五灰散 治下血不止成血崩。
莲蓬壳 百草霜 黄绢 血余 棕皮（以上共烧存性） 山栀 蒲黄（炒） 血竭 京墨
每细末一二钱。调服。
十灰散 治下血不止。
锦片 木贼 棕皮 柏叶 干漆 艾叶 当归 血余 鲫鱼鳞 鲤鱼鳞
以上各烧存性。等分研末。入麝香少许。每末二钱。空心酒下。
十灰丸 治崩漏不止。
绵灰 黄绢灰 马尾灰 艾叶灰 藕节灰 莲房灰 油须灰 赤松皮灰 棕灰 蒲黄灰
等分。醋煮米糊丸。每五七十丸至百丸。空心米饮下。
妇女者阴之集。常与湿居者也。男子之为道也以精。妇女之为道也以血。精为阳。此其所以成男子也。血为阴。此
其所以为妇女也。盖自十四冲任脉通而天癸至。血气之存。外循经络。内荣脏腑。不失其度。则月事以时下。而诸疾不
生。如不然者。阴气浮溢。百想经心。内伤五脏。外损姿容。月水去留。前后互异。瘀血停滞。中道断绝。其间伤损。
不可俱论。圣惠方云。妇女所以别立方者。以其气血不调。胎妊产生崩伤多异之故。旨哉言乎。可见妇女之不同于男子。
妇女之病难治于男子数倍也。盖以男子之病。多由伤精。妇女之病。多由伤血。然而妇女之欲。每甚于丈夫。故感病亦
每易于丈夫。又况嫉妒忧患。系恋爱憎。入之深。着之固。情不自抑。不知解脱。由阴凝之气。郁结专滞。一时不得
离散。非若阳气之偶有所抑。毕竟易于发散。故其为病根深也。夫妇女之病。莫有如经。莫有如胎。莫有如产前后。莫
有如崩中带下。此数大端。别自有论。此外有最易作而最难治者。一曰痨瘵。一曰积聚 瘕。一曰浮肿。其痨瘵之由。
复有数种。或因先天气血不足。乍寒乍热。不思饮食。 羸无力。宜滋阴百补丸。或吐衄。咳唾血。发热盗汗。痰嗽心
惴。因虚劳而经水不调。宜滋阴地黄丸。甚或心肺俱损。血脉虚弱。皮聚毛落。亦因虚劳而致经水不调。宜滋血汤。其
有先经水不调而致痨瘵者。则五心烦热。寒热如疟。或烦热潮热。盗汗痰嗽。宜逍遥散、加味逍遥散。至如室女思虑伤
心。经闭成痨。则名干血痨。其候最难调治。只宜益阴血。制虚火。慎勿妄用通经破血之药。（要法俗人不知）宜柏子仁
丸、泽兰汤。或因产后早犯房事。劳役过度。将理失宜。皆能致病。名曰产后痨。宜人参鳖甲散、胡氏牡丹散。又或血
气既亏。为风冷所搏。则不能温于肌肤。使人虚羸憔悴。饮食不消。又或风邪两感于肺。肺受微寒。喘嗽口干头昏。百
节痛。又或风邪侵于营卫。流及脏腑。寒热如疟。盗汗。背膊烦闷。四肢沉重。名曰蓐痨。俗总谓之产后痨。宜黄 丸、
白茯苓散。当与产后篇参看。积聚 瘕者。本男女皆有之病。而妇人患此。大约皆胞胎生产。月水往来。血脉精气不调。
及饮食不节。脾胃亏损。邪正相侵。积于腹中之所生。准绳谓推之不动为 。推之动为瘕是也。试详言之。 有二。一、
血。由脏腑气虚。风冷相侵。或饮食失节。与血气相搏。适值月水往来。经络痞塞。恶血不除。结聚成块。渐至心腹。
两胁痛苦。害于饮食肌肤瘦羸。宜桃仁、五灵脂、生地、牛膝、大黄、甘草。二、食 。亦由月信往来食生冷之物。而
脏腑虚弱不能消化。与脏气搏结。聚而成块。盘坚不移也。瘕有八。一、黄瘕。由经来或大小。产后血气未定。脏腑空
虚。或当风便利。阴阳开合。关节四边。中于风湿。邪从下入于阴中。积留不去所成。其症寒热身重。淋露不食。左胁
下有结气拒按。宜皂荚散。二、青瘕。由新产起行浣洗太早。阴阳虚。产门四边解散。子户未安。骨肉皆痛。手臂不举。
又犯风湿所成。其症苦寒。洒洒入腹。烦闷。结热不散。恶血不除。聚在两胁下。藏于背膂。其后月水不通。或反不禁。
宜青瘕坐导方。三、燥瘕。由月水未尽。或以夏暑。或以举重汗出。卒以恚怒。致月水与气相搏。反快凉饮。月水横流。
溢入他脏。有热。则成燥瘕。大如半杯。上下腹中痛。连两胁下。上引心而烦。喜呕吐。腰背重。足酸削。忽遗溺。月
闭。宜疗燥瘕方。四、血瘕。由月事中止。饮食过度。五谷气盛。溢入他脏。或大饥寒。呼吸未调。而自劳动。血下未
定。左右走肠胃间。留络不去。内有寒热。与月水合会而成。其症不可俯仰。横骨下有积气。坚如石。少腹急痛。背疼。
腰腹挛。阴中若生风冷。月水来止不常。宜疗血瘕方、桃仁煎。五、脂瘕。由月信初来。或生未盈月而交。胞门伤。子
户失禁。关节散。脏腑津流。阴道 动。百脉四解。子精与血气相遇。不能成子而成脂瘕。其症少腹重。腰背如刺。四
肢不举。卧不安。左右走腹中痛。时少气。头眩。身体解 。苦寒恶风。二便血。月事来止不常。宜疗脂瘕方、导散方。
六、狐瘕。由月来悲忧。或风雨雷电惊恐。且受湿。心神恍惚。四肢振寒。体倦神散。邪入阴里不去而成。其症少腹滞。
阴中肿。小便难。胸膈腰背痛。气盛善食。多所思。如有身状。宜疗狐瘕方。七、蛇瘕。由月新止。阴阳未平。饮污井
之水。食不洁之物。误吞蛇鼠之精。留脏不去而成。其症长成蛇形。在脐上下。或左右胁。不得吐气。上蚀心肝。少腹
热。膀胱引阴中痛。腰痛。两股胫间痛。时寒热。月水或多少。宜疗蛇瘕方。八、鳖瘕。由月水新至。其人作劳。适受
风湿。恍惚觉悟。心尚未平。复见所好。心为之开。魂魄感动。五内消脱。或沐浴不以时出。而神不守。水气与邪气俱
入至三焦中幕。玉门先闭。津液妄行。留络不去而成。其症形如小枰。小腹切痛。左右走。上下腹中痛。持之跃手。下
引阴里痛。腰背亦痛。不可以息。月事不通。宜疗鳖瘕方。由此推之。又有近脐左右。各有一条筋脉急痛。大如臂。小
