🌿 Folk Prescriptions

A female patient experienced menstruation and then caught a cold, presenting with headache, alternating chills and fever, lower abdominal distension and pain, poor appetite, no thirst or minimal thirst. Diagnosed at a hospital as "common cold," she received Western medicine intravenous therapy for several days with no improvement. She then tried traditional Chinese medicine with poor results, prompting her to seek my treatment. Observing the previous physician’s prescription—Yin Qiao San with modifications—I found the patient’s current condition: headache, dizziness, alternating chills and fever, sweating followed by fever reduction, mild thirst but little drinking, lower abdominal distension and pain, irritability, insomnia, chaotic dreams, chest and rib fullness, palpitations, scanty menstrual flow with prolonged bleeding, short and red urine, red tongue, wiry pulse. I diagnosed this as exogenous infection during menstruation with residual pathogen, heat entering the blood chamber, heat and stasis intermingling. Treatment should harmonize Shaoyang, clear heat, calm the spirit, activate blood, and regulate menstruation. Prescription: Bupleurum 10g, Scutellaria 10g, Moutan 10g, Gardenia 10g, Honeysuckle 10g, Forsythia 10g, Dandelion 15g, Motherwort 15g, Eclipta 10g, Safflower 10g, Angelica 10g, Red Peony 10g, Raw Dragon Bone 30g (boiled first). After three doses, symptoms improved, chills and fever subsided, more clots were expelled with menstruation, and menstruation ceased. Continuing for another three doses, all symptoms vanished.
This condition involves catching an exogenous pathogen during menstruation, falling under the category of "Heat Entering the Blood Chamber" in TCM. Regarding "Heat Entering the Blood Chamber," both *Shanghan Lun* and *Jin Kui Yao Lue* describe similar conditions, classified within exogenous diseases. The term "blood chamber" has varied interpretations among ancient commentators: some say it refers to the Chong Meridian, others to the liver, and still others to the uterus. Synthesizing various views and clinical practice, for women, the blood chamber actually refers to a comprehensive functional concept centered on the uterus, including connected meridians such as Chong and Ren, and associated organs related to menstruation. Since Chong is the Sea of Blood and Ren governs the uterus, essential for reproduction, and since the Liver Meridian connects to the genitalia and stores blood, the concept of the blood chamber must be comprehensively understood to match clinical reality—not reduced to a single physical organ.
The etiology and pathogenesis of "Heat Entering the Blood Chamber" stem from pre-existing emotional distress, depression, and stagnated liver Qi. During menstruation or postpartum, when blood is depleted, external pathogens such as wind-cold or wind-heat invade, combining with menstrual blood, triggering conflict between pathogen and righteous Qi, preventing external resolution, causing stagnation in the uterus. Clinical manifestations include fever, headache, no thirst or minimal thirst, normal eating, silence, confusion, delirium resembling seeing ghosts, constipation. Differential diagnosis and treatment methods are as follows:
1. Initial Heat Invasion: Symptoms include alternating chills and fever resembling malaria—treat with Xiao Chai Hu Tang, and acupuncture at Qimen.
2. Heat Pathogen Invading Interior in Warm Diseases: Treat with Tao’s Xiao Chai Hu Tang or Gui Zhi Hong Hua Tang with modifications.① If menstruation just began, wind-cold invaded externally, transforming into heat, leading to heat entering the blood chamber, initially alternating chills and fever, then resembling malaria, with interrupted menstruation—treat with Yi Chai Hu Yin for mild cases or weak constitutions.② If accompanied by blood clots or lower abdominal distension and pain, indicating blood stasis, add Motherwort, Angelica, Eclipta, Safflower to activate blood and regulate menstruation, promote circulation and resolve stasis.③ Due to exogenous wind-heat or heavy heat, combined with dysfunction of Chong and Ren meridians, liver failing to store blood, heat forcing blood flow—resulting in prolonged or sudden heavy bleeding—treat by clearing heat, cooling blood. Add Rehmannia, Moutan, Artemisia, Lycium, Dandelion, Honeysuckle to the Xiao Chai Hu Tang to cool blood, nourish yin, and clear heat.④ If Chong and Ren meridians are weak and bleeding is heavy, add Astragalus, Sophora, Lotus Pod Charcoal to solidify Chong and Ren, and Sanqi to stop bleeding.⑤ If heat is severe, blood blocked by heat, stagnating in the uterus, heat and stasis clash, rising via Chong and Ren meridians to affect Yangming—symptoms include dry mouth and bitterness, thirst, headache, flushed face, restlessness—add Coptis and Gardenia for mild cases; if constipation, increase Rhubarb or modify Da Chai Hu Tang.⑥ If menstruation is ending or postpartum, blood sea empty, external pathogen enters internally, causing heat stagnation and blood stasis in the uterus—treat with Chai Hu Si Wu Tang, Xiao Yao San, or Dan Zhi Xiao Yao San with modifications.
3. Even if the disease improves, but with weak constitution and unresolved heat or uncontrolled bleeding—treatment should use formulas like Bu Qi Yi Yin Jian.
4. If spleen qi is weak, use Gui Pi Tang.
5. If both qi and blood are deficient, use Shi Quan Da Bu Tang.
6. If blood is hot and stagnant, use Xiao Chai Hu Tang with Moutan, Safflower, Angelica, etc.
In summary, "Heat Entering the Blood Chamber" rarely presents with all textbook symptoms in clinical practice. Therefore, one must base treatment on the actual etiology and pathogenesis, apply syndrome differentiation flexibly, and adjust prescriptions accordingly to achieve better outcomes.