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Mr. Jiang Chunhua has formulated the Eighteen Methods for Activating Blood and Resolving Stasis based on his rich clinical practice. These methods include: Activating Blood and Clearing Heat, Activating Blood and Detoxifying, Activating Blood and Nourishing Qi, Activating Blood and Nourishing Blood, Activating Blood and Nourishing Yin, Activating Blood and Assisting Yang, Activating Blood and Regulating Qi, Activating Blood and Purging, Activating Blood and Cooling Blood, Activating Blood and Stopping Bleeding, Activating Blood and Opening Orifices, Activating Blood and Promoting Urination, Activating Blood and Resolving Phlegm, Activating Blood and Unblocking Meridians, Activating Blood and Expelling Wind, Activating Blood and Softening Hardness, Activating Blood and Attacking Hardness, and Activating Blood and Expelling Cold. These combinations not only reflect a pioneering spirit but also comprehensively illustrate the dialectical application of activating blood and resolving stasis in the treatment of blood stasis syndrome, which holds significant guiding importance.
1. Activating Blood and Clearing Heat, and Activating Blood and Detoxifying
Mr. Jiang believes that internal heat toxins can cause blood stasis; conversely, blood stasis can also generate heat and toxins. When blood stasis and heat toxins are intermingled, it results in the syndrome of stasis-heat or stasis-toxicity, which should be treated with a combination of activating blood and resolving stasis with clearing heat or detoxifying. Common herbs for clearing heat include Huang Qin (Scutellaria baicalensis), Huang Bai (Phellodendron amurense), Zhi Mu (Anemarrhena asphodeloides), Da Huang (Rheum palmatum), Yang Ti (Hibiscus sabdariffa), Shi Gao (Gypsum), Di Gu Pi (Lycium barbarum), Qing Hao (Artemisia annua), Chai Hu (Bupleurum chinense), and Lian Qiao (Forsythia suspensa); for detoxifying, common herbs include Yin Hua (Lonicera japonica), Lian Qiao (Forsythia suspensa), Guan Zhong (Cynanchum atratum), Zao Xiu (Houttuynia cordata), Pu Gong Ying (Taraxacum mongolicum), Ban Lan Gen (Isatis indigotica), Da Qing Ye (Isatis tinctoria), Sheng Ma (Cimicifuga foetida), and Bai Jiang Cao (Patrinia scabiosaefolia).
In cases of chronic hepatitis or liver cirrhosis with elevated alanine aminotransferase (ALT), using only clearing heat and detoxifying herbs is often ineffective. Mr. Jiang believes this is related to the intermingling of blood stasis and heat toxins, advocating for the combined use of activating blood and resolving stasis with clearing heat and detoxifying methods. Commonly used herbs include Sheng Chuan Jun (Corydalis yanhusuo), Tao Ren (Prunus persica), Di Bie Chong (Eupolyphaga sinensis), Zi Shen (Scutellaria baicalensis), Dan Shen (Salvia miltiorrhiza), Yang Ti (Hibiscus sabdariffa), Tian Ji Huang (Hedyotis diffusa), Gang Ren Gen (Hedyotis diffusa), Chi Bai Shao (Paeonia lactiflora), and Pu Gong Ying (Taraxacum mongolicum). This combination often improves liver function and leads to a significant decrease in ALT levels.
In cases of acute exacerbation of chronic nephritis, symptoms may include fever, sore throat, redness and swelling, dry mouth, short and turbid urination, thin yellow tongue coating, and rapid pulse, indicating acute infection with heat toxin symptoms, along with renal area percussion pain, lower back pain, and edema, indicating blood stasis. Mr. Jiang often uses a combination of Sheng Di (Rehmannia glutinosa), Dan Shen (Salvia miltiorrhiza), Chi Shao (Paeonia lactiflora), Yin Hua (Lonicera japonica), Lian Qiao (Forsythia suspensa), Mao Gen (Imperata cylindrica), Liu Yue Xue (Duchesnea indica), Pu Huang (Typha angustifolia), Huang Bai (Phellodendron amurense), Mu Tong (Akebia quinata), and Yi Mu Cao (Leonurus japonicus) for the treatment of nephritis diagnosed as blood stasis and heat intermingling, which has shown significant efficacy.
