脉
妇人带下，六极之病。脉浮则为肠鸣腹满，紧则为腹中痛，数
则阴中痒痛生疮，弦则阴户掣痛。凡漏下赤白不止，脉小虚滑者生，实大紧数者死。
证
带下者，荣卫滞气之所成也，经分赤白之殊，感病有深浅之异，所以男子遗精白浊，女子带下白淫。
赤属荣，白属卫，此病之常言也。皆因喜怒忧思，素有湿热，产育房劳，伤于荣卫包络，使浊气渗入膀胱，故
流秽物，或如白涕，或如红津，或黄如烂瓜，或青如泥泽，或黑如 血，皆合五脏之色也。轻则来而不来，重
则来而无度，下流不止，面色无光，使腰腿酸疼，或便血淋沥，以致饮食减常，精神短少，皆带下之所致也。
世俗皆行温补燥热涩剂，从而效者，或有因而延绵者，止知下焦白带之虚寒，凝结浊物，
故为之带下。热气熏蒸，则为腥腐之气，安独言其虚寒者乎？
治
治之当清上实下，清浊自分，理脾养血，湿热自解，更能清心薄滋味，然后温补下元，带自除矣。一
云带下是胃中痰积，流下渗入膀胱，当升之，二陈汤加苍术、白术、柴胡、升麻。甚者以吐法
以提其气，一用二陈汤加二术以燥湿痰。
方
清白散 治白带。
当归 川芎 白芍（炒） 生地（酒洗过，姜汁炒） 黄柏（盐水炒） 贝母 樗
根白皮（酒炒，各等分） 干姜（炒黑） 甘草（各减半）
上锉一剂，生姜煎服。肥人多湿痰，加白术，半夏。赤带，加酒芩、荆芥；久下、加熟地、牡蛎。气
虚，加人参、黄 。腰腿痛，加鹿角胶，或只以二陈汤加苍术、白术。气虚，加人参。
血虚，加芎、归。升膀胱之湿，二陈加升麻、柴胡、苍术、白术。
解带散 治妇人血气不调，湿热白带，四肢倦怠，五心烦热，痰郁嘈杂。
归身（一钱半） 川芎（八分） 白芍（酒炒） 白术（炒，各一钱二分） 苍术（米泔浸
炒） 香附（醋炒） 丹皮（酒洗） 茯苓（去皮，各一钱） 陈皮（去白，一钱） 玄胡（炒，
八分） 甘草（炙，四分）
上锉一剂，生姜煎，空心服。
八妙丸 治经脉不调，湿气白带，腹痛胃弱。
香附（便制） 丹皮 川芎（酒炒） 玄胡索（炒，各二两） 归身（酒洗） 生地
（姜汁炒） 白茯（各二两） 赤芍药（酒炒，两半）
上为细末，酒糊为丸，如绿豆大。每五十丸，空心滚水下，腹痛，酒下七十丸。
固经丸 治赤白带下属湿热者。
苦参（五钱） 黄柏（一两，炒） 栀子（二两，炒） 香附（一两，炒） 贝母（二钱） 白
术（七钱） 白芍（七钱半） 山茱萸（去核，五钱） 干姜（二钱，炒） 龟甲（二两，酒炒）
樗根白皮（五钱，酒炒）
上为末，酒糊为丸，如梧桐子大。每服八十丸，空心滚水送下。
玉仙散（秘方） 治赤白带下属寒者。
干姜（炒，一两） 香附（炒，一两） 白芍（炒，一两） 甘草（生，五钱）
上为末，每服三钱，空心黄酒送下。
朝元散（云林制） 治赤白带下，腹脐冷痛，子宫虚寒。
白芷 陈皮 浓朴 枳壳 桔梗 川芎 白芍 当归 茯苓
苍术 半夏 干姜 官桂 香附 吴茱萸 小茴香 甘草
上锉一剂，生姜三片，枣一枚，水煎空心服。一方加乳香、没药（各二钱半），乌药一两，酒煎入米
糖一斤，早晚随量饮酒，大效。
大温经汤 治妇人经水不调，赤白带下，或如梅汁淋沥，或成片，有隔两三个月者，此气血虚弱，渐
生潮热。饮食少进，四肢倦怠，日久生骨蒸，即成劳疾。急当调经活血，退虚热，先服加味八物汤，后服此药∶
当归（八分） 白芍（七分） 川芎（五分） 熟地（五分） 人参 白术（土炒） 茯苓
（各五分） 甘草（三分） 香附（八分，便制） 陈皮（炒） 砂仁（炒） 小茴（各四分） 沉香
（三分，另研） 吴茱萸（炮） 玄胡索（炒） 鹿茸（酒炙，各五分）
上锉一剂，生姜煎服。汗出不止，加黄 、酸枣仁（炒，各四分。）
潮热，加柴胡、黄芩（各五分）。咳嗽，加杏仁、桔梗、五味子、半夏。
四神丸（贾兰峰传） 治白带。
香附米（八两，酒、醋、童便各浸二两，浸三日，炒） 砂仁（二两，炒） 苍术（二
两，米泔水浸牡蛎粉，炒） 椿根白皮（二两，蜜水炒）
上为末，黄米煮饭为丸，如梧子大。每服五六十丸，空心黄酒送下。
二气丹（丁平溪传） 治赤白带下。
舶上硫黄（溶化倾入水中，如此七次，一两） 朱砂（一两） 官桂（一两） 干姜
（一两，炮） 大附子（面包煨去皮，五钱） 鹿茸（二两，酥炙） 麝香（一钱）
上为末，醋糊为丸，如梧桐子大。每服三十丸，空心盐汤送下。
如虚劳发热，先以四物汤四钱，小柴胡汤六钱，合和煎服，后用十全大补汤。
乌鸡丸（京师传） 治下焦虚寒，赤白带下，脐腹冷痛。
乌鸡（一只，不刀血，去毛，用醋五大碗煮热，火 存性成灰为末） 香附米（十
两，酒浸旬日，用醋煮，焙干） 乌药（二两） 净艾（二两，醋浸，炒白米饭少许，入杵
臼内捣成饼，火上炙令干） 当归（三两，醋洗） 川芎 白芍 熟地（各一两） 小茴
（三两，醋炒） 山药 牡蛎（各二两） 破故纸（醋炒，五钱） 良姜（五钱） 白姜（一两
