Seattle Institute of Oriental Medicine

Translations: Cases

Wu Ling San Clinical Uses

Chris Steckler

Medical Chinese VI

8/1/04

Wu Ling San Clinical Uses

Liu Jing Yi; Sichuan Journal of Traditional Chinese Medicine, 2001, Vol. 19, No.10. Pg. 76.

This article discusses how Wu Ling San is not only useful for cases of exterior conditions with simultaneous accumulation of water, but can be used almost any time where the primary pathology is failure of normal urinary bladder qi transformation as the root of the symptoms. The author cites some examples of this in the initial paragraph, such as summerheat surrounding the Spleen leading to strangury symptoms, or water swelling, or blocked urination type symptoms. He explains that although the functions of Wu Ling San are to transform qi, move water, and simultaneously resolve the exterior, the emphasis of the formula is on transforming qi and moving water.

In each of the four cases presented, all of them have some variation of externally contracted disease which lingers and eventually block urinary bladder qi transformation. Each one is a little different and the modifications used to treat them vary as well. The first case is a 29 y/o male who contracted summerheat damp and developed a high fever with vexation and thirst. He took Bai Hu Tang and a western medication which eliminated his summerheat evil but the dampness lingered. It was concluded that this dampness was obstructing the bladder qi mechanism so that qi failed to be transformed by water, and this caused heart vexation, thirst, copious sweating, inhibited urination, and a feeling of heaviness in his body. The formula he was given was a combination of Wu Ling San and Liu Yi San (Gan Cao 1 + Hua Shi 6), which treats summerheat evil.

Case 2 was a 9 year old boy who 4 days prior to his exam started having urinary strangury with non-stop dripping. He also has urinary urgency, pain with urination, vexation and thirst, and his body felt heavy, and he had a sagging feeling in his lower abdomen. These symptoms came about following him catching a cold a week prior, and being given a ginger decoction to sweat the cold. Two days later these symptoms began. The author believes the unresolved external evil followed the channels and entered the urinary bladder organ, from where it is generated all these signs. He was given Wu Ling San plus Bian Xu, Qu Mai, Tong Cao, and Dan Zhu Ye.

Case 3 was a 21 year old man who had sudden onset of water edema swelling of his face and eyes, followed by lower body edema. His urine showed some albumin and elevated white blood cell counts. He was given the western medical diagnosis of acute kidney inflammation and given an anti-biotic which caused nausea and vomiting, but did not relieve the symptoms. His other signs were he also had an uncomfortable feeling in his lower abdomen, and inhibited urination. This was considered qi not being transformed from water and causing water overflow in the muscles and skin. His formula was Wu Ling San plus Fu Ling Pi, Sheng Jiang Pi, Fang Ji, Chen Pi, and Da Fu Pi.

In the discussion section at the end of the article, Liu Jing Yi gives a particularly good explanation of why Gui Zhi is appropriate to use in this formula, even in the absence of exterior symptoms, and can even be used when vexation and thirst are included as clinical signs. The important distinction to make is that vexation and thirst must be due to obstruction of the urinary bladder qi mechanism, for which gui zhi is useful to unblock, and not due to other causes such as Yang Ming Heat.

This is a nice article because it explains some alternative uses of Wu Ling San beyond what it is traditionally used for. The author gives good case studies to demonstrate this, provides a discussion of the underlying disease mechanism, explains the appropriateness of using gui zhi in good detail, and gives some useful ways to consider modifying the formula for special circumstances.