Class 3~5: Herbs and Formulas That Invigorate Blood

1. Class 3~5: Herbs and Formulas That Invigorate Blood Xianhui Li and Cui Han

2. Herbs • *Radix Ligusticum chuanxiong (Chuan xiong) • Radix Salviae militiorrhizae (Dan shen) • Caulis Millettiae seu spatholobi (Ji xue teng) • Rhizoma corydalis Yanhusuo (Yan hu suo) • Radix Curcumae (Yu jin) • Rhizoma Curcumae longae (Jiang huang) • Herba Leonuri (Yi mu cao) • Herba Lycopi (Ze lan) • Rx Paeoniae Rubra (Chi shao)*Semen Persicae (Tao ren) • *Flos Carthami (Hong hua) • Rhizoma Zedoariae (E zhu) • Rhizoma Sparganii (San leng) • Resina Olibanum (Ru xiang) • Resina myrrhae (Mo yao) • *Radix Achyranthis bidentatae (Niu xi) • Semen Vaccariae (Wang bu liu xing) • Sanguis Draconis (Xue jie) • Excrementum Trogopteri (Wu ling zhi) • Hirudo seu whitmaniae (Shui zhi)

3. Chuan xiong (Ligusticum root) • Taste and Property: warm, acrid • Meridian Tropism: Liver, gallbladder and pericardium • Actions: invigorates the blood, promoters the movement of qi, expels wind, stops pain • Application: • For any blood stasis pattern: dysmenorrhea, amenorrhea, difficult labor, or retained lochia. For patterns of qi stagnation and blood stasis: pain and soreness in the chest, flanks and hypochondria. It is also called qi herbs in the blood. • For externally-contracted wind disorder characterized by headache, dizziness, or painful obstruction, used with fang feng, jing jie, i.e. chuan xiong cha tiao san, used with qiang huo, gao ben, i.e. qiang huo sheng shi tang • Dosage: 3-9g • Attention: used with caution during pregnancy or bleeding easily or have profuse menses, not for fire from yin deficiency

4. Dan shen (Radix Salviae ) • Taste and Property: Bitter, slight cold • Meridian Tropism: Heart, pericardium, liver • Actions: invigorates the blood, tonifies the blood, calms irritability due to blood heat • Application: • For a wide variety of blood stasis disorders in any part of the body, used with yi mu cao, tao ren for abdominal pain, used with ze lan, bie jia, for abdominal masses, used with tan xiang, sha ren, for pain in the chest, epigastrium and abdominal due to qi stagnation and blood stasis, i.e. dan shen yin • For restlessness, irritability, palpitations, and insomnia due to heat entering the nutritive level, used with xuan shen, lian qiao, i.e. qing ying tang, used with suan zao ren, bai zi ren for palpitations and insominia due to heart blood and yin deficiency, i.e. tian wang bu xin dan • Cools the blood and reduces abscesses: for sores or the early stages of breast abscess, used with yin hua, lian qiao, • Dosage: 6-15g. • Attention: contraindicated during pregnancy, fan li lu

5. Ji xue teng (Caulis Millettiae seu spatholobi ) • Taste and Property: bitter, sweet, warm • Meridian Tropism: Liver, heart and spleen • Actions: invigorates the blood, tonifies the blood, soothers the sinews and invigorates the collaterals • Application: • For blood deficiency patterns presenting with such problems as dysmenorrhea, irregular menstruation, or amenorrhea accompanied by abdominal pain. Used with si wu tang • For numbness of the extremities, lower back pain, kne pain, or generalized joint soreness from wind-damp painful obstruction with either blood deficiency or stasis • Dosage: 9-15g • Attention: contraindicated in those with profuse mense

6. Yan hu suo (Rhizoma corydalis Yanhusuo ) • Taste and Property: bitter, acrid, warm • Meridian Tropism: Liver, heart and stomach • Actions: invigorates the blood, promotes the movement of qi, and stops pain • Application: • For pain of almost any kind affecting the chest, abdomen, or limbs, including that due to blood stasis and trauma • Used with wu ling zhi for pain in the chest and abdomen due to blood stasis • Used with xiang fu, dang gui for dysmenorrhea from qi stagnation and blood stasis • Used with chuan lian zi for pain in the flank and upper right quadrat, i.e jin ling zi san • Used with xiao hui xiang and wu yao for abdominal pain and bulging disorders from obstruction of qi and blood due to cold • Used with dan shen, hong hua, and chuan xiong for coronary artery disease • Dosage: 3-9g

