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Leukorrhea is fundamentally a dampness syndrome. It is named "dai" (belt) because the Dai Mai (Girdle Vessel) fails to constrain, leading to this condition. The Dai Mai connects with the Ren Mai (Conception Vessel) and Du Mai (Governor Vessel); when the Ren and Du vessels are diseased, the Dai Mai subsequently becomes affected. The function of the Dai Mai is to constrain the ligaments of the uterus. If the Dai Mai lacks strength, it cannot lift and secure, inevitably resulting in an unstable uterus; thus, it is said that if the Dai Mai is weak, pregnancy is prone to miscarriage, and if damaged, the fetus is insecure. However, injury to the Dai Mai is not solely due to falls, sprains, or qi stagnation from trauma, nor only from excessive sexual activity or drunken madness. Although there may be no acute pain, there is insidious consumption of essence. Consequently, qi fails to transform menstrual blood, instead turning into leukorrhea. Therefore, women suffering from leukorrhea are mostly nuns, widows, or married women, while virgins rarely suffer from it. Furthermore, compounded by spleen qi deficiency, liver qi stagnation, invasion of dampness, and pressure from heat, how can one avoid developing leukorrhea? Thus, some women experience a continuous flow of white discharge throughout the year, resembling mucus or saliva, which they cannot control, sometimes even becoming foul-smelling. This is what is referred to as "white leukorrhea." White leukorrhea arises from excess dampness and deficient fire, liver stagnation and weak qi, which injure the Spleen Earth. The qi of damp-earth sinks downward, causing the Spleen's essence to fail to remain stored. It cannot transform nutritious blood into menstrual blood, but instead transforms into slippery white matter, flowing directly from the vagina, impossible to stop voluntarily. The treatment method should heavily tonify Spleen and Stomach qi, slightly assisting with herbs that soothe the Liver. This ensures that Wood qi does not become blocked within the earth, allowing earth qi to naturally rise to heaven. When Spleen qi is robust and dampness dissipates, leukorrhea will naturally cease.
The formula used is Wandai Tang (Complete Belt Decoction).
Baizhu (Atractylodis Rhizoma, 1 liang, stir-fried with soil), Shanyao (Dioscoreae Rhizoma, 1 liang, stir-fried), Renshen (Ginseng Radix et Rhizoma, 2 qian), Baishao (Paeoniae Radix Alba, 5 qian, stir-fried with wine), Cheqianzi (Plantaginis Semen, 3 qian, stir-fried with wine), Cangzhu (Atractylodis Rhizoma, 3 qian, processed), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian), Chenpi (Citri Reticulatae Pericarpium, 5 fen), Hei Jiesui (Schizonepetae Spica, charred, 5 fen), Chaihu (Bupleuri Radix, 6 fen).
Decoct in water and take orally. Symptoms alleviate after two doses, stop after four doses, and resolve completely after six doses. This formula treats the Spleen, Stomach, and Liver meridians simultaneously. It incorporates tonification within dispersal and embedding reduction within lifting. By opening the Qi of Liver Wood, Liver blood remains moist, preventing it from overacting on Spleen Earth. By tonifying the primal qi of Spleen Earth, Spleen qi remains dry, facilitating the dispersion of fluid metabolism. Tonifying the Spleen while concurrently tonifying the Stomach reflects the relationship from interior to exterior. Without strong Stomach qi, Spleen weakness cannot be revitalized; thus, tonifying the Stomach is precisely how one tonifies the Spleen.
Marginal Note: The field of gynecology is notoriously difficult to treat. The difficulty lies not in prescribing formulas but in syndrome differentiation. The differentiation of the five types of leukorrhea is extremely clear, and the formulated prescriptions are excellent. If a prescription proves ineffective, it is likely due to irregular menstruation, requiring consideration of treatments for regulating menstruation and promoting conception, which will invariably yield results. For instance, in cases of white leukorrhea where medication fails, if the patient also experiences delayed menstruation and lower abdominal urgency, Kuandai Tang (Loose Belt Decoction) should be administered. Other cases should be referenced similarly, see page 23.
Verse:
Women flow white matter all year round,
Like mucus and saliva, often foul and sour.
Spleen deficiency, Liver stagnation, Dampness prevails,
Ren and Du diseases make the Belt vessel fail its constraints.
Wandai uses fried Baizhu and Shanyao,
With Renshen, Baishao, Cheqian, Cangzhu, and raw Gancao.
Chenpi, Chaihu, and charred Schizonepeta,
When Spleen qi is robust, Dampness naturally dissipates.