如指。因气而成。如弦之状。名曰 者。又有僻匿在两胁间。时痛时止。名曰癖者。皆由阴阳乖。经络痞。饮食滞。邪
冷搏而成也。俱宜麝香丸。又有脏腑虚弱。气血劳伤。风冷入腹。与血相结。留聚浮假而痛。推移则动。名曰疝瘕者。
乃由经产后胞中有恶血。复为邪结而成也。宜干漆散、黑神丸。又有所谓肠覃者。寒客大肠。与胃相搏。大肠为肺传送。
寒则浊气凝结。日久便生 肉。始如鸡卵。大如怀胎。按之坚。推之动。月则时下。此气病而血未病也。宜 露丸。
或二陈汤加香附。又有所谓石瘕者。寒客下焦。血气俱为所闭塞。日益大。亦如怀子。但不得推移。且多坠小腹。与肠
覃相类而实异。宜见 丹。要之妇人积聚之病。虽屡多端。而究其实。皆血之所为。盖妇人多郁怒。郁怒则肝伤。而肝
藏血
者也。妇人多忧思。忧思则心伤。而心主血者也。心肝既伤。其血无所主则妄溢。不能藏则横行。迨至既溢既行。离其
部分。或遇六淫。或感七情。血逐瘀滞。而随其所留脏腑。所入经络。于是而百疾作。有如前种种恶症矣。若夫月经偶
闭。或产后恶露未尽。乘风取凉。为风冷所乘。便成瘀血。而此瘀在腹中。必至发热面黄。食少体瘦。然此但为瘀血而
未成积聚等症者。不早图之。坚结成形。亦难免矣。妇女浮肿之病。有先断经而后致四肢浮肿。小便不通者。乃血化为
水。古人谓之血分。宜椒仁丸、人参丸。亦有先因小便不通。而后身面浮肿。竟至经水不通者。乃水化为血。古人谓之
水分。宜葶苈丸。其原皆由外伤六淫。内伤七情。饮食失度。起居失宜。渐至脾胃受伤。失生发统摄之节。气与血俱乖
而后然也。盖人身气血。本属相须。血者气之化。气者水之母。非气无以生血。非血无以养气。若经水不通。则血病。
血病而气亦病矣。血不通而化水者。实是气壅不能化血。遂变为水也。至薛氏云。月水不通。凝结于内。久而变为血瘕。
血水相搏。亦为水肿。夫血凝成瘕。因而致肿。亦属于水。此症之故。则以血水相搏。既凝之血。亦从乎水者矣。当细
思之。总之血分者。不可以水治。水分者。不可以血治。理固然也。以上皆最易作。而最难治之病也。其有不易作。而
实难治者。妇女阴中之疾是已。如阴户肿痛不闭。寒热。溺涩体倦。少食。宜补中益气汤加升、柴。量入茯苓、山栀。
阴户不闭。小便淋沥。腹中一物。攻动腹痛。宜逍遥散加柴胡、山栀、车前。皆由肝脾有伤之故。尝考石室秘录曰。妇
人羞
隐之处。不便明言。然大约非寒即热。今拟一方。先用归、芍各三钱。川芎一钱。熟地五钱。甘草、柴胡、白芥子各一
钱。黄芩、炮姜各三分。水煎服之后。较前平善。则是虚症。随用四物治之可也。未好。则是热痛作祟。方中加栀子三
钱治之。必奏效。此诚可谓善于试之者矣。至若阴疮阴挺一切等症。详载杂病源流前阴条。参考可也。而妇女之疾。关
系最钜者。则莫如乳。如乳炭岩、乳痈、乳吹等症。亦详杂病源流身形门。兹不赘。其有乳 者。女子十三四岁。经脉
将行。
或一月二次。或过月不行。致生此疾。多生于寡薄虚弱之人。每乳上止有一核。可治。若串成三四个。即难疗。宜服败
毒散加生地。再服黄矾丸。通用逍遥调经汤。其有乳硬者。多因浓味湿热之痰。停蓄膈间。与滞乳相搏而成。又有滞乳。
因儿口气吹嘘而成。又有拗怒气激滞而生者。 石膏、栝蒌子、青皮、甘草节。皆神效药也，然此病。若早治之。立消。
有月经时
悉是轻病者。到五六十岁无月经时。不可作轻易看也。其有未产而乳自出者。谓之乳泣。生子多不育。产后乳汁自出者。
乃胃气虚。宜服补药止之。或治以漏芦散亦可。以上皆不易作而难治之病也。此外若妇女气盛于血。往往无子。且变生
诸症。头晕膈满。有所必至。抑气散、异香四神丸。若血风体痛。寒热盗汗。颊赤口干。胸满痰嗽。月水不调。脐腹
痛。
瘕癖成块。宜人参荆芥散。若风虚梦与鬼交。妄有所见。言语错乱。宜伏神汤。若经水不调。血气攻注。遂至腹胁疼痛。
积聚成块。宜神仙聚宝丹。若怒气伤肝。不能藏血。血失常经。以致肌肤手足间。俱有血线络隐然可见。宜橘归丸。则
皆妇女之病所不可忽者。至于寻常杂病。与男子略同者。已详杂病源流中。故可无赘。惟此种种。乃妇女所独。因不惮
条载而缕述之焉。
脉法 脉经曰。妇人疝瘕积聚。脉弦急者生。虚弱者死。又曰。少阴脉浮而紧。紧则疝瘕。半产而堕伤。浮则
亡血。恶寒绝产。
虚劳原由症治 王肯堂曰。劳倦所伤。用补中益气汤调治。乃暴病也。失治而有发热潮热。盗汗咳嗽诸症出焉。
谓之虚劳。又复失治。而有皮聚毛落。饮食不为肌肤。骨髓中热。经闭不行诸症出焉。谓之瘵骨蒸热。至于传尸劳。别
自一种。其原不起于劳倦。其流至于灭门。
鳌按。妇女虚劳。多半由于经血。即有由劳倦者。亦必内伤脾胃。及于冲任之故。不与男子虚劳一般。
大全曰。妇人冷劳。即无热虚劳也。由血气不足。脏腑虚寒。以致脐腹冷痛。手足时寒。月经失常。饮食不省。或
时呕吐。恶寒发热。骨节酸疼。肌肤羸瘦。面色蒌黄也。妇人热劳。即有热虚劳也。由心肺壅热。伤于气血。以致心神
烦躁。颊赤头疼。唇干眼涩。口舌生疮。神思困倦。四肢壮热。饮食无味。肢体酸疼。心忡盗汗。肌肤日瘦。或寒热往
来。当审其所因。调补气血。其病自愈矣。又曰。妇人有瘵骨蒸热。多因经行胎产。或饮食起居七情。重伤肝脾之所致。
又有失于调摄。或过于攻伐而成。与男子治法。稍有不同。故方亦专治妇人。薛己曰。无热虚劳。有内外真寒。有内外
真热。有内真热而外假寒。有内真寒而外假热者。若饮食难化。大便不实。饮食畏寒。手足逆冷。面黄呕吐。畏
