Han Xuejie: Three Levels and Three Formulas for Activating Blood and Resolving Stasis

Promoting Traditional Chinese Medicine, Inheriting the Lifeblood

Continuing the teachings of the sages, opening peace for all generations

The Qi Huang School of Traditional Chinese Medicine holds a crucial and significant position in traditional studies, being an inseparable part of it. Throughout the long river of history, it has condensed the wisdom of the Chinese people, contributing significantly over five thousand years to safeguard against disasters and ensure the prosperity of the Chinese nation. This long historical flow has also accumulated a wealth of medical civilization, becoming a brilliant pearl. Sharing the Qi Huang School’s medical arts daily aims to inherit and promote it, better benefiting humanity.

Blood Stasis Syndrome: The term “blood stasis syndrome” encompasses a broader range than “stasis of blood”. The symptoms arising from blood circulation disorders are referred to as blood stasis syndrome. In contrast, stasis of blood refers to blood that has deviated from the meridians, either overflowing from the vessels or accumulating in the skin, which is termed stasis of blood. This is a more specific syndrome. For instance, in gynecology, symptoms such as dark menstrual blood or dysmenorrhea indicate blood stasis syndrome.

Within blood stasis syndrome, there are several classifications, which we also refer to as the three generations of activating blood and resolving stasis. The naming can vary; it can be called whatever one wishes.

