Library

Wang Shishan stated: Leukorrhea presents with discharge that is either red or white, and the pathology involves differences in Qi and Blood. Its symptoms resemble dysentery (Li Ji), but it stems entirely from the deficiency and collapse of Middle Qi, leading to abnormal transport and transformation. This causes damp-heat to stagnate in the Lower Jiao, specifically within the distribution area of the Dai Mai (Girdle Vessel), where fluids渗流 (seep and flow) downward, hence the name "Leukorrhea" (Dai Xia). Treatment should primarily focus on clearing dampness; one must avoid rich and greasy foods to prevent aggravating damp-heat. Therefore, Zhu Danxi discussed red and white leukorrhea as resulting from internal injury by the Seven Emotions, which exhausts the Lower Yuan (Kidney and Mingmen), causing damp-heat and phlegm accumulation to flow downward due to deficiency. Wang Shuhe stated that prolonged bleeding from metrorrhagia can transform into white leukorrhea. "Prolonged bleeding" implies the exhaustion of the Lower Yuan. Regarding treatment methods: Luo Taiwu suggested that Shizao Tang (Ten Date Decoction), Shenyou Wan (Divine Protection Pill), and Yuzhu San (Jade Candle Powder) are all applicable. However, for patients who are weak, harsh purgatives should not be used. Zhu Danxi’s use of the lifting method is truly a profound insight.

Shen Zhai commented: The above six items describe leukorrhea caused by damp-heat. Since the *Taiping Shenghui Fang* and Yuan dynasty formulas, the prevailing view attributed leukorrhea to wind-cold pathogens. Zhang Zihe refuted this, asserting it is caused by stagnant damp-heat, not wind-cold. Consequently, Liu Hejian and Li Jiegou both based their theories on damp-heat. However, damp-heat pathology may stem from deficiency in the Ren Mai (Conception Vessel), heat invading the Taiyang (Greater Yang) channel, turbid Qi in the Middle Jiao, or stagnation in the Lower Jiao. In all cases, damp-heat descends, but the specific meridians involved differ. Overall, Zhang Zihe’s examination of the etiology regarding the Dai Mai (Girdle Vessel) is the most detailed and accurate.

Zhang Zhongjing said: A woman aged fifty suffers from diarrhea for dozens of days without cessation, experiences fever in the evening, urgency and tightness in the lower abdomen, abdominal fullness, vexatious heat in the palms, and dryness of the lips and mouth. What is the diagnosis? The Master replied: This disease belongs to the category of leukorrhea. Why? Because she has a history of miscarriage, and blood stasis remains in the lower abdomen. How do we know this? The symptom of dry lips and mouth indicates this condition. It should be treated primarily with Wen Jing Tang (Warm the Menses Decoction).

Wang Shuhe stated: In women with leukorrhea, if there is pus in the intestines, it is due to the conflict between Ying (Nutrient) and Wei (Defensive) Qi, where blood transforms into foul turbidity. There are distinctions between cases suitable for purgation and those that are not.

The commentary in *Zhunsheng* (Standard of Medical Science) states: In leukorrhea, foul pus may drip continuously with an extremely fishy and foul odor, leading to cold pain in the umbilical and abdominal regions. This is likely caused by foul pus. One may use Bai Zhi (Angelicae Dahuricae Radix) 1 liang, Dan Ye Hong Shu Kui Gen (Hibisci Malvae Root) 2 liang, Bai Shao Yao (Paeoniae Radix Alba) and Bai Fan (Alumen) each 5 qian. Grind into powder, make pills with wax, and administer with rice water. Once the pus is exhausted, follow up with tonic herbs to support recovery.