Fu Qingzhu's Yi Huang Tang
Yi Huang Tang comes from Fu Qingzhu Nüke (Fu Qingzhu's Gynecology). It is composed of Shanyao (Rhizoma Dioscoreae, stir-fried) and Qianshi (Semen Euryales, stir-fried) each 1 liang (30 g), Huangbai (Cortex Phellodendri, stir-fried with salt water) 2 qian (6 g), Cheqianzi (Semen Plantaginis, stir-fried with wine) 1 qian (3 g), and Baiguo (Semen Ginkgo, crushed, ten pieces) (12 g).
Fu Qingzhu used it to treat "yellow vaginal discharge." According to the upper volume of Fu Qingzhu Nüke, the symptoms of yellow discharge are: "In women with vaginal discharge that is yellow, like thick yellow tea broth, with a foul odor-this is what is called yellow discharge." That is, there is a yellow, sticky vaginal discharge with a fishy, foul smell. There may also be accompanying symptoms such as sore and weak lower back and knees, poor appetite, a red tongue with yellow greasy coating, and a soft, slippery pulse.
Modern TCM mostly uses Yi Huang Tang to treat cervicitis, cervical erosion, vaginitis, chronic pelvic inflammatory disease, urethritis and other conditions of the lower-jiao damp-heat pattern. This formula can also be used for chyluria, proteinuria in chronic nephritis, prostatitis, vulvar itching and other conditions of the kidney-deficiency with downward-downpour of damp-heat pattern.
Fu Qingzhu believed that yellow vaginal discharge is caused by damp-heat in the Ren meridian. Fu Qingzhu Nüke says: "Yellow discharge is damp-heat in the Ren meridian. ... Only when heat pathogen remains in the lower jiao does the body fluid fail to transform into essence and instead transform into dampness. ... The method is to supplement the deficiency of the Ren meridian and clear the blazing kidney fire, and that will be close to success! ... This is not only a formula for treating yellow discharge; it can treat any kind of vaginal discharge, and its effect is even more marvelous for yellow discharge. Shanyao and Qianshi specifically supplement the deficiency of the Ren meridian and also promote diuresis; adding Baiguo to guide the herbs into the palace of the Ren meridian makes the action even more direct, which is why it works so quickly. As for using Huangbai, it clears the fire within the kidney. The kidney and the Ren meridian communicate and support each other; resolving the fire in the kidney resolves the heat in the Ren meridian."
Yi Huang Tang can be modified according to the patient's condition. If damp-heat is heavy and the patient is not weak, remove Shanyao and Qianshi and increase Huangbai and Cheqianzi to strengthen heat-clearing and dampness-draining; if dampness predominates over heat with thick, copious discharge, add Tufuling (Rhizoma Smilacis Glabrae) and Yiyiren (Semen Coicis) to strengthen dampness-draining; if heat-toxin is exuberant with a red tongue, yellow coating and strongly fishy foul discharge, increase heat-clearing and detoxifying by adding Kushen (Radix Sophorae Flavescentis), Baijiangcao (Herba Patriniae), Pugongying (Herba Taraxaci), Yimucao (Herba Leonuri) and Zhizi (Fructus Gardeniae); if there is qi-stagnation pain, add Xiangfu (Rhizoma Cyperi), Zhiqiao (Fructus Aurantii), Baishao (Radix Paeoniae Alba), Yujin (Radix Curcumae) and Chaihu (Radix Bupleuri) to soothe the liver, resolve stagnation, move qi and stop pain; if back pain is marked, add Tusizi (Semen Cuscutae), Xuduan (Radix Dipsaci), Duzhong (Cortex Eucommiae), Bajitian (Radix Morindae Officinalis) and Weilingxian (Radix Clematidis) to tonify the kidney, strengthen the lower back and stop pain.