Qingjing San: Fu Qingzhu’s Formula for Advanced Menstruation
Qingjing San comes from Fu Qingzhu Nüke (Fu Qingzhu’s Gynecology) and is a formula by Fu Qingzhu for treating advanced menstruation in women. It is composed of: Digupi (Lycii Cortex) 5 qian (15 g); Mudanpi (Moutan Cortex), Chao Baishao (white Paeoniae Radix, dry-fried), and Shudihuang (Rehmanniae Radix Praeparata), each 3 qian (9 g); Qinghao (Artemisiae Annuae Herba) 2 qian (6 g); Fuling (Poria) 1 qian (3 g); Huangbo (Phellodendri Cortex) 5 fen (1.5 g). It is decocted in water for oral use.This formula clears heat and cools blood, nourishes blood, and regulates menstruation. It is indicated for early menstruation or menstrual-period fever due to exuberant yang and blood heat, with heat damaging the Chong and Ren vessels. Signs include: menstruation arriving early, excessive menstrual volume, dark, thick menstrual blood; vexation and oppression in the chest and heart; dry mouth with a liking for cold drinks; dry stools; scanty, dark urine; a red face and hot body; a red tongue with yellow coating; and a slippery, rapid pulse. The above signs are commonly seen in early menstruation, functional uterine bleeding, puerperal infection, pelvic inflammatory disease, endometriosis, cervical cancer, and postpartum night sweats.In this formula, Digupi (Lycii Cortex) clears deficiency heat and cools blood to stop bleeding; it is a key TCM herb for steaming bone fever and reckless movement of hot blood. Mudanpi (Moutan Cortex) both clears heat and cools blood and activates blood to resolve stasis, and treats hematemesis and epistaxis from blood heat, yin-deficiency fever, and steaming bone fever. The pairing of Digupi and Mudanpi is a classic TCM combination for clearing deficiency heat and cooling blood heat.Baishao (white Paeoniae Radix) paired with Shudihuang (processed Rehmannia) both nourishes yin and descends fire and tonifies blood. Women with early menstruation and excessive flow often have blood deficiency and need blood tonification. The Baishao-Shudihuang combination is, in effect, the famous blood-tonifying formula Siwu Tang (Four-Substance Decoction) minus Danggui (Angelicae Sinensis Radix) and Chuanxiong (Chuanxiong Rhizoma), which tend to provoke bleeding; from this detail one can see the meticulousness of Fu Qingzhu’s formula composition.Qinghao (Artemisiae Annuae Herba) is also an important herb for clearing deficiency heat, cooling blood, and dissipating steaming heat; it has anti-malarial, antiviral, antifungal, anti-inflammatory, and antipyretic effects. When used in a decoction, Qinghao should be added later; with this formula, after the other herbs have been decocted, add the Qinghao last and simmer for another 5–10 minutes.Fuling (Poria) has a dampness-draining action; when the disease is in the lower jiao, a small amount of Fuling helps the pathogen exit downward. Huangbo (Phellodendri Cortex) is bitter and cold and dries dampness; it is both a key herb for nourishing yin and descending fire and a dampness-drying herb. In this formula, Huangbo both helps Digupi, Mudanpi, and Qinghao clear heat and helps Fuling eliminate dampness—a single herb serving two purposes. But Huangbo is bitter and should not be used in large doses, as too much injures the spleen and stomach; hence only 5 fen are used here.Fu Qingzhu composed formulas with extreme economy; a formula often contains only a few herbs, yet the reasoning is rigorous, so they are usually effective. In this author’s experience, combining this formula with Erzhi Wan (Two-Solstices Pill, composed of equal parts Mohanlian (Ecliptae Herba) and Nüzhenzi (Ligustri Lucidi Fructus)) seems to yield even better results.