妇人之病，因虚、积冷、结气，为诸经水断绝，至有历年，血寒积结胞门。寒伤经络，凝坚在上，
呕吐涎唾，久成肺痈，形体损分。在中盘结，绕脐寒疝；或两胁疼痛，与脏相连；或结热中，痛在关
元，脉数无疮，肌若鱼鳞。时着男子，非止女身。在下来多，经候不匀，令阴掣痛，少腹恶寒；或引腰
脊，下根气街，气冲急痛，膝胫疼烦，奄忽眩冒，状如厥癫；或有忧惨，悲伤多嗔。此皆带下，非
有鬼神。久则羸瘦，脉虚多寒。三十六病，千变万端，审脉阴阳，虚实紧弦，行其针药，治危得安。其
虽同病，脉各异源，子当辨记，勿谓不然。
【按】此条为妇人杂病提纲，当冠篇首，以揭病情，在下来多之“来”字，当是
“未”字。本条皆经水断绝之病，若系来多，则与上文不合，与下文经候不匀亦不合。又
本条内有“此皆带下”一句，当在“非有鬼神”之下，文义相属，是传写之讹。
【注】此条为妇女诸病纲领，其病之所以异于男子者，以其有月经也。其月经致病之
根源，则多因虚损、积冷、结气也。三者一有所感，皆能使经水断绝。至有历年寒积胞
门，以致血凝气结而不行者。先哲云∶女子以经调为无病，若经不调，则变病百出矣。以
下皆言三者阻经之变病。其变病之不同，各因其人之脏腑、经络、寒热、虚实之异也。如
寒外伤经络，其人上焦素寒，则凝坚在上，故上焦胸肺受病也。形寒伤肺，则气滞阻饮，故
呕吐涎唾也。若其人上焦素热，寒同其化，久则成热，热伤其肺，故成肺痈，而形体损瘦
也。若其人中焦素寒，则在中盘结，故绕脐疝痛也，或两胁疼痛，是中焦之部，连及肝
脏故也。或其人中焦素热，则不病寒疝，而病结热于中矣。中热故不能为寒疝，而绕脐
之痛，仍在关元也。其人脉数当生疮，若无疮，则热必灼阴，皮肤失润，故肌粗若鱼鳞
也。然此呕吐涎唾，寒疝疼痛，肌若鱼鳞等病，亦时着男子，非止女子病也。在下未多，
谓经候不匀，而血不多下也。邪侵胞中，乃下焦之部，故病阴中掣痛，少腹恶寒也，或
痛引腰脊，下根气街急痛，腰膝疼烦，皆胞中冲任为病所必然也。或痛极奄忽眩冒，状
如厥癫，亦痛甚之常状也。若其人或有忧惨悲伤多嗔之遇，而见此眩冒厥巅之证，实非
有鬼神也。凡此胞中冲任血病，皆能病带，故谚曰∶十女九带也。然带下病久，津液必伤，
形必羸瘦，诊其脉虚，审其多寒。岂止病此三十六病，而千变万端矣。虽千变万端，然
必审脉阴阳虚实紧弦，与病参究，行其针药，治危得安也。其有病虽同而脉不同者，则当
详加审辨，故曰∶子当辨记，勿谓不然也。
妇人咽中如有炙脔，半夏浓朴汤主之。
【注】咽中如有炙脔，谓咽中有痰涎，如同炙肉，咯之不出，咽之不下者，即今之梅
核气病也。此病得于七情郁气，凝涎而生。故用半夏、浓朴、生姜，辛以散结，苦以降逆，
茯苓佐半夏，以利饮行涎，紫苏芳香，以宣通郁气，俾气舒涎去，病自愈矣。此证男子
亦有，不独妇人也。
【集注】尤怡曰∶凝痰结气，阻塞咽嗌之间，《千金》所谓咽中帖帖如有炙肉，吞之不
下，吐之不出者是也。
半夏浓朴汤方
半夏（一升） 浓朴（三两） 茯苓（四两） 生姜（五两） 干苏叶（二两）
上五味，以水七升，煮取四升，分温四服，日三夜一服。
妇人脏躁，喜悲伤欲哭，象如神灵所作，数欠伸，甘麦大枣汤主之。
【按】甘草小麦大枣汤，方义未详，必是讹错。
【注】脏，心脏也，心静则神藏。若为七情所伤，则心不得静，而神躁扰不宁也。故
喜悲伤欲哭，是神不能主情也。象如神灵所凭，是心不能神明也，即今之失志癫狂病也。
数欠伸，喝欠也，喝欠顿闷，肝之病也，母能令子实，故证及也。
甘草小麦大枣汤方
甘草（三两） 小麦（一升） 大枣（十枚）
上三味，以水六升，煮取三升，温分三服，亦补脾气。
妇人吐涎沫，医反下之，心下即痞，当先治其吐涎沫，小青龙汤主之。涎沫止，乃
治痞，泻心汤主之。
【注】吐涎沫，形寒饮冷也，不温散而反下之，则寒饮虚结成痞硬也。当先治其吐涎
沫，以小青龙汤治外寒内饮，俟涎沫止，以半夏泻心汤，乃治痞也。
【集注】尤怡曰∶吐涎沫，上焦有寒饮也，不与温散而反下之，则寒内入而成痞。然虽
痞而犹吐涎沫，是寒饮未已，不可治痞，当先治饮，而后治痞，亦如伤寒例，表解乃可
攻痞也。
小青龙汤方（见肺痈中）
泻心汤方（见惊悸中）
问曰∶妇人年五十，所病下利，数十日不止，暮即发热，少腹里急，腹满，手掌烦
热，唇口干燥，何也？师曰∶此病属带下。何以故？曾经半产，瘀血在少腹不去。何以知
