赵养葵曰∶女人带下之疾,带者,奇经八脉之一也,腰脐间围身一周,如束带焉。八脉俱属肾经,人身带
脉,统摄一身无形之水。下焦肾气损虚,带脉漏下,白为气虚,赤为有火,治法俱以补肾为主。白者多,赤者
少,有脾虚者,六君子加升麻;有气虚者,补中汤;肝虚者,逍遥散兼六味丸。
缪仲淳曰∶赤带多因心肝二火,时炽不已,久而阴血渐虚,中气渐损,遂下赤带,治宜养心为主,兼和肝
缓中,凉血清气。赤带久不止则血虚,宜胶艾四物汤,加便 牡蛎粉、枣仁、麦冬。
慎斋按∶以上四条,序带下属于血枯、脾虚、肾虚为病也。带证自外邪风冷湿热,内伤瘀血、湿痰,皆有余
之病。若东垣,以血海将枯,津液复亡,是原其病在血虚也。仲淳以脾精不守,元气下陷,是原其病在气虚也。
养葵更推原带脉为病,下焦肾气虚损所致,尤为探本之要。此吴梅坡以十六味保元汤、六龙固本丸,治妇人带
下证,盖有自来矣。
张子和曰∶赤白痢者,是邪热传于大肠,下广肠,出赤白也。带下者,传于小肠,入脬经,下赤白也。据
此二证,皆可同治湿之法治之。
娄全善曰∶洁古治带下,少腹冤结而痛者,先以十枣汤下之,次服苦楝丸、大延胡散,是先攻后补法也。
丹溪治结痰白带,先于半饥时,津下小胃丹十余粒,至郁积行,用白术、四物诸药补之,亦先攻后补法也。
Zhao Yangkui stated: The disease of leukorrhea in women, the term "Dai" (Belt Vessel), refers to one of the Eight Extraordinary Vessels. It encircles the waist and umbilicus once, like a belt. The Eight Extraordinary Vessels all belong to the Kidney Meridian. The Dai Vessel of the human body governs the invisible fluids of the whole body. When the Qi of the Lower Jiao (Lower Burner) is damaged and deficient, the Dai Vessel leaks; white discharge indicates Qi deficiency, while red discharge indicates the presence of Fire. The treatment method for both primarily focuses on tonifying the Kidney. If there is much white discharge and little red discharge, and it belongs to Spleen deficiency, Liu Jun Zi Tang (Six Gentlemen Decoction) with Sheng Ma (Cimicifugae Rhizoma) is used; if it belongs to Qi deficiency, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used; if it belongs to Liver deficiency, Xiao Yao San (Free and Easy Wanderer Powder) combined with Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) is used.
Miu Zhongchun stated: Red discharge is mostly caused by the excessive blazing of Heart and Liver Fire, which persists without ceasing. Over time, Yin Blood gradually becomes deficient, and Middle Qi gradually deteriorates, leading to red discharge. Treatment should prioritize nourishing the Heart, while simultaneously harmonizing the Liver, soothing the Middle Jiao, cooling the Blood, and clearing Qi. If red discharge persists for a long time, it leads to Blood deficiency, and Jiao Ai Si Wu Tang (Colla Corii Asini, Moutan and Four Substances Decoction) added with Calcitrum Pulvis (Oyster Shell Powder), Suan Zao Ren (Ziziphi Spinosae Semen), and Mai Dong (Ophiopogonis Radix) is suitable.
Shen Zhai commented: The above four items outline that leukorrhea disease arises from Blood exhaustion, Spleen deficiency, and Kidney deficiency. Leukorrhea syndromes caused by external pathogens such as Wind, Cold, Dampness, and Heat, or internal injuries such as Blood stasis and Damp-Phlegm, are all diseases of excess. If Li Dongyuan attributes the condition to the impending exhaustion of the Blood Sea and the loss of body fluids, he traces the root cause to Blood deficiency. Zhongchun attributes it to the failure of Spleen Essence to remain secure and the sinking of Yuan Qi (Original Qi), tracing the root cause to Qi deficiency. Yangkui further traces the pathology of the Dai Vessel to damage and deficiency of Kidney Qi in the Lower Jiao, which is particularly crucial for exploring the root cause. This explains why Wu Meipo uses Shi Liu Wei Bao Yuan Tang (Sixteen-Ingredient Decoction to Protect the Origin) and Liu Long Gu Ben Wan (Six Dragons Root-Firming Pill) to treat leukorrhea in women, as this approach has historical precedents.
Zi Hezi stated: Dysentery with red and white stool results from pathogenic heat transmitting to the Large Intestine, descending into the Guang Chang (Broad Intestine/Rectum), and being discharged as red and white matter. Leukorrhea results from pathogenic heat transmitting to the Small Intestine, entering the Pao Jing (Bladder Meridian/Vessel), and discharging red and white secretions. Based on these two conditions, both can be treated using methods for resolving Dampness.
Lou Quanshan stated: Jiegu treated leukorrhea accompanied by painful knotting in the lower abdomen by first administering Shi Zao Tang (Ten Date Decoction) to purge, followed by Ku Lian Wan (Toosendan Pill) and Da Yan Hu San (Major Corydalis Powder). This is a method of attacking first and tonifying later. Danxi treated leukorrhea caused by phlegm accumulation by having the patient take more than ten pills of Xiao Wei Dan (Small Stomach Pill) with saliva when half-hungry. Once the stagnation was resolved, Tonification with Bai Zhu (Atractylodis Macrocephalae Rhizoma), Si Wu Tang (Four Substances Decoction), and other herbs was used. This is also a method of attacking first and tonifying later.