Invigorate Blood, dispel Blood stasis, Move Liver Qi, Open the channels and Stop Pain

• Pain in the chest and hypochondria
• A chronic, stubborn headache with a fixed, piercing quality
• Incessant hiccups, a choking sensation when drinking, dry heaves
• Depression or low spirits with a sensation of warmth in the chest and cold extremities
• Alternatively, heat in the palms and soles with dry or scaly skin
• Palpitations, insomnia, restless sleep, irritability, extreme mood swings, evening tidal fever
• A dark-red tongue with dark spots on the sides, dark or purplish lips or complexion
• A wiry, choppy or tight pulse

• Tao Ren, Hong Hua and Chuan Xiong (chiefs) invigorate Blood and dispel Blood stasis, particularly in the upper Jiao.
• Dang Gui, Chi Shao and Niu Xi (deputies) also invigorate Blood, with Niu Xi leading the movement of Blood downwards.
• Sheng di (assistant) cools the Blood and clears Heat, and with Dang Gui, nourishes Blood and moistens dryness.
• Chai Hu (assistant) softens the flow of Liver Qi, relieves constraint and raises clear Yang, working with Chuan Niu Xi to open the chest and restore the flow of Qi and Blood.
• Jie Geng and Zhi Shi (assistants) work with Chai Hu to open the chest and promote Qi movement and Qi’s ability to move Blood.
• Gan Cao (envoy) regulates and harmonises the actions of the other herbs.

• Headache: add Man Jing Zi and Bai Ji Li
• Hypochondriac pain: add Yu Jin and Xie Bai
• Immobile intercostal and abdominal masses: add Yu Jin and Dan Shen
• Amenorrhoea or dysmenorrhoea: omit Jie Geng and add Xiang Fu, Yi Mu Cao and Ze Lan
• Angina pectoris due to coronary artery disease: increase the dose of Hong Hua, Chuan Xiong and Dan Shen

• This is a variation on the combination of Tao Hong Si Wu Tang and Si Ni San It’s generally used for chest pain, but may also be used for PTSD insomnia in children.
• The formula both invigorates Blood and transforms stasis at the Xue level, it also relieves depression and constraint at the Qi level.
• The formula is appropriate for sensations of warmth in the chest and cold extremities due to Qi and Blood stagnation, and hot palms and soles with dry skin due to chronic stasis transforming into heat.
• With the appropriate presentation, this formula may be used for coronary artery disease, rheumatic valvular heart disease, hypertension, pulmonary heart disease, intercostal neuralgia, costochondritis, post-concussion syndrome, migraine, trigeminal neuralgia, psychosis, menopausal syndrome, primary dysmenorrhoea, and urticaria.

Contraindicated in pregnancy and most cases of excessive uterine bleeding

Invigorates the Blood, dispels Blood stasis, warms the menses, and alleviates pain

• Palpable masses in the lower abdomen that may or may not be painful
• Lower abdominal distension or pain
• Lower back pain or lower abdominal distension during menstruation
• Frequent menstruation (2 to 5 times a month) with dark or purple blood
• Abnormal uterine bleeding with soreness, pain or clots
• A lower abdomen that feels cold and firm to the touch, and a dislike of cold
• A mauve, purple or blue tongue, possible dark spots on the side, dark and congested sublingual veins
• A wiry, choppy or tight pulse

• Xiao Hui Xiang (chief) warms the channels, disperses Cold and relieves pain.
• Yan Hu Suo (deputy)activates Qi and Blood movement and relieves pain.
• Rou Gui and Gan Jiang (deputies) warm and tonify the Kidney Yang, dispel Cold and open channels to relieve pain.
• Mo Yao, Chuan Xiong, Chi Shao, Wu Ling Zhi (assistants) combine to move Blood and Qi to regulate the Ren and Chong Mai.
• Dang Gui (assistant) nourishes and moves Blood.
• Pu Huang (assistant) stops Bleeding and eliminates stagnation.

• Increase blood moving: add Tao Ren (3-9) and Hong Hua (3-9)
• With Cold: add Wu Zhu Yu (1.5-5), Li Zhi He (10-15) to move and warm Qi
• Delayed cycle: add Chuan Niu Xi (10-15)
• Oppression in chest & insomnia: add Yu Jin (6-12), He Huan Hua (10-15)
• Endometriosis or masses: add E Zhu (3-10), San Leng (3-10).
• Blood stasis + Damp-Heat (PID): add Bai Jiang Cao (6-15), Hong Teng (10-15).
• Headache: add Man Jing Zi and Bai Ji Li
• Hypochondriac pain: add Yu Jin and Xie Bai
• Liver cirrhosis: add Sheng di Huang, Xiang Fu, Wu Yao, Tao Ren, Hong Hua and Si Gua Luo

• This is a variation of Xue Fu Zhu Yu Tang that targets the lower Jiao rather than the chest and is more warming to expel internal Cold.
• With the appropriate presentation, this formula may be used for hypertension, primary dysmenorrhoea, endometriosis, menorrhagia, functional uterine bleeding, irregular menstruation, infertility, chronic pelvic inflammatory disease, and menopausal syndrome.

