What Would I do without Yunnan Baiyao in My Integrative Practice?

Have you ever wondered what your veterinary practice would be like if you had to give up some of your favorite holistic tools upon which you have become so dependent? For me, Yunnan Baiyao is a must-have herbal.

Yunnan Baiyao (YBY) is a proprietary Chinese herbal formulation which originated in the Yunnan province in China. Bai means white and yao means medicine. The main ingredients in this Yunnan white medicine are two types of ginseng, and several members of the yam family. Traditionally this formula is used to Transform Stasis, Resolve Stagnation, Tonify Qi, Invigorate Blood and Clear Heat.(1) A Western analysis of the physiologic effects of this herbal combination identifies its ability to stop bleeding. Specifically, in one rat study, the Panax notoginseng saponins were able to attenuate induced microcirculatory disturbance. (2)

Astringent and resinous herbs are present which stop bleeding and enhance healing.(1) In one human study, 100 participants with upper gastrointestinal bleeding were treated with a Yunnan Baiyao blend of herbals. A 95 % effective rate was reported. (3) A 2009, prospective, randomized, double-blind, placebo-controlled study was published in the International Journal of Oral and Maxillofacial Surgery which demonstrated the effects of preoperative administration of Yunnan Baiyao on lessening of blood loss.

According to Dr. Huisheng Xie, world renown TCVM instructor and formulator for Jing Tang herbals, “Yunnan Baiyao is one of the emergency herbal formulas herbalists carry all the time.”(1) YBY can be applied directly onto open wounds, into the abdominal cavity, into tooth extraction sites and taken orally! The brown powder is supplied in a package of 16 rust-colored capsules or a tiny 4 gram vial. The capsules can be swallowed or opened. The powder may be used topically or mixed into food. The powder can even be mixed with water and squirted into the nasal passages for a nose bleed. Keep in mind it is very astringent and may be uncomfortable for a moment, but, it does work!

Anecdotally, university surgeons are using YBY capsules orally as a pre-med to prevent adverse bleeding during surgery. YBY has been an invaluable aid in stopping leakage from splenic hemangiosarcoma masses, thereby decreasing the associated anemia, improving quality of life, and increasing longevity, especially when surgical intervention is not an option or has failed.

The mystery which surrounds Yunnan Baiyao is interesting and concerning. According to legend, in order to keep the formula secret, there are thirteen separate teams who mix the product. None of them know the ingredients which the other teams are blending.(1)

According to ShanghaiDaily.com, “the traditional Chinese medicine maker, Yunnan Baiyao

Group Co., Ltd has been sued by a lawyer in central China's Hunan Province for concealing an alleged toxic ingredient in its signature product from consumers.” The potentially toxic ingredient is radix aconite agrestis, also known as gelsemium elegan or “heartbreak grass”. This source also says that in 2009 a lawyer in Beijing suffered an allergic reaction after taking the medicine. The attorney lost this lawsuit. The government agreed that the formulation is protected as a state secret. It is protected until 2015 according to China’s FDA.

Some doctors say high doses of the toxic herbal ingredient can cause dizziness, nausea or even death.

Despite this, in the veterinary field, small doses have been administered safely for long periods of time, even years. For example, a 75 pound dog can consume 1 capsule twice daily for greater than one year as part of a cancer management protocol with no adverse effects.(3)

A well-accepted veterinary resource recommends dosing YBY as follows(1):

Dogs: 0.5-5g twice daily orally

Cats: 0.2-0.5g twice daily orally

When applied topically daily into a deep dog bite puncture or a large dehiscence, YPY seems to stimulate granulation tissue and inhibit the development of infection. The application can be repeated two to four times per day. This use alone makes it valuable to any practice!