之？其证唇口干燥，故知之。当以温经汤主之。
【按】所病下利之“利”字，当是“血”字，文义相属，必是传写之讹。
【注】妇人年已五十，冲任皆虚，天癸当竭，地道不通矣。今下血数十日不止，宿瘀
下也。五心烦热，阴血虚也；唇口干燥，任冲血伤，不上荣也；少腹急满，胞中有寒，瘀
不行也。此皆曾经半产崩中，新血难生，瘀血未尽，风寒客于胞中，为带下，为崩中，为
经水愆期，为胞寒不孕。均用温经汤主之者，以此方生新去瘀，暖子宫补冲任也。
【集注】李 曰∶妇人年五十，则已过七七之期，任脉虚，太冲脉衰，天癸竭，地道
不通时也。所病下利，据本文带下观之，当是崩淋下血之病。盖血属阴，阴虚故发热，暮
亦属阴也。任主胞胎，冲为血海，二脉皆起于胞宫，而出于会阴，正当少腹部分，冲脉
侠脐上行，故冲任脉虚，则少腹里急，有干血亦令腹满。《内经》云∶任脉为病，女子带
下瘕聚是也。手背为阳，掌心为阴，乃手三阴过脉之处，阴虚，故掌中烦热也。阳明脉
侠口环唇，与冲脉会于气街，皆属于带脉。《难经》云∶血主濡之。以冲脉血阻不行，则
阳明津液衰少，不能濡润，故唇口干燥。断
以病属带下，以曾经半产，少腹瘀血不去，则津液不布，新血不生，此则唇口干燥之所由
生也。
温经汤方
吴茱萸（三两） 当归 芎 芍药（各二两） 人参 桂枝 牡丹皮 阿胶 生姜（各二两）
甘草（二两） 半夏（半升） 麦门冬（去心，一升）
上十二味，以水一斗，煮取三升，分温三服。亦主妇人少腹寒，久不受胎，兼取崩
中去血，或月水来过多，及至期不来。
【集解】李 曰∶《内经》云∶血气虚者，喜温而恶寒，寒则凝涩不流，温则消而去之。
此汤名温经，以瘀血得温即行也。方内皆补养气血之药，未尝以逐瘀为事，而瘀血自去
者，此养正邪自消之法也。故妇人崩淋不孕，月事不调者，并主之。
带下经水不利，少腹满痛，经一月再见者，土瓜根散主之。
【按】“再”字当是“不”字，若是“再”字，一月两来，与上文不利不合，是传
写之讹。
【注】此亦前条在下未多，经候不匀之证。带下，胞中病也。胞中有宿瘀，从气分或寒
化，则为白带；从血分或热化，则为赤带；从气血寒热错杂之化，则为杂色之带也。若兼
经水不利，少腹满痛，乃有瘀血故也。其经至期不见，主以土瓜根散者，土瓜能逐瘀血，
虫能开血闭，桂枝合芍药舒阳益阴，通和营气，则瘀去血和，经调带止矣。
土瓜根散方
土瓜根 芍药 桂枝 虫（各三分）
上四味，杵为散，酒服方寸匕，日三服。
寸口脉弦而大，弦则为减，大则为芤；减则为寒，芤则为虚；寒虚相搏，此名曰革。妇
人则半产漏下，旋复花汤主之。
【按】此条详在《伤寒论·辨脉法篇》，错简在此。“旋复花汤主之”一句，亦必是错简。
半产漏下，则气已下陷，焉有再用旋覆下气之理。
旋复花汤方
旋复花（三两） 葱（十四茎） 新绛（少许）
上三味，以水三各升，煮取一升，顿服之。
妇人陷经漏下，黑不解，胶姜汤主之。
【注】陷经者，谓经血下陷，即今之漏下崩中病也。黑不解不成文，胶姜汤方亦缺。
【集注】李 曰∶陷经漏下，谓经脉下陷，而血漏下不止，乃气不摄血也。黑不解者，瘀
血不去，则新血不生，荣气腐败也。然气血喜温恶寒，用胶姜汤温养气血，则气盛血充，
推陈致新，而经自调矣。
【按】此条文义，必有缺误，姑采此注，以见大意。
妇人少腹满如敦状，小便微难而不渴，生后者，此为水与血俱结在血室也，大黄甘遂
汤主之。
【注】敦，大也。少腹，胞之室也。胞为血海，有满大之状，是血蓄也。若小便微难
而不渴者，水亦蓄也。此病若在生育之后，则为水与血俱结在血室也。主之大黄甘遂汤，是
水血并攻之法也。
大黄甘遂汤方
大黄（四两） 甘遂（二两） 阿胶（二两）
上三味，以水三升，煮取一升，顿服之，其血当下。
妇人中风七八日，续来寒热，发作有时，经水适断，此为热入血室，其血必结，故使
如疟状，发作有时，小柴胡汤主之。
【注】详见《伤寒论·少阳篇》内，不复
释。
妇人伤寒发热，经水适来，昼日明了，暮则谵语，如见鬼状者，此为热入血室，治之
无犯胃气及上二焦，必自愈。
【注】详见《伤寒论·少阳篇》内，不复释。
妇人中风，发热恶寒，经水适来，得之七八日，热除，脉迟，身凉和，胸胁满，如
结胸状，谵语者，此为热入血室也，当刺期门，随其实而泻之。
【注】详见《伤寒论·少阳篇》内，不复释。
