Always Bruised, Blood Feeling Stuck? — Doctor Luo Dalun Explains How to Use Blood-Activating Herbs the Right Way

Search terms: blood stasis / activating blood and resolving stasis / blood blocked up / bruising easily / how to regulate a missed period / blurry eyes after childbirth / how to treat hemorrhoids

Corresponding medical terms: blood stasis syndrome · qi stagnation with blood stasis · central retinitis · amenorrhea · hemorrhoids

Opening: the founding father of blood-activating therapy is still Zhang Zhongjing

Today we continue the thread of activating blood and resolving stasis, and we’ll look at a famous formula — Di Dang Tang (Resist the Blockage Decoction).

💬 Note from Doctor Luo: As we’ve discussed before, Doctor Zhang Zhongjing founded the whole method of treating blood stasis in the Shanghan Zabing Lun (Treatise on Cold Damage and Miscellaneous Diseases) — how to treat it and which formulas to use were all laid out completely, so Zhang Zhongjing is the founder. Later physicians kept developing these ideas; today the blood-activating medicines are very numerous and the methods are complete.

Insect remedies and herbs: worlds apart in force

Blood-activating medicines first divide into two big classes.

💬 Note from Doctor Luo: The first class is the insect remedies — shui zhi (leech), quan xie (scorpion), tu bie chong (ground beetle), wu gong (centipede), and so on. These all have a boring, channel-piercing action and are the stronger stasis-resolvers. Take di long (earthworm), for example — my family uses it all the time. I once explained using earthworm to treat hemorrhoids. In fact a hemorrhoid is itself a kind of stagnant blood: it forms when a venous plexus swells. Earthworm can treat it precisely because it cools the blood and moves it.

The second class is herbs, which are gentler — dang gui (angelica), dan shen (salvia), tao ren (peach kernel), hong hua (safflower). They act mildly, and sometimes they nourish the blood as they move it — chi shao (red peony), for instance: bai shao (white peony) nourishes blood and restrains yin, while red peony leans toward moving, yet it also nourishes blood and restrains yin. Herb-based stasis resolution is much milder in force.

The first patient: caught wind after childbirth, couldn’t see clearly for two years

Let’s start with a case from Doctor Liu Duzhou, the great Cold Damage master of our school, Beijing University of Chinese Medicine.

💬 Note from Doctor Luo: The patient, Ms. Liu, was a 31-year-old woman who caught wind after childbirth. Note that — after giving birth, she was exposed to wind, which caused eye pain, and her vision kept declining — for more than two years. The trouble started in the right eye and the vision kept falling. Examination showed retinal edema and a brownish-black change in the macula, diagnosed as central retinitis. After treatment she recovered somewhat, but then the left eye started declining too — from 1.5 down to 0.1.

Later she was regulated with the patent medicine Shi Hu Ye Guang Wan (Dendrobium Night Vision Pill), and her vision partly recovered: left eye 0.8, right eye 1.2.

💬 Note from Doctor Luo: But her other symptoms never improved — she constantly felt back pain, and her right lower abdomen ached; at every period her legs swelled and her lower back and abdomen ached violently; she was tense, terrified, palpitating and forgetful, sleeping badly, easily forgetting things — her mind itself was disturbed. And look at the tongue: dark purplish-red, with a stasis spot on the right edge — what does that mean? Blood stasis.

A string of strange symptoms, all pointing to one word: “stasis”

The lower-abdominal pain and the back pain were both caused by stasis. And where did the stasis come from?

💬 Note from Doctor Luo: It connects to her catching wind after childbirth. The stasis was never fully expelled. The pulse was wiry and slippery, and from pulse and symptoms together the diagnosis was: stasis in the lower jiao, qi stagnation with blood stasis, turbid stasis rising to disturb the upper body — which changed her vision and caused the recurrent pain. How to treat it? By driving out stasis and activating blood — using the Di Dang Tang approach: da huang (rhubarb), tao ren (peach kernel), mang chong (gadfly), shui zhi (leech), plus dan pi (moutan bark) and bai shao (white peony) to soften the liver and drain liver fire.

One dose of Di Dang Tang — six or seven hours later, “qi rushes to the disease site”

Once the medicine went down, the reaction came fast and fierce.

💬 Note from Doctor Luo: About six or seven hours after taking it, she developed throbbing pain at the back of the head — this is what we call qi rushing to the disease site: the blood level had come alive and the stasis was beginning to dissolve. At the same time her lower abdomen ached, and then she passed a great deal of stool, and her urine came out red as blood — proof that the stasis was dissolving; the stagnant blood really was being broken up. After that, all her symptoms eased rapidly; she suddenly felt light all over and clear-headed.

Switching to Xue Fu Zhu Yu Tang — six doses and her vision returned to normal

Once the stasis had been expelled, the next step was aftercare and regulation.