Contraindicated in pregnancy and most cases of excessive uterine bleeding

Invigorate Blood, eliminate Stasis, move Liver Qi, clear Heat, stop Pain

• Palpable masses in the abdomen that may or may not be painful or visible
• Abdominal distension or pain
• Back pain or abdominal distension, worse during menstruation
• A mauve or purple tongue, possible dark spots on the sides, dark and congested sublingual veins
• A wiry, choppy or tight pulse

• Dang Gui, Chuan Xiong, Chi Shao, Tao Ren and Hong Hua are modifications to Tao Hong Si Wu Tang, which nourishes and invigorates Blood. Here, Chi Shao replaces Bai Shao to further invigorate blood, and Shu Di Huang is removed.
• Wu Ling Zhi, Yan Hu Suo and Mu Dan Pi invigorate Blood, eliminate stasis and stop pain.
• Xiang Fu, Zhi Ke and Wu Yao move Qi to move Blood.
• Zhi Zi clears Heat and Dampness downwards, cools Blood, stops bleeding and relieves pain.
• Fu Ling and Gan Cao support the Stomach and Spleen Qi from damage by these strongly moving herbs.

With Cold: remove Zhi Zi and Mu Dan Pi and add Gui Zhi (5-10) and Wu Zhu Yu (2-5).

• This formula is appropriate for use in cases of chronic pelvic pain due to Qi & Blood stasis (with Heat), including physical blockages of the Fallopian tubes.
• With the appropriate presentation, this formula may be used for functional uterine bleeding, irregular menstruation, primary dysmenorrhea, infertility, polycystic ovaries, chronic pelvic inflammatory disease, and menopausal syndrome.

Contraindicated in pregnancy and most cases of excessive uterine bleeding

Warms the menses, Dispels Cold, Nourishes Blood and Dispels Blood Stasis

• Mild persistent uterine bleeding
• Irregular menstruation (either early or late) between periods
• Extended or continuous menstrual flow
• Bleeding between periods
• Pain, distension and cold in the lower abdomen
• Infertility
• Dry lips and mouth
• Low-grade fever at dusk and warm palms and soles

• Wu Zhu Yu, Gui Zhi and Sheng Jiang warm the uterus and expel Cold.
• Dang Gui, Bai Shao, E Jiao and Chuan Xiong nourish and invigorate Blood; the Cold in the uterus obstructs the Chong Mai and prevents new Blood from filling the uterus.
• Ren Shen tonifies Yuan Qi to nourish Blood and warms the Kidneys.
• Mai Men Dong, along with E Jiao, nourishes Yin.
• Mu Dan Pi clears any Empty Heat that might arise from Blood deficiency.
• Ban Xia harmonises the uterus via the Stomach channel (which is connected via the Ren Mai).
• Gan Cao harmonises the formula and enters all the channels.

• Severe abdominal cold and pain: omit Mai Dong and Mu Dan Pi, swap Rou Gui for Gui Zhi and add Xiao Hui Xiang and Ai Ye.
• Severe Qi stagnation: add Xiang Fu and Wu Yao.
• Mild, persistent uterine bleeding of pale blood: omit Mu Dan Pi and add Pao Jiang, Ai Ye and Shu di Huang.
• Qi deficiency: add Huang Qi
• Persistent bleeding after miscarriage: omit Gan Cao and add Dan Shen, Yi Mu Cao and Chuan Niu Xi
• Infertility due to Blood deficiency and Cold: add Qing Pi and Xiang Fu. With the herbs only taken during the menstrual flow.
• Chronic endometriosis: add Ru Xiang and San Qi.

• This formula is appropriate for Cold and Ren and Chong Mai deficiency with Blood stagnation. There may be mild persistent uterine bleeding or bleeding between periods, with coldness and pain in the lower abdomen eased by warmth.
• The formula also clears deficient Heat arising from Blood deficiency or obstruction, the signs of which are hot flushes at dusk, warm hands and feet and dry lips and mouth. (Not a dry mouth and throat as occurs with Yin deficiency), and there is cold in the lower abdomen.
• the formula is also appropriate for male infertility with the correct presentation.
• However, the large dose of Wu Zhu Yu is extremely unpleasant, challenging client compliance.
• With the appropriate presentation, this formula may be used for functional uterine bleeding, irregular menstruation, primary dysmenorrhea, infertility, polycystic ovaries, chronic pelvic inflammatory disease, and menopausal syndrome.

