妇人两 生疮，或因胎产，饮食失宜，伤损脾胃；或因忧思郁怒，亏损肝脾，以致湿热下注
；或外邪所侵。外 属足三阳可治，内 属足三阴难治。若初起发肿赤痛，属湿毒所乘，用
人参败毒或槟苏败毒散。若漫肿作痛，或不肿不痛，属脾虚湿热下注，用补中益气或八珍汤
。若脓水淋漓，体倦少食，内热口干，属脾气虚弱，用补中益气加茯苓、酒炒芍药。若午后
头目不清，属阴火，用前汤加酒炒黑黄柏。若午后发热体倦，属血虚，用前汤加川芎、熟地
。若怀抱不乐而甚，用归脾汤加山栀、柴胡。若恚怒气逆而甚，用补中益气加川芎、山栀。
若内热体倦，痰涎口疮，属脾肾虚热，用六味丸。若肢体畏寒，饮食少思，属脾肾虚寒，用
八味丸。大抵色赤属热毒易治，色黯属脾肾虚寒难治，设误用攻伐，复伤胃气，难保其生。
治验
一妇人患之，四畔微赤，作痛重坠，脓水淋漓，胸膈不利，饮食少思，内热口苦，夜间少寐
，此属脾虚郁伤。用归脾汤解郁结而生脾血，用补中益气加茯苓、半夏补脾气而除湿热，寻愈。
一妇人久不愈，色赤微热，日晡 肿，形体虚弱，饮食少思，劳则喘渴，恶寒发热，此脾虚
下陷，用补中益气汤而愈。
一妇人三年矣，色黯肿硬，恶寒发热，饮食少思，形体消瘦，作渴饮汤，饮食稍多，或腹胀
，或泄泻，或作呕，或吞酸，此脾气虚寒。用补中益气加干姜、肉桂，五十余剂而愈。
一妇人因入朝步履，恶寒发热，倦怠懒食，疮口出血，此劳伤元气，不能摄血归经，用补中
一妇人因怒，寒热头眩，或耳项胸胁胀痛，或小腹阴道闷坠，或小便频数下血，此属肝火血
热，先用小柴胡汤加炒黑山栀、川芎、当归、车前，二剂诸症顿退，又用加味逍遥散，补其
阴血而愈。后因饮食劳倦，前症复作，疮口出血，用补中益气汤治之而愈。
一妇人患将两月， 赤肿痛，小便频数，饮食如常，用活命饮二剂，诸症悉愈，又用八珍汤而痊。
一妇人患此 痛，恶寒发热，用槟苏败毒散，而寒热退，用仙方活命饮，而 痛止，再用补
中益气汤，而形气健。
The vulva of women develops sores. This may be caused by improper diet after pregnancy or childbirth, damaging the Spleen and Stomach; or by worry, thinking, depression, and anger, depleting the Liver and Spleen, leading to damp-heat pouring downward; or by invasion of external pathogens. Sores on the exterior (external genitalia) belong to the Foot Yangming and Taiyang meridians and are treatable; sores on the interior (deep vaginal area) belong to the Foot Yin meridians and are difficult to treat. If initially swollen, red, hot, and painful, it is due to damp-toxin invasion, treated with Renshen Baidu San (Ginseng Detoxification Powder) or Bingsu Baidu San (Betel Seed and Perilla Detoxification Powder). If diffusely swollen and painful, or neither swollen nor painful, it is due to Spleen deficiency with damp-heat pouring downward, treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Bazhen Tang (Eight Treasures Decoction). If pus flows continuously, the body feels fatigued, appetite is poor, there is internal heat, and dry mouth, it is due to Spleen Qi deficiency, treated with Buzhong Yiqi Tang plus Fuling (Poria), and Shaoyao (Peony Root) stir-fried with wine. If the head and eyes feel unclear in the afternoon, it is due to Yin fire, treated with the previous formula plus Huangbai (Phellodendron Bark) stir-fried with wine until blackened. If there is fever and fatigue in the afternoon, it is due to Blood deficiency, treated with the previous formula plus Chuanxiong (Sichuan Lovage Rhizome) and Shudi (Rehmannia Root Prepared with Wine). If the mood is depressed and severe, treated with Guipi Tang (Restore the Spleen Decoction) plus Zhizi (Gardenia Fruit) and Chaihu (Bupleurum Root). If anger causes Qi rebellion and is severe, treated with Buzhong Yiqi Tang plus Chuanxiong and Zhizi. If there is internal heat, fatigue, phlegm-saliva, and mouth ulcers, it is due to Spleen and Kidney deficient heat, treated with Liuwei Wan (Six-Ingredient Pill with Rehmannia). If the limbs fear cold, and appetite is reduced, it is due to Spleen and Kidney deficient cold, treated with Bawei Wan (Eight-Ingredient Pill with Rehmannia). Generally, red color indicates heat-toxin and is easy to treat; dark color indicates Spleen and Kidney deficient cold and is difficult to treat. If mistakenly using attacking/draining methods, further damaging Stomach Qi, life cannot be guaranteed.
