Sharp Pains in One Spot, a Tight Chest, and Getting Angry for No Reason? Doctor Luo Dalun on Xue Fu Zhu Yu Tang (House of Blood Stasis Decoction) — the Famous Qing-Dynasty Formula for Qi Stagnation and Blood Stasis

After the pandemic, have you noticed people like this around you? The heart stabs now and then, almost like angina; a nodule shows up in the lung; at night they toss and turn and cannot sleep; by day the head is foggy and heavy, and they doze off at the slightest excuse; a tiny little thing makes the chest feel suffocated, and they get impatient easily… If you or a family member have any of these, this decoction is something you really should get to know today.

💬 Note from Doctor Luo: Dear friends, good morning, everyone. These past days I have been talking about the various problems caused by the pandemic. Today I will continue, because the truth is that the pandemic has left too many problems behind. Every day I read the things you write, and my heart aches — how can we get everyone’s body back to normal as quickly as possible? So I have to keep at it relentlessly, talking a little every day. You listen, and you can regulate some of your own problems.

Opening: why does this decoction suddenly come to mind after the pandemic? — the ‘blood stasis’ problem COVID left behind

Doctor Luo Dalun says that before the pandemic, he had never really formally lectured on this formula — it was the pandemic that pushed it to the front of the stage. The reason is simple: this pandemic has left behind a huge amount of blood stasis (yu xue).

💬 Note from Doctor Luo: COVID (Omicron) causes blood stasis — I raised this point long ago. Now more and more people are studying it, and it really turns out to be true. Western medicine has confirmed it too: they have researched in fine detail the people with heart problems, microcirculation problems, platelet aggregation. For example, after the pandemic many people feel their heart is not right — it pounds wildly at the slightest movement, they often have heart pain, sometimes stabbing pain, pain after eating, just like angina. All kinds of heart trouble — this is a very dangerous thing. Of the people I saw who passed away, quite a lot of middle-aged people died from heart problems, not from lung problems.

Where else does blood stasis settle? In the lungs — inflammation, forming various nodules and blockages; the kidneys also take a hit — some people’s creatinine went up after catching the virus, meaning the waste that should have been carried out of the blood did not leave, and the kidneys’ filtration function is in trouble.

💬 Note from Doctor Luo: What does a high creatinine mean? Half of the kidney has already stopped working. If even half is working, creatinine will not rise — the kidneys are highly compensatory, the remaining half does all the work. If creatinine is high, it means more than half of the kidney has already failed. That is quite frightening.

Then there is the aching arms and legs, the sleepless nights (some are a Shao Yang pattern, some are simply caused by blood stasis), and the poor blood supply to the head — constantly foggy and heavy, sleepier than before, dizzy, always wanting to doze off. All of these are the mischief of blood stasis. So the formula we talk about today is aimed precisely at it — Xue Fu Zhu Yu Tang (House of Blood Stasis Decoction).

Who created it? — the Qing-dynasty reformer who dared to dissect corpses: Doctor Wang Qingren

Where does this formula come from? From a great master of Chinese medicine in the Qing Dynasty — Doctor Wang Qingren, in his book Yi Lin Gai Cuo (Correcting the Errors in the Medical World).

💬 Note from Doctor Luo: Doctor Wang Qingren was a reformer of Chinese medicine. He found that many things in Chinese medicine were not clearly explained — anatomy in particular — so he went and dissected corpses himself. The Chinese traditionally did not touch corpses — in the most ancient times, in the Huang Di Nei Jing (Yellow Emperor’s Inner Classic), there was anatomy: through war and slavery, people knew roughly how the body was put together. But in later generations, anatomy was not done enough. Doctor Wang Qingren personally performed dissections, discovered certain problems, and put forward some reformist ideas — some were right, some had small errors, but that does not affect how well he composed his formulas. Yi Lin Gai Cuo produced many formulas, every one of them excellent — and the most famous is Xue Fu Zhu Yu Tang.

How is the formula put together? — Tao Hong Si Wu Tang plus Si Ni San, three jobs done at once

The strategy of Xue Fu Zhu Yu Tang can be summed up in one sentence: move the qi, invigorate the blood and resolve stasis, and nourish the blood — all at the same time. It is built from two famous formulas joined together — Tao Hong Si Wu Tang (Peach Kernel and Safflower Four Agents Decoction) plus Si Ni San (Four Rebellious Powder).

💬 Note from Doctor Luo: What is Si Ni San? It soothes the liver, moves and opens the qi of the chest — four herbs: chai hu (bupleurum), zhi shi (immature bitter orange), shao yao (white peony), gan cao (licorice). Why move the qi? Qi must move for blood to flow — you say there is stasis here, so I come to unblock the stasis; but if the qi does not move, how can the blood move? The qi is knotted up inside, so of course the blood congeals. So you must move the qi; moving the qi is what allows the blood to circulate and the stasis to resolve. This is a very elevated strategy.

