张子和曰∶带脉起少腹侧，季胁之端，环身一周，如束带之于身。与冲、督、任三脉，同起而异行，一原
而三歧，皆络带脉。冲、督、任三脉，皆统于篡户，循阴器。冲、督、任三脉以带脉束之，因余经上下往来，
遗热于带脉之间。热者血也，血积多日不流，火则从金之化，金则从革而为白，乘少腹间冤热，白物滑溢，
随溲而下，绵绵不绝，多不痛也。或有痛者，则壅碍，因壅而成痛也。《内经》∶少腹冤热，溲出白液。冤
者，屈滞也。病非本经，为他经冤抑而成此疾也。
朱丹溪曰∶带下，赤属血，白属气。主治湿痰为先。漏与带俱是胃中痰积流下，渗入膀胱，无人知此。
只宜升提。甚者上必用吐法，以提其气。下用二陈汤加苍白术，仍用丸子。
又云∶赤白带下皆属血，出于大肠小肠之分，肥人多是湿痰，海石、半、星、苍术、柏、川芎、椿皮、青
黛。瘦人白带少，多是热，以炒柏、滑石、椿皮、川芎、海石、蛤粉。罗先生法∶或十枣汤，或伸佑丸，或玉
烛散，皆可服。但实者可行，虚者不可峻攻。血虚者加减四物。气虚者，参、术、陈皮，间服之。湿胜者，
用固肠丸。相火动者，于诸药中少加黄柏、滑石。滑者加龙骨、赤石脂。滞者加葵花。性躁者加黄连。痰
气带下者，苍术、香附、滑石、蛤粉、半夏、茯苓，丸服。寒月少加干姜。临机应变。必须断浓味。
薛立斋曰∶赤白带下，徐用诚先生云∶前证白属气而赤属血，东垣先生云∶血崩久则亡阳。故白滑之
物下流，未必
全拘于带脉，亦有湿痰流注下焦，或肾肝阴淫之湿胜，或因惊恐而木乘土位，浊液下流，或思慕为筋痿。戴人
以六脉滑大有力，用宣导之法，此泻其实也。东垣以脉微细沉紧，或洪大而虚，用补阳调经，乃兼责其虚也。
丹溪用海石、南星、椿根皮之类，乃治其湿痰也。窃谓前证皆当壮脾胃、升阳气为主，佐以各经见证之药。色
青者属肝，小柴胡加山栀、防风。湿热壅滞，小便赤涩，用龙胆泻肝汤。肝血不足，或燥热风热，用六味丸。
色赤者属心，用小柴胡加黄连、山栀、当归。思虑过伤，用妙香散等药。色白者属肺，用补中盖气加山栀。色
黄者属脾，用六君子加山栀、柴胡；不应，用归脾汤。色黑者属肾，用六味丸。气血俱虚，八珍汤。阳气下陷，
补中益气汤。湿痰下注，前汤加茯苓、半夏、苍术、黄柏。气虚痰饮下注，四七汤送六味丸。不可拘肥人多痰，
瘦人多火，而以燥湿泻火之药轻治之也。
薛立斋医案
一孀妇，腹胀胁痛，内热晡热，月经不调，肢体酸麻，不时吐痰。或用清气化痰，喉间不利，带下青黄，
腹胁膨胀；用行气之剂，胸膈，不利，肢体时麻。此郁怒伤损肝脾，前药益甚也。朝用归脾汤，以解脾郁、生
脾气；夕用加味逍遥散，以生肝血、清肝火。兼服百剂而安。
一妇人，疟久，兼之带下，发后口干倦甚。余用七味白术
散加麦冬、五味，作大剂，煎与恣饮，再发稍可，乃用补中益气加茯苓，半夏，十余剂而愈。
一妇人，吞酸胸满，食少便泄，月经不调，服法制清气化痰丸，两膝渐肿，寒热往来，带下黄白，而青体
倦。余以为脾胃虚，湿热下注，用补中益气，倍用参、术，加茯苓、半夏、炮姜而愈。若因怒，发热少食，或
两腿赤肿，或指缝常
湿，用六君加柴胡、升麻，及补中益气汤。
一妇人，年逾六十，带下者白，因怒胸膈不利，饮食少思，服消导利气之药，反痰喘胸满，大便下血。
余曰∶此脾虚亏损，不能摄血归原也。用补中益气汤加茯苓、半夏、炮姜四剂，诸症顿愈，又用八珍汤加柴
胡、山栀而安。
Zi Hezi stated: The Dai Mai (Belt Vessel) originates from the sides of the lower abdomen, at the end of the costal margin, encircling the body once like a belt binding the body. It shares the same origin but follows different pathways with the Chong Mai (Penetrating Vessel), Du Mai (Governing Vessel), and Ren Mai (Conception Vessel); one source branches into three, all connecting to the Dai Mai. The Chong, Du, and Ren vessels are all governed by the Cu Hu (Huiyin point), circulating along the external genitalia. The Chong, Du, and Ren vessels are bound by the Dai Mai; because other meridians circulate up and down, they leave residual heat in the area of the Dai Mai. Heat is blood; when blood accumulates for many days without flowing, fire transforms according to the nature of Metal (Jin), and Metal changes to become white. Riding on the "wronged" (stagnant) heat in the lower abdomen, white substances slide and overflow, discharging with urine, continuously without cessation, mostly without pain. If there is pain, it is due to obstruction and blockage, causing pain through stagnation. The *Neijing* states: "Wronged heat in the lower abdomen causes white fluid to discharge from the urethra." "Yuan" (wronged) means屈曲 (bent/stagnant). This disease does not originate from the primary meridian but is formed by the oppression of other meridians.
