益腎通经汤 Yi Shen Tong Jing Tang Boost the Kidneys and Open-Through the Menstruation Decoction

In this next entry on Dr. Xia’s opening through methods, we learn some very interesting principles.  His formula, Yi Shen Tong Jing Tang is indicated for Kidney deficiency type amenorrhea or scanty menstruation.  However the mechanism of the formula works with the Heart’s descending action to both supplement the Kidneys and to open through the menstruation.  This formula and this chapter on the formula illustrates a fundamental aspect of women’s physiology that is not often described.  This is the relationship between the Heart Qi and the vessels of the womb.  The Heart Qi must descend to the womb.

It is also interesting to note that Dr. Xia uses this formula for adolescent women who are suffering from amenorrhea, scanty or late menstruation.  He makes clear that there must be some vaginal discharge present to begin this formula.  In other words, if the woman is completely dry, with no vaginal discharge, the first treatment principle must be to increase moisture.  When the moisture just begins to show – that is the time to use this formula.  After using this formula, the vaginal discharge and ovulation mucous will begin to flow even more abundantly.

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进退温经汤 Jin Tui Wen Jing Tang Modified Warm the Menses Decoction

This is the next entry in this series of entries.  If you haven’t read the previous 3 entries, I recommend you go back and read them.  Each entry is an expansion of the previous one.

Here we expand on the idea of opening through by looking at blocked menstruation when there is cold.  Dr. Xia has created this formula based on Wen Jing Tang (Warm the Menses Decoction). What i didn’t realize before reading this chapter, is that there is another formula named Wen Jing Tang besides the one from the Jin Gui Yao Lue (Essentials from the Golden Cabinet).  There is a formula of the same name from the Fu Ren Da Quan Liang Fang (Complete Book of Effective Formulas for Women).  The ingredients of this formula are as follows: Continue reading

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五味调经散 Wu Wei Tiao Jing San Five Flavor Synchronize the Menstruation Powder

“He substituted Mu Dan Pi for Zhi Zi and Shan Zha for Liu Qu.  He did this because Mu Dan Pi and Shan Zha enter the blood level while Zhi Zi and Liu Qu do not.  Brilliant! ”

Todays entry includes the next section in Dr. Xia Guisheng’s chapter on opening through menstruation.  He uses his formula Wu Wei Tiao Jing Tang (Five Flavor Synchronize the Menstruation Decoction) as a jumping off point to discuss some basic ideas about the treatment of irregular menstruation due to congealed blood.   Wu Wei Tiao Jing Tang is a simple and small formula.  It’s design represents some of the basic principles of working with blood stasis in relation to menstruation and it’s size makes it ideal for combining with other formulas or for adding other herbs. Continue reading

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Opening-Through continued

加减通瘀煎 Jia Jian Tong Yu Jian Modified Opening Through Stasis Decoction

It is very important that the lack of free flow is paired with fullness, pain or up-bearing symptoms

By way of introduction to this first chapter, I’d like to write a bit about women’s physiology and the tubular quality of the Ren vessel and the Bao Tai.  Though I have not heard of these pathways written or spoken of as “tubular” per se, thinking of them in this way has helped me to visualize and understand women’s physiology, patho-physiology and the use of herbs in formulas.  So, please bear with me…If we think of the Ren vessel/Bao Tai as a tubular pathway extending from the upper body (Heart and chest) to the womb, physiologically, this tube provides the route for the Heart fire to descend to warm the womb and for the Kidney water to ascend to control, moisten and cool the Heart.  This pathway allows the communication and interaction of fire and water between the upper Jiao and womb.  We can also see that what travels within this tube is the interaction of fire and water which is the red blood.   Continue reading

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“Opening Through” the menstruation Tong Jing 通经

In relation to blood stasis – many of my own students don’t come in with much more of an understanding of blood stasis herbs other than that they all move the blood and that they should therefore not be used when there is heavy bleeding or during pregnancy.  And yet, through experience we learn that sometimes we must strongly move the blood in order to stop heavy bleeding and that sometimes moving the blood can help prevent a miscarriage.

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Mei Gui Hua By Dr. Ban Xiu-Wen

Mei Gui Hua is a cultivated courtyard flower.  In addition to it having value as a beautiful flower to observe it also has worth as a medicinal herb.

It is warm and harmonious.  It primarily courses and raises, being able to course and raise the Liver, Gallbladder, Spleen and Lung Qi.  It is an herb that nourishes the Heart and Liver blood vessels.  It is not really an attacking herb.  Because the characteristics of this herb are even and harmonious and it is warm without being drying, it courses without damaging the Yin.  It is suitable for women who have weaker bodies in which the blood vessels are not open through and the Qi mechanism is stagnant and constrained.  Furthermore, the fragrance is sweet and refreshing.

It refreshes the Heart and makes a person feel happier.

By boosting both the Liver and Spleen, this is a primary herb to treat Liver blood stasis in women.  I often use to treat irregular menstruation, red and white leucorrhea, illnesses relating to early or late menstruation, and menopausal syndrome especially when these are accompanied by autonomic nervous dysfunction women’s pathology.  It is very effective. Continue reading

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Ji Mai San 蒺麦散: Case 4

from the practice of Dr. Qiu Xiao-mei

The relationship between the breasts and women’s disharmonies such as amenorrhea, dysmenorrhea and infertility.

