Huangu Dan (Bone-Transforming Pill) for Stroke Sequelae, Recorded in the Bian Que Xin Shu
In the book Bian Que Xin Shu (Heartbook of Bian Que), compiled by the Song-dynasty physician Dou Cai, a formula named “Huangu Dan” (Bone-Transforming Pill) is recorded. Its composition is: Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Alba Radix), Renshen (Ginseng Radix), and Weilingxian (Clematidis Radix et Rhizoma), each 2 liang (60 g); Tiannanxing (Arisaema cum Bile, i.e., processed Dannannanxing) 3 liang (90 g); Ruxiang (Olibanum, degreased) 2 liang (60 g); Moyao (Myrrha, degreased) 2 liang (60 g); Mahuang (Ephedrae Herba, nodes removed, decocted separately and the juice combined with the other herbs) 3 jin (1.5 kg).
Except for Mahuang, grind the above herbs into a fine powder. Use the decocted Mahuang juice to knead the powder into pills the size of a bullet (about 6 g each). Take 1 pill each time, washed down with ash-free rice wine, 3 times a day; the dose is adjusted until sweating is induced. This formula expels wind and resolves phlegm, activates blood and unblocks the collaterals, and is indicated for hemiplegia, slurred speech, and aphasia resulting from stroke—i.e., the hemiparesis and speech disorders seen in post-stroke sequelae.
The Tiannanxing in this formula must not be raw Arisaema, as it is too toxic; processed Dannannanxing (Arisaema cum Bile) must be used. Judging from its composition, the formula mainly supplements deficiency, expels wind, resolves phlegm, and activates blood. Renshen strongly supplements original qi; Danggui and Baishao both nourish and activate blood; Tiannanxing dissipates phlegm and disperses nodules; Ruxiang and Moyao activate blood and resolve stasis; Weilingxian is a key herb for bi-syndrome and provides symptomatic support for hemiplegia; Mahuang expels wind and disperses cold, while also activating blood, promoting urination, and reducing swelling. Used together, they address the constellation of problems in post-stroke patients.
However, the safety of this formula requires further verification. Not only is the Tiannanxing relatively toxic, but the Mahuang in the formula also raises blood pressure; since most stroke-sequelae patients already have hypertension, patients taking it should watch for adverse reactions and monitor their blood pressure.
No ready-made patent version of this formula is sold. If a patient wishes to try it, it must be prepared by the method above.