Formula

Bu Yang Huan Wu Tang

Five Restoring Decoction | 补阳还五汤

Also known as:

Tonify the Yang to Restore Five Decoction , Tonify the Yang to Restore Five Tenths Decoction

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

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About This Formula*

Traditional Chinese Medicine background and properties

Formula Description*

A classical formula for recovery after stroke and for conditions involving poor circulation due to Qi deficiency. It works by strongly boosting the body's Qi to drive blood flow through blocked channels, helping to restore movement and sensation in paralyzed or weakened limbs. It is best suited for people whose weakness stems from underlying Qi deficiency rather than excess conditions.

Formula Category*

Main Actions*

  • Tonifies Qi
  • Invigorates Blood and Dispels Stasis
  • Unblocks the Channels and Collaterals

TCM Patterns*

In TCM, symptoms don't appear randomly — they cluster into recognizable patterns of disharmony that reveal what's out of balance in the body. Bu Yang Huan Wu Tang is traditionally associated with these specific patterns.

The following describes this formula's classification within Traditional Chinese Medicine theory and is provided for educational purposes only.

Why Bu Yang Huan Wu Tang addresses this pattern

This is the primary pattern addressed by Bu Yang Huan Wu Tang and the one for which it was specifically designed. The pathomechanism is "deficiency leading to stasis" (因虚致瘀): when Qi becomes severely depleted, it can no longer propel Blood through the vessels and channels. Blood then slows, pools, and obstructs the network vessels, depriving the muscles, tendons, and tissues of nourishment. The heavy dose of Huang Qi directly addresses the Qi deficiency root, while the team of blood-moving herbs (Dang Gui Wei, Chi Shao, Chuan Xiong, Tao Ren, Hong Hua) and the channel-opening Di Long clear the resulting stasis. The formula simultaneously treats both the cause (Qi deficiency) and the consequence (blood stasis) without further weakening the patient.

A practitioner would look for one or more of these signs

Hemiplegia

Paralysis or weakness of one side of the body, the hallmark symptom

Facial Paralysis

Deviation of the mouth and eye on one side

Slurred Speech

Difficulty speaking due to impaired tongue movement

Drooling

Saliva leaking from the corner of the mouth due to muscle weakness

Urinary Incontinence

Frequent urination or inability to hold urine due to Qi failing to control fluids

Muscle Weakness

Weakness and wasting of the affected limbs

Eye Fatigue

General exhaustion and lack of strength reflecting the underlying Qi deficiency

How It Addresses the Root Cause*

Bu Yang Huan Wu Tang addresses a condition that Chinese medicine calls Qi deficiency with Blood stasis (气虚血瘀), specifically in the context of stroke (中风, zhong feng) and its aftermath. The formula's creator, Wang Qingren, called this mechanism "stasis caused by deficiency" (因虚致瘀, yin xu zhi yu), a concept that was quite original for its time.

The underlying logic works like this: Qi is the motive force that drives Blood through the vessels. When a person's Qi becomes severely depleted, it can no longer push Blood through the fine network of channels and collaterals that nourish the muscles, tendons, and limbs. Blood slows down, pools, and eventually forms stasis. This stasis blocks the collaterals, cutting off nourishment to one side of the body. The result is hemiplegia (paralysis of one side), facial drooping, slurred speech, and drooling. Because Qi also holds things in place (its "securing" function), severe Qi deficiency also leads to loss of bladder control. Wang Qingren compared the body's original Qi to ten parts distributed evenly. When five parts are lost, the remaining five can still sustain life but cannot power both sides equally, so they "collapse" to one side, leaving the other side paralyzed.

The key insight is that the root problem is Qi deficiency, not the Blood stasis itself. The stasis is a consequence. Therefore, the correct treatment must primarily rebuild the Qi so the body can push its own Blood through again, with Blood-moving herbs playing only a supporting role. This is why the formula uses an extraordinarily large dose of Huang Qi and only small amounts of blood-activating herbs.

Formula Properties*

Temperature

Slightly Warm

Taste Profile

Predominantly sweet and slightly pungent. The massive dose of Huang Qi gives the formula a strongly sweet character that tonifies Qi, while the smaller amounts of pungent blood-moving herbs (Chuan Xiong, Hong Hua, Tao Ren) add a dispersing quality that prevents the sweetness from causing stagnation.

