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Jin Gui

Yao Lue -

Essential Prescriptions of the Golden Cabinet


Chapter 22
Womens Miscellaneous Disease
OVERVIEW
Womens Miscellaneous Disease

This chapter discusses the causes, signs, and


treatments of womens miscellaneous diseases (fu zen za
bing), a term that covers a variety of womens conditions
related to menstruation, vaginal discharge, the genitalia,
and emotional disturbances. It includes diseases like heat
in the blood chamber, visceral agitation, plum pit qi, a
sensation in the throat like a lump of roasted meat,
inhibited menstrual flow, vaginal discharge, spotting,
abdominal pain, shifted bladder, and vaginal sores, but
focuses particularly on menstrual disorders, vaginal
discharge, and abdominal pain.
Pulses, Signs, Treatments
The three major causes of
womens disease in this
chapter are vacuity of qi
and blood, accumulated
cold, and qi bind, which
refers to binding
oppression of the qi
dynamic.
All these can disorder the
menses and, in severe
cases, cause a range of
gynecological conditions
related to menstrual block.
Pulses, Signs, Treatments
The diagnosis of womens disease is based on a careful
analysis of the pulse in terms of yin and yang, heat and
cold, and vacuity and repletion.
Treatment is varied, including both internal and
external application, with internal preparations like
salves, decoctions, powder, pills, and wines, and
external therapies like acupuncture, washes, and
suppositories.
This chapter thus has served in subsequent centuries as
an important foundation of the practice of identifying
patterns and determining treatment in womens
miscellaneous diseases.
SCHEMATIC OVERVIEW
Miscellaneous Womens Diseases

1. General Features
a) Causes and pathomechanism:
Vacuity, accumulated blood, and bound qi.
b) Principles of treatment:
Differentiate yin and yang, identify vacuity and
repletion, and apply acupuncture or medical \
therapy.
2. Determining treatment on the basis of patterns
identified
a) Heat entering the blood chamber.
Signs: On the seventh or eighth day after wind-strike,
with extended aversion to the cold and heat effusion
that break out at regular times, the women happens to
experience interrupted menstrual flow.
Treatment:
Xiao Chai Hu Tang (Minor Bupleurum Decoction) and
needling of Cycle Gate (qi men, LV-14)
b) Lump in the throat (plum pit qi).
Signs:
A sensation in the throat like a lump of roasted meat.

Treatment:
Ban Xia Hou Po Tang (Pinellia and Officinal
Magnolia Bark Decoction)
c) Visceral agitation
Signs:
Tendency to sorrow and desire to weep, as if possessed
by spirits, and frequent yawning and stretching.

Treatment:
Wen Jing Tang (Channel-Warming (Menses-Warming)
Decoction to warm and nourish qi and blood and to
disperse stasis.
d) Spotting
Signs:
Channel Fall with black spotting that fails to
resolve.

Treatment:
Jiao jiang tang (Ass Hide Glue and Ginger
Decoction) to warm and supplement the thoroughfare
and controlling vessels.
Inhibited Menstruation
Inhibited Menstruation

1. Blood stasis menstrual irregularities


Signs:
Disease below the girdle with inhibited menstrual
flow, lesser abdominal fullness and pain, and
periods coming twice in one month.
Treatment:
Tu Gua Gen San(Cucumber Gourd Root Powder)
to quicken the blood, transform stasis, and stanch
bleeding.
Inhibited Menstruation
2. Blood stasis menstrual block.
Signs:
Inhibited descent of a womens menses.
Treatment:
Di Dang Tang(Dead-On Decoction) expels stasis
and breaks accumulations.
Inhibited Menstruation
3. Blood and water binding in the blood chamber.
Signs:
Postpartum lower abdominal fullness that appears
like a serving bowl, with slight difficulty in urination
and no thirst
Treatment:
Da Huang Gan Sui Tang(Rhubarb and Kansui
Decoction) to break stasis and expel water.
Abdominal Pain

Abdominal Pain
1. Wind and blood contending with each other.
Signs:
Blood and qi stabbing pain in the abdomen
Treatment:
Hong Lan Hua Jiu (Carthamus Wine) to quicken
the blood, disinhibit qi, and relieve pain
Abdominal Pain
Abdominal Pain

2. Liver-Spleen disharmony.
Signs: All abdominal pain in women
Treatment:
Dang Gui Shao Yao San(Chinese Angelica and
Peony Powder) to harmonize the liver and spleen
Abdominal Pain

3. Center qi vacuity cold.


Signs: Womens abdominal pain.
Treatment:
Xiao Jian Zhong Tang (Minor Center-Fortifying
Decoction) to warm the center and nourish blood.
Vaginal Discharge
Vaginal Discharge
1. Damp-heat vaginal discharge.
Signs: Blocked and inhibition menstrual flow with
discharge of white matter.
Treatment:
Fan Shi Wan (Alum Pill) to transform dampness.
Note that this is a topical formula.
Vaginal Discharge
2. Cold-damp vaginal discharge.
Signs: Cold in the vagina
Treatment:
She Chuang Zi San (Cnidium Seed Powder) to
expel cold-damp from the vagina
Shifted Bladder
Shifted Bladder

This disease is caused by bladder tie being twisted.