见风寒。此内外真寒之症也。宜用附子理中汤以回阳。八味丸以壮火。若饮食如常。大便坚实。胸腹痞胀。饮食喜冷。
手足烦热。面赤呕吐。不畏风寒。此内外真热之症也。宜用黄连解毒汤以消阳。六味丸以壮水。若饮食如常。大便坚实。
胸腹痞胀。饮食喜寒。手足逆冷。面黄呕吐。畏见风寒。此内真热而外假寒也。亦用解毒汤、六味丸。若饮食少思。大
便不实。吞酸嗳气。胸腹痞满。手足逆冷。面赤呕吐。畏见风寒。此内真寒而外假热也。亦用理中汤、八味丸。当求其
属而治之。（属谓心肾也）经曰。益火之源以消阴翳。壮水之主以制阳光。使不知真水火之不足。泛以寒热药治之。则旧
疾未去。新病复生矣。夫所谓属者。犹主也。谓心肾也。求其属者。言水火不足。而求之于心肾也。火之源者。阳气之
根。
即心也。水之主者。阴气之根。即肾是也。非谓火为心。源为肝。水为肾。主为肺也。又曰。有热虚劳。乃壮火食气。
虚火煎熬真阴之所致也。王太仆云。如大寒而甚。热之不热。是无火也。热来复去。昼见夜伏。夜发昼止。是无火也。
当治其心。如大热而甚。寒之不寒。是无水也。热动复止。倏忽往来。时动时止。是无水也。当助其肾。心盛则生热。
Wu Hui San (Five Ashes Powder) treats continuous lower bleeding leading to metrorrhagia (sudden, heavy uterine bleeding).
Lianpengke (Peltophyllum Fructus), Baicaoshuang (Soot from Kitchen Chimney), Huangjuan (Yellow Silk), Xueyu (Scorched Hair), Zongpi (Bromelia Fruit Peel) (the above are all burnt to retain their properties), Shanzhi (Gardeniae Fructus), Puhuang (Typhae Pollen, stir-fried), Xuexie (Dracaenae Sangues), Jingmo (Beijing Ink).
Grind into fine powder, take one to two qian per dose, mix with water and swallow.
Shi Hui San (Ten Ashes Powder) treats continuous lower bleeding.
Jinpian (Brocade Fragments), Muzei (Equiseti Herba), Zongpi (Bromelia Fruit Peel), Baiye (Platycladi Cacumen), Ganqi (Drymarchon Bituberosum Rhizome), Aiye (Artemisiae Argyi Folium), Danggui (Angelicae Sinensis Radix), Xueyu (Scorched Hair), Jiyulin (Cyprini Carassii Squama), Liyulin (Cyprini Carpio Squama).
Burn each of the above to retain their properties, grind into equal parts powder, add a small amount of Shexiang (Moschus). Take two qian of powder per dose, swallow with wine on an empty stomach.
Shi Hui Wan (Ten Ashes Pill) treats persistent metrorrhagia and metrostaxis (irregular uterine bleeding).
Mianhui (Cotton Ash), Huangjuanhui (Yellow Silk Ash), Maweihui (Horse Tail Ash), Aiyehui (Artemisiae Argyi Folium Ash), Oujiiehui (Nelumbinis Rhizomatis Nodus Ash), Lianfanghui (Nelumbinis Fructus Spadix Ash), Youxuhui (Oil Mustache Ash), Chisongpihui (Red Pine Bark Ash), Zonghui (Bromelia Fruit Peel Ash), Puhuanghui (Typhae Pollen Ash).
Equal parts, boil in vinegar with rice paste to make pills. Take fifty to seventy or one hundred pills per dose, swallow with rice water on an empty stomach.