Target Organs
Spleen Liver Heart Brain
Channels Entered
Spleen Liver Heart

Formula Origin

Yi Lin Gai Cuo (醫林改錯, Corrections of Errors in the Field of Medicine) by Wang Qing-Ren (王清任)

This is just partial information on the formula's TCM properties. More detailed information is available on the formula's dedicated page

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Product Details

Manufacturing, supplier, and product specifications

Product Type

Granules

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Treasure of the East

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Ingredients in Bu Yang Huan Wu Tang

Detailed information about each herb in Bu Yang Huan Wu Tang and their roles

Kings
Deputies
Assistants
Huang Qi
Huang Qi

Astragalus root

Dosage: 30 - 120g

Temperature Slightly Warm
Taste Sweet (甘 gān)
Organ Affinity Spleen, Lungs
Parts Used Root (根 gēn)
Role in Bu Yang Huan Wu Tang

Heavily dosed to powerfully tonify the original Qi. When Qi is abundant, it can propel Blood through the vessels and channels, addressing the root cause of blood stasis due to Qi deficiency. Raw (Sheng) Huang Qi is used specifically for its ascending and outward-moving quality.

Dang Gui
Dang Gui

Chinese Angelica root

Dosage: 6 - 10g

Temperature Warm
Taste Sweet (甘 gān), Acrid / Pungent (辛 xīn)
Organ Affinity Liver, Heart, Spleen
Parts Used Root (根 gēn)
Role in Bu Yang Huan Wu Tang

The tail portion of Dang Gui is specifically chosen for its stronger blood-invigorating action compared to the whole root. It activates blood circulation while also nourishing blood, achieving the effect of dispelling stasis without damaging healthy blood.

Chi Shao
Chi Shao

Red peony root

Dosage: 5 - 10g

Temperature Slightly Cool
Taste Bitter (苦 kǔ), Sour (酸 suān)
Organ Affinity Liver
Parts Used Root (根 gēn)
Role in Bu Yang Huan Wu Tang

Invigorates blood and dispels stasis, reinforcing the Deputy herb's blood-moving action. Chi Shao also cools the blood slightly, helping to moderate any warming tendency from the heavy dose of Huang Qi.

Chuan Xiong
Chuan Xiong

Sichuan lovage rhizome

Dosage: 3 - 10g

Temperature Warm
Taste Acrid / Pungent (辛 xīn)
Organ Affinity Liver, Gallbladder, Pericardium
Parts Used Rhizome (根茎 gēn jīng)
Role in Bu Yang Huan Wu Tang

A key herb for moving both Blood and Qi. It promotes blood circulation, relieves pain, and helps drive the formula's actions upward to the head, which is especially relevant for post-stroke symptoms.

Tao Ren
Tao Ren

Peach kernel

Dosage: 3 - 10g

Temperature Neutral
Taste Bitter (苦 kǔ), Sweet (甘 gān)
Organ Affinity Heart, Liver, Large Intestine
Parts Used Seed (种子 zhǒng zǐ / 子 zǐ / 仁 rén)
Role in Bu Yang Huan Wu Tang

A strong blood-moving herb that breaks up blood stasis and helps open blocked channels. Works synergistically with Hong Hua to enhance the stasis-dispelling effect.

Hong Hua
Hong Hua

Safflower flower

Dosage: 3 - 10g

Temperature Warm
Taste Acrid / Pungent (辛 xīn)
Organ Affinity Heart, Liver
Parts Used Flower (花 huā)
Role in Bu Yang Huan Wu Tang

Invigorates blood and dispels stasis. Paired with Tao Ren, this classic combination amplifies the formula's ability to remove blood stagnation from the channels and collaterals.

Di Long
Di Long

Earthworm

Dosage: 3 - 10g

Temperature Cold
Taste Salty (咸 xián)
Organ Affinity Liver, Spleen, Urinary Bladder, Lungs
Parts Used Animal — whole (全虫 quán chóng)
Role in Bu Yang Huan Wu Tang

Excels at unblocking the channels and collaterals. Its nature is to travel through and penetrate narrow passages, making it particularly effective for opening obstructed network vessels in the limbs. Also has a mild heat-clearing action.

Modern Research (5 studies)

  • Systematic review and meta-analysis of BHD for acute ischemic stroke (19 RCTs, 2012)
  • Meta-analysis of BHD for ischemic stroke rehabilitation (2021)
See all research on the formula page

Usage & Safety

How to use this formula and important safety information

Important Medical Disclaimer

The information provided here is for educational purposes only and is not intended as medical advice or to replace consultation with a qualified healthcare professional. This formula is a dietary supplement and has not been evaluated by the FDA. It is not intended to diagnose, treat, cure, or prevent any disease.

