China Tung Hsueh Wan & Blood Stagnation

Plum Flower™ China Tung Hsueh Wan (MW#3957), also known as ‘China Unblock Blood Pills’ / Zhōngguó Tōng Xuè Wán (中國通血丸) is a modern formula particularly designed for the treatment of occasional moderate pain or chronic pain due to Blood Stagnation (or ‘stasis’) (Xuè yū/血瘀) and/or obstructed channels (Bi Syndrome 痺症) due to Blood Stagnation, perhaps combined with Cold, Wind, Damp, or Phlegm. This formula is designed to invigorate and move Blood (Xuè 血) and Qi 氣 stagnation to relieve pain, nourish Blood, and to benefit the Liver and Kidney to strengthen tendons and bones. The formula is especially appropriate following traumatic injury (Diē dǎ 跌打), post-surgery, or for old injuries and/or tissue damage often accompanied by swelling, bruising, and pain. Over time, and if left inadequately treated, the pain may become severe and debilitating.

Blood Stagnation

Blood Stagnation occurs when blood no longer circulates optimally in the blood vessels. Damage to tissues, organs, and/or vessels may result in bleeding, which activates the clotting mechanism. On the exterior, this clot may form a scab. Interiorly, if the vessel is compromised and blood leaves the vessels, an ecchymosis (a bruise), a hematoma, or purpura will form. If visible, this Blood Stagnation will appear red, purple, dark brown, green, or black. If the clot remains in the circulatory system, a thromboembolism may occur. In any case, the normal function of cells, tissues, or organs may be compromised or inhibited.

Blood Stagnation may be a part of the presentation of various risk factors or conditions including smoking, obesity, age (increased risk for people over age 60), a family history of blood clots, irregular menses, oral contraceptives, pregnancy, sports or traumatic injury, certain surgeries, certain cancers, diabetes, hypertension, hypercholesterolemia, immobility (including prolonged inactivity, such as being bedridden, or long trips by plane or car), and long-term overuse such as might occur with repetitive motion injury.

Devascularization may occur in arteries, veins, capillaries, and since they are intimately connected with the blood supply, tissues, sinews, organs, and cells that have been damaged from any cause. Common organ locations of Blood Stagnation internally occur mainly in the Liver, Heart, Uterus, Intestines and Stomach. Heat in the Blood also eventually causes blood to stagnate or congeal, as does Internal Cold. Damage to any Yin structure engenders an inflammatory response by the immune system which intends to promote healing of the damage. The immune system sends specialized cells to effect repair that are accompanied by chemical mediators such as histamines, prostaglandins, bradykinin, et al., which signal the central nervous system that interprets these messages as pain, qualitatively, quantitatively, spatially and temporally, until the tissue is healed. If the damage or injury to the Yin continues or remains unresolved, the pain can become chronic. Chronic pain can not only impair normal functioning, but also affect a patient psychologically. This chronic pain due to an unresolved inflammatory process may also be understood as Blood Stagnation, even without apparent active bleeding.

Another aspect of Blood Stagnation is the need for nourishing the Blood. Whether there is actual blood loss or whether one understands the role of the blood supply in healing damage to the Yin, replenishing, augmenting, and supporting the components of blood is required. Not only do platelets, lymphocytes, monocytes, macrophages and chemical mediators, et al. circulate in the blood, but the proteins, carbohydrates, and lipids necessary for healing damaged cells and tissues are brought by blood to the site of injury as well.

Patient presentation

Patients who may benefit from this formula often present in clinic with a complaint of ‘rheumatism’, ‘lumbago’, ‘arthritis’, traumatic injury, or with a history of an old injury that ‘never went away’. They may exhibit a deep, wiry or choppy pulse (unless they are obviously constitutionally deficient) and a tongue that is dark or with dark spots. If the tongue is red purple, Heat (or inflammation) may be present or active and if the tongue is blue purple, this may indicate concomitant Cold. If there is active bleeding, the blood will be dark in color and there may be clots present.

