularly effective for blocked or hardened fallopian tubes, which can occur in cases of infertility. It can help to open the fallopian tubes.
Lu Lu Tong 10g: People often ask where mushrooms and black fungus grow. They grow on damp, decaying wood, not on good wood, right? They say, “Look at these women, their ovaries and uterus often develop cysts and tumors, just like that decaying wood, damp and obstructed. You see, living wood definitely does not grow anything.” This indicates obstruction. I suddenly understood! The fact that these women develop these things indicates they are obstructed, with qi and blood not flowing, and dampness present. Therefore, when treating gynecological diseases, it is essential to open the meridians, dry dampness, and resolve phlegm. I later applied this story in my clinical practice, and the results were indeed good. Once the meridians are open, they do not develop these issues, just like traffic; when there is a jam, no one can pass, but once it is cleared, everyone can go quickly. If it is blocked, not even one vehicle can pass; this is the principle. Gynecological diseases are particularly prevalent now. One reason is that women may only have one child, and some may undergo abortions. After an abortion, they may not expel everything, or the medication may not clear everything. Additionally, repeated abortions can lead to uterine congestion. When they are pregnant, hormone levels are relatively high, and if you forcibly terminate the pregnancy, it is like taking away something they are happy about, and they only realize it afterward. Therefore, their condition becomes unstable, and the fetus is not stable, making it easier for them to develop issues. This is why there are so many gynecological diseases in women today. They may only have one child, use an IUD, or undergo artificial termination, all of which are related. Do you understand? Therefore, when using this treatment, our professor told us a story that has some truth to it.
So, in gynecology, I particularly like to use Ji Xue Teng, Shen Jin Cao, and Lu Lu Tong. Once they are unblocked, they do not get sick. When they are blocked, dampness comes, and unwanted growths develop, leading to nodules. Now, many women have pelvic fluid accumulation, right?
Gynecological inflammation can also lead to pelvic fluid accumulation, and Western medicine’s anti-inflammatory drugs do not resolve it. Do you know why there is fluid accumulation? It is because inflammation blocks the area, and it slowly seeps out, leading to fluid accumulation that does not get absorbed! Because the entire area is not open, it is called “leakage.” Right? The simple principle is called “leakage.” If it cannot pass through, it leaks. Therefore, I say that one must open the meridians. When there is pelvic fluid accumulation, add Bai Hua She She Cao (Oldenlandia diffusa) 30g. If the patient has inflammation in the abdominal cavity, for example, if the fallopian tubes are blocked or there is inflammation in the uterus causing pelvic fluid accumulation, add Bai Hua She She Cao 30g and Chao Ting Li Zi (Stellaria dichotoma) 10-30g, to promote lung drainage and clear dampness, allowing the fluids to be re-circulated. In Beijing, if you want to use Chao Ting Li Zi 30g, you must have a name stamp; just having a stamp is not enough, and in Beijing, if the leech exceeds 5g, you must sign. If you want to use 30g of Chao Jiao Ren (Ziziphus jujuba), you must sign if you want to use 60g; exceeding the limit requires a signature, so it is very strict. Right? This means that if you exceed the limit and something happens, it is your responsibility. Therefore, I want to remind everyone that there is a function of activating blood, resolving stasis, and unblocking the meridians. Simply activating blood and resolving stasis is not enough.
You say I will use a little San Leng (Sparganium) and E Zhu (Curcuma zedoaria), but if you do not unblock the meridians, the effect will still be poor. When activating blood and resolving stasis, it is essential to use herbs that unblock the meridians; only then can gynecological inflammation and fluid accumulation improve.
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There was a girl whose one fallopian tube was removed due to an ectopic pregnancy, and the other fallopian tube had fluid accumulation and was blocked. She wanted to get pregnant, but Western medicine told her, “Your chances of getting pregnant are almost zero.” Then she came to me, very eager to get pregnant. I cannot tell her she cannot get pregnant! I cleverly comforted her. I said, “In your case, there is hope, but I do not know when that hope will come. I am not a fortune teller; I cannot predict.” Right? Then the patient asked, “Can you give me an estimate of how long?” I said, “At least six months.” If I cannot treat you in six months, I will not treat you anymore. In my gynecological practice, I say, “Especially for amenorrhea and similar conditions, I say I will give you a maximum of one year; if I cannot treat you in a year, I will not treat you anymore.” Why? If my skills are not sufficient, I will change practitioners. Then about five and a half months later, she came back, sitting there sighing, saying, “Oh, Dr. Han, it has been almost six months, why am I not pregnant yet?” I said, “What can we do?” After that, about two weeks later, she came back and said, “Dr. Han, I am really pregnant.” She was overjoyed and sent me a photo of her beautiful son. This is what I mean: even in uncertain situations, you can encourage the patient. I was not sure if I could cure her, but she had one fallopian tube removed and the other was blocked with fluid; I did not expect her to get pregnant. I just used the methods I mentioned earlier to activate blood, resolve stasis, unblock the meridians, and promote lung drainage to allow her to open up. Additionally, I want to tell you that if the fallopian tubes are blocked or adhered, it is advisable not to keep trying to unblock them. Why? If they are adhered, the more you try to unblock them, the more they will adhere, and the area will become larger. Do you understand? After unblocking once, do not try to unblock again; you need to use traditional Chinese medicine. I tell patients, “You have already passed that stage; do not try to unblock again. If it is not smooth, I will adjust your treatment.” After six months, she got pregnant and solved the problem. If she could not get pregnant, she could consider artificial insemination or other options. The more you try to unblock, the more painful it becomes because it cannot pass through, which can worsen the situation. I want to emphasize this point.