7. Yu jin (Radix Curcumae ) • Taste and Property: acrid, bitter, cold • Meridian Tropism: Liver, heart and lung • Actions: invigorates the blood and stops pain, promotes the movement of qi and resolves constraint, clears heat and cools blood, opens the orifices, benefits the gallbladder and reduces jaundice • Application: • Used topically and internally for pain related to traumatic injury and to hasten the healing process of chronic sores • For chest, abdominal, flank, or menstrual pain from constrained liver qi, particularly useful for constrained liver qi patterns with heat signs. Used with chai hu, xiang fu, dang gui, bai shao • For heat in the blood aspect causing chaotic movement of the blood leading such problems as nosebleed, vomiting of blood, and blood in the urine, used with mu dan pi, niu xi • Use when hot phlegm obstructs the heart orifices with such symptoms as anxiety, agitation, seizures or mental derangement, used with shi chang pu, zhu li • For pain in the flanks with jaundice, used with yin chen, zhi zi • Dosage: 6-12g • Attention: used with caution during pregnancy

8. Jiang huang (Rhizoma Curcumae longae ) • Taste and Property: acrid, bitter, warm • Meridian Tropism: Liver, spleen and stomach • Actions: invigorates the blood and unblocks menstruation, promotes the movement of qi and alleviates pain, expels wind and promotes the movement of blood • Application: • For chest or abdominal pain, amenorrhea, or dysmenorrhea due to blood stasis caused by cold from deficiency, also used for pain and swelling due to trauma or the early stages of sores and abscesses • For episgastirc and abdominal pain due to qi stagnation, used with yu jin • For wind-damp painful obstruction with blood stasis, especially in the shoulders, used with qiang huo, fang feng, dang gui • Dosage: 6-9g • Attention: used with caution during pregnancy

9. Yi mu cao (Herba Leonuri ) • Taste and Property: acrid, bitter, slight cold • Meridian Tropism: Liver, heart and bladder • Actions: invigorates the blood, regulates menstruation, promotes urination, clears heat and resolves toxicity • Application: • Commonly used for gynecological disorders such as irregular menstruation, premenstrual abdominal pain, heavy menstruation with clots, fixed abdominal masses, infertility, and postpartum abdominal pain with retained lochia, used with dang gui, chuang xiong, xiang fu • For acute systemic edema, especially useful when accompanied by blood in the urine, used with bai mao gen, ze lan • For sores, abscesses and toxic swellings, used either internally or topically • Dosage: 9-15g • Attention: not used for yin deficiency or insufficient blood, caution with during pregnancy

10. Ze lan (Herba Lycopi ) • Taste and Property: acrid, bitter, slight warm • Meridian Tropism: Liver and spleen • Actions: invigorates the blood and disperses stasis, promotes urination • Application: • For pain due to blood stasis obstructing the mense, and for postpartum abdominal pain from blood stasis. Also used for topically or internally for pain and swelling from traumatic injury or abscess, used with chuan xiong, dan shen • For postpartum edema, postpartum painful urinary dribbling and systemic or facial edema • Dosage: 9-15g • Attention: not used for insufficient blood or in the absence of blood stasis, caution with during pregnancy

11. Tao ren (Semen Persicae) • Taste and Property: bitter, sweat, neutral • Meridian Tropism: Liver, heart, LI, lung • Actions: invigorates the blood, dispels stasis, moistens the intestines, stop coughs and wheezing • Application: • For many blood stasis patterns: dysmenorrhea, amenorrhea, difficult labor, or retained lochia. Traumatic injury, flank pain, lung abcess and intestinal abscess with fixed abdominal pain. Used with hong hua, dang gui, chi shao, i.e. tao hong si wu tang, used with pao jiang, chuan xiong, sheng hua tang, used with da huang, mu dan pi, i.e. da huang mu dan pi tang • For constipation due to dry intestine • Dosage: 4.5-9g • Attention: used with caution during pregnancy

12. Hong hua (Flos Carthami) • Taste and Property: acrid, warm • Meridian Tropism: Liver, heart • Actions: invigorates the blood, stops pain • Application: • For many blood stasis patterns: dysmenorrhea, amenorrhea, difficult labor, or retained lochia and abdominal masses. used with hong hua, dang gui, i.e. xue fu zhu yu tang, used with yi mu cao, niu xi for abdominal pain • Traumatic injury, carbuncles, incomplete expression of rash of measles or pain fu obstruction of the chest due to blood stasis, used with zi cao, dang gui for measles carbuncles, boils • Dosage: 3-9g • Attention: used with caution during pregnancy

