The Blood-Activating, Pain-Relieving Shixiao Powder
Shixiao Powder comes from Taiping Huimin Hejiju Fang (Taiping Imperial Formulary). This formula is made from equal parts of Puhuang (Typhae Pollen) and Wulingzhi (Faeces Trogopterori), ground together into a fine powder. Each dose is 3 g, mixed with vinegar and taken twice daily. Shixiao Powder has the actions of activating blood and dispelling stasis, and dissipating nodules and relieving pain; it is used for the syndrome of static blood stasis. Symptoms include stabbing pain in the chest and heart, epigastric and abdominal pain, or failure of lochia to flow after childbirth, or irregular menstruation with acute lower abdominal pain.
The formula song says: "Shixiao: Wulingzhi and Puhuang, equal parts as powder, decocted in vinegar; when blood stasis causes pain in chest and abdomen, dispelling stasis and stopping pain is extraordinarily effective." Shixiao Powder is decocted with vinegar, not water. Chinese medicine holds that vinegar enters the liver channel; after herbs are processed with vinegar, their pain-relieving effect is stronger, and powder decocted or taken with vinegar also relieves pain better. In fact, plain white vinegar itself has some analgesic effect; traditional Chinese medicine also uses vinegar fumes to treat traumatic injuries.
Today Shixiao Powder is mostly used for chronic gastritis, gastric and duodenal ulcers, angina pectoris, hyperlipidemia, viral hepatitis, poor postpartum uterine involution in women, ectopic pregnancy, endometriosis, pelvic inflammatory disease, dysmenorrhea, functional uterine bleeding, prolonged lochia, costochondritis, cancer, and other conditions belonging to the syndrome of static blood stasis.
Shixiao Powder is a famous formula for activating blood and relieving pain; in the past pharmacies commonly stocked ready-made powder. The Puhuang in the formula is the pollen of cattail, naturally in powder form; Puhuang has the actions of resolving stasis, stopping bleeding, and promoting urination. Wulingzhi is the dried feces of orange-footed flying squirrels and related animals of the Trogopteridae family. Used raw, Wulingzhi moves blood and stops pain, treating various pains due to qi and blood in the chest and abdomen, female amenorrhea, and postpartum stasis pain; externally it treats snake, scorpion, and centipede bites. Fried, it stops bleeding, treating metrorrhagia, excessive menstruation, and persistent red vaginal discharge. The two used together both activate blood and stop bleeding, embodying the biphasic action of certain blood-regulating formulas in Chinese medicine. At the same time, Shixiao Powder also dissipates nodules and relieves pain, making it the formula of first choice for pain due to static blood stasis.
Cancer pain belonging to the syndrome of static blood stasis can also be treated with Shixiao Powder, but Shixiao Powder alone has a limited effect on cancer pain. In treating cancer pain, the author often combines Shixiao Powder with Haifu Powder (equal parts of Ruxiang, Olibanum and Moyao, Myrrha) or Jinlingzi Powder (equal parts of Jinlingzi, Toosendan Fructus and Yuanhu, Corydalis Rhizoma). These three powders are all famous analgesic formulas in Chinese medicine, and all may be decocted or taken with vinegar.
Analgesia uses powder rather than pills or decoction because Chinese medicine says "san means dispersing"; powders have the action of dissipating nodules and scattering static blood. In the past, taking powder saved medicinal materials, was relatively less trouble than decocting, and many herbs used as powder are insoluble in water, so water decoction cannot extract their active components. Once in the stomach, powder is quickly absorbed by the body and takes effect faster than pills; pain relief brooks no delay, so powder is better than pills.
Wulingzhi in Shixiao Powder cannot be used together with Renshen (ginseng), so in principle one must not take ginseng while taking Shixiao Powder. However, some Chinese medicine practitioners do use ginseng and Wulingzhi together to achieve better therapeutic effects. Still, out of caution, the inexperienced should not combine them with ginseng. These blood-activating, stasis-resolving herbs must also not be used in pregnant women, and those with heavy bleeding should use this formula cautiously.