Combining Yunv Jian and Erzhi Wan Works Well for Stomach-Fire Flaring Upward

Yunv Jian (Jade Woman Decoction) comes from Jingyue Quanshu (Complete Works of Zhang Jingyue). Zhang Jingyue used it to treat “water deficiency with fire exuberance, all six pulses floating, surging, slippery and large, lesser-yin deficiency, yangming excess, vexing heat and dry thirst, headache and toothache, and bleeding syndromes,” and notes that those with loose stools should not take it. Yunv Jian consists of: Sheng Shigao (raw gypsum) 3–5 qian (15–30 g), Shudi (rehmannia, processed) 3–5 qian or one liang (15–50 g), Maidong (Ophiopogon) 2 qian (10 g), Zhimu (Anemarrhena) and Niuxi (Achyranthes), each one-and-a-half qian (7 g).

Erzhi Wan (Two-Season Pill) comes from Yibian. It is made from Mohanlian (Eclipta) and Nvzhenzi (Ligustrum lucidum fruit), equal parts, ground into powder and formed into parasol-seed-sized pills; 30–60 pills are taken each time. If used in a decoction, each herb may be dosed at 10–30 g. TCM holds that Erzhi Wan nourishes the yin of the liver and kidney, and can treat bitter mouth and dry throat, dizziness and blurred vision, insomnia and dreaminess, aching and weakness of the lower back and knees, tinnitus and deafness, limp weakness of the lower limbs, seminal emission and premature ejaculation, early greying of hair, and in women, early or heavy menstruation—all due to liver-kidney yin deficiency. I have also used Erzhi Wan to treat hair loss, gingival bleeding, and epistaxis, with good results.

These two formulas combined can treat the many symptoms caused by stomach fire flaring upward. What TCM calls stomach fire flaring upward mostly corresponds to modern Western-medicine gastritis and gastric ulcer (often caused by Helicobacter pylori infection), and is also common in gastric cancer. Such patients often have bad breath, gums that bleed easily, mouth ulcers, nosebleeds, insomnia, and anxiety; patients on paclitaxel-based chemotherapy or certain targeted drugs also readily develop these side effects. Cancer patients on chemotherapy or targeted drugs, in addition to the above, often also develop red rashes and ulcerations of the skin.

From the TCM perspective, both formulas nourish yin and downbear fire and have similar actions; used together they treat the various reactions caused by stomach fire flaring upward more effectively. But both have a certain laxative effect, so patients with weak digestion who tend to loose stools or diarrhea should not use them.

The combination of Yunv Jian and Erzhi Wan also has a good effect on gastric bleeding caused by exuberant heat in the upper burner, and on hemoptysis from lung disease; adding Baiji (Bletilla) 6–30 g and Xianhecao (Agrimonia) 30–100 g improves the result. If the patient is constipated, Shudahuang (processed rhubarb) or Dahuangtan (charred rhubarb) 6–30 g may also be added. Using only Baiji and Xianhecao can stop bleeding, but it does not nourish yin and downbear fire, so it cannot fundamentally solve the patient's problem. Note that after taking Mohanlian, the patient's stool usually becomes darker than normal the next day, so this should be explained to the patient in advance; otherwise it easily causes alarm.