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 (Liquidambar orientalis) 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, what 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, and it can also 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, use a smaller amount; if there is no acid reflux, Chi Shao can be used in a larger amount, up to 20g. It can also help reduce transaminases in cases of jaundice; if transaminases are very high, then Chi Shao can be used in larger amounts. 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 also treat angina when blood vessels are obstructed. Ji Xue Teng 10g: Ji Xue Teng nourishes the blood. Shen Jin Cao 10g: Shen Jin Cao can also travel through fine meridians. It is particularly effective for blocked or hardened fallopian tubes; in cases of infertility, we may write that the fallopian tubes are open but not smooth or have become hardened, and Shen Jin Cao can help to open them. Lu Lu Tong 10g: People often ask where mushrooms and black fungus grow. They grow on what? On wet wood, decaying wood, right? They don’t grow on good wood, do they? They say, “Look at this woman; her ovaries and uterus tend to develop cysts and tumors, just like that decaying wood, damp and obstructed; you see, living wood definitely does not grow on it.” Right? This indicates obstruction.I suddenly understood! The fact that this woman tends to develop these things indicates she is 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 were opened, these issues did not recur, just like traffic; when there is a blockage, 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 like this; currently, there are many such cases. One is that she only has one child, and some need to undergo abortion; after the abortion, she may not expel everything, or the medical abortion may not be complete.Additionally, repeated abortions can lead to uterine congestion. When she is pregnant, the hormone levels are relatively high, and if you forcibly terminate the pregnancy, it is like she is in a state of joy, and you hit her with a stick to make her come to her senses; thus, her condition becomes unstable, and the fetus is not stable, making it easier for her to develop issues.Therefore, the increase in women’s diseases, especially gynecological diseases, is related to this. She may only have one child, have an IUD, or undergo artificial termination, all of which are related. Do you understand? So when using this, our professor told us a story, and many of these have their reasons. Thus, in gynecology, I particularly like to use Ji Xue Teng, Shen Jin Cao, and Lu Lu Tong; once they are unblocked, they will not get sick. When they are blocked, dampness comes, and unwanted growths appear, leading to nodules. Now, many women have pelvic effusion, right? Gynecological inflammation can also lead to pelvic effusion, and Western medicine’s anti-inflammatory drugs cannot resolve it. Do you know why there is effusion? It is because inflammation blocks it, and it slowly seeps out, leading to effusion, which does not get absorbed! Because the entire area is not open. “Leakage.” Right? The simple principle is called “leakage.” If it cannot pass through, it leaks; therefore, I say that one must open the meridians. In cases of pelvic effusion, add Bai Hua She She Cao (Oldenlandia diffusa).If a patient undergoes an ultrasound and finds inflammation in the abdominal cavity, for example, if the fallopian tubes are blocked or the uterus has inflammation, leading to pelvic effusion, add Bai Hua She She Cao 30g, and add Chao Ting Li Zi (Stellaria media) 10-30g to promote lung drainage and clear dampness.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; in Beijing, if the dosage of leeches exceeds 5g, you need to sign; if you want to use 60g of Chao Jiao Ren (Ziziphus jujuba), you need to sign for exceeding the dosage. Therefore, it is very strict. Right? This means that if you exceed the dosage and something happens, it is your responsibility. So 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 bit of San Leng (Sparganium) and E Zhu (Curcuma zedoaria); 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 effusion improve.There was a girl whose one fallopian tube was removed due to an ectopic pregnancy, and the other fallopian tube had effusion 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, and I couldn’t say she couldn’t. I cleverly comforted her. I said, “For someone like you, there is hope; when that hope will come, I do not know; 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 gynecological diseases, I say, “Especially for amenorrhea, I say I will treat you for a maximum of one year; if I cannot treat you in a year, I will not treat you anymore.” Why? If my level is not sufficient, I will change doctors.Then about five and a half months later, she came back, sitting there