Kai Yu Er Chen Tang: Activating Blood and Resolving Stasis, Dissolving Phlegm and Dispelling Nodules, and Soothing the Liver and Relieving Stagnation
In the Wan's Nü Ke (Wan's Gynecology) there is a formula called "Kai Yu Er Chen Tang." It is composed of Chen Pi (Tangerine Peel), Fu Ling (Poria), Cang Zhu (Atractylodes Rhizome), Xiang Fu (Cyperus), and Chuan Xiong (Sichuan Lovage), each one qian; Ban Xia (Pinellia), Qing Pi (Green Tangerine Peel), E Zhu (Curcuma), and Bing Lang (Betel Nut), each seven fen; and Gan Cao (Licorice) and Mu Xiang (Aucklandia), each five fen. When used, these are ground to a powder and decocted in water. The original book also requires taking "Si Zhi Xiang Fu Wan" (Four-Process Cyperus Pills) at the same time.
In ancient times this formula was mostly used to treat women's qi-stagnation amenorrhea and dysmenorrhea, presenting with mental depression, irritability and easy anger, chest and hypochondriac distending pain, lower abdominal pain, or lumps in the lower abdomen that are soft on pressure and sometimes painful, profuse sticky leukorrhea, chest and epigastric fullness, an obese build, a dark-purple tongue or petechiae, obvious varicosity of the sublingual veins, and a white greasy tongue coating. The key indication for this formula is the patient's depressive irritability together with abundant phlegm and qi-stagnation pain.
In modern times it is mostly used for women's amenorrhea, premenstrual tension syndrome, ovarian cysts, uterine fibroids, pelvic inflammatory disease, and mammary hyperplasia belonging to phlegm-dampness and stasis binding with qi stagnation; it can also be used for various early-stage tumors belonging to phlegm obstructing qi and blood stasis lingering internally. In addition, this formula can relieve pain caused by hepatobiliary diseases such as cholecystitis, gallstones, liver cancer, gallbladder cancer, and bile duct cancer.
This formula is mainly composed of herbs that move qi, resolve stasis, and resolve phlegm. The "Kai Yu" (opening stagnation) in the name already indicates that the patient has symptoms of mental stagnation; the "Er Chen" is because the formula contains the famous phlegm-resolving formula Er Chen Tang (Two Aged Herbs Decoction—composed of Chen Pi, Ban Xia, Fu Ling, and Gan Cao, the most commonly used TCM phlegm-resolving formula). Phlegm-dampness and blood stasis often bind together, forming the pattern of phlegm and stasis mutually binding, and then induce the sequela of qi stagnation. Therefore, treating such diseases must address moving qi, resolving stasis, and resolving phlegm simultaneously.
In this formula, Chen Pi, Qing Pi, Xiang Fu, Mu Xiang, and Bing Lang are all qi-moving herbs; E Zhu, while activating blood and resolving stasis, also moves qi and stops pain; Chuan Xiong and E Zhu activate blood and resolve stasis; among the qi-moving herbs, Xiang Fu and Qing Pi also activate blood, resolve stasis, and soothe the liver and relieve stagnation; Fu Ling, Ban Xia, and Cang Zhu dry dampness and resolve phlegm; Gan Cao harmonizes the other herbs. Thus the combined herbs achieve the effects of activating blood and resolving stasis, dissolving phlegm and dispelling nodules, and soothing the liver and relieving stagnation.
If the patient's pain is severe, this formula may be combined with Jin Ling Zi San (made of Yuan Hu/Corydalis and Chuan Lian Zi/Toosendan Fruit); if blood-stasis pain is severe, it may be combined with Hai Fu San (made of Ru Xiang/Frankincense and Mo Yao/Myrrh) or Qi Li San. When used for tumors, this formula must be combined with antitumor drugs such as Xi Huang Wan, Xiao Jin Wan, and Hua Chan Su; using this formula alone has no notable anticancer effect.