One of my main gynecology teachers was Dr. Qiu Xiao-Mei. I studied with her in 1990 when I lived in Hang Zhou, PRC. I have also translated her text entitled Qiu Xiao Mei’s Clinical Experience in Gynecology (裘笑梅妇科临床经验选). I’ve published material from this text in this blog but I primarily use the text as a teaching reference for students in the Graduate Mentorship Program. In this text, Dr. Qiu shares some herbal formulas that she developed herself. Her insight into herbs is astounding and sometimes magical.
A recent exchange with a student of mine inspired me to share information about one particular formula of hers. Check out the results!
This is just one example of her creativity and effectiveness. Her work is something to study and try to keep alive.
My student’s inquiry:
“I have never treated a case like this and would love some input.
A patient gave birth one month ago. She is having significant pain and bleeding due to 4th degree tearing. She saw her OB/GYN yesterday who was unable to do an internal exam because of the pain. The pain is sharp and feels ‘tight’. The blood itself is light colored. initially there were clots but she has not seen any lately.
She is having minimal/no bleeding from her uterus and will only rarely experience a very quick ‘contraction’.
Other than the pain she is healthy. GI/bowels are normal. Although she is taking a stool softener so that she can easily pass her bowels (so as not to aggravate/increase pain) She is breast feeding and producing ample milk.
Her temperature also seems ‘normal’. ie no strong preference for hot or cold.
I have asked her every which way where the bleeding is coming from – and she is convinced that it is from the tear and not ‘internal’. Her OB/Gyn seems to agree. Her OB/GYN believes that the wound is not healing (and she confirms it is not healing) because of low estrogen levels due to breastfeeding.
The patient is doing very little to aggravate it (ie not wiping but washing with a stream of water instead) The bleeding is not heavy – it is one pad a day. And yes, could be describes as ‘like tea’. The contractions are few and are not when breast feeding. She is getting rest and does have help at home.
To me, these seems like treating trauma and wound healing – I have no experience treating a case like this!
Look in your notes from our GMP class in which we covered postpartum care. Dr. Qiu has a formula called Chuang Shang Yu He San Wound Healing Powder. Below I will cut and paste the section for you with a couple of her case studies:
Chuang Shang Yu He San
Wound Healing Powder
Translated from Qiu Xiao Mei:
BaiJi Mo Rhizoma Belittle (powdered) 3 gm
Rou Gui Mo Cortex Cinnamomi Cassiae (Powdered) 3 gm
Method for Use: The above herbs are ground into a fine powder and washed down with warm water. Five to seven days constitutes one course.
Function: Promotes the movement of Qi and Blood, generates flesh and stops bleeding.
Indications: Poor healing of post partum surgical incision on the abdomen or perineum.
Formula Explanation: This prescription includes Bai Ji which has a sticky quality and an astringent nature. It can restrain and stop bleeding, disperse swelling and generate muscles.
Rou Gui has a pungent flavor and a hot nature. It is able to warm and help Qi to penetrate through. The combined herbs are used to promote the movement of Qi and Blood so the muscles and flesh can again be generated. It can both get rid of old Blood and generate it anew.
Personal Experience of Usage: See the case studies on birth wounds
Case Examples of Birth Wound
Ms. Shen was 25 years old when she came for her first visit on October 28, 1%0. Her complaint was related to the birth of her child which occurred full term. Her baby was born with occipital transverse presentation and the birth was assisted with forceps. The episiotomy was sutured with 8 stitches but the wound wasn’t healing. It extended six centimeters into the left vaginal wall. It was repaired twice but still didn’t heal. After this I gave her Chuang Shang Yu He San Wound Healing Powder for five days and after two courses of treatment the wound healed.
Ms. Shao, a 28 year old woman, was first seen on March 29, 1%0. She was five months pregnant and had high blood pressure (260/160) and a severe headache. On April 11 her pregnancy ended by cesarean section. One week later, the lower end of her incision began to seep a small amount of blood. Under the skin a hematoma formed. After the hematoma was eliminated I gave her two packages of Chuang Shang Yu He San Wound Healing Powder and the wound gradually healed. Her body temperature became normal. I continued treatment with four more packages and after two courses of treatment her wound had healed and she left the hospital.
During childbirth, women occasionally face the prospect of peranial episiotomy or a post-cesarean section incision that doesn’t heal easily. More often than not, as a result of childbirth or surgery, a woman’s Qi and Blood does not recover sufficiently to promote movement. The result of this is that incisions do not heal easily. Bai Ji Rhizoma Bletilla and Rou Gui Cortex Cinammomi CassiIze promote movement and cause the muscle and flesh to again have vitality and ability. These herbs are also able to heal flesh and stop bleeding. Though the composition of this prescription is simple, its effectiveness is outstanding.
Outcome according to the student/practitioner
I wanted to give people an update on this case.
I gave the patient a simple formula of bai ji and rou gui 3 g each powdered and combined with warm water. I wanted to see how she responded to this simple formula before I added anything else.
After taking the formula for two days, I received this message from my patient:
“I’m on day 2 of the herbs I haven’t taken any pain meds since 6:30 this morning. Right now I’d say my pain level is at a one! Good work!”
On day 4 I received this message:
“I am doing so much better! I haven’t had any pain meds! Yesterday the baby and I went for a 45 minute walk & I wasn’t in excruciating pain during the walk or right after. I also haven’t taken a stool softener & (drum roll please) I used toilet paper this morning! There was no bleeding in the last 24 hours either. these herbs are amazing!!!”
As I initially mentioned, I rarely treat pregnant women (or post partum) but for those of you that do, I wanted to share how amazing this recovery has been.
For those of you interested there are some other blog entries here that include some of Dr. Qiu’s Magical Experiential Formulas: