Wu Ling San

Functions

Wu Ling San primarily functions to warm yang and reinforce vital energy, remove dampness by diuresis and promote the flow of qi. The formula is used to treat painful urination, edema, abdominal distention, vomiting and diarrhea, and thirst with no desire for liquids.

Dosage Info

Powder or pill: 6 to 9 grams each time twice a day. Tablet: 4 to 5 tablets each time twice a day. Internal administration, 5:1 concentrated extract: 9 grams/day.

Ingredients

Precautions

Wu Ling San is contraindicated in kidney and spleen insufficiencies without dysuria, and for yin deficiency with insufficient body fluids. Exercise caution when prescribing the formula to patients suffering a fluid-depleting high fever.

Pharmacology

Effects on plasma ANF levels in mice:Experiments have shown that Wu Ling San can increase the levels of plasma ANF in mice. (1)

Effects on water and electrolyte metabolism in ethanol poisoning: In ethanol poisoning, Wu Ling San has been shown to have a regulatory effect on various metabolic abnormalities. It can regulate both water and electrolyte metabolism and raise the set point of osmotic pressure. (2)

Effects on gastric emptying and intestinal propulsion: Experiments have shown that when fed to mice, Wu Ling San can lower the rate of residual pigment in the subjects’ stomach and enhance the subjects’ intestinal propulsion. (3)

Inhibiting calcium oxalate crystal formation: An experiment showed that Wu Ling San inhibits, both in vitro and in vivo, formation of lithangiuria. In vitro, Wu Ling San has been shown to decrease the calcium oxalate crystal growth from 53.8% to 15.2%; and in vivo (rats), Wu Ling San has been shown to inhibit the growth of calcium oxalate crystal in the subjects’ liver. (4)

Effects on GAGS in the urine: Wu Ling San can raise the level of glycosaminoglycans in the urine of urolithiasis patients from 31.2mg/24h to 46.4mg/24h. (5)

Effects on experimental acute renal hypertension: Experiments on rats have demonstrated that Wu Ling San can lower blood pressure in rats with acute renal hypertension. (6)

Clinical Applications

Treating simple edema in the lower limbs
Chen treated 27 cases of simple edema in the lower limbs with a modification of Wu Ling San. The modified formula consisted of Gui Zhi (Cinnamon Twigs), Fu Ling (Poria), Ze Xie (Alisma), Zhu Ling (Polyporus), Che Qian Zi (Plantain Seed), Bai Zhu (white Atractylodes), Fu Zi (processed Aconite), Niu Xi (Achyranthes), and Huang Qi (Astragalus). For those who had yellowish greasy tongue fur, Fu Zi was removed, and Fang Ji (Stephania) and Yi Yi Ren (Coix) were added. For patients with sublingual varices, Dan Shen (Salvia) and Chi Shao (Peony Red) were added. After treatment, in all 27 cases, swelling had subsided completely in 14 days (19 cases did so in 7 days). (7)

Treating Meniere’s syndrome
Ye treated 86 cases of Meniere’s syndrome with a modification of Wu Ling San. The modified formula consisted of Gui Zhi (Cinnamon Twigs), Bai Zhu (Atractylodes), Ban Xia (Pinellia), Shi Chang Pu (Grassleaved Sweetflag Rhizome), Zhu Ling (Polyporus), Fu Ling (Poria), Ze Xie (Alisma), and Xian He Cao (Agrimony). The formula was further modified to suit individual patients’ symptoms. The patients were administered one to two doses of the formula in a decoction daily and one course of treatment last a week. While under treatment, the patients were advised to avoid hot, cold, raw, and greasy foods. The results showed that 54 cases were resolved, 27 improved, and the remaining 5 did not respond to the treatment, with a total effectiveness rate of 94.2%. (8)

Treating infantile nervous micturition
Shi et al. treated 56 cases of infantile nervous frequency of micturition with modified Wu Ling San. The formula consisted of Fu Ling (Poria), Zhu Ling (Polyporus), Ze Xie (Alisma), Chai Hu (Bupleurum), Bai Zhu (Atractylodes), Sheng Ma (Cimicifuga), and Gui Zhi (Cinnamon Twigs). One dose of the formula in a decoction was administered daily. The results were, 55 cases were resolved and the remaining case did not respond to the treatment. (9)

Treating auditory vertigo
Tao treated 34 cases of auditory vertigo with Wu Ling San. For patients who were experiencing nausea and vomiting, Ban Xia (Pinellia) and Zhu Ru (Bamboo shavings) were added. For those suffering from dysphoria and severe palpitations, Gou Teng (Uncaria) was added. For patients who had a bitter taste in the mouth and a wiry pulse, Long Dan Cao (Gentiana Root) and Chai Hu (Bupleurum) were added. And for the patients with red tongue, thready pulse, and feverish sensations in the palms and soles, Shu Di (prepared Rehmannia) and Gou Qi Zi (Lycium Fruit) were added. The patients were administered one dose of the formula in decoction daily. After taking 3 to 39 doses, patients no longer experienced vertigo symptoms. (10)

Treating urinary system calculus
Li treated 30 cases of urinary system calculus with a modification of Wu Ling San. The modified formula consisted of Bai Zhu (Atractylodes), Fu Ling (Poria), Di Long (Earthworm), Gui Zhi (Cinnamon Twigs), Ze Xie (Alisma), Mang Xiao (Mirabilitum), Rou Gui (Cinnamon Bark), Zhu Ling (Polyporus), and Jin Qian Cao (Glechoma). For patients experiencing damp-heat symptoms, Huang Bo (Phellodendron) and Hu Zhang (Giant Knotweed Rhizome) were added. For those suffering insufficiency of yang, Ren Shen (Ginseng) and Shou Fu Zi (cooked Aconite) were added. For insufficiency of yin, Sheng Di (Rehmannia) and Shan Yu Rou (Cornus) were added. For qi stagnancy and blood stasis, Chuan Niu Xi (Achyranthes Chuan), Chuan Xiong (Cnidium), and E Zhu (Zedoaria) were added. And for hematuria, Di Yu Tan (Sanguisorba Carbon) and Hu Zhang (giant Knotweed Rhizome) were added. The patients were administered one dose of the formula daily. After treatment, 24 cases were resolved, 4 improved, and the remaining 2 cases did not respond to the treatment, with a total effectiveness rate of 93.3%. (11)

References

  1. Zhou Lian, et al. The effect of Wu Ling San and its constituent herbs on plasma ANF in healthy mice. China Journal of Integrated Medicine. 1995;15 (1):36-37.
  2. Zhao Yun Kun. Wu Ling San’s effect on ethanol metabolism. Journal of Chinese Patented Medicine Research. 1986;(6):24.
  3. Li Yan, et al. Wu Ling San’s effect on gastrointestinal movement in mice. China Journal of Digestion. 1997;17(1):9.
  4. Kang Xin Li, et al. Wu Ling San’s inhibitory effect on calcium oxalate crystal formation and its effect on urine GAGS level. China Journal of Urinary System Surgery. 1991;12(3):227.
  5. Kang Xin Li, et al. Wu Ling San’s inhibitory effect on calcium oxalate crystal formation and its effect on urine GAGS level. China Journal of Urinary System Surgery. 1991;12(3):227.
  6. Zhang Zhong Yi, et al. Wu Ling San’s effect on experimental renal hypertension in rats. Tianjin Journal of TCM. 1994;11(4):29,19.
  7. Chen De An. Treating 27 cases of edema in the lower limbs with Wu Ling San. Xinjiang Journal of Traditional Chinese Medicine. 1998;16(1):19-20.
  8. Ye Ke Fu. Treating 86 cases of Meniere’s syndrome with Wu Ling San. Journal of New TCM. 1999;31(9):43-44.
  9. Shi Ji, et al. Treating 56 cases of infantile nervous micturition with modified Wu Ling San. Sichuan Journal of TCM. 1999;17(8):50.
  10. Tao Yong Yue. Treating 34 cases of auditory vertigo with Wu Ling San. Xinjiang Journal of Traditional Chinese Medicine. 1999;8(9):1481.
  11. Li Yang. Treating 30 cases of urinary system calculus with Wu Ling San. National Journal of Medicine Forum. 1996;11(2):18.