【Original Text】For those with seminal loss, presenting with a tense and painful lower abdomen, coldness in the genital area, dizziness, hair loss, and a pulse that is extremely weak and thin, this indicates a deficiency of blood and seminal loss; if the pulse is slightly tight and weak, it indicates seminal loss in men and dream intercourse in women, treated with Gui Zhi Long Gu Mu Li Tang (Cinnamon Twig, Dragon Bone, and Oyster Decoction).“Essentials of the Golden Coffer: Blood Bi and Xu Lao Disease Pulse Diagnosis and Treatment”
[Note] Tian Xiong San is listed under Gui Zhi Long Gu Mu Li Tang, but is not mentioned in the original text.
【Composition and Usage】Tian Xiong 3 liang, Pao Bai Zhu 8 liang, Gui Zhi 6 liang, Long Gu 3 liang. Grind these four ingredients into a powder, take half a qian with wine, three times a day, and increase as needed.
【Efficacy】Warms Yang and astringes essence.
Case Study of Leukorrhea
Li, 43 years old.
Initial Diagnosis: June 4, 2005. For nearly three years, the leukorrhea has been abundant, with a texture like water or glue, and during coughing, white discharge overflows, pale yellow in color with a slight odor. Reproductive history: 1-0-2-1, with an intrauterine contraceptive device in place. Gynecological examination indicated chronic mild cervicitis and sequelae of pelvic inflammatory disease. Previously treated with Qing Zhen Tang plus Qiang Huo, Fang Feng, Gao Ben, Pu Gong Ying, Da Xue Teng, Bai Jiang Cao, and Guan Zhong for 14 doses, which slightly reduced the leukorrhea, but it soon increased again. Currently, the leukorrhea is intermittent like water, white in color, with an odor; there is cough and urinary incontinence, and occasional nausea. The tongue is pale red with a thin white coating, and the pulse is thin.
Treatment Method: Warm Yang, strengthen the spleen, and lift Yang to astringe.
Prescription: Tian Xiong San combined with Shui Lu Er Xian Dan (Water and Land Two Immortals Pill) with modifications.
Dan Fu Pian 5g, Gui Zhi 5g, Cang Zhu 10g, Duan Long Gu 20g, Jin Ying Zi 20g, Qian Shi 30g, Bai Zhi 10g, Fang Feng 10g, Hai Piao Xiao 30g. 4 doses.
Second Diagnosis: June 18, 2005. The leukorrhea has decreased, with a scratchy throat and coughing for 3 days, tongue and pulse as above. Treated with a spicy cool exterior-releasing formula, Sang Ju Yin, for 3 doses.
Third Diagnosis: July 12, 2005. Due to abdominal pain, the patient reports that since the initial diagnosis, the leukorrhea has not increased, and there is no urinary incontinence.
【Comparison of Formulas】Comparison of Gan Cao Fu Zi Tang and Tian Xiong San
Both formulas contain Fu Zi (Aconite), Bai Zhu (White Atractylodes), and Gui Zhi (Cinnamon Twig). The difference is that Gan Cao Fu Zi Tang also contains Gan Cao (Licorice), while Tian Xiong San contains Long Gu (Dragon Bone). Therefore, both formulas warm Yang and dispel cold, but the former adds Gan Cao to eliminate Bi (obstruction), while the latter pairs with Long Gu to enhance astringency.
Commentary
Tian Xiong San is listed under Gui Zhi Jia Long Gu Mu Li Tang, although it does not specify its treatment. Logically, its treatment should be similar to Gui Zhi Jia Long Gu Mu Li Tang, hence the “Yi Chun Sheng Yi” states that “Tian Xiong San treats Yang deficiency and blood loss leading to seminal loss.” Gui Zhi Jia Long Gu Mu Li Tang is indicated for “men’s seminal loss and women’s dream intercourse,” similar reports have emerged, while Tian Xiong San is only seen in the treatment of male seminal abnormalities causing infertility (“Essentials of the Golden Coffer Modern Research Digest”), and there are no reports regarding its use in gynecological diseases.
