【Source】

Dan Xi Xin Fa, Vol. 3.

 【Ingredients】

Cyperus (Xiang Fu), Atractylodes (Cang Zhu), Chuan Xiong, Massa Medicata Fermentata (Shen Qu), stir-fried Gardenia (Zhi Zi). All herbs in equal parts, prepared as pills with fermented flour paste.

 【Categorization】

<Regulating Qi>: Cyperus (Xiang Fu)

<Aromatic Transform Dampness>: Atractylodes (Cang Zhu)

<Invigorate Blood & Remove Stasis>: Chuan Xiong

<Clear Heat & Purge Fire>: stir-fried Gardenia (Zhi Zi)

<Aid Digestion>: Massa Medicata Fermentata (Shen Qu)

【Formularic Rationale】

Yi Fang states: (1) The classics state that ascending, descending, floating, and sinking should follow the normal pattern, while cold, heat, warmth, and coolness should be counteracted. (2) This formula treats conditions related to the Hand and Foot Taiyin, and Hand Shaoyang meridians. (3) Wu Hegao said: ‘Yue Ju’ means to release and alleviate various stagnations (Ju Yu). (4) Cyperus (Xiang Fu): opens Qi stagnation. (5) Atractylodes (Cang Zhu): dries dampness stagnation. (6) Ligusticum wallichii (Fu Xiong, i.e., Chuan Xiong): regulates blood stagnation. (7) Gardenia (Zhi Zi): resolves fire stagnation. (8) Massa Medicata Fermentata (Shen Qu): dispels food stagnation. (9) Chen Laizhang said: ‘All these ingredients regulate Qi; when Qi flows smoothly, stagnation is relieved.’ Shan Bu (Supplemented Compilation) states: ‘Humans are based on Qi; if Qi is harmonious, ascending and descending maintain their proper rhythm, and its function remains unobstructed. How do diseases arise? If dietary habits are irregular, cold and warmth are inappropriate, emotions are unstable, or worry and overthinking are excessive, it can cause the harmonious Qi to lose its normal ascent and descent, leading to stomach stagnation causing loss of appetite, spleen stagnation causing impaired digestion of food and water, Qi stagnation causing chest and abdominal distention, blood stagnation causing stabbing pain in the chest and diaphragm, damp stagnation causing phlegm and fluid retention, fire stagnation causing heat, as well as vomiting, nausea, acid regurgitation, belching, and a myriad of other illnesses. Therefore, Cyperus (Xiang Fu) is used to open Qi stagnation, Atractylodes (Cang Zhu) to dispel damp stagnation, Ligusticum wallichii (Fu Xiong, i.e., Chuan Xiong) to move blood stagnation, Gardenia (Shan Zhi) to clear fire stagnation, and Massa Medicata Fermentata (Shen Qu) to resolve food stagnation. This is Zhu Zhenheng’s modification of the method for treating the ‘Five Stagnations.’ The five herbs work synergistically to achieve the effects on these five stagnations. However, one should inquire which stagnation is more severe and accordingly prioritize that herb. For instance, for Qi deficiency, add Ginseng (Ren Shen); for Qi pain, add Costus Root (Mu Xiang); for severe stagnation, add Turmeric Tuber (Yu Jin); for poor appetite, add malt/barley (Gu Bai); for distention, add Magnolia Bark (Hou Po); for epigastric glomus, add Immature Bitter Orange (Zhi Shi); for vomiting with phlegm, add Ginger (Sheng Jiang) and Pinellia (Ban Xia); for excessive fire, add Evodia (Wu Zhu Yu) and Coptis (Huang Lian). These adjustments depend on the detailed discretion of the practitioner in clinical practice.’ Yi Fang also notes: (1) For damp stagnation, add Poria (Fu Ling) and Angelica dahurica (Bai Zhi). (2) For fire stagnation, add Indigo Naturalis (Qing Dai). (3) For phlegm stagnation, add Arisaema (Nan Xing), Pinellia (Ban Xia), Trichosanthes (Gua Lou), and Pumice (Hai Shi). (4) For blood stagnation, add Peach Kernel (Tao Ren) and Safflower (Hong Hua). (5) For Qi stagnation, add Costus Root (Mu Xiang) and Areca Seed (Bing Lang). (6) For food stagnation, add Malt (Mai Ya), Hawthorn (Shan Zha), and Cardamom (Sha Ren). (7) If accompanied by cold, add Evodia (Wu Zhu Yu). (8) Seasonal additions: In spring, add Ledebouriella Root (Fang Feng); in summer, add Sophora flavescens (Ku Shen); in winter, add Evodia (Wu Zhu Yu). (1) If Qi stagnation is predominant, use Cyperus (Xiang Fu) as the chief herb, adding Costus Root (Mu Xiang), Immature Bitter Orange Peel (Zhi Ke), and Magnolia Bark (Hou Po) to enhance its effects of moving Qi and resolving stagnation. (2) If blood stagnation is predominant, use Chuan Xiong as the chief herb, adding Peach Kernel (Tao Ren), Red Peony Root (Chi Shao), and Safflower (Hong Hua) to strengthen its effects of invigorating blood and dispelling stasis. (3) If damp stagnation is predominant, use Atractylodes (Cang Zhu) as the chief herb, adding Poria (Fu Ling) and Alisma (Ze Xie) to promote diuresis and resolve dampness. (4) If food stagnation is predominant, use Massa Medicata Fermentata (Shen Qu) as the chief herb, adding Hawthorn (Shan Zha) and Malt (Mai Ya) to aid digestion and resolve food retention. (5) If fire stagnation is predominant, use Gardenia (Shan Zhi Zi) as the chief herb, adding Scutellaria (Huang Qin) and Coptis (Huang Lian) to clear heat and purge fire. (6) If phlegm stagnation is predominant, add Pinellia (Ban Xia) and Trichosanthes (Gua Lou) to resolve phlegm. (7) If accompanied by cold, add Evodia (Wu Zhu Yu) and Dried Ginger (Gan Jiang) to dispel cold.