Then Tao Hong Si Wu Tang — Si Wu Tang (di huang rehmannia, dang gui angelica, shao yao white peony, chuan xiong ligusticum) nourishes the blood, while tao ren (peach kernel) and hong hua (safflower) invigorate the blood. Two more guiding herbs are added: niu xi (achyranthes) carries things downward, and jie geng (platycodon) carries things upward, so the qi mechanism flows freely above and below instead of knotting in the middle.

💬 Note from Doctor Luo: Why must a blood-invigorating, stasis-resolving formula also nourish the blood? This is the most brilliant part of the formula — I must nourish your blood first, and only then can the stasis truly dissolve. If you do not nourish the blood, many people simply invigorate blood and resolve stasis without nourishing blood or tonifying qi — and sometimes that actually harms the upright qi. Why? Think of a river: in summer the water is nearly dried up, and in certain places it silts up section by section — why does it silt up? Because the total water is insufficient! Once we top the water up, the blockages get washed open by themselves. That is the elevated strategy of nourishing blood while invigorating blood.

Moreover, in the later stage of the pandemic, a great many people became blood deficient. People with blood deficiency have a typical symptom: they take a fever-reducing medicine and cannot even break a sweat — the fever will not come down.

💬 Note from Doctor Luo: Why is this person blood deficient? Give them blood-nourishing treatment, and it is like clouds — with no clouds, how can it rain? Increase the clouds, raise the clouds to bring rain, and suddenly they sweat, and only then does the pathogen retreat. Many people are blood deficient without knowing it. Look at this formula: Si Wu Tang nourishes the blood, tao ren and hong hua invigorate the blood, niu xi and jie geng regulate the qi above and below, Si Ni San soothes the liver horizontally — moving qi while nourishing blood, moving qi without harming upright qi, and resolving stasis at the same time. This is a very complete strategy.

How is it different from Tongxinluo and Naoxintong? — moving qi and resolving stasis, not tonifying qi and resolving stasis

There are many proprietary cardiovascular medicines on the market today. What is the difference between Xue Fu Zhu Yu Tang (or its capsule form) and those? Doctor Luo Dalun made a specific comparison.

💬 Note from Doctor Luo: Tongxinluo capsules contain qi-tonifying herbs like ren shen (ginseng), plus some insect-based channel-freeing agents — its strategy is to tonify qi, nourish blood and free the channels. Buchang Naoxintong uses another formula by Doctor Wang Qingren — the Bu Yang Huan Wu Tang (Tonify Yang to Restore Five-Tenths Decoction) approach: huang qi (astragalus) to tonify qi plus blood-invigorating, stasis-resolving herbs — again, tonify qi and resolve stasis. But Xue Fu Zhu Yu Tang? It is move qi and resolve stasis — remember this, the directions are different. If your qi is very deficient, you can add a bit of huang qi or ren shen into it to pair with the qi tonification; or you can take a qi-tonifying medicine one or two hours apart, and drink it more often — either way works.

The first ailments Doctor Wang listed: stubborn headache, chest pain, and the strange illness of ‘nothing can touch my chest’

In Yi Lin Gai Cuo, Doctor Wang Qingren listed a long string of indications for Xue Fu Zhu Yu Tang. Let us start with the two most common kinds of pain.

💬 Note from Doctor Luo: The first is headache — some headaches simply will not get better no matter how you treat them. Why? Blood stasis. Headaches caused by qi-blood stasis from qi stagnation respond very well to this formula. The second is chest pain — the usual qi-regulating methods do not work, but this kind of stasis chest pain caused by qi stagnation in the chest stops with a single dose. So the main battlefield of his treatment is the chest.

Then come two especially legendary strange illnesses — ‘chest that cannot bear objects’ (xiong bu ren wu) and ‘chest that must bear weight’ (xiong ren zhong wu).

💬 Note from Doctor Luo: Xiong bu ren wu — lying down, nothing can be placed on the chest. There was a Jiangxi governor, Master Ali Gong, 74 years old. At night he had to sleep with his chest exposed — he could not cover it, could not wear clothes; even one layer of cloth over it and he could not sleep. It had been seven years. He invited Doctor Wang Qingren to treat him — five doses, and he was cured. Xiong ren zhong wu? A 22-year-old woman had to have a maid or another woman sit on her chest to fall asleep at night — two years of this. Doctor Wang Qingren cured her with three doses. Doctor Wang himself said: if you brought these two illnesses together and asked me what the root cause was, I could not even answer (he yi da zhi) — blood stasis can cause strange symptoms, throw the body’s functions out of balance, and lead to sleep disorders. So some people cannot sleep lying flat but can sleep on their side — why? There is blood stasis, stasis in the chest, pressing on the heart through some unknown mechanism, and they genuinely cannot sleep. These strange cases are one in a hundred, we may never see one, but you cannot say they do not exist.

