Shujin Bao'an Powder by the Song Physician Chen Yan for Stroke Sequelae
In the Song-dynasty medical work Sanyin Ji Yi Bingzheng Fanglun (Treatise on the Three Categories of Pathogenic Factors of Diseases) by the medical scholar Chen Yan, there is a formula called "Shujin Bao'an San" (Sinew-Relaxing and Security Powder). Its composition is as follows: dried Mugua (Fructus Chaenomelis), Bixie (Rhizoma Dioscoreae Hypoglaucae), Wulingzhi (Faeces Trogopterori), Niuxi (Radix Achyranthis Bidentatae), Tianma (Rhizoma Gastrodiae), Xuduan (Radix Dipsaci), Baijiangcan (Bombyx Batryticatus), Songshen (Lignum Pini Nodi), Baishao (Radix Paeoniae Alba), Wuyao (Radix Linderae, wood removed), Weilingxian (Radix Clematidis), Huangqi (Radix Astragali), Chuandanggui (Radix Angelicae Sinensis), Fangfeng (Radix Saposhnikoviae, forks removed), and Hugu (Os Tigris, now replaced by dog bone or omitted), each 1 liang (30 g). Steep the above herbs in 7.5 sheng of unashed wine for 27 days, sealing tightly. After several days, remove the herbs, bake them dry, and pound them together into a coarse powder. Prepare as a powder; take 2 qian (6 g) each time, washed down with 75 ml of the herb-infused wine, followed by rice-water gruel.
The actions of this formula are to dispel wind and dampness, activate blood and relax the sinews. It is indicated for left-side and right-side paralysis, muscle and vessel spasms, hemiplegia, weakness of the legs, dry and wet beriberi, and dampness obstructing the channels and collaterals with inability to stand for long. The above symptoms are mostly seen in patients with cerebral thrombosis or sequelae of cerebral hemorrhage.
Chen Yan's formula uses dampness-draining herbs (such as Mugua, Bixie, Weilingxian), wind-dispersing herbs (such as Fangfeng and Wuyao), blood-activating herbs (such as Wulingzhi, Danggui, Songshen, and Niuxi), as well as the phlegm-resolving herbs of traditional TCM (such as Baijiangcan) and root-supporting, zheng-securing herbs (such as Danggui, Huangqi, Xuduan, Tianma, and Niuxi). Hugu (tiger bone) is no longer used today because tigers are protected animals; modern practice often substitutes dog bone. In fact, even without tiger bone, this formula is already complete in composition, so omitting this single herb has little effect on efficacy.
This formula can improve blood supply to the brain. In the formula, Tianma has some repairing effect on the nervous system; Wulingzhi, Danggui, Songshen, and Niuxi have relatively obvious anticoagulant and antithrombotic effects. The formula uses wine to steep the herbs because the organic compounds in the various herbs dissolve in ethanol; after wine-steeping, their active constituents are readily extracted.
Stroke sequelae are difficult to treat. Although this formula has some effect on such conditions, recovery will not be quick. Patients should psychologically prepare for long-term medication; the course of treatment is basically at least three months.