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Dai Fu'an stated: Both red and white leukorrhea are caused by internal injury from the seven emotions, or deficiency-cold of the lower origin; the causes are not singular. Generally, white discharge is more common, while red discharge occurs occasionally. For both, it is appropriate to use Shunqi San (Regulate Qi Powder), swallow Zhenling Dan (Sedating Spirit Pill), and assist with Aifu Wan (Mugwort and Ligusticum Pill). If leukorrhea persists and leads to emaciation, use Siwu Tang (Four Substances Decoction) added with Oyster Shell (Mu Li), and administer Guchang Wan (Intestine-Securing Pill).

Li stated: In cases of leukorrhea with deficiency-cold, where the discharge is fishy and odorous, it is due to persistent dribbling of urine, sudden profuse uterine bleeding (Bengzhong), or excessive blood loss postpartum. This results in yin depletion and yang exhaustion, failure of Ying (Nutritive) Qi to ascend, stagnation and sluggishness of the meridians, sinking of Wei (Defensive) Qi, and accumulation of essence and turbidity in the lower jiao. The resulting discharge is white, slippery like phlegm, and flows out with a fishy odor. Treat with Huangjianzhong Tang (Yellow Middle-Jiao Replenishing Decoction), removing Cinnamon Twig (Guizhi), and adding Angelica Sinensis (Danggui).

Shenzhai commented: The above six passages describe leukorrhea in women as caused by wind-cold pathogenic factors. Women's leukorrhea is not solely caused by wind-cold interference. Since *Taiping Shenghui Fang* established the theory that wind-cold invades the uterine collaterals, scholars following Chao Yuanfang held no dissenting views. However, one must recognize that pathogenic factors vary. Therefore, Zhang Hezi’s theories on damp-heat are placed subsequently, allowing for integrated treatment with damp-heat theories to avoid bias and error.

*Chanbao Baiwen* (Hundred Questions on Childbirth Treasures) stated: There are three diseases affecting unmarried girls. What are they? First, when menstruation first begins, the vagina becomes hot; if one lies exposed to wind or drinks cold beverages while cooling down, this constitutes the first disease. Second, when the Taichong Meridian is vigorous, causing internal heat, if one washes with cold water, this is the second disease. Third, if one experiences fright and terror upon seeing carbuncles, or is struck by qi of depression, anger, or sorrow, this is the third disease. If any of these three conditions are violated, leukorrhea will inevitably develop later.

Lou Quanshan stated: For unmarried girls, if they bathe in cold water immediately after menstruation stops, or expose themselves to wind when hot, this is the cause of leukorrhea in virgins. For married women, excessive sexual activity injures the uterine collaterals; wind pathogens enter through the deficiency. When the uterine collaterals are touched by cold, turbid fluid forms and mixes with blood and water to flow downward. Postpartum leukorrhea arises from excessive blood loss leading to Qi collapse and injury to the uterine collaterals. With the vaginal opening (Yumen) still unsealed, external wind attacks the deficient body; wind-cold penetrates, and cold combats with heat, forming fluid that flows downward.

Shenzhai commented: The above two passages describe leukorrhea in virgins and married women. Although the contracted pathogens differ among three types of syndromes, they all fundamentally stem from injuries caused by wind-cold exogenous pathogens.