Three Experience Formulas for "Beng Lou" (Uterine Bleeding) Collected by Gynecology Master Xu Rongzhai

Xu Rongzhai (1911-1982) was a famous contemporary master of TCM gynecology in China. He summarized his experience in treating gynecological diseases into a book, Essentials of Gynecology (Fuke Zhiyao). In this book there are experience formulas collected by Mr. Xu for treating women's "beng lou" (irregular uterine bleeding); these formulas were all clinically effective prescriptions used by TCM medical institutions at that time. Three of them are excerpted below for readers' reference.

Zhuyu Zhixue Decoction (Stasis-Expelling and Bleeding-Stopping Decoction)

Herbal composition: Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), Notoginseng Radix (Sanqi), Myrrha (Moyao), Typhae Pollen (Puhuang), Trogopterorum Faeces (Wulingzhi), Moutan Cortex (Danpi), Asini Corii Colla (Ejiao), Artemisiae Argyi Carbon (Aiye Tan), Salviae Miltiorrhizae Radix (Danshen), Sepiae Os (Haipiaoxiao), Ossis Mastodi Fossilia (Longgu), Ostreae Concha (Muli). The indications of this formula are beng lou due to blood stasis, presenting as continuous spotting leakage or sudden heavy bleeding, purple-black in color with clots, and lower abdominal pain that refuses pressure (the pain is slightly relieved after clots are discharged).

This formula is a modification of Jiai Decoction (Ass-Hide Gelatin and Mugwort Decoction) combined with Shixiao Powder (Sudden Smile Powder), with the effects of dispelling stasis, stopping bleeding and alleviating pain. Adding Notoginseng Radix (Sanqi), Myrrha (Moyao) and Sepiae Os (Haipiaoxiao) makes the efficacy more reliable; but the dosage of Chuanxiong Rhizoma (Chuanxiong) should be small, only 2.4 to 3 g, about one third of that of Angelicae Sinensis Radix (Danggui). Use Notoginseng Radix (Sanqi) 1.5-2.4 g, taken in two portions with warm boiled water before the meal, which works better than decocting. Myrrha (Moyao), Typhae Pollen (Puhuang) and Trogopterorum Faeces (Wulingzhi) should be wrapped in a gauze bag before decocting, which causes less gastric irritation. Generally, 3-5 doses suffice.

Quyu Xiaozheng Decoction (Stasis-Expelling and Mass-Dissolving Decoction; experience formula of Wenzhou Hospital of TCM)

Herbal composition: Spatholobi Caulis (Jixueteng) and Actinidiae Root (Mihoutaogen), each 30 g; Patriniae Herba (Baijiangcao) 12 g; Reddish Aucklandia (Hongmuxiang) 9 g. Indications: menorrhagia, metrorrhagia and metrostaxis caused by uterine fibroids, accompanied by increased vaginal discharge, sometimes with a bearing-down pain in the lower abdomen, abdominal pain not marked but tender to pressure, slightly purple-dark tongue, mostly thin yellow coating, and a wiry rough pulse.

This formula was the experience formula introduced by Wenzhou Hospital of TCM at the 1973 Zhejiang Province TCM Gynecology Clinical Experience Exchange Symposium. The hospital used this formula to treat 7 cases of beng lou caused by uterine fibroids; 5 were cured, with the fibroids disappearing and bleeding stopping, and the treatment course ranged from 37 days to 2 months.

Gongxue Formula (Functional Bleeding Formula; experience formula of Shanghai First Medical College)

Herbal composition: Rehmanniae Radix (Shengdi), Ecliptae Herba (Mo Hanlian), Cirsii Japonici Herba (Daji), Cirsii Herba (Xiaoji), fried Sophorae Flos (Chao Huaihua), fried Typhae Pollen (Chao Puhuang), Sepiae Os (Wuzei Gu), each 12 g; Ligustri Lucidi Fructus (Nüzhenzi), Paeoniae Radix Alba (Baishao), Rubiae Radix (Qiancao), Duhal Herba (Liu Jinu), each 9 g; Aurantii Fructus (Zhiqiao) 4.5 g. Indications: beng lou due to accumulated stasis generating heat and blood-heat causing reckless movement of blood, clinically presenting as a short yet regular menstrual cycle, prolonged bleeding time, with the bleeding manifesting as ovulatory functional bleeding. Administration: start taking one week before menstruation and continue until the menstrual period ends. If the bleeding is heavy or prolonged, considering that qi deficiency fails to control blood, add Codonopsis (Dangshen) 12 g, Atractylodis Macrocephalae Rhizoma (Baizhu) 9 g, Cimicifugae Rhizoma (Shengma) 6 g.

According to the experience of Shanghai First Medical College, this formula is mostly effective for ovulatory functional bleeding; patients of other types should use other formulas.

Bai Di Decoction (Pulsatilla and Sanguisorba Decoction; experience formula published in New TCM, 1975, issue 1)

Herbal composition: Pulsatillae Radix (Baitouweng) 60 g, fried Sanguisorbae Radix (Chao Diyu) 30 g. Decoct in water to a concentrated decoction, add white sugar 30 g, and take in two divided doses; up to 2 doses may be taken per day consecutively. It is reported that this formula treated 58 cases of functional uterine bleeding with good results.

This formula uses few herbs but a large dosage, with focused and potent action. Before discovering this formula, Mr. Xu had used the "Diyu Kujiu Decoction" (Sanguisorbae Radix 30 g, decocted in vinegar) from Essentials of Gynecology (Nüke Zhiyao) to treat such diseases, which was also very effective.

Jiangjun Zhangguan Decoction (General's Gate-Breaking Decoction; proven formula of the Zhu family of Shanghai) Herbal composition: processed Rhei Radix et Rhizoma carbon (Zhi Dahuang Tan) 3 g; Morindae Officinalis Radix (Bajitian), Poria cum Pini Radix (Fushen), Typhae-fried Asini Corii Colla (Puhuang Chao Ejiao), Angelicae Sinensis Radix (Danggui), Rehmanniae Radix (Shengdi), Rehmanniae Radix Praeparata (Shudi), fried Setariae Fructus Germinatus (Chao Guya), each 9 g; Astragali Radix (Huangqi) and Atractylodis Macrocephalae Rhizoma (Baizhu), each 4.5 g; Agrimoniae Herba (Xianhecao) 18 g; separately use croci Stigma (Zang Honghua) 1 g and Notoginseng Radix powder (Sanqi Mo) 1 g, taken infused with black tea liquid.

The indication of this formula is beng lou of deficiency complicated by excess: the patient has had beng lou for a long time with residual stasis not resolved, characterized by dull pain in the lower abdomen, continuous vaginal bleeding, overall deficiency signs, and a deficient fine rough pulse.