肝脉抵少腹,环阴器。督脉起少腹以下骨中央,女子入系廷孔,循阴器。凡妇科前阴诸症,不外肝督二
经主病。然有阴肿、阴痒、阴冷、阴挺、阴蚀等类,为条列而分治之。
〔阴肿〕玉门 肿,并两 俱痛,憎寒发热,小水涩少,肝经湿热也,龙胆泻肝汤渗而清之。阴肿急痛,
寒热往来,肝火血虚也,加味逍遥散凉而调之。风热客于阴经, 发肿痛,小水淋沥,积热闭结也,元参、
荆芥、 本、甘草梢,加入大厘清饮宣以泄之。阴肿下坠,气血虚陷也,补中益气汤举而补之。但肿痛者,
加味四物汤凉而和之。肿痛而玉门不闭者,夹虚也,逍遥散、或十全大补汤和而补之。湿痒出水,兼痛者,
忧思过也,归脾汤加丹、芍、柴、栀调畅之。腐溃者,内服逍遥散,外以黄柏面、海螵蛸末渗之。如因产伤
阴户而肿者,不必治肿,但调气血,肿自退。产后受风而肿者,芎归汤加羌、防、荆芥等,煎汤洗之。阴肿
如石,痛不可忍,二便不利,用枳实、陈皮各四两,炒香研末,乘热以绢包,从上身熨至下部,并阴肿处频
频熨之,冷则互换。气行自愈。又阴肿以海螵蛸散外敷。
〔阴痒〕阴中痒,多由肝经湿热,化生 虫,微则痒,甚则痛,或脓水淋沥,治宜清肝火。加味逍遥散、
龙胆泻肝汤。如小腹胀痛,晡发寒热者,加味小柴胡汤。怒伤肝脾,胸闷阴痒者,加味归脾汤。瘦人阴虚燥
痒者,六味丸三钱,合滋肾丸一钱,外用蛇床子、川椒煎汤熏洗。日三次。痒甚必有虫,以甘庶渣烧灰,入冰
片擦之,或以猪肝煮熟,纳阴中,引虫出。一妇患此,诸药不效,因食黍 米饭粥而愈。
〔阴冷〕妇人阴冷,由风冷客于子脏。宜五加皮酒。其肥盛而阴冷者,多湿痰下流。二术二陈汤加羌活、
防风。立斋谓∶阴
冷属肝经湿热,外乘风冷。若小便涩滞,小腹痞痛,宜龙胆泻肝汤。内伤寒热,经候不调,宜加味逍遥散。
寒热体倦,饮食少思,加味四君子汤。郁怒发热,少寐懒食,加味归脾汤。下元虚冷,腹痛便溏,八味丸。
阴冷,用温中坐药。蛇床子研末,白粉少许,和匀,如枣大,绵裹纳阴中。自热,或以蛇床子五钱,吴茱萸三
钱,加麝少许,为末蜜丸,以绵裹纳之。
〔阴挺〕妇人阴中挺出数寸,如菌如芝。因损伤胞络,或临产用力所致,以升补元气为主。补中益气汤。
若肝经湿热,小水涩滞,龙胆泻肝汤。阴虚滑脱,固阴煎、秘元煎。肝脾气郁,归脾汤。服药不效,用一捏
金丸。妇人瘕聚,阴中突出如茄子,与男疝同,亦名 疝,卧则上升,立则下坠,多因气虚,劳力举重。
宜大补元煎。
〔阴蚀〕阴中生疮如小蛆,名曰 ,痛痒如虫行,脓水淋沥。乃七情郁火,伤损肝脾,致湿热下注。其
外症突出蛇头,或如鸡冠,肿痛湿痒,溃烂出水。其内症,口干内热,经候不调,饮食无味,体倦发热,胸
膈不利,小腹痞胀,赤白带下。其治法,肿痛者,加味四物汤。湿痒者,加味归脾汤。淋涩者,龙胆泻肝汤。
溃腐者,加味逍遥散。肿闷脱坠者,补中益气汤加山栀、丹皮。佐以外治法。《肘后方》∶杏仁、雄黄、
白矾各五钱、麝香二分,为末敷入。
〔交接出血〕女人交接辄出血作痛,多由阴气薄弱,肾元不固,或阴分有火而然。如肝肾阴虚不摄者,
固阴煎。阴分有火者,保阴煎。心脾不摄者,归脾汤。《千金方》用桂心、伏龙肝各五钱,为末酒下。交接
违理出血,用乱发、青布,烧灰敷之,立止。或以赤石脂末渗之,或以五倍子末掺之。一妇交接出血,辄
面黄如蜡,终身不育。
〔伤丈夫头痛〕强弱相陵,四肢沉重,头痛昏晕,局方来复丹。立斋用补中益气汤、六味丸以滋化源。
《集验方》∶用生地八两,白芍五两,甘草三两,香豉一升,葱白四两,生姜二两,水七升,煮取二升,
分三服。忌房事。
〔小户嫁痛〕内用甘草、生姜、白芍各五分,桂心二分,煎
服。外用甘草、小麦煎汤洗,效。或以海螵蛸、烧为末,酒调服。
The Liver meridian descends to the lower abdomen and encircles the external genitalia. The Du meridian originates from the central part below the bones of the lower abdomen; in women, it enters and connects with the Ting Kong (opening of the uterus/vagina), and ascends along the external genitalia. All gynecological disorders of the anterior yin are essentially diseases governed by the Liver and Du meridians. However, conditions such as Yin swelling (swelling of the vulva/vagina), Yin itching, Yin coldness, Yin prolapse (uterine prolapse), and Yin erosion are listed separately for differentiated treatment.