Contraindicated in pregnancy and most cases of excessive uterine bleeding

Invigorates the Blood, transforms Blood stasis, and reduces fixed abdominal masses

• Mild, persistent uterine bleeding of purple or dark blood during pregnancy with abdominal pain that increases with pressure
• Immobile masses in the lower abdomen with pain and tenderness
• Abdominal tension and spasms
• Amenorrhoea with abdominal distension and pain
• Dysmenorrhoea
• Retention of the lochia (products of conception)
• A choppy pulse

• Gui Zhi warms and combines with Fu Ling to penetrate the channels of the Lower Jiao and direct the blood-moving herbs there. Fu Ling also nourishes and calms the Heart and Spleen to calm the foetus.
• Chi Shao, Mu Dan Pi and Tao Ren invigorate Blood, eliminate stasis and dissolve masses.

• Mild persistent bleeding: remove Mu Dan Pi, add Pao Jiang (2-4), Ai Ye (3-9) and Shu Di Huang (6-9).
• Abdominal spasms: replace Chi Shao with Bai Shao or simply add Bai Shao.
• Severe Blood stasis: add Da Huang (6-15).
• Qi tiredness: add Huang Qi (12-18).
• Phlegm accumulation: add Huang Yao Zi (15) and Jie Nei Jin (9).

• Zhang Zhong-Jing constructed this formula to treat blood stasis during pregnancy. It has a relatively gentle dispersing action and is particularly effective at treating myomas (fibroids).
• With the appropriate presentation, this formula may be used for myomas, primary dysmenorrhoea, cervical erosion, ovarian cysts, chronic salpingitis, chronic pelvic inflammatory disease, endometriosis and retention of lochia.

This is a relatively gentle formula for the situation and may require many months to treat fixed abdominal masses with pain and tenderness.

Invigorates the Blood, transforms Blood Stasis, harmonises the Nutritive Qi, reduces swelling and alleviates pain

• Traumatic injury such as a sprain with bruising
• Swelling, distended aching and pain at a fixed location

• Dang Gui, Chuan Xiong, Ru Xiang, Mo Yao, Xue Jie and Tu Bie Tong invigorate the Blood and promote circulation and dispel Blood stasis.
• Ma Huang (envoy) opens the tissues between the skin and muscles and regulates the interstices and pores to guide the main herbs to the muscles and exterior levels of the body.
• This enhances the formula’s effectiveness in invigorating Blood, reducing swelling and alleviating pain.
• Ma Huang is restricted in some regions – the suggested substitution is Xiang Ru (Herba Elsholtziae seu Moslae)
• Zi Ran Tong helps promote the healing of fractured bones but is unavailable in the UK. Increase the dose of Mo Yao and Ru Xiang.

With the appropriate presentation, this formula may be used for trauma including fractures, contusions and strains.

Contraindicated in pregnancy, not for long-term use.

Invigorates the Blood, dispels Blood Stasis, unblocks the Collaterals and alleviates pain

• Pain in various locations; heart, abdomen, stomach, back, leg or arm
• Bruising and swelling due to traumatic injury
• Rheumatic pain
• Fixed abdominal masses
• Internal or external ulceration
• A dark tongue, or one with static points
• A wiry pulse

• Dang Gui (chief) invigorates and nourishes Blood and alleviates pain.
• Dan Shen cools the Blood, reduces ulceration and strengthens the Blood-moving action of Dang Gui.
• Ru Xiang and Mo Yao invigorate the Blood, dispel Blood stasis, promote the movement of Qi and alleviate pain.

• Pain in the lower extremities: add Du Huo and Huai Niu Xi
• Pain in the upper extremities: add Qiang Huo, Jiang Huang and Lian Qiao
• Abdominal pain in women: add Tao Ren and Wu Ling Zhi
• Red, swollen, hot and painful ulceration: add Jin Yin Hua, Lian Qiao and Zhi Mu
• Deep-rooted Yin-type ulcers: adds Rou Gui and Lu Jiao Jiao
• Non-healing ulcers: add Huang Qi, Zhi Mu and Gan Cao
• Abscesses of the internal organs: add San Qi and Niu Bang Zi

• This formula was originally designed to treat fixed abdominal masses due to Blood stasis or pain due to restricted blood flow in the collaterals.
• To transform the stasis and facilitate the flow of blood in the collateral vessels the formula uses herbs that invigorate the blood and unblock the collaterals.
• this is consistent with the ‘attacking method’ to treat retention and the ‘reducing method’ to treat hard masses.
• The formula is quite strong and vague; it’s flexible and benefits from additional herbs to treat specific problems.
• With the appropriate presentation, this formula may be used for ectopic pregnancy, angina pectoris, angina pectoris, cerebral thrombosis, sciatica, pelvic inflammatory disease, arthritis and traumatic injury.

Contraindicated in pregnancy, not for long-term use.