阳明病，下血，谵语者，此为热入血室，但头汗出，当刺期门，随其实而泻之， 然
汗出即愈。
【注】详见《伤寒论·阳明篇》内，不复释。
妇人经水不利下，抵当汤主之。
【注】妇人经水不利下，言经行不通利快畅下也。乃妇人恒有之病，不过活瘀导气，调
和冲任，足以愈之。今曰抵当汤主之，夫抵当重剂，文内并无少腹结痛，大便黑，小便
利，发狂善忘，寒热等证，恐药重病轻，必有残缺错简，读者审之。
抵当汤方
水蛭（熬，三十个） 虻虫（熬，去翅足，三十枚） 桃仁（去皮尖，二十个） 大
黄（酒浸，三两）
上四味为末，以水五升，煮取三升，去滓，温服一升。
妇人经水闭不利，脏坚癖不止，中有干血，下白物，矾石丸主之。
【注】脏，阴内也。不止，不去也。经水闭而不通。瘀，宿血也。阴中坚块不去，血
干凝也。下白物，化血成带也。用矾石丸坐药治之。此方治下白物，若从湿化者可也，恐
未能攻坚癖干血也。
【集注】尤怡曰∶脏坚癖不止者，子脏干血坚凝，成癖而不去也。干血不去，则新血
不荣，而经闭不利矣。由是蓄泄不时，胞宫素湿，所积之血，与湿化而成白物，时时自
下，是宜先去其脏之湿。矾石燥湿水，杏仁润干血也。
矾石丸方
矾石（烧，三分） 杏仁（一分）
上二味，末之。炼蜜和丸，如枣核大，五内中，剧者，再内之。
妇人六十二种风，及腹中血气刺痛，红蓝花酒主之。
【注】六十二种风无可考。腹中血气刺痛，用红蓝花酒通经行血，诚要方也。
红蓝花酒方
红蓝花（一两）
上一味，以酒一大升，煎减半，顿服一半，未去再服。
妇人腹中诸疾痛，当归芍药散主之。
【注】诸疾腹痛，谓妇人腹中诸种疾痛也。既曰诸疾痛，则寒、热、虚、实、气、食等
邪，皆令腹痛，岂能以此一方概治诸疾痛耶？当归芍药散主之，必是错简。
当归芍药散方（见妊娠中）
妇人腹中痛，小建中汤主之。
【注】若因木盛土衰，中虚急痛者，用此补虚缓中定痛可也。
小建中汤方（见虚劳中）
问曰∶妇人病，饮食如故，烦热不得卧，而反倚息者，何也？师曰∶此名转胞，不得
尿也。以胞系了戾，故致此病。但利小便则愈，宜肾气丸主之。
【注】病不在胃，故饮食如故也。病在于胞，故不得尿也。阳气不化，故烦热也。水
不得下行，故倚息不得卧也。名曰转胞，以胞系乖戾不爽也，故致此病，但当利小便则
愈。主之肾气丸，以温行下焦阳气，阳气化则尿出，诸病自解矣。胞者乃谓尿胞，非血
胞也。
【集注】赵良曰∶此方在虚劳中，治腰痛小便不利，小便拘急，此亦用之何也？盖因
肾虚用之也，用此补肾则气化，气化则水行而愈矣。然转胞之病，岂尽由下焦肾虚气不
化出致耶？或中焦脾虚，不能散精归于胞，及上焦肺虚，不能下输布于胞，或胎重压其胞，
或忍尿入房，皆足成此病，必求其所因以治之也。
肾气丸方
干地黄（八两） 薯蓣（四两） 山茱萸（四两） 泽泻（三两） 茯苓（三两） 牡
丹皮（三两） 桂枝 附子（炮，各一两）
上八味，末之，炼蜜和丸，梧子大，酒下十五丸，加至二十五丸，日再服。
【集解】李 曰∶方名肾气丸者，气属阳，补肾中真阳之气也。内具六味丸，壮肾水以
Women's diseases are caused by deficiency, accumulated cold, and qi stagnation, leading to the cessation of menstruation. In severe cases, this may persist for years, with blood-cold accumulating in the uterus (Bao Gong). Cold damages the meridians; if it condenses in the upper part, it causes vomiting of saliva and froth, which over time develops into lung abscess (Fei Yong) and physical wasting. If it knots in the middle, it results in cold hernia pain around the navel, or pain in both hypochondria connected to the zang