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The meridians passing through the anterior yin region are two: one is the Liver Meridian, and the other is the Du Meridian (Governing Vessel). The *Classic* states: "The Foot-Jueyin Liver Meridian enters the pubic hair area, passes over the genitalia, and reaches the lower abdomen." This is the path of the Liver Meridian. The Du Meridian originates from the central bone below the lower abdomen; in women, it connects to the Ting Kong (a point near the urethra/vagina) and runs along the genitalia; in men, it runs along the penis down to the perineum, equal in length to that of women. This is the path of the Du Meridian.

In women, vulvar swelling may be caused by deficiency and damage to the Bao Luo (uterine collateral vessels), where wind-cold pathogens invade and contend with Qi and Blood, leading to swelling; or by depression and anger damaging the Liver and Spleen; or by excessive sexual activity causing damp-heat to flow downward; or by intense desire generating excessive heat and parasites, resulting in simultaneous swelling and itching. All these conditions require abstention from sexual intercourse and prompt treatment; otherwise, the pathogenic factors will gradually intensify, leading to ulceration and non-healing of the vaginal opening. If Qi and Blood are deficient, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to lift and raise Yang Qi. If there is damp-heat in the Liver Meridian, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) to drain and clear damp-heat. If there is Liver-Spleen depression and anger, sinking of Yuan Qi, and stagnation of damp-heat, administer Guipi Tang (Spleen-Restoring Decoction) with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) in the morning to resolve depression and tonify Spleen Qi, and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) in the evening to clear Liver Fire, generate Liver Blood, remove heat, and eliminate dampness. As for vulvar itching and ulcers, they mostly belong to parasitic erosion. Initially caused by damp-heat, three types of parasites arise in the intestines and stomach and become active due to Zang organ deficiency. These parasites erode the essence of the vagina, causing intermittent itching; severely, they cause unceasing itching and pain, ulcerating into sores. Virgins, widows, and nuns are prone to this condition. Unfulfilled emotional desires lead to stagnation of essence and blood, brewing damp-heat that persists for a long time, forming parasites. The unbearable itching can penetrate deep into the Zang organs, leading to death, accompanied by fever and aversion to cold, resembling consumptive disease. Some cases result from excessive sexual injury causing heat stagnation, swelling, itching, internal pain, and external presentation as biandu (perianal abscesses). None are not caused by sexual activity damaging the Kidney and Liver, where Kidney Yin is deficient and Liver Fire is hyperactive. Wood Qi is depressed and needs dispersal; the stagnant fire of the Liver Meridian travels through hollow orifices and sinks downward, causing itching and parasite formation. Internal treatment should use Longdan Xiegan Tang and Xiaoyao San. External treatment involves fumigating and washing with a decoction of Chuangzi (Cnidii Fructus), and specifically applying a paste made of Tao Ren (Persicae Semen) ground into ointment, mixed with Xionghuang (Realgar) powder and Ji Gan (Gallus Gallus Domesticus Hepat et Testis), formed into a cake and inserted into the vagina to control parasites. If limbs are fatigued, there is stifling itching in the vagina, and urine is red and scanty, use Guipi Tang with Zhizi (Gardeniae Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), and Danpi (Moutan Cortex). If one only focuses on clearing heat and drying dampness, Qi and Blood will daily decline, and the harm will extend beyond mere vulvar itching.

Vulvar coldness in women is caused by labor injuring the Zi Zang (uterus), allowing wind-cold pathogens to invade. If urination is obstructed and the lower abdomen is distended and painful, use Longdan Xiegan Tang. If urine is clear, appetite is poor, and stools are loose, treat with Bawei Wan (Eight-Ingredient Pill). Bawei Wan is highly effective for treating blood deficiency failing to nourish Zang organs, dryness of body fluids, and cold pathogens residing in the uterus causing vulvar coldness.

Prolapse of the uterus or vaginal walls (Yinting Xiaduo), pulling and causing abdominal pain, may be due to damage to the Bao Luo, deficiency-cold of the Zi Zang, improper sexual conduct, or exertion during childbirth. The primary treatment should be lifting and tonifying Yuan Qi. If there is Liver-Spleen depression and sinking of Qi due to deficiency, use Buzhong Yiqi Tang. If there is Liver Fire and damp-heat with red, scanty urine, use Longdan Xiegan Tang. If a mass protrudes from the vagina like a mushroom, surrounded by swelling and pain, with frequent urination, afternoon fever, sensation of itching and pain, and heavy sensation in urination, this indicates Liver Fire and damp-heat causing swelling and pain, and Spleen deficiency with sinking causing heaviness. First, use Buzhong Yiqi Tang with Zhizi, Fuling (Poria), and Qingpi (Citri Reticulatae Pericarpium Viride) to clear Liver Fire and ascend Spleen Qi, followed by Jiawei Guipi Tang to regulate Spleen depression. Externally, apply fresh pig lard mixed with Lili powder to astringe. Pain in the vaginal introitus after marriage should be treated by soothing depression and harmonizing blood, using Siwu Tang with Xiangfu (Cyperi Rhizoma) and Honghua (Carthami Flos).

Bleeding during intercourse is caused by excessive Liver Fire leading to over-dispersal, combined with Liver deficiency failing to store blood and Spleen deficiency failing to control blood. Use Buzhong Yiqi Tang and Guipi Tang, adjusting usage as needed. If all six pulses are surging, this indicates Kidney Yin deficiency failing to secure and store, treated with Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) plus Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus).

The *Jingui Yaolue* states: "When Stomach Qi leaks downward, causing flatulence through the vagina (Yinchui) with loud noise, it means that grain Qi cannot ascend to the clear pathways, nor can it follow the meridians to exit through the posterior yin. This is a deviation of Yin and Yang, similar to the concept of intestinal crossing." In severe cases, there may be rustling sounds, resembling flatus from the anus. Treat with Buzhong Yiqi Tang plus Wuweizi.