治妇人风虚,与鬼交通,妄有所见闻,言语杂乱。
茯神(一两半) 茯苓 人参 石菖蒲(各一两) 赤小豆(半两)
上 咀,每服三大钱。水一盏,煎至六分,去滓,食前温服。
治妇人与鬼魅交通。
辰砂 槟榔 当归 桃仁(各三分) 水银(一分,枣肉研令星尽) 麝香 阿魏(面
裹煨) 沉香(各半两)
上为细末,炼蜜丸如梧桐子大。空心,桃仁汤吞下十丸。
又方∶似辟瘟丹。
虎头骨(二两) 朱砂 雄黄 雌黄 鬼臼 皂荚 芜荑仁 鬼箭 藜芦(各一两)
上件生,为末,炼蜜为丸如弹子大,囊盛一丸,男左女右系臂上。及用一丸,当病患
户前烧之,一切邪鬼不敢进。
太乙神积丹、苏合香丸皆可用也。
论曰∶古人治病,先论其所主,男子调其气,妇人调其血。血室不蓄,则二气谐和;血
室凝结,则水火相刑。伤寒气口紧盛,即宜下;人迎紧盛,即宜汗。妇女左关浮紧不可下
,当发其汗以救血室。荣卫得和,津液自通,浃然汗出而解。仲景云∶妇人伤寒,经水适断
,昼日明了,暮则谵语,如见鬼状,此为热入血室。无犯胃气及上二焦。无犯胃气者,言不
可下也,小柴胡汤主之。若行汤迟则热入胃,令津燥中焦。上焦不荣成血结胸状,须当针期
门也。五行相克以生,相扶以出。平居之日,水常养于木,水木相生,则荣养血室;血室不
蓄,则脾无蕴积;脾无蕴积,则刚燥不生。刚燥既生,若犯胃气则昼夜谵语喜忘,小腹满,
小便利,属抵挡汤证也(伤寒胃实,谵语,宜下之;妇人热入血室谵语者,不可下也)。虽
然妇人伤寒与男子治法不同,男子先调气,妇人先调血,此大略之辞耳。要知脉紧无汗名伤
寒,脉缓有汗为伤风。热病脉洪大,中暑脉细弱,其证一也。假如中 用白虎,胃实用承气,
岂必调血而后行汤邪?仲景《伤寒论》所以不分妇人者,良亦在学人皆可随病,于男子药证
中以意选用也。
若妊妇伤寒,药性须凉,慎不可行桂枝、半夏、桃仁等药。小柴胡去半夏名黄龙汤,盖
为妊妇而去也。大抵产前先安胎,产后先补益,次服伤寒药。若病稍退,则止药不可尽剂,
此为大法。
黄帝问∶妇人重身,毒之奈何?岐伯曰∶有故无殒,亦无殒也。大积大聚,其可犯,衰
其大半,过其厄。
男子、妇人伤寒,仲景治法别无异议。比见民间有妇人伤寒方书,称仲景所撰,而王叔
和为之序。以法考之,间有可取,疑非古方,特假圣人之名,以信其说于天下。今取《金匮
玉函》治妇人伤寒,与俗方中可采者列为一卷。虽不足以尽妇人伤寒之详,并可以《百问》
中参用也。
妇人伤寒,发热恶寒,四肢拘急,口燥舌干,经脉凝滞,不得往来,宜桂枝红花汤。
Treats women suffering from wind deficiency, interaction with spirits, hallucinations and delusions, and disordered speech.
Fushen (Radix Poriae Cum Radice, 1.5 liang) Fuling (Poria, 1 liang) Renshen (Radix Ginseng, 1 liang) Shichangpu (Rhizoma Acori Tatarinowii, 1 liang) Chixiaodou (Phaseoli Semen Rubrum, 0.5 liang)
The above herbs are chopped. Take three qian per dose. Add one sheng of water, decoct until six fen remains, remove the dregs, and take warm before meals.
Treats women interacting with ghosts or demons.
Chensha (Cinnabar, 3 fen) Binglang (Arecae Semen, 3 fen) Danggui (Radix Angelicae Sinensis, 3 fen) Taoren (Persicae Semen, 3 fen) Shuiyin (Hydrargyrum, 1 fen, ground with jujube flesh until no mercury particles remain) Shexiang (Moschus, 0.5 liang)awei (Ferulae Resina, 0.5 liang, baked in flour coating) Chenxiang (Aquilariae Lignum Resinatum, 0.5 liang)
Grind the above herbs into a fine powder. Mix with refined honey to form pills the size of sophora seeds. Take ten pills on an empty stomach, swallowed with Tao Ren Tang (Decoction of Persicae Semen).
Another prescription: Similar to Biwen Dan (Plague-Expelling Pill).
