【Source】

Volume 2 of “Distinguishing Internal and External Injuries and Resolving Doubts” (Nei Wai Shang Bian Huo).

 【Composition】

Astragalus Root (Huang Qi), Chinese Angelica Root (Dang Gui)

 【Categorization】

<Blood-Tonifying>: Chinese Angelica Root (Dang Gui)

<Qi-Tonifying>: Astragalus Root (Huang Qi)

【Formula Principles】

From “Yi Fang” (Medical Formulas): Taiyin and Jueyin Meridians.

(1) Chinese Angelica Root (Dang Gui): Its qi and flavor are both rich (thick), making it the yin among yin, thus it nourishes yin and enriches blood.

(2) Astragalus Root (Huang Qi): This is a qi-tonifying herb. Why is it used in five times the amount of Dang Gui, and yet the formula is called “Blood-Supplementing Decoction”? This is because tangible blood is generated from intangible qi, and with Dang Gui as a guide, it then promotes blood generation.

(3) The Classic states: “When Yang flourishes, Yin grows.” This is the underlying principle.

(4) Ren’an said: The illness originates from overstrain and fatigue, which not only damages blood but also harms qi. Therefore, these two herbs are used together to tonify both. From “Shan Bu” (Revisions and Supplements): Wu Kun said: When blood is full, the body is cool; when blood is deficient, the body is hot. This occurs when hunger, exhaustion, or overstrain depletes yin blood, causing yang to dominate, leading to various symptoms. This syndrome purely resembles Baihu Tang (White Tiger Decoction) syndrome, but the pulse is large and deficient, not large and full, which distinguishes it. This is what “Nei Jing” (The Yellow Emperor’s Classic of Internal Medicine) refers to as a deficient pulse and deficient blood.

Among the five flavors, only sweet can tonify. Chinese Angelica Root (Dang Gui) is sweet and rich in flavor; a rich flavor tonifies blood. Astragalus Root (Huang Qi) is sweet and mild (thin) in flavor; a mild flavor tonifies qi. Although Huang Qi is used in several times the amount, and it is called a blood-tonifying formula, this is because tangible blood cannot generate itself but arises from intangible qi. The Classic states: “When Yang flourishes, Yin grows,” referring to this principle. From “Cheng Fang Bian Du” (Commentary on Complete Prescriptions): If, after severe blood loss, these pulse and symptom patterns are observed, it indicates not only a depletion of yin blood but also a tendency for yang qi to scatter and dissipate. At this time, tangible blood cannot be quickly generated, so intangible qi must be urgently consolidated.

Therefore, Astragalus Root (Huang Qi), which powerfully tonifies the original qi of the Lung and Spleen and consolidates the exterior, is used as the chief herb. This is because at this point, yang qi has left the interior and surged to the exterior. Fearing that consolidating the interior might be too slow, it is necessary to protect the exterior to retain it.

Chinese Angelica Root (Dang Gui) enriches blood and harmonizes ying (nutritive qi). When these two herbs are combined, they can promote “Yang flourishing, Yin growing,” allowing the damaged blood to return to its respective meridian and consolidate itself. It is not comparable to ordinary blood-tonifying and greasy/cloying herbs.

 【Functions】

Tonifies qi and generates blood.

 【Indications】

Internal injury due to overstrain and fatigue, qi and blood deficiency, yang floating to the exterior, dry and hot skin, resulting in low-grade fever, flushed face and red eyes, pale-yellow complexion after severe blood loss, mental fatigue, weak and powerless pulse, and other qi and blood dual deficiency syndromes. Also, for women with blood deficiency manifesting as fever and headache during menstruation or postpartum, postpartum agalactia (no lactation); or canker sores in the mouth and on the tongue, and chronic non-healing sores after ulceration. From “Yi Fang”: Injury due to overstrain and fatigue, hot skin with flushed face, vexation and thirst with desire to drink, and a large but deficient pulse. From “Shan Bu”: Blood deficiency in men and women resembling Baihu Tang (White Tiger Decoction) syndrome, with hot skin and flushed face, vexation and thirst with desire to drink, a surging, large but deficient pulse, becoming faint upon heavy pressure.

 【Contraindications】

Contraindicated for those with yin deficiency with tidal fever or damp-heat.

 【Mnemonics】

(1) When the wife needs blood supplementation, the husband naturally returns home (Qi Gui – a pun on Huang Qi and Dang Gui). (2) Hoping for the husband’s return (Qi Gui).

 【Modifications】

(1) If the placenta has not descended postpartum with severe hemorrhage, add Sheng Hua Tang (Generation and Transformation Decoction) to activate blood and dispel stasis. (2) If chronic sores do not heal, with dual deficiency of qi and blood and residual toxins, add Honeysuckle Flower (Jinyinhua) and Licorice Root (Gan Cao) to clear heat and detoxify. (3) If accompanied by itchy skin, add Whole Scorpion (Quan Xie), Centipede (Wu Gong), Clematis Root (Wei Ling Xian), and Fructus Cnidii (She Chuang Zi) to dispel wind and relieve itching.

 【Pharmacology】

It has anti-injury effects, enhances the body’s immune and hematopoietic functions, improves hemorheology, promotes nucleic acid and protein synthesis, raises blood pressure, and exhibits anti-stress properties. It can significantly enhance the phagocytic function of macrophages.