sighing, saying, “Oh, Doctor Han, it has been almost half a year, why am I not pregnant yet?” I said, “What can we do?” After saying that, about two weeks later, she came back and said, “Doctor Han, I am really pregnant.” She was overjoyed and sent me a photo of her son.This is what I mean: even in uncertain situations, you can encourage her. After saying that, I was also uncertain about whether I could cure her. Imagine, she had one fallopian tube removed, and the other had effusion and was completely blocked, yet I used these herbs I just mentioned to activate blood, resolve stasis, unblock the meridians, and promote lung drainage to let her flow.And I want to tell you that for blocked fallopian tubes and adhesions, it is advisable not to frequently attempt to unblock them. Why? Because different adhesions can worsen with repeated attempts, increasing the area of adhesion. Do you understand? After unblocking once, do not attempt to unblock again; you need to use Traditional Chinese Medicine. I tell patients, “You have already passed through; do not attempt to unblock again; if it is not smooth, I will adjust it for you.” Then after six months, she got pregnant, solving the problem. If she cannot get pregnant, she can go for artificial insemination or anything else. The more you try to unblock, the more painful it becomes because it cannot pass, which can worsen the situation; I want to remind everyone of this. Another example: a woman had been married for three years without getting pregnant, and her mother-in-law was unhappy, wanting 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. Doctor Han, can you help me?” I said, “I can help you.” She said, “If you can help me, write me a note to show my mother-in-law, saying not to divorce yet; I will first get treated, the doctor said it can be cured.”This is something I have never done; you diagnose the patient, what is the disease? “Write it down.” You say she can get pregnant, or else she will get divorced. You say, “How can I treat it?” I am a person who is kind-hearted. I said, “Okay, this disease can be treated with herbal adjustments to help her get pregnant.” 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%. Oh, just barely enough.I said, “Your husband also has issues; he needs to come for treatment too; I can extend your treatment time.” She asked, “How long will it take?” I said, “At least three months.” Then she wrote down the treatment needed, and I also wrote down the treatment. I said, “I have become the mediator for your family.” In total, this person took 45 doses of herbal medicine and then got pregnant. I still have her herbal prescription. 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 solve their psychological issues; the more anxious they are, the less likely they are to get pregnant. Why? Because of hormonal imbalances. Therefore, if you want to get pregnant with me, I first tell her, “Your body is not well; you cannot get pregnant now.” I inform her that she cannot get pregnant. Then she asks, “When can I get pregnant?” I say, “In three months.” Now, first adjust your body. What is this? A delaying tactic.Additionally, you should first suggest to her not to think about getting pregnant; just adjust her body. I have found that many people get pregnant in less than three months. Why? Because when their attention is diverted, ah! If they cannot get pregnant for now, then they cannot; they should do what they need to do, and many patients, this is a trick I teach you. Next time, if someone is eager to get pregnant, just tell her, “You need to adjust.” If you need to adjust, once the attention is diverted, she will quickly get pregnant.This girl took 45 doses and did not see me. I thought she might have changed doctors and did not see me again. At that time, I treated her for liver qi stagnation and phlegm-dampness because her emotions were poor, her appetite was bad, and she could not sleep. Then a girl came in and said, “Do you remember who so-and-so is?” Of course, I remember. Because I remember these two cases very clearly. I said, “What happened?” Now she is pregnant! Very good, so she came to introduce me. Wow! I said, “Victory.” These two patients, I never expected what the outcome would be; one had not gotten pregnant for three years, and the other had issues with both fallopian tubes, and I never expected they would get pregnant.So what I mean to say is that through effort and cooperation between the patient and you, anything can happen, and good outcomes can occur. If this patient is always thinking negatively, always worrying, “Oh, I cannot live anymore; what if this is an ectopic pregnancy?” Then it is over! She will basically not get pregnant. I said, “If you think of bad things every day, good things will not come; you must be happy.” Ah, as long as you suggest to the patient and give her confidence, that is the first step.

