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Tong Qiao Huo Xue Tang通窍活血汤

Unblock the Orifices and Invigorate the Blood Decoction

Regulating Blood 理血剂Invigorate Blood and Dispel Stasis 活血祛瘀

Ingredients9 herbs

赤Chi Shao赤芍3gCools and disperses stasis in the vessels of the head and face川Chuan Xiong川芎3gMoves qi within blood and rises to the head, guiding the formula upward桃Tao Ren桃仁研泥9gBreaks up congealed blood in the small vessels红Hong Hua红花9gInvigorates blood and dissolves stasis in the surface
老Lao Cong (Cong Bai)老葱切碎Frees the yang qi and helps the aromatic herbs reach the surface
鲜鲜姜切碎9g
红Da Zao红枣去核Nourishes and harmonizes so the drastic herbs do not injure the middle
麝She Xiang麝香绢包0.16gPenetrates and opens the orifices, carrying the blood herbs to the head; the defining herb of the formula
黄黄酒250g

Indications

Invigorates blood in the head and faceOpens the orifices and frees the collateralsDisperses stasis in the surface

Blood stasis obstructing the orifices and vessels of the head, face and body surface. The obstruction is small-vessel and superficial rather than deep, so the signs are sensory and cutaneous rather than painful masses.

Clinical Manifestations

  • Chronic fixed headache or dizziness from stasis
  • Long-standing deafness or tinnitus
  • Hair loss with a dull, dark complexion
  • Brandy noseand vitiligo patches
  • Childhood malnutrition with a hard abdomen
TongueDull purple or with stasis spots
PulseChoppy or wiry

Health Categories

Skin Health

Modern Applications

Chronic headacheMigraineTinnitusSensorineural hearing lossAlopeciaRosaceaVitiligo

Common adjustments

  • She Xiang unavailable — substitute synthetic muscone, or use Shi Chang Pu 石菖蒲 as a weaker orifice-opening replacement
  • Headache severe and long-standing — add Quan Xie 全蝎 or Bai Zhi 白芷
  • Deafness with Kidney deficiency — pair with a Kidney-nourishing formula between courses
  • Skin patches predominant — add Ji Xue Teng 鸡血藤 to nourish and move blood in the surface

Contraindications

Not for headache from ascendant Liver yang, blood deficiency or exterior wind. Not for anyone with a bleeding tendency or on anticoagulants. A new, severe or changing headache must be investigated medically before it is treated as stasis. The rice wine in the classical preparation is unsuitable for anyone who should not drink alcohol.

For licensed practitioners’ reference only — not a self-treatment guide.

Pregnancy

Absolutely contraindicated in pregnancy. She Xiang is the classical abortifacient of the materia medica, and Tao Ren and Hong Hua add further blood-moving force; the combination can cause miscarriage. Not to be used while breastfeeding. It also raises bleeding risk alongside anticoagulant and antiplatelet drugs.

Related Formulas

References

Source Yi Lin Gai Cuo 《医林改错》 · Qing

「治头面四肢、周身血管血瘀之症。」
— 《医林改错》(classical source, public domain)
  1. 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）— listed among the 附方 grouped with 血府逐瘀汤.
    4. CITES Appendix I listing for musk deer — sourcing restriction on 麝香 and the synthetic substitute.

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.