[Yin Swelling] Swelling of the Yu Men (vaginal opening), accompanied by pain on both sides, aversion to cold, fever, and scanty, difficult urination, is caused by Damp-Heat in the Liver meridian. Treat with Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) to drain dampness and clear heat. Acute pain of Yin swelling with alternating chills and fever indicates Liver Fire with Blood deficiency. Treat with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) to cool and regulate. If Wind-Heat invades the Yin meridians causing swelling and pain with dribbling urination, this is due to accumulated Heat blocking and binding. Use Xuanshen (Scrophulariae Radix), Jingjie (Schizonepetae Herba), Gaoben (Ligustici Rhizoma et Radix), and Gancao Shao (Glycyrrhizae Radix et Rhizoma) added to Dali Qingyin to disperse and vent the heat. Drooping of Yin swelling indicates Qi and Blood deficiency sinking. Treat with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to lift and tonify. For simple swelling and pain, use Jiawei Siwu Tang (Modified Four Substances Decoction) to cool and harmonize. Swelling and pain with inability of the Yu Men to close indicate a mixed deficiency pattern. Treat with Xiaoyao San or Shiquan Dabu Tang (Ten Significant Tonifying Decoction) to harmonize and tonify. Itching with weeping fluid and pain, caused by excessive worry and thought, should be treated with Guipi Tang (Restore the Spleen Decoction) plus Danpi (Moutan Cortex), Shaoyao (Paeoniae Radix), Chaihu (Bupleuri Radix), and Zhizi (Gardeniae Fructus) to smooth the Qi mechanism. For ulceration and rotting, take Guipi Tang internally, and apply Huangbai (Phellodendri Cortex) powder and Haipiaoxiao (Sepiae Endoconcha) externally to dry dampness and astringe. If swelling results from childbirth injury to the vaginal introitus, there is no need to treat the swelling specifically; simply regulate Qi and Blood, and the swelling will subside spontaneously. For swelling due to Wind invasion postpartum, wash with a decoction of Xionggui Tang (Angelica and Ligusticum Decoction) plus Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), and Jingjie. If the Yin swelling is hard as stone and unbearable painful with obstruction of both bowels and bladder, use Zhi Shi (Aurantii Fructus Immaturus) and Chenpi (Citri Reticulatae Pericarpium), each 4 liang, stir-fried until fragrant and ground into powder. Wrap in silk while hot and apply moxibustion-like warming compresses from the upper body down to the lower part, frequently applying to the swollen area; replace when cool. When Qi moves freely, health returns. Alternatively, apply Haipiaoxiao San externally to Yin swelling.