Yunnan Baiyao has won three national gold medals for quality. It is ranked among the most famous of Chinese traditional medicines. It has been designated as one of two Class-1 protected traditional medicines for a 20 year protective term in China. The YBY reputation is equal to that of penicillin in the United States. The story of Yunnan Baiyao and its formulator, Mr. Qu Huangzhang, is known all over China and has been made into a film.(4)

SIX CASE STUDIES The following cases demonstrate the diverse uses of YBY. This unique herbal formulation is complementary to other herbals and medications, and is an alternative when other modalities are not options. It is efficacious both orally and topically. It appears to be safe when utilized long term in dogs.

1. THOR, a seven-and-a-half-year-old M/N Weimaraner presented on August 22, 2013 for lethargy and anorexia. He was diagnosed with a splenic mass and hemoabdomen via abdominal ultrasound and abdominal tap. Surgical intervention was declined. Treatment with Yunnan Baiyao (1 capsule BID orally) and Gui Pi Tang was initiated, and appetite and energy improved.

2. TILT, an eight-and-a-half-year-old F/S Belgian Tervuren, presented February 15, 2013 with nasal neoplasia, right epistaxis, purulent drainage and sneezing. CT scan and histopathologic diagnosis were consistent with sarcoma. Radiation therapy was recommended but declined. Case management began with multiple Chinese and Western immune supportive herbals including Yunnan Baiyao (1 capsule BID orally) and essential oil therapies. Boswellia sacra – via diffusion, topically and orally – was initiated. In addition to this, a rigid, species- appropriate, fresh meat-based diet, high in blended, dark, leafy green vegetables and no starch was implemented. Multi-modal treatment is common for cancer in holistic patients. Therefore, the efficacy of Yunnan Baiyao in isolation cannot be evaluated. Discharge diminished and resolved within two months. Currently, Tilt sneezes daily, but intermittently. She is actively involved and winning in agility eight months post-diagnosis.

3. GOOLY, a 16½-year-old M/N Australian Shepherd, presented October 8, 2012 with a smooth, raised, depigmented 1 cm mass involving gingival tissue dorsal to his left upper carnassial. Resection with good margins left root exposure; histopathologic diagnosis was consistent with an ossifying epulis. This lesion could recur, invade bone and cause disfigurement. The owner was instructed to pack the site twice per day with Yunnan Baiyao, and massage gingiva with an esterified fatty acid. Several oral immune modulatory supplements were implemented. At Gooly’s two-week recheck exam, the gingival margin was filled with normal-appearing tissue adherent to the alveolar bone of the carnassial root. His owner continues to apply YBY intermittently. There has been no recurrence one-year post resection.

4. HERO, a ten-year-old M/N Rottweiler, presented with anorexia, halitosis, bradycardia and mild anemia. Upon palpation, a cranial abdominal mass was confirmed radiographically. HCT 30 (37-62). Hero has a history of hypothyroidism. Specialist surgical referral was declined. Possible blood transfusion was declined. Yunnan Baiyao, one capsule BID, was initiated on December 31, 2012. His guardian reported improved energy on January 4, 2013. On January 8, HCT was 35 pre-surgery. A splenectomy was performed which revealed a 4” diameter mass. Histologic diagnosis was splenic infarction with marked hemorrhage and necrosis. Hero is currently alive and well.

5. SHARDAY, a nine-year-old F Pit Bull victim of dog fighting, presented with multiple bite punctures, severe lacerations, gaping shoulder and auxillary wounds with severe edema. Treatment was declined at ER. ER suspected limb amputation might be necessary. The case was managed with essential oil soaks, antibiotics and Yunnan Baiyao applied directly into wounds. All wounds were managed with second intention healing, no primary closure. One drain was placed. All wounds granulated in and healed closed within four weeks. One minor scar is present.

6. BLUE, a 15-year-old M/N Chocolate Labrador Retriever was diagnosed with splenic hemangiosarcoma after a splenectomy. Yunnan Baiyao (1 BID orally) and other immunosupportive herbals were initiated in May 2005. Blue lived 8 years post diagnosis.