Women are the gathering place of Yin Qi, often residing with dampness. The way of men lies in Jing (Essence); the way of women lies in Blood. Essence is Yang; this is what constitutes a man. Blood is Yin; this is what constitutes a woman. Generally, from age fourteen, when the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) become unobstructed and Tian Gui (substance promoting reproduction) arrives, the storage of Qi and Blood circulates externally along the meridians and nourishes internally the Zang-Fu organs without exceeding proper limits. Thus, menstruation occurs at regular intervals, and various diseases do not arise. If not so, Yin Qi floats and overflows, excessive thoughts linger in the heart, damaging the five Zang organs internally and impairing physical appearance externally. Menstrual flow may be retained or discharged, varying in timing; blood stasis stagnates, cutting off the flow midway. The resulting damage cannot be fully discussed here. *Shenghui Fang* states that separate prescriptions for women exist because of their irregular Qi and Blood, and differences in pregnancy, childbirth, metrorrhagia, and trauma. This statement is profound. It shows that women differ from men, and women's diseases are several times harder to treat than men's. Generally, men's diseases often result from injury to Jing; women's diseases often result from injury to Blood. However, women's desires are often stronger than men's, so they are also more susceptible to disease. Moreover, jealousy, worry, love, and hate run deep and remain fixed; emotions cannot be suppressed or released. Due to stagnant Yin Qi, depression and stagnation occur, unable to disperse temporarily, unlike Yang Qi which, even if occasionally suppressed, eventually disperses easily. Thus, the root of their disease is deep. Among women's diseases, none is more significant than menstrual disorders, pregnancy, pre- and postpartum conditions, or metrorrhagia and leukorrhea. These major categories have separate discussions. Besides these, the easiest to occur but hardest to treat include: 1. Lao Zhai (consumptive disease), 2. Ji Ju and Xia (abdominal masses), 3. Edema.