[Yin Itching] Itching within the vagina is mostly due to Damp-Heat in the Liver meridian generating parasites. Mild cases cause itching, severe cases cause pain, possibly with purulent discharge. Treatment should focus on clearing Liver Fire. Use Jiawei Xiaoyao San or Longdan Xiegan Tang. If there is lower abdominal distending pain with evening onset of chills and fever, use Jiawei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction). Anger injuring Liver and Spleen causing chest tightness and Yin itching should be treated with Jiawei Guipi Tang. In thin individuals with Yin deficiency causing dry itching, take Liuwei Wan (Six-Ingredient Pill with Rehmannia) 3 qian combined with Zishen Wan (Kidney-Nourishing Pill) 1 qian. Externally, fumigate and wash with Shechuangzi (Cnidii Fructus) and Chuanjiao (Zanthoxyli Pericarpium) decoction, three times daily. Severe itching implies the presence of parasites. Burn sugarcane dregs to ash, add Bingpian (Borneolum Syntheticum), and apply. Alternatively, cook pork liver thoroughly and insert into the vagina to draw out parasites. One woman suffered from this condition unresponsive to various medicines but was cured after eating millet rice porridge.
[Yin Coldness] Female Yin coldness is caused by Wind-Cold invading the Zi Zang (uterus). Wujia Pi Jiu (Acanthopanacis Cortex Wine) is suitable. For obese women with Yin coldness, it is often due to Damp-Phlegm flowing downward. Use Er Zhu Er Chen Tang (Two Atractylodes and Two Citrus Decoction) plus Qianghuo and Fangfeng. Li Zhai stated: Yin coldness belongs to Damp-Heat in the Liver meridian compounded by external Wind-Cold. If urination is obstructed and the lower abdomen is distended and painful, use Longdan Xiegan Tang. Internal Cold-Heat with irregular menstruation should be treated with Jiawei Xiaoyao San. Chills, fever, fatigue, and poor appetite require Jiawei Sijunzi Tang (Modified Four Gentlemen Decoction). Depressive anger with fever, insomnia, and anorexia call for Jiawei Guipi Tang. Deficiency-Cold of the Lower Yuan with abdominal pain and loose stools requires Ba Wei Wan (Eight-Ingredient Pill). For Yin coldness, use warming sitz medications. Grind Shechuangzi into powder, mix with a small amount of Bai Fen (rice flour), form into dates-sized pills, wrap in cotton, and insert into the vagina. It will generate warmth. Alternatively, use Shechuangzi 5 qian, Wuzhuyu (Evodiae Fructus) 3 qian, add a little Muxiang (though text says Muxiang/Musk contextually usually implies Musk here given "Muxiang" vs "Muxiang" typo potential, text says "Muxiang" which is Musk/Ruyi, wait text says "Muxiang" -> Musk? No, text says "Muxiang" is likely a typo for "Muxiang" (Agastache) or "Muxiang" (Costus)? Actually "Muxiang" usually refers to Costus root, but in this context of warming/musk-like effect, let's stick to literal translation of ingredients provided: Wu Zhu Yu + "Muxiang" (likely intended as Musk/Renshui or similar potent warming agent, but strictly translating text: Muxiang/Costus). *Correction*: Text says "Muxiang" (麝香 - Musk) is not explicitly written, it says "Muxiang" (木香 - Costus) or "Muxiang" (麝香 - Musk)? The text says "Muxiang" (麝香) is NOT in the text segment "加麝少许". Ah, looking closely at the prompt text: "加麝少许". Yes, it is She (Musk). So: Add a little She (Musk). Grind into powder, make honey pills, wrap in cotton, and insert.
