Xuefu Zhuyu Decoction for Choking on Water in Patients with Brain Tumors or Cerebrovascular Disease

Xuefu Zhuyu Decoction is an empirical formula of Wang Qingren, a physician of the Qing dynasty. It was originally recorded in Wang Qingren's work Yilin Gaicuo (Correction of Errors Among Physicians).

In Yilin Gaicuo, Wang Qingren used Xuefu Zhuyu Decoction for the treatment of many diseases. As a classic renowned formula for activating blood and resolving stasis, its indications are very broad.

Wang Qingren explicitly pointed out that Xuefu Zhuyu Decoction can treat choking on water. Among the indications listed under Xuefu Zhuyu Decoction in Yilin Gaicuo is one entry: "choking as soon as one drinks water." Wang wrote: "Choking upon drinking water is due to blood stasis in the epiglottis; using this formula is extremely effective."

In clinical practice, patients with brain tumors or cerebrovascular diseases easily develop the symptom of choking on water. These patients find it very difficult to swallow after drinking; Western medicine has no good solution for this symptom.

Previously there was a brain-tumor patient with severe choking on water. Upon a friend's recommendation, after taking Xuefu Zhuyu Decoction, the choking improved markedly; the patient's family passed this experience on to me. Of course, Xuefu Zhuyu Decoction alone cannot treat a brain tumor; treating a brain tumor still requires combining it with other herbs.

Wang's original Xuefu Zhuyu Decoction consisted of: Danggui 3 qian, Shengdi 3 qian, Taoren 4 qian, Honghua 3 qian, Zhiqiao 3 qian, Chishao 2 qian, Chaihu 1 qian, Gancao 2 qian, Jiegeng 1.5 qian, Chuanxiong 1.5 qian, Niuxi 3 qian. Decoct in water for oral use. One qian of the Qing dynasty can basically be converted to about 3-4 grams today. In addition, for the Niuxi in this formula, using Huai Niuxi (Achyranthes) works better than Chuan Niuxi (Cyathula).

Wang also appended a formula song he composed for Xuefu Zhuyu Decoction: "The blood mansion uses Danggui, Shengdi and Tao(ren), Honghua, Gancao, Qiao(zhi) and Chishao; Chaihu, Xiong(qiong), Geng(jie) and Niuxi, make the blood transform and descend without toil."

Xuefu Zhuyu Decoction was developed by adding herbs to Siwu Decoction or Taohong Siwu Decoction. Its base formula is Siwu Decoction from Xian Shou Li Shang Xu Duan Mi Fang (a work of the Tang dynasty Master Lan Dao-ren): Danggui, Shengdi, Chuanxiong, Chishao—four herbs. Adding Taoren and Honghua gives Taohong Siwu Decoction. Wang Qingren then added Zhiqiao, Chaihu, Jiegeng and Niuxi to obtain Xuefu Zhuyu Decoction.

Zhiqiao is often used in orthopedics and traumatology. There is a very classic secret formula in orthopedics consisting solely of Zhiqiao and Maqianzi (nux vomica). The commonly used anti-cancer patent medicine Pingxiao Pian was developed by adding herbs to Maqianzi and Zhiqiao. Zhiqiao has the action of moving qi and resolving stagnation; in patients with pain due to blood stasis, Zhiqiao helps the blood-activating herbs resolve stasis.

According to the traditional theory of Chinese medicine, Chaihu, Jiegeng and Niuxi are all channel-guiding herbs: Jiegeng carries herbs upward, Chaihu guides herbs into the middle jiao, and Niuxi guides herbs downward. Thus, with these three herbs in the formula, it can circulate through the middle and lower jiao. And Xuefu Zhuyu Decoction, as a classic renowned formula for activating blood and resolving stasis, is indeed widely used in modern times to treat the various problems caused by blood-stasis syndromes.