Fluid Physiology and Pathology in TCM by Steve Clavey
Forward by Heiko Lade of The Acupuncture Clinic – Hastings: This post was in fact originally 3 articles translated by Steve Clavey and appeared in the Newsletter of the Australian Chinese Medicine Education and Research Council, Volume 3:5 May 1998. It has been reprinted here with the kind permission of Steve Clavey, the author of Fluid Physiology and Pathology in Traditional Chinese Medicine. If you are not familiar with this book, it is clearly one of the top ten essential texts on TCM in the English language and comes highly recommended if you are a practitioner of TCM. Steve Clavey is a TCM fertility specialist and practises from The Apricot Grove in Melbourne. Please note that this post is intended for educational purposes for qualified practitioners of Traditional Chinese Medicine.
General formula for “men’s problems” as basis for changes
Bei Tu Tang 萆菟汤
(Dioscorea and Cuscuta Decoction)
Designed by Xu Fu-Song, discussed in the Zhong Yi Za Zhi (Journal of Chinese Medicine, 1996:9; Vol 37, p. 532)
This 14 herb formula was designed by the modern doctor Xu Fu-Song of Nanjing TCM University, and is used for all sorts of men’s problems, such as impotence, spermatorrhea, haemaspermia, poor semen liquification, chronic prostatitis, and so on.
He is very flexible in his changes, for example in one case history he even removed the Tu Si Zi – the second herb in the name of the formula – because it was too warming! For example, if there are varicose veins in the scrotum (varicocele), add more blood movers, if yang deficient, remove the Huang Bo, and so on.
Bei Xie 15g (Dioscoreae, Rhizoma)
Tu Si Zi 10g (Cuscutae, Semen)
Fu Ling 15g (Poriae Cocos, Sclerotium)
Che Qian Zi 9g (Plantaginis, Semen)
Ze Xie 9g (Alismatis PLantago-aquaticae, Rhizoma)
Mu Li 15g (Ostreae, Concha)
Gou Qi Zi 12g (Lycii Chinensis, Fructus)
Chuan Duan 12g (Dipsaci, Radix)
Shan Yao 20g (Dioscoreae Oppositae, Radix)
Sha Yuan Ji Li 20g (Astragali, Semen)
Dan Shen 20g (Salviae Miltiorrhizae, Radix)
Shi Chang Pu 3g (Acori Graminei, Rhizoma)
Huang Bo 12g (Phellodendri, Cortex)
Gan Cao 3g (Glycyrrhizae Uralensis, Radix)
Antisperm antibodies
Microscopic evaluation of the liquefied semen may reveal agglutination (clumping) of sperm. Agglutination may be head-to-head, head-to-tail, or tail-to-tail and may suggest an inflammatory or immunologic process.
Antisperm antibodies, although not an absolute cause of infertility, appear to be capable of reducing the likelihood of pregnancy. Antisperm antibodies should be suspected in couples with repeated abnormal post coital tests. Antisperm antibodies appear to interfere with normal penetration and transit of sperm through normal cervical mucus. The concentration of antisperm antibodies in the semen influence the degree of impairment.
Anitisperm antibodies do not immobilize sperm, but they do appear to interfere with sperm function by simply attaching to the plasma membrane of the spermatozoa, which causes sperm agglutination. Infections may lead to agglutination of sperm as well though.
Antisperm antibodies also should be suspected in sub fertile men with a history compatible with disruption of the integrity of the genital tract, and when sperm agglutination or reduced motility is observed on semen analysis.
The immunobead binding test (IBT) is one of the most informative and specific of all assays currently available to detect antisperm antibodies bound to the surface of sperm.
Types and Formulae (designed by a specialist in male infertility)
Kidney yang deficiency in antisperm antibodies
Antisperm antibodies test and agglutinisation test positive. Characteristic Kidney yang deficiency symptoms. In TCM terms this is cold congealing the semen. Wang Jing, tonify Kidney yang.