This case involves leukorrhea. The “Suwen: Wei Lun” states: “When thoughts are endless, desires are unfulfilled, and one indulges excessively in sexual activity, it leads to relaxation of the reproductive muscles, resulting in muscle atrophy and leukorrhea.” The term “leukorrhea” here also refers to leukorrhea in women. Zhu Danxi stated: “Leukorrhea and nocturnal emissions are treated with the same method.” Based on this reasoning, Tian Xiong San can certainly treat leukorrhea. However, in women, leukorrhea often belongs to damp-heat conditions, and many cases are due to spleen deficiency, while those with spleen and kidney Yang deficiency, presenting with clear, watery leukorrhea, intermittent like urinary incontinence, and without odor, are rare. As Zhang Congzheng stated in “Rumen Shiqin”: “Like water leaking from a cave, it flows continuously.”
This condition likely belongs to the slippery condition of spleen and kidney Yang deficiency, and the primary treatment should be to warm Yang to secure and astringe. Tian Xiong San contains Tian Xiong (Aconite) and Gui Zhi, which can dispel the cold like the sun emerging from the clouds; Bai Zhu and Long Gu strengthen the spleen and secure astringency. Bai Zhu is superior to Cang Zhu in drying dampness. Shui Lu Er Xian Dan and Hai Piao Xiao can enhance its astringent effects; Fang Feng, Bai Zhi, and Qiang Huo are wind herbs, used to overcome dampness.
Chen Xiuyuan stated: “If Tian Xiong is not available, it should be replaced with Da Fu Zi (Large Aconite).”
Application of the “Essentials of the Golden Coffer” Formulas in Gynecological Diseases
We recommend “Gynecological Essentials of the Golden Coffer Application”, click to read the original text for direct purchase.
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Content Summary
This book is a study of the inheritance and application of Zhang Zhongjing’s formulas in the field of gynecology. The entire book is organized around formulas, listing the relevant texts, medicinal compositions, usage, and efficacy; it focuses on case studies using classical formulas to treat gynecological diseases, and compares similar formulas. In the commentary section, in addition to introducing the original treatment scope of the formulas, it emphasizes discussing anatomical and re-understanding methods of classical formulas, revealing how combinations of formulas or modifications can be used to treat various complex gynecological diseases.
The book utilizes 151 formulas from the “Essentials of the Golden Coffer” to treat over 100 gynecological diseases, including more than 500 case studies, many of which demonstrate remarkable efficacy and provoke deep thought. At the end of the book, there is a “Gynecological Disease Application Search Table of the Essentials of the Golden Coffer” and a “Stroke Index of the Essentials of the Golden Coffer”, facilitating readers’ mastery of classical formulas.
Learning classical formulas is to better apply them; this book provides a reference for readers to learn and use Zhang Zhongjing’s formulas, which is of great value for those engaged in clinical practice in traditional Chinese medicine, especially in gynecology, as well as for researchers of Zhang Zhongjing’s theories.
Author Biography
Ma Dazheng, Chief Physician of Traditional Chinese Medicine Gynecology, Level II Professional Technical Position, Master’s Supervisor at Shanghai University of Traditional Chinese Medicine, Doctoral Supervisor at Zhejiang University of Traditional Chinese Medicine. Enjoys special government allowances from the State Council, awarded the titles of “National Old TCM Expert Academic Experience Inheritance Work Guidance Teacher” by the former Ministry of Health, Ministry of Personnel, and National Administration of Traditional Chinese Medicine in the third, fifth, sixth, and seventh batches, and “Famous TCM Master of Zhejiang Province”, “National Famous TCM Gynecology Master” by the Chinese Association of Traditional Chinese Medicine, and an outstanding scientific and technological worker of the Zhejiang Province TCM Association. Serves as an expert reviewer for the Chinese Association of Traditional Chinese Medicine Science and Technology Award, an expert evaluation member of the China International Science and Technology Promotion Association, a key academic leader in the “Eleventh Five-Year Plan” of the National Administration of Traditional Chinese Medicine, and an expert in the infertility collaboration group. Previously served as a standing committee member of the Gynecology Branch of the National TCM Association, Vice Chairman of the Gynecology Branch of the Zhejiang Province TCM Association, and Chairman of the Gynecology Branch of the Wenzhou TCM Association. The “Ma Dazheng National Famous Old TCM Expert Inheritance Work Studio” was established with the approval of the National Administration of Traditional Chinese Medicine, and he is a pioneer of medical reading culture in China.
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