朱丹溪治陶遵外姑，年七十，形瘦善啖，患白带。食前姜汤吞大补丸五十丸，一二次，午膳后及卧睡时，
各与小胃丹十五丸愈。
胡安人白带下，月经甚多，食少倦怠，面黄，经中血块，有如筋膜者。与参、术等补血气，调脾胃，后诸
症皆除退。惟带不止，以樗皮丸主之。
薛立斋治一妇带下，四肢无力。薛曰∶四肢者，土也。此脾胃虚弱，湿痰下注。以补中益气、《济生》归
脾，二药治之而愈。（雄按∶湿痰何以不治？）
孙文垣治吴涌澜母，年六十余，久患白带，历治不效，变为白崩。诊得右寸滑，左寸弱，两关濡，两尺软
弱。据脉心肾俱不足，中焦有湿。古云崩中日久为淋带，漏下多时骨髓枯。今白物下多，气血日败，法当燥脾，
兼补心肾。以既济丹补其心肾，以断下丸燥中宫之湿，则万全矣。果未终剂而愈。
一僧治蔡大尹内人崩中，赤白带下。用暮头回一把，酒水各半盏，童便半盏，新红花一捻，煎七分，卧
时服，日近一服，久则三服愈。（董炳《集验方》。）
一妇人小腹痞胀，小便时下白带，小水淋沥。此肝经湿热下注，用龙胆泻肝汤而愈。
一女人赤带腰痛，以四君子加干姜、肉桂、地榆而愈。男子腰痛亦效。
一妇人赤白浊腰痛，四君子加当归、杜仲、续断、干姜、地榆而愈。
王海藏云∶李知府妻梅氏，带下病七年，血崩不止，骨痿着床，日服紫菀丸五丸、十丸、十五丸，服下脓
血五升，黄水一升，肉块如鸡子状始愈。（方见瘀血门。）
王教授云∶有来觅赤白带药者，予以震灵丹与之，震灵丹能活血温中故也。以其神效，故书于此。但有孕
不可服。若灸带脉穴，尤奇。（《资生经》。）
一妇人白带兼病痛风，半夏、茯苓、川芎、陈皮、甘草、苍术米泔浸、黄柏酒洗晒干炒、南星、牛膝酒洗，
煎服。（同上。）
萧万舆治龚氏外家，年三十，娩未百日，恣啖生冷，呕吐脐痛，病白带月余，行经冲任冒寒，发热烦渴，赤
带频下，脉沉迟无力，此内真寒而外假热症也。用四物、二陈加炮姜、肉桂、木香，少佐升麻，丸服月余而愈。
一寡妇年三旬，时或憎寒发热，通宵不寐，时或白昼昏睡，喃喃独语，遇劳肢体厥冷，每用姜、葱解表，
遂致热停脾胃，乘虚下注，而患赤带。脉沉伏，重按搏指，以为相火蕴结，外假寒而内真热也。用四物加黄连、
龙胆、炒栀、知母、茯苓、木通，投八剂，诸症悉安。
来天培治一妇，年四旬外，苦于白带，朝夕常流不止，已十余日矣。外症头晕腰痛，诊其脉涩，此肝肾阴
亏，气虚下陷所致。法宜以十剂中涩可去脱之剂治之，否则因循，虑成弱症矣。以六味饮去萸肉、泽泻，加牡
蛎、龙骨、川续断、肉桂、杜仲、白芍、鹿角胶，不数剂而瘳。（雄按；今秋许兰屿室患腰腹左痛，诸药罔瘳。
黄某询其泛愆，进肾气汤多剂，痛益剧，痛甚则白带如注，犹曰虚寒已极，药不能胜，附、桂日增，痛无停晷。
病家谓服此大补而无功，已绝望矣。陈雪舫荐余诊之，左关尺弦数无伦，形消舌赤，夜不成眠，与龟板、乌 、
苁蓉、楝实、枸杞、黄柏、归身、白薇、竹茹、丝瓜络、蒲桃、干藕，一剂即安。数剂后，加熟地、
阿胶补之，泛行而愈。
一闺女年十五岁，夏间患白带月余，更兼腹痛。诊之，六脉俱弦细而数，按之中指下时一沉，此属脾气下
陷，肝脏湿热为患。用升麻、柴胡、苍术、白术、茯苓、半夏、广皮、甘草、黄柏、黄芩，二剂而霍然。
沈尧封曰∶带下有主风冷入于脬络者，巢元方、孙思邈、严用和、杨仁斋、娄全善诸人是也。有主湿热者，
刘河间、张洁古、张戴人、罗周彦诸人是也。有主脾虚、气虚者，赵养葵、薛立斋诸人是也。有主湿痰者，朱
丹溪是也。有主脾虚、肾虚者，张景岳、冯兆张是也。又有主木郁地中者，方约之、缪仲淳是也。其所下之物，
严主血不化而成，张主血积日久而成，刘主热极则津液日出。其治法有用大辛热者，有用大苦寒者，有用大攻
伐者，有用大填补者。虽立论制方，各有意义，然其所下之物，究竟不知为何物。惟丹溪云∶妇人带下，与男
子梦遗同，显然指着女精言。千古疑窦，一言道破。但精滑一症，所因不同，惜其所制之方，囿于痰火二字中
耳。由是言之，白带即同白浊，赤带即同赤浊，此皆滑腻如精者。至若状如米泔，或臭水不粘者，此乃脾家之
物，气虚下陷。然高年亦有患此者，非精气之病，不可混治。
雄按∶带下一症，湿热下注者为实，精液不守者为虚。体强气旺之人，不甚为害，惟干燥则病甚。盖荣
津枯槁即是虚劳。凡泛愆而带盛者，内热逼液而不及化赤也。并带而枯燥全无者，则为干血劳之候矣。汇
而观之，精也，液也，痰也，湿也，血也，皆可由任脉下行而为带。然有虚寒，有虚热、有实热三者之分，
治遗精亦然，而虚寒证较少，故叶天士治带，必以黄柏为佐也。又任脉虚而带下不摄者，往往投滋补而不
应，余以海螵蛸一味为粉，广鱼鳔煮烂，杵丸绿豆大，淡菜汤下，久服无不收功，真妙法也。
Zhu Danxi treated the grandmother of Tao Zun, a seventy-year-old woman who was emaciated but had a good appetite, suffering from leukorrhea (dai xia). Before meals, she took fifty pills of Da Bu Wan (Great Tonifying Pill) swallowed with ginger soup. After one or two doses, she took fifteen pills of Xiao Wei Dan (Small Stomach Pill) after lunch and before sleep, which cured her.
Hu Anren suffered from leukorrhea, with very heavy menstruation, poor appetite, fatigue, sallow complexion, and blood clots in the menstrual flow resembling fascial membranes. She was given Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), and other herbs to tonify Qi and Blood and regulate the Spleen and Stomach. Subsequently, all other symptoms disappeared. Only the leukorrhea persisted, so it was treated primarily with Chu Pi Wan (Bark of Chinese Toona Pill).
