Runxue Tang for Relieving Dysphagia

In Xingyuan (Volume 4) there is a formula called Runxue Tang (“Blood-Moistening Decoction”). Its composition is: Dangguxu (Angelica tail) 1 qian 2 fen (3.6g); Chuanxiong (Ligusticum) 1 qian (3g); Marenzi (linseed) 1 qian (3g); Taoren (peach kernel, skin and tip removed) 1 qian (3g); Honghua (safflower, washed in wine) 3 fen (0.9g); Gancao (raw Glycyrrhiza) 4 fen (1.2g); Chishaoyao (red Paeonia), Huangqin (Scutellaria), and Shengdihuang (raw Rehmannia), each 7 fen (2.1g); and Jupi (tangerine peel, pith removed) 7 fen (2.1g). Decoct in water and take before meals. If the stool is bound and blocked, add a small amount of wine-fried Dahuang (Rheum).

This formula treats ye syndrome (dysphagia), presenting as food having to twist its way down and water and fluids being difficult to swallow. The ye syndrome of TCM is what we commonly call choking on food: the patient has difficulty swallowing. Not only can they not swallow food, but even drinking water is hard. This TCM ye syndrome differs from an isolated, sudden episode of choking on something eaten; it is a recurrent symptom. It is most often seen in patients with lesions of the esophagus or cardia: reflux esophagitis, esophageal cancer, and achalasia of the cardia can all cause ye syndrome, and mediastinal lesions can also cause it. Some cancer patients also experience inability to swallow after radiotherapy. Dysphagia patients commonly have constipation; in severe cases the stool becomes as hard and dry as sheep pellets.

TCM holds that ye syndrome is mostly caused by blood dryness, so treatment should follow the approach of cooling the blood, invigorating blood, and moistening dryness. Runxue Tang is a modification of Taohong Siwu Tang (made of peach kernel, safflower, raw Rehmannia, red Paeonia, Ligusticum, and Angelica). Taohong Siwu Tang cools the blood, invigorates blood, and dissolves stasis to dissipate nodules; added to it are Marenzi, which moistens the intestines and unblocks the bowels, Huangqin, which clears heat and purges fire, and Jupi, which moves qi, resolves phlegm, and dissipates nodules—together forming a formula that cools the blood and dissolves stasis, moistens the intestines and unblocks the bowels, clears heat and purges fire, and resolves phlegm and dissipates nodules. For severe constipation, Dahuang is added to purge heat and unblock the bowels; composed in this way, it hits the disease mechanism squarely.

This formula can be used to relieve the inability to swallow in patients with esophageal cancer and after-effects of radiotherapy.