 【Functions】

Regulates Qi and relieves stagnation, broadens the chest/middle-jiao and reduces fullness.

 【Indications】

For all symptoms caused by the ‘Six Stagnations’ (Qi, Blood, Phlegm, Fire, Dampness, Food), such as chest and diaphragm oppression, or epigastric and abdominal distention and pain, acid regurgitation, indigestion, belching, and vomiting. Yi Fang states: Generally treats the Six Stagnations causing chest and diaphragm oppression, acid regurgitation, vomiting, and indigestion. (Among the Six Stagnations, Qi is primary. When Qi flows, stagnation disperses.) Shan Bu states: All types of damp, phlegm, food, fire, Qi, and blood stagnations.

 【Modern Applications】

(1) Gastric ulcer, chronic gastritis, gastroptosis, gastrointestinal neurosis. (2) Chronic hepatitis, intercostal neuralgia. (3) Pregnancy vomiting, dysmenorrhea, irregular menstruation, amenorrhea, mammary gland diseases, menopausal syndrome. (4) Pediatric indigestion and other related conditions.

 【Contraindications】

Not suitable for use alone in cases of stagnation due to deficiency syndromes.

 【Mnemonic】

The more you think, the angrier you get (越想越氣, Yue Xiang Yue Qi) — Poor woman sings a tune (窮婦唱支曲, Qiong Fu Chang Zhi Qu – for Chuan Xiong, Xiang Fu, Cang Zhu, Zhi Zi, Shen Qu).

 【Pharmacology】

Gardenia (Zhi Zi) in this formula inhibits gastrointestinal motility and reduces gastric acid secretion. Gardenia (Zhi Zi) also increases bile secretion and mitigates carbon tetrachloride-induced liver damage. Chuan Xiong and its active components inhibit platelet aggregation and improve microcirculation. Chuan Xiong and Gardenia (Zhi Zi) have sedative effects, while Cyperus (Xiang Fu) has an analgesic effect.