Tong Qiao Huo Xue Tang (通窍活血汤) — Unblock the Orifices and Invigorate Blood Decoction

Tong Qiao Huo Xue Tang is one of Wang Qingren’s classical Blood-stasis formulas from the Qing dynasty, targeting Blood stasis in the head. It is used for post-concussion syndrome, chronic headache with fixed stabbing pain, hair loss from Blood stasis and long-standing tinnitus of Blood-stasis type. The classical formula contained She Xiang (musk); this entry describes the modern welfare-compliant version using Shi Chang Pu.

On this page

Overview
TCM pattern
Modern welfare-compliant modification
Ingredients
Actions and indications
Dosing
Cautions and contraindications
Related formulas
Treatment at my clinic

1. Overview

Tong Qiao Huo Xue Tang (通窍活血汤) — Unblock the Orifices and Invigorate Blood Decoction — is a classical Chinese herbal formula in the Invigorate Blood category. Source: Yi Lin Gai Cuo (Correction of Errors in the Forest of Medicine), 1830 CE, by Wang Qingren. I prescribe it as bespoke pharmaceutical-grade granules from Sun Ten in Taiwan at my clinic in Wokingham, Berkshire and via online herbal consultations.

2. TCM pattern

Blood stasis in the head and orifices: fixed, stabbing headache; long-standing tinnitus with dark constitutional signs; hair loss following head injury; a dark or purple tongue; a wiry, choppy or thready pulse.

3. Modern welfare-compliant modification

Classical formula contains She Xiang (musk deer). This entry describes the modern welfare-compliant version replacing She Xiang with Shi Chang Pu — the accepted plant substitute for its orifice-opening action.

4. Ingredients

Chi Shao — Paeonia lactiflora (red peony) (3g) — invigorates Blood, cools Blood
Chuan Xiong — Ligusticum chuanxiong (3g) — moves Blood in the head channels
Tao Ren — Prunus persica (peach kernel) (9g) — breaks Blood stasis
Hong Hua — Carthamus tinctorius (safflower) (9g) — invigorates Blood
Sheng Jiang — Zingiber officinale (fresh) (9g) — warms and promotes Yang
Cong Bai — Allium fistulosum (spring onion white) (3 stalks) — opens the Yang orifices in the head
Da Zao — Ziziphus jujuba (7 pieces) — harmonises and protects the Middle
Shi Chang Pu — Acorus tatarinowii (3–6g) — opens the orifices (replaces She Xiang in the modified form)

5. Actions and indications

Principal actions

Invigorates Blood and dispels stasis
Opens the orifices
Frees the head channels

Indications

Post-concussion syndrome with persistent headache
Long-standing tinnitus with a Blood-stasis pattern
Chronic headache with fixed stabbing pain
Hair loss following head injury or with a Blood-stasis picture
Cognitive fog after head trauma

6. Dosing

As decoction. Modern granule 6–9g/day. Duration 8–16 weeks for chronic conditions.

7. Cautions and contraindications

Contraindicated in pregnancy.
Not for Blood deficiency without stasis.
Post-concussion pictures require prior conventional neurological assessment.
Any acute worsening of headache with new features (fever, vision loss, weakness) needs urgent conventional review.

9. Treatment at my clinic

I prescribe Tong Qiao Huo Xue Tang where the TCM pattern above matches the patient’s presentation, typically as part of a wider prescription tailored to the individual. Return to the Chinese herbal formulas directory or the Chinese herbal medicine main page.