半） 丁香（一两，不见火） 如赤白带下不止，加龙骨一两、五倍子一两半。
上为末，饭丸如梧子大。每服五十丸，空心醋汤下。
一妇人赤白带下，上热下寒，口出恶气，咽干，牙痛，耳鸣，上下流注疼痛，发热憎寒，口吐酸水，
嘈杂恶心，心腹气痛，时下五色相杂，来而无度，面黄肌瘦，不思饮食。
当归 川芎 赤芍 生地 陈皮 半夏（姜炒） 茯苓 苍术（米泔浸炒）
香附（童便浸炒） 黄芩（酒炒） 柴胡 升麻 丹皮 甘草 加地榆尤良。
上锉，生姜煎服。
Pulse Diagnosis
Leukorrhea in women belongs to the category of "Six Extremes" (six types of extreme deficiency syndromes). A floating pulse indicates intestinal murmurs and abdominal fullness; a tight pulse indicates abdominal pain; a rapid pulse indicates itching and pain in the vagina with ulceration; a wiry pulse indicates pulling pain in the vaginal orifice. In cases where red and white discharge continues without stopping, a small, deficient, and slippery pulse indicates a favorable prognosis, whereas a excess, large, tight, and rapid pulse indicates an unfavorable prognosis (death).
Syndrome Differentiation
Leukorrhea is formed by the stagnation of Ying (Nutritive) and Wei (Defensive) Qi. The classics distinguish between red and white leukorrhea, noting that the depth of pathogenic invasion varies; thus, men may experience seminal emission and turbid urine, while women experience leukorrhea.
Red corresponds to Ying, and white corresponds to Wei; this is the general principle regarding this disease. It is caused by emotional disturbances such as anger, joy, worry, and overthinking, combined with pre-existing damp-heat, or by damage to Ying, Wei, and the Chong and Ren vessels due to childbirth, nursing, or sexual fatigue. This allows turbid Qi to seep into the Bladder, resulting in the flow of foul substances. The discharge may resemble white mucus, red fluid, yellow rotting melon, green mud, or black blood, corresponding to the colors of the Five Zang organs. Mild cases come and go intermittently; severe cases are continuous and uncontrolled, leading to a lusterless complexion, soreness and pain in the lower back and legs, hematochezia or dripping urine, reduced appetite, and diminished spirit. All these are caused by leukorrhea.
