Zhao Bingnan’s Empirical Formula “Zhuxue Poyu Decoction” for Phlebitis and Intra-abdominal Blood Stasis
“Zhuxue Poyu Decoction” (Blood-Driving and Stasis-Breaking Decoction) is recorded in Zhao Bingnan’s Experience Collection. Its composition is: Shuizhi (Hirudo, leech) 6–12 g, Mengchong (Tabanus, horsefly) 6–12 g, Dilong (Pheretima, earthworm) 9–15 g, Zhechong (Eupolyphaga/Steleophaga, ground beetle) 6–12 g, Heichou (black Pharbitidis Semen) 9–15 g, Lulutong (Liquidambaris Fructus) 15–30 g, Tougucao (Speranskiae Tuberculatae Herba) 9–15 g, Shuihonghuazi (Polygoni Orientalis Fructus) 9–15 g, Panlongshen (Spirantchis Rhizoma) 9–15 g, Zicao (Arnebiae/Lithospermi Radix) 9–15 g.
The actions of this formula are to activate blood and break stasis, unblock the meridians and collaterals. It is indicated for deep thrombophlebitis (the TCM disease name “blood impediment”), intra-abdominal blood stasis, and abdominal masses. If cold is pronounced, add Ziyou Rougui (high-quality Cinnamomi Cortex) 3–6 g.
Zhao Bingnan calls this a heavy-duty blood-activating formula. In it, Shuizhi, Mengchong, and Zhechong break blood and expel stasis; Zicao and Shuihonghua soften hardness, regulate qi, and resolve phlegm; Heichou causes a vigorous purgation and can clear away old, lodged stasis; Lulutong and Tougucao activate blood, unblock the collaterals, and resolve stasis; Panlongshen supplements qi and nourishes yin to support the righteous qi.
Thus this formula both expels pathogen and supports the righteous qi, but it primarily belongs to the pathogen-expelling category.
In this formula of Zhao Bingnan’s, Panlongshen is a relatively uncommon Chinese herb; its main actions are to clear heat and nourish yin, and to supplement qi and support the righteous. Shuizhi, Dilong, and the other herbs in this formula all have strong anticoagulant effects; their thrombolytic action is even stronger than that of aspirin. It is therefore well suited to treating phlebitis, intra-abdominal blood stasis, and abdominal masses.
TCM formula composition differs from Western medicine. TCM formula composition pays great attention to drug pairing. For this disease, Zhao Bingnan used blood-activating and stasis-breaking herbs to dissolve clotted, dead blood, while also using Panlongshen and Zicao to clear heat and cool the blood (which have anti-inflammatory and antibacterial effects), and diuretic herbs such as Heichou and Lulutong to promote the excretion of these harmful substances through the urine—in TCM, “giving the pathogen a way out.” In this author’s humble opinion, replacing Heichou in this formula with Yimucao (Leonuri Herba) might give a better effect with fewer side effects. Such composition creates a systematic therapeutic strategy, which is why it can treat difficult and complicated diseases.
Zhao Bingnan was a renowned master of dermatological and surgical medicine during his lifetime; his formulas fully reflect his profound TCM foundation.