Duoming Huanzhen Dan from Wanbing Huichun for Stroke Sequelae
Duoming Huanzhen Dan (Life-Snatching Truth-Retaining Elixir) comes from Wanbing Huichun (Restoring Health to Myriad Diseases) by the Ming-dynasty physician Gong Tingxian. It is a formula that primarily supports the righteous qi for treating stroke sequelae. In that book, Gong Tingxian says: “For stroke with paralysis of the hands and feet, a crooked mouth, and slurred speech, when the condition is due to blood deficiency with exuberant fire, clear supplementation is appropriate.” For this condition he recommends clear supplementation, using the formula Duoming Huanzhen Dan. The indications recorded by Gong Tingxian are: “hemiplagia after stroke, paralysis of the hands and feet, deviation of the mouth and eye, and stiffness and slurring of speech”—typical sequelae of stroke.
The composition of Duoming Huanzhen Dan is as follows: Danggui (Angelicae Sinensis Radix; washed in wine, one liang), Chuanxiong (Ligustici Chuanxiong Rhizoma; five qian), Baishao (Paeoniae Alba Radix; wine-fried, one liang), Shudihuang (Rehmanniae Praeparata Radix; five qian), Shengdihuang (Rehmanniae Radix; five qian), Renshen (Ginseng Radix et Rhizoma; root removed, seven qian), Baizhu (Atractylodis Macrocephalae Rhizoma; root removed, seven qian and a half), Chenpi (Citri Reticulatae Pericarpium; white part removed, five qian), Baifuling (Poria; skin removed, one liang), Banxia (Pinelliae Rhizoma; processed with ginger, one liang), Zhiqiao (Aurantii Fructus; bran-fried, one liang), Jiegeng (Platycodi Radix; root removed, one liang), Muxiang (Aucklandiae Radix; seven qian and five fen), Guizhi (Cinnamomi Cortex; five qian), Quanxie (Scorpio; toxin removed, five qian), Tianma (Gastrodiae Rhizoma; seven qian and five fen), Fangfeng (Saposhnikoviae Radix; root removed, one liang), Jiangcan (Bombyx Batryticatus; fried, five qian), Qianghuo (Notopterygii Rhizoma et Radix; one liang and five qian), Duhuo (Angelicae Pubescentis Radix; seven qian and five fen), Gaoben (Ligustici Rhizoma; seven qian and five fen), Xixin (Asari Radix et Rhizoma; three qian), Boheye (Menthae Folium; one liang), Juhua (Chrysanthemi Flos; five qian), Zhimu (Anemarrhenae Rhizoma; one liang), Ruan Shigao (Gypsum; one liang), Chaihu (Bupleuri Radix; one liang), Huangqin (Scutellariae Radix; five qian), Huanglian (Coptidis Rhizoma; five qian), Digupi (Lycii Cortex; five qian), Manjingzi (Viticis Fructus; five qian), Tusizi (Cuscutae Semen; wine-processed, seven qian and five fen), Xiaohuixiang (Foeniculi Fructus; wine-fried, one liang), Duzhong (Eucommiae Cortex; wine-fried, one liang), Mahuang (Ephedrae Herba; one liang), Gejie (Gecko;酥炙 gilded-fried, one liang), Gancao (Glycyrrhizae Radix et Rhizoma; one liang). Grind all thirty-seven herbs into powder; refine with honey into pills the size of a pellet, coated with gold foil. Take one pill each time, chew finely, and send down with tea or wine as desired.
In the Ming dynasty, one liang equaled ten qian, and one qian equaled ten fen. The above formula may be prepared by these proportions. However, coating with gold foil is impractical and can be omitted. In addition, Xixin in this formula has carcinogenic side effects with long-term use, and treatment of stroke sequelae generally requires a long course; this herb may also be omitted. Gong Tingxian’s formula is a large compound; omitting one or two herbs has little effect on efficacy.
From Gong Tingxian’s record on stroke sequelae and his compositional logic, he must have had rich clinical experience in treating stroke sequelae. His formula is basically based on Shiquan Dabu Tang (Ten-Ingredient Great Supplementation Decoction), with added heat-clearing and fire-purging, blood-activating and stasis-resolving, and orifice-opening, mind-awakening herbs. This formula supplements qi and blood, lowers blood pressure, anticoagulates, thrombolyzes, stops pain, and unblocks the channels and collaterals, and has some effect in improving cerebral circulation.
Gong Tingxian used 37 herbs in total; such a formula counted as a large one even in the past. But this formula lacks calming-the-spirit and sleep-promoting herbs, which is its shortcoming, so there is room for improvement. Still, this base formula is already quite good. Stroke sequelae are extremely complex and difficult to treat; they cannot be solved by a simple formula alone. That Gong dared to medicate so comprehensively is already remarkable.