Secular physicians often use warming, tonifying, drying, hot, and astringent agents. While some respond well, others suffer from prolonged illness. They only recognize that lower-jiao white leukorrhea is due to deficiency-cold condensing turbid matter, hence the name. However, heat qi steaming generates fishy and putrid odors; how can one solely attribute it to deficiency-cold?
Treatment Principles
Treatment should focus on clearing the upper Jiao and solidifying the lower Jiao, allowing clear and turbid substances to separate naturally. Regulate the Spleen and nourish Blood, so damp-heat resolves spontaneously. Furthermore, clear Heart fire and maintain a bland diet, then warm and tonify the Lower Yuan (Kidney essence), and leukorrhea will be eliminated.
Another view holds that leukorrhea is caused by phlegm accumulation in the Stomach flowing down and seeping into the Bladder. One should raise the Qi using Er Chen Tang (Two-Cured Decoction) added with Cang Zhu (Atractylodis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chai Hu (Bupleuri Radix), and Sheng Ma (Cimicifugae Rhizoma). For severe cases, induce vomiting to lift the Qi, or simply use Er Chen Tang added with Cang Zhu and Bai Zhu to dry damp-phlegm.
Formulas
Qing Bai San (Clear White Powder): Treats white leukorrhea.
Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba, stir-fried), Sheng Di Huang (Rehmanniae Radix, washed in wine, stir-fried with ginger juice), Huang Bo (Phellodendri Cortex, fried with salt water), Bei Mu (Fritillariae Bulbus), Chu Gen Bai Pi (Stemonae Radix Cortex, wine-fried, all equal parts), Gan Jiang (Zingiberis Rhizoma, charred), Gan Cao (Glycyrrhizae Radix et Rhizoma, half dose each).
Crush for one dose, decoct with fresh ginger and take orally. For obese patients with damp-phlegm, add Bai Zhu and Ban Xia. For red leukorrhea, add Jiu Qin (Scutellariae Radix fried with wine) and Jing Jie (Schizonepetae Spica). For chronic cases, add Shu Di Huang (Rehmanniae Radix Preparata) and Mu Li (Ostreae Concha). For Qi deficiency, add Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix). For lower back and leg pain, add Lu Jiao Jiao (Colla Cornus Cervi), or simply use Er Chen Tang added with Cang Zhu and Bai Zhu. For Qi deficiency, add Ren Shen. For Blood deficiency, add Chuan Xiong and Dang Gui. To lift dampness from the Bladder, use Er Chen Tang added with Sheng Ma, Chai Hu, Cang Zhu, and Bai Zhu.
Jie Dai San (Unbind Leukorrhea Powder): Treats women with irregular Qi and Blood, damp-heat white leukorrhea, limb fatigue, five-palm heat, phlegm stagnation, and gastric discomfort.
Gui Shen (Angelicae Sinensis Radix, 1.5 qian), Chuan Xiong (8 fen), Bai Shao (wine-fried), Bai Zhu (stir-fried, both 1.2 qian), Cang Zhu (soaked in rice wash water and stir-fried), Xiang Fu (Cyperi Rhizoma, vinegar-fried), Dan Pi (Moutan Cortex, wine-washed), Fu Ling (Poria, peeled, all 1 qian), Chen Pi (Citri Reticulatae Pericarpium, pith removed, 1 qian), Yan Hu Suo (Corydalis Rhizoma, stir-fried, 8 fen), Zhi Gan Cao (Licorice Root, honey-fried, 4 fen).
Crush for one dose, decoct with fresh ginger, take on an empty stomach.
Ba Miao Wan (Eight Wonders Pill): Treats menstrual irregularities, dampness-induced white leukorrhea, abdominal pain, and weak Spleen/Stomach.
