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Zhu Danxi stated: Red discharge belongs to the blood level, while white discharge belongs to the qi level or phlegm-dampness. All such cases are due to phlegm accumulation in the Stomach flowing downward and infiltrating the Bladder. Treatment should employ lifting and raising methods, yet few are aware of this principle. Obese individuals mostly suffer from damp-phlegm; thin individuals rarely suffer from leukorrhea, but if they do, it is mostly hot-phlegm. Treatment may use Pinelliae Rhizoma (Banxia), Aconiti Lateralis Preparata Radix (Tianxing), Atractylodis Rhizoma (Cangzhu), Spongia (Haishi), Phellodendri Cortex (Huangbai) stir-fried, Indigo Naturalis (Qingdai), Chuanxiong Rhizome (Chuanxiong), and Toona Bark (Chunpishu).

*Ji Yin Gang Mu* commentary: Xue Lizhai said, one must not rigidly adhere to the notion that "obese people have much phlegm, thin people have much fire," and lightly apply drying-dampness or purging-fire methods. The theory of "phlegm in obesity, fire in emaciation" is Zhu Danxi's general key to recognizing diseases; it does not teach one to stick blindly to a single formula. Although treatment should not be casual, fire and dampness ultimately cannot escape detection. If one considers this a prudent statement and thus dares not treat lightly, then could Jiegu's Shizao Tang (Ten Date Decoction), Hezi's vomiting and purging methods, Taiwu's Shenyou Wan (Divine Protection Pill), Yuzhu San (Jade Candle Powder), and Xiaowei Dan (Small Stomach Pill) be used casually?

Shenzhai noted: The above three sections discuss leukorrhea caused by blood stasis, putrid pus, and damp-phlegm. Leukorrhea can be caused by wind-cold or damp-heat, which are excess conditions from external pathogens. Leukorrhea caused by blood stasis, putrid pus, or damp-phlegm are excess conditions from internal injury. The pathogenesis varies and must be carefully examined.

Li Dongyuan said: There is a case of white leukorrhea that constantly leaks and has not stopped despite long-term medication. Pulse diagnosis revealed a faint pulse at the Chi position of the Pericardium channel, indicating continuous downward leakage. Wang Shuhe stated: Prolonged metrorrhagia transforms into leukorrhea; frequent leakage leads to bone marrow exhaustion. Metrorrhagia initially involves bloody flooding; over time, blood becomes deficient, leading to the loss of Yang Qi. Consequently, white slippery substances flow down continuously. This occurs because the Blood Sea is nearly exhausted, and body fluids are further depleted, causing dryness that fails to nourish the sinews and bones. Treatment should use herbs that guide action along the relevant meridian as guides, employing pungent-sweet and greasy herbs to moisten dryness and nourish essence. Pungent-hot herbs should be used to tonify the Yang pathway and generate blood vessels. Bitter-cold herbs should be used to purge Lung heat and rescue upper jiao heat. For Qi deficiency, Ginseng Radix et Rhizoma (Renshen) is used for tonification, assisted by bitter-warm herbs, named Bu Jing Gu Zhen Tang (Tonify Meridian and Secure True Decoction).

Miao Zhongchun said: Women often suffer from worry, thought, depression, and anger, damaging the Heart and Spleen. Lung Fire flares up intermittently, causing blood to wander and fail to return to its vessels, leading to frequent red and white leukorrhea. White leukorrhea is mostly due to Spleen deficiency. Liver Qi stagnation injures the Spleen; Spleen injury causes Damp-Earth Qi to sink, resulting in the failure of Spleen Essence to guard itself and transform into Ying-Blood, instead leaking down as white slippery substances. This is caused by Liver Wood stagnating within the Earth (Spleen). The method should involve lifting Liver Qi and assisting Spleen Yuan. Generally, since white leukorrhea often belongs to Qi deficiency, strengthening the Spleen and tonifying Qi is the essential method. If leukorrhea resembles rice water with a fishy, foul odor, it indicates excessive damp-heat. In cases of Spleen-Stomach Qi deficiency failing to control water, leading to sinking damp-phlegm, Atractylodis Rhizoma (Baizhu/Cangzhu), Poria (Fuling), Scutellariae Radix (Huangqin), Phellodendri Cortex (Huangbai), and Plantaginis Semen (Cheqianzi) should be the main herbs, assisted by lifting agents. If leukorrhea resembles egg white, it indicates extreme Spleen-Kidney deficiency. The complexion will likely lack luster, legs and shins will swell, and lower back and legs will ache. Wuweizi (Schisandrae Fructus) and Jiwei Wan (Eight Ingredient Pill) should be used, interspersed with formulas that open the Spleen and nourish the Heart, such as Guipi Tang (Restore the Spleen Decoction). For Yin deficiency with fire, Liuwei Wan (Six Ingredient Pill) should be used, including Tusisi (Cuscutae Semen), Wuweizi, Cheqianzi, and Huangbai. Wang Shuhe stated: Prolonged metrorrhagia transforms into leukorrhea; frequent leakage leads to bone marrow exhaustion. This means that after prolonged bleeding, Qi and Blood are depleted, and white slippery substances leak continuously. Although this condition has distinctions regarding Qi/Blood and Cold/Heat, it fundamentally belongs to Qi deficiency with sinking.