Regarding Lao Zhai, there are several causes. Some due to congenital deficiency of Qi and Blood, alternating chills and fever, loss of appetite, emaciation and weakness; use Ziyin Baibu Wan (Nourish Yin Hundred Tonics Pill). Or hematemesis, epistaxis, coughing up blood, fever, night sweats, phlegm-cough, palpitations due to deficiency labor causing irregular menstruation; use Ziyin Dihuang Wan (Nourish Yin Rehmannia Pill). Even severe damage to Heart and Lung, weak blood vessels, dry skin, falling hair due to deficiency labor causing irregular menstruation; use Zixue Tang (Nourish Blood Decoction). Those whose irregular menstruation leads to Lao Zhai present with heat in the five centers, chills and fever like malaria, or vexing tidal fever, night sweats, phlegm-cough; use Xiaoyao San (Free and Easy Wanderer Powder) or Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder). For virgins whose thinking damages the Heart, leading to amenorrhea and forming Lao disease, named Gan Xue Lao (Dry Blood Consumption), symptoms are hardest to regulate. Only benefit Yin Blood and control deficient fire; do not recklessly use drugs to unblock meridians and break blood stasis. (Key methods unknown to laypeople): use Baizi Ren Wan (Biota Seed Pill) or Zelan Tang (Lycopus Decoction). Or due to early sexual intercourse after childbirth, excessive labor, improper care causing disease, named Chan Hou Lao (Postpartum Consumption); use Renshen Biejia San (Ginseng Softshell Turtle Powder) or Hu Shi Mudan San (Mr. Hu's Tree Peony Powder). Or if Qi and Blood are already deficient, attacked by wind-cold, failing to warm the skin and muscles, causing emaciation, poor digestion. Or if wind pathogen affects both lungs, lung suffers slight cold, causing wheezing, cough, dry mouth, dizziness, joint pain. Or if wind pathogen invades Ying and Wei, spreading to Zang-Fu, chills and fever like malaria, night sweats, chest and shoulder oppression, heavy limbs, named Ru Lao (Bedridden Consumption), commonly called Postpartum Lao; use Huang Wan (Yellow Pill) or Bai Fuling San (White Poria Powder). Refer to the Postpartum chapter.
Ji Ju (accumulation) and Xia (mass) are diseases common to both sexes, but in women, they generally arise from conception, childbirth, menstrual cycles, irregular blood and essence, unregulated diet, Spleen-Stomach deficiency, invasion of pathogenic factors, accumulating in the abdomen. *Zhunsheng* states: pushing without movement is "Ji" (fixed mass); pushing with movement is "Xia" (mobile mass). Detailed explanation: There are two types of Ji. First, Blood Ji, caused by Zang-Fu Qi deficiency, wind-cold invasion, or dietary irregularity clashing with Qi and Blood during menstruation, blocking meridians, preventing expulsion of evil blood, forming clumps, gradually affecting heart and abdomen, causing hypochondriac pain, impairing diet, leading to emaciation; use Tao Ren (Persicae Semen), Wulingzhi (Trogopteri Dung), Shengdi (Rehmanniae Radix), Niuxi (Achyranthis Bidentatae Radix), Dahuang (Rhei Radix et Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma). Second, Food Ji, also occurring during menstruation after eating raw/cold foods, where weak Zang-Fu fail to digest, clashing with organ Qi, forming hard, immobile masses.
