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Women presenting with a greenish-yellow complexion, emaciated limbs, palpitations (heart trembling), and soreness/weakness of the waist and knees, who discharge turbid secretions intermittently. These discharges vary in color—yellow, red, green, white, dark, and black—and are mixed together. This condition arises from damage to the blood of the Dai Mai (Girdle Vessel) and is therefore named "Dai Syndrome" (Leukorrhea).

Ancient methods further distinguished a category called "White Turbidity." It was believed that leukorrhea is a disease of the Dai Mai, characterized by impure and mixed colors, whereas white turbidity is a disease of the Heart, Spleen, and Kidney meridians, characterized by pure white color. Although the formulas used are similar, they essentially stem from the same pathology. I clarify that both white turbidity and the five-colored leukorrhea involve discharges that resemble blood but are not blood; rather, they are fluids from the Bao Zhong (Uterus/Womb). When this fluid is clear, it is called Tian Gui (Heavenly Water/Menstrual Essence), which nourishes menstrual blood, as detailed in previous discussions. When this fluid becomes turbid, it manifests as white turbidity or the five-colored leukorrhea; the turbidity of the fluid leads to the turbidity of the blood. The Dai Mai connects downward to the uterus and binds the body centrally, located in the middle of the torso, and belongs to the Spleen meridian. When the Earth Qi of the Spleen meridian is harmonious and mild, the Dai Mai remains clean and tranquil, and the fluids in the uterus are clear and harmonious. Consequently, three days after menstruation, uterine fluid appears, yellow and bright like gold. This is the Tian Gui water from the Kidney, regulated by the Earth of the Dai Mai and Spleen, manifesting a yellow and moist color, indicating the optimal time for conception and representing normal menstruation in a healthy state. If the Spleen Earth loses its harmony and fails to control water, damaging the Dai Mai, water pours into the uterus, triggering Dai Syndrome with white turbidity and impurity. Treatment should focus on harmonizing the Spleen to promote diuresis. Treating the Spleen is treating the Dai Mai, and treating the Dai Mai is treating the water. Observing Shen Zhuo Tang (Kidney Fixation Decoction), which uses Bai Zhu (Atractylodis Macrocephalae Rhizoma) to treat lower back pain feeling as heavy as carrying five thousand coins: Shen Zhuo Tang explicitly states that this is water evil in the Kidney adhering to the Dai Mai, thus treated via the Spleen, using Earth to control Water, thereby healing the Dai Mai naturally. From this, we know that women's Dai Syndrome is caused by unclear water; men's turbidity is also due to unclear water. There is no need to force a distinction; the primary approach is always to harmonize the Spleen and promote diuresis. The main formula is Wei Ling Tang (Stomach and Pingwei Decoction). For cases with heat, remove Gui Zhi (Cinnamomi Ramulus) and add Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), and Huang Bo (Phellodendri Cortex). For cases with cold, add Xi Xin (Asari Radix) and Wu Zhu Yu (Evodiae Fructus). If Spleen Earth stagnation generates steaming dampness, leading to putrefaction and transformation into five-colored leukorrhea with red and white impurities, one should regulate the Spleen and resolve stagnation, using Xiao Yao San (Free and Easy Wanderer Powder) with Fang Ji (Stephaniae Tetrandrae Radix) and Mu Tong (Akebiae Caulis) as the main addition. For heat, add Dan Pi (Moutan Cortex), Zhi Zi (Gardeniae Fructus), and Huang Bo. For cold, add Tai Wu Yao (Linderæ Semen), Ai Ye (Artemisiae Argyi Folium), and Sha Ren (Amomi Fructus). Although the above discussion does not exhaustively cover all treatments for leukorrhea and turbidity, it provides the fundamental method. Students should extrapolate and expand upon this: for heat syndromes, using Xiao Shi (Natrii Sulfas), Da Huang (Rhei Radix et Rhizoma), and Gan Sui (Kansui Radix) may be appropriate; for cold syndromes, using Ren Shen (Ginseng Radix), Bai Zhu, and Fu Zi (Aconiti Lateralis Radix Praeparata) is essential. For mixed cold and heat patterns, formulas can be adjusted according to the syndrome. Some nuances cannot be fully conveyed by paper and pen; it depends on the physician's self-realization.

