肝气者。妇女之本病。妇女以血为主。血足则盈而木气盛。血亏则热而木气亢。木盛木亢。皆
易生怒。故肝气唯妇女为易动焉。然怒气泄则肝血必大伤。怒气郁则肝血又暗损。怒者。血
之贼也。其结气在本位者。为左胁痛。移邪于肺者。右胁亦痛。气上逆者。头痛目痛。胃脘痛。气
旁散而下注者。手足筋脉拘挛。腹痛小腹痛。瘰 乳岩。阴肿阴痒阴挺诸症。其变病也不一。
随症而治之。
左胁痛。肝气不和。柴胡疏肝散。若七情郁结。用逍遥散、解恨煎。右胁痛。用推气散。如肝燥而皮泡胀
痛者。栝蒌散。头痛者。痛或连眉棱骨眼眶。逍遥散主之。目痛者。蒺藜汤加柴胡、山栀。胃脘痛者。
沉香降气散、柴胡疏肝散并主之。手足筋脉拘挛者。肝气热也。五痿汤加黄芩、丹皮。腹痛者。木乘
土也。芍药甘草汤主之。小腹痛者。疝瘕之气。橘核丸主之。
瘰 者。血燥有火也。消瘰丸散之。兼服逍遥散。乳岩者。逍遥散、归脾汤二方间服。阴肿阴痒阴挺
诸症。逍遥散主之。甚则龙胆泻肝汤。
带症有青黄赤白黑之分。亦不必分属五脏。总之不外乎脾虚有湿而已。用五味异功散加
扁豆、苡仁、山药、泽泻等。无不愈者。倘挟五色。则加本脏药一二味亦可。若有热。加黄柏、莲心
为得。
青色属肝。异功散加柴胡、山栀。黄色属脾。加石斛、荷叶、陈米。赤色属心。加丹参、当归。白色属肺。
倍加苡仁。黑色属肾。加杜仲、续断。
Liver Qi (Liver Qi) disease is the fundamental pathology in women. Women take Blood (Blood) as their essence. When Blood is sufficient, Yin-Blood is full and Liver Wood Qi (Liver Wood Qi) is prosperous; when Blood is deficient, internal Heat (Heat) arises and Liver Wood Qi becomes hyperactive. Both prosperity and hyperactivity of Liver Wood easily generate anger. Therefore, Liver Qi stagnation is most prone to occur in women. However, venting anger through diarrhea will severely damage Liver Blood, while suppressing anger will secretly impair Liver Blood. Anger is the thief that harms Blood. If Qi stagnates in its own location (the Liver), it manifests as pain in the left hypochondrium; if the pathogenic factor shifts to the Lung, pain also occurs in the right hypochondrium. When Qi rebels upward, symptoms include headache, eye pain, and epigastric pain. When Qi scatters laterally and flows downward, symptoms include spasm of tendons and vessels in the hands and feet, abdominal pain, lower abdominal pain, scrofula (Scrofula), breast cancer (Breast Cancer), vulvar swelling, vulvar pruritus, and uterine prolapse (Uterine Prolapse). The resulting pathological changes are diverse; treatment should follow the specific symptoms.
Pain in the left hypochondrium indicates Disharmony of Liver Qi, treated with Chaihu Shugan San (Bupleurum Powder to Soothe the Liver). If caused by emotional stagnation, use Xiaoyao San (Free and Easy Wanderer Powder) or Jiehen Jian (Decoction to Remove Hatred). Pain in the right hypochondrium is treated with Tuiqi San (Powder to Push Away Qi). If dryness of the Liver causes blistering and distending pain of the skin, use Gualou San (Trichosanthes Powder). For headache, where pain may radiate to the supraorbital ridge and eye sockets, Xiaoyao San is the primary formula. For eye pain, use Jili Tang (Tribulus Decoction) added with Chai Hu (Radix Bupleuri) and Shan Zhi (Fructus Gardeniae). For epigastric pain, Chenxiang Jiangqi San (Aucklandia Decoction to Descend Qi) and Chaihu Shugan San are both indicated. Spasm of tendons and vessels in the hands and feet indicates Heat in Liver Qi, treated with Wuwei Tang (Five Withered Decoction) added with Huang Qin (Radix Scutellariae) and Dan Pi (Cortex Moutan). Abdominal pain indicates Liver Wood overacting on Spleen Earth, treated with Shaoyao Gancao Tang (Peony and Licorice Decoction). Lower abdominal pain indicates Qi of Hernia and Masses (Hernia and Masses), treated with Juhe Wan (Citrus Seed Pill).
Scrofula is due to Blood dryness with Fire, dispersed using Xiaoluo Wan (Eliminating Scrofula Pill), taken concurrently with Xiaoyao San. Breast cancer is treated by alternating between Xiaoyao San and Guipi Tang (Restore the Spleen Decoction). Various symptoms including vulvar swelling, pruritus, and uterine prolapse are primarily treated with Xiaoyao San; in severe cases, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) is used.
Leukorrhea presents in five colors: green, yellow, red, white, and black. It need not be strictly attributed to the Five Zang Organs. In essence, it is nothing but Spleen Deficiency with Dampness. Using Wumei Yigong San (Five-Ingredient Powder for Extraordinary Merit) added with Bian Dou (Seed of Lablab Purpureus), Yi Ren (Semen Coicis), Shan Yao (Rhizoma Dioscoreae), and Ze Xie (Rhizoma Alismatis) will invariably cure the condition. If mixed with the five colors, adding one or two herbs corresponding to the affected Zang Organ is also effective. If Heat is present, adding Huang Bo (Cortex Phellodendri) and Lian Xin (Plumula Nelumbinis) is appropriate.
Green color corresponds to the Liver; add Chai Hu and Shan Zhi to Yigong San. Yellow corresponds to the Spleen; add Shi Hu (Herba Dendrobii), He Ye (Folium Nelumbinis), and Chen Mi (Rice). Red corresponds to the Heart; add Dan Shen (Radix Salviae Miltiorrhizae) and Dang Gui (Radix Angelicae Sinensis). White corresponds to the Lung; double the dosage of Yi Ren. Black corresponds to the Kidney; add Du Zhong (Cortex Eucommiae) and Xu Duan (Radix Dipsaci).