bubble_chart Concept

Multi-colored leukorrhea refers to the discharge from a woman's vagina that appears in several colors. The discharge may be thin like water, resemble rice water, appear as bloody fluid, or be pus-like, and it often has a foul and unpleasant odor, which is the main distinction from other leukorrheal diseases. This type of leukorrhea is often a characteristic of malignant changes in the uterus or cervix caused by sexually transmitted diseases, and it should be taken seriously in clinical practice.

bubble_chart Pattern Analysis

1. Qi Depression︰The color of leukorrhea may be white or red, with a foul fishy odor, lower abdominal pain, mental depression, distension in the head and hypochondriac pain, or chest tightness and poor appetite. The tongue texture may sometimes appear slightly bluish with a white coating, and the pulse is often wiry and choppy. It is mostly caused by qi depression and stagnation, liver-spleen stagnation, accumulation of dampness and stasis, prolonged heat transformation, and injury to the Ren and Dai meridians. The key diagnostic points are: foul-smelling leukorrhea, thick or sometimes watery in texture, or mixed with blood, accompanied by symptoms of qi depression such as chest tightness, hypochondriac pain, lower abdominal pain, and a wiry, choppy pulse. Treatment should focus on regulating qi and resolving stasis, supplemented by dispelling dampness and clearing heat. The recommended formula is Modified Peripatetic Powder.
2. Dampness-heat︰The leukorrhea varies in color and consistency, with a scant or copious amount, and a foul, unpleasant odor. It is often accompanied by dizziness, lack of strength, emaciation, occasional low-grade fever, a sticky sensation in the mouth, a greasy and slightly yellow tongue coating, and a wiry, slippery, and rapid pulse. This condition is mostly caused by deficiency of the Conception and Belt Vessels with prolonged accumulation of dampness-heat. Its clinical characteristics include: leukorrhea that is watery, rice-water-like, or blood-streaked, sometimes with purulent discharge and a foul odor, along with dizziness, lack of strength, emaciation, low-grade fever, a yellow and greasy tongue coating, and a slippery and rapid pulse—signs indicative of dampness-heat and yin deficiency. Treatment should focus on clearing and draining damp-heat while also nourishing yin, using Anemarrhena, Phellodendron, and Rehmannia Pill plus bittersweet herb, Hedyotis, and Barbated Skullcup Herb.
3. Yin Deficiency︰Leukorrhea with more red than white discharge, a foul odor, lower abdominal pain radiating to the thighs or back, accompanied by fever, frequent urination, stabbing pain, a dark red tongue with thin yellow coating, and a thready rapid pulse. This is often due to the progression of dampness-heat causing multicolored leukorrhea, leading to the depletion of yin fluids. The characteristic symptoms and signs include: increased bloody discharge, persistent leukorrhea with a more pronounced foul odor, lower abdominal pain radiating to the legs or back, persistent fever, frequent and painful urination, and a thready rapid pulse, indicating yin deficiency. The treatment should focus on clearing heat and consolidating yin, while also regulating the liver and kidney. Use Six-Ingredient Rehmannia Pill supplemented with Chinese Angelica, Peony Root, bittersweet herb, Hedyotis, and Barbated Skullcup Herb.
4. Deficiency-Cold︰Under the condition of multi-colored leukorrhea, prolonged and lingering, with a large amount of thin discharge, a foul odor, soreness in the waist and weakness in the legs, occasional abdominal pain, emaciated muscles, dizziness and blurred vision, physical fatigue and mental exhaustion, a pale tongue with scant coating, and a weak, thin pulse. This is often caused by prolonged leukorrhea leading to initial depletion of yin essence, followed by yin impairment affecting yang. The clinical manifestations include: leukorrhea that is white or red, or multiple colors appearing together, with a large amount of thin discharge and a foul odor, more severe abdominal pain, a sallow complexion, physical fatigue and mental exhaustion, a pale tongue with scant coating, and a weak, thin pulse. The treatment should focus on warming and tonifying to consolidate and astringe, while also nourishing qi and blood. The recommended formula is Left-Restoring Pill with Achyranthes Root removed and Tangshen, Astragalus Root, Chinese Angelica, and Sanqi powder added.

Multi-colored leukorrhea should be differentiated between deficiency and excess. Deficiency pattern is mostly due to yin-yang deficiency or insufficient qi and blood, while excess pattern is often caused by qi depression or dampness-heat pouring down. If the condition persists for a long time without improvement, the excess pattern may transform into a deficiency pattern, and local weakness may also lead to systemic weakness. In addition to addressing the disease cause with medication, the treatment of this condition also requires strengthening the spleen and tonifying the kidneys to consolidate the root. According to literature reports and personal clinical experience, regardless of the syndrome type, bittersweet herb, Hedyotis, and Barbated Skullcup Herb can be added to the treatment based on pattern identification. Alternatively, Rhinoceros Bezoar Pill (a prepared medicine) can be taken together with decoctions for better efficacy.

bubble_chart Documentation

1. Jiyin Gangmu．The chapter on "Red and White Discharge" states: "Women suffering from leukorrheal disease, it has five names, caused by wind evil entering the cervical orifice during menstruation or postpartum, transmitting to the zang-fu organs. If it injures the Foot Jueyin Liver Meridian, the color is like green mud; if it injures the Hand Shaoyin Heart Meridian, the color is like red fluid; if it injures the Hand Taiyin Lung Meridian, the form is like white mucus; if it injures the Foot Taiyin Spleen Meridian, it is yellow like rotten melon; if it injures the Foot Shaoyin Kidney Meridian, it is black like clotted blood. People have a belt vessel that runs horizontally around the waist, like a belt, and when disease arises here, it is therefore called 'belt'."