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. For the second generation, if the person has amenorrhea or scanty menstruation, I will use stronger herbs for activating blood and resolving stasis. For example, I can use a bit of 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 blood. Moreover, our San Qi powder is particularly noted for caution in pregnant women. Is that so?I tell you, during pregnancy, if there are signs of miscarriage, San Qi powder can be used, 1.5-3g; after taking it, it can treat her signs of miscarriage and help maintain the pregnancy.Yunnan Baiyao and San Qi powder can also be used; I have treated cases where after maintaining the pregnancy, there were no issues, but do not use large amounts, 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, at most twice a day, or once a day is also fine. In cases of threatened miscarriage, progesterone can also be administered; this is not a problem. Su Mu 10g: If the patient has obstructed blood vessels and abdominal distension, use Su Mu. Su Mu has the effects of activating blood, resolving stasis, and alleviating pain; it can be used for angina and abdominal pain, and it has a warming effect. Hong Hua 5-10g: If the effect of Su Mu is not good, use Hong Hua. For scanty menstruation, use 5-10g; start with 5g, and if it does not work, use 10g.For example, a woman I saw yesterday told me, “I have taken Hong Hua and leeches, but the effect is not good.” I said, “You are a stubborn old patient; it is very difficult to treat.” She wants to get pregnant; I treated the oldest woman, how old? 49 years old. She still wants to get pregnant, but her menstruation is normal. She flies from Guangzhou every time to see me, but I have a message on my phone; I do not know who sent it. It is not signed, saying, “Zhu Xiaobao was born smoothly, weighing so many pounds.” Who sent it? I do not know if it is this woman because I treated her for about half a year. So next time you send me a message, be sure to sign your name; otherwise, if you send me this Zhu Xiaobao, I know Zhu Xiaobao is the child’s name, but I do not know the adult’s name. You should clarify the names of the child and the adult.Use Hong Hua 5-10g. This herb has the effect of activating blood and breaking blood. If you want to get pregnant, do not use this herb; it can definitely lead to miscarriage.So every time I ask, “What kind of infertility is more difficult?” 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, you are sometimes afraid she wants to get pregnant, and it can easily cause miscarriage; what do you do? I thought of a trick: when the patient comes on her period, I give her 10g to take for four or five days, then stop. At that time, you will not say I gave her something that caused a miscarriage, right? But it can still regulate the menstrual flow, so I always write Hong Hua (in a package), to be taken when menstruation starts; do not use it before menstruation starts, but immediately when menstruation begins, this is clear, right? That is why Hong Hua is packaged at 10g.Additionally, for women with scanty menstruation, you can have them drink red wine every night, about one or two taels, a small cup; some people bleed when they drink red wine, as they are very sensitive, so for scanty menstruation, they should drink red wine. They should drink it gradually every night. Additionally, red wine is the essence of grains, calming and inducing sleep, and after drinking red wine, the skin looks good; red wine also warms the body. So, for those with scanty menstruation who want to get pregnant, when menstruation starts, give them this herb. San Leng and E Zhu, I generally use one of them; if one does not work, I use both. However, when using them, you must 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 menstruation, it is very stubborn. I have treated several women with this condition. E Zhu can also be used for esophageal cancer; it can be used for those with difficulty swallowing. I tell you, I generally use San Leng, E Zhu, and Hong Hua; for mild amenorrhea, it works within a week or two, but for stubborn cases, it may take two to three months without effect; this is very difficult to treat. So now I observe the patient’s condition; I generally use Hong Hua when menstruation starts, and if it does not come, I use San Leng, E Zhu, and Hong Hua together. Some people have treated a whole cycle without improvement; after taking your three doses, they feel better. If menstruation can come within a month, it is relatively easy to adjust; if menstruation does not come for two or three months, it is very difficult to adjust; she may not even respond to Western medicine. Do you understand? So 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 after an allergic reaction, the effect may worsen, so I rarely use them.Di Long (Earthworm): For numbness in the feet and hands, or for hypertension, Di Long can lower blood pressure, unblock the meridians, and relieve asthma. If this person is allergic, using Di Long may worsen their asthma. Do you understand? What do you do? I write a note saying “package”. Sometimes, to be cautious, I write a note. First, use 5g; you tell them not to add Di Long the first time; add it the second time, and if they feel uncomfortable after taking it, remove it.I treated an elderly man in his 50s with pulmonary fibrosis; he had used steroids and other Western medicines, but they were ineffective, and he was severely short of breath. However, I tell you, “I will not use insect-based herbs the first time; generally, I use them in the third or fourth treatment.” I gave him Hong Hua because pulmonary fibrosis hardens the lungs, and his lung ventilation function was significantly reduced, so I needed to activate blood and unblock 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 wanted to try, so I prescribed 5g of Di Long and said, “You package it.” I told him not to drink it the first day; drink it the second day to compare. He said, “The next day, after taking it, I felt worse and more short of breath.” I said, “Then do not take it.” Later, I continued to adjust, 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 I mentioned that 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 are all smelly, so after boiling, it is unbearable, so I grind it into powder and put it in capsules. When putting it in capsules, 3g is enough; if boiled in water, use 5g, and let the patient take it warm, not too hot; if it is too hot, they will vomit, so it must be taken at least 40 minutes after meals; this is for Shui Zhi. It is suitable for the heart, blood vessels, and high blood pressure with high blood lipids. Tu Yuan 10g: However, Teacher Shen rarely uses it now. He said, “This herb crawls out of the soil; it can easily grow mold sometimes.” So 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; moreover, foreign proteins can cause allergies; if the patient does not respond well, it will be your responsibility.”I told Teacher Shen about it, and I was not very daring to use them. Now, sometimes I use just one; I might use one leech or one insect. Why do I use them? Because some diabetic patients have heel pain; I first use Di Long, and he said it felt a bit better, but not completely; then I added Shui Zhi, and he felt a bit better, but not fully recovered; then I switched to centipedes or scorpions, do you understand? Teacher Shen saw it and scolded me.I said, “I am also being cautious now!” When I use them, I sometimes use Shui Zhi with Hong Hua or Shui Zhi with Dan Shen; I will use one insect-based herb; or use Di Long with Hong Hua; or just use Hong Hua. Do you understand? So if the patient needs it, you observe their reaction.Now, in clinical practice, there are many people with heel pain; one is due to bone spurs, and the other is 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 (Mulberry) to warm the kidney and unblock the blood; simply using insect-based herbs is not enough; just after using them, they may feel better, but over time, they will revert to their 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. This is specifically for treating lower back pain, and using Chao Bai Zhu in foot baths 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 by warming and unblocking the meridians, after the patient soaks their feet, they 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; when using it for the first time, if you are not sure, you can package it; you ask the patient if they feel uncomfortable after taking this medicine? If not, then you do not need to package it next time; this is the responsibility of a doctor to be cautious! This is blood stasis.Follow the WeChat public account Guoxue Sui for more content.

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