Hutougu (Ossis Tigridis, 2 liang) Zhusha (Cinnabar, 1 liang) Xionghuang (Realgar, 1 liang) Cihuang (Orpiment, 1 liang) Guijiu (Podophylli Rhizoma et Radix, 1 liang) Zaojiao (Gleditsiae Fructus Spinosus, 1 liang) Wuyiren (Chrysanthemi Indici Fructus, 1 liang) Guijian (Euonymi Ramulus cum Spina, 1 liang) Lilu (Veratri Rhizoma, 1 liang)
Process the above herbs raw, grind into powder, mix with refined honey to form pills the size of bullet seeds. Store one pill in a pouch and tie it to the arm; men on the left, women on the right. Additionally, burn one pill near the patient's genitalia; all evil spirits will dare not approach.
Taiyi Shenji Dan (Great One Divine Accumulation Pill) and Suhexiang Wan (Styrax Pill) can also be used.
Discussion states: In ancient times, when treating diseases, physicians first discussed the primary focus. For men, qi is regulated; for women, blood is regulated. If the Blood Chamber (Xueshi, uterus/blood reservoir) is not stagnant, then qi and blood harmonize; if the Blood Chamber is coagulated, then water and fire conflict. In cold damage disease, if the Cun Kou (radial artery at the wrist) pulse is tight and full, purgation should be used; if the Ren Ying (carotid artery) pulse is tight and full, diaphoresis should be used. For women, if the Left Guan pulse is floating and tight, purgation is contraindicated; instead, diaphoresis should be used to rescue the Blood Chamber. When Ying (nutritive) and Wei (defensive) harmonize, body fluids flow naturally, and the disease resolves through mild sweating. Zhang Zhongjing said: "When a woman suffers from cold damage and her menstruation has just ceased, she is clear during the day but delirious at night, seeing things as if they were ghosts. This is heat entering the Blood Chamber." Do not injure Stomach Qi or the Upper and Middle Jiao. "Do not injure Stomach Qi" means do not use purgation; Xiao Chaihu Tang (Minor Bupleurum Decoction) is the main formula. If treatment is delayed, heat enters the Stomach, causing dryness in the Middle Jiao. The Upper Jiao fails to nourish, resulting in symptoms resembling Blood Congestion Chest Syndrome, requiring acupuncture at Qimen (LR14). Five Elements generate each other through mutual restriction and support each other to expel pathogens. In normal health, Water nourishes Wood; Water and Wood generate each other, thus nourishing the Blood Chamber. If the Blood Chamber is not stagnant, the Spleen has no accumulation; if the Spleen has no accumulation, rigid dryness does not arise. Once rigid dryness arises, if it invades Stomach Qi, it causes day-and-night delirium and forgetfulness, lower abdominal fullness, and free urination, which belongs to the Dandang Tang (Resist the Dead Decoction) syndrome (In cold damage with Stomach excess and delirium, purgation is indicated; however, in women with heat entering the Blood Chamber and delirium, purgation is contraindicated). Although the treatment for women's cold damage differs from men's, with men regulating qi first and women regulating blood first, this is only a general statement. One must know that a tight pulse without sweat indicates Cold Damage, while a slow pulse with sweat indicates Wind Injury. Heat diseases present with a large, flooding pulse; heatstroke presents with a thin, weak pulse, yet their clinical manifestations may appear similar. For example, if heatstroke is treated with Baihu Tang (White Tiger Decoction), and Stomach excess is treated with Chengqi Tang (Order the Qi Decoction), why must blood regulation precede herbal administration? The reason Zhang Zhongjing's Shanghan Lun (Treatise on Cold Damage) does not separate women is likely because scholars can select appropriate formulas based on the patient's condition from the male prescriptions.
If a pregnant woman suffers from cold damage, the medicinal properties must be cooling. Avoid using Guizhi (Cinnamon Twig), Banxia (Pinellia Rhizome), Taoren (Persicae Semen), etc. Xiao Chaihu Tang with Banxia removed is named Huanglong Tang (Yellow Dragon Decoction), presumably established for pregnant women. Generally, before delivery, the fetus should be stabilized; after delivery, tonification should be prioritized, followed by treatment for cold damage. If the illness subsides slightly, stop medication and do not complete the full course; this is the general principle.
The Yellow Emperor asked: How should toxic medicines be used for a heavily pregnant woman? Qibo replied: "If there is a disease, the disease bears the toxicity, so neither the mother nor the fetus is harmed." For large accumulations and masses, attack may be permitted, but once the pathogen is reduced by more than half, stop to avoid exceeding the limit.
For cold damage in both men and women, Zhang Zhongjing's treatment methods are consistent without dispute. Recently, I have seen folk books on women's cold damage claiming to be written by Zhang Zhongjing with a preface by Wang Shuhe. Examining the methods, some are useful, but they are suspected not to be ancient prescriptions, merely borrowing the sage's name to gain credibility. Now, I have selected treatments for women's cold damage from Jin Gui Yu Han (Golden Cabinet Jade Box) and useful parts from common prescriptions, compiling them into one volume. Although this is insufficient to detail all aspects of women's cold damage, it can be used in conjunction with Bai Wen (Hundred Questions).
When women suffer from cold damage with fever and aversion to cold, limb stiffness and spasms, dry mouth and tongue, stagnant meridians, and impaired circulation, Guizhi Honghua Tang (Cinnamon Twig and Safflower Decoction) is suitable.