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Abstract:
The Shanghai Dachang Gouju Li Shen’s Gynecology, which began in the early Ming Dynasty, has a history of 600 years through 20 generations. This article summarizes the eight methods of warming Yang in gynecology, namely, the method of warming Yang to regulate the Chong and Ren meridians, the method of warming Yang to stabilize bleeding, the method of warming Yang to stop leucorrhea, the method of warming Yang to relieve pain, the method of warming Yang to unblock the meridians, the method of warming Yang to promote urination, the method of warming Yang to stabilize the fetus. In each method, the author lists commonly used herbs in addition to symptoms. The final case study analyzes the principles, methods, and prescriptions, providing valuable insights.
Eight Methods of Warming Yang in Gynecology
Authors: Shen Shaogong, Shen Yigong
For women with Kidney Yang deficiency and cold-type gynecological diseases, the method of tonifying the kidneys and warming Yang is used for treatment. The Shanghai Shen’s Gynecology summarizes the eight methods of warming Yang in gynecology, which are introduced below:
Method of Warming Yang to Regulate the Chong and Ren Meridians
In cases of Kidney Yang deficiency, with internal cold and excess Yin, Qi and blood cannot transform and generate, leading to disharmony of the Chong and Ren meridians, and the blood sea cannot fill properly. Symptoms include pale tongue with white coating, deep and slow pulse, delayed menstruation with scanty light-colored flow, persistent abdominal pain, preference for warmth and pressure, pale complexion, cold limbs, lumbar soreness and fatigue, dizziness, and shortness of breath. Warming Yang to regulate the Chong and Ren meridians is recommended.Herbs: Xianlingpi (Immortal Spirit), Rougui (Cinnamon), Chuan Duan (Break Stone), Duzhong (Eucommia), Chuan Niuxi (Sichuan Achyranthes), Gouqizi (Goji Berries), Danggui (Angelica), Danshen (Salvia). If cold is severe, add Fuzhu (Aconite) and Ganjiang (Dried Ginger); if deficiency is severe, add Renshen (Ginseng), Huangqi (Astragalus), and Huangjing (Polygonatum).
Image: Danggui (Angelica)Method of Warming Yang to Stabilize Bleeding
In cases of insufficient Kidney Yang, with weakened original Qi, the Chong and Ren meridians are not stable, leading to excessive menstrual flow. Symptoms include pale tongue with thin coating, weak and large pulse, heavy menstrual flow that is light in color, or continuous spotting, cold limbs, pale complexion, and shortness of breath. Warming Yang to stabilize bleeding is recommended.Herbs: Lu Jiao Shuang (Deer Antler Powder), Xianlingpi (Immortal Spirit), Ganjiang (Dried Ginger), Huangqi (Astragalus), Baizhu (Atractylodes), Shudi (Rehmannia), Danggui (Angelica), Xianhecao (Herba Agrimoniae), Shengma (Cimicifuga). If sweating and cold limbs occur, add Renshen (Ginseng) and Fuzhu (Aconite) to tonify Qi and restore Yang.
Method of Warming Yang to Stop Leucorrhea
In cases of Yang deficiency with internal cold, the Dai meridian is not regulated, and the Ren meridian is not stable. Symptoms include pale and swollen tongue with teeth marks and white coating, deep and slow pulse, excessive clear and thin leucorrhea, cold sensation in the lower abdomen, dark complexion, frequent clear urination, and loose stools. Warming Yang to stop leucorrhea is recommended.Herbs: Lu Jiao Shuang (Deer Antler Powder), Xianlingpi (Immortal Spirit), Tu Si Zi (Cuscuta), Chuan Duan (Break Stone), Sheng Duzhong (Eucommia), Baizhu (Atractylodes), Sang Qiao (Silkworm), Qian Shi (Euryale). For dizziness, add Tong Jizhi (Tribulus), Bai Jizhi (White Jizhi), and Tianma (Gastrodia); for loose stools, add Bu Guo Zhi (Psoralea) and Rou Dou Kou (Nutmeg).
