Library

Yan stated: Chao Yuanfang's *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) discusses thirty-six diseases in women, including seven types of *xia* (abdominal masses), eight types of *jia* (abdominal masses), nine types of pain, and twelve types of leukorrhea. (Most of what Chao described is unreliable; even this statement lacks methods for seeking medical treatment, so it cannot be relied upon.) Moreover, the original text does not clearly specify the manifestations of leukorrhea. Nowadays, people only know of red and white leukorrhea. This condition arises from labor injury to the Chong and Ren vessels (the Penetrating Vessel and Conception Vessel, which regulate menstruation and reproduction), allowing wind-cold pathogens to occupy the collaterals of the uterus. In daily life, a woman's blood should be abundant while qi should be relatively scarce, preventing various diseases. If qi significantly exceeds blood (the character "bei" can be interpreted as "stagnation"), excess qi generates cold, and blood fails to transform into red, resulting in white leukorrhea. If qi is balanced but blood is deficient, deficiency of blood generates heat, and blood fails to transform into red, resulting in red leukorrhea. When cold and heat intertwine, both red and white leukorrhea occur simultaneously (these two sentences provide a thorough analysis). The pulse at the right chi position is floating. A floating pulse indicates yang; if yang is exhausted, conception is impossible. If cold feet accompany leukorrhea, mild cases present as dripping bleeding (lou xia), while severe cases present as uterine bleeding (beng zhong). These are caused by the Heart failing to nourish blood and the Liver failing to store blood (quoting the *Mai Jing*). The pulse at the cunkou position is wiry and large. Wiry indicates decline, and large indicates hollow (kou); decline signifies cold, and hollow signifies deficiency. Cold and deficiency interacting result in a leather-like pulse (ge mai), indicating miscarriage or persistent dripping bleeding. Furthermore, deficiency pulses at both cun and chi positions indicate leaking blood; if the pulse in leaking blood cases is floating, it is incurable.

The *Chan Bao* states that the thirty-six leukorrhea diseases refer to twelve types of *xia*, nine types of pain, seven types of harm, five types of injury, and three types of fixation, collectively called the thirty-six diseases. (Although divided into thirty-six types, they all stem from varying degrees of cold and heat. Hence, later generations summarized them simply as red and white leukorrhea.) The twelve types of *xia* refer to the appearance of discharged substances: 1. like paste, 2. like green blood, 3. like purple juice, 4. like red skin flakes, 5. like pus crusts, 6. like bean soup, 7. like mallow broth, 8. like clotted blood, 9. like clear water mixed with blood, 10. like rice wash water, 11. like menstrual dregs, 12. like menstruation extending beyond its proper period. The nine types of pain are: 1. pain in the yin, 2. dripping pain in the yin, 3. painful urination, 4. pain due to cold, 5. abdominal pain during menstruation, 6. foot pain when qi distension occurs, 7. pain in the yin like insect bites when sweating, 8. pain in the hypochondriac skin, 9. lower back pain. The seven types of harm are: 1. harm from food, 2. harm from qi stagnation, 3. harm from cold, 4. harm from labor, 5. harm from sexual intercourse, 6. harm from pregnancy, 7. harm from sleep. The five types of injury are: 1. pain in the orifices, 2. pain from cold, 3. lower abdominal pain, 4. insensitivity of the zang organs, 5. misalignment of the zi men (cervix/os) pulling on the back. The three types of fixation are: closure and obstruction of menstruation. The other two types are missing from the text. Zhang Zhongjing stated that the thirty-six diseases all arise from cold-heat imbalance and damage to the zi zang (uterus), originating within the yin.