自妇女前阴、疮 、菌挺,一切皆汇于此部中,以便检阅参治。
《金匮》云∶胃气下泄,阴吹而正喧,此谷气既不能上升清道,复不能循经下走
后阴,阴阳乖僻,如肠交之义是也。甚或簌簌有声,如后阴之失气状,宜补中益气汤加五味子主之。
《见闻随录》云∶产妇不得食葱,如误食之,必成阴吹。
王肯堂曰∶阴器属足厥阴肝经、任脉之会。(《准绳》)
又曰∶运气阴疮皆属寒。经云∶太阳之湿,阴中乃疡,隐曲不利,治以苦热是也。
《素问》云∶厥阴之脉络阴器,系于肝。
又云∶督脉者,其络循阴器合纂间是也。至于足太阳外合清水,内属膀胱而通
水道,手太阳外合淮水,内属小肠而水道出焉,则又属手足太阳也。肾主水则又属
足少阴也。饮入于胃,游溢精气,上输于脾,脾气散精,上归于肺,通调水道,下
输膀胱,则又属手太阴也。《素问》又谓前阴者,宗筋之所聚,太阳阳明之所合,则
又属脾与肾矣。痈疮生其间,须细心求而责之,不可专主一厥阴肝经,而惟清肝导湿之为事,斯无误矣。
《灵枢》云∶筋者聚于阴器,而脉络于舌本,肝者筋之会也,又属督脉。
张仲景云∶少阴脉滑而数者,阴中即生疮,阴中蚀烂者,野狼牙汤洗之。(用野狼牙二两,
以水四升煮至半升,以绵缠箸如茧,浸汤沥阴中茧二遍。)
岐天师曰∶大约暗疾,妇人十居其九,或生于儿门之外,或生于儿门之中,止可
陈说,然犹有羞愧而不肯尽言者,止可意会,而默思之也。大约儿门之病,非痒则
痛,当以默治汤主之,此汤皆是平肝去湿之品,毋论有火无火,有风有湿,俱奏奇
功,正不必问其若何痒,若何肿,若何痛,若何烂也。(《秘录》)
陈实功曰∶妇人阴疮乃七情郁火伤损肝脾,湿热下注为患,形多不一,总由邪火所化也。(《正宗》)
薛立斋曰∶阴户毛际正中发毒名曰阴盖毒,红肿疼痛,此乃肝火郁结而成。治
当清肝养血,外用敷消,如已成脓,治同痈疽法。
又曰∶阴户一边结肿,亦有两边结肿,其形如茧,名曰阴茧。内脓成自溃头,得
之于肝火湿热,或新婚伤损,或交合不洁染毒,均成此证。
又曰∶阴户内子宫肿痛溃烂,名廷孔毒。肝火郁结者重,交合所伤者轻,俱用
海浮散油调灌入,仰卧良久,后换玉红膏调海浮散,以绵润透,插入自效。
The anterior yin of women, along with conditions such as yin sores (ulcers of the vulva/vagina) and jun ting (vaginal polyps/prolapse), are all compiled in this section for easy reference and treatment consultation.
*Jingui Yaolue* states: "When stomach qi descends abnormally, causing yin blowing (flatulence from the vagina) with loud noise, it is because grain qi cannot ascend to the clear orifices, nor can it follow the meridians downward to exit through the posterior yin. The yin and yang qi are deviant and disordered, similar to the meaning of intestinal entanglement." In severe cases, there may be rustling sounds resembling flatulence from the anus. The appropriate treatment is Buzhong Yiqi Tang (Supplement the Middle and Boost Qi Decoction) added with Wuweizi (Schisandra Berry).
*Jianwen Suilu* records: "If a postpartum woman consumes green onions, accidental ingestion will inevitably lead to yin blowing."
Wang Kentang stated: "The external genitalia are the convergence point of the Foot-Jueyin Liver Meridian and the Ren Mai (Conception Vessel)." (*Zhunsheng*)
He further stated: "According to the theory of influencing factors (Yunqi), yin sores belong to cold patterns. The classic text says: 'With dampness of Taiyang, ulcers occur in the yin region, accompanied by difficulty in private functions; treat with bitter-hot herbs.' This refers to the use of bitter and hot natured medicines."
