Veteran Physician Zhu Yongxian's Experienced Formula for Metrorrhagia and Metrostaxis in Women
Vaginal bleeding in women outside the menstrual period is collectively called benglou in TCM—metrorrhagia and metrostaxis. There are many causes. Modern medicine holds that female genital inflammation, dysfunctional uterine bleeding, adenomyosis, and gynecological tumors may all cause benglou symptoms. In addition, some tumor patients develop benglou while taking certain anti-tumor drugs.
In TCM, benglou is a collective term but is divided into two types: heavy, flooding bleeding is beng (metrorrhagia), while light, dripping bleeding is lou (metrostaxis); lou sometimes resembles the "red leukorrhea" among the "five-colored leukorrheas." As Yizong Jinjian puts it: "After a woman's menstruation, if it drips incessantly, it is called jinglou (metrostaxis). If menstrual blood suddenly comes down in a flood and will not stop, it is called jingbeng (metrorrhagia)." Beng and lou often occur together.
Veteran physician Zhu Yongxian held that benglou can be treated by taking blood-activating and stasis-resolving therapy as the base, adding hemostatic and qi-regulating herbs to form a comprehensive regimen. His common formula comprises Danshen (Salviae Miltiorrhizae Radix), Danggui (Angelicae Sinensis Radix), Yimucao (Leonuri Herba), Huainiuxi (Achyranthis Bidentatae Radix), Chishao (Paeoniae Rubra Radix), Yujin (Curcumae Radix), Zhiqiao (Aurantii Fructus), Qiancaogen (Rubiae Radix), Jingjisui (Schizonepetae Spica), Guangmuxiang (Aucklandiae Radix), Paojiang (Zingiberis Rhizoma Praeparatum), Jiguanhua (Celosiae Cristatae Flos), Xianhecao (Agrimoniae Herba), Shengdiyu (Sanguisorbae Radix), and Sanqi powder.
This prescribing logic builds on Siwu Decoction, omitting Chuanxiong (Ligustici Rhizoma) because it is pungent and forceful, unsuitable for patients with bleeding. The use of Zhiqiao and Jingjisui follows the logic of Huaihua Powder (composed of Huaihua, Ceboye, Zhiqiao and Jingjisui): Jingjisui scatters wind and Zhiqiao regulates qi; when these are combined with blood-activating and hemostatic herbs, they strengthen the hemostatic effect.
Yujin is used because it both activates blood and resolves stasis and courses the liver and resolves depression; it is a common gynecological herb. The famous gynecologist Professor Liu Fengwu, when treating women's diseases, particularly valued herbs that course the liver and resolve depression such as Chaihu, Yujin, Xiangfu and Meiguihua. Dr. Liu held that women are prone to depression, so using some liver-coursing, depression-resolving herbs when treating gynecological conditions improves outcomes.
Veteran physician Zhu Yongxian once used this experienced formula to treat many patients with benglou of various causes, with success. His case records, however, do not specify the dosage of each herb for each patient, presumably because the doctor himself adjusts according to the patient's specific condition.