There are eight types of Xia. First, Huang Xia (Yellow Mass), occurring during menstruation or bowel movements, or postpartum when Qi and Blood are unsettled and Zang-Fu are empty, or exposing to wind while defecating, opening and closing of Yin-Yang, joints on four sides struck by wind-damp, pathogen entering vagina from below, accumulating; symptoms: chills, fever, heaviness, dysuria, anorexia, qi knot in left hypochondrium refusing pressure; use Zhaojiao San (Gleditsiae Sinensis Powder). Second, Qing Xia (Green Mass), arising from washing too early after childbirth, Yin-Yang deficiency, relaxation of vaginal walls, unstable uterus, bone and flesh pain, inability to raise arms, compounded by wind-damp; symptoms: bitter cold sensation penetrating abdomen, oppression, lingering heat, retained evil blood gathering in hypochondria, storing in back; later amenorrhea or incontinence; use Qing Xia Zuodao Fang (Green Mass Suppository Formula). Third, Zao Xia (Dry Mass), occurring when menstruation is incomplete, or in summer heat, or after heavy lifting sweating, sudden anger causing menstrual blood to clash with Qi, drinking cold liquids rapidly, menstrual blood flowing horizontally into other organs, generating heat, forming Dry Mass, size of half cup, pain in upper and lower abdomen extending to hypochondria, vexing heart, vomiting, heavy back, sore legs, sudden enuresis, amenorrhea; use Liao Zao Xia Fang (Treat Dry Mass Formula). Fourth, Xue Xia (Blood Mass), occurring when menstruation stops, overeating, excessive grain Qi overflowing into other organs, or extreme hunger/cold, irregular breathing, exertion while blood flow is unstable, moving between intestines, remaining in collaterals, internal cold/heat combining with menstruation; symptoms: inability to bend or stretch, qi accumulation under pubic bone, hard as stone, lower abdominal urgent pain, back pain, waist/abdominal spasms, wind-cold sensation in vagina, irregular menstruation; use Liao Xue Xia Fang (Treat Blood Mass Formula) or Tao Ren Jian (Peach Kernel Decoction). Fifth, Zhi Xia (Fat Mass), occurring during first menstruation or intercourse before one month postpartum, damaging uterine gate, losing control, relaxing joints, flowing organ fluids, shaking vagina, dispersing vessels, sperm meeting blood/Qi failing to conceive, forming Fat Mass; symptoms: heavy lower abdomen, stabbing back, inability to lift limbs, restless sleep, wandering abdominal pain, shortness of breath, dizziness, body laxity, aversion to cold/wind, bloody stool/urine, irregular menstruation; use Liao Zhi Xia Fang (Treat Fat Mass Formula) or Dao San (Guide Powder). Sixth, Hu Xia (Fox Mass), occurring during menstruation with sorrow/fear, storm/thunder fright, dampness invasion, confused spirit, trembling limbs, fatigue, pathogen entering Yin interior; symptoms: lower abdominal stagnation, vulvar swelling, difficult urination, chest/diaphragm/back pain, strong appetite, excessive thoughts, feeling pregnant; use Liao Hu Xia Fang (Treat Fox Mass Formula). Seventh, She Xia (Snake Mass), occurring after menstruation stops, Yin-Yang imbalance, drinking well water, eating unclean food, swallowing snake/rat essence, staying in organs; symptoms: snake-shaped mass around umbilicus or hypochondria, inability to exhale, eroding heart/lung, lower abdominal heat, bladder pain radiating to vagina, back pain, thigh/shin pain, intermittent chills/fever, variable menstruation; use Liao She Xia Fang (Treat Snake Mass Formula). Eighth, Die Xia (Turtle Mass), occurring when menstruation just arrived, exertion, wind-damp exposure, confusion, heart unsettled, seeing desired objects opening heart, soul moved, internal depletion, bathing improperly causing spirit loss, water/qi and pathogen entering Triple Burner, closing jade gate, misdirected fluids remaining in collaterals; symptoms: scale-like shape, sharp lower abdominal pain, wandering, upper/lower abdominal pain, jumping upon touch, pain radiating to vagina/back, difficulty breathing, amenorrhea; use Liao Die Xia Fang (Treat Turtle Mass Formula).
From this, we deduce another condition: tendons/vessels near umbilicus painful and tight, arm-to-finger sized, Qi-induced, string-like, named Ben Tun (Running Piglet). Also, masses hiding in hypochondria, intermittent pain, named Pi (Partial Mass), caused by Yin-Yang disharmony, meridian blockage, food stagnation, cold/pathogen clash. All should use Shexiang Wan (Musk Pill). Another type: Zang-Fu weakness, Qi/Blood exhaustion, wind-cold entering abdomen clashing with blood, floating/pseudo-pain, movable upon pushing, named Shan Xia (Hernia Mass), caused by evil blood in uterus post-menstruation/parturition combined with pathogen. Use Ganqi San (Drymarchon Powder) or Heishen Wan (Black Divine Pill).
Also known as Chang Tan (Intestinal Polyp): Cold lodges in Large Intestine, clashes with Stomach; Large Intestine transmits to Lung; cold causes turbid Qi condensation, forming polyps over time, starting egg-sized, growing to pregnancy size, hard to press, movable, menstruation continues normally. This is Qi disease, Blood unaffected. Use Lu Wan (Dew Pill) or Er Chen Tang (Two Aged Things Decoction) plus Xiangfu (Cyperus Rhizome). Also known as Shi Xia (Stone Mass): Cold lodges in Lower Jiao, blocking Qi and Blood, growing daily like pregnancy, immovable, frequent bearing-down sensation, similar to Chang Tan but distinct. Use Jian Dan (See Red Pill).
In summary, women's accumulation diseases are numerous but fundamentally rooted in Blood. Women often suffer depression/anger, injuring Liver (which stores Blood). Women often suffer worry/thought, injuring Heart (which governs Blood). Once Heart/Liver are injured, Blood lacks governance, overflowing or moving wildly. When displaced, encountering Six Excesses or Seven Emotions, Blood becomes stagnant, lodging in organs/meridians, causing myriad diseases as described. If menstruation occasionally stops, or lochia remains postpartum, catching wind/cold creates blood stasis. If this stasis remains in abdomen, it causes fever, yellow face, poor appetite, emaciation. If not treated early, it hardens into masses.
Women's edema: Amenorrhea followed by limb edema and urinary obstruction is Blood transforming into Water, called Blood Division (Xue Fen), use Jiaoren Wan (Pepper Kernel Pill) or Renshen Wan (Ginseng Pill). Urinary obstruction followed by facial/body edema and amenorrhea is Water transforming into Blood, called Water Division (Shui Fen), use Tingli Wan (Descurainia Seed Pill). Causes include external Six Excesses, internal Seven Emotions, dietary excess, improper lifestyle, damaging Spleen/Stomach, losing generation/control of Qi/Blood. Qi and Blood rely on each other; Blood is transformation of Qi, Qi is mother of Water. Without Qi, no Blood; without Blood, no Qi nourishment. Amenorrhea means Blood disease, which affects Qi. Blocked Blood turning to Water is actually Qi stagnation failing to transform Blood, becoming Water. Xue Yi stated: Amenorrhea congeals internally, becoming Blood Xia over time; Blood/Water clash causes edema. Congealed Blood following Water nature explains this. Carefully consider: Blood Division cannot be treated with Water-draining methods; Water Division cannot be treated with Blood-invigorating methods. These are the most common yet hardest-to-treat diseases.
Harder to treat but less common are diseases of the female Yin (genitals). Vulvar swelling/pain, open closure, chills/fever, dysuria, fatigue, anorexia: use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) plus Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), adjust with Fuling (Poria), Zhizi (Gardeniae Fructus). Vulvar non-closure, dribbling urine, abdominal mass moving painfully: use Xiaoyao San plus Chaihu, Zhizi, Cheqian (Plantaginis Semen). All due to Liver/Spleen injury. *Shishi Milu* notes: Private parts are taboo to discuss, but generally Cold or Heat. Proposed formula: Danggui, Shaoyao 3 qian each, Chuanxiong 1 qian, Shudi 5 qian, Gancao, Chaihu, Baijiezi 1 qian each, Huangqin, Paojiang 0.3 fen each. Decoct and drink. If improved, it was Deficiency; treat with Siwu Tang (Four Substances Decoction). If not improved, Heat/Pain dominates; add Zhizi 3 qian. This demonstrates skillful trial treatment. For Yin sores/prolapse, see *Zabing Yuanliu* Anterior Genital section.
Most critical female disease relates to Breasts. Ru Tan Yan (Breast Cancer), Ru Yong (Breast Abscess), Ru Chui (Blocked Milk) detailed in *Zabing Yuanliu* Body Section. Breast nodules in girls aged 13-14, approaching menarche, irregular cycles, common in weak constitutions, single nodule curable; three-four nodules hard to treat. Use Baidu San plus Shengdi, then Huangfan Wan, general Xiaoyao Tiaojing Tang. Breast hardness due to rich/damp-heat phlegm stagnating in diaphragm clashing with stagnant milk, or infant breath blowing milk, or anger stagnation. Shigao (Gypsum), Gualouzi (Trichosanthis Semen), Qingpi (Citri Reticulatae Pericarpium Viride), Gancaojie (Licorice Joint) are effective. Early treatment cures instantly. Mild during menstruation; serious after menopause (50-60 years). Premature lactation called Ru Qi (Breast Weeping), offspring often die; postpartum spontaneous lactation due to Stomach Qi deficiency, tonify or use Loulu San (Euphorbiae Humifusae Radix Powder).
Other difficult cases: Qi excess over Blood causing infertility and symptoms like dizziness/chest fullness; use Yiqi San (Suppress Qi Powder) or Yixiang Sishen Wan (Rare Fragrance Four Spirits Pill). Wind-Blood body pain, chills/fever, night sweats, red cheeks, dry mouth, chest fullness, phlegm-cough, irregular menstruation, abdominal pain, masses; use Renshen Jingjie San (Ginseng Schizonepeta Powder). Wind-deficiency dreaming of ghost intercourse, hallucinations, confusion; use Fushen Tang (Poria Decoction). Irregular menstruation, Qi/Blood attacking abdomen/hypochondrium, masses; use Shenxian Jubao Dan (Immortal Treasure Gathering Pill). Anger injuring Liver, failing to store Blood, Blood leaving meridians, visible blood lines on skin/extremities; use Jugui Wan (Orange Return Pill). These are不可忽视 (non-negligible) women's diseases. Common miscellaneous diseases same as men are in *Zabing Yuanliu*. These unique women's diseases are listed here.
Pulse Method: *Mai Jing* states: Women with Shan Xia/Ji Ju, pulse Xian Ji (Wiry-Tight) indicates survival; Ruo Xu (Weak-Deficient) indicates death. Also: Shao Yin pulse Fu Jin (Floating-Tight), Tight indicates Shan Xia, miscarriage/injury; Fu indicates Blood loss, aversion to cold, sterility.
Xu Lao (Deficiency Labor) Etiology/Treatment: Wang Kentang states: Injury from fatigue treated with Buzhong Yiqi Tang is acute illness. Untreated leads to fever, tidal fever, night sweats, cough, called Xu Lao. Further untreated leads to dry skin, falling hair, poor nutrition, marrow heat, amenorrhea, called Zhai Gu Zheng Re (Consumption Bone Steaming Fever). Chuan Shi Lao (Transmitting Corpse Labor) is distinct, not from fatigue, leads to family extinction.
Shen Jin'ao comments: Women's Xu Lao mostly stems from menstrual blood. Even if from fatigue, it must damage Spleen/Stomach and affect Chong/Ren vessels, differing from men's Xu Lao.
*Daqian* states: Women's Leng Lao (Cold Consumption) is Xu Lao without heat, due to Qi/Blood deficiency, Zang-Fu cold deficiency, causing cold abdominal pain, cold extremities, irregular menstruation, poor appetite, vomiting, chills/fever, joint pain, emaciation, sallow complexion. Women's Re Lao (Heat Consumption) is Xu Lao with heat, due to Heart/Lung heat damaging Qi/Blood, causing irritability, red cheeks, headache, dry lips/eyes, mouth ulcers, fatigue, hot limbs, tasteless food, body ache, palpitations, night sweats, wasting, alternating chills/fever. Investigate cause, tonify Qi/Blood, disease heals. Also: Zhai Gu Zheng Re often due to menstruation/childbirth, diet/lifestyle/emotions severely injuring Liver/Spleen, or improper care/over-treatment. Treatment differs slightly from men, formulas specific to women.
Xue Ji states: Xu Lao without heat has True Cold Inside/Outside, True Heat Inside/Outside, False Cold Outside/True Heat Inside, False Heat Outside/True Cold Inside.
If indigestion, loose stools, fear of cold food, cold extremities, yellow face, vomiting, fear of wind/cold: True Cold Inside/Outside. Use Fuzi Lizhong Tang (Aconite Regulate Middle Decoction) to restore Yang, Bawei Wan (Eight Flavor Pill) to strengthen Fire.
If normal diet, firm stools, chest/abdominal distension, preference for cold food, hot feet, red face, vomiting, no fear of wind/cold: True Heat Inside/Outside. Use Huanglian Jiedu Tang (Coptis Detoxification Decoction) to clear Yang, Liuwei Wan (Six Flavor Pill) to strengthen Water.
If normal diet, firm stools, chest/abdominal distension, preference for cold food, cold extremities, yellow face, vomiting, fear of wind/cold: True Heat Inside/False Cold Outside. Use Jiedu Tang, Liuwei Wan.
If poor appetite, loose stools, acid regurgitation, belching, chest/abdominal fullness, cold extremities, red face, vomiting, fear of wind/cold: True Cold Inside/False Heat Outside. Use Lizhong Tang, Bawei Wan. Seek the root (Shu) to treat. (Shu refers to Heart/Kidney). Classic says: Benefit source of Fire to eliminate Yin shadow; strengthen master of Water to control Yang light. Ignoring true Water/Fire deficiency and using generic cold/hot drugs leaves old disease and creates new ones. "Shu" means Master, referring to Heart/Kidney. Seeking Shu means seeking Water/Fire deficiency in Heart/Kidney. Source of Fire is root of Yang Qi, i.e., Heart. Master of Water is root of Yin Qi, i.e., Kidney. Not Fire=Heart, Source=Liver, Water=Kidney, Master=Lung.
Also: Heat Xu Lao is caused by Strong Fire consuming Qi, Deficient Fire roasting True Yin. Wang Taipu says: Severe cold unwarmed by heat drugs = No Fire. Heat comes/goes, day/night variation = No Fire. Treat Heart. Severe heat uncooled by cold drugs = No Water. Heat moves/stops, sudden changes = No Water. Strengthen Kidney. Heart excess generates heat.