organs. If heat knots in the middle, pain occurs at the Guanyuan point; the pulse is rapid but there are no sores, and the skin is rough like fish scales. These conditions can affect men as well, not just women. Conditions in the lower part are more common, presenting with irregular menstruation, pulling pain in the yin region, aversion to cold in the lower abdomen, or pain radiating to the waist and spine, extending down to the Qijie area, with urgent pain at the Chongqiong point and painful restlessness in the knees and shins. Sudden dizziness and vertigo may occur, resembling Jue syndrome or Dian epilepsy. There may also be sorrow, grief, and irritability. All these belong to Dai Xia (leukorrhea), not to possession by spirits. Prolonged illness leads to emaciation and a deficient, cold pulse. The thirty-six types of gynecological miscellaneous diseases have myriad variations. One must examine the pulse for Yin/Yang, deficiency/excess, tightness, and wiriness, and apply acupuncture and herbal treatment to stabilize critical conditions. Even if diseases are similar, their pulse origins differ; you must distinguish and record them, do not deny this.
[Commentary] This passage serves as the general outline for women's miscellaneous diseases and should be placed at the beginning of the chapter to reveal the nature of the illness. The character "Lai" (coming/flowing) in "Zai Xia Lai Duo" should likely be "Wei" (not/yet). This section describes diseases of menstrual cessation; if it referred to heavy flow, it would contradict the preceding text and the subsequent mention of irregular cycles. Furthermore, the phrase "Ci Jie Dai Xia" (all these are leukorrhea) should follow "Fei You Gui Shen" (not ghosts/spirits) for logical coherence, indicating a scribal error.
