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1 Application of Danggui Shaoyao San (Angelica and Peony Powder)
Formula Explanation: The formula emphasizes the use of Bai Shao (White Peony) to nourish the liver, harmonize the blood, and alleviate pain, complemented by Danggui (Angelica) and Chuanxiong (Sichuan Lovage) to regulate the liver and blood, along with Fuling (Poria), Baizhu (White Atractylodes), and Zexie (Alisma) to strengthen the spleen and drain dampness.
Case 1: Uterine Prolapse (Yin Ting): Ms. Mei, 26 years old, first diagnosed on October 5, 1989. She reported that two months after giving birth, she felt a prolapse of the uterus, with about 1.5 cm protruding outside the vaginal opening when standing. She thought it would retract automatically after a month, but it did not, accompanied by dull pain in the lower abdomen, a preference for pressure, slight thirst, a flushed face, normal appetite, soft stools, short and yellow urine, and a thin, wiry pulse. She had previously taken a modified Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) for five doses, but felt uncomfortable with dry mouth and bitter taste, and the uterine prolapse persisted, leading her to seek treatment from me. Considering this was due to disharmony between the liver and spleen, and damp-heat stagnation, causing the Dai Mai (Girdle Vessel) to be unregulated, I prescribed a modified Danggui Shaoyao San: Danggui 10g, Bai Shao 15g, Baizhu 10g, Zexie 10g, Fuling 10g, Chuanxiong 5g, Zhike 10g. I instructed her to take one dose daily for five doses.
On October 11, 1989, she returned for a follow-up. After taking the medicine, her abdominal pain decreased, and the uterine prolapse showed slight improvement. She continued with another five doses, and after two more visits, her overall symptoms gradually improved, and the uterine prolapse resolved. In total, she took 20 doses, and all symptoms disappeared.
Note: Uterine prolapse is related to the Dai Mai, and Tang Rongchuan believes that the Dai Mai belongs to the spleen, hence uterine prolapse is often treated from the perspective of the spleen using Bu Zhong Yi Qi Tang. Additionally, the liver and spleen are closely related physiologically and pathologically; liver diseases can affect the spleen, and spleen diseases can also affect the liver. Therefore, although uterine prolapse is closely related to the spleen, spleen dysfunction can also stem from liver issues. Thus, if treatment for the spleen is ineffective, one should consider treating the liver, or both the liver and spleen together. In this case, I used a modified Danggui Shaoyao San because the symptoms indicated disharmony between the liver and spleen, damp stagnation, and included signs such as dull pain in the lower abdomen, short urination, soft stools, a flushed face, and a thin, wiry pulse, leading to a quick recovery.
Case 2: Threatened Miscarriage (Fetal Leakage, Unstable Fetal Movement): Ms. Lan, 34 years old, first diagnosed on February 5, 1972. The patient had missed her period for over 60 days and experienced vaginal bleeding for one week, with a small amount of dark red blood, continuous but without clots, accompanied by lower back and abdominal distension and pain, good appetite, no vomiting or acid reflux, slight thirst, and normal urination. She had been feeling emotionally unwell for the past half month. After using progesterone and other hemostatic agents, the bleeding decreased slightly, but vaginal bleeding persisted, with a wiry pulse and a pale red tongue with thin white coating. Pregnancy test was positive. This was diagnosed as disharmony between the liver and spleen, with damp-heat stagnation causing blood to move erratically. I prescribed a modified Danggui Shaoyao San: Danggui 10g, Bai Shao 15g, Baizhu 10g, Zexie 10g, Fuling 10g, Chuanxiong 5g, Sangjisheng (Mulberry Mistletoe) 15g, Ejiao (Donkey-hide Gelatin) 9g, Juzhu (Chinese Dodder) 10g, and Duzhong (Eucommia) 10g. After taking 10 doses, the bleeding stopped, and she subsequently delivered a healthy baby boy at full term.