Signs: Eating and drinking as normal, but vexing
heat with inability to sleep, propped breathing, and
inability to urinate.
Treatment:
Shen Qi Wan (Kidney Qi Pill) to invigorate kidney
qi and disinhibit urine.
Disease of the anterior yin
1. Yin Sores
Signs: A lesser yin pulse is slippery and rapid;
putrefying eroding sores in the vagina.
Treatment:
Lang Ya Tang(Langya Decoction) to clear heat and
dry dampness and to kill worms and relieve itching
Disease of the anterior yin
2. Vaginal Flatulence (passing gas via the vagina)
Signs: Downward draining of stomach qi with yin
flatulence in continuous blasts means repletion of
grain qi
Treatment:
Gao Fa Jian (Lard and Hair Brew) to moisten the
intestines and free the stool.
Pattern & Treatment
Pattern & Treatment :
Plum-Pit Qi
Line 5: (P 595)
It caused by constraint of seven affects with phlegm
congealing and Qi stagnation. Phlegm and Qi
ascends in the throat, manifesting wit ha sensation
of obstruction that cannot be relieved by swallowing
or expectorating. The condition is painless, and
eating is not affected.
Ban Xia Hou Po Tang
Treatment including bind-opening, phlegm-
transforming, Qi regulating and counterflow-
downbearing methods
Ban Xia Hou Po Tang

Commentary:
It is not limited to females; its similar to chronic
pharyngitis; emotional depression, anger, agitation,
glomus and oppression signs in the chest, sighing,
and a pale slippery tongue with wiry and slippery
pulses.
Clinical application:
Chronic pharyngitis, bronchitis, and bronchial
asthma when associated with phlegm and Qi
stagnation.
Visceral Agitation
Line 6 : P 596
The condition is caused by excessive thinking or
rumination that leads to Qi constraint which transforms
into fire to damage the HT, SP and scorch Yin fluids. The
manifestations include disquietude, unexplainable
sorrow with a desire to weep, frequent yawning and
stretching, fatigue, and lack of strength.
Gan Mai Dai Zao Tang
The treatment method include tonify HT and SP and
calm the HT spirit
Gan Mai Da Zao Tang
Clinical application:
With modification, it could be used in the treatment of
neurological and mental diseases including mania,
schizophrenia, neurasthenia, neurosis, climacteric period
syndrome, sleepwalking, and epilepsy.
Can be combined with +
Suan Zao Ren Tang;
Sheng Mai San;
Ba He Di Huang Tang;
Liu Wei Di Huang Wan or Xiao Yao San
Flooding and Spotting
Deficiency cold with Stasis
Line 9 : P 602
The pattern and treatment of flooding and spotting
as associated with deficiency cold of penetrating
and conception vessels with static blood.

Wen Jing Tang


The treatment including channel-warming, blood
nourishing and stasis dispelling methods.
Wen Jing Tang
Clinical application:
It can be used in the treatment of dysmenorrhea,
amenorrhea, dysfunctional uterine bleeding,
endometriosis, endometrial hyperplasia, ovarian
cysts, uterine fibroids, atrophic vaginitis when
associated with pattern of deficiency cold with
stasis
Case study (1)
P 604
Case study (2)
P 605
SUMMARY

Disease Associated Signs and Principles of Formula


Pattern Pathomechanisms Symptoms Treatment
Miscellaneous Improper Upper burner cold rheum, Ejection of foamy Warm the lung, trans-form Xiao Qing Long Tang
Diseases purgation epigastric glomus drool, glomus rheum (Minor Blue-Green Dragon
Decoction) Xie Xin Tang
(Heart-Draining Decoction)
Unresolved Heat entering the blood Alternating heat and Clear liver and gall-bladder Xiao Chai Hu Tang (Minor
wind strike chamber, heat exploiting cold after 7-8 days, heat. disperse binding Burpleurum Decoction)
deficiency cessation of menses

Heat entering in the blood Menses appear after Course the liver eliminate Qi Men
chamber, static heat binding 7-8 days, chest and static heat
internally rib side fullness,
(LV-14)
delirious speech
SUMMARY