The methods of activating blood and clearing heat, as well as activating blood and detoxifying, have been experimentally proven to improve microcirculation in affected areas, facilitating the penetration of anti-infection medications into infected lesions, enhancing antibacterial and detoxifying effects. Additionally, they can regulate the body’s response, enhance immune capacity, and achieve anti-infection effects based on improving overall and local blood circulation. Mr. Jiang points out that some herbs possess both activating blood and resolving stasis and clearing heat and detoxifying properties, such as Lei Gong Teng (Tripterygium wilfordii), Kunming Shan Hai Tang (Begonia), Zi Shen (Scutellaria baicalensis), Bai Hua She She Cao (Hedyotis diffusa), Hong Teng (Sargentodoxa cuneata), Bai Jiao Cao (Patrinia scabiosaefolia), and Luo De Da (Lonicera japonica), which can effectively treat both stasis-heat and stasis-toxicity.
2. Activating Blood and Nourishing Qi
The method of activating blood and nourishing Qi is used for the syndrome of Qi deficiency and blood stasis, with symptoms including palpitations, shortness of breath, fatigue, pale complexion, facial swelling, chest pain, or side pain, or slight purple tongue, with a fat and tender tongue, and thin, rough, or intermittent pulse. Mr. Jiang often adds Dang Shen (Codonopsis pilosula), Huang Qi (Astragalus membranaceus), and Bai Zhu (Atractylodes macrocephala) to the activating blood and resolving stasis herbs. For example, when treating coronary heart disease, Mr. Jiang points out that most cases of angina pectoris and myocardial infarction exhibit varying degrees of heart Qi deficiency and blood stasis symptoms, characterized by increased blood viscosity and left ventricular dysfunction. Common prescriptions include Bai Ren (Panax ginseng), Huang Qi (Astragalus membranaceus), Wu Wei Zi (Schisandra chinensis), and Huang Jing (Polygonatum sibiricum) to nourish Qi and support the righteous Qi, enhancing cardiac function; along with Dan Shen (Salvia miltiorrhiza), Gua Lou (Trichosanthes kirilowii), Tan Xiang (Santalum album), Hong Hua (Carthamus tinctorius), Chuan Xiong (Ligusticum chuanxiong), Dang Gui (Angelica sinensis), and Tao Ren (Prunus persica) to activate blood and resolve stasis, acting on blood vessels to increase coronary blood flow. The efficacy is superior to using activating blood herbs alone.
3. Activating Blood and Nourishing Blood
The method of activating blood and nourishing blood is used when blood stasis has not been resolved and new blood has not been generated, indicating blood stasis combined with blood deficiency. Tang Rongchuan once said: “If blood is not nourished, how can stasis be completely resolved? … Both nourishing and purging should be done simultaneously; once stasis is resolved, the righteous Qi will not be harmed.” Mr. Jiang’s experience shows that in cases of blood stasis with anemia, symptoms may include dizziness, pale complexion, pale tongue, pale lips, and weak pulse. If only activating blood and resolving stasis is used, symptoms are difficult to improve. The method of activating blood and nourishing blood can be expected to enhance efficacy. Common herbs include Dan Shen (Salvia miltiorrhiza), Dang Gui (Angelica sinensis), Shu Di (Rehmannia glutinosa), Chuan Xiong (Ligusticum chuanxiong), Tao Ren (Prunus persica), Niu Xi (Achyranthes bidentata), Ji Xue Teng (Spatholobus suberectus), Chi Bai Shao (Paeonia lactiflora), Long Yan Rou (Dimocarpus longan), E Jiao (Colla corii asini), He Shou Wu (Polygonum multiflorum), Qi Zi (Lycium barbarum), Bie Jia (Trionyx sinensis), and Dang Shen (Codonopsis pilosula). This formula has been used to treat several cases of chronic aplastic anemia, resulting in significant improvement in blood counts.