Xue Lizhai treated a woman suffering from leukorrhea and weakness in the four limbs. Xue said: "The four limbs belong to Earth (Spleen). This is due to Spleen-Stomach deficiency with Damp-Phlegm sinking downward." It was cured by treating with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Gui Pi Tang from *Ji Sheng Fang* (Prescriptions for Generating Life). (Xu Lingtai notes: Why was Damp-Phlegm not treated separately?)
Sun Wen Yuan treated the mother of Wu Yonglan, over sixty years old, who had suffered from leukorrhea for a long time without effect from previous treatments, which then transformed into white beng (profuse discharge of white material). The pulse was slippery at the right Cun position, weak at the left Cun position, soggy at both Guan positions, and soft/weak at both Chi positions. Based on the pulse, Heart and Kidney were both deficient, with Dampness in the Middle Jiao. As the ancients said: "Prolonged beng leads to lin and dai; prolonged leakage causes marrow exhaustion." Now, excessive discharge of white material indicates daily deterioration of Qi and Blood. The treatment method should be to dry the Spleen and simultaneously tonify the Heart and Kidney. Ji Ji Dan (Ji Ji Pill) was used to tonify the Heart and Kidney, and Duan Xia Wan (Stop Discharge Pill) was used to dry the Dampness in the Middle Palace. The cure was assured. Indeed, she recovered before finishing the course of medication.
A monk treated the wife of Vice-Prefect Cai for beng zhong (metrorrhagia) with red and white leukorrhea. He used one handful of Mu Tou Hui (a herb), half a cup of wine and half a cup of water, half a cup of child's urine, and a pinch of fresh Hong Hua (Carthamus tinctorius L.), decocted to seven-tenths volume, taken at bedtime. Taking nearly one dose daily, three doses over a long period cured her. (From Dong Bing's *Ji Yan Fang*.)
A woman suffered from epigastric fullness and distension, intermittent discharge of white leukorrhea with urination, and dribbling dysuria. This was due to Damp-Heat pouring downward from the Liver Channel. It was cured by Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver).
A young woman with red leukorrhea and lower back pain was cured by Si Jun Zi Tang (Four Gentlemen Decoction) added with Gan Jiang (Dried Ginger), Rou Gui (Cinnamon Bark), and Di Yu (Sanguisorbae Radix). This formula is also effective for lower back pain in men.