Huang Shi Zeng Jing Wang (Mr. Huang’s Augment Jing Pill)
Fu Zi 90g (Aconiti Carmichaeli Praeparata, Radix)
Rou Gui 60g (Cinnamomi Cassiae, Cortex)
Jiu Cai Zi 90g (Alli Tuberosi, Semen)
Yin Yang Huo 90g (Epimedii, Herba)
Tu Si Zi 180g (Cuscutae, Semen)
Lu Rong 90g (Cervi Parvum, Cornu)
Lu Jiao Jiao 270g (Cervi Colla Cornu)
Bai Shao 150g (Paeoniae Lactiflora, Radix)
Ren Shen 30g (Ginseng, Radix)
Powder finely, sieve and make pills with toffied honey, each pill 12g. take morning, noon, and night with wine. Decoctions, with proportionately reduced doses, can also be used.
Kidney yin deficiency in antisperm antibodies
Antisperm antibodies test and agglutinisation test positive. Characteristic Kidney yin deficiency symptoms. In TCM terms this is lack of yin fluids and heat congealing the jing. Augment jing, tonify Kidney yin to reduce congealing:
Yi Shen Bu Jing San (Benefit Kidneys and tonfiy jing powder)
Lu Rong 30g (Cervi Parvum, Cornu)
Yin Yang Huo 120g (Epimedii, Herba)
Tu Si Zi 150g (Cuscutae, Semen)
Lu Jiao Jiao 180g (Cervi Colla, Cornu)
Huang Jing 180g (Polygonati, Rhizoma)
Wu Wei Zi 90g (Schisandrae Chinensis, Fructus)
Nu Zhen Zi 90g (Ligustri Lucidi, Fructus)
Ren Shen 60g (Ginseng, Radix)
Zi He Che 180g (Hominis, Placenta)
Powder finely, take 3 times per day with salt water. Take no hot spicy foods.
Liver channel damp heat in antisperm antibodies
Qing Re Chu Shi Xiao Ning Tang (Cool Heat Eliminate Damp and Dissolve Coagulation Decoction)
Long Dan Cao 12g (Gentianae Scabrae, Radix)
Ku Shen 9g (Sophorae Flavescentis, Radix)
Chao Huang Bo 6g (Phellodendri, Cortex, dryfried)
Dan Zhu Ye 9g (Lophatheri Gracilis, Herba)
Ze Xie 9g (Alismatis Plantago-aquaticae, Rhizoma)
Mu Dan Pi 6g (Moutan Radicis, Cortex)
Han Fang Ji 9g (Stephaniae Tetrandrae, Radix)
Cang Zhu 9g (Atractylodis, Rhizoma)
Chi Fu Ling 9g (Poriae, Cocos Rubrae, Sclerotium)
Liver qi blockage in antisperm antibodies
Si Ni San with additions
Chai Hu 90g (Bupleuri, Radix)
Bai Shao 100g (Paeoniae Lactiflora, Radix)
Zhi Xiang Fu 90g (Cyperi Rotundi, Rhizoma, prepared)
Mu Xiang 90g (Saussureae seu Vladimiriae, Radix)
Chen Pi 60g (Citri Reticulatae, Pericarpium)
Gan Cao 60g (Glycyrrhizae Uralensis, Radix)
Powder finely, sieve; take 9 – 12g twice per day.
Kidney yin deficiency points:
Shen Shu (Bl-23)
Zhi Shi (BL-52)
Wei Zhong (Bl-40)
Qi Hai (Ren-6)
Guan Yuang (Ren-4)
Tonify with medium stimulation; best every other day.
Liver channel damp heat points:
San Yin Jiao (Sp-6)
Zu San Li (St-36)
Tai Xi (K-3)
Tian Shu (St-25)
Zhong Wan (Ren-12)
Xia Wan (Ren-10)
Guan Yuan (Ren-4)
Reducing method on first three points, the rest even method; best every other day.
Liver qi blockage points:
Zhang Men (Liv-13)
Qi Men (Liv-14)
Jing Men (GB-25)
Qu Quan (Liv-8)
Tai Chong (Liv-3)
Zu San Li (St-36)
Zhi Gou (SJ-6)
Even method on first four points, reduce Tai Chong and Zhi Gou, tonify Zu San Li. Medium stimulation, no need to leave needle.
