TCM Functions: Clears Damp-Heat from the Uterus, Restrains the Leakage of Fluids, Nourishes Blood.
TCM Diagnosis: Damp-heat in the Uterus causing fluid leakage. Also for damp-heat with an underlying Liver Blood deficiency that allows the damp-heat to linger.
Presentation: occasional change in vaginal discharge. May be accompanied by occasional excessive discharge, occasional vaginal itching or irritation, and discomfort during intercourse. May also be accompanied by other damp-heat signs such as unpleasant smell, dry mouth, bitter taste in the mouth, lower abdominal distension, occasional mild lower back pain, occasional fatigue, uncomfortable urination, occasional diarrhea and/or changeable bowel habits.
Tongue: greasy yellow coat
Pulse: soft, slippery, rapid
Ingredients: Chun gen pi/Ailanthis altissima bark 46.9%, Bai shao/Paeonia lactiflora root 15.6%, Shu di huang/Rehmannia glutinosa root-prep 12.5%, Dang gui/Angelica sinensis root 9.4%, Huang bai/Phellodendron chinense bark 6.3%, Gao liang jiang/Alpinia officinarum rhizome 6.2%, Chuan xiong/Ligusticum chuanxiong rhizome 3.1%.
Dosage & Administration: The standard dosage is 8 pills, 3 x day. In acute cases, dosage may be increased to 8 pills every 2-4 hours, then reduced to a maintenance dose as the formula takes effect. May be used short-term for a few days to a few weeks. Once the acute symptoms of this pattern are resolved, this formula should be discontinued. Administer half an hour before or one hour after eating for optimal digestion & absorption. In the presence of mild food stagnation or if there is difficulty digesting the formula, it may be administered with Curing Pills/Kang Ning San, Bao He San/Wan or Xiang Sha Liu Jun Zi San/Wan. Monitor for signs of Yin or Spleen Qi deficiency.
Cautions & Contraindications: Use with caution in Spleen deficient patients with a tendency to loose stools, diarrhea, poor appetite or chronic digestive weakness. Contraindicated for conditions due to damp-cold. Contraindicated during the early stages of acute infection or illness, such as cold or flu.
Clinical Comments: This elegant modern prescription is a variation of the classic formula Chun Pi Wan from Dr. Wang Kentang’s Zheng Zhi Zhun Sheng/Standards for Diagnosis and Treatment published in 1602, with the additions of Shu di huang, Dang gui and Chuan xiong. Yu Dai Wan supports the female reproductive system, at once clearing and tonifying to protect and balance vaginal flora and fauna. Discharge due to disruption to the flora and fauna can easily occur with hormonal shifts – such as during peri-menopause, pregnancy, and with contraceptive or fertility hormones. Dysbiosis may also be due to medications such as antibiotics or corticosteroids, excessive emotional stress, or improper diet – such as a diet high in sugar, dairy, white flour, processed foods, alcohol and other damp and heat-producing foods.
In traditional Chinese medicine normal vaginal discharge is produced, stored and secreted by the Kidneys, transformed and distributed by the Spleen, secured by the Ren Mai, and controlled by the Dai Mai. Occasional excessive vaginal discharge is classed as “Dai Xia Bing,” which roughly means “issue below the belt or below the Dai Mai.” The most common etiologies for Dai Xia Bing are downward percolation of damp-heat, Spleen Qi deficiency with dampness, and Liver Qi stagnation with dampness. This formula treats damp-heat discharge, arguably the most prevalent type because dampness can stagnate and generate heat, or Liver Qi stagnation with dampness can smolder and create heat, either of which result in the creation of damp-heat. Yu Dai Wan treats both yellow and “red and white” discharge.
The chief herb in the formula, Chun gen pi, is bitter, cold and astringent. Chun gen pi directly clears heat and drains dampness while also astringing, making it an ideal herb to clear the root by draining damp-heat while simultaneously astringing leakage at the branch. Chun gen pi is also useful to regulate and cool the Blood in cases of “red and white” discharge. Bitter and cold Huang bai works with Chun gen pi to increase the ability to drain damp-heat and focuses the formula specifically on the lower jiao. Acrid hot Gao liang jiang strongly warms the center and dispels cold, and thereby prevents damage to the Stomach and Spleen by balancing the cold property of Chun gen pi and Huang bai with its warmth. Shu di huang, Dang gui, Bai shao and Chuan xiong work together as in Si Wu Tang to strongly nourish and gently invigorate the Blood, to in turn nourish and regulate the Chong and Ren channels. Shu di huang and Bai shao also nourish and secure the Yin, to help astringe leakage and benefit the normal body fluids. The inclusion of the essential gynecological Blood tonic Si Wu Tang allows this balanced formula to clear damp-heat without damaging the Blood and Yin, while keeping the circulation in the lower jiao smooth to prevent the further build-up of damp-heat. Yu Dai Wan strongly drains excess damp-heat, while at the same time nourishing the Blood and protecting the Spleen, in order to bring about lasting change.
Combinations: For patients with more significant Spleen Qi deficiency, or for patients with an underlying Yin deficiency that develop damp-heat in the lower jiao, Yu Dai Wan should be used short-term to deal with the damp-heat and then followed up with an appropriate constitutional formula, such as Bu Zhong Yi Qi Wan to strengthen the Spleen Qi, or Liu Wei Di Huang Wan to nourish the Yin. If there is Liver fire, combine with Long Dan Xie Gan Wan.
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