子和云∶一妇人病带下,连绵不绝,白物或来,已三载矣,命予脉之。诊其两手脉俱滑
大而有力,得六七至,常上热口干,眩晕,时呕酢水,予知其实有寒痰在胸中,以瓜蒂散吐
出冷痰二三升,皆酢水也,间如黄涎,状如烂胶。次以浆粥养其胃气,又次用导水禹功,以
泻其下,然后以淡剂渗泄之药,利其水道,不数日而愈。(脉证俱属实热,而曰寒痰者,盖为败浊之液,既聚成痰,
则与本气不相和,故痰积之久,自成冷物。曰寒痰者,因病患自觉其冷而言,然亦有热者,不可不明,如酢水酸水也,
岂属寒耶)
息城李左衙之妻,病白带,如水窈漏中绵绵不绝,臭秽之气不可近,面黄食减,已三年
矣。诸医皆云积冷,阳起石、硫黄、姜、附之药,重重燥补,污水转多。戴人断之曰∶此带
浊水,本热乘太阳经,其寒水不禁固,故如此也。夫水自高而趋下,宜先绝其上源(肾主秘藏,热乘之,则坚凝之性
失矣!故不能秘藏而带下,绝其上源之法,妙甚),乃涌痰
二三升,次日下污水斗余,行三遍,汗出周身,至明旦,病患云∶污已不下矣。次用寒凉之
剂,服及半载,产一男。
丹溪云∶带与漏俱是胃中痰积流下,渗入膀胱(积痰恐不能渗入膀胱,若言湿热则可),
无人知此,只宜升提,甚者上必用吐,
以提其气,下用二陈汤加白术苍术,仍用丸子。肥人有带,多是湿痰,用海石、半夏、南星
、炒柏、青黛、苍术、川芎(方中并无升提法,惟川芎一味为血分升气之药)。瘦人带病少,如有多是热,用炒柏、蛤
粉、滑石、川芎、青黛、樗皮。(丹溪治带,与白浊同,是男女之湿热一也)
罗先生法∶或十枣汤,或神佑丸,或玉烛散,皆可用之。虚者不可峻攻,实者可行。
洁
Dai Ren once said: A woman suffered from leukorrhea (dai xia), continuous and unceasing, with white discharge occurring intermittently for three years. I was asked to examine her pulse. Upon palpating both wrists, the pulses were slippery, large, and forceful, beating six or seven times per breath cycle. She frequently experienced upper body heat, dry mouth, dizziness, and occasional vomiting of sour fluid. I determined that there was indeed cold phlegm accumulated in her chest. I administered Gengti San (Melon Stalk Powder) to induce vomiting, expelling two to three sheng of cold phlegm, which consisted mainly of sour fluid, interspersed with yellow saliva-like substance resembling rotten glue. Subsequently, I nourished her stomach qi with grain porridge. Next, I used Daoshui Yugong Wan (Water-Guiding Yu Gong Pill) to purge the lower jiao, followed by administering mild diuretic herbs to promote water metabolism. Within a few days, she recovered. (Note: Although the pulse and symptoms indicated excess-heat, it was termed "cold phlegm" because turbid fluids, once aggregated into phlegm, become discordant with the original qi; thus, long-standing phlegm accumulation feels cold. The term "cold phlegm" arises from the patient's subjective sensation of cold, but one must recognize that phlegm can also be hot; for instance, sour fluid is clearly not cold.)
The wife of Li Zuo Ya from Xicheng suffered from leukorrhea resembling clear water leaking continuously from a hole, with a foul odor that was unbearable. Her complexion was sallow, and her appetite was diminished for three years. Various physicians diagnosed it as accumulated cold and prescribed warming, drying, and tonifying herbs such as Yangqishi (Stalactite), Liuhuang (Sulfur), Jiang (Ginger), and Fuzi (Aconite Root). Consequently, the amount of turbid discharge increased. Dai Ren diagnosed this as turbid leukorrhea caused by heat invading the Taiyang Meridian, leading to a failure of the kidney to secure and retain fluids. Since water flows from high to low, one should first cut off its source (The Kidney governs storage; when invaded by heat, its firm and consolidating nature is lost, leading to an inability to store fluids and resulting in leukorrhea. Cutting off the source is a brilliant method). He induced vomiting to expel two to three sheng of phlegm. The next day, more than a dou of turbid water was purged. After three treatments, profuse sweating occurred throughout the body. By the following morning, the patient reported that the discharge had ceased. She then took cooling formulas for half a year and subsequently gave birth to a son.
Danxi stated: Leukorrhea and metrorrhagia are both caused by phlegm accumulation in the stomach flowing downward and seeping into the Bladder. (Note: Phlegm accumulation likely does not directly seep into the Bladder; describing it as damp-heat is more accurate.) No one understood this, believing only in lifting and raising methods. For severe cases, emesis is used above to raise the qi, while Erchen Tang (Two-Cured Decoction) combined with Baizhu (Atractylodes Macrocephala Rhizome) and Cangzhu (Atractylodes Lancea Rhizome) is used below, typically formulated as pills. In obese individuals, leukorrhea is mostly due to damp-phlegm, treated with Haishi (Pumice), Banxia (Pinellia Tuber), Nanting (Arisaema Cum Bile), Chao Baihuanglian (Fried Phellodendron Bark), Qingdai (Indigo Naturalis), Cangzhu, and Chuanxiong (Ligusticum Chuanxiong Rhizome). (Note: This formula contains no lifting agents; only Chuanxiong acts to lift qi within the blood level.) Lean individuals rarely suffer from leukorrhea; if they do, it is mostly due to heat, treated with Chao Baihuanglian, Ge Fen (Margarita), Huashi (Talcum), Chuanxiong, Qingdai, and Chu Pi (Catechu Bark). (Note: Danxi’s treatment of leukorrhea is identical to that of white turbidity, indicating that the principle of damp-heat applies equally to men and women.)
Master Luo’s method: One may use Shizao Tang (Ten Jujube Decoction), Shenyu Wan (Shen Yu Pill), or Yuzhu San (Jade Candle Powder), all of which are applicable. Deficiency patterns should not be treated with harsh purgatives, whereas excess patterns can undergo purgation.