In my last column, I discussed basic, potential formula combinations for use in cold/flu presentations. In this month's article, I will continue the discussion of formula combination by addressing common TCM pattern presentations found in gynecological pathologies.
TCM gynecology is a vast and often complex area of study which cannot be comprehensively addressed in this short article. However, a handful of basic TCM patterns and organ pathologies create the foundation of TCM gynecology. If one understands these basic patterns and pathologies, it becomes much easier to navigate through complex and confusing clinical presentations to more effectively treat Western patients.
One of the vaguest concepts in TCM gynecology is the discussion of chong/ren pathologies. One commonly finds statements such as "quieting or downbearing the chong " or "regulating and supplementing the chong and ren ." It can be helpful to examine the TCM medicinals used to treat chong / ren pathologies in order to find clues as to which TCM organs are key to target the chong / ren .
The majority of medicinals and formulas used to address the chong / ren target the following key organs: liver, spleen and kidneys. Therefore any medicinal or formula which treats the liver, spleen or kidney will, in theory, affect chong / ren pathologies. This simple idea can be very helpful when choosing TCM formula combinations.
Another clue to treating the chong / ren is the TCM saying: "The chong and ren cannot move by themselves." In TCM theory, all body fluids and substances are transported to the extraordinary vessels via the 12 regular channels. Therefore, de facto , if a pathology makes reference to the chong / ren , treatment must include the regular channels of the liver, spleen and kidneys. With this in mind, we can examine basic TCM patterns and formulas that target these organs to effectively and intelligently address any gynecological complaint.
When examining patterns involving the liver, spleen and kidneys, the following basic patterns must be kept in mind: qi depression, blood stasis, depressive heat, qi vacuity, blood vacuity, yin / yang vacuity and vacuity heat. These patterns, while not comprehensive, can address the majority of gynecological presentations if properly targeted. If one understands the TCM mechanisms involved in these patterns, it can be simple to deduce other potential patterns which might evolve in chronic conditions.
The following are some basic examples of how to combine formulas to address multi-pattern gynecological complaints:
Qi stagnation/blood stasis: Si Ni San/Chai Hu Shu Gan San + Ge Xia Zhu Yu Tang/Gui Zhi Fu Ling Wan
Depressive heat with qi vacuity and blood stasis: Jia Wei Xiao Yao Wan + Gui Zhi Fu Ling Wan/Ge Xia Zhu Yu Tang
Qi vacuity with damp heat in lower jiao: Bu Zhong Yi Qi Tang + Er Miao San
Qi vacuity with yin vacuity: Bu Zhong Yi Qi Tang + Er Zhi Wan
Qi vacuity/blood vacuity/yin-yang vacuity: Shi Quan Da Bu Tang + Er Zhi Wan
Liver/spleen disharmony with depressive/vacuity heat: Jia Wei Xiao Yao Wan + Da Bu Yin Wan (This creates a variation of Hei Xiao Yao Wan.)
Severe qi/blood vacuity with vacuity heat: Dang Gui Bu Xu Tang + Er Zhi Wan
Severe qi/blood vacuity with kidney essence vacuity: Shi Quan Da Bu Tang + Wu Zi Yang Zao Wan/Huan Shao Wan
This simple list of formulas barely scratches the surface of potential formula combinations. The formulas must be modified accordingly, as needed. However, I have found these combinations can be extremely effective even if they are unmodified for patients unwilling to consume custom-made teas.
I hope this short article stimulated your creativity when addressing complex gynecological presentations and inspires you to develop your own effective formula repertoire. In my next column, I will conclude my formula combination series by focusing on gastro-intestinal issues.
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