Note: The Essentials of Golden Coffer states: “When a woman is pregnant and experiences abdominal pain, Danggui Shaoyao San is the main treatment.” The patient experienced abdominal pain at two months of pregnancy, and since there was also bleeding, I used Danggui Shaoyao San as the main formula, adding Ejiao to nourish the blood and stop bleeding, and Juzhu to stabilize the fetus due to unstable fetal movement. For lower back pain, I added Duzhong and Sangjisheng to tonify the kidneys and stabilize the fetus. This formula is often avoided by modern clinicians for threatened miscarriage, preferring to use Shoutai Wan (Fetal Longevity Pill). However, according to research by Nakata Keigo in Japan, among 40 pregnant women who took this formula, 27 were followed up, and no adverse effects on maternal and child health were found. Furthermore, no harmful effects on maternal recovery and child development were observed. Modern medicine believes that taking medication during the early stages of pregnancy when the fertilized egg is rapidly dividing increases the risk of deformities. However, observing the use of this formula, administering it before the embryo is formed improves the maternal environment, positively influencing the development of the fertilized egg into an embryo, with no observed teratogenic effects, and it plays a positive role in the health of children. I encounter similar cases every year, and using a modified Danggui Shaoyao San has yielded satisfactory results, demonstrating the reliability of classical formulas.
Case 3: Edema (Chronic Nephritis): Ms. Hu, 45 years old, first diagnosed on September 12, 1990. She reported suffering from nephritis for many years, with facial swelling in the morning and leg swelling in the afternoon. She had generalized edema for over six months, but it was not severe, with a fair appetite, a sallow complexion, average energy, soft stools, short and yellow urine, no burning sensation, and a thin, wiry pulse. Urine protein was + + +. Previous doctors had treated her with sweating and diuretics for nearly three months, but there was no improvement in edema or proteinuria. Considering her sallow complexion, thin and wiry pulse, and mild edema, I diagnosed her with blood deficiency and dampness stagnation, and prescribed the original formula of Danggui Shaoyao San: Danggui 10g, Bai Shao 15g, Chuanxiong 6g, Zexie 10g, Baizhu 10g, Fuling 10g. After taking 7 doses, the edema slightly decreased, and urine protein reduced to + +. After taking another 7 doses of the original formula, the edema further decreased, and urine protein became +. After another 7 doses, the edema completely resolved, and urine protein was negative. To consolidate the effect, I prescribed the original formula for another month, and she has not relapsed since.
Note: The key to diagnosing this condition lies in the thin, wiry pulse and sallow complexion, indicating blood deficiency, while soft stools and edema suggest spleen deficiency with dampness. Therefore, I used the original formula of Danggui Shaoyao San, which was very effective.
In addition to the three cases mentioned above, Danggui Shaoyao San can also be used to treat chronic appendicitis, pelvic inflammatory disease, adnexitis, ovarian tumors, vaginal bleeding, functional uterine bleeding, leukorrhea, habitual miscarriage, infertility, ectopic pregnancy, abnormal fetal position, pregnancy-related edema, pregnancy-induced hypertension, eclampsia, menopausal syndrome, chloasma, bacterial dysentery, chronic diarrhea, hepatitis, urinary retention (prostate enlargement), urinary stones, and lower limb stasis, among other common clinical conditions. According to the Eight Principles classification: it belongs to interior syndrome from the perspective of exterior and interior, and to yin syndrome from the perspective of yin and yang (Foot Jueyin Liver, Foot Taiyin Spleen), and from the perspective of deficiency and excess, it is a mixture of deficiency and excess. The key points for diagnosis include the etiology of liver stagnation and spleen deficiency, damp-heat stagnation, with the disease location in the liver and spleen, and symptoms may include blood deficiency (pale complexion, dizziness, scanty light menstruation, pale tongue, etc.), spleen deficiency with dampness (soft stools, poor urination, sticky mouth), focusing on abdominal diseases.
2 Application of Zhuling Tang (Polyporus Decoction)
Formula Explanation: Zhuling (Polyporus), Fuling (Poria), Zexie (Alisma), and Huashi (Talc) promote diuresis and clear heat, while Ejiao nourishes yin and moistens dryness, allowing water to be eliminated and heat to be detached, thus stopping thirst.