Sweating at dawn and the ‘lantern disease’ — spontaneous and night sweats are not always deficiency; blood stasis also makes you sweat

An age-old conclusion says: sweating during the day is spontaneous sweating from qi deficiency, sweating while asleep at night is night sweats from yin deficiency — so you should tonify qi to secure the exterior, and nourish yin to downbear fire. But Doctor Wang Qingren discovered that some people’s sweating is rooted not in deficiency, but in stasis.

💬 Note from Doctor Luo: Some people sweat when they wake at dawn. Tonifying qi to secure the exterior, nourishing yin to downbear fire — all tried, no effect, and sometimes it even gets a bit worse after taking the medicine. Doctor Wang Qingren said: you do not know — blood stasis also causes spontaneous sweating and night sweats. Why? The channels are blocked, the body fluids cannot circulate smoothly, and at certain moments they leak out from the side — like a river: put a rock in it to block the flow, the water cannot go its normal way, and it gushes out around the sides. This kind of abnormal sweating stops with one or two doses of Xue Fu Zhu Yu Tang.

There is another condition called the ‘lantern disease’ (deng long bing) — cold on the outside, hot inside.

💬 Note from Doctor Luo: The heart feels as if a fire is burning in it, a stifling sensation, yet the body feels cold. You think it is deficiency heat — you tonify, and the more you tonify the worse it gets. You think it is excess fire — you clear it with cold herbs, and the more you clear, the more it congeals. Why? Because blood stasis is blocking things up inside, so the heart feels fidgety and hot. Use Xue Fu Zhu Yu Tang to spread the qi mechanism open and unblock the stasis, and it gets better quickly.

Muffled by small things, talking too fast when upset, dreaming every night, stubborn hiccups — these ‘emotional ailments’ are also qi stagnation and blood stasis

Doctor Wang Qingren also wrote about many symptoms related to emotion. Doctor Luo Dalun says his writing is very interesting — he only describes the phenomena, hardly analyzes them, but behind every one of them there is a principle.

💬 Note from Doctor Luo: The first is called mao men — muffled gloom. A tiny little matter, and the heart is stifled beyond endurance. This is liver qi stagnation, related to emotion: bad mood, a bit of anger, qi stagnation and blood stasis, and the heart knots up. At this point you need to soothe the liver qi open — that is exactly what the Si Ni San in the formula does. Once the liver qi is soothed and the stasis resolved, two or three doses will do. The second is irritability — normally a good-natured person, but when ill they become impatient and speak very fast. This is not a personality problem; the qi really is not flowing smoothly: the qi in the chest is blocked and impatient, and once they get worked up the suffocation gets worse and the speech speeds up. You see a lot of such people in the Northeast — fine normally, but the moment they get anxious, their speech stumbles. People with impatient qi almost always have blood stasis, and this formula works very well for them.

Then there are the dreams every night and the stubborn hiccups.

💬 Note from Doctor Luo: Dreaming every night — constrained liver qi, and constrained liver qi leads to blood stasis, and blood stasis makes the liver qi even more constrained — a vicious cycle, which is why the dreams are so many. Doctor Wang Qingren said one or two doses cure it. Stubborn hiccups — the usual stomach-warming formulas do not work; some of them are simply blood stasis, and Xue Fu Zhu Yu Tang stops them immediately.

Choking on water, rolling around the bed all night, babies crying at night, a racing heart — the strange ailments, all collected

The symptoms Doctor Wang Qingren listed go far beyond these. Doctor Luo Dalun walks through them one by one — all of them are real clinical problems.

Choking on water (yin shui ji qiang) — choking even when drinking water; examination shows blood stasis at the epiglottis.

💬 Note from Doctor Luo: Qi stagnates in the chest and rushes upward, creating blood stasis at the throat and epiglottis. If modern medicine examines it, there will be inflammation — why? Constrained liver qi, the qi mechanism rushing upward, stomach acid and other contents refluxing up and slowly eroding the throat — so some people cough yellow phlegm for no reason, or have sore throats for no reason. For this kind of choking-on-water, use the soothe-liver, move-qi, resolve-stasis approach, plus a little throat-clearing medicine, and it works even better. Doctor Wang Qingren said: this formula is extremely effective, and the old masters’ commentaries were all wrong.

Insomnia (bu mian) — cannot sleep at night; sedative and blood-nourishing medicines have all been tried and failed.

💬 Note from Doctor Luo: Doctor Wang Qingren said this formula works like magic. Why can one not sleep peacefully? Constrained liver qi, qi mechanism knotted, leading to blood stasis; qi and blood cannot circulate smoothly, blood cannot nourish the heart — how could sleep be good? Spread the qi open, soothe the liver, move the qi, resolve the stasis — and the formula also contains blood-nourishing herbs; together the effect is excellent.

Infant crying at night (xiao er ye ti) — perfectly fine during the day, but at night the baby wails and cries.

💬 Note from Doctor Luo: In the old days people pasted little notes on telephone poles: “Our family has a night-crying boy; kind passersby, take a look, may he sleep through till dawn.” Doctor Wang Qingren asked: why does he not cry in the day, only at night? Because there is blood stasis inside — blood is yin, so the illness acts at night. One or two doses of this formula cure it. Doctor Wang Qingren observed life carefully — very interesting man.

A racing, anxious heart (xin tiao xin mang) — the heart pounding wildly. This one truly got used after the pandemic.

💬 Note from Doctor Luo: The heart is flustered, pounding terribly. Some cases can be nourished, but when Gui Pi Wan (Spleen-Restoring Pill) and calming formulas have no effect, what do you do? This formula hits the mark every time — anyone with signs of blood stasis can try it.

Restless nights (ye bu an) — about to lie down, then up again; lying down, then wanting to sit up; not a moment of peace all night, rolling around the bed.

💬 Note from Doctor Luo: This is blood stasis in the chest, actually caused by constrained liver qi — of course you cannot sleep well at night; it is the same as insomnia, a clear agitation related to emotion.

Getting angry for no reason (wu gu ai sheng qi) — flying into a temper over nothing.

💬 Note from Doctor Luo: Anger for no reason is constrained liver qi. Doctor Wang Qingren rarely used the term “gan qi bu shu (constrained liver qi)”, but he never left emotion out of the picture. This formula nourishes the blood, resolves stasis, and soothes the liver qi all at once — so Xue Fu Zhu Yu Tang is quite a suitable formula for modern people. Have you noticed?

There is also dry retching (gan ou) — a sign of constrained liver qi (strictly speaking, not much to do with blood stasis); and an evening fever flare (wan fa yi zhen re) — internal heat and a flare of skin heat every evening, from blood stasis knotting up so the blood cannot return and repair; one dose cures it, two for severe cases.

How to tell if you have blood stasis? — look at the lips, the tongue, and under the tongue

After all these symptoms, how do you know you have a blood-stasis constitution? Doctor Luo Dalun gives the three most direct signs.

💬 Note from Doctor Luo: Anyone with blood stasis — dark purple lips, purple tongue edges, thick sublingual veins — can use this formula. To sum up: constrained liver qi, qi mechanism stagnant, causing qi to knot and blood to knot, and blood stasis forms. The regulating strategy is to soothe the liver, nourish the blood, free the channels, and resolve stasis. When you meet this kind of qi stagnation that needs qi moving, this formula can be used; when you need to resolve stasis, it can be used too.

Closing: pair it with astragalus if your qi is deficient — the big recovery strategy after COVID

The one thing this formula “lacks” is qi tonification. How should people with qi deficiency use it? Doctor Luo Dalun gives a concrete method, and also sums up the whole recovery strategy for the post-pandemic period.

💬 Note from Doctor Luo: What this formula lacks is tonifying the qi. If you feel your upright qi is insufficient, you can separate the qi tonification from the stasis resolution — for example, take Xue Fu Zhu Yu, then one or two hours later take a qi-tonifying medicine, pair it with a bit of huang qi (astragalus), and drink it more often. That works. I think after COVID, everyone’s body produces some blood stasis; regulating it is just a few strategies: support the upright qi, tonify qi and nourish blood, move qi and resolve stasis, and sometimes add a little phlegm-resolving herb — a bit of chen pi (aged tangerine peel) is enough. Think this strategy through and it becomes clear.

One last observation: the capsule form of this formula, Xue Fu Zhu Yu Jiaonang, now sells extremely well.

💬 Note from Doctor Luo: Xue Fu Zhu Yu capsules have almost climbed into the top ranks of cardiovascular medicines — the dosage is enormous. Why? Because people have found that it genuinely works. Before this pandemic I had never seriously lectured on this formula, but I have mentioned it everywhere. When you meet a friend with blood stasis — COVID really does cause the blood to coagulate — invigorating blood and resolving stasis is what is needed. Once you know the indications of Xue Fu Zhu Yu Tang and its regulating strategy, you know how to use it.

Compiled from Doctor Luo Dalun’s formula lecture series. The formula comes from Doctor Wang Qingren’s Yi Lin Gai Cuo (Correcting the Errors in the Medical World), written in the Qing Dynasty.