Wulong Wan (Black Dragon Pills) for Treating Sequelae of Stroke

The Wulong Wan (Black Dragon Pill) formula comes from the Puji Fang (Prescriptions Universal Relief, quoting the Jingyan Fang, Experienced Prescriptions). Its composition is as follows: "One whole Zaoshe (Zaocys, pit viper; use the entire snake, remove the head and tail, cut into segments of about 6 cm, pound lightly, steep in wine overnight, remove the skin and bones, and dry in an oven); Jingjiesui (Schizonepeta spike), Bohezhi (mint juice), and Weilingxian (Clematis; only scrape off the fine downy rootlets, rinse quickly in warm water until clean, do not expose to fire, dry in the sun) — each 4 liang (120 g)."

The preparation method is to grind the above herbs into a fine powder. Separately take 500 g of Zaojiao (honey locust), scrape off the black bark and pound it, steep in 2 L of running water overnight, wash clean, wring out the juice, filter through raw silk, and simmer slowly in a silver or earthenware vessel until 1 L remains. Add 120 g of white honey and continue simmering into a thick paste. Mix this paste thoroughly with the herbal powder and form into pills the size of a parasol tree seed.

The dosing is 15–20 pills each time, taken with a decoction of Bohe (mint), three times daily, regardless of meals. After taking it for 5–7 days, the patient may feel pain in the hands and feet. Do not be alarmed — this is a expected reaction to the medication. Continue taking it until the patient has basically recovered, then maintain on one or two doses daily for another 3–6 months before stopping.

This formula has the actions of expelling wind and dampness, and unblocking the channels and collaterals. It is indicated for post-stroke hemiplegia of the hands and feet, with phlegm-saliva and hesitancy of speech. According to this description, it can treat hemiplegia, drooling of phlegm-saliva, and speech disturbance caused by cerebral hemorrhage or cerebral infarction.

This formula uses simple ingredients. Zaoshe, Jingjiesui, Bohezhi, and Weilingxian all have wind-expelling and blood-activating actions; among them, Zaojiao has the strongest blood-activating effect. However, caution is needed with Zaojiao, because it may trigger a hemolytic reaction with relatively serious consequences. Patients taking this formula should therefore be observed closely.

From the perspective of modern pharmacology, this combination functions as a fairly potent thrombolytic agent with strong anticoagulant effects. When using such drugs, close attention must be paid to any bleeding reaction. If the patient's stools turn black, the medication should not be continued, as this may indicate gastric bleeding.