Case 4: Insomnia (Neurasthenia): Ms. Wu, 35 years old, a farmer, first diagnosed on June 21, 1978. The patient had been experiencing dizziness and insomnia for over two months, with severe dizziness accompanied by vertigo but no vomiting, requiring assistance to walk, timid and easily startled, afraid to cross the street, with insomnia and vivid dreams, and slight thirst without a desire to drink much. Her husband is a physician, and she had previously used Chinese medicine to nourish yin and calm the spirit, tonify qi and nourish blood, but with no effect. She also tried western sedatives, but there was no improvement. Examination in the internal medicine and neurology departments of a certain hospital revealed no abnormalities, and she was diagnosed with neurasthenia. Later, she consulted me. During the consultation, her symptoms were as described, with short and yellow urine occasionally accompanied by a burning sensation, dry stools, slightly sticky mouth, a flushed face, a red tongue with white coating, and a deep, thin, wiry pulse, indicating damp-heat injuring yin in the lower jiao, leading to disharmony between the heart and kidneys. I prescribed a modified Zhuling Tang: Zhuling 10g, Fuling 10g, Huashi 15g, Zexie 10g, Ejiao 10g, Ye Jiao Teng (Polygala) 10g, and Suanzaoren (Sour Jujube Seed) 10g. After five doses, on June 27, she returned for a follow-up: after taking the formula, her urine became longer and clearer, with occasional burning sensations, and her palpitations, insomnia, and dizziness all decreased. I continued with the original formula for another five doses. The patient returned several times, and as her condition improved daily, I kept the original formula unchanged, totaling 25 doses, and all symptoms disappeared.
Note: The reason for diagnosing this case as damp-heat injuring yin leading to disharmony between the heart and kidneys is due to the thin, wiry pulse, indicating insufficient yin and blood, while the deep pulse suggests that the deficiency is in the lower jiao kidney. The burning sensation in urine and sticky mouth indicate damp-heat. Overall, it is clear that damp-heat injuring yin is the diagnosis. The “Shang Han Lun” states: “In Shaoyin disease, if there is diarrhea for six or seven days, cough, and thirst, with irritability and inability to sleep, Zhuling Tang is the main treatment.” Therefore, I chose Zhuling Tang for treatment, achieving good results.
Case 5: Hematuria (Urinary Tract Infection): Ms. Hu, 24 years old, first diagnosed on November 5, 1986. She had visible blood in her urine for two weeks, and western medicine diagnosed her with a urinary tract infection. After receiving high doses of penicillin, streptomycin, and gentamicin injections for 10 days, there was no significant effect, and she sought treatment from traditional Chinese medicine. Current diagnosis: continuous blood in urine, bright red color, frequent urination with burning sensation, thirst, a feeling of heaviness in the lower abdomen, and back pain, with no obvious edema. The tongue was red with thin yellow coating, and the pulse was rapid. Urinalysis showed numerous red blood cells, white blood cells + + +, and protein + +. Abdominal X-ray showed no abnormalities in the kidneys, ureters, or bladder. This was caused by heat forcing the bladder, and treatment should focus on clearing heat, promoting diuresis, and cooling blood to stop bleeding. I prescribed a modified Zhuling Tang with Bai Mao Gen (Imperata) 30g and Da Huang (Rhubarb) 12g. After taking 15 doses, all symptoms subsided, and urinalysis returned to normal, achieving a complete recovery.
Additionally, Zhuling Tang has been used to treat nephritis-related edema, hydronephrosis, cystitis, hemorrhagic fever during the shock phase, bleeding due to liver cirrhosis, urinary retention, and ascites. The diagnostic key points for this formula include three aspects: (1) due to yin deficiency, there may be dry throat, red or crimson tongue, thin pulse, or a combination of at least two of these; (2) due to the mutual accumulation of water and heat, the tongue coating must be yellow or dry white, urine must be yellow and scanty, the bladder must be urgent, or water may seep into the large intestine causing diarrhea, or fluids may not ascend causing thirst; (3) due to the use of mild diuretics, there must be water accumulation and scanty urine. If the pathology is due to fluid deficiency with no urine output, Zhuling Tang is absolutely contraindicated.