Case Records:
A woman suffered from this condition, with slight redness around the periphery, pain with a heavy bearing-down sensation, continuous pus discharge, discomfort in the chest and diaphragm, poor appetite, internal heat, bitter taste in the mouth, and insomnia at night. This belongs to Spleen deficiency with Qi stagnation injury. Treated with Guipi Tang to resolve stagnation and generate Spleen Blood, and Buzhong Yiqi Tang plus Fuling and Banxia (Pinellia Tuber) to tonify Spleen Qi and eliminate damp-heat, eventually cured.
A woman suffered from this for a long time without cure, with slightly red color and mild heat, swelling at dusk, weak physique, poor appetite, panting and thirst upon exertion, aversion to cold and fever. This is Spleen deficiency with sinking Qi, cured with Buzhong Yiqi Tang.
A woman had suffered for three years, with dark color, swelling, and hardness, aversion to cold and fever, poor appetite, emaciation, thirst desiring hot drinks, abdominal distension after eating slightly more, diarrhea, vomiting, or acid regurgitation. This is Spleen Qi deficient cold. Treated with Buzhong Yiqi Tang plus Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark), cured after more than fifty doses.
A woman, due to walking to court, experienced aversion to cold and fever, fatigue, reluctance to eat, and bleeding from the sore. This is labor injuring Yuan Qi (Primal Qi), unable to control blood returning to the vessels... [Text cuts off here in original, implied treatment with Buzhong Yiqi Tang].
A woman, due to anger, experienced alternating chills and fever, dizziness, or distending pain in the ears, neck, chest, and hypochondrium, or stifling bearing-down sensation in the lower abdomen and vagina, or frequent urination with hematuria. This belongs to Liver Fire and Blood Heat. Initially treated with Xiaochaihu Tang (Minor Bupleurum Decoction) plus stir-fried black Zhizi, Chuanxiong, Danggui (Angelica Sinensis), and Cheqian (Plantago Seed). After two doses, all symptoms retreated significantly. Then treated with Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder) to tonify Yin and Blood, resulting in recovery. Later, due to improper diet and overwork, previous symptoms recurred with bleeding from the sore, cured with Buzhong Yiqi Tang.
A woman suffered for nearly two months, with local redness, swelling, and pain, frequent urination, but normal appetite. Treated with Xianfang Huoming Yin (Immortal Formula for Preserving Life Infusion) for two doses, all symptoms resolved, then recovered with Bazhen Tang.
A woman suffered from this carbuncle/pain, with aversion to cold and fever. Treated with Bingsu Baidu San, chills and fever subsided. Treated with Xianfang Huoming Yin, pain stopped. Finally treated with Buzhong Yiqi Tang, physique and Qi strength recovered healthily.