bubble_chart Concept

Under normal circumstances, a small amount of white mucus is present in a woman's vagina, which is odorless and does not cause local irritation. It serves to lubricate and protect the surface of the vagina. As Wang Mengying stated, "Leukorrheal disease is something women are born with, always moist and lubricated, and is not an illness." If the mucus increases, resembling a continuous discharge, and is accompanied by other clinical symptoms, it is referred to as leucorrhea. As for the increase in leucorrhea during the initial stage of pregnancy or around the time of menstruation, these are normal physiological phenomena and are not considered pathological.

bubble_chart Pattern Analysis

1. Spleen Deficiency︰Profuse leukorrhea, sticky in texture, without peculiar odor, continuously dripping all day, poor appetite, mental fatigue and lack of strength, soreness and weakness of the limbs, increased leukorrhea after exertion, or accompanied by edema, or accompanied by abdominal distension and fullness, pale tongue, white or greasy coating, weak and slow pulse. Mostly caused by spleen qi deficiency, weakness of the belt vessel's restraining function, and inability to retain yin fluids. The key points of pattern identification are: persistent leukorrhea, sticky in texture, worsening after exertion, often accompanied by edema or abdominal distension and fullness and other symptoms of spleen deficiency. The treatment should focus on tonifying the spleen and replenishing qi, raising yang and eliminating dampness. The recommended formulas are Discharge-Ceasing Decoction or Spleen-Tonifying Leukorrhea-Stopping Decoction.
2. Kidney Deficiency︰The leukorrhea is clear and thin like water, profuse and gushing, odorless, with cold lower abdomen and limbs, soreness in the lower back and weak legs, dizziness, blurred vision, clear and abundant urine, pale tongue with thin white coating, and weak pulse. This is mostly caused by insufficient kidney yang, weakened restraint function of the belt vessel, insecurity of the conception vessel, and downward flow of yin essence. The key points for diagnosis are: leukorrhea gushing, more profuse than in the pattern of spleen deficiency, thinner in quality than in the pattern of spleen deficiency, and accompanied by symptoms of kidney deficiency such as soreness in the lower back, weak legs, dizziness, and blurred vision. The treatment should focus on warming the kidneys and strengthening the spleen, consolidating and astringing to stop leukorrhea. Recommended formulas are Neibu Wan (Internal Tonifying Pill) or Bushen Zhidai Tang (Kidney-Tonifying and Leukorrhea-Stopping Decoction).
3. Dampness-heat︰The leukorrhea is milky white in color, appearing curd-like (or resembling tofu dregs), with a foul and fishy odor, accompanied by intense itching of the vulva, or possibly stabbing pain in the vagina. The tongue coating is thin and white or yellow and greasy, and the pulse is soggy and rapid. The primary cause of the disease is "dampness." When dampness invades the belt vessel and transforms into heat, the turbid dampness flows downward, leading to symptoms such as excessive leukorrhea that is curd-like in appearance and severe itching of the vulva. The treatment should focus on clearing heat and dispelling dampness, using the prescription "Zhi Dai Tang."
4. Damp Phlegm︰Excessive leukorrhea with sticky texture, profuse phlegm, nausea and poor appetite, chest tightness, abdominal distension and fullness, bland taste in the mouth with greasiness, white and greasy tongue coating, deep and slippery pulse. Symptoms include obesity and copious thick leukorrhea. Treatment should focus on resolving phlegm and drying dampness, supporting the spleen and warming the kidneys. The recommended formula is Six Gentlemen Decoction with degelatined deer horn, Chinese Angelica, and motherwort herb.

Spleen deficiency leucorrhea and kidney deficiency leucorrhea: both are deficiency pattern, commonly seen in patients with weak constitutions. Spleen deficiency leucorrhea and kidney deficiency leucorrhea often occur together and can transform into each other. Moreover, if leukorrheal disease persists for a long time or is excessive, even in cases of dampness-heat excess pattern, it can easily injure the spleen and kidneys, leading to spleen deficiency or kidney deficiency symptoms. Therefore, in the treatment of leukorrhea, it is common to use a small amount of spleen-tonifying or kidney-tonifying herbs in addition to the main treatment based on pattern identification.

bubble_chart Documentation

1. Nyuke Jinglun-Leucorrhea quoting Miao Zhongchun: "Excessive white discharge is mostly due to spleen deficiency. When liver qi stagnates, the spleen is injured; when the spleen is injured, the damp-earth qi sinks downward. This means the spleen essence fails to be retained and cannot transform into nourishing blood, resulting in the downward flow of white, slippery discharge—all caused by the stagnation of liver wood within the earth. The treatment should focus on uplifting liver qi and supplementing spleen vitality. Since white discharge is mostly due to qi deficiency, strengthening the spleen and replenishing qi is the essential method."