吴茱萸三两 当归 芎藭 芍药各二两 人参 桂枝 牡丹皮 阿胶 生姜各二两
甘草二两 半夏半升 麦冬(去心)一升
右十二味,以水一斗,煮取三升,分温三服。亦主妇人少腹寒,久不受胎,兼取崩中
去血,或月水来过多,及至期不来。
【集解】
李□曰:『内经』云:血气虚者,喜温而恶寒,寒则凝涩不流,温则消而去之。此汤
名温经,以瘀血得温即行也。方内皆补养气血之药,未尝以逐瘀为事,而瘀血自去者
,此养正邪自消之法也。故妇人崩淋不孕,月事不调者,并主之。
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带下经水不利,少腹满痛,经一月再见者,土瓜根散主之。
【按】
「再」字当是「不」字,若是「再」字,一月两来,与上文不利不合,是传写之□。
【注】
此亦前条在下未多,经候不匀之证。带下胞中病也,胞中有宿瘀,从气分或寒化,则
为白带;从血分或热化,则为赤带;从气血寒热错杂之化,则为杂色之带也。若兼经
水不利,少腹满痛,乃有瘀血故也。其经至期不见,主以土瓜根散者,土瓜能逐瘀血
,□虫能开血闭,桂枝合芍药舒阳益阴,通和荣气,则瘀去血和,经调带止矣。
土瓜根 芍药 桂枝 □虫各三钱
右四味,杵为散,酒服方寸匕,日三服。
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寸口脉弦而大,弦则为减,大则为芤,减则为寒,芤则为虚,寒虚相搏,此名曰革,
妇人则半产漏下,旋覆花汤主之。
【按】
此条详在『伤寒论·辨脉法篇』,错简在此。「旋覆花汤主之」一句,亦必是错简。
半产漏下,则气已下陷,焉有再用旋覆下气之理。
Fuzhi Radix (Wuzhuyu) 3 liang, Danggui (Angelicae Sinensis Radix), Xiongqiong (Chuanxiong Rhizoma), and Shaoyao (Paeoniae Radix) each 2 liang, Renshen (Ginseng Radix), Guizhi (Cinnamomi Ramulus), Mudanpi (Moutan Cortex), Ejiao (Colla Corii Asini), and Shengjiang (Zingiberis Rhizoma Recens) each 2 liang, Gancao (Glycyrrhizae Radix et Rhizoma) 2 liang, Banxia (Pinelliae Rhizoma) half sheng, Maidong (Ophiopogonis Radix) (decored of heart) 1 sheng.
The above twelve ingredients are decocted in one dou of water until three sheng remain, divided into three warm doses. This formula also treats cold in the lower abdomen of women, long-term infertility, as well as metrorrhagia and metrostaxis (abnormal uterine bleeding), excessive menstrual flow, or amenorrhea when the period is due.
[Collected Explanations]
Li [Name] said: The *Neijing* states that those with deficiency of blood and qi prefer warmth and dislike cold; cold causes stagnation and sluggishness without flow, while warmth dissipates and removes it. This decoction is named "Wen Jing" (Warming the Channels) because blood stasis moves upon receiving warmth. All herbs in this formula nourish and tonify blood and qi; they do not primarily aim to purge blood stasis, yet the stasis naturally resolves. This is the method of supporting righteous qi so that pathogenic factors eliminate themselves. Therefore, it treats women's conditions such as metrorrhagia, infertility, and irregular menstruation.
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For leukorrhea accompanied by dysmenorrhea or irregular menstruation, fullness and pain in the lower abdomen, and menstruation occurring twice a month [Note: Textual criticism suggests "bu" (not) instead of "zai" (again)], Tugua Gen San (Trichosanthes Root Powder) is indicated.
[Commentary]
The character "zai" (again/twice) should likely be "bu" (not). If it were "zai," implying menstruation occurs twice a month, it would contradict the preceding description of "unfavorable" (irregular/sluggish) menstruation. This is a transcription error.
[Annotation]
This refers to a condition of slight pathology in the lower jiao with irregular menstrual cycles. Leukorrhea originates from the uterus (bao gong); if residual blood stasis exists in the uterus and transforms via the qi level, often due to cold, it results in white leukorrhea; if it transforms via the blood level, often due to heat, it results in red leukorrhea; if it transforms through a mixture of cold and heat in both qi and blood, it results in mixed-color leukorrhea. If accompanied by irregular menstruation and lower abdominal fullness and pain, this indicates the presence of blood stasis. For amenorrhea at the expected time, Tugua Gen San is used because Tugua Gen (Trichosanthes Radix) expels blood stasis, E chong (Mylabris) opens blood obstructions, and Guizhi combined with Shaoyao soothes yang and benefits yin, harmonizing ying (nutritive) qi. Thus, stasis is removed, blood is harmonized, menstruation becomes regular, and leukorrhea ceases.
Tugua Gen (Trichosanthes Radix), Shaoyao (Paeoniae Radix), Guizhi (Cinnamomi Ramulus), and E chong (Mylabris) each 3 qian.
The above four ingredients are pounded into a powder. Take one fang cun bi (a square-inch measure) with wine, three times daily.
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The pulse at the cunkou position is wiry (Xian) and large (Da). Wiry indicates reduction (Jian), large indicates hollow (Kou). Reduction implies cold, and hollow implies deficiency. Cold and deficiency intertwining is termed Ge (Reed-like) pulse. In women, this presents as miscarriage followed by continuous dripping bleeding (Lou Xia), treated with Xuanfu Hua Tang (Inula Flower Decoction).
[Commentary]
This passage is detailed in the *Shanghan Lun · Bian Mai Fa Pian* (Chapter on Differentiating Pulse Methods), and its placement here is due to bamboo slip disorder (cuo jian). The phrase "treated with Xuanfu Hua Tang" is also certainly a misplaced text. After a miscarriage with continuous bleeding, the qi has already sunk; therefore, it makes no sense to use Xuanfu Hua (Inulae Flos), which directs qi downward.