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If a formula can resolve a hundred or eighty diseases, it can be considered a remarkable formula that has “gone viral.” In reality, is there such a classic remedy that can “cure all diseases”? Naturally, there are, such as many formulas among the “Top Ten Famous Formulas in Traditional Chinese Medicine (TCM)” that possess this capability.Among the “Top Ten Famous Formulas in TCM,” the one closest to our era is the Xuefu Zhuyu Decoction by the Qing Dynasty physician Wang Qingren..
The Xuefu Zhuyu Decoction is derived from Wang Qingren’s “Yilin Gai Cuo” and is primarily composed of “Tao Ren (Peach Kernel) 12g, Dang Gui (Angelica Sinensis), Sheng Di Huang (Rehmannia), Hong Hua (Safflower), Niu Xi (Achyranthes) 9g each, Zhi Ke (Bitter Orange), Chi Shao (Red Peony), Gan Cao (Licorice) 6g each, Jie Geng (Platycodon), Chuan Xiong (Szechuan Lovage) 4.5g each, Chai Hu (Bupleurum) 3g” and other Chinese herbs[1], decocted in water for oral administration. The original dosage is as stated, and modern dosages can also be calculated based on the original formula (1 qian is approximately 3 grams). Upon closer examination of the Xuefu Zhuyu Decoction, one will find that it is composed of the Tao Hong Si Wu Decoction (with Sheng Di Huang replaced by Shu Di Huang and Chi Shao replaced by Bai Shao) combined with Si Ni San (with Zhi Ke replaced by Zhi Shi) plus Jie Geng and Niu Xi. Although it is a relatively new formula, it possesses unique characteristics, not only inheriting from the Han and Tang dynasties but also closely linked to the Song and Yuan dynasties.The Tao Hong Si Wu Decoction (Dang Gui, Shu Di Huang, Chuan Xiong, Bai Shao, Tao Ren, Hong Hua) is also a classic formula with a convoluted history, originally sourced from the Yuan Dynasty’s “Yi Lei Yuan Rong,” emphasized in the Ming Dynasty’s “Yu Ji Wei Yi,” and formally named in the Qing Dynasty’s “Yi Zong Jin Jian.” The primary function of the Tao Hong Si Wu Decoction is to invigorate blood, dispel stasis, nourish blood, and promote qi circulation. Meanwhile, Si Ni San (Chai Hu, Shao Yao, Zhi Shi, Gan Cao) is passed down from the medical sage Zhang Zhongjing and primarily functions to harmonize the liver and spleen, dispel pathogenic factors, and soothe the liver while regulating the spleen. Both of these formulas are top-tier in their own right, and Wang Qingren combined them, adding a guiding herb that promotes downward movement, creating the “Xuefu Zhuyu Decoction,” which “shocked” the TCM community!
The Xuefu Zhuyu Decoction is established on the principle of “promoting qi and invigorating blood,” with remarkable clinical efficacy. Its high application frequency, broad usage scope, and treatment of numerous conditions demonstrate its excellent clinical practical value, thus earning it the title of the ‘Top Formula for Activating Blood and Resolving Stasis’[2]. Moreover, the Xuefu Zhuyu Decoction is the only classic formula selected among the many formulas from the Ming and Qing dynasties to be included in the “Top Ten Famous Formulas in TCM.” This shows that the Xuefu Zhuyu Decoction truly has a “main character aura.” So, what “unknown” secrets lie within the composition of this formula, which is hailed as the “Top Formula for Activating Blood and Resolving Stasis”? The conventional interpretation of the entire formula’s composition is as follows: the Tao Ren and Hong Hua are the monarch herbs, primarily functioning to break blood stasis, invigorate blood, and alleviate dryness and pain; Chi Shao, Chuan Xiong, and Niu Xi are the minister herbs, mainly serving to invigorate blood, dispel stasis, and relieve pain; Sheng Di Huang, Dang Gui, Jie Geng, Zhi Ke, and Chai Hu are the assistant herbs, primarily nourishing blood, invigorating blood, broadening the chest, promoting qi circulation, and soothing the liver to relieve depression; Gan Cao is the envoy herb, mainly harmonizing the other herbs. However, there are differing opinions, as Niu Xi and Jie Geng in the formula are guiding herbs and can also serve as assistant or envoy herbs, which may lead to new variations in the monarch-minister-assistant-envoy hierarchy. Nevertheless, in terms of the entire formula, the combination of herbs is indeed exceptional. Dang Gui, Shao Yao, Chuan Xiong, and Di Huang are known as the “first formula for gynecology,” and by replacing Shu Di Huang with Sheng Di Huang and Bai Shao with Chi Shao, this adjustment primarily enhances the ability to cool blood and invigorate blood. Additionally, the classic herb pair of Tao Ren and Hong Hua enhances the effects of invigorating qi and blood, dispelling stasis, unblocking meridians, and alleviating pain. Chai Hu functions to “soothe the liver and relieve depression, and expel pathogenic factors,” while replacing the Zhi Shi with Zhi Ke in Si Ni San primarily aims to take advantage of the idea that “Zhi Ke is slower while Zhi Shi is faster,” thereby reducing the speed and intensity of “regulating qi, relieving depression, and dispelling heat and resolving masses.” This combination is already quite powerful, but with the addition of Jie Geng and Niu Xi as guiding herbs, it can reach the entire body. Jie Geng carries the medicine upward, while Niu Xi directs blood downward, and the combination of these two herbs primarily functions to achieve “simultaneous treatment of qi and blood, and coordination of ascending and descending.”[3].