13. E zhu (Rhizoma Zedoariae ) • Taste and Property: bitter, acrid, warm • Meridian Tropism: Liver, heart • Actions: breaks up blood stasis, promotes the movement of qi, dissolves accumulations and alleviates pain • Application: • For abdominal pain, dysmenorrhea, amenorrhea, abdominal masses, and epigastic masses due to blood stasis, used with san leng together • For pain, distention, fullness, and constriction in the chest and abdomen due to food stagnation, also for childhood nutritional impairment, used with mu xiang, i.e. mu xiang bing lang wan • Dosage: 3-9g • Attention: contraindicated during pregnancy or in those with excessive menstruation

14. San leng (Rhizoma Sparganii ) • Taste and Property: bitter, acrid, neutral • Meridian Tropism: Liver, spleen • Actions: breaks up stagnation of both the qi and blood, disperses food stagnation, stops pain • Application: • For blood stasis patterns with amenorrhea, dysmenorrhea, postpartum abdominal pain and abdominal masses, used with e zhu, dang gui, hong hua, tao ren • For severe abdominal pain and distention due to food stagnation and stagnant qi • Dosage: 3-9g • Attention: contraindicated during pregnancy or in those with excessive menstruation

15. Ru xiang (Resina Olibanum ) • Taste and Property: bitter, acrid, warm • Meridian Tropism: Liver, heart, spleen • Actions: invigorates the blood and promotes the movement of qi, reduces swelling and generates flesh • Application: • For traumatic pain due to blood stasis, as well as the early stages of carbuncles, sores, swellings and pain, also for chest, epigastric, or abdominal pain due to blood stasis • Applied topically as an ointment or powder to reduce swelling, generates flesh, alleviate pain and promote healing of sores, carbuncles and traumatic injury, also for pain, redness, and swelling of the gums, mouth and throat, used with mo yao together • Dosage: 3-9g • Attention: contraindicated during pregnancy or in those with excessive menstruation

16. Mo yao (Resina myrrhae ) • Taste and Property: bitter, neutral • Meridian Tropism: Liver, heart and spleen • Actions: breaks up blood stasis to stop pain, reduces sweling, generates flesh. • Application: • For problems due to blood stasis, including pain from trauma, sores, carbuncles, swellings, fixed abdominal masses, painful obstruction, chest pain, abdominal pain and amenorrhea, used with yan hu suo, wu ling zhi, xiang fu for epigastric and abdominal pain due to obstruction of qi and blood • Used topically to promote the healing of chronic nonhealing sores • Dosage: 3-9g • Attention: used with caution during pregnancy, should not be used long term

17. Radix Achyranthis (Niu Xi) • Taste and Property: bitter, sour and neutral • Meridian tropism: Liver and kidney • Actions: invigorates the blood and dispels blood stasis; tonifies liver and kidney, strengthens the tendons and bones, benefits the joints; induces the downward movement of blood and fire; clears damp-heat in the lower jiao • Applications: • For blood stasis patterns with such symptoms as dysmenorrhea, amenorrhea, and retained lochia, used with ru xiang, mo yao • For pain and soreness affecting the lower back and knees due to deficiency, used with shi di huang, gui ban, as in hu qian wan • For blood heat in the upper jiao or yin deficiency with ascending fire, manifestations include nosebleed, vomiting blood, toothaches, bleeding gums, dizziness, headache, blurred vision • For cases of dam heat pouring downward manifesting as knee pain or lower back damp painful urinary dribbling or vaginal discharge, such as san miao wan • Dosage: 6-15g

18. Wang bu liu xing (Semen Vaccariae ) • Taste and Property: bitter, neutral • Meridian Tropism: Liver, stomach • Actions: invigorates the blood and disperses clumping and stasis, promotes lactation • Application: • For insufficient lactation or amenorrhea due to blood stasis, used with dang gui and xiang fu for blood stasis leading to menstural irregularities or amenorrhea, used with lu lu tong, tong cao, huang qi for insufficient lactation, used with huang qi, dang gui for insufficient lactation due to postpartum qi and blood deficiency • For painful swellings, especially of the breast or testicles, used with pu gong yin and gua lou for breast abscess • Dosage: 4.5-9g • Attention: used with caution during pregnancy