4. Activating Blood and Nourishing Yin
The method of activating blood and nourishing Yin is used for the syndrome of Yin deficiency with insufficient blood and poor circulation, characterized by symptoms such as emaciation, dry mouth, red tongue, and little coating. Common herbs include Shu Di (Rehmannia glutinosa), E Jiao (Colla corii asini), Xuan Shen (Scrophularia ningpoensis), Mai Dong (Ophiopogon japonicus), Tian Dong (Asparagus cochinchinensis), and Shi Hu (Dendrobium nobile). In cases of Yin deficiency and blood stasis seen in tuberculosis, Yue Hua Wan can be used; in cases of stubborn hepatitis and liver cirrhosis, Tong You Decoction can be used; in cases of coronary heart disease, Sheng Mai Yin and Dan Shen Decoction can be used; in cases of lupus erythematosus, Mr. Jiang uses Sheng Di (Rehmannia glutinosa), Xuan Shen (Scrophularia ningpoensis), Tian Hua Fen (Trichosanthes kirilowii), Chi Bai Shao (Paeonia lactiflora), He Shou Wu (Polygonum multiflorum), Ji Xue Teng (Spatholobus suberectus), Dang Gui (Angelica sinensis), Dan Pi (Moutan cortex), Tian Mai Dong (Ophiopogon japonicus), Shi Hu (Dendrobium nobile), Zhi Bie Jia (Trionyx sinensis), Zhi Gui Ban (Testudinis Carapax), and Gong Lao Ye (Gonglao leaf). From the perspective of blood rheology, patients with Yin deficiency and blood stasis have higher blood viscosity compared to normal individuals and those with Yin deficiency and blood stasis. Clinically, after using nourishing Yin and activating blood and resolving stasis formulas, the whole blood viscosity can significantly decrease, showing better efficacy than using activating blood and resolving stasis alone.
5. Activating Blood and Assisting Yang
The method of activating blood and assisting Yang is used for blood stasis syndrome combined with spleen and kidney Yang deficiency, and internal cold, characterized by symptoms such as pale and dull complexion, purple lips, abdominal distension, limb swelling, soft and doughy upon palpation, preference for warmth and aversion to cold, cold limbs, pale purple tongue or pale tongue with stasis spots, and deep, slow pulse. Mr. Jiang often combines warming herbs such as Rou Gui (Cinnamon), Fu Zi (Aconitum carmichaelii), Cong Rong (Cistanche deserticola), Xian Mao (Curculigo orchioides), Xian Ling Pi (Epimedium), Suo Yang (Cynomorium songaricum), and Lu Rong (Cervus nippon) with activating blood and resolving stasis herbs such as Dan Shen (Salvia miltiorrhiza), Chuan Xiong (Ligusticum chuanxiong), Tao Ren (Prunus persica), Hong Hua (Carthamus tinctorius), and Niu Xi (Achyranthes bidentata). Experimental evidence confirms that the combination of Yang-assisting herbs and activating blood herbs not only enhances blood circulation but also stimulates and strengthens the functions of multiple systems in the body. This aligns with the principle stated in the “Su Wen: Treatise on Regulation of Menstruation” that “blood and Qi prefer warmth and dislike cold; cold prevents blood from flowing, while warmth promotes its movement.”
6. Activating Blood and Regulating Qi
The method of activating blood and regulating Qi is used for blood stasis and Qi stagnation syndrome. Mr. Jiang believes that Qi is the commander of blood; blood follows Qi in its movement, and Qi stagnation leads to blood stasis, but blood stasis can also cause Qi stagnation. As Qing Wang Yutai stated: “There cannot be Qi stagnation without blood being harmonized; if blood is not harmonized, Qi will become more stagnant.” Therefore, activating blood and resolving stasis formulas often include Qi-regulating herbs. Mr. Jiang points out that Qi-regulating herbs and activating blood herbs often have synergistic effects. For example, Qi herbs in blood include Chuan Xiong (Ligusticum chuanxiong), Yu Jin (Curcuma longa), Jiang Huang (Curcuma zedoaria), E Zhu (Curcuma zedoaria), Yan Hu Suo (Corydalis yanhusuo), Jiang Xiang (Dalbergia odorifera), Ru Xiang (Boswellia carterii), and Mo Yao (Commiphora molmol); while blood herbs in Qi include Xiang Fu (Cyperus rotundus), Chai Hu (Bupleurum chinense), Mu Xiang (Aucklandia lappa), Xie Bai (Allium macrostemon), She Xiang (Moschus), Tan Xiang (Santalum album), Chen Xiang (Aquilaria sinensis), and Mei Gui Hua (Rosa rugosa). For patients with blood stasis and Qi stagnation presenting with chest tightness, abdominal distension, and pain from hernias, the combination of activating blood and resolving stasis with Qi-regulating herbs can provide smooth regulation of smooth muscles in different organs, relieve spasms and pain, expel gas, and improve blood circulation, achieving a complementary effect.