[Yin Prolapse] Tissue protruding several inches from the vagina, resembling mushrooms or lingzhi, caused by damage to the Bao Luo (uterine collaterals) or exertion during childbirth. Treatment primarily focuses on lifting and tonifying Yuan Qi. Use Buzhong Yiqi Tang. If Liver Damp-Heat causes obstructed urination, use Longdan Xiegan Tang. Yin deficiency with slipping/prolapse requires Guyin Jian (Secure Yin Decoction) and Miyuan Jian (Secret Prime Decoction). Liver-Spleen Qi stagnation calls for Guipi Tang. If medication is ineffective, use Yi Nie Jin Wan. For female Zha Ju (masses), tissue protruding like an eggplant, identical to male hernia, also named Hu Hernia, rising when lying down and dropping when standing, mostly due to Qi deficiency from labor and heavy lifting. Use Dabu Yuan Jian.
[Yin Erosion] Ulcers appearing like small maggots in the vagina, termed Du Jing (or specific erosive condition), with pain and itching like insects crawling, and purulent discharge. This results from emotional stagnation transforming into Fire, damaging Liver and Spleen, leading to Damp-Heat pouring downward. External symptoms include protrusions like snake heads or chicken combs, with swelling, pain, dampness, itching, ulceration, and weeping. Internal symptoms include dry mouth, internal heat, irregular menstruation, loss of taste, fatigue, fever, chest oppression, lower abdominal distension, and red-and-white leukorrhea. Treatment: For swelling and pain, use Jiawei Siwu Tang. For dampness and itching, use Jiawei Guipi Tang. For dribbling and obstruction, use Longdan Xiegan Tang. For ulceration and rotting, use Jiawei Xiaoyao San. For swelling, oppression, and prolapse, use Buzhong Yiqi Tang plus Zhizi and Danpi. Assist with external treatments. From *Zhouhou Fang*: Almond, Xionghuang (Realgar), Baifan (Alumen), each 5 qian, and She (Musk) 2 fen, grind into powder and apply inside.
[Bleeding upon Intercourse] Women experiencing bleeding and pain immediately after intercourse are mostly due to weak Yin Qi, insecure Kidney Essence, or Fire in the Yin aspect. For Liver-Kidney Yin deficiency failing to contain blood, use Guyin Jian. For Fire in the Yin aspect, use Baoyin Jian (Preserve Yin Decoction). For Heart-Spleen failing to contain blood, use Guipi Tang. *Qianjin Fang* prescribes Guixin (Cinnamomi Cortex) and Fulonggan (Dragon's House Earth), each 5 qian, taken with wine. Bleeding due to improper intercourse can be stopped immediately by applying ash made from tangled hair and blue cloth. Alternatively, apply Chishizhi (Halloysit Rubrum) powder or Wubeizi (Myrobalani Fructus) powder. One woman bled upon intercourse, resulting in a sallow complexion like wax and lifelong infertility.
[Headache from Injury by Husband] When strength is mismatched, causing heavy limbs, headache, and dizziness, use Jufang Laifu Dan. Li Zhai used Buzhong Yiqi Tang and Liuwei Wan to nourish the source of transformation. *Jiyan Fang*: Use Dihuang (Rehmanniae Radix) 8 liang, Baishao (Paeoniae Radix Alba) 5 liang, Gancao (Glycyrrhizae Radix) 3 liang, Xiangchi (Fermented Soybean) 1 sheng, Congbai (Allii Fistulosi Bulbus) 4 liang, and Shengjiang (Zingiberis Rhizoma Recens) 2 liang. Boil in 7 sheng of water to obtain 2 sheng, divide into three doses. Avoid sexual activity.
[Xiaohu Jiatong (Small Household Marriage Pain)] Internally, decoct Gancao, Shengjiang, and Baishao, each 5 fen, and Guixin 2 fen, and take orally. Externally, wash with a decoction of Gancao and Xiaomai (Tritici Fructus); effective. Alternatively, burn Haipiaoxiao to powder, mix with wine, and take orally.