Disease Associated Signs and Principles of Formula


Pattern Pathomechanisms Symptoms Treatment
Heat entering the blood Bloody stools, sweating Course the liver, drain Qi Men
chamber, yangming heat, frenetic on the head heat
movement of blood
(LV-14)

Plum-pit qi Congealed phlegm, phlegm-qi Sensation of throat Transform phlegm, Ban Xia Hou Po Tang
ascent, affect-mind contraint obstruction open binding, (Pinellia and Official
regulate qi, downbear Magnolia Bark Decoction)
counterflow
Visceral agitation Qi constraint, fire damaging heart Disquietude, sorrow, Supplement heart and Gan Mai Da Zao Tang
and spleen, yin-fluid depletion fatigue, yawning spleen, calm the (Licorice, Wheat, and jujube
spirit, moisten Decoction)
dryness
Flooding and Deficiency cold of the penetrating Incessant bleeding for Warm the channels, Wen Jing Tang (Channel-
spotting and conception vessels, static several days, evening nourish blood, dispel Warming Decoction)
blood, yin deficiency with internal heat effusion, lower stasis
heat abdominal urgency, hot
palms, dry mouth and lips
SUMMARY
Disease Associated Signs and Principles of Formula
Pattern Pathomechanism Symptoms Treatment
s
Spotting Deficiency cold of the Incessant dribbling of Warm the channels, nourish Jiao Jiang Tang (Ass Hide
penetrating and conception dark blood the blood, stanch bleeding Glue and Ginger
vessel, failure to contain blood Decoction)

Spotting QI and blood stagnation in the Large wiry pulse, Free the collaterals disperse Xuan Fu Hua Tang (Insula
liver collaterals spotting, late binding, dispel stasis Decoction)
miscarriage

Inhibited Static blood Menstrual irregularities, Dispel stasis, invigorate blood Tu Gua Gen San
menstruation lower abdomen fullness (Thladiantha Powder)
and pain
SUMMARY
Disease Associated Signs and Principles of Formula
Pattern Pathomechanisms Symptoms Treatment

Inhibited Static blood binding internally, Ammenorrhea Break blood, dispel stasis Di Dang Tang (Resistance
menstruation menstrual block Decoction)

Inhibited Water and blood binding in the Lower abdominal Break blood, expel water Da Huang Gan Sui Tang
menstruation blood chamber swelling slightly difficult (Rhuburb and Kunsui
urination, no thirst Decoction)

Abdominal Static blood, qi stagnation, Stabbing abdominal Invigorate blood, dispel stasis Hong Lan Hua Jia (Cathamus
Pain wind contending with blood pain Wine)

Abdominal Disharmony of the liver and Abdominal pain and Course the liver, strengthen Dang Gui Shao Yao San
Pain spleen, internal dampness fullness, inhibited the spleen, nourish blood, (Chinese Angelica and Peony
urination, mild swelling dispel dampness Powder)
of the limbs
SUMMARY
Disease Associated Signs and Principles of Formula
Pattern Pathomechanisms Symptoms Treatment

Abdominal Stomach-spleen deficiency Abdominal pain relieved Warm the middle, strengthen Xiao Jian Zhong Tang
Pain cold by warmth and the spleen, benefit qi, (Minor Center-Fortifying
pressure, fatigue, engender blood Decoction)
diarrhea, pale
complexion
Vaginal Damp-heat pouring Vaginal discharge, Clear heat, dispel dampness Fan Shi Wan (Alum Pill)
Discharge downward, static blood, dry inhibited or blocked
blood binding in the uterus menses, pudendal
itching

Vaginal Cold-damp congealing in the Clear thin white Warm the uterus, dispel She Chuang Zi San (Cnidium
Discharge lower burner discharge, weak limbus, dampness Seed Powder)
itching

Shifted Kidney yang deficiency, urinary Vexing heat, insomnia Warm yang, disinhibit urine Shen QI Wan (Kidney Qi Pill)
bladder block, turbid yin counterflow inhibit-ed urination,
lower abdominal pain,
propped breathing
SUMMARY
Disease Associated Signs and Principles of Formula
Pattern Pathomechanisms Symptoms Treatment

Yin sores Damp-heat in the lower burner Genital ulceration and Cleat heat, dry dampness Lang Du Tang (Wolfs Bane)
itching, slippery rapid Decoction)
kidney pulses

Vaginal Dryness binding in the Vaginal flatulence, dry Moisten the intestines, Gao Fa Jian (Lard and
flatulence stomach and intestines, static stools, inhibited eliminate static heat Human Hair Brew)
heat urination