💬 Note from Doctor Luo: From there the prescription switched to Xue Fu Zhu Yu Tang (Drive Out Stasis in the Mansion of Blood Decoction) — a formula by Doctor Wang Qingren of the Qing dynasty — plus jue ming zi (cassia seed) and chong wei zi (motherwort fruit). After six more doses, her vision recovered to normal. An eye examination showed that the brownish-black change in the macula had basically disappeared. This illness, you see, was entirely a case of stasis at work. Sometimes stasis presents very strangely, and you genuinely cannot tell at first that stasis is the culprit.

And where was the root of this woman’s disease? In childbirth.

💬 Note from Doctor Luo: After she gave birth, her stasis was never fully expelled; then she caught cold and wind, the blood congealed, and the stagnant blood stayed inside. This is exactly why the Chinese ancients said you must keep warm during zuo yue zi (the month of confinement) — no cold wind, no cold water. There is absolutely a reason for it: when blood congeals it is hard to expel, the stasis lodges inside, lodges in the abdomen, and then emotional problems appear, mental problems appear, insomnia, easy forgetfulness, and aching places all over the body — every one of these matches stasis. Ordinary blood-activating herbs would also work, but more slowly; Doctor Liu Duzhou’s single dose settled the whole matter — he used Di Dang Tang to expel the stasis, then regulated with the routine stasis-resolving formula Xue Fu Zhu Yu Tang, and six doses brought complete recovery. That is the power of the classical formulas (jing fang).

The second patient: three months of pills, yet the girl grew thinner and thinner

The second case is a teenage amenorrhea case treated by Doctor Shen Yannan.

💬 Note from Doctor Luo: A teenage girl surnamed Zhou, living near the Little South Gate, about eighteen or nineteen years old, her period absent for three months, complexion withered yellow — note, the yellow of stasis is that withered, dead yellow, a dull dark yellow — and her lower abdomen slightly swollen. It looked like liver-blood wasting, but Doctor Shen saw that stasis was the cause, so he told her to take Da Huang Zhe Chong Wan (Rhubarb and Ground Beetle Pill) — a Zhang Zhongjing formula, a blood-activating patent medicine made of insect remedies. 9 grams per dose, three times a day — quite a large amount; a month should have done it. From then on, the girl’s period did come.

But three months later, a middle-aged woman suddenly arrived with a girl in tow, asking for treatment —

💬 Note from Doctor Luo: One look at the girl — her cheeks were wasted, she hardly looked human, bent over with a distended belly, pressing both hands on her abdomen, moaning without stop. The doctor was puzzled and asked: the disease has come to this — why did you not seek treatment earlier? The woman burst into tears: This is my daughter. Three months ago she saw you, sir, and you had her take the pill. Now her distension has increased, her limbs grow thinner day by day, her backbone sticks out, and her period still has not come. Counting it up, the girl had gone six months without a period.

Doctor Shen broke into a cold sweat: switch to Di Dang Tang at once

When Doctor Shen Yannan heard this, he was horrified and deeply regretted his earlier prescription: he had not given the right formula, and the treatment had made things worse.

💬 Note from Doctor Luo: Doctor Shen said: the disease is now at its last gasp; I must treat it with all the more care. One look at the situation — skin and bone only, wasted to a skeleton; the lower abdomen distended and hard, painful even on light pressure. This is abdominal diagnosis: as I’ve explained before, a hard, full, painful lower abdomen is stasis bound within — if we do not attack the stasis, how can the disease be removed! But he also considered: her qi had already been injured, and she might not withstand attack — should he tonify first? Yet tonifying would let the pathogenic qi linger inside and refuse to leave. He hesitated back and forth, and finally decided: use one fierce dose — Di Dang Tang: mang chong (gadfly) 3 g, shui zhi (leech) 3 g, da huang (rhubarb) 15 g, tao ren (peach kernel) 50 pits.

The next day, mother and daughter came together: the girl had passed a great deal of black stasis, the distension had eased, and the pain was gone. Checking the pulse — extremely deficient; no more attacking. He immediately switched to sheng di (rehmannia), huang qi (astragalus), dang gui (angelica), lu dang shen (codonopsis), chuan xiong (ligusticum), bai shao (white peony) and chen pi (tangerine peel) to tonify qi, move blood and regulate qi. After one dose, she did not return for follow-up.

💬 Note from Doctor Luo: Six years later, he happened to meet her on the road — the young woman had given birth to a son, a child of four or five, and her body had completely recovered. This case is very instructive: at the start, the girl was given a pill formula to resolve stasis, and instead she grew thinner and thinner — why? Blood-activating therapy has its prohibitions; you must know when not to use it.

The big lesson: people with insufficient qi and blood cannot simply activate blood and resolve stasis

Formulas like Di Dang Tang are quite fierce — notice that in these cases nobody takes them for two months straight; usually one dose settles the problem, and once the purging is done, it’s finished, no more.