Beng Lou (Metrorrhagia and Metrostaxis) refers to bleeding outside the menstrual period. Scanty bleeding is called "Lou Xia" (Dripping Down), while profuse bleeding is called "Xue Beng" (Blood Collapse). Excessive bleeding during menstruation, resembling an unceasing flow of water, is also termed Xue Beng. In ancient times, this was called "Beng Zhong" (Collapse in the Middle), implying that blood is controlled by the Spleen Earth of the Middle Jiao. Since the Spleen fails to control the blood, collapse occurs, hence the name "Beng Zhong," indicating that treating Beng requires treating the Middle Jiao (Spleen). Menstrual blood is called "Xin Shui" (Trustworthy Water) because among the Five Elements, only Earth governs "Trust." When Earth Qi is robust, menstruation is regular; when Earth Qi is deficient, trust is lost, leading to dripping or collapse. The treatment principle always focuses on the Spleen. Whether due to fatigue injuring the Spleen, or excessive worry/dietary irregularities injuring the Spleen, resulting in deficiency and failure to control blood, Gui Pi Tang (Restore the Spleen Decoction) should be used, added with Ai Ye (Artemisiae Argyi Folium), E Jiao (Colla Corii Asini), and Zao Xin Tu (Furnace Hearth Earth). For severe deficiency, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) should be used, added with E Jiao, Xu Duan (Dipsaci Radix), Sheng Ma (Cimicifugae Rhizoma), Pao Jiang (Zingiberis Rhizoma Praeparatum), Suan Zao Ren (Ziziphi Spinosae Semen), and Shan Yu Rou (Corni Fructus). Additionally, stewed consumption of Yu Du (Fish Bladder), Lu Jiao Shuang (Deer Antler Frost), Lian Mi (Nelumbinis Semen), Ginger, and Salt aids recovery. Decoction of Huang Qi (Astragali Radix), Nuomi (Glutinous Rice), and Dang Gui (Angelicae Sinensis Radix) also greatly tonifies Qi and Blood. Liu Jun Zi Yang Rong Tang (Six Gentlemen Nourishing Youth Decoction) and Zhi Gan Cao Tang (Prepared Licorice Decoction) are tonifying herbs for the Spleen meridian and can be used with modifications. For all cases of Beng Zhong, this is the standard treatment. Another approach involves treating the Liver to address the "Thief" of the Spleen. If Liver Fire moves recklessly, Wood stagnation overacts on Earth, and Fire disturbs causing blood instability, the patient may exhibit irritability, headache, bitter taste, vertigo, hypochondriac and abdominal distension, with wiry and rapid pulses throughout. This differs significantly from Spleen deficiency-cold patterns. One may use Gui Pi Tang added with Dan Pi, Zhi Zi, Chai Hu (Bupleuri Radix), Bai Shao (Paeoniae Radix Alba), Mai Dong (Ophiopogonis Radix), and Wu Wei Zi (Schisandrae Fructus) to tonify Spleen Earth and clear Liver Fire, addressing both aspects. Alternatively, use Dan Zhi Xiao Yao San (Moutan and Gardenia Free and Easy Wanderer Powder) added with Mu Li (Ostreae Concha), E Jiao, and Pu Huang (Typhae Pollen).

Note: Although Dai and Lou are primarily water disorders, they may also involve stasis blood obstructing Qi, leading to turbidity. Xiao Tiao Jing Tang (Minor Regulating Menses Decoction) should be used with modifications for cold or heat. Although Beng is a blood disorder, it is fundamentally due to Qi deficiency. When Qi sinks, water follows and drains. Water is the forerunner of blood; when Qi moves, water moves; when water moves, blood moves. Therefore, Qi-tonifying herbs should be taken to raise the water; once water rises, blood rises. Treat with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).

Observing Beng and Dai together: one is a water disorder, the other a blood disorder. Both men and women suffer from blood and water diseases and should be viewed comprehensively.