[Annotation] This passage outlines the principles of various women's diseases. The reason these diseases differ from men's is the presence of menstruation. The root causes of menstrual disorders are often deficiency, accumulated cold, and qi stagnation. Any of these three factors can cause menstrual cessation. Over years, cold accumulates in the uterine gate, causing blood coagulation and qi stagnation. Ancients said: Women are healthy when menstruation is regular; irregularity leads to myriad diseases. The following sections describe the variations caused by these three factors obstructing menstruation. Variations depend on individual differences in zang-fu, meridians, cold/heat, and deficiency/excess. For instance, external cold damaging meridians combined with inherent upper jiao cold causes condensation in the upper part, affecting the chest and lungs. Cold damaging the lungs causes qi stagnation and fluid retention, leading to vomiting of saliva. If the upper jiao is inherently hot, cold transforms into heat, damaging the lungs and forming lung abscess with physical wasting. If the middle jiao is inherently cold, it knots in the middle, causing periumbilical hernia pain or hypochondriac pain due to liver connection. If the middle jiao is inherently hot, it does not cause cold hernia but heat knotting in the middle. Middle heat prevents cold hernia but pain remains at Guanyuan. A rapid pulse usually indicates sores; without sores, heat burns yin fluids, causing dry, scaly skin. However, symptoms like vomiting saliva, cold hernia, and scaly skin can also occur in men. "Zai Xia Wei Duo" refers to irregular menstruation with scanty flow. Pathogens invading the uterus (lower jiao) cause pulling pain in the yin and cold in the lower abdomen, or pain radiating to the waist, spine, and Qijie, with knee/shin restlessness, all due to Chong and Ren meridian pathology. Severe pain may cause sudden dizziness resembling Jue/Dian. Emotional distress exacerbating these symptoms is not due to spirits. All blood diseases of the uterus and Chong/Ren meridians can lead to leukorrhea, hence the saying: "Ten women, nine with leukorrhea." Long-term leukorrhea injures fluids and causes emaciation and a deficient, cold pulse. Although there are thirty-six diseases, they vary infinitely. One must examine pulses and correlate them with symptoms, using acupuncture and herbs to restore health. Even with similar diseases, different pulses require careful distinction.
Women with a sensation of a grilled meat plug in the throat are treated with Banxia Houpo Tang.
[Annotation] "Sensation of grilled meat" refers to phlegm-damp in the throat, feeling like roasted meat, difficult to expectorate or swallow, known today as Plum Pit Qi (Meiheqi). This arises from emotional stagnation condensing fluids. Banxia, Houpo, and Shengjiang disperse knots and direct rebellious qi downward; Fuling assists Banxia to drain dampness; Zisu promotes qi circulation. Once qi flows and phlegm clears, the disease resolves. Men can also suffer from this.
[Collected Commentary] You Yi states: Condensed phlegm and stuck qi block the throat, as described in *Qianjin Fang*: "feeling like grilled meat in the throat, cannot be swallowed or spat out."
Banxia Houpo Tang Formula
Banxia (1 sheng), Houpo (3 liang), Fuling (4 liang), Shengjiang (5 liang), Ganziye (2 liang)
Boil the five ingredients in 7 sheng of water to obtain 4 sheng. Divide into four warm doses: three during the day, one at night.
Women suffering from Zang Zao (Visceral Restlessness), who frequently feel sad and want to cry, appearing possessed by spirits, and yawning/stretching often, are treated with Ganmai Dazao Tang.
[Commentary] The rationale for Gancao Xiaomai Dazao Tang is unclear; it is likely an error.
[Annotation] "Zang" refers to the Heart. When calm, the Spirit resides. Injury from seven emotions disturbs the Heart, causing spiritual restlessness. Sadness and crying indicate the Spirit cannot govern emotions. Appearing possessed indicates the Heart-Mind lacks clarity, akin to modern insanity. Frequent yawning/stretching relates to Liver pathology; as the Mother element, Liver affects the Heart.
Ganmai Dazao Tang Formula
Gancao (3 liang), Xiaomai (1 sheng), Dazao (10 pieces)
Boil the three ingredients in 6 sheng of water to obtain 3 sheng. Take warm in three divided doses. It also tonifies Spleen Qi.