Ms. Chang was twenty-five when she came for her first visit on December 13, 1976. She had been married for three years without becoming pregnant. Premenstrually she suffered from breast distention and pain each month and her menstruation was early or late without regularity. The amount was profuse and continued for six to seven days. During menstruation her bowels were sticky and each day moved repeatedly. Her pulse was sinking and thin and her tongue moss was sticky. Her pulse and pattern corresponded. Continue reading

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Ji Mai San 蒺麦散: Case 3

Ji Mai San Case Example 3

Ms. Qu was thirty years old when she carne for her first visit on April 5, 1977. She had been married for three years without becoming pregnant. The iodized oil roentgenograpy revealed that the fallopian tubes on both sides had inflammatory changes. The liquid went through but not smoothly. Her menstruation had been changing for several months. After using female hormones the amount of menstruate became scanty and she experienced dull pain on both sides of her lower abdomen. Her pulse was deep and thin and her tongue moss was thin and white. This appeared to be a case of Chong and Ren Mai vacuity cold and Liver Qi depressive knotting. To treat, I decided to warm her uterus and course her Liver so I used modified Gui Xian Tang, Cinnamon Immortal Soup as the prescription:

Zhi Shi Ying               Fluoritum         15gm.

Yin Yang Huo       Herba Epimidium           9gm.

Xian Mao            Rhizoma Curculingus       9gm.

Rou Cong Rong         Caulis Cistanches            12gm.

Ba Ji Tian                 Radix Morinda              12gm.

Rou Gu Mo      Cortex Cinnamon Powder     3 gm.(stir in powder)

Da Mai Ya           Massa Fermentata Hordei            15gm.

Chao Dang Gui     Stir-fried Radix Angeilca Sinensis     9gm.

Chao Chi Shao     Stir-fried Radix Peoniae Rubra     15gm.

Chao Chuan Xiong     Stir-fried Rhizoma Ligusticum        4.5 grn.

JuHe                Semen Citri                                            4.5 gm.

Ju Luo              Fructus Vascularis Citri                         4.5 gm.

Tu Hong Hua        Flos Carthami                                         4.5gm.

Pu Gong Ying        Herba Cum Radicis Taraxum                 12gm.

Bai Mao Teng      Herba Solanum Lirati                             30 gm.

There after I used the same prescription, modified in accordance with the symptoms.

She intermittently took the herbs for a period of close to one year. In April of the next year she became pregnant.

Sharon’s commentary:

As with the previous case, we see here how Dr. Qiu strings formulas together in mixed patterns.  In case one she used Ji Mai San with Wu Zi Yan Zong Wan when the presentation was a Liver Qi stasis and Kidney Qi deficiency.  In this case she has determined that the diagnosis is Liver depression and Kidney Yang deficiency because the patient’s pulse is thin and deep and her tongue moss is white.  In cases of Kidney Yang deficiency leading to infertility, Dr. Qiu uses her experiential formula Gui Xian Tang Cinnamon Immortals Soup.    In this case she combines this with Ji Mai San.  Dr. Qiu has also added the more vitalizing aspects of Si Wu Tang by including Dang Gui, Chuan Xiong and Chi Shao as well as Hong Hua to improve the quality and movement of the blood.  Generally, when a woman exhibits scanty menstruation or amenorrhea with lower abdominal pain, Dr. Qiu would consider blood stasis an aspect of the diagnosis.  Bai Mao Teng, 白毛藤 is an herb Dr. Qiu uses to treat fallopian tube and ovarian inflammation.

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Ji Mai San 蒺麦散 Case 2

Case 2 from the practice of Dr. Qiu Xiao-mei  The relationship between the breasts and women’s disharmonies such as amenorrhea, dysmenorrhea and infertility.

Ji Mai San Case Example 2

Ms. Wu was twenty-eight years old when she came for her first visit on December 8, 1976. She had been married for four years without becoming pregnant. At a hospital she underwent an iodized oil radiograph which showed that her uterus was crooked and collapsed. Her two fallopian tubes were unobstructed. By her own report she suffered from premenstrual abdominal pain and breast distention. Her pulse was sinking and thin and her tongue was red and moist. For treatment it was appropriate to course the Liver and rectify the Qi while simultaneously boosting the Kidney. I gave her the following prescription: Continue reading

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PMS and Ji Mai San

Ji Mai San 蒺麦散:

Case 1 from the practice of Dr. Qiu Xiao-mei

The relationship between the breasts and women’s disharmonies such as amenorrhea, dysmenorrhea and infertility.

Her menstruation came regularly but premenstrually she had breast pain and distention for two weeks.  When her breast was palpated, there were many scattered small seed-like lumps.  The pain extended to below her armpit and when she bent and stretched her arm it was uncomfortable.

Ji Mai San Case Example 1

I treated a woman named Guo who was 35 years old.  She had been married 7 years with no pregnancy.  Her menstruation came regularly but premenstrually she had breast pain and distention for two weeks.  When her breast was palpated, there were many scattered small seed-like lumps.  The pain extended to below her armpit and when she bent and stretched her arm it was uncomfortable.  She had suffered with this for 10 years.  The surgery department diagnosed her with breast lobular hyperplasia.  Her Traditional Chinese diagnosis was breast lump.  Her pulse was deep and thin and her tongue had a thin moss.   Continue reading

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