Clinical Application of the Empirical Prescriptions for Chronic Pelvic Inflammation

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JTCM June 2004 76/51
Cao Danong

(Archive subscribers please click on 'find out more' to see abstract. The full article is not available online and must be bought as a photocopy delivered by post).

Clinical Application of the Empirical Prescriptions for Chronic Pelvic Inflammation

by Cao Danong

In this interesting article, the author has used the prescriptions of the ancient TCM physician Zhang Zhongjing for the treatment of chronic pelvic inflammatory disease (PID), with an effective rate of over 97%. He identifies 3 main patterns and gives the classical prescription for each (although the volume of each herb is not given). 1. For treating stagnant heat, with severe lower abdominal pain before or during the menstrual period, red tongue and wiry pulse, he suggests Si Ni San (Frigid Extremities Powder). This consists of Chai Hu (Radix Bupleuri), Bai Shao (Radix Paeoniae Lactiflorae), Zhi Shi (Fructus Citri seu Ponciri Immaturus), Gan Cao (Radix Glycyrrhizae Uralensis), and Bai Shao (Radix Paeoniae Lactiflorae). For excessive pathogenic heat, Lian Qiao (Fructus Forsythiae Suspensae), Pu Gong Ying (Herba Taraxaci Mongolici cum Radice) and Jiu Da Huang (Radix et Rhizoma Rhei soaked in wine) may be added. For severe blood stasis and obvious abdominal pain, Dan Shen (Radix Salviae Miltiorrhizae), Yu Jin (Tuber Curcumae), Ze Lan (Herba Lycopi Lucidi) and Wu Ling Zhi (Excrementum Trogopterori seu Pteromi) may be added. Originally prescribed for treating cold limbs due to excess of heat, this formula works for PID by dispersing the pathogenic heat stagnating in the Penetrating and Conception vessels, and reducing the stagnation of qi and blood. 2. For treating Spleen deficiency and Liver depression, with indications of long term repeated attacks of abdominal and lumbosacral pain, along with signs of Spleen deficiency including pain associated with overwork, lingering leucorrhoea, lassitude, wanting to lie down, poor appetite and loose stools, pale and flabby tongue and deep, weak pulse, he suggests Dang Gui Shao Yao San (Powder of Chinese Angelica and Peony). This consists of Dang Gui (Radix Angelicae Sinensis), Chuan Xiong (Radix Ligustici Wallichii), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Sclerotium Poriae Cocos), Ze Xie (Rhizoma Alismatis Plantago-aquaticae) and Bai Shao (Radix Paeoniae Lactiflorae). Where the flow of qi is particularly poor, Li Zhi He (Semen Litchi Chinensis) and Xiang Fu (Rhizoma Cyperi Rotundi) should be added. To dispel pelvic masses, add Ze Lan (Herba Lycopi Lucidi), Shui Zhi (Hirudo seu Whitmaniae) and Gan Cao (Radix Glycyrrhizae Uralensis). In this pattern, vital qi is weak whilst the invasive pathogens are not. In the view of the author, eliminating individual pathogens might injure vital qi still further, whist tonifying qi might tonify the pathogens. Therefore, the preferred approach is to soothe the Liver and strengthen the Spleen, remove blood stasis, regulate the flow of qi and resolve dampness. 3. For treating insufficiency of vital qi and blood stasis, which presents as intractable lingering abdominal pain, dysmenorrhoea, profuse leucorrhoea, lassitude and vexation, aversion to cold, dry throat or mouth, infertility after childbirth, pale dull tongue and deep thready hesitant pulse, the author suggests Wen Jing Tang (Warm the Menses Decoction). This decoction contains Gui Zhi (Ramulus Cinnamomi Cassiae) and two groups of drugs. The first, for nourishing Spleen qi and Stomach yin and promoting the formation of qi and blood, consists of Ren Shen (Radix Ginseng), Mai Men Dong (Tuber Ophiopogonis Japonici), Wu Zhu Yu (Fructus Evodiae Rutaecarpae), Ban Xia (Rhizoma Pinelliae Ternatae), Sheng Jiang (Rhizoma Zingiberis Officinalis Recens), E Jiao (Gelatinum Asini), Bai Shao (Radix Paeoniae Lactiflorae) and Gan Cao (Radix Glycyrrhizae Uralensis). The second group which promote blood circulation and remove accumulated heat in the blood, consists of Dang Gui (Radix Angelicae Sinensis), Chuan Xiong (Radix Ligustici Wallichii) and Dan Pi (Cortex Moutan Radicis). To enhance regulation of the flow of qi and promote transportation, Li Zhi He (Semen Litchi Chinensis) and Xiao Hui Xiang (Fructus Foeniculi Vulgaris) can be added. To warm the channels and collaterals so as to promote the circulation of qi and blood, Wu Gong (Scolopendra Subspinipes) and Shui Zhi (Hirudo seu Whitmaniae) can be added.

JTCM June 2004

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