19. Xue jie (Sanguis Draconis ) • Taste and Property: sweet, salty, neutral • Meridian Tropism: Liver, heart • Actions: internally: invigorates the blood, disperses stasis, stops pain; externally: generates flesh, assists sores and wounds to heal, stops bleeding • Application: • For symptoms related to injury from falls, fractures, contusions, and sprains, as well as pain due to blood stasis patterns from other causes, used with ru xiang, mo yao • Applied topically to stop bleeding due to external injury and for chronic nonhealing ulcers, used with pu huang together • Dosage: 1-1.5g in pills and powders • Attention: used with caution during pregnancy

20. Wu ling zhi (Excrementum Trogopteri ) • Taste and Property: bitter, sweet, warm • Meridian Tropism: Liver • Actions: disperses blood stasis and alleviates pain, transforms stasis and stops bleeding • Application: • For a variety of disorders caused by blood stasis, including amenorrhea, dysmenorrhea, postartum abdominal pain and epigastric pain, used with pu huang, shi xiao san • For uterine bleeding and retained lochia due to blood stasis, used with sheng di huang and san qi • Dosage: 3-9g • Attention: used with caution during pregnancy

21. Shui zhi (Hirudo seu whitmaniae ) • Taste and Property: salty, bitter, neutral, slightly toxic • Meridian Tropism: Liver, bladder • Actions: breaks up blood stasis, disperses stagnation • Application: • For amenorrhea and fixed abdominal masses due to blood stasis, as well as traumatic injury • Used with san qi for trauma-induced pain, swelling, and bruising • Used with tao ren, meng chong for blood stasis in the lower abdomen • Used with san leng, e zhu, and dang gui for palpable, fixed abdominal masses • Dosage: 3-6g in decoctions, 0.3-0.6g in pills and powders • Attention: used with caution during pregnancy

22. Formulas • Formulas that invigorate the blood and dispel blood stasis • Peach Pit Decoction to Order the Qi (tao he cheng qi tang) • Drive out Blood Stasis in the Mansion of Blood Decoction (xue fu zhu yu tang) • Drive Out Blood Stasis Below the Diaphragm Decoction (Ge Xia Zhu Yu Tang) • Drive-Out Blood Stasis in the Lower Abdomen Decoction (Shao Fu Zhu Yu Tang) • Drive Out Blood Stasis from a Painful Body Decoction (Shen Tong Zhu Yu Tang) • Sudden Smile Powder (shi xiao san) • Salvia Decoction (dan shen yin) • Tonify the Yang and Restore Five-tenths Decoction (bu yang huan wu tang) • Formulas that warm the menses and dispel blood stasis • Cinnamon Twig and Poria Pill (gui zhi fu ling wan) • Generation and Transformation Decoction (sheng hua tang) • Warm the Menses Decoction (wen jing tang) • Formulas that invigorate the blood in the treatment of traumatic injury • Seven-Thousandths of a Tael Powder (qi li san) • Fantastically Effective Pill to Invigorate the Collaterals (huo luo xiao ling dan) • Revive Health by Invigorating the Blood Decoction (Fu Yuan Huo Xue Tang)

23. Tao he cheng qi tang (Peach Pit Decoction to Order the Qi ) Ingredients: Tao ren 12g, Da huang 12g, Gui zhi 6g, Mang xiao 6g, Zhi gancao 6g

24. Actions and indications of the formula • Actions • Drain heat and break up blood stasis. • Indications • Acute lower abdominal pain, incontinence of urine, night fevers, delirious speech, irritability, restlessness and thirst, and a submerged, full or choppy pulse.

25. Analysis of Formula • Chief: Tao ren, da huang • Tao ren: break up and eliminate blood stasis • Da huang: purge accumulation and clear heat. • Depute: gui zhi • warm the sinews, unblock the vessels, dispel blood stasis. • Assistant: mang xiao • soften hardness and dispel accumulation. • Envoy: Gan cao • protect the stomach and spleen

26. Modern application and modifications • Modern application: • Acute endometritis, retained placenta, pelvic inflammatory disease, and intestinal obstruction • Attentions: • Contraindicated during pregnancy. If there are still exterior symptoms, the exterior should first be released before using this formula. • Modifications: • For irregular menstruation or dysmenorrheal, add dang gui and hong hua.