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Another example is a woman who had been married for three years without getting pregnant, and her mother-in-law was unhappy and wanted her husband to divorce her. Then her uncle brought this patient to me for treatment. She said, “I am so worried; I am about to get divorced. Dr. Han, can you help me?” I said, “I can help you.” She said, “If you can help me, write me a note to give to my mother-in-law, saying not to divorce me yet; I will first see the doctor, and the doctor said he can help me.” I have never done this before; how do you diagnose a patient? “Write it down.” You say you can get pregnant, or else you will get divorced. How do I treat this? I am a person who is kind-hearted. I said, “Okay, this condition can be treated with traditional Chinese medicine.” I wrote a note, and she took it back. Then she brought her husband’s test results, and I looked at them; his sperm vitality was just over 50%. I said, “Your husband also has issues; he needs to come for treatment too.” I said, “In this case, I can extend your treatment time.” She asked, “How long will it take?” I said, “At least three months.” While she was writing down the treatment plan, I said, “I have become the mediator for your family.” In total, this person took 45 doses of herbal medicine and then became pregnant. I still have her herbal formula. Why? Because of depression. I want to tell everyone that those who cannot get pregnant are often very anxious and depressed, under a lot of pressure. Therefore, for such people, you must address their mental state; the more anxious and tense they are, the less likely they are to get pregnant. Why? Because of hormonal imbalances. So, if someone comes to me wanting to get pregnant, I first tell them, “Your body is not well; you cannot get pregnant right now.” I inform them that they cannot get pregnant. Then they ask, “When can I get pregnant?” I say, “Three months from now.” First, we need to adjust the body. What is this? A delaying tactic. Additionally, I subtly suggest to them, “Do not think about getting pregnant for now; focus on adjusting your body.” I have found that many people get pregnant within three months. Why? Because when their attention is diverted, they think, “Oh! If I cannot get pregnant, then I cannot get pregnant; I will do what I need to do.” Many patients have experienced this; this is a trick I am teaching you. Next time, if someone is eager to get pregnant, tell them, “You need to adjust your body first.” Once they adjust their focus, they often get pregnant quickly. This girl took 45 doses and did not see me for a while. I thought she might have changed doctors and not come back. Then one day, a girl came in and said, “Do you remember so-and-so?” Of course, I remember. Because of these two cases, I remember very clearly. I asked, “What happened?” She said, “I am pregnant now!” I was thrilled and said, “Victory!” I never expected the outcome of these two patients; one had not gotten pregnant for three years, and the other had issues with both fallopian tubes. I did not expect them to conceive. What I want to convey is that through effort and cooperation between the patient and the doctor, anything is possible, and good outcomes can occur. If the patient is always thinking negatively, thinking, “Oh, I cannot live like this; what if I have an ectopic pregnancy?” then they will not get pregnant. I said, “If you keep thinking about bad things, good things will not come. You must stay positive.”
Second Generation of Activating Blood and Resolving Stasis Herbs:
Hong Hua (Carthamus tinctorius) 5-10g, Su Mu (Sappan wood) 10g, San Qi (Notoginseng) powder 3-6g, San Leng (Sparganium) 10g, E Zhu (Curcuma zedoaria) 10g.
The second generation, if the patient has amenorrhea or scanty menstruation, I will use stronger herbs for activating blood and resolving stasis. For example, I can use a little San Qi; a small amount of 3g has the effect of nourishing and activating blood, while 6g has the effect of activating blood and resolving stasis without breaking the blood. Additionally, our San Qi powder should be noted that it should be used with caution in pregnant women. Is that right? I tell you, during pregnancy, if there are signs of miscarriage, San Qi powder can be used at 1.5-3g; after taking it, it can treat threatened miscarriage and help maintain the pregnancy. Yunnan Baiyao and San Qi powder can be used; I have treated this before, and after maintaining the pregnancy, there were no issues. However, do not use a large amount; do not exceed 3g. Generally, use 1.5g. One dose of San Qi powder is 3g; you can give her half a dose at a time, and at most, take it twice a day or once a day.
