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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: White discharge belongs to Qi disorders, while red discharge belongs to Blood disorders. This distinction is merely between Qi and Blood, and does not differentiate between Cold and Heat patterns. It is often claimed that all treatments for this condition address Damp-Heat. Is this true? Currently, practitioners treating leukorrhea (white vaginal discharge) often use bitter-cold herbs such as Scutellariae Radix (Huangqin, 黄芩) and Coptidis Rhizoma (Huanglian, 黄连) without distinguishing between Cold and Heat patterns; this is a biased view. Women's diseases are predominantly Cold rather than Heat. Therefore, Yangrong Tang (Nourishing the Vigor Decoction) is effective for treating leukorrhea because it contains Cinnamomi Ramulus (Guizhi, 桂枝). Taking Ai Jian Wan (Mugwort Decoction Pills) for one or two courses can also cure it, following the same principle. The key lies in carefully examining the nature of the discharge during clinical practice. As for red discharge, it is a Heat pattern; hot-natured medicines should not be taken, and Neibu Ai Jian Wan (Internal Nourishing Mugwort Decoction Pills) is contraindicated. Instead, Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) added with Scutellariae Radix and Coptidis Rhizoma is suitable. Cyperi Rhizoma (Xiangfu, 香附) is indispensable and is considered a sacred medicine in gynecology. Zhang Jingyue discussed Bingli (metrorrhagia and leukorrhea) extensively, which has been recorded under the section on Metrorrhagia. He stated that the most appropriate treatment for this disease is to regulate Qi and Blood and clear internal Heat. Additionally, Xuelin (blood strangury) refers to menstruation occurring every thirty-five days, continuing for several months before stopping. If accompanied by abdominal pain, Siwu Tang (Four Substances Decoction) should be used; if there is likely blood stasis, bleeding should not be stopped abruptly. If there is heavy bleeding without pain and good appetite, Bayi Tang (Eight Ingredients Decoction) added with Scutellariae Radix and Coptidis Rhizoma is indicated. If food intake is reduced, Neibu Tang (Internal Nourishing Decoction) with Ginseng removed may be used. Alternatively, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Phellodendri Cortex (Huangbai, 黄柏) can be applied. When treating blood strangury, one must examine whether there is lower abdominal pain and whether the Spleen and Stomach are Excess or Deficient. If there is no lower abdominal pain and the Spleen/Stomach are Excess, Bayi Tang added with Scutellariae Radix and Coptidis Rhizoma can be used. If the Spleen/Stomach are Deficient, this formula is contraindicated; instead, Bugong Tang (Nourish the Uterus Decoction) is suitable. Generally, treating strangury focuses primarily on regulating the Spleen.

Yangrong Tang (see "Baiyin") | Siwu Tang (see "Xuefeng") | Bayi Tang (see "Jingshui Guoqi")
Buzhong Yiqi Tang
Astragali Radix (Huangqi, 黄芪) | Atractodis Rhizoma (Baizhu, 白术) | Ginseng Radix et Rhizoma (Renshen, 人参) | Citri Reticulatae Pericarpium (Chenpi, 陈皮) | Angelicae Sinensis Radix (Guishen, 归身) | Cimicifugae Rhizoma (Shengma, 升麻) | Bupleuri Radix (Chaihu, 柴胡) | Glycyrrhizae Radix et Rhizoma (Gancao, 甘草)