27. Xue fu zhu yu tang (Drive out stasis in the mansion of Blood decoction) Ingredients: Tao ren 12g, Hong hua 9g, Dang gui 9g, Chuan xiong 4.5g, Chi shao 6g, Sheng di huang 9g, Niu xi 9g, Chai hu 3g, Jie geng 4.5g, Zhi ke 6g, Gan cao 3g

28. Actions and indications of the formula • Actions • Invigorate the blood, dispel blood stasis, spread the qi of the liver, and unblock the channels. • Indications • Pain in the chest and hypochondria, chronic, stubborn headache with a fixed, piercing quality, chronic, incessant hiccough, a choking sensation when drinking, a dark-red tongue, dark spots on the sides of the tongue, dark or purplish lips, complexion or sclera, and a choppy or wiry and tight pulse.

29. Analysis of Formula • Chief: Tao ren, hong hua, chuan xiong • Tao ren, hong hua, chuan xiong: invigorate the blood and dispel blood stasis. • Depute: Dang gui, chi shao, niu xi • Dang gui, chi shao: invigorate blood without injuring the yin and blood • Chuan niu xi: eliminate blood stasis, induce the downward movement of blood. • Assistant: sheng di huang, chai hu, jie geng, zhi ke • Sheng di huang: cool blood and clear heat • Chai hu: smoothen the flow of liver qi, relieve constraint and raise the clear yang. • Jie geng, zhi ke: expand the chest and promote the movement of qi. • Envoy: Gan cao • Gan cao---regulate and harmonize the action of other herbs

30. Modern application and modifications • Modern application: • Coronary artery disease, hypertension, intercostals neuralgia, migraine, trigeminal neuralgia, psychosis, menopausal syndrome, primary dysmenorrheal, and urticaria • Modifications: • For angina pectoris due to coronary artery disease, increase the dosage of hong hua and chuan xiong and add dan shen. • For severe pain and hard fullness in the lower abdomen, take with shi xiao san • Attentions: • Contraindicated during pregnancy, and excessive menstrual bleeding. It is also contraindicated in cases with bleeding diathesis or any active hemorrhagic disorder.

31. Shi xiao san (Sudden Smile Powder ) Ingredients: Wu ling zhi 9g, Pu huang 9g

32. Actions and indications of the formula • Actions • Invigorate the blood, dispel blood stasis, disperse accumulation, and alleviate pain. • Indications • Irregular menstruation, dysmenorrheal, retention of the lochia, post partum abdominal pain. acute, colicy pain in the lower, middle or upper abdomen.

33. Analysis of Formula • Chief: Wu ling zhi • remove obstruction from the blood vessels, disperse the retained blood, and alleviate pain. • Depute: Pu huang • strongly promote the circulation of blood and stop bleeding.

34. Modern application and modifications • Modern application: • Angina pectoris, coronary artery disease, endometriosis, lochioschesis • Attentions: • Contraindicated during pregnancy and stomach deficiency. • Modifications: • For angina pectoris from blood stasis, add chuan xiong, chi shao, hong hua, and dan shen • For severe qi stagnation, add Jin ling zi san. • For irregular menstruation due to a pattern of blood stasis and blood deficiency, take with Si wu tang.

35. Dan shen yin (Salvia Decoction ) Ingredients: dan shen, tan xiang, sha ren

36. Actions and indications of the formula • Actions • Invigorates the blood, dispels blood stasis, promotes the movement of qi, and alleviates pain. • Indications • Abdominal or epigastric pain which may radiate upward accompanied by signs and symptoms of blood stasis and qi stagnation

37. Analysis of Formula • Chief: dan shen • Invigorate the blood, transforms blood stasis and alleviates pain. • Depute: tan xiang • Warms the middle jiao and regulates qi • Assistant: sha ren • Promotes the movement of qi, relaxes middle jiao, disperses the sensation of constraint and oppression in the chest and alleviates pain

38. Modern application and modifications • Modern application: • Angina pectoris, coronary artery disease, hepatitis, pancreatitis, cholecystitis, chronic gastritis, peptic ulcer, and primary or secondary dysmenorrhea • Modifications: • For angina pectoris and dyspnea associated with coronary artery disease, combine with gua lou xie bai ban xia tang • Attentions: • Contraindicated during pregnancy and in cases with bleeding diathesis or any active hemorrhagic disorder.

