Library

Zhu Danxi stated: For the treatment of red and white leukorrhea, Luo Xiansheng’s (Luo Tianyi) methods include the use of Shizao Tang (Ten Jujube Decoction), Shenyou Wan (Divine Protection Pill), or Yuzhu San (Jade Candle Powder), all of which are applicable. However, patients with deficiency should not undergo harsh purgation; only those with excess patterns may be treated with purgative methods.

For blood deficiency, Siwu Tang (Four Substances Decoction) should be modified accordingly; for qi deficiency, Renshen (Radix Ginseng), Baizhu (Rhizoma Atractylodis Macrocephalae), and Chenpi (Pericarpium Citri Reticulatae) should be used alternately. Red discharge pertains to the blood level, while white discharge pertains to the qi level. The primary therapeutic principle is to dry dampness first; in severe cases, Guchang Wan (Intestine-Securing Pill) is indicated. If there is hyperactivity of ministerial fire (Xianghuo, 相火), Chao Huangbai (Fried Phellodendri Cortex) should be added to the formula; if there is slipping and loss of control, Longgu (Fossilized Bones) and Chishizhi (Halloysitum Rubrum) should be added. The treatment of leukorrhea in women follows the same principles as the treatment of nocturnal emission in men.

Fang Yuezhi stated: The Dai Mai (Girdle Vessel) binds all the vessels, preventing them from acting recklessly, much like a person wearing a belt that hangs forward. Women often suffer liver injury due to depression and anger. The Liver belongs to Wood, and the Spleen belongs to Earth. When Liver pathogenic factors invade the Spleen, the Earth element is damaged, leading to the generation of dampness. Dampness generates heat, and heat promotes circulation, causing turbid substances to seep into the Bladder and exit via urination. Ancients attributed this to cold-dampness and prescribed acrid-warm herbs, which was incorrect. Danxi correctly identified it as damp-heat and prescribed bitter-cold herbs. The term "not knowing" refers to failing to distinguish that bitter-cold represents direct treatment (Zhengzhi, 正治), whereas acrid-warm represents contrary treatment (Congzhi, 从治). If damp-heat is constrained internally, causing abdominal pain and leukorrhea, can one disperse the constraint without using acrid-warm contrary treatment? If there is no lower abdominal pain and only red and white discharge occurs, even if damp-heat is present, if the qi mechanism is not constrained, treating with bitter-cold herbs is appropriate.

Liu Zongnong stated: Leukorrhea syndromes generally originate from yin deficiency and yang exhaustion, where Ying Qi (Nutritive Qi) fails to ascend, meridians become stagnant, and Wei Qi (Defensive Qi) sinks. Essence and qi accumulate in the Lower Jiao (Lower Burner) and the extraordinary vessels, condensing to form the disease. Etiologies include drunkenness and overeating, sexual fatigue, or the ingestion of drying-hot agents. Other causes involve damp-phlegm flowing into the Lower Jiao, excessive dampness from Kidney and Liver yin abundance, fright causing Liver Wood to overact on Spleen Earth leading to turbid fluid downward flow, endless rumination causing sinew atrophy, or damp-heat stagnating in the lower abdomen from other meridians descending. All these result from qi and blood deficiency and the accumulation of Ying and Wei essence and qi. Previous theories have exhaustively explained the pathogenesis, yet there is no fixed treatment method. For instance, Zhang Hezi observed that when both radial pulses were slippery, large, and forceful in leukorrhea patients, he used emesis to remove phlegm-fluid above and Daoshui Wan (Water-Guiding Pill) to drain heat and dampness below, followed by bland diuretics; this is a method of draining excess. Conversely, if pulses are fine, or deep-tight and choppy, feeling empty upon pressure, or large-slippery but weak upon pressure, this indicates insufficiency of original qi, yin deficiency with middle cold. Li Dongyuan provided formulas for tonifying yang and regulating menstruation. Danxi treated damp-phlegm sinking by using Haishi (Pumice), Nanxing (Arisaematis Rhizoma Preparatum), Banxia (Pinelliae Rhizoma), combined with lifting methods. Treatments may combine releasing with tonifying, tonifying with draining, drying with lifting, or moistening with qi-tonifying and astringing. Examples vary because pathogenesis differs in severity and depth.