💬 Note from Doctor Luo: Da Huang Zhe Chong Wan is fierce too, and as a pill at 9 grams three times a day the girl took it for three months — a slow grinding attack; the stasis never came down, and instead the person wasted away. Why? There is a rule in activating blood and resolving stasis: when your qi and blood are insufficient, activating blood and resolving stasis will definitely cause problems. When there is genuinely obvious stasis inside, dissolve it in one go, then quickly support the upright qi; if you want to resolve stasis long-term with a pill formula, you must tonify qi and blood at the same time, or tonify qi and blood first. Never activate blood and resolve stasis for someone whose qi and blood are deficient — the body is weak, and you push and push at the channels; the more you do, the more it consumes the upright qi.

Doctor Luo himself once saw a woman —

💬 Note from Doctor Luo: After childbirth she felt unwell and went to a doctor, who took one look and said: oh! Stasis! So he gave her shui zhi (leech), mang chong (gadfly), wu gong (centipede) and other stasis-resolving herbs to drink every day. After a while she began to fail — black spots before her eyes, emaciated, even her mind disturbed; she could hardly think. Her upright qi had been injured, and it took years to recover. When I saw that prescription — good heavens, leeches and everything — it was simply too fierce. So I helped her support the upright qi as quickly as possible. Everyone remember: do not hate the disease. If the stasis isn’t that much and you attack it with everything — peach kernel, safflower, leech all at once — can the body withstand that kind of assault? You must guide the body with rational TCM theory.

How to resolve stasis in daily life? Eat san qi powder this way, and it’s safe

So what about ordinary people who want to activate blood and resolve stasis — can we eat a little san qi (notoginseng) powder or dan shen powder?

💬 Note from Doctor Luo: It depends on whether your qi and blood are sufficient. If they’re normal, a small amount is fine; if qi and blood are deficient, you must pair it with blood-nourishing remedies — for qi deficiency add something that tonifies middle qi, for blood deficiency use Gui Pi Wan (Spleen-Returning Pill), tonifying both qi and blood. On top of nourishment, resolve stasis slowly — the effect is better, and anything taken long-term must support the upright while resolving stasis. For constrained liver qi, pair with Xue Fu Zhu Yu capsule — that one combines regulating qi with activating blood and resolving stasis.

Why does Doctor Luo keep urging people to eat san qi powder?

💬 Note from Doctor Luo: San qi belongs to the same plant family as ginseng and looks very much like it; it also has a tonifying action — especially when san qi is prepared (cooked), it becomes tonifying — tonifying and moving at the same time. So a small amount — one gram a day, taken consistently long-term — is safe. And san qi contains ginsenosides, which tonify qi while activating blood and resolving stasis. But I really have met people so weak that san qi made them dizzy — why? Too deficient; even the slightest movement of qi and blood is more than they can bear. Such people should first nourish with Gui Pi Wan, let the upright qi build up a little, then resolve stasis gradually. If you want to combine: san qi powder with American ginseng powder — san qi tonifies qi and is warm, American ginseng tonifies qi and nourishes yin — and add a little dan shen powder for movement (dan shen both moves and nourishes blood). Together they’re gentler; one gram each per day, taken consistently, is excellent for activating blood and resolving stasis.

💬 Note from Doctor Luo: Also, many patent medicines contain insect remedies — Tong Xin Luo capsule has shui zhi (leech), Buchang Nao Xin Tong has di long (earthworm) — the amounts are tiny, so a little at a time is fine for resolving stasis; just don’t swallow dozens of pills at once. On the nature of the herbs: dan shen nourishes blood; dang gui nourishes blood while resolving stasis; tao ren and hong hua handle movement; san leng and e zhu move strongly but nourish little — these medicines generally need to be used in combination. And if you add moxibustion, gua sha, cupping or acupuncture, the stasis dissolves even better. Once stasis is dissolved and qi and blood flow freely, the body can be truly healthy; as long as qi and blood are blocked somewhere, the body will definitely have problems — it’s a time bomb.

This article is compiled from Doctor Luo Dalun’s lecture on Doctor Zhang Zhongjing’s blood-activating approach; the case records come from Doctor Liu Duzhou and Doctor Shen Yannan.

What to take away

• Blood stasis causes a huge range of baffling symptoms — fixed pain, back and abdominal pain, insomnia, forgetfulness, emotional disturbance, eye disease, missed periods — and the root may be stasis left behind after childbirth, injury, or long-term obstruction.
• Insect remedies are the heavy artillery (leech, gadfly, scorpion, centipede, earthworm); herbs are the gentle troops (angelica, salvia, peach kernel, safflower). Match the force to the case.
• Never attack stasis when qi and blood are deficient. Fierce formulas like Di Dang Tang or Da Huang Zhe Chong Wan are for a single decisive blow, followed at once by supporting the upright; long-term stasis resolution must pair tonifying with resolving.
• For everyday care, a small daily dose of san qi powder (paired with American ginseng and dan shen if you like) is safe and gentle — but the very weak should tonify first.