Method of Warming Yang to Relieve Pain
In cases of Kidney deficiency and Yang deficiency, with disharmony of the Chong and Ren meridians, the Mingmen fire is weak, unable to warm, leading to Qi and blood stagnation and pain, resulting in dysmenorrhea. Symptoms include pale tongue with thin coating, tight pulse, cold pain in the lower abdomen during menstruation, severe pain with cold extremities, relief with warmth, light-colored and scanty menstrual flow, cold limbs, and lumbar soreness. Warming Yang to disperse cold and invigorate blood to relieve pain is recommended.Herbs: Fuzhu (Aconite), Pao Jiang (Dried Ginger), Wuyao (Lindera), Baishao (White Peony), Taoren (Peach Kernel), Honghua (Safflower), Puhuang (Typha), Wulingzhi (Lindera). For severe lumbar pain, add Chuan Duan (Break Stone) and Sheng Duzhong (Eucommia); for lower abdominal pain, add Xiao Hui Xiang (Fennel) and Juzi He (Tangerine Seed); for flank pain, add Qingpi (Green Peel), Zhihua (Bitter Orange), Chuanlianzi (Melia), and Yuanhu (Corydalis).
Method of Warming Yang to Unblock the Meridians
In cases of inherent Yang deficiency, with Qi and blood depletion, and exposure to wind and cold, leading to obstruction of the meridians. Symptoms include pale tongue with moist coating, deep and thin pulse, soreness in the lower back and limbs, joint pain, and aversion to cold and wind. Warming Yang to disperse cold and unblock the meridians to relieve pain is recommended.Herbs: Fuzhu (Aconite), Pao Jiang (Dried Ginger), Chuanwu (Chuanwu), Caowu (Aconitum), Qianghuo (Notopterygium), Duhuo (Angelica), Qian Nian Jian (Himalayan Yew), Fangfeng (Siler), Fangkui (Dichroa), Jixueteng (Spatholobus). For joint pain, add Qingfeng Teng (Clematis), Haifeng Teng (Clematis), and Luoshiteng (Clematis); for Qi deficiency, add Renshen (Ginseng), Huangqi (Astragalus), and Dangshen (Codonopsis).
Image: Huangqi (Astragalus)
Method of Warming Yang to Promote Urination
In cases of inherent Kidney deficiency, after pregnancy, Yang Qi is difficult to distribute, unable to transform Qi and circulate fluids, leading to water retention and swelling. Symptoms include pale tongue with white and moist coating, deep and slow pulse, swelling of the face and limbs during pregnancy, palpitations, shortness of breath, lumbar soreness, and cold feet. Warming Yang to promote urination is recommended.Herbs: Lu Jiao Shuang (Deer Antler Powder), Xianlingpi (Immortal Spirit), Bajitian (Morinda), Baizhu (Atractylodes), Yunling (Poria), Guizhi (Cinnamon), Zhuling (Polyporus), Zexie (Alisma). For treating pregnancy-related swelling (edema), the common method is to strengthen the spleen and promote urination. The Kidney governs the Yang of the body, and treating both the spleen and kidney together enhances Yang Qi, ensuring orderly Qi transformation and better therapeutic effects.
Method of Warming Yang to Stabilize the Fetus
In cases of inherent weakness, congenital deficiency, or depletion after pregnancy, with weak Kidney Qi, the Chong and Ren meridians are unstable, leading to insufficient nourishment for the fetus. Symptoms include restless fetal movement, pale tongue with white coating, weak pulse, soreness in the lower back and knees, a feeling of emptiness in the lower abdomen, cold limbs, possible vaginal bleeding, dizziness, tinnitus, frequent urination, or even incontinence. Warming Yang to stabilize the fetus is recommended.Herbs: Tu Si Zi (Cuscuta), Sang Ji Sheng (Mulberry Mistletoe), Chuan Duan (Break Stone), Duzhong (Eucommia), Shanyurou (Cornus), Shudi (Rehmannia), Ejiao (Donkey-hide Gelatin), Shanyao (Chinese Yam). For severe Kidney deficiency and Qi weakness, add Xianlingpi (Immortal Spirit), Lu Jiao Shuang (Deer Antler Powder), Bu Guo Zhi (Psoralea), Huangqi (Astragalus), Dangshen (Codonopsis), and Baizhu (Atractylodes); for involuntary urination, add Yizhiren (Alpinia) and Qian Shi (Euryale); for bleeding, add Aiye (Mugwort) and Xianhecao (Herba Agrimoniae); for habitual miscarriage, add Renshen (Ginseng), Huangqi (Astragalus), Baishao (White Peony), and Ramie Root.