Su Mu 10g: If the patient has blood circulation issues and abdominal distension, use Su Mu. This herb activates blood, resolves stasis, and alleviates pain, and can be used for angina and abdominal pain. This herb has a warming and unblocking effect.
Hong Hua 5-10g: If the effect of Su Mu is not good, use Hong Hua. If the menstrual flow is still very scanty, use 5-10g; start with 5g, and if that does not work, use 10g. For example, a woman I saw yesterday told me, “I have used Hong Hua and leeches, but the effect is not good.” I said, “You are a stubborn case; it is very difficult to treat.” She wants to get pregnant, and I treated an older woman who was 49 years old and still wanted to get pregnant, but her menstruation was still normal. She flies from Guangzhou every time to see me, but I received a message on my phone that I do not know who sent it. It said, “Zhu Xiaobao has successfully been born, weighing so many grams.” Who sent me this? I do not know if it was this woman because I treated her for about six months. So next time you send me a message, be sure to indicate your name; otherwise, if you send me a message about Zhu Xiaobao, I will know that Zhu Xiaobao is the name of the child but not the adult’s name. You must clarify the names of the child and the adult so I know whose child it is. Use Hong Hua 5-10g. This herb has the effect of activating blood and breaking blood. If someone wants to get pregnant, do not use this herb, as it can definitely lead to miscarriage. Therefore, I always ask:“What type of infertility is more difficult to treat? It is those who want to get pregnant but have scanty menstruation; using this herb is not a problem.”Using other herbs like Ji Xue Teng, Su Mu, and Dan Shen is almost ineffective, so for those with scanty menstruation, it is necessary to use Hong Hua. However, if you are concerned that they want to get pregnant, it can easily lead to miscarriage; what do you do? I thought of a trick: when the patient gets their period, I give them 10g to take for four or five days, then stop. At that time, you will not say that I gave you something that caused a miscarriage, right? But it can still help regulate the menstrual flow. Therefore, I always write Hong Hua (in a package), and when the period comes, do not use it; as soon as the period starts, use it immediately. Do you understand why Hong Hua needs to be packaged in 10g? Additionally, for women with scanty menstruation, I suggest they drink red wine every night, about a small cup, one or two taels. Some people may experience bleeding after drinking red wine, as they are very sensitive, so for those with scanty menstruation, they should drink red wine. They should drink it gradually. Furthermore, red wine is the essence of grains, it calms and induces sleep, and after drinking red wine, the skin looks good, and it warms the body. So, for those with scanty menstruation who want to get pregnant, as soon as their period comes, I give them this herb.
San Leng and E Zhu: I generally use one of these two herbs; if one does not work, I use both together. However, when using them, I tell the patient to take them after meals because these herbs can be irritating; if taken on an empty stomach, they may cause vomiting. For example, E Zhu can be used for dysmenorrhea and scanty menstruation. Sometimes I use San Leng, E Zhu, and Hong Hua together; for those with insufficient menstrual flow, it can be very stubborn. I have treated several women with this condition.E Zhu can also be used for esophageal cancer.It can be used for esophageal cancer and swallowing difficulties. I tell you, I generally use San Leng, E Zhu, and Hong Hua together; for mild amenorrhea, it can be effective in one to two weeks, but for stubborn cases, it may take two to three months without effect, which is very difficult to treat. Therefore, I now observe the patient’s condition; I generally start with Hong Hua when the period comes. If Hong Hua does not come, I will use San Leng, E Zhu, and Hong Hua together. Some people have gone through a full cycle of treatment without improvement, but after taking your three doses of medicine, they feel better. If menstruation can come within a month, it is relatively easy to adjust; if menstruation does not come for two to three months, it becomes very difficult to adjust, and they may not be able to get it even with Western medicine. Do you understand? Therefore, you need to know the severity of the patient’s condition. This is the category of activating blood and resolving stasis that I use more frequently, about 95% of the time.
Third Generation of Activating Blood and Resolving Stasis Herbs:
The third generation consists of insect-based herbs. I use insect-based herbs very cautiously in clinical practice because modern people are very sensitive; some may have allergies, and if they have an allergic reaction, the effect may worsen, so I rarely use them.
