Wen Qing San (Warm-Cooling Powder): Combining Warming-Tonifying with Heat-Clearing
Wen Qing San is from Wanbing Huichun (Recovery of All Diseases) by the Ming-dynasty physician Gong Tingxian. It is composed of Danggui (Angelica), Chuanxiong (Chuanxiong Rhizoma), Shudi (prepared Rehmannia), Baishao (Paeonia alba), Huanglian (Coptis), Huangqin (Scutellaria), Huangbo (Phellodendron), Zhizi (Gardenia), each one and a half qian (about 5 g today). The formula was used to treat "women with uncontrolled menses, or discharge like bean juice, mixed five colors, a sallow yellow complexion, stabbing umbilical and abdominal pain, alternating chills and fever, and incessant metrorrhagia and metrostaxis" — a formula for uncontrolled gynecological bleeding. In the past this condition was called beng lou (metrorrhagia/metrostaxis) or five-colored vaginal discharge; these symptoms are seen in dysfunctional uterine bleeding, cervical cancer bleeding, uterine fibroid bleeding, and adenomyosis bleeding.
Wen Qing San is made of two classic formulas: one is the famous blood-tonifying Siwu Tang (Four-Substance Decoction), the other is Huanglian Jiedu Tang (Coptis Detoxifying Decoction). So the Qing-dynasty physician Shen Jin'ao renamed this formula Jiedu Siwu Tang (Detoxifying Four-Substance Decoction) or Wen Qing Yin (Warm-Cooling Beverage), and added Shengdihuang (raw Rehmannia) to strengthen its heat-clearing, blood-cooling, and hemostatic effect.
Wen Qing Yin is very popular in Japanese Kampo, where it is used for various bleeding disorders. Because it contains both the warming-tonifying Siwu Tang and the heat-clearing toxin-resolving Huanglian Jiedu Tang, it is a classic formula combining warming and cooling. It was historically used mainly for gynecological bleeding; as Shen Jin'ao said, it "treats metrorrhagia with sallow complexion and abdominal pain." Asada Sōhaku wrote in Futai Yakushikata Hōfō Kuketsu: "The brilliance of this formula lies in the combination of warming and cooling; it works for women's metrostaxis or vaginal discharge, or for men's long-standing blood in the stool."
According to traditional TCM theory, the pattern differentiation for this formula is blood deficiency and blood heat. Blood deficiency shows as a sallow complexion and fatigue; reckless movement of hot blood shows as various bleedings — epistaxis, blood in stool, hematuria, vaginal bleeding, skin purpura, and so on. When using this formula for more severe bleeding disorders, one may add Xianhecao (Agrimoniae Herba), Baimaogen (Imperatae Rhizoma), Xiaoji (Cirsii Herba), Baiji (Bletillae Rhizoma), Fengweicao (Pteridis Herba), Huaruishi (Ophicalcitum), Diyu (Sanguisorbae Radix) to strengthen hemostasis, plus Renshen and Huangqi to greatly tonify original qi.
But this formula is not limited to common gynecological conditions such as early menstruation, prolonged periods, and dysmenorrhea. It can also be used in orthopedics for fractures, and in oncology for cervical, endometrial, uterine-body, and prostate cancer. Other doctors have reported good results using it for urticaria, herpes zoster, ectopic dermatitis, atopic dermatitis, aphthous ulcers, recurrent oral ulcers, aphthous stomatitis, cerebral infarction, wasting-thirst (diabetes), huohu disease (Behçet's-like syndrome), dermatomyositis, Behçet's disease, and vulvar ulcers.
In another Ming physician, Xue Ji's, Liyang Jiyaozhi (Essentials of Scrofula and Sores) there is a formula called "Qingre Jiedu San" (Heat-Clearing Toxin-Resolving Powder) very similar to this one, composed of Huanglian, Zhizi, Lianqiao (Forsythia), Danggui, Chuanxiong, Baishao, Shengdihuang, Yinhua (Lonicera), and Gancao. Qingre Jiedu San treats yang-pattern carbuncles and sores presenting with redness, swelling, heat, pain, dry mouth, and irritability. Xue Ji's Qingre Jiedu San was developed from the combination of Siwu Tang and Huanglian Jiedu Tang, and is better suited to TCM external-medicine conditions.