Method of Warming Yang to Assist Conception
In cases of congenital deficiency, weak Kidney Qi, or depletion of essence and blood, leading to damage to Kidney Yang and inability to warm, with weakened Chong and Ren Qi, resulting in difficulty conceiving. Symptoms include pale tongue, white and moist coating, deep and slow pulse, prolonged infertility, scanty light menstrual flow, dull complexion, fatigue, and soreness in the lower back and knees, with frequent clear urination. Warming Yang to assist conception is recommended.Herbs: Tu Si Zi (Cuscuta), Lu Jiao Shuang (Deer Antler Powder), Xianlingpi (Immortal Spirit), Bajitian (Morinda), Sheng Duzhong (Eucommia), Baizhu (Atractylodes), Yunling (Poria), Baishao (White Peony), Danggui (Angelica), Shudi (Rehmannia), Danshen (Salvia). For severe deficiency of true Yang in the lower body, add Rougui (Cinnamon), Fuzhu (Aconite), and Bu Guo Zhi (Psoralea); for cold pain in the lower abdomen, add Rougui (Cinnamon), Aiye (Mugwort), Wuzhuyu (Evodia), Xiangfu (Cyperus), and Baishao (White Peony).
Case Study
Cui, female, 34 years old.
Medical history: After marriage, she has been pregnant 4 times, but has had multiple miscarriages. Usually experiences soreness in the lower back and knees, aversion to cold, poor appetite, loose stools, fatigue, and palpitations, with light menstrual flow. Currently, she has missed her period for 50 days, and the pregnancy test is positive, requesting to preserve the pregnancy.
Examination: Pale tongue with teeth marks, thin white coating, fine and slippery pulse. Pregnancy test is positive.
Diagnosis: Inherent Yang deficiency, disharmony of the Chong and Ren meridians, insufficient nourishment for the fetus, and instability of the fetal source, leading to multiple miscarriages; Kidney deficiency and Yang Qi not adequately distributed, resulting in soreness in the lower back and knees, aversion to cold; fire not generating earth, spleen Yang not invigorated, leading to poor appetite, loose stools, and light menstrual flow; pale tongue with thin coating, fine and weak pulse, all indicating deficiency of both spleen and kidney. The disease is located in the spleen and kidney, with a diagnosis of Spleen and Kidney Yang deficiency.
Diagnosis: Habitual miscarriage, Spleen and Kidney Yang deficiency syndrome.
Treatment method: Tonify the spleen and kidney, warm Yang to stabilize the fetus.
Prescription: Chuan Duan 20g, Sheng Duzhong 20g, Tu Si Zi 15g, Bu Guo Zhi 15g, Shan Yao 20g, Bai Zhu 20g, Huang Qi 15g, Zhu Ma Gen 20g.
Image: Shan Yao (Chinese Yam)
Result: The above prescription was taken once daily, decocted in water, divided into two doses. After taking 7 doses, her spirit improved slightly, and she continued with the original prescription while being advised to rest and avoid stress. After one month, her spirit was invigorated, complexion was rosy, appetite and sleep were stable, and she later gave birth to a healthy baby boy.
Commentary: Habitual miscarriage is often due to Spleen and Kidney Yang deficiency, and treatment should focus on tonifying both the spleen and kidney, warming Yang to stabilize the fetus. This prescription of Chuan Duan, Sheng Duzhong, Tu Si Zi, and Bu Guo Zhi tonifies the kidney and warms Yang to stabilize the fetus; Shan Yao nourishes the liver and kidney, benefiting essence and Qi; Bai Zhu and Shan Yao tonify the spleen and benefit Qi; Huang Qi and Zhu Ma Gen benefit Qi and stabilize the fetus. The combination of these herbs promotes Yang generation and Yin growth, harmonizing the Chong and Ren meridians, thus stabilizing the fetal source.
Recommended Reading
《A True Renowned Traditional Chinese Medicine Practitioner: Clinical Cases of Xiong Jibai》
This book selects clinical cases that reflect Professor Xiong Jibai’s academic thoughts, clinical reasoning, and experience, covering nearly 100 diseases in internal medicine, surgery, gynecology, pediatrics, emergency medicine, and difficult and strange diseases. It is hoped that Professor Xiong Jibai’s rich clinical experience can be shared with those aspiring to become qualified, good, and renowned practitioners of Traditional Chinese Medicine.
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Copyright Statement
This article is excerpted from 《Comprehensive Clinical Strategies of Shanghai Shen’s Gynecology》，Edited by Shen Shaogong and Shen Yigong, published by China Traditional Chinese Medicine Press, copyright belongs to the relevant rights holders, please indicate the source when reprinting.All images are copyrighted by the publisher, please do not steal images.
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