Bu Yang Huan Wu Tang

What It Is

Bu Yang Huan Wu Tang, translated as “Tonify the Yang to Restore the Five (tentatively referring to the five kinds of paralysis or five organs)”, is a traditional Chinese medicinal formula developed by the Qing dynasty physician Wang Qing-Ren, and first recorded in his book Yi Lin Gai Cuo (Correction of Errors Among Physicians).

It is composed of seven primary herbs, typically:

• Huang Qi (Astragalus membranaceus) – chief herb
• Dang Gui Wei (Angelica sinensis tail)
• Chi Shao (Paeonia rubra)
• Chuan Xiong (Ligusticum chuanxiong)
• Tao Ren (Prunus persica seed)
• Hong Hua (Carthamus tinctorius)
• Di Long (Pheretima aspergillum, Earthworm)

The formula is primarily used to reinvigorate Qi (vital energy) and promote blood circulation, especially in conditions resulting from Qi deficiency leading to blood stasis, such as post-stroke hemiplegia or numbness.

How It Works

In TCM theory, Qi is the driving force of blood movement. When Qi is weak, blood circulation becomes sluggish, leading to blood stasis, which manifests as paralysis, numbness, or weakness—particularly following stroke or traumatic injury.

• Huang Qi (Astragalus) serves as the chief herb, powerfully tonifying Qi, strengthening the body’s energy, and supporting the functions of other herbs.
• Dang Gui Wei, Chuan Xiong, Chi Shao, Tao Ren, and Hong Hua work together to activate and nourish blood, dissolve stasis, and open obstructed channels.
• Di Long (Earthworm) is added to unblock the channels and collaterals, improving movement and neurological recovery.

From a modern pharmacological perspective, Bu Yang Huan Wu Tang has been found to:

• Improve cerebral blood flow and neuronal repair after ischemic injury.
• Exhibit anti-inflammatory, antioxidant, and neuroprotective effects.
• Promote angiogenesis (formation of new blood vessels) and neurogenesis (generation of new nerve cells).

This makes it a powerful restorative formula for post-stroke rehabilitation, targeting both Qi and blood components.

Why It’s Important

Bu Yang Huan Wu Tang is significant in both traditional and modern integrative medicine because it bridges classical herbal theory with modern neurovascular science.

• In TCM practice, it represents a balanced approach: strengthening the body’s vital energy (Qi) while dispersing stagnation (Blood stasis).
• Clinically, it has been widely applied in the rehabilitation phase of cerebrovascular diseases, including ischemic stroke, hemiplegia, facial paralysis, and peripheral neuropathies.
• Modern research supports its potential in promoting functional recovery and reducing neurological deficits after brain injury.

Its importance lies in its dual action: restorative (tonification) and circulatory (mobilization)—a combination that addresses both the root (Qi deficiency) and the manifestation (Blood stasis) of disease.

Considerations

While Bu Yang Huan Wu Tang is potent, it must be used carefully under professional supervision. Key considerations include:

Individual Constitution

• It is suited for patients with Qi deficiency (fatigue, pale complexion, weak pulse) and blood stasis (numbness, paralysis, purple tongue). It should not be used in cases of strong excess syndromes or active inflammation without deficiency signs.

Contraindications

• Not recommended during acute stroke phase with high fever or hypertension.
• Avoid in cases of bleeding disorders, pregnancy, or blood-heat syndromes.
• May interact with anticoagulants or antiplatelet drugs, increasing bleeding risk.

Dosage and Duration

• Typically prescribed as a decoction or granule extract, dosage and duration depend on the severity of Qi and blood stagnation, age, and constitution. Long-term use should be monitored by a TCM practitioner.

Integration with Western Medicine

• Bu Yang Huan Wu Tang is often used alongside physiotherapy and Western medical treatments in post-stroke recovery programs. Coordination between healthcare providers ensures safety and efficacy.