3 Application of Chixiaodou Danggui San (Red Bean and Angelica Powder)
Formula Explanation: Chixiaodou (Red Bean) drains dampness and clears heat, detoxifies and drains pus; Danggui (Angelica) invigorates blood, removes stasis, and generates new blood; the decoction is cool and detoxifying.
In the Essentials of Golden Coffer, this formula is used to treat abscesses and blood-related issues, and currently, it is mainly used for treating heat toxins in the small intestine flowing into the large intestine, leading to blood in the stool (later referred to as visceral toxins, hemorrhoids, intestinal wind bleeding) and blood stasis, intestinal abscesses, etc.; it is also commonly used for treating exudative skin diseases (infectious eczema-like dermatitis, contact dermatitis, lacquer allergy, summer boils, acute eczema, pustular dermatitis, etc.). For treating perianal diseases, modifications include: for anal ulcers, hemorrhoids, and blood in stool, add Huaihua (Sophora Flower), Yinhua (Honeysuckle), Zihua Diding (Viola), and Jiegeng (Platycodon); for persistent blood in stool, add fried Chun Gen (Mulberry Root) white skin, Cèbǎi (Arborvitae), and Zicao (Lithospermum); for cases with heavy damp-heat, add Huangbai (Phellodendron), Kǔshēn (Sophora), and Zhimu (Anemarrhena); for hemorrhoids with significant heat, add Ma Chi Xian (Portulaca), Huaihua, Diyi (Sanguisorba), and Huangqin (Scutellaria).
4 Application of Bai Tou Weng Tang (Pulsatilla Decoction)
Formula Explanation: Bai Tou Weng (Pulsatilla) clears heat and cools blood as the main action, supplemented by Qin Pi (Fraxini) to drain heat and bind the large intestine, and Huanglian (Coptis) and Huangbai (Phellodendron) to clear heat and dry dampness, solidifying the yin and thickening the intestines to stop dysentery.
Case 6: Urolithiasis (Kidney Stones): Mr. Wan, 24 years old, a worker, first diagnosed on October 17, 1983. The patient presented with left flank pain, sometimes accompanied by hematuria, diagnosed as kidney stones and hospitalized for treatment. After a month of comprehensive treatment, the flank pain persisted, with frequent urination, urgency, and burning sensation, and a feeling of discomfort in the abdomen. I found his pulse to be thin and rapid, and his symptoms were as described, with a thin coating on the tongue and a red tongue. I diagnosed it as liver wind with heat forcing the bladder, and treated it with Bai Tou Weng Tang combined with Dao Chi San (Guide Red Powder) (the original formula was not modified). After five doses, he passed a small stone, and all symptoms disappeared, with follow-up showing no recurrence.
Note: Bai Tou Weng Tang is primarily used to treat dysentery (diarrhea), and renowned TCM expert Yao Hesheng believes this formula has the effect of extinguishing wind and clearing heat. He has used this formula combined with Dao Chi San to treat urinary retention, achieving significant results. Inspired by him, I used it to treat urolithiasis due to liver wind, also achieving remarkable results.
Currently, Bai Tou Weng Tang is commonly used to treat bacterial dysentery, amoebic dysentery, ulcerative colitis, wind-heat eye diseases, urinary tract infections, etc. When used for diarrhea, it is primarily for the syndrome of liver wind forcing down, with key differentiating points being: red stools are often hot, while white stools are often cold; wind and heat can both be seen in the urgency of the stool, but heat is more pronounced than wind; heat symptoms are often accompanied by significant pain, while liver wind forcing down causes a feeling of heaviness. In summary, one is primarily characterized by pain, with abdominal pain resisting pressure, accompanied by urgency; the other is primarily characterized by urgency, with no time to spare, and a feeling of heaviness and burning in the anus.