Di Long (Earthworm): It is effective for numbness in the feet and hands, or for patients with hypertension. Di Long can lower blood pressure, unblock the meridians, and relieve asthma. If a person is allergic, using Di Long may worsen their asthma. What do you do? I write a note saying “package”. Sometimes, to be cautious, I write “package”. First, use 5g, and tell them not to add Di Long the first time; add it the second time and see how they feel. If they feel uncomfortable after taking it, remove it.
I treated an elderly man in his 50s with pulmonary fibrosis. He had used Western medicine with hormones, but it was ineffective; he was very short of breath. However, I tell you:“I will not use insect-based herbs the first time; generally, I will use them in the third or fourth treatment.”I used Hong Hua for him because pulmonary fibrosis causes the lungs to harden, and his lung ventilation function was significantly reduced. Therefore, to tonify qi and promote circulation, I activated blood and unblocked the meridians. I used Hong Hua, and the effect was quite good. He said, “I still feel a bit short of breath.” I was bold and decided to try; I prescribed 5g of Di Long and told him to package it. I told him not to drink it the first day, but to drink it the next day to compare. He said, “After taking it the next day, I felt worse and had more difficulty breathing.” I said, “Then you cannot take it.” After that, I continued to adjust his treatment, and the effect was quite good.
Shui Zhi (Leech): Shui Zhi is similar; animal-based herbs are all foreign proteins, which can have both good and bad effects. Shui Zhi activates blood, resolves stasis, and unblocks the meridians. It is especially suitable for numbness in the limbs, and for women with amenorrhea, especially overweight women, if the above herbs do not work, I will add Shui Zhi 3-6g; I generally use 5g. However, this herb has a strong odor; animal-based herbs tend to smell bad. After boiling, the smell can be unbearable, so I grind it into powder and put it in capsules. When using capsules, 3g is enough; if boiled in water, use 5g, and let the patient take it warm, not too hot, as it may cause vomiting. Therefore, it is essential to have the patient take it at least 40 minutes after a meal.
Tu Yuan 10g: However, Teacher Shen rarely uses it now. He said, “This herb crawls out of the soil and can easily grow mold.” Therefore, I do not use it now. I used to be quite bold and used all insect-based herbs, including centipedes. Once, I used three insect-based herbs, and Teacher Shen saw it and scolded me: “You are quite bold; I do not use them this way; you used three insect-based herbs at the same time.” He said, “Insect-based herbs are toxic, and foreign proteins can cause allergies. If the patient does not respond well, you will have to deal with the consequences.”
I told Teacher Shen that I was cautious. Now, I sometimes use just one insect-based herb, like Shui Zhi, or use it with another herb. Why? Because some diabetic patients have heel pain; I first use Di Long, and they say it feels a bit better but not completely. Then I add Shui Zhi, and they feel a bit better but not fully recovered. Then I switch to centipedes or scorpions. Do you understand? Teacher Shen saw this and scolded me. I said, “I am also being cautious now!” Sometimes I use Shui Zhi with Hong Hua or Shui Zhi with Dan Shen; I will use one insect-based herb or just use Hong Hua. Do you understand? Therefore, when patients need treatment, observe their reactions.Currently, there are many patients with heel pain, one due to bone spurs and another due to postpartum wind-cold. Therefore, in addition to using Di Long and Shui Zhi, you must also use Chuan Duan (Euphorbia) and Sheng Du Zhong (Eucommia) and Sang Ji Sheng (Taxillus) to warm yang and promote blood circulation. Simply using insect-based herbs is not enough; after using them, the condition may improve temporarily, but over time, it may return to the original state, so it is essential to tonify kidney yang.
Chuan Duan: This herb is particularly effective for the waist and below the legs. Chuan Duan 10g, Sheng Du Zhong 10g, Sang Ji Sheng 10g, Chao Bai Zhu 10-30g. It is specifically used to treat lower back pain, and soaking feet in water with Chao Bai Zhu is effective for heel pain and leg numbness. Why? Because as people age, they first feel it in their feet; the twelve meridians start from the feet, so soaking the feet helps to warm and unblock the meridians. After soaking, patients feel very comfortable, especially those who are sensitive to cold and numbness in their feet. Using one insect-based herb is sufficient, so I want to remind everyone to be cautious. The first time you use it, if you are not sure, you can package it. Ask the patient if they feel uncomfortable after taking the medicine. If not, you do not need to package it next time. This is the responsibility of a doctor; you must be cautious! This is about blood stasis.
Copyright Statement
This article is excerpted from the internet. Author: Han Xuejie.
Note:All the herbal formulas and prescriptions mentioned in this article are for reference and learning purposes only and should not be used as prescriptions. Please do not use them blindly; this platform does not bear any responsibility for any consequences arising from this. Always follow medical advice and do not self-diagnose.
Xinglin Moxiang
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