Xiao Huo Luo Dan

Xiao Huo Luo Dan (Minor Invigorate the Collaterals Special Pill), from the Tai Ping Hui Min He Ji Ju Fang (Imperial Grace Formulary of the Tai Ping Era) by Imperial Medical Department.

Actions: Dispels wind and dampness; Resolves phlegm and dredges the channels; Activates blood circulation and stops pain.

Presentation: 1. Obstruction of wind, cold, and dampness in the channels and collaterals: muscle spasms and cramps, limited mobility and difficult movement of the joints, painful extremities, and migratory pain. 2. Zhong feng (wind stroke) with obstruction of dampness, phlegm, and blood stasis in the channels and collaterals: numbness and pain in the extremities, and heaviness and pain in the lower back and legs.

Cautions:

• Potent formula for strong, generally healthy constitutions; use with caution in blood deficiency or yin-deficient heat
• Contraindicated during pregnancy

Toxicology: Overdose occasionally toxic: numbness of hands/feet, stiff tongue, dizziness, pallor, cold extremities, sweating, nausea, vomiting, diarrhea, palpitations, arrhythmia, loss of consciousness; also allergy and acute GI bleeding. Attributed to Zhi Chuan Wu, Zhi Cao Wu and Tian Nan Xing. Management: gastric lavage; decoction of Gan Cao and Lu Dou; IV fluids with dexamethasone (10 mg twice daily).

Pharmacological effects reported:

• Analgesic: marked analgesic effect in mice at 20-100 mg/kg
• Sedative: dose-dependent sedation in mice
• Pharmacokinetic: two-compartment distribution, mean half-life 13.16 hours

Source: Chen JK, Chen TT. Chinese Herbal Formulas and Applications: Pharmacological Effects & Clinical Research. Art of Medicine Press, 2009, p. 1177.

Source: blast-fry the two aconites and Tian Nan Xing first to reduce toxicity; powder, form small pills (~5 mm, Wu Tong Zi size) with grain liquor; take 20 pills at noon on empty stomach with cold liquor or Jing Jie tea. Today: honey pills, 1 pill [3g] twice daily with aged liquor or warm water; or decoct with bracketed doses.