[Source]

The Corrected Records of the Forest of Medicine (醫林改錯)

 [Composition]

Peach Kernel, Safflower, Angelica Sinensis, raw Rehmannia, Sichuan Lovage Rhizome, Red Peony Root, Achyranthes Bidentata Root, Platycodon Grandiflorum Root, Bupleurum Root, Fructus Aurantii Immaturus, Licorice Root
(11)

 [Classification Group]

<Blood-tonifying>: Angelica Sinensis

<Clearing Heat and Cooling Blood>: raw Rehmannia

<Regulating Qi>: Fructus Aurantii Immaturus

<Tonifying Spleen and Middle Qi>: Licorice Root

<Releasing the Exterior with Acrid and Cool Herbs>: Bupleurum Root

<Invigorating Blood and Dispelling Stasis>: Safflower, Sichuan Lovage Rhizome, Red Peony Root, Peach Kernel, Achyranthes Bidentata Root

<Resolving Phlegm>: Platycodon Grandiflorum Root

[Rationale of the Formula]

From “Annotations on The Corrected Records of the Forest of Medicine” (《醫林改錯注解》): Xue Fu Zhu Yu Tang uses Peach Kernel, Safflower, Sichuan Lovage Rhizome, and Red Peony Root to invigorate blood and dispel stasis, combined with Angelica Sinensis and raw Rehmannia to invigorate blood and nourish blood, thus dispelling blood stasis without harming the blood. Bupleurum Root and Fructus Aurantii Immaturus soothe the Liver and regulate Qi; when Qi flows, blood flows. Achyranthes Bidentata Root breaks up blood stasis and unblocks meridians, guiding blood stasis downwards. Platycodon Grandiflorum Root enters the Lung channel, guiding the herbs upwards to exert their effects in the chest (blood mansion), and also opens up stagnant Qi in the chest and diaphragm, promoting the circulation of Qi and blood, aiding in the transformation and movement of blood stasis in the chest. When used with Fructus Aurantii Immaturus and Bupleurum Root, it is particularly effective in opening the chest and dissipating accumulations. Achyranthes Bidentata Root guides blood stasis downwards, one ascending and one descending, making the circulation of Qi and blood easier. Licorice Root moderates tension and connects all the meridians to harmonize the herbs. From “Formulas of Traditional Chinese Medicine” (《方劑學》): This formula was created by Wang Qingren to treat various symptoms caused by “blood stasis in the chest” (胸中血府血瘀), consisting of Tao Hong Si Wu Tang (桃紅四物湯) combined with Si Ni San (四逆散), with the addition of Platycodon Grandiflorum Root and Achyranthes Bidentata Root. The chest and hypochondria are where the Liver meridian passes. When blood stasis is in the chest, Qi is obstructed, leading to Liver depression and discomfort, manifesting as stabbing pain in the chest and hypochondria that is persistent, and irritability and anger. Prolonged stasis transforms into heat, and Qi stagnation transforms into fire, leading to internal heat and vexation, or palpitations and insomnia, or tidal fever in the afternoon and evening. It can ascend and disturb the clear orifices, causing headaches. It can invade the Stomach, disrupting its descending function, leading to dry heaving and belching, or even choking when drinking water. The signs seen in the lips, eyes, tongue, and pulse are all indicative of blood stasis. Therefore, the treatment should focus on invigorating blood and dispelling stasis, with concurrent regulation of Qi and alleviation of depression. The formula’s Tao Hong Si Wu Tang invigorates blood, dispels stasis, and nourishes blood. Si Ni San regulates Qi, harmonizes blood, and soothes the Liver. Platycodon Grandiflorum Root opens the Qi of the Lungs and guides the herbs upwards. Combined with Fructus Aurantii Immaturus, it regulates the Qi of the upper and middle Jiao and widens the chest. Achyranthes Bidentata Root especially facilitates blood circulation and guides blood downwards. These herbs cooperate to invigorate blood and promote Qi circulation, resolving stasis and clearing heat, thus relieving Liver depression and self-healing all symptoms.

 [Function]

Invigorates blood and dispels stasis, regulates Qi and stops pain, opens the chest and dissipates accumulations.

 [Indications]

(1) Chest pain due to blood stasis obstructing the chest and impaired blood circulation, chronic headache with stabbing and fixed pain. (2) Persistent dry heaving and belching. (3) Internal heat and vexation, palpitations and insomnia, irritability and anger, tidal fever in the afternoon and evening. (4) Or dark red tongue with ecchymoses on the sides, or blood spots on the tongue surface, dark lips or dark circles under the eyes, and wiry or tight pulse.

 [Indications for Use]

Headache, dizziness, cerebral thrombosis, cerebral infarction, sequelae of craniocerebral injury, angina pectoris due to coronary atherosclerosis, rheumatic heart disease, chest contusion, chest pain due to blood stasis obstruction, intercostal neuralgia, neurasthenia, and other diseases characterized by Qi stagnation and blood stasis, confirmed by syndrome differentiation.

 [Contraindications]

Contraindicated for pregnant women.

 [Mnemonic]

Tao Hong Si Wu Tang (桃紅四物湯) (with modified Red Peony Root) + only Bupleurum and Platycodon drive cattle to eat grass (枳柴桔甘牛草). Or + grass for upper, middle, and lower Jiao (上桔中枳柴下牛).

 [Additions and Subtractions]

(1) If Qi stagnation is severe, add Citrus Reticulata Viridis and Cyperus Rotundus Rhizome to enhance the action of regulating Qi. (2) For amenorrhea and dysmenorrhea due to blood stasis, remove Platycodon Grandiflorum Root and add Motherwort, Lycopus lucidus, Cyperus Rotundus Rhizome, etc., to invigorate blood, regulate menstruation, and stop pain. (3) For masses in the hypochondria due to blood stasis, add Curcuma wenyujin and Salvia miltiorrhiza to invigorate blood, dispel stasis, resolve masses, and disintegrate accumulations. (4) For chronic pain due to stasis that has entered the collaterals, add Scorpio Japonicas, Scolopendra, <a href='https://whatsintcm.com/dt_articles/穿山甲/’>Manis Scale, Earthworm to unblock collaterals and stop pain.

 [Pharmacology]

It has effects such as inhibiting platelet aggregation, improving cardiac function, anti-arrhythmia, improving blood rheology and microcirculation, anti-hypoxia, analgesia, anti-inflammation, lowering blood lipids, and enhancing immune function.