A woman with red and white turbid discharge and lower back pain was cured by Si Jun Zi Tang added with Dang Gui (Angelicae Sinensis Radix), Du Zhong (Eucommiae Cortex), Xu Duan (Dipsaci Radix), Gan Jiang, and Di Yu.
Wang Haicang stated: The wife of Prefect Li, Ms. Mei, suffered from leukorrhea for seven years, with continuous metrorrhagia, bone atrophy confining her to bed. She took five, ten, and fifteen pills of Zi Wan Wan (Aster Pill) daily. After taking them, she discharged five sheng of pus and blood, one sheng of yellow fluid, and meat-like lumps the size of chicken eggs, after which she recovered. (Formula see section on Blood Stasis.)
Professor Wang stated: Someone came seeking medicine for red and white leukorrhea. I gave him Zhen Ling Dan (Zhen Ling Pill) because it can invigorate Blood and warm the Middle. Due to its miraculous efficacy, I recorded it here. However, pregnant women must not take it. Moxibustion on the Dai Mai acupoint is especially wonderful. (From *Zi Sheng Jing*.)
A woman with leukorrhea complicated by gouty arthritis was treated with Ban Xia (Pinelliae Rhizoma), Fu Ling (Poria), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Cang Zhu (Atractylodis Rhizoma soaked in rice water), Huang Bai (Phellodendri Cortex washed with wine, dried, and stir-fried), Nan Xing (Arisaematis Rhizoma), and Niu Xi (Achyranthis Bidentatae Radix washed with wine), decocted and taken orally. (Same source as above.)
Xiao Wanyu treated the relative of the Gong family, thirty years old, less than one hundred days postpartum. She indulged in raw and cold foods, leading to vomiting and umbilical pain, and leukorrhea for over a month. During menstruation, the Chong and Ren vessels were invaded by Cold, causing fever, irritability, and thirst, with frequent red leukorrhea. The pulse was deep, slow, and powerless. This was a syndrome of true internal Cold and false external Heat. Si Wu Tang (Four Substances Decoction) and Er Chen Tang (Two Aged Herbs Decoction) were used, added with Pao Jiang (Prepared Dried Ginger), Rou Gui, and Mu Xiang (Aucklandiae Radix), with a small amount of Sheng Ma (Cimicifugae Rhizoma). Taken as pills for over a month, she recovered.
A widow, around thirty years old, occasionally experienced aversion to cold and fever, insomnia all night, daytime drowsiness, and muttering to herself. Upon exertion, her limbs became cold. Each time she used Jiang (Ginger) and Cong Bai (Scallion White) to release the exterior, Heat stopped in the Spleen and Stomach, poured downward through deficiency, causing red leukorrhea. The pulse was deep and hidden, beating forcefully upon heavy pressure. This was considered accumulation of Minister Fire, presenting as false external Cold and true internal Heat. Si Wu Tang was added with Huang Lian (Coptidis Rhizoma), Long Dan Cao (Gentianae Radix), Chao Zhi Zi (Stir-fried Gardenia Fruit), Zhi Mu (Anemarrhenae Rhizoma), Fu Ling, and Mu Tong (Akebiae Caulis). Eight doses resolved all symptoms.
Lai Tianpei treated a woman, over forty years old, suffering from leukorrhea flowing continuously day and night for over ten days. External symptoms included dizziness and lower back pain. The pulse was choppy. This was caused by deficiency of Yin in the Liver and Kidney, with Qi deficiency and sinking. The treatment method should use a prescription from the Ten Formulas that has an astringent action to prevent collapse. Otherwise, procrastination might lead to a chronic weak condition. Liu Wei Di Huang Yin (Six Ingredient Pill with Rehmannia Decoction) was modified by removing Shan Zhu Yu (Corni Fructus) and Ze Xie (Alismatis Rhizoma), adding Mu Li (Ostreae Concha), Long Gu (Fossilia Ossis Mastodi), Chuan Xu Duan (Dipsaci Radix), Rou Gui, Du Zhong, Bai Shao (Paeoniae Radix Alba), and Lu Jiao Jiao (Colla Cornus Cervi). She recovered after a few doses. (Xu Lingtai notes: This autumn, the wife of Xu Lanyu suffered from left-sided waist and abdominal pain, unresponsive to various medicines. Mr. Huang asked about her menstrual irregularities and administered Shen Qi Tang (Kidney Qi Decoction) for many doses, which aggravated the pain. Severe pain caused leukorrhea to pour like a stream. He still claimed extreme deficiency-Cold, stating medicines could not overcome it, increasing Fu Zi (Aconiti Lateralis Radix Praeparata) and Rou Gui daily, with no cessation of pain. The family felt hopeless after this major tonification failed. Chen Xuefang recommended me to diagnose. The Left Guan and Chi pulses were wiry and rapid beyond measure. The body was emaciated, tongue red, unable to sleep at night. I prescribed Gui Ban (Testudinis Carapax et Plastrum), Ou Hai Xiao (Sepiae Endoconcha), Rou Cong Rong (Cistanches Herba), Lian Shi (Meliae Semen), Gou Qi Zi (Lycii Fructus), Huang Bai, Dang Gui Shen (Angelicae Sinensis Radix), Bai Wei (Cynanchi Stauntonii Radix), Zhu Ru (Bambusae Folium), Si Gua Luo (Luffae Fructus Retinervus), Pu Tao (Vitis Vinifera), and Gan Ou (Zingiberis Rhizoma Recens). One dose brought relief. After several doses, Shu Di Huang (Rehmanniae Radix Preparata) and E Jiao (Colla Corii Asini) were added to tonify. Menstruation resumed, and she recovered.)
A fifteen-year-old maiden suffered from leukorrhea for over a month in summer, accompanied by abdominal pain. Diagnosis revealed all six pulses were wiry, thin, and rapid, with occasional depression under the middle finger upon pressing. This belonged to Spleen Qi sinking and Liver Damp-Heat pathology. Sheng Ma, Chai Hu (Bupleuri Radix), Cang Zhu, Bai Zhu, Fu Ling, Ban Xia, Guang Pi (Tangerine Peel), Gan Cao, Huang Bai, and Huang Qin (Scutellariae Radix) were used. She recovered miraculously after two doses.
Shen Yaofeng said: Regarding leukorrhea, some attribute it to Wind-Cold entering the bladder collaterals, represented by Chao Yuanfang, Sun Simiao, Yan Yonghe, Yang Renzhai, and Lou Quanshan. Some attribute it to Damp-Heat, represented by Liu Hejian, Zhang Jiegu, Zhang Daren, and Luo Zhouyan. Some attribute it to Spleen deficiency and Qi deficiency, represented by Zhao Yangkui and Xue Lizhai. Some attribute it to Damp-Phlegm, represented by Zhu Danxi. Some attribute it to Spleen-Kidney deficiency, represented by Zhang Jingyue and Feng Zhaozhang. Others attribute it to Liver Qi stagnation in the Earth element, represented by Fang Yue zhi and Miao Zhongchun. Regarding the discharged substance, Yan Yonghe attributed it to blood failing to transform, Zhang Jingyue to blood accumulation over time, and Liu Hejian to extreme heat causing fluids to emerge. Treatments have used major acrid-hot herbs, major bitter-cold herbs, major purgatives, and major tonics. Although each theory and formula has its rationale, the exact nature of the discharged substance remains unknown. Only Zhu Danxi stated: "Female leukorrhea is similar to nocturnal emission in males," clearly referring to female essence. This broke through a millennium of doubt. However, the causes of seminal slipperiness differ. It is a pity that his formulated prescriptions were confined to the concepts of Phlegm and Fire. From this perspective, white leukorrhea is equivalent to white turbidity, and red leukorrhea to red turbidity; these are slippery and essence-like. In contrast, substances resembling rice water or foul non-viscous water originate from the Spleen, due to Qi deficiency and sinking. Elderly people may also suffer from this, which is not a disease of essence, and thus should not be treated indiscriminately.
Xu Lingtai notes: Leukorrhea due to Damp-Heat pouring downward is excess; loss of essence retention is deficiency. In robust individuals with strong Qi, it is not highly harmful, but dryness exacerbates the disease. For Ying-Jin (Nutritive Fluids) depletion constitutes consumption (Xu Lao). In cases of menstrual irregularity with abundant leukorrhea, internal heat forces fluids out without transforming into red blood. When leukorrhea is present alongside complete dryness, it indicates Dry Blood Consumption (Gan Xue Lao). Synthesizing these, essence, fluid, phlegm, dampness, and blood can all descend via the Ren Mai to become leukorrhea. There are distinctions among deficiency-Cold, deficiency-Heat, and excess-Heat. Treatment of nocturnal emission follows similar principles, though deficiency-Cold syndromes are less common. Therefore, Ye Tianshi always uses Huang Bai (Phellodendri Cortex) as an assistant in treating leukorrhea. Furthermore, when Ren Mai deficiency fails to control leukorrhea, tonics often fail. I use a single herb, Hai Piao Xiao (Sepiae Endoconcha), powdered, mixed with boiled and pounded Guang Yu Biao (Fish Swim Bladder), formed into pills the size of mung beans, taken with Clam Broth. Long-term use yields success. Truly a brilliant method.