《妇人良方》曰∶妇人带下,其名有五,因经行产后,风邪入胞门,传于脏腑而致之。若伤足厥阴肝经,
色如青泥。伤手少阴心经,色如红津。伤手太阴肺经,形如白涕。伤足厥阴脾经,黄如烂瓜。伤足少阴肾经,
黑如 血。人有带脉,横于腰间,如束带之状,病生于此,故名为带。
《金匮要略》曰∶妇人中风七八日,续来寒热,发作有时,经水适断,此为热入血室,其血必结,故使如
疟状,发作有时,小柴胡汤主之。
徐注曰∶妇人热入血室有四,热入血室必谵语,此则不谵语,但如疟状,谓伤寒男女皆有之,而妇人有独
异,故首曰妇人中风,即伤寒中所主桂枝汤之风证也。七八日,则表邪已解,复有寒热,故曰续来。然不长热,
故曰有时,问其经水,则已来而适断,明是余热未尽,乘虚入之,则余血必结,故寒热有时。然非太阳传入少
阳此,因结血之热致有此病,故曰使如症状。虽非传入少阳,而药仍用小柴胡者,盖血室之气,肝主之,肝
与胆为表里,胆因肝受邪,而病如疟。非他药所宜,故主和表里,谓上焦之气和,而骤结之血将自行也。若峻
攻之如抵当汤证,则犯少阳之禁矣。
按∶以上一条,是言经行未尽而适断,虽有结血,未为全实,小柴胡加当归、丹皮、生地以凉之。
The *Furen Liangfang* (Good Prescriptions for Women) states: There are five types of leukorrhea in women, caused by wind-pathogen invading the uterine gate during menstruation or postpartum, and transmitting to the zang-fu organs. If the Foot-Jueyin Liver Meridian is injured, the discharge resembles green mud. If the Hand-Shaoyin Heart Meridian is injured, the discharge resembles red fluid. If the Hand-Taiyin Lung Meridian is injured, the discharge resembles white nasal mucus. If the Foot-Taiyin Spleen Meridian [Note: Original text erroneously says Foot-Jueyin] is injured, the discharge is yellow like rotting melon. If the Foot-Shaoyin Kidney Meridian is injured, the discharge is black like clotted blood. The human body possesses a Dai Mai (Belt Vessel), which crosses horizontally at the waist, resembling a sash. Since diseases arise here, it is named Dai Xia (Leukorrhea).
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: In women suffering from Wind-Cold for seven to eight days, if chills and fever continue to occur intermittently with regular timing, and the menstrual flow happens to stop abruptly, this is termed Re Ru Xue Shi (Heat Entering the Blood Chamber). The blood must be congealed, causing symptoms resembling malaria with intermittent onset. Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be administered as the primary treatment.
Xu Zhongke annotates: There are four variations of Heat Entering the Blood Chamber in women. Typically, Heat Entering the Blood Chamber presents with delirium, but this case lacks delirium, presenting only with malaria-like symptoms. This indicates that while Shang Han (Cold Damage) affects both men and women, women have unique pathophysiology. Thus, it begins with "Woman suffering from Wind," referring to the Wind-pattern treated by Guizhi Tang (Cinnamon Twig Decoction) in Shang Han texts. By the seventh or eighth day, the exterior pathogen has resolved, yet chills and fever recur, hence described as "continuing to appear." However, the fever does not persist continuously, hence "intermittent." Inquiry reveals the menses had started but stopped abruptly, indicating residual heat remaining and invading due to deficiency, causing residual blood to congeal, thus resulting in intermittent chills and fever. This is not a transmission from Taiyang (Greater Yang) to Shaoyang (Lesser Yang); rather, the heat generated by congealed blood causes these symptoms, hence resembling malaria. Although the pathogen did not transmit to Shaoyang, Xiao Chai Hu Tang is still used because the Qi of the Blood Chamber is governed by the Liver, and the Liver and Gallbladder are interior-exterior partners. The Gallbladder is affected by the Liver's invasion, manifesting as malaria-like symptoms. Other medications are unsuitable; therefore, the method advocates harmonizing the interior and exterior. When the Qi of the Upper Jiao harmonizes, the suddenly congealed blood will dissipate on its own. Using harsh purgatives, as indicated for Didang Tang (Ephedra and Madder Decoction), would violate the contraindications for Shaoyang disease.
Commentary: The above passage discusses cases where menstruation ends abruptly before completion. Although there is blood congealing, it is not a full excess pattern. Xiao Chai Hu Tang should be modified with Dang Gui (Angelica Sinensis Root), Dan Pi (Moutan Cortex), and Sheng Di Huang (Rehmannia Root) to cool the blood.