7. Activating Blood and Purging
The method of activating blood and purging is used for blood stasis with interior excess syndrome. Zhang Zhongjing first proposed the treatment principles for blood stasis and purging to resolve stasis, listing formulas such as Tao Ren Cheng Qi Decoction, Di Dang Decoction, Di Dang Pill, and Xia Yu Xue Decoction. The purging and activating blood method is currently commonly used for various acute abdominal conditions, such as appendicitis, pancreatitis, cholecystitis, cholelithiasis, intestinal obstruction, and ectopic pregnancy. Since the six fu organs function through communication, if there is a physical accumulation and stagnation combined with cold and heat, Qi and blood become obstructed, leading to internal stasis of heat or cold stasis, which can cause abnormal descent of the fu Qi and result in disease. Mr. Jiang often adds Sheng Da Huang (Rheum palmatum) and Mang Xiao (Sodium sulfate) to activating blood and resolving stasis formulas, and for cold conditions, he adds Fu Pian (Aconitum carmichaelii) and Gan Jiang (Zingiber officinale), while for heat conditions, he adds Huang Lian (Coptis chinensis), Dan Pi (Moutan cortex), and Shan Zhi (Gardenia jasminoides) to promote the descent of fu Qi and disperse stasis, showing significant efficacy for acute abdominal conditions.
8. Cooling Blood and Activating Blood
The method of cooling blood and activating blood is used for blood heat and blood stasis syndrome. When pathogenic heat penetrates deeply into the Ying and blood, it can cause coagulation and stasis, obstructing the Ying and blood, leading to symptoms such as skin purpura, dark purple color, and severe cases may present with bleeding, fever, and mental confusion, with a red or dark purple tongue and no coating, and a thin, rapid pulse. It is advisable to use cooling Ying and blood, along with activating blood and resolving stasis. Common herbs for this purpose include Dan Pi (Moutan cortex), Shan Zhi (Gardenia jasminoides), Xi Jiao (Rhinoceros horn), and Sheng Di (Rehmannia glutinosa). Mr. Jiang believes that cooling blood and activating blood can clear blood heat and calm the vessels, allowing stasis to disperse and blood to return to the meridians. Especially in the treatment of warm diseases, he advocates using cooling blood and resolving stasis for severe warm diseases such as septicemia, epidemic hemorrhagic fever, and viral encephalitis at the stage of Qi and Ying heat, without waiting for the pathogenic heat to penetrate into the blood. When the pathogen first enters the Ying, a large dose of Qing Wen Bai Du Decoction combined with Dan Shen to cool blood and resolve stasis can intercept the pathogen early, achieving a proactive approach. Clinical observations have shown the following effects: (1) it can control or prevent bleeding, such as epistaxis, hematuria, and subcutaneous bleeding; (2) it reduces or prevents coma and convulsions; (3) it is beneficial for controlling high fever and shortening the duration of illness. Therefore, cooling blood and activating blood is beneficial for clearing Ying heat and intercepting pathogens, preventing warm pathogens from entering the blood and causing blood movement, depleting blood and injuring Yin. These viewpoints further expand the indications for the use of cooling blood and activating blood, and hold significant importance for treating acute infectious diseases and shortening the course of illness.
9. Activating Blood and Stopping Bleeding
The method of activating blood and stopping bleeding is used for various bleeding conditions, which are both a cause of blood stasis and a symptom of blood stasis. After bleeding, the blood that has left the meridians may not be expelled from the body, accumulating and becoming blood stasis, which obstructs the vessels, preventing blood from circulating properly, leading to continuous bleeding. On the other hand, if the speed of blood flow is slow or the blood is viscous and altered, it can also lead to blood leaving the meridians. Therefore, Tang Rongchuan stated: “For any vomiting or bleeding, regardless of whether it is fresh or dark, always prioritize removing stasis first.” The characteristics of bleeding due to blood stasis include repeated bleeding, dark purple blood with clots, or fresh blood mixed with dark purple clots, accompanied by stasis pain symptoms, which can be seen in various bleeding syndromes in both the hematological and non-hematological systems, such as hematemesis, hemoptysis, melena, and menorrhagia. Common prescriptions often include San Qi (Panax notoginseng), Pu Huang (Typha angustifolia), Qian Cao Gen (Rubia cordifolia), Di Yu (Sanguisorba officinalis), Mao Gen (Imperata cylindrica), Da Huang (Rheum palmatum), and Bai Ji (Bletilla striata) in activating blood and resolving stasis formulas.
