茯苓汤治支饮手足麻痹多唾眩冒
半夏 赤茯苓 橘红(各一两) 枳实 桔梗 甘草(各半两)
上 咀每服四五钱入姜七片水煎
按此言支饮能为痹证即饮能为香港脚证是也大抵因虚而传注邪客日久荣卫壅郁多致湿热经
缓不能自收持如逢热则纵也以上方未能尽其例用者自宜通变也
内经阴阳别论云二阳之病发心脾有不得隐曲女子不月其传为风消为息贲者死不治东垣曰
妇人
脾胃久虚或形羸气血俱衰而致经水断绝不行或病中消胃热善食渐瘦津液不生夫经者血脉津液
所化津液既绝为热所烁肌肉消瘦时见渴躁血海枯竭病名曰血枯经绝宜泻胃之燥热补盖气血经
自行矣此证或经适行而有子子不安为胎病者有矣或心包脉洪数燥作时见大便秘涩小便虽清不
利而经水闭绝不行此乃血海干枯宜调血脉除包络中火邪而经自行矣内经所谓小肠移热于大肠
为痣瘕为沉月涩不利则月事沉滞而不利故云为痣瘕为沉也或因劳心心火上行月事不来安心补
血泻火经自行矣故内经云月事不来者胞脉闭也胞脉者属心而络于胞中令气上迫肺心气不得下
故月事不来也曾治验裴泽之夫人病寒热而月事不至者数年矣已加喘嗽医者率以蛤蚧桂附等投
之曰不然夫人病阴为阳所搏温剂太过故无益而反害投以凉血和血之药则经行矣已而果然
要略曰妇人之病因虚积冷结气为证经水断绝至有历年血寒积结胞门寒伤经络凝坚在上呕
吐涎
唾久成肺痈形体损分在中盘结绕脐寒疝或两胁疼痛与脏相连或结热中痛在关元脉数无疮经候
不匀冷阴掣痛少腹恶寒或引腰脊下根气街(云云)
谨按良方言妇人月水不通由劳伤血气致令体虚受风寒邪气客于胞内损冲任之脉并手太阳
少阴
二经致胞络内血绝不通如以上病机皆略之不议且血病经闭又岂止手太阳少阴二经耶然亦有不
因寒热或痰饮积聚疝瘕所致如七情所动其为气病血从一也况阴道常虚不足者实多宜既血证门
血属阴难成易虚论及后丹溪先生等说
Fuling Tang treats *Zhi Yin* (fluid retention in the chest and diaphragm) manifesting as numbness of the hands and feet, excessive salivation, dizziness, and vertigo.
Banxia (Pinelliae Rhizoma), Chi Fuling (Poria with Red Wood), Juhong (Citri Reticulatae Pericarpium Rubrum) (each 1 liang); Zhishi (Aurantii Fructus Immaturus), Jiegeng (Platycodonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang).
The above herbs are cut into small pieces. For each dose of 4-5 qian, add 7 slices of fresh ginger and decoct with water.
Commentary: The text states that *Zhi Yin* can cause Bi syndrome (obstruction syndrome), implying that fluid retention can also cause Hongjiao (foot disease/gouty arthritis). Generally, this arises from deficiency allowing pathogenic transmission; when pathogens reside for a long time, Ying and Wei (nutritive and defensive qi) become stagnant and depressed, often leading to damp-heat. The meridians become flaccid and unable to maintain their tone; upon encountering heat, they relax and slacken. The aforementioned prescription does not cover all cases; practitioners should adapt it flexibly according to circumstances.
The *Neijing · Yin Yang Bie Lun* chapter states: "Diseases of the Two Yangs originate in the Heart and Spleen; there is difficulty in expressing hidden grievances, and women may experience amenorrhea." If it transmits to Fengxiao (wind emaciation) or Xiben (lung distension), it is a death case, untreatable. Li Dongyuan stated: In women, chronic deficiency of the Spleen and Stomach, or emaciation with exhaustion of both Qi and Blood, can lead to the cessation of menstruation. Alternatively, one may suffer from Zhongxiao (middle xiao/thirst), where stomach heat causes polyphagia but gradual emaciation, failing to generate fluids. Since menstruation is transformed from blood vessels and body fluids, once fluids are exhausted and scorched by heat, muscles waste away, thirst and irritability occur frequently, the Sea of Blood becomes depleted, the disease is named "Blood Dryness" (Xue Ku), and menstruation ceases. It is appropriate to clear dryness-heat from the Stomach and tonify/nourish Qi and Blood, after which menstruation will resume naturally. This condition may also occur if conception happens immediately after menstruation, causing fetal instability. Or, if the Pericardium mer pulse is surging and rapid, with intermittent dryness-heat, constipation, clear but difficult urination, and complete amenorrhea, this indicates depletion of the Sea of Blood; it is appropriate to regulate the blood vessels and clear fire from the Pericardium, after which menstruation will resume. The *Neijing* states that heat transferring from the Small Intestine to the Large Intestine forms masses (Zhijia) and causes sluggish, irregular menstruation, hence termed "Zhijia" and "Chen" (sluggish). Or, due to mental overwork causing Heart Fire to ascend, menstruation stops; calming the mind, nourishing blood, and clearing fire will restore menstruation. Thus, the *Neijing* says: "Menstruation fails to come because the Bao Mai (Uterine Vessels) are closed." The Bao Mai belongs to the Heart and connects to the Uterus. Now, Qi forces upward against the Lung, preventing Heart Qi from descending, hence menstruation does not come. I once treated the wife of Pei Zezhi, who suffered from alternating chills and fever and had no menstruation for several years, accompanied by asthma and cough. Physicians typically administered Gejie (Gecko), Rougui (Cinnamon Bark), and Fuzi (Aconite Root). I said, "Incorrect. This patient's condition involves Yin being constrained by Yang; excessive warm-toning agents are unhelpful and harmful." I prescribed cooling and harmonizing blood herbs, and her menstruation resumed, which proved correct.
The *Jin Gui Yao Lue* states: Women's diseases arise from deficiency, accumulated cold, and stagnated Qi, leading to amenorrhea, sometimes lasting years. Cold-blood accumulation in the Baomen (uterine gate) damages meridians; condensation in the upper part causes vomiting of saliva/phlegm, eventually forming Lung Abscess; damage in the middle causes core-like pain around the umbilicus (Han Han/cold colic); or pain in the hypochondrium connected to organs; or heat accumulation in the center with pain at Guanyuan, rapid pulse without sores, irregular menses, cold pulling pain, aversion to cold in the lower abdomen, or radiation to the waist and spine, extending down to Qichuang (etc.).
Respectfully commenting: Liang Fang states that amenorrhea in women results from labor injuring Qi and Blood, causing body weakness and susceptibility to Wind-Cold pathogens invading the interior of the uterus, damaging the Chong and Ren meridians as well as the Hand Taiyang and Hand Shaoyin meridians, causing absolute blockage of blood in the uterine collaterals. Such pathological mechanisms are briefly mentioned here without detailed discussion. Moreover, blood-related amenorrhea is not limited to just the Hand Taiyang and Hand Shaoyin meridians. However, there are cases not caused by cold/heat, phlegm-fluid retention, or hernias/masses, but rather by emotional disturbances affecting Qi, which subsequently affects Blood. Furthermore, the female pathway is often deficient and insufficient; thus, it is advisable to refer to the section on "Blood belongs to Yin, hard to form, easy to vacate" in the Blood Syndrome chapter, as well as the theories of Mr. Danxi and others.