Fu Qingzhu's Guben Zhibeng Tang for Gynecological Hemorrhage

Guben Zhibeng Tang (Root-Securing and Collapse-Stopping Decoction) comes from Fu Qingzhu Nüke (Fu Qingzhu's Gynecology) by Fu Qingzhu, a renowned physician of the late Ming and early Qing dynasties. Fu Qingzhu, whose given name was Fu Shan, was a legendary figure of the late Ming: calligrapher, thinker, and physician. Fu Qingzhu's Gynecology is one of the classic works that every student of TCM gynecology must read.

Gynecological bleeding is one of the most common gynecological conditions. In TCM it is called xuebeng (blood collapse) or benglou (metrorrhagia and metrostaxis). In modern medicine, functional uterine bleeding, habitual abortion, uterine fibroids, and gynecological tumors can all cause gynecological hemorrhage. Heavy bleeding is called beng (collapse); scanty but prolonged bleeding is called lou (stomia). Most women who develop this condition have prolonged bleeding, sometimes heavy, so the combined term benglou is used.

Benglou often causes anemia, with a pale complexion and spontaneous cold sweating. Fu Qingzhu's Guben Zhibeng Tang is composed of Shudi (Prepared Rehmannia) and Chao Baizhu (Stir-fried Atractylodes), each one liang (now 30 g); Renshen (Ginseng) and Sheng Huangqi (Raw Astragalus), each three qian (now 9 g); Danggui (Angelica) five qian (now 15 g); and Paojiang (Blast-fried Ginger) two qian (now 6 g). It strongly bolsters original qi, restores the pulse and rescues from desertion, tonifies spleen and lung, generates fluids and stops thirst, and calms the spirit and benefits intelligence. It is used for the blood-desertion and qi-deficiency pattern caused by women's benglou, presenting with uterine bleeding, dim, dark vision, even fainting and loss of consciousness, and a surging but deficient pulse that feels forceless under heavy pressure.

In this formula, Shudi, Renshen, Sheng Huangqi, and Danggui all strongly supplement qi and blood; Chao Baizhu fortifies the spleen and boosts qi and also prevents miscarriage, making it an essential gynecological herb; Paojiang warms the meridian and stops bleeding. Combined, the herbs focus on strongly supplementing original qi and restoring the pulse to rescue desertion, while also warming the meridian to stop bleeding.

For severe benglou with heavy bleeding, pouring cold sweat, and ice-cold limbs, increase Renshen and Sheng Huangqi: Renshen up to 15–30 g and Sheng Huangqi up to 30–60 g, plus Fuzi (Aconite) 10–30 g to urgently return yang. If bleeding is hard to stop, add Duan Longgu (Calcined Os Draconis), Duan Muli (Calcined Concha Ostreae), Qiancaogen (Madder root), Xianhecao (Agrimonia), and Xiaoji (Thistle) to strengthen hemostasis. For center-qi collapse with fatigue and shortness of breath, follow Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction) and add a small amount of Shengma (Cimicifuga) and Chaihu (Bupleurum) to raise yang and lift the fallen. If the patient shows yin deficiency with dry throat, tinnitus, hair loss, or premature graying, combine with Erzhi Wan (Two-Marvel Pill), i.e., add Mohanlian (Eclipta) and Nüzhenzi (Ligustrum), each 10–30 g.

In practice, Guben Zhibeng Tang is not limited to gynecological bleeding. It can also be used for gastrointestinal bleeding of any cause presenting with a cold-deficiency pattern. In addition, it may be used after cancer radiotherapy and chemotherapy, and in patients with aplastic anemia, to raise low white blood cell, red blood cell, and hemoglobin counts.