10. Activating Blood and Opening Orifices
The method of activating blood and opening orifices is suitable for the syndrome of stasis-heat intermingling and obstruction of the heart orifices, commonly seen in cases of viral encephalitis, meningitis, severe septicemia, toxic hepatitis, acute cerebrovascular disease, and uremic coma. Yu Genchu once said: “When heat invades the pericardium, causing mental confusion, it is either phlegm obstructing the heart or stasis blocking the heart orifices.” Due to the internal invasion of pathogenic heat, the heart orifices become obstructed, presenting with symptoms such as coma, inability to speak, cyanosis of lips, subcutaneous purpura resembling dark eggplant, cold limbs, or diarrhea with dark stools, purple or dark purple tongue, and a hidden pulse. It is urgent to open the orifices and activate blood. Mr. Jiang often adds Zhi Bao Dan (a traditional formula) to activating blood and resolving stasis herbs to promote unblocking, clear the brain vessels, and descend the turbid Yin to facilitate awakening of consciousness.
11. Activating Blood and Promoting Urination
The method of activating blood and promoting urination is used for cases where blood stasis is combined with water retention, such as ascites, edema, and difficulty in urination. Common herbs added to activating blood and resolving stasis formulas include Fu Ling (Poria cocos), Ze Xie (Alisma orientale), Che Qian Zi (Plantago asiatica), Chen Hu Lu (Trichosanthes kirilowii), Chong Sun (Cynanchum atratum), and Xu Sui Zi (Plantago asiatica).
12. Activating Blood and Resolving Phlegm
The method of activating blood and resolving phlegm is used for cases where blood stasis is combined with phlegm, such as subcutaneous nodules, facial asymmetry, and limb paralysis. Common herbs added to activating blood and resolving stasis formulas include Nan Xing (Arisaema cumingii), Ban Xia (Pinellia ternata), Fu Ling (Poria cocos), Chen Pi (Citrus reticulata), and Bai Fu Zi (Typhonium giganteum).
13. Activating Blood and Unblocking Meridians
The method of activating blood and unblocking meridians is used for blood stasis obstructing the meridians, such as liver and spleen enlargement, venous obstruction, and hemiplegia. Common herbs added to activating blood and resolving stasis formulas include Di Long (Lumbricus), Pao Shan Jia (Manis pentadactyla), etc.
14. Activating Blood and Expelling Wind
The method of activating blood and expelling wind is used for blood stasis combined with wind, such as joint pain. This follows the principle of “treating wind by first activating blood; when blood flows, wind will naturally dissipate.” Therefore, activating blood herbs are heavily used along with Fang Feng (Saposhnikovia divaricata), Qin Jiao (Gentiana macrophylla), Du Huo (Angelica pubescens), Chuan Wu (Aconitum carmichaelii), Jiang Huang (Curcuma longa), etc.
15. Activating Blood and Softening Hardness
The method of activating blood and softening hardness is used for softening and dissipating hard masses, such as thyroid nodules. Common herbs added to activating blood and resolving stasis formulas include Kun Bu (Laminaria japonica), Hai Zao (Sargassum), and Mu Li (Oyster); for spleen enlargement, add Bie Jia (Trionyx sinensis), Ze Lan (Lycopus lucidus), and Shi Jian Chuan (Lycopus lucidus); for breast fibromas, add Yu Jin (Curcuma longa) and Xiao Jin Dan (Corydalis yanhusuo).
16. Activating Blood and Attacking Hardness
The method of activating blood and attacking hardness is used for severe blood stasis and dryness, such as hard abdominal masses in robust patients. Common herbs include Shui Zhi (Hirudo), Meng Chong (Stomobomus), San Leng (Sparganium stoloniferum), E Zhu (Curcuma zedoaria), Chuan Shan Jia (Manis pentadactyla), and Shu Fu (Scolopendra).
17. Activating Blood and Unblocking Yang
The method of activating blood and unblocking Yang is used for blood stasis with Yang Qi not being expressed, such as chest Yang obstruction and chest pain. Common herbs added to activating blood and resolving stasis formulas include Gui Zhi (Cinnamon), Ban Xia (Pinellia ternata), Sheng Jiang (Zingiber officinale), Xi Xin (Asarum sieboldii), Cong Bai (Allium fistulosum), and Xie Bai (Allium macrostemon), Gua Lou (Trichosanthes kirilowii).
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