'Shengxue Qifei Tang' from the Bianzhen Lu for Stroke Sequelae
The Qing-dynasty physician Chen Shiduo's Bianzhen Lu (Records of Pattern Differentiation) contains a formula called Shengxue Qifei Tang (Blood-Generating and Paralysis-Rising Decoction). Its composition is: Yuzhu (Polygonatum) 2 liang (60 g), Shudi (processed Rehmannia) 1 liang (30 g), Shanzhuyu (Cornus Fruit) 4 qian (12 g), Danggui (Angelica) 1 liang (30 g), Fuling (Poria) 5 qian (15 g), Baizjiezi (White Mustard Seed) 5 qian (15 g). Decoct all the herbs together in water, strain, and take warm twice daily.
Shengxue Qifei Tang nourishes yin and blood, resolves phlegm and unblocks the collaterals. It is indicated when blood deficiency fails to nourish the sinews, with phlegm obstructing the collaterals, presenting numbness and insensitivity of the left side of the body, slurred speech, and drooling from the corner of the mouth. Judging from its indications, the formula mainly treats stroke sequelae in modern medicine, most often due to cerebral hemorrhage or cerebral infarction; it is especially suited to ischemic stroke and its sequelae.
This formula uses a large dose of Yuzhu because Yuzhu has some therapeutic effect on nervous system injury. The Shennong Bencaojing (Divine Husbandman's Classic of Materia Medica) records that Yuzhu "maintains the great heat of stroke, inability to move, sinew-binding and flesh-knotting, and all kinds of deficiency," showing that ancient physicians had already found it useful for the hemiplegia and paralysis caused by stroke. Contemporary pharmacological research shows that Yuzhu also treats poliomyelitis; one clinical study included in the Zhongyao Da Cidian (Dictionary of Chinese Materia Medica) reports that decocting Huangqi, Baizhu, Yuzhu, and similar herbs treated 34 cases of poliomyelitis, with 25 cured, 7 markedly effective, and 2 effective. Thus both ancient texts and modern clinical studies show Yuzhu has some effect on nervous system injury.
Shudi and Danggui are common TCM blood-tonifying herbs. TCM holds that Shudi "greatly supplements blood deficiency, unblocks the blood vessels, and boosts qi and strength." Danggui both nourishes and invigorates blood, and works well for diseases of blood deficiency accompanied by blood stasis. Shanzhuyu treats yin-blood deficiency, dizziness, tinnitus, dry throat, and steaming bone arising from dual liver-kidney deficiency; it is also a yin-nourishing, blood-tonifying substance. Fuling fortifies the spleen and leaches dampness; Baizjiezi expels phlegm, moves qi, disperses nodules, and unblocks the collaterals. Together they leach dampness, expel phlegm, and unblock the collaterals. TCM holds that hemiplegia is mostly due to phlegm obstructing the collaterals, so dampness-leaching, phlegm-expelling, collateral-unblocking herbs are used.
This design treats both root and manifestation, and should have some effect on the hemiplegia, slurred speech (speech impairment), and drooling of stroke sequelae that involve both yin-blood deficiency and phlegm obstructing the collaterals.