复原活血汤

4. Common modifications

• Marked qi stagnation with pronounced distending pain: add Chuan Xiong (Sichuan lovage rhizome), Xiang Fu (cyperus rhizome), and Yu Jin (turmeric tuber) to strengthen the effect of moving qi and stopping pain.
• Severe blood stasis with pronounced swelling and pain: add Ru Xiang (frankincense), Mo Yao (myrrh), and San Qi (notoginseng) powder to strengthen the effect of invigorating blood, reducing swelling, dispelling stasis, and settling pain.
• Modern application: this formula is widely used for soft tissue injury, intercostal neuralgia, costochondritis, and the early stage of fractures where the pattern is blood stasis with qi stagnation.

5. Cautions and clinical notes

• Contraindications:
  • Contraindicated in pregnancy. This formula has a relatively strong action of invigorating blood and purging.
  • Not suitable for those without blood stasis retention.
  • If, after taking the formula, bowel movement becomes free and pain is relieved, the medicine should be stopped, to avoid excessive dosing damaging the righteous qi.

6. Granule conversion and dose

• Calculation of the total raw herb weight of the original formula (using a substitute for Chuan Shan Jia/pangolin scales):
  • Chai Hu (bupleurum root) 15 g + Da Huang (rhubarb rhizome) 30 g + Tao Ren (peach kernel) 9 g + Hong Hua (safflower) 6 g + Dang Gui (Chinese angelica root) 9 g + Wang Bu Liu Xing (vaccaria seed) 9 g + Tian Hua Fen (trichosanthes root) 9 g + Gan Cao (licorice root) 6 g = 93 g.
• Conversion to 5:1 granules:
  • 93 g raw herb ÷ 5 = 18.6 g granules.
• Recommended dose:
  • One dose daily, taken in two portions morning and evening, dissolved in warm yellow rice wine or warm water, about 9 g per dose. (The original formula emphasizes decocting with wine added, as wine helps carry the medicinal action upward and strengthens the effect of invigorating blood and unblocking the collaterals.)
  • Or as directed by a practitioner; this formula is a key formula in traumatology, and the dose and Duration of use must be determined strictly according to the severity of the injury and the patient's constitution, stopping once the disorder resolves.