5 Application of Danggui Beimu Kushen Wan (Angelica, Fritillaria, and Sophora Pill)
Formula Explanation: Danggui (Angelica) invigorates blood and moistens dryness; Beimu (Fritillaria) regulates qi and relieves stagnation, also treating heat dysuria; Kushen (Sophora) drains damp-heat, removes heat accumulation, and when combined with Beimu, can clear the lungs and disperse bladder heat, allowing blood to be nourished, heat to be released, and bladder function to be regulated, thus facilitating urination.
Case 7: Dysuria (Urinary Tract Infection): Ms. Zhao, 23 years old. One week ago, she noticed frequent and urgent urination, accompanied by lower back pain. Urinalysis showed protein +, red and white blood cells + + + +, leading to a diagnosis of urinary tract infection. After several days of treatment, her symptoms did not improve, and she also experienced leukorrhea, prompting her to come to my clinic. Upon examination, her tongue was slightly red, and her pulse was thin and slippery, indicating yin deficiency with damp-heat descending. I prescribed a modified Danggui Beimu Kushen Wan: Danggui 12g, Beimu 12g, Kushen 12g, and Shengdi (Rehmannia) 25g. After the third dose, her lower back pain and frequent urination improved significantly, and the leukorrhea decreased markedly. After four doses, the symptoms basically disappeared. The tongue and pulse remained the same, and a follow-up urinalysis returned to normal. I then added Huashi (Talc) 30g and Gancao (Licorice) 6g to the formula for further treatment.
Note: I added Shengdi to the formula because the patient had a red tongue and thin pulse, aiming to nourish yin and clear heat, ensuring that diuresis would not harm yin.
Modifications for this formula include: for habitual constipation, add Ma Ren (Hemp Seed), Sheng Shou Wu (Fleeceflower Root), Lai Fu Zi (Radish Seed), and Xuan Shen (Scrophularia) to nourish yin and moisten the intestines; for prostatitis with damp-heat accumulation in the lower jiao, add Huashi combined with Zhibai Dihuang Tang (Anemarrhena and Rehmannia Decoction) to nourish the kidneys, tonify blood, clear heat, and promote diuresis; for pregnant women with severe dysuria, add Gancao (Licorice) and Huashi to facilitate urination; for those with deep yellow urine, add Bianxu (Plantago), Qumai (Sedge), and Wild Chrysanthemum to clear heat and detoxify.
Danggui Beimu Kushen Wan is currently mainly used to treat dysuria during pregnancy and constipation, pyelonephritis, prostatitis with urinary difficulties, and urinary tract infections. The disease location is in the lower jiao, with the etiology being damp-heat. From the perspective of qi and blood, it belongs to the blood aspect, from the perspective of exterior and interior, it is an interior syndrome, and from the perspective of yin and yang, it is a yin syndrome (liver and kidney). Symptoms include incomplete urination, painful urination, yellow-red urine, or accompanied by dry stools, red tongue, yellow coating, and wiry or slippery pulse. This formula is not suitable for those with a slow pulse, as Kushen can slow the heart rate. Regarding Beimu in this formula, if there is a dry cough, use Chuanbeimu (Fritillaria) instead; if there is prostate enlargement, use Zhebeimu (Zhejiang Fritillaria).
Other formulas such as Puhui San, Danggui San, and Niaoshi Fan, etc., are sometimes difficult to use clinically due to the unavailability of certain herbs or their simplicity, making it challenging to provide specific experiences.
Yesterday’s Medical Talk Review: The remarkable effects of old TCM secret formulas are often unknown to many, and I feel compelled to share them for future generations. Selected effective secret formulas from renowned old TCM experts are repeatedly effective, and I recommend saving them. Gui Zhi Fu Ling Wan, Eight Principles of Medical Talk, Jiang Chunhua’s experience with Da Huang, special external use formulas, commonly used powder formulas in ENT, and clinical experience from specialized doctors.
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