Always consult with a qualified healthcare provider, particularly if you are pregnant, nursing, have a medical condition, or are taking other medications. Discontinue use and consult your healthcare provider if you experience any adverse reactions.

Recommended Dosage

Instructions for safe storage and consumption

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Best Time to Take

Warm, on an empty stomach or 30-60 minutes before meals, once or twice daily. Taking it before meals enhances absorption of the Qi-tonifying Huang Qi.

Typical Duration

Long-term use, typically 4-12 weeks or longer, reassessed regularly by a practitioner. The original text states that the formula must be taken persistently to show results, and should be continued even after improvement (every 3-8 days) to prevent relapse.

Dietary Advice

Favor foods that support Qi and Blood: cooked whole grains, root vegetables, lean proteins, warm soups, and easily digestible meals. Foods like congee with red dates, millet porridge, and lightly cooked greens are ideal. Avoid cold and raw foods (salads, ice cream, cold drinks, raw fruit) as these can impair the Spleen's ability to generate Qi, working against the formula's intent. Avoid greasy, heavy, and overly rich foods that can create Dampness and Phlegm, potentially blocking the collaterals the formula is trying to open. Limit alcohol, as it generates Heat and can interact unpredictably with the blood-moving herbs. Also avoid excessively spicy or heating foods, as the patient may already have impaired circulation and inflammation in the vessels.

Modern Usage*

Bu Yang Huan Wu Tang is a classical herbal formula renowned for its application in treating paralysis. It is particularly valued for its ability to invigorate Blood circulation, strengthen Qi (vital energy) and restore proper function to the body channels.

TCM practitioners often prescribe Bu Yang Huan Wu Tang for individuals recovering from a stroke, particularly those experiencing hemiplegia. Symptoms that may benefit from this formula include paralysis, facial asymmetry, speech difficulties, drooling, weakness in the lower limbs, and issues such as frequent urination or incontinence.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Special Populations

Pregnancy

Contraindicated during pregnancy. The formula contains several herbs that strongly invigorate Blood and dispel stasis: Tao Ren (Peach Kernel), Hong Hua (Safflower), Chuan Xiong (Chuanxiong Rhizome), Chi Shao (Red Peony Root), and Dang Gui Wei (Angelica tail). These herbs promote blood circulation and can stimulate uterine contractions, posing a risk of miscarriage or premature labor. Tao Ren and Hong Hua are specifically listed as pregnancy-prohibited (妊娠禁忌) herbs in standard Chinese pharmacopoeia references. This formula should not be used during any stage of pregnancy.

Breastfeeding

Use with caution during breastfeeding. While there is no specific classical prohibition, the formula contains multiple blood-activating herbs (Tao Ren, Hong Hua, Chuan Xiong, Chi Shao, Dang Gui Wei) whose active compounds may transfer into breast milk. The large dose of Huang Qi (Astragalus) is generally considered safe, but the cumulative blood-moving effect of the other ingredients warrants caution. If the formula is clinically necessary for the mother (e.g. post-stroke recovery), a practitioner should carefully weigh the benefits against potential risks, consider reducing the blood-activating herbs, and monitor the infant for any unusual signs such as easy bruising or loose stools.

Pediatric Use

Bu Yang Huan Wu Tang is not a standard pediatric formula, as its primary indication (post-stroke hemiplegia from Qi deficiency and Blood stasis) mainly affects adults and the elderly. However, historical sources note it has been applied for pediatric conditions such as poliomyelitis sequelae causing limb weakness, where the pattern fits Qi deficiency with Blood stasis. If used in children, significant dose reductions are essential. Typical adjustments: children under 6 should receive roughly one-quarter to one-third of the adult dose; children 6-12 about one-half. The Huang Qi dose in particular must be started low and increased gradually. The blood-moving herbs (Tao Ren, Hong Hua) should be used at the minimum effective dose. A qualified practitioner experienced in pediatric prescribing should supervise all use in children.

Cautions & Warnings

Although this formula is typically safe for most individuals, it may cause side effects in some people. Pregnant women, nursing mothers, postpartum women, and those with liver disease should use the formula with caution.

As with any Chinese herbal remedy, it is advisable to seek guidance from a qualified TCM practitioner before beginning treatment.