Two herb formulas which I have prescribed hundreds of times both in the clinic and in the context of martial arts and sports injuries are the General Die Da Decoction (General Injury Formula) and Shen Tong Zhu Yu Tang (Drive Out Stasis From a Painful Body Decoction). These formulas are relatively easy to use and modify according to the situation, can be prepared in advance and stored, and can be used for a wide variety of injuries both acute and chronic. Two formulas that work in a wide variety of situations can be more useful than a host of very specific formulae.
One of the problems with injuries and the Western medicine approach to treatment is the focus on immediate symptoms without a global view to the trajectory of the injury and how local stasis of Qi, blood, fluids, lymph, etc. can have long term effects that not only impact the ability of the injury to fully heal, but may also lead to deeper organ imbalances and even interfere with the health of organ systems.
While Western treatment of injuries focuses on the immediate – reducing swelling and pain through the use of ice and anti-inflammatories and resting the injured area – beyond physical therapy prescribed after the initial swelling is down there is no real focus on restoring circulation and tissue alignment to normal. Hence even many years after an ankle sprain, that was treated “properly”, according to Western Medicine, we often still see a faint swelling, stiffness and a propensity for re-injury. Long-term, these residual issues can have more global effects on knee and hip alignment and even shoulder alignment, creating potential for injury in these areas as well.
Two Important Factors Related to Injury and Healing
Traditional Chinese medicine, on the other hand, recognizes the two big issues related to healing and injury and provides multiple strategies and methods for addressing them.
The first big issue is realignment of the tissues, which usually takes place after the initial swelling and pain are reduced. This is achieved through Tui Na and Zheng Gu (massage and bone-setting) methods in conjunction with externally applied liniments and poultices (gao) that move local stasis. Zheng Gu literally means “correct the bone”, but in fact refers to realigning soft tissue as well.
When the bones and tissues (muscles, tendons, ligaments, fascia) are properly realigned, the injured area is reconnected properly to the rest of the body and has a chance to heal and reintegrate with overall structure. A simple analogy is a tower or structure of blocks where one block is sticking out at odd angle. This creates a “break” in the alignment of the blocks, and is a weak point of the structure.
Realignment of tissues and bones requires having skills in Tui Na and Zheng Gu. These skills are beyond the scope of a short post. We regularly offer classes in Traditional Tui Na, in which we teach these methods, and they are open to everyone – not just Chinese Medicine practitioners. Contact us directly if you are interested in learning Tui Na and Bone-setting (Zheng Gu) classes. Our next class in New York City takes place over three 3-day weekends beginning in January 2026. For more information CLICK HERE.
The second big issue is the necessity of clearing stasis in the local tissues and the channels and collaterals, which includes the capillary system as well as the meridians and their branches. Stasis that was not properly cleared, and stasis that was made worse by the application of ice and anti-inflammatories, often prevents proper healing and leads to cascade effects that only manifest much later.
More about the dangers of ice and ibuprofen can be found in the following posts:
Inflammation Part 1: Inflammation, Joint Injuries & Anti-Inflammatory Drugs
Inflammation Part 2: Inflammation, RICE, & Chinese Medicine
Inflammation Part 3: Other Perspectives on Inflammation – Causes & Consequences
Clearing Stasis can involve acupuncture, cupping and bleeding therapies and the use of external liniments, soaks, poultices and plasters. More on this subject can be found in these posts:
The 3 Stages Of Healing Sinew (Soft Tissue) Injuries: Stage 1 – Acute
The 3 Stages Of Healing Sinew (Soft Tissue) Injuries: Stage 2 – Sub-Acute
The 3 Stages Of Healing Sinew (Soft Tissue) Injuries: Stage 3 – Chronic
Internal Herb Formulas
Internal formulas (the subject of this article) can also be very helpful during the acute stage of treatment – the first 0-7 days after the injury – and also in sub-acute and chronic situations in which stasis was not properly cleared. I put these words in bold because this is often the key element in n0n-healing fractures, sprains and strains that are chronic and easily re-injured, or painful joints that ache even long after the injury is supposedly “healed.”
Dried blood and fluids that remain stuck in the soft tissue create a constant impediment to proper circulation and prevent the tissues from realigning. Additionally they can create a blockage that impacts other areas of the body and even the internal organs. There are indications that even seemly minor injuries that one has forgotten about, but never fully healed can create serious diseases over time.
The sooner the blockage is moved, the sooner the body can get on with healing, regenerating and realigning the damaged tissues. Hence the importance of liniments, poultices and internal injury formulas in the early, acute stage of an injury, even if it seems like the injury is minor. So treat seeming “small things” when they are small and they never become big things.
Structure of Internal Injury Formulas
Injury formulas often contain relatively low dosages of herbal ingredients, because it is the synergistic effect of the herbs working together that create the desired effect. Injury formulas that are effective also tend to operate at multiple levels.
General Die Da Decoction
This is one of the first injury formulas I learned in my martial arts training. It is a very balanced and cleverly constructed formula with wide applicability especially when combined with judicious use of guiding (envoy) herbs.
Instructions: add the herbs to four cups of water. Bring to boil and simmer for 45-50 minutes. Strain the liquid and set aside. The final herb (San Qi) is powdered and mixed into the liquid. Then drink all of the liquid.