*Suwenn* states: "The meridians of Jueyin connect to the external genitalia and are tied to the Liver."
It also states: "The Luo (Connecting) vessels of the Du Mai (Governing Vessel) circulate along the external genitalia and converge between the perineum." As for the Foot-Taiyang Bladder Meridian, it externally corresponds to clear water, internally belongs to the Bladder, and regulates water passages; the Hand-Taiyang Small Intestine Meridian externally corresponds to Huai water, internally belongs to the Small Intestine, and water passages emerge from it. Thus, these involve the Hand and Foot Taiyang meridians. Since the Kidney governs water metabolism, this also involves the Foot-Shaoyin Kidney Meridian. When drink enters the Stomach, its essence floats up, is transported upward to the Spleen, the Spleen scatters the essence, which returns upward to the Lung; the Lung regulates water passages and transports them downward to the Bladder. Thus, this involves the Hand-Taiyin Lung Meridian. *Suwenn* further states that the anterior yin is where the Zongjin (Major Sinews) gather, and is the convergence of the Taiyang and Yangming meridians; thus, it also involves the Spleen and Kidney. When abscesses and sores arise in this area, one must carefully investigate the cause and determine responsibility. One should not focus solely on the Foot-Jueyin Liver Meridian, treating only by clearing Liver heat and draining dampness, to avoid errors.
*Lingnu* states: "Sinews gather at the external genitalia and their meridians connect to the root of the tongue. The Liver is the assembly of sinews, and it also relates to the Du Mai."
Zhang Zhongjing stated: "When the Shaoyin pulse is slippery and rapid, sores will appear in the yin region. If the yin region is eroded and ulcerated, wash it with Yelangya Tang (Wolf's Tooth Decoction). [Usage: Use two liang of Yelangya (Tetracentron sinense stem bark), boil in four sheng of water until reduced to half a sheng. Wrap cotton around a chopstick like a silkworm cocoon, dip in the decoction, and irrigate the yin region twice.]"
Qian Tianshi said: "Roughly, nine out of ten hidden diseases affect women. They may occur outside or inside the Ermen (anus). These can only be described generally, yet many feel ashamed and unwilling to speak fully. They can only be understood intuitively and contemplated silently. Generally, diseases of the Ermen present as either itching or pain. They should be treated with Mozhi Tang (Silent Treatment Decoction). This formula consists of herbs that soothe the Liver and remove dampness. Regardless of whether there is fire or no fire, wind or dampness, it achieves miraculous results. There is no need to ask specifically how it itches, swells, hurts, or ulcerates." (*Milu*)
Chen Shigong stated: "Women's yin sores are caused by emotional stagnation transforming into fire, damaging the Liver and Spleen, with damp-heat pouring downward. The manifestations vary, but all originate from evil fire transformation." (*Zhengzong*)
Xue Lizhai stated: "A toxic sore arising in the center of the hairline of the yin opening is called Yingai Du (Yin Cover Toxin), characterized by redness, swelling, and pain. This is formed by stagnant Liver fire. Treatment should involve clearing the Liver and nourishing blood, with external applications to dissipate swelling. If pus has formed, treat according to the methods for carbuncles and sores."
He further stated: "Swelling nodules on one side of the yin opening, or on both sides, shaped like a silkworm cocoon, are called Yin Jian (Yin Cocoon). Internal pus forms and eventually ruptures spontaneously. This condition results from Liver fire and damp-heat, or injury from new marriage, or infection from unclean intercourse."
He also stated: "Swelling, pain, and ulceration of the uterus within the yin opening are called Tingkong Du (Palace Hole Toxin). Severe cases stem from stagnant Liver fire; mild cases from sexual injury. For both, Hai Fu San (Sea Floating Powder) mixed with oil should be instilled. The patient should lie supine for a long time, then apply Yu Hong Gao (Jade Red Ointment) mixed with Hai Fu San, soaked into a cotton tampon, and inserted for effectiveness."