Liang Di Tang — Two Rehmannia Decoction

On this page

1. Overview
2. TCM pattern
3. Key herbs
4. Formula actions
5. Conditions treated
6. Cautions

Overview

Liang Di Tang — the “Two Rehmannia Decoction” (referring to Sheng Di and Di Gu Pi) — is from Fu Qing-zhu’s Fu Qing Zhu Nu Ke (Fu Qing-zhu’s Gynaecology). It treats menstrual bleeding from Yin deficiency with empty Heat, where lack of cooling fluids allows Heat to harass the Blood and push periods early and heavy. Unlike Heat-pattern formulas that use draining cold herbs, this formula nourishes Yin to anchor the empty Heat at the source.

I prescribe Liang Di Tang as part of bespoke herbal formulas from pharmaceutical-grade granules sourced from Sun Ten in Taiwan.

TCM pattern

Liang Di Tang is prescribed for Yin deficiency with empty Heat causing menstrual irregularity:

• Periods come early (cycle shorter than 24 days)
• Heavy or moderate flow, bright or slightly dark red
• Possibly with small clots
• Five-palm Heat, low-grade afternoon flushes
• Dry mouth and throat
• Insomnia, mild night sweats
• Dry skin, scant cervical mucus
• Tongue — red, scant coat or peeled
• Pulse — thin, rapid

Key herbs

1. Sheng Di Huang — cools Blood; nourishes Yin
2. Di Gu Pi (lycium bark) — clears Heat from the Yin (empty-Heat); cools Blood
3. Xuan Shen — nourishes Yin; cools Blood; clears upward-floating Yin-deficient Heat
4. Mai Men Dong — nourishes Lung and Stomach Yin
5. Bai Shao — nourishes Liver Blood and Yin
6. Ah Jiao (E Jiao) substitution — classical formula contains E Jiao (donkey-hide gelatin), excluded on welfare grounds; substitute with Shu Di Huang and Sang Shen, or Dang Gui plus Bai Shao to nourish Blood

Formula actions

1. Nourishes Yin
2. Cools Blood and stops empty-Heat bleeding
3. Regulates the menstrual cycle

Conditions treated

1. Early-cycle heavy menstrual bleeding with Yin deficiency — see heavy periods
2. Short menstrual cycle with Yin-deficient pattern
3. Perimenopausal heavy bleeding with empty Heat
4. Climacteric heavy periods with hot flushes
5. Functional uterine bleeding with Yin-deficient pattern
6. Menstrual disorders in PCOS with Yin-deficient pattern (rare)

Cautions

The classical formula contains E Jiao (donkey-hide gelatin); my practice excludes E Jiao on welfare and sustainability grounds — suitable Blood-nourishing substitutes are used.

Heavy menstrual bleeding always warrants medical investigation to exclude fibroids, polyps, hyperplasia, malignancy or coagulation disorders.

Not appropriate for Spleen-Qi-deficient bleeding (pale dilute blood, fatigue, pale tongue) or cold-pattern bleeding — the cold nourishing herbs damage Spleen Yang.

Always consult a qualified Chinese herbalist registered with the RCHM.

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