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Women may experience leukorrhea with a black color, even resembling the juice of black beans, with a fishy odor; this is referred to as Black Leukorrhea (Hei Dai Xia). Black leukorrhea results from extreme heat-fire. Some might doubt that since the color of fire is red, how can it become black? They might suggest it could be due to extreme cold in the lower jiao. However, they do not realize that "extreme fire resembles water" is merely an illusion. The symptoms must include abdominal pain, urination feeling like being pierced by a knife, swelling of the vaginal opening, a red complexion, and over time, emaciation with a sallow complexion. The appetite will be greater than normal, and there will be a sensation of heat and thirst in the mouth. Drinking cool water provides slight relief. This indicates excessive stomach fire combining with fire in the Mingmen (Gate of Life), Bladder, and Sanjiao (Triple Burner) to scorch and dry up fluids, turning them into a charcoal-like color. It is undoubtedly a transformation of extreme heat-fire, not involving any cold pathogen. Such cases do not progress to mania only because the Kidney Water and Lung Metal are healthy; their continuous vital energy moistens the Heart and assists the Stomach to rescue the body. Thus, the condition manifests only as black leukorrhea because the fire is knotted in the lower jiao and does not flare upward. The treatment method focuses solely on draining fire; once the heat-fire recedes, dampness will naturally disappear.

The formula used is Fire-Draining Decoction (Li Huo Tang).
Dahuang (Rhei Radix et Rhizoma, 3 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, 5 qian, stir-fried with soil) Fuling (Poria, 3 qian) Cheqianzi (Plantaginis Semen, 3 qian, stir-fried with wine) Wangbuliuxing (Vaccariae Semen, 3 qian) Huanglian (Coptidis Rhizoma, 3 qian) Zhizi (Gardeniae Fructus, 3 qian, stir-fried) Zhimu (Anemarrhenae Rhizoma, 2 qian) Shigao (Gypsum Fibrosum, 5 qian, crushed) Liu Jinu (Artemisiae Annuae Herba, 3 qian)
Decoct in water and take orally. After one dose, urinary pain stops and flow becomes smooth. After two doses, black leukorrhea turns white. After three doses, white leukorrhea also decreases significantly. A few more doses lead to complete recovery. Some argue this formula is too rapid and potent. However, when fire is rampant, gentle methods contrary to the pathology cannot be used. It is like fighting a fire; if one hesitates or delays, the flames will spread until everything is consumed. Now, using a batch of cold-cooling herbs such as Huanglian, Shigao, Zhizi, and Zhimu, combined with Dahuang, allows for rapid elimination of pathogens. Furthermore, Wangbuliuxing and Liu Jinu have urgent damp-draining effects, leaving no room for dampness and heat to stagnate. Baizhu assists the Earth element (Spleen/Stomach), Fuling percolates dampness, and Cheqianzi promotes water passage. Thus, fire recedes and water advances, achieving the hexagram of Water-Fire Ji Ji (Completion/After Completion).

Marginal Note: After recovery, one should regulate diet, avoid spicy and hot foods, and nourish the Spleen Earth. If one relies on this formula and takes it immediately upon recurrence of symptoms, vital Qi will inevitably be damaged. Be cautious!

Verse:
Leukorrhea is black with a fishy smell,
Abdominal pain and urination feel like piercing knives.
Stomach, Mingmen, and Sanjiao fires are all vigorous,
Fire knots in the lower part without flaring upward.
Fire-Draining Decoction contains Dahuang, Shigao, and Huanglian,
Baizhu, Fuling, and stir-fried Cheqianzi.
Wangbuliuxing, Liu Jinu, Zhizi, and Zhimu,
As fire recedes and water advances, black leukorrhea diminishes.