Note: After straining the liquid, the dregs of the herbs can be applied on the injured area as a poultice.
This formula is also available in capsules (ground raw herbs) from Kamwo Meridian Herbs: Blood Stasis Pill (Die Da (Trauma) Wan) – Tooth from the Tiger’s Mouth Product Line
Formula Architecture
The General Die Da Decoction contains many herbs that quicken the blood and break stasis, including Ze Lan, Dan Shen, Mo Yao, Ru Xiang, Tao Ren, and San Qi.
However, the first two herbs in this formula are an important combination used by Die Da experts. This combination is specifically aimed at preventing the formation of Dead Blood. Sheng Di Huang both clears heat and cools the blood and moistens and enriches Yin. Qing Pi breaks Qi binds (Qi that is bound up), in order to disperse stagnation. Together these herbs moisten and move blood that is static.
The other interesting inclusion vis-a-vis Dead Blood is Jie Geng and Fang Feng. Jie Geng is added because it dispels phlegm due to impairment of lung diffusion (of the Qi). It also diffuses Lung Qi and courses the exterior. In this formula it is a unique addition aimed at preventing pockets of dead blood and stagnant fluids from accumulating. Fang Feng eliminates wind and dampness in the channels and network vessels and in sinews and bones.[1] With Jie Geng it clears and moves stasis in the network vessels and exterior layers of the body.
Lastly Dan Shen, Gui Sui Bu and Wei Ling Xian are also interesting additions. Gu Sui Bu supplements the Kidneys to join broken bones and tissues, but also quickens the blood so it appears in many trauma formulas where there is injury to the sinews and bones. Wei Ling Xian dispels wind and damp. It is said to reach all parts of the body eliminating phlegm and dispersing accumulations. It is used for joint pain with inhibited bending and stretching. Dan Shen dispels stasis but also helps engender new blood and cools the blood and calms the spirit.
In this formula there is an interaction of herbs that move stasis with those that prevent the common trajectories of damp accumulation and blood heat leading to dead blood. At the same time, Yin and new blood are engendered, which also prevents blood from drying. The true brilliance of this prescription however lies in the inclusion of Wei Ling Xian, Fang Feng and Jie Geng which help clear the network vessels, prevent the penetration of external evils into the weakened area and at the same time forestall the possible formation of phlegm which might otherwise combine with blood stasis.
Shen Tong Zhu Yu Tang (Drive Out Stasis From a Painful Body Decoction)
Shen Tong Zhu Yu Tang quickens the blood to dispel blood stasis and simultaneously dispels wind-damp-cold Bi. This formula treats blood stasis in channels and collaterals.
Instructions: add the herbs to four cups of water. Bring to boil and simmer for 45-50 minutes. Strain the liquid and set aside. The final herb (San Qi) is powdered and mixed into the liquid. Then drink all of the liquid.
Note: After straining the liquid, the dregs of the herbs can be applied on the injured area as a poultice.
Formula Architecture
Shen Tong Xue Yu Tang contains many herbs that quicken the blood and break stasis, including, Mo Yao, Ru Xiang, which work synergisticallyally to move blood stasis. These two herb can also help break up “dead blood” that is stuck in the local tissues and channels. Another synergistic pairing,Tao Ren and Hong Hua, moves stasis in the lower and upper body respectively and Niu Xi aids blood circulation in the legs and low back area. Dan Gui and Chuan Xiong are a third pair of herbs that together move stasis, particularly when wine-fried before cooking. Dan Gui both nourishes and harmonizes the blood and Chuan Xiong moves the Qi within the blood. Qiang Huo and Qin Jiao open the channels and expel wind-damp-cold obstructions which can block the normal circulation of Qi and blood, while soothing the sinews and channels. Obstructions of cold and Damp can themselves be a result of diminished circulation due to blood stasis in localized areas. Xiang Fu disperses and harmonizes the Qi, therefore it is an assistant to the blood moving herbs in this formula. Wu Ling Zi helps break up blood stasis – it is a strong pain reliever for pain due to blood stasis. Finally Di Long (Earthworm) is added for its ability to unblock the channels and collaterals by opening and penetrating obstruction.
Adding Guide Herbs
Shen Tong Zhu Tang and General Die Da Decoction are easily modified – guide herbs insect, sap and network vessels clearing herbs can be added as needed to address Dead Blood.
A few examples of guide herbs are:
For the head: Chuan Xiong and Bai Zhi
Neck and Shoulders: Ge Gen
Spine: Gou Ji
Upper Back: Yan Hu Suo
Shoulders: Jiang Huang
Flank-Ribs: Qing Pi and Chai Hu
Chest: Dan Shen
Lower Abdomen: Wu Yao
Lower Back: Du Zhong and Du Huo
Inguinal Area: Chuan Lian Zi
Knees: Mu Gua and Niu Xi
Note:
[1] Ten Lectures on the Use of Medicinals from the Personal Experience of Jiao Shu-De, Translated by Craig Mitchell, Nigel Wiseman, Marnae Ergil and Shelly Ochs. Brookline MA: Paradigm Publications, 2003, p. 17.