If a woman vomits saliva and the physician incorrectly uses purgatives, epigastric fullness (Pi) results. First treat the vomiting with Xiao Qinglong Tang. Once saliva stops, treat the Pi with Xiexin Tang.
[Annotation] Vomiting saliva indicates cold-fluid retention from external cold and cold drinks. Purging instead of warming causes cold-fluid to form Pi hardness. Treat the cold-fluid first with Xiao Qinglong Tang (dispersing exterior cold and internal fluid). After resolution, use Banxia Xiexin Tang for the Pi.
[Collected Commentary] You Yi states: Vomiting saliva indicates upper jiao cold-fluid. Purging allows cold to enter, forming Pi. Since Pi persists with ongoing saliva vomiting, the cold-fluid remains. Do not treat Pi yet; treat the fluid first, then the Pi, similar to Shaoyang principles where exterior resolution precedes treating interior excess.
Xiao Qinglong Tang Formula (See Lung Abscess section)
Xiexin Tang Formula (See Palpitations section)
Question: A fifty-year-old woman has diarrhea for dozens of days without stopping, evening fever, urgency/fullness in the lower abdomen, vexatious heat in palms, and dry lips/mouth. Why? Master says: This belongs to Dai Xia (chronic gynecological disease). Why? Because of previous miscarriage, with blood stasis remaining in the lower abdomen. How do we know? The symptom of dry lips/mouth confirms it. Treat with Wenjing Tang.
[Commentary] The character "Li" (diarrhea) should be "Xue" (blood). This is a scribal error.
[Annotation] At fifty, Chong and Ren are deficient, Tian Gui is exhausted, and menstruation should cease. Bleeding for days indicates old stasis expelling. Five-palm heat indicates yin-blood deficiency. Dry lips/mouth indicate injury to Ren/Chong blood failing to nourish upward. Lower abdominal urgency/fullness indicates cold in the uterus and stagnant stasis. These result from previous miscarriage/heavy bleeding, where new blood fails to generate and wind-cold invades the uterus, causing Dai Xia, Beng Zhong (metrorrhagia), irregular periods, or infertility. Wenjing Tang generates new blood, removes stasis, warms the uterus, and tonifies Chong/Ren.
[Collected Commentary] Li states: At fifty, past the "Seven Sevens," Ren is deficient, Taichong declines, Tian Gui exhausts. "Diarrhea" here likely refers to metrorrhagia. Blood is yin; yin deficiency causes fever, especially in the evening (yin time). Ren governs the uterus; Chong is the Sea of Blood. Both originate in the uterus/groin, passing through the lower abdomen. Chong ascends alongside the navel. Deficiency causes lower abdominal urgency and fullness from dry blood. *Neijing* states: Ren pathology causes leukorrhea and masses. Palm heat indicates yin deficiency in Hand Three Yin meridians. Yangming meridians encircle the mouth and meet Chong at Qijie, governed by Dai Mai. *Nanjing* states: Blood moistens. Obstruction in Chong reduces Yangming fluids, causing dry lips. Thus, the disease is Dai Xia due to post-miscarriage stasis preventing fluid distribution and new blood generation.
Wenjing Tang Formula
Wuzhuyu (3 liang), Danggui, Chuanxiong, Shaoyao (2 liang each), Renshen, Guizhi, Mudanpi, Ejiao, Shengjiang (2 liang each), Gancao (2 liang), Banxia (0.5 sheng), Maimendong (decored, 1 sheng)
Boil twelve ingredients in 1 dou of water to obtain 3 sheng. Take warm in three divided doses. Also treats cold lower abdomen, infertility, metrorrhagia, menorrhagia, or amenorrhea.
[Collected Commentary] Li states: *Neijing* says: Blood/Qi deficiency prefers warmth and dislikes cold; cold causes stagnation, warmth disperses it. Named "Warming Meridians," it moves stasis via warmth. The formula tonifies Qi/Blood; stasis resolves naturally by supporting正气 (Righteous Qi). Thus, it treats metrorrhagia, infertility, and irregular menses.
For leukorrhea with irregular menstruation, lower abdominal fullness/pain, and menstruation occurring twice a month, Tuguagen San is indicated.
[Commentary] The character "Zai" (again/twice) should be "Bu" (not). Twice monthly contradicