Bu Yang Huan Wu Tang补阳还五汤
Tonify the Yang to Restore Five-Tenths Decoction
Ingredients7 herbs
Indications
Qi deficiency with blood stasis in the collaterals, the sequelae stage of wind-stroke. Yuan qi has been depleted, blood no longer moves under its own pressure, and the vessels of one half of the body are left obstructed.
Clinical Manifestations
- Hemiplegia and facial deviation after stroke
- Slurred or laboured speech, drooling
- Numbness or weakness of one limb
- Frequent urination or incontinence after stroke
- Chronic qi-deficient stasis with limb heaviness
Health Categories
Modern Applications
Common adjustments
- Cold in the limbs with clear aversion to cold — add Fu Zi to warm and support the yang
- Speech markedly impaired with phlegm — add Yuan Zhi 远志 and Shi Chang Pu 石菖蒲 to open the orifices and clear phlegm
- Upper limb affected more than the lower — add Sang Zhi 桑枝 to guide the formula to the arm
- Lower limb weakness predominant — add Du Zhong 杜仲 and Niu Xi to strengthen the low back and knees
- Long-standing stasis with hard, fixed obstruction — add Shui Zhi 水蛭 only under close supervision, and never alongside anticoagulant medication
Contraindications
Not for the acute phase of a stroke, and never where haemorrhage is suspected or unconfirmed — the formula pushes blood outward. Not for stroke patterns of ascendant liver yang or internal wind with a red face, headache, forceful wiry pulse and rigid limbs. Because the Huang Qi dose is unusually large it is built up gradually and stopped if the blood pressure rises.
For licensed practitioners’ reference only — not a self-treatment guide.
Pregnancy
Contraindicated in pregnancy. Tao Ren, Hong Hua and Dang Gui Wei are blood-moving herbs that can stimulate the uterus, and the stroke sequelae this formula addresses are not a pregnancy indication in any case. The large Huang Qi dose also raises blood pressure in some patients, which is unwanted in pregnancy. Because the formula moves blood, it adds to the bleeding risk of warfarin, direct oral anticoagulants and antiplatelet drugs — a real concern in stroke patients, who are frequently on them. Any combination must be known to and managed by the prescribing physician.
References
Source Yi Lin Gai Cuo 《医林改错》 · Qing
「此方治半身不遂，口眼歪斜，语言謇涩，口角流涎，大便干燥，小便频数，遗尿不禁。」
- Classical source (public domain) — 《医林改错》, Qing dynasty, Wang Qing-ren.
2. Scheid, Bensky, Ellis & Barolet. Chinese Herbal Medicine: Formulas & Strategies, 2nd ed. — composition & dosage cross-checked.
3. 《方剂学》（全国中医药行业高等教育规划教材）— 理血剂 · 活血祛瘀, pattern and 配伍 analysis cross-checked.
Professional reference notice. Entries are scholarly references for licensed TCM practitioners and students — not medical advice, and not a recommendation to self-prescribe. Chinese herbal formulas should be used under the guidance of a qualified practitioner. Content is an original editorial compilation by Cura x Cura, cross-checked against the cited references.