The Xuefu Zhuyu Decoction, with its complete composition, not only adheres to the physiological relationship of “qi movement leads to blood movement” but also considers the pathological interaction of “qi stagnation leads to blood stasis.” The Xuefu Zhuyu Decoction employs a combination of multiple blood-invigorating herbs with a small amount of qi-regulating herbs, enhancing the clinical efficacy through mutual reinforcement and complementarity. This is not only the success of this formula but also holds practical value for clinical prescription and medication. The composition of this formula reflects the characteristics of “simultaneous regulation of qi and blood, nourishing while invigorating, and simultaneous ascending and descending,” and also contains the scientific connotation of modern pharmacology in combined medication, fully demonstrating the profound and extensive theory of TCM compatibility.[2]Although the Xuefu Zhuyu Decoction is a relatively young formula, it is undoubtedly a timeless classic. Modern pharmacological research on it is gradually deepening. Pharmacological studies have found that the Xuefu Zhuyu Decoction has various pharmacological effects, including lowering blood pressure, anti-arrhythmic effects, lowering blood lipids, anti-atherosclerosis, and anti-myocardial ischemia; improving blood rheology, improving microcirculation, inhibiting platelet aggregation, promoting hematopoiesis; anti-inflammatory, analgesic, enhancing immunity, anti-tumor, anti-fibrosis, and anti-hypoxia effects.[4] It is not difficult to see that the Xuefu Zhuyu Decoction can indeed be applied in multiple fields and targets in clinical practice, making it a truly remarkable formula. So, what clinical conditions can the Xuefu Zhuyu Decoction be applied to? Generally speaking, it can be used for various diseases in internal medicine, surgery, urology, gynecology, otorhinolaryngology, orthopedics, dermatology, cardiovascular system, endocrine system, digestive system, nervous system, and urinary reproductive system, especially for various headaches, insomnia, cardiovascular and cerebrovascular diseases, and gynecological diseases, showing good clinical efficacy. Overall, the Xuefu Zhuyu Decoction has varying degrees of therapeutic effects on “blood stasis syndrome” caused by various reasons, with over 110 diseases treated, including internal, external, gynecological, pediatric, dermatological, and otorhinolaryngological conditions[2], making it truly capable of “curing all diseases!”
The clinical efficacy of the Xuefu Zhuyu Decoction is commendable, but its modifications must also be approached with caution. So, how is the Xuefu Zhuyu Decoction generally modified? Generally speaking, if there is blood stasis pain entering the meridians, one can add herbs such as Quan Xie (Scorpion), Shan Jia (Armored Scorpion), and Di Long (Earthworm) to enhance the effect of unblocking the meridians. One can also add herbs like San Leng (Sparganium), E Zhu (Curcuma), Feng Chong (Fly Larva), and Shui Zhi (Leech) to enhance the blood-breaking power. If qi stagnation is more severe, one can add herbs like Xiang Fu (Cyperus) and Qing Pi (Green Tangerine Peel) to enhance the effect of soothing the liver and regulating qi, or add Chuan Lian Zi (Toosendan) and Xuan Hu Suo (Corydalis) to enhance the effects of invigorating blood and relieving pain. If there are masses or accumulations in the chest and surrounding areas, one can appropriately add herbs like Dan Shen (Salvia), Wu Gong (Centipede), Shui Zhi (Leech), and Yu Jin (Curcuma) to enhance the effects of invigorating blood, dispelling stasis, and resolving masses. If a female experiences amenorrhea or dysmenorrhea due to blood stasis, one can remove Jie Geng from the formula and add Xiang Fu, Ze Lan (Lycopus), Ma Bian Cao (Verbena), and Yi Mu Cao (Leonurus) to enhance the effects of regulating qi, invigorating blood, and alleviating pain. Reviewing the Xuefu Zhuyu Decoction, its core is blood stasis, so it is essential to recognize the basic characteristics of blood stasis in clinical practice. Generally speaking, the characteristics of blood stasis in the Xuefu Zhuyu Decoction mainly include five points:First is pain, characterized by stabbing pain; Second is abnormal sensations in the chest; Third is emotional changes, such as feelings of oppression and irritability; Fourth is sleep abnormalities, such as frequent dreams at night, insomnia, and restlessness; Fifth is fever, especially “cold on the outside, heat on the inside” (also known as lantern disease).[5] Of course, blood stasis syndrome can also be identified through tongue diagnosis, where dark red tongue or stasis spots is a significant reference indicator. In summary, the Xuefu Zhuyu Decoction, as the most representative formula for activating blood and resolving stasis, is widely used in clinical practice. Blood stasis blockage in any part of the body can pose significant health risks, hence the saying “once blood stasis is resolved, hundreds of diseases disappear.” The Xuefu Zhuyu Decoction is indeed an outstanding formula capable of treating numerous diseases in modern clinical practice, and if used appropriately, it brings joy to both doctors and patients!References
[1] Qing Dynasty, Wang Qingren. Yilin Gai Cuo [M]. Beijing: People’s Health Publishing House, 2005.
[2] Lei Yan, Wang Junhui, Li Zhongwen. Overview of Experimental Research on the Composition and Modification of Xuefu Zhuyu Decoction [J]. Journal of Chinese Experimental Formulas, 2001, 7(6): 57-59.
[3] Liu Min, Tang Decai. Insights into the Significance of Guiding Herbs Jie Geng and Niu Xi in the Composition of Xuefu Zhuyu Decoction [J]. Liaoning Journal of Traditional Chinese Medicine, 2010, 37(12): 2326-2327.
[4] Shen Yingjun. Pharmacology of Chinese Medicine (2nd Edition) [M]. Beijing: People’s Health Publishing House, 2011.
[5] Zhang Dongmei. Wang Qingren’s Inherited Famous Formula [M]. Beijing: China Medical Science and Technology Press, 2013.Image and text source: Shen Xi Yuan
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