39. Gui zhi fu ling wan (cinnamon twig and poria pill) Ingredients: gui zhi, fu ling, shao yao, mu dan pi, tao ren

40. Actions and indications of the formula • Actions • Invigorate the blood, dispel blood stasis, and reduces fixed abdominal masses. • Indications • Mild, persistent uterine bleeding of puple or dark blood during pregnancy accompanied by abdominal pain that increases with pressure. Also for such problems as immobile masses in the lower abdomen with pain and tenderness, abdominal distention and pain, dysmenorrhea, and retention of the lichia, choppy pulse

41. Analysis of Formula • Chief: gui zhi, fu ling • Gui zhi: acrid, and warm, unblocks the blood vessels and reduces the stasis of blood by promoting circulation • Fu ling: nourishes the qi of the heart and spleen and helps to promote the circulation of the blood, quiets heart and spirit and the fetus, promotes urination and transforms phlegm. • Depute: shao yao • Chi shao: invigorates blood and alleviates blood stasis. • Bai shao: alleviates abdominal pain • Assistant: mu dan pi, tao ren • Mu dan pi, tao ren: transform blood stasis and clear heat due to constraint.

42. Modern application and modifications • Modern application: • Gynecological or post partum problems, primary dysmenorrhea, leiomyoma (uterine fibroids), cervical rosion, ovarian cysts, chronic salpingitis, chonic pelvic inflammatory disease, endometriosis and lochioschesis • Modifications: • For more severe blood stasis, add da huang

43. Bu yang huan wu tang (tonify the yang to restore five decoction) Ingredients:huang qi 120g, dang gui 6g, chuan xiong 3g, chi shao, 4.5g, tao ren 3g, hong hua 3g, di long 3g

44. Actions and indications of the formula • Actions • Tonifies qi, invigorates the blood, unblocks the channels. • Indications • Sequelae of wind stroke including hemiplegia, paralysis, and atrophy of the lower limbs, facial paralysis, slurred speech, drooling, dry stools, frequent urination or urinary incontinence, a white tongue coating

45. Analysis of Formula • Chief: huang qi • Huang qi: strongly tonifies the source qi, when qi is strong, it can more effectively impel the circulation of blood. • Depute: dang gui wei, chuan xiong, chi shao • Invigorate the blood and harmonize the nutritive qi • Assistant: di long, tao ren, hong hua • Invigorate the blood, dispel blood stasis, and unblock the channels

46. Modern application and modifications • Modern application: • Sequelae of cerebrovascular accident, sequelae of poliomyelitis, acute myelitis, sciatica, and thromboangiitis obliterans • Modifications: • For a predominance of cold: add fu zi • For a predominance of spleen and stomach deficiency, add dang shen, bai zhu • For profuse sputum, add ban xia, tian zhu huang • For marked slurred speech, add shi chang pu, yuan zhi • Attentions: • Contraindicated immediately after a stroke when the cause is cerebral hemorrhage • During pregnancy

47. Sheng hua tang (generation and transformation decoction) Ingredients: dang gui, chuan xiong, tao ren, pao jiang, zhi gan cao

48. Actions and indications of the formula • Actions • Invigorates the blood, transforms and dispels blood stasis, warms the menses, and alleviates pain. • Indications • Retention of the lochia accompanied by cold and pain in the lower abdomen, a pale-purple tongue or a pale tongue with purple spots, and a thin submerged, and choppy pulse

49. Analysis of Formula • Chief: dang gui • Dang gui: tonifies and invigorates the blood, transforms blood stasis, and generates new blood. • Depute: tao ren, chuan xiong, • Chuan xiong: invigorates the blood and promotes the movement of qi • Tao ren: invigorates the blood and dispels the stasis • Assistant: pao jiang, • Enters blood and dispels cold, warms menses, and alleviates pain • Yellow wine: warms and dispels cold • Envoy: gan cao • Regulates and harmonizes the other ingredients

50. Modern application and modifications • Modern application: • For post partum recovery when there is retention of the lochia with lower abdominal pain • Retention of placental fragments within the uterus, lochioschesis, painful post partum uterine contractions and chronic endometritis • Modifications: • For severe abdominal pain due to retention of blood stasis: add pu huang, wu ling zhi • For severe cold: add rou gui • For qi deficiency: add huang qi, ren shen • Attention: Blood stasis due to heat