If endometrial tissues emerge outside the uterine cavity, the symptom is termed "Endometriosis." It is characterized by secondary, progressive painful menstruation, irregular menstruation and sterility. In TCM, it is discussed under the topics of Tong jing (dysmenorrhea), Beng Lou (metrorrhagia and metrostaxis), Zhengjia (abdominal mass) and Bu Yun (sterility). This illness is caused by impeded flow of Qi and blood, beading t the obstruction of the Penetrating Channel and Controlling Channel and dysfunction of the uterus.

Classifications and Treatments

This disease is commonly caused by the stagnation of Qi and blood stasis.

Clinical manifestations: Abdominal pain starting from 1-2 days preceding the menstrual cycle, drastic pain on the first day of menstruation which is aggravated progressively year by year; the pain in the lower abdomen and lumbo-sacral region which radiates to the perineum, the anus or the thighs; copious menses or prolonged menstrual cycle wit incessant drippings of bleeding; a case history of sterility. The tongue is purplish dark with thin, either whitish or yellowish fur. The pulse is either deep and taut or uneven.

Gynecological examination finds purplish blue nodes in the posterior fornix of the vagina or in the uterine cervix, with the uterus retroversed, adhered and fixed, and with its activity restricted. On the posterior uterine wall, in the retrouterine excavation and uterosacral ligament, bean-like, hard-textured nodes can be touched with obvious tenderness; in the appendicular region in active cystic mass is perceivable with mild tenderness when pressed.

Therapeutic method: Promote blood circulation and get rid of blood stasis.

Recipe: Gexia Zhuyu Decoction 

Ingredients: 

Radix Angelicae Sinensis

Faeces Trogopterorum Praeparata

Rhizoma Ligustici Chuanxiong

Radix Paeoniae Rubra

Semen Persicae

Flos Carthami

Fructus Aurantii

Rhizoma Corydalis

Cortex Moutan Radicis

Rhizoma Cyperi

Radix Linderae

Radix Glycyrrhizae

Decoct the herbs in water to get 200-300ml of decoction for a day's dose. Take one half of it in the morning and the other half in the evening.

Modification: In case of listlessness and poor appetite, deduct Faeces Trogopterorum Praeparata, but add to the recipe Radix Codonopsis Pilosulae, Radix Astragali seu Hedysari.

In case of cold pain in the lower abdomen which can be relieved by warmth, deduct Cortex Moutan Radicis, Radix Paeoniae Rubra, but add Fructus Foeniculi,Fructus Evodiae. In case of sterility due to obstruction of the oviduct, add Herba Speranskiae Tuberculata, Squama Manitis,Spina Gleditsiae.

Other therapies

The cases with anemia, use the following formula:

Radix Salviae Miltiorrhizae

Rhizoma Ligustici Chuanxiong

Rhizoma Sparganii

Rhizoma Zedoariae

Resina Olibani Praeparata

Myrrha

Flos Carthami

Sanguis Draconis

Decoct the above herbs into 150-200 ml of decoction. Inject the liquid into the colon through the anus as its temperature drops to 37¡æ. The operation is done before night sleep.

Caution

The stricture of the cervix and the excessive retroflexion of the uterus must be rectified so as to prevent the countercurrent of the menses caused by blood stasis.

Avoid unnecessary pelvioscopy during the menstrual period. Avoid the implantation of endometria caused by manipulations in the surgical operation.