Zhu Danxi stated: In leukorrhea, red indicates blood involvement, and white indicates Qi involvement. The primary treatment should focus on resolving damp-phlegm. Both metrorrhagia and leukorrhea result from phlegm accumulation in the Stomach flowing downward and seeping into the Bladder, a fact unknown to many. Only lifting methods should be used. For severe cases, emesis must be used on the upper side to lift the Qi, while on the lower side, Er Chen Tang (Two-Cured Decoction) combined with Cang Zhu (Atractylodis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) should be used, preferably prepared as pills.
He further stated: Red and white leukorrhea both belong to blood disorders, originating from the boundaries of the Large Intestine and Small Intestine. Obese individuals mostly suffer from damp-phlegm; herbs such as Hai Shi (Aragoniae Lapis), Ban Xia (Pinelliae Rhizoma), Xing (Tian Nanxing/Arisomatis Rhizoma), Cang Zhu, Bai (Huangbai/Phellodendri Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Chun Pi (Toosendan Fructus Cortex), and Qing Dai (Indicum Folium) may be used. Thin individuals have less white leukorrhea and mostly suffer from heat; herbs such as Chao Bai (Fried Phellodendri Cortex), Hua Shi (Talcum), Chun Pi, Chuan Xiong, Hai Shi, and Ge Fen (Margarita Pulvis) may be used. Mr. Luo's method: Shizi Zao Tang (Ten Jujube Decoction), Shen You Wan (Shenyou Pill), or Yu Zhu San (Yu Zhu Powder) can all be taken. However, excess patterns can be purged, while deficiency patterns must not be harshly attacked. For blood deficiency, Si Wu Tang (Four Substance Decoction) with modifications is used. For Qi deficiency, Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu, and Chen Pi (Citri Reticulatae Pericarpium) are taken intermittently. For dampness predominance, Gu Chang Wan (Intestine-Stabilizing Pill) is used. For hyperactive ministerial fire, Huang Bai and Hua Shi are added in small amounts to the aforementioned formulas. For slippery discharge, Long Gu (Fossilia Ossis Mastodi) and Chi Shi Zhi (Halloysit Rubrum) are added. For stagnation, Kui Hua (Sunflower Flower) is added. For irritable temperaments, Huang Lian (Coptidis Rhizoma) is added. For phlegm-Qi leukorrhea, Cang Zhu, Xiang Fu (Cyperi Rhizoma), Hua Shi, Ge Fen, Ban Xia, and Fu Ling (Poria) are made into pills. In cold months, Gan Jiang (Zingiberis Rhizoma) is added in small amounts. Clinical application requires flexibility. Rich and strong-flavored foods must be avoided.
Xue Lizhai stated: Regarding red and white leukorrhea, Xu Yongcheng stated that white indicates Qi and red indicates Blood; Dongyuan stated that prolonged blood flooding leads to Yang loss. Therefore, the discharge of white slippery substances does not necessarily strictly adhere to the Dai Mai; it may also be caused by damp-phlegm flowing to the lower Jiao, or excessive dampness from Kidney and Liver Yin, or Wood overacting on Earth due to fright and panic causing turbid fluids to flow downward, or sinew flaccidity due to obsessive longing. Dai Ren treated cases with slippery, large, and forceful pulses using guiding and draining methods, which is draining excess. Dongyuan treated cases with fine, deep, tight, or large and empty pulses using warming Yang and regulating menstruation methods, addressing deficiency simultaneously. Danxi used Hai Shi, Nan Xing, and Chun Gen Pi, treating damp-phlegm. I believe all these conditions should primarily strengthen the Spleen and Stomach and raise Yang Qi, supplemented by herbs corresponding to the manifestations of each meridian. Green color indicates Liver involvement; Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Shan Zhi (Gardeniae Fructus) and Fang Feng (Saposhnikoviae Radix) is used. For damp-heat congestion with red and scanty urination, Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver) is used. For Liver blood deficiency or dry wind-heat, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is used. Red color indicates Heart involvement; Xiao Chai Hu Tang with Huang Lian, Shan Zhi, and Dang Gui (Angelicae Sinensis Radix) is used. For injury from excessive thinking, Miao Xiang San (Miraculous Incense Powder) is used. White color indicates Lung involvement; Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction) with Shan Zhi is used. Yellow color indicates Spleen involvement; Liu Jun Zi Tang (Six-Gentleman Decoction) with Shan Zhi and Chai Hu (Bupleuri Radix) is used; if ineffective, Gui Pi Tang (Restore the Spleen Decoction) is used. Black color indicates Kidney involvement; Liu Wei Di Huang Wan is used. For dual Qi and Blood deficiency, Ba Zhen Tang (Eight Treasure Decoction) is used. For sinking of Yang Qi, Bu Zhong Yi Qi Tang is used. For damp-phlegm pouring downward, the previous formula is added with Fu Ling, Ban Xia, Cang Zhu, and Huang Bai. For Qi deficiency with phlegm-fluid pouring downward, Si Qi Tang is used to deliver Liu Wei Di Huang Wan. One must not rigidly adhere to the notion that obese people have much phlegm and thin people have much fire, lightly treating them with drying-dampness and draining-fire herbs.
Xue Lizhai Medical Cases:
A widow suffered from abdominal distension and hypochondriac pain, internal heat and afternoon fever, irregular menstruation, soreness and numbness of the limbs, and occasional expectoration of phlegm. Someone used Qing Qi Hua Tan Wan (Clear Qi and Transform Phlegm Pill), resulting in throat discomfort, green-yellow leukorrhea, and abdominal/hypochondriac distension; switching to Qi-moving agents caused chest and diaphragm discomfort and intermittent limb numbness. This was Liver-Spleen damage from depression and anger, exacerbated by previous medications. Morning administration of Gui Pi Tang resolved Spleen depression and generated Spleen Qi; evening administration of Jia Wei Xiao Yao San (Modified Free Wanderer Powder) generated Liver Blood and cleared Liver Fire. After taking more than a hundred doses, she recovered.
A woman suffered from long-standing malaria accompanied by leukorrhea, with extreme thirst and fatigue after attacks. I used Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder) added with Mai Dong (Ophiopogonis Tuber) and Wu Wei Zi (Schisandrae Fructus), decocted in large quantities for her to drink freely. Recurrences were slightly alleviated, then Bu Zhong Yi Qi Tang added with Fu Ling and Ban Xia was used for over ten doses until cure.
A woman suffered from acid regurgitation, chest fullness, poor appetite, loose stools, and irregular menstruation. After taking Zhi Fa Qing Qi Hua Tan Wan, her knees gradually swelled, she experienced alternating chills and fever, yellow-white leukorrhea, and general fatigue. I diagnosed Spleen-Stomach deficiency with damp-heat pouring downward, using Bu Zhong Yi Qi Tang with doubled Ren Shen and Bai Zhu, added with Fu Ling, Ban Xia, and Pao Jiang (Prepared Zingiberis Rhizoma), leading to recovery. If anger causes fever and poor appetite, or red swelling of the legs, or wetness between fingers, Liu Jun Zi Tang added with Chai Hu and Sheng Ma ( Cimicifugae Rhizoma), along with Bu Zhong Yi Qi Tang, is used.
A woman over sixty years old had white leukorrhea. Due to anger, she experienced chest/diaphragm discomfort and poor appetite. Taking digestion-promoting and Qi-moving drugs led to phlegm-wheezing, chest fullness, and hematochezia. I said: This is Spleen deficiency and depletion, failing to control blood return to its source. Bu Zhong Yi Qi Tang added with Fu Ling, Ban Xia, and Pao Jiang was administered for four doses, instantly resolving all symptoms. Then Ba Zhen Tang added with Chai Hu and Shan Zhi stabilized her condition.