Xiang Fu (processed with urine), Dan Pi, Chuan Xiong (wine-fried), Yan Hu Suo (stir-fried, all 2 liang), Gui Shen (wine-washed), Sheng Di Huang (ginger juice-fried), Bai Fu Ling (all 2 liang), Chi Shao Yao (Paeoniae Radix Rubra, wine-fried, 1.5 liang).
Grind into fine powder, make pills with wine paste, size of mung beans. Take 50 pills on an empty stomach with boiling water. If abdominal pain occurs, take 70 pills with wine.
Gu Jing Wan (Consolidate Menses Pill): Treats red and white leukorrhea due to damp-heat.
Ku Shen (Sophorae Flavescentis Radix, 5 qian), Huang Bo (1 liang, stir-fried), Zhi Zi (Gardeniae Fructus, 2 liang, stir-fried), Xiang Fu (1 liang, stir-fried), Bei Mu (2 qian), Bai Zhu (7 qian), Bai Shao (7.5 qian), Shan Zhu Yu (Corni Fructus, pitted, 5 qian), Gan Jiang (2 qian, stir-fried), Gui Jia (Testudinis et Chelonis Carapax et Plastrum, 2 liang, wine-fried), Chu Gen Bai Pi (5 qian, wine-fried).
Grind into powder, make pills with wine paste, size of paulownia seeds. Take 80 pills on an empty stomach with boiling water.
Yu Xian San (Jade Immortal Powder) (Secret Recipe): Treats cold-type red and white leukorrhea.
Gan Jiang (charred, 1 liang), Xiang Fu (stir-fried, 1 liang), Bai Shao (stir-fried, 1 liang), Gan Cao (raw, 5 qian).
Grind into powder. Take 3 qian per dose on an empty stomach with yellow wine.
Zhao Yuan San (Morning Origin Powder) (Prepared by Yun Lin): Treats red and white leukorrhea, cold pain in abdomen and umbilicus, uterine deficiency-cold.
Bai Zhi (Angelicae Dahuricae Radix), Chen Pi, Hou Po (Magnoliae Officinalis Cortex), Zhi Qiao (Aurantii Fructus), Jie Geng (Platycodonis Radix), Chuan Xiong, Bai Shao, Dang Gui, Fu Ling, Cang Zhu, Ban Xia (Pinelliae Rhizoma), Gan Jiang, Guan Gui (Cinnamomi Cortex), Xiang Fu, Wu Zhu Yu (Evodiae Fructus), Xiao Hui Xiang (Foeniculi Fructus), Gan Cao.
Crush for one dose, decoct with three slices of fresh ginger and one jujube, take on an empty stomach. Another formula adds Ru Xiang (Olibanum) and Mo Yao (Myrrha) (2.5 qian each), Wu Yao (Linderae Radix, 1 liang), decocted with wine and 1 jin of rice sugar. Drink morning and evening according to tolerance; highly effective.
Da Wen Jing Tang (Great Warming Menses Decoction): Treats menstrual irregularities, red and white leukorrhea, either dripping like plum juice or forming clumps, sometimes occurring every two to three months. This indicates Qi and Blood deficiency gradually generating tidal fever. Reduced appetite, limb fatigue, bone-steaming fever over time leads to consumptive disease. Urgently regulate menses and invigorate Blood, dispel deficiency heat. First take Jia Wei Ba Wu Tang (Modified Eight Substances Decoction), then this medicine:
Dang Gui (8 fen), Bai Shao (7 fen), Chuan Xiong (5 fen), Shu Di Huang (5 fen), Ren Shen, Bai Zhu (earth-stir-fried), Fu Ling (all 5 fen), Gan Cao (3 fen), Xiang Fu (8 fen, processed with urine), Chen Pi (stir-fried), Sha Ren (Amomi Fructus, stir-fried), Xiao Hui Xiang (all 4 fen), Chen Xiang (Aquilariae Lignum Resinatum, 3 fen, separately ground), Wu Zhu Yu (prepared), Yan Hu Suo (stir-fried), Lu Rong (Cervi Cornu Pantotrichum, wine-baked, all 5 fen).
Crush for one dose, decoct with fresh ginger. For excessive sweating, add Huang Qi and Suan Zao Ren (Ziziphi Spinosae Semen, stir-fried, both 4 fen). For tidal fever, add Chai Hu and Huang Qin (both 5 fen). For cough, add Xing Ren (Armeniacae Semen Amarum), Jie Geng, Wu Wei Zi (Schisandrae Fructus), and Ban Xia.
Si Shen Wan (Four Spirits Pill) (Transmitted by Jia Lan Feng): Treats white leukorrhea.
Xiang Fu Mi (10 liang, soaked in wine, vinegar, and child's urine (2 liang each) for three days, then stir-fried), Sha Ren (2 liang, stir-fried), Cang Zhu (2 liang, soaked in rice wash water, stir-fried with Oyster Shell powder), Chun Gen Bai Pi (Toosendan Fructus Cortex, 2 liang, stir-fried with honey water).
Grind into powder, make pills with yellow millet rice paste, size of paulownia seeds. Take 50-60 pills on an empty stomach with yellow wine.
Er Qi Dan (Two Qi Elixir) (Transmitted by Ding Ping Xi): Treats red and white leukorrhea.
Bo Shang Liu Huang (Sulfur imported from overseas, melted and poured into water, repeated seven times, 1 liang), Zhu Sha (Cinnabaris, 1 liang), Guan Gui (1 liang), Gan Jiang (1 liang, prepared), Da Fu Zi (Aconiti Lateralis Radix Preparata, baked in dough, skin removed, 5 qian), Lu Rong (2 liang, roasted with butter), She Xiang (Moschus, 1 qian).
Grind into powder, make pills with vinegar paste, size of paulownia seeds. Take 30 pills on an empty stomach with salt water.
If accompanied by deficiency-consumption fever, first decoct Si Wu Tang (Four Substances Decoction, 4 qian) and Xiao Chai Hu Tang (Minor Bupleurum Decoction, 6 qian) together and take orally, then follow with Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction).
Wu Ji Wan (Black Chicken Pill) (Transmitted from Capital): Treats lower-jiao deficiency-cold, red and white leukorrhea, cold pain in umbilicus and abdomen.
Wu Ji (One black chicken, slaughtered without cutting blood, feathers removed, boiled in five big bowls of vinegar until carbonized to ash and powdered), Xiang Fu Mi (10 liang, soaked in wine for ten days, boiled in vinegar, dried), Wu Yao (2 liang), Jing Ai Ye (Artemisiae Argyi Folium, 2 liang, soaked in vinegar, mixed with a little stir-fried white rice flour, pounded into cakes, roasted on fire until dry), Dang Gui (3 liang, washed in vinegar), Chuan Xiong, Bai Shao, Shu Di Huang (all 1 liang), Xiao Hui Xiang (3 liang, vinegar-fried), Shan Yao (Dioscoreae Rhizoma), Mu Li (all 2 liang), Po Gu Zhi (Cibotii Rhizoma, vinegar-fried, 5 qian), Liang Jiang (Alpiniae Officinarum Rhizoma, 5 qian), Bai Jiang (Zingiberis Rhizoma Recens, 1.5 liang), Ding Xiang (Caryophylli Flos, 1 liang, avoid direct fire). If red and white leukorrhea does not stop, add Long Gu (Fossilia Ossis Mastodi, 1 liang) and Wu Bei Zi (Galla Chinensis, 1.5 liang).
Grind into powder, make pills with rice paste, size of paulownia seeds. Take 50 pills on an empty stomach with vinegar water.
Case History
A woman suffered from red and white leukorrhea, upper heat and lower cold, foul breath, dry throat, toothache, tinnitus, radiating pain throughout the body, fever with aversion to cold, sour regurgitation, gastric discomfort and nausea, Qi pain in heart and abdomen, intermittent passage of five-colored mixed discharge without control, sallow complexion, emaciation, and loss of appetite.
Prescription: Dang Gui, Chuan Xiong, Chi Shao, Sheng Di Huang, Chen Pi, Ban Xia (stir-fried with ginger), Fu Ling, Cang Zhu (soaked in rice wash water and stir-fried), Xiang Fu (stir-fried with child's urine), Huang Qin (stir-fried with wine), Chai Hu, Sheng Ma, Dan Pi, Gan Cao. Adding Di Yu (Sanguisorbae Radix) is particularly beneficial.
Crush for one dose, decoct with fresh ginger and take orally.