They may describe their pain as stabbing, boring, or sharp, and fixed in one location (or area). Sometimes, the pain is worse with activity, or they may describe stiffness or weakness with movement. This pain may occur in the chest, epigastrium, hypochondrium, lower abdomen, lower back, or near a joint that has been injured (even if the injury occurred in the past). This formula may be especially appropriate for the elderly or individuals with poor circulation.

Formula Analysis

China Tung Hsueh Wan treats Blood Stagnation, essentially an Excess condition, accompanied by some deficiency, especially of the Liver, Kidney, and/or Blood. Its predominance of invigorating constituents has a distinctive ability to target specific manifestations of pain and trauma. This formula uses herbs that move Qi and stronger herbs to invigorate Blood, while breaking Blood stasis.

The chief herb in the formula is Dāng guī 當歸/Angelica sinensis and together with Shú dì huáng 熟地黃 /prepared Rehmannia glutinosa makes up 25% of the formula. These two herbs work to tonify and nourish Blood, with the Dang gui also assisting the other Invigorate Blood herbs in dispersing Cold and alleviating chronic Bi pain due to Blood Stagnation combined with Blood deficiency. Shu di huang also functions to nourish Yin and tonify Jing, helping with lower back pain.

The bulk of the formula is made up with bitter herbs that mostly go to the Heart and Liver meridians, including Dān shēn丹參/Salvia miltiorrhiza, Rǔ xiāng乳香/Boswellia, Mò yào沒藥/Myrrha, Yán hú suǒ延胡索/Corydalis yanhusuo and Xuè jié血竭/Daemonorops draco that fall into the invigorate Blood and remove stasis categories. Yan hu suo is also notable for its function in treating traumatic injury and moving Qi. Like Yan huo suo, Tǔ mù xiāng 木香(土) /Inula helenium is included to help move and rectify Qi while assisting in stopping pain. Xù duàn續斷/Dipsacus asper tonifies the Liver and Kidneys and strengthens sinews and bone and Ròu guì肉桂/ Cinnamomum cassia bark works to warm the Kidney and tonify Yang, dispersing Cold, warming and unblocking the Channels.

One interesting feature of this unique formula is the inclusion of the herb Ān xí xiāng安息香/ Styrax benzoin, which opens the orifices while invigorating Qi and Blood. Incorporation of this herb brings additional moving, opening and clearing properties to this already powerful combination.

The Formula

Prescribing Information

Dosage: 5 pills, 3 times daily as needed.
Cautions and contraindications: Contraindicated during pregnancy or with hemorrhagic disorders. Use with caution during menses, and those on anti-coagulant therapy. Patients with a deficiency condition such as the elderly, the immune-compromised, and those weakened by chronic disease, may benefit from additional herbs to treat their deficiency.

In the past, this famous formula was adulterated by some manufacturers with pharmaceutical drugs and contained endangered species herbs. Be sure to choose Plum Flower™ China Tung Hsueh Wan, which is authentically formulated, lab-tested, and guaranteed free from adulteration.

About the Author

Skye Sturgeon, DAOM is the Quality Assurance Manager and Special Consultant for Mayway, USA. Skye was the former Chair of Acupuncture & East Asian Medicine and core faculty member at Bastyr University, core faculty member and Faculty Council Chair at the American College of Traditional Chinese Medicine, and President and Senior Professor of the Acupuncture & Integrative Medicine College, Berkeley. Before making Chinese medicine his career choice, Skye held various positions in the Natural Foods Industry for 12 years and prior to that was a clinical biochemist and toxicologist.

References

• Bensky, D. et al., Chinese Herbal Medicine Materia Medica, 3rd Edition, Eastland Press, Seattle, 2004.
• Birch, S., et al., “Understanding blood stasis in traditional East Asian medicine: a comparison of Asian and Western sources”, European Journal of Integrative Medicine, June 2021.
• Fratkin, J., Essential Chinese Formulas, Shya Publications, 2014.
• Xie, Z., On the Standard Nomenclature of Traditional Chinese Medicine, Foreign Language Press, Beijing 2003.
• https://www.sacredlotus.com/
• https://www.americandragon.com/
• https://baike.baidu.com/item/%E5%9C%9F%E6%9C%A8%E9%A6%99/758526