Leukorrhea in women originates from the Dai Mai (Girdle Vessel) around the waist, hence the name. Although it presents in red and white colors, it ultimately belongs to Kidney Deficiency. Its presentation is similar to strangury, but the discharge from strangury is mostly scattered and thin, with a fishy and foul odor. In contrast, leukorrhea discharge is slippery, thick, and sticky, without a fishy or foul odor; this serves as the point of differentiation. *Baoming Ji* states: Red discharge indicates Heat entering the Small Intestine, while white discharge indicates Heat entering the Large Intestine. Tracing the root cause, both result from Damp-Heat binding in the vessels. Thus, body fluids overflow, causing red and white leukorrhea. This is not originally caused by pathogenic accumulation, but rather by deficiency in the five vessel systems leading to constrained Heat stagnating in the Dai Mai, resulting in pain below the umbilicus and continuous discharge from the vagina. The *Neijing* states: Disease of the Ren Mai (Conception Vessel) causes seven types of hernias in men and leukorrhea and masses in women. Wang Bing’s commentary notes: The Ren Mai passes upward from the uterus, and the Dai Mai crosses above the umbilicus; thus, men develop internal hernias, while women suffer from leukorrhea and metrorrhagia. The Dai Mai originates at the costal margin and Zhangmen (LR13), resembling a belt. Now, due to unresolved Damp-Heat binding, disease arises. The classics state: When Spleen disease transmits to the Kidney, it is called Hernia and Mass. Pain in the Small Intestine with binding discharging white fluid is called Gu; this explains the binding nature of leukorrhea. "Yu" means constraint; constrained stagnation leads to unresolving Heat. First, administer Shizao Tang (Ten Jujube Decoction) to purge, then take Kunlian Wan (Toosendan Fruit Pill), followed by Dahuansu San (Major Corydalis Powder) to regulate. Once Heat is cleared and Dampness removed, the disease will heal naturally. Zhao Ren'an asked about using lifting methods; adding Erchen Tang (Two Aged Things Decoction) with Atractodis Rhizoma and Atractylodis Rhizoma Macrocephalae (Cangzhu, 苍术) to strengthen the Spleen and dry Dampness is another method. Regarding women with dripping red and white discharge losing several sheng of blood daily, a rapid pulse indicates death, while a slow pulse indicates survival. If red and white discharge continues, a small, deficient, and slippery pulse indicates survival, whereas a large, tight, full, and rapid pulse indicates death. Luo Xiansheng’s use of Shizao Tang, Shenyuan Wan (Divine Protection Pill), Yuzhu San (Jade Candle Powder), etc., should not be used aggressively in Deficient cases, nor indiscriminately in Excess cases. For Blood Deficiency, use Modified Siwu Tang; for Qi Deficiency, tonify with Ginseng, Atractodis Rhizoma, and Citri Reticulatae Pericarpium; for severe cases, use Guchang Wan (Intestine-Stabilizing Pill). For hyperactive Ministerial Fire, add Phellodendri Cortex; for slipping/looseness, add Ostreae Concha (Longgu, 龙骨) and Halloysit Rubrum (Chishizhi, 赤石脂); for stagnation, add Hibisci Rosa-Sinensis Flos (Kuihua, 葵花); for dryness, add Coptidis Rhizoma; in winter, slightly add Cinnamomi Cortex (Guirou, 肉桂) and Aconiti Lateralis Radix Praeparata (Fuzi, 附子). Clinical flexibility is essential. Zhu Danxi treated red and white leukorrhea using the same method as treating nocturnal emission. Obese women with leukorrhea usually have Damp-Phlegm; use Haishi Erchen Tang (Aragonite Two Aged Things Decoction) added with Pinelliae Rhizoma (Nanxing, 南星), Phellodendri Cortex, Indigo Naturalis (Qingdai, 青黛), and Chuanxiong Rhizome. Thin women with leukorrhea usually have Depressive Heat; use Cyperi Rhizoma, Amomi Fructus Rotundus (Sharen, 砂仁), Phellodendri Cortex, and Indigo Naturalis. If leukorrhea is caused by accumulated Phlegm, use Xiaowei Dan (Small Stomach Pill); take a few pills with saliva when half-hungry, and once the accumulation moves, switch to tonic formulas for regulation.

Kunlian Wan (Toosendan Fruit Pill)
Toosendan Fructus (Kualianzi, 苦楝子) (crushed and soaked in wine) | Illicii Fructus Recursatus (Huixiang, 茴香) (stir-fried) | Angelicae Sinensis Radix
Grind into powder, make pills with wine paste. Take 30 pills per dose with wine on an empty stomach. For lower back pain, take with Siwu Qianghuo Fangfeng Tang (Four Substances, Notopterygium and Saposhnikovia Decoction).

Shizao Tang (Ten Jujube Decoction)
Genkwa Flos (Yanhua, 芫花) (stir-fried until black) | Kansui Radix (Gansui, 甘遂) | Oldenlandiae Radix (Daji, 大戟) (equal parts)
Add ten large jujubes (Zaoren, 大枣).

Xiaowei Dan (Small Stomach Pill)
Genkwa Flos (steeped in vinegar overnight, stir-fried black in earthenware, do not burn) | Kansui Radix (soaked in water for half a month, boiled and dried) | Prepared Rheum Palmatum Radix et Rhizoma (Zhida Huang, 制大黄) (each 1.5 liang) | Oldenlandiae Radix (boiled for one hour, washed and dried, 5 qian) | Phellodendri Cortex (stir-fried, 3 liang)
Grind into powder, make pills with Atractodis Rhizoma paste, size of radish seeds. Swallow with saliva before bed.

Shenyuan Wan (Divine Protection Pill)
Kansui Radix | Genkwa Flos | Oldenlandiae Radix (each 1 liang, stir-fried with vinegar) | Rheum Palmatum Radix et Rhizoma | Bunium Ternatum Semen (Baichou, 白丑) | Tangerine Peel (Qingpi, 青皮) | Tangerine Peel (Chenpi, 陈皮) | Costus Root (Muxiang, 木香) | Areca Seed (Binglang, 槟榔) (each 5 qian) | Calomelas (Qingfen, 轻粉) (1 qian)
Make pills using water method.

Blood Distension in Women
The syndrome of Blood Distension in women, although sometimes caused by Qi and Food retention, is mostly caused by Blood issues. If caused by Qi and Food, the abdomen is distended but menstruation does not stop. If caused by Blood, menstruation must cease. Women typically have abundant Blood, so monthly menstruation is not pathological. However, if blocked and unflowing, it accumulates day by day. Initially, the lower abdomen distends; later, it extends upward to the Zhongwan area, becoming tight and drum-like, with visible blue veins, forming the Blood Distension syndrome. Some cases arise from postpartum lochia failing to descend, reversing upward, infiltrating the skin and muscles, filling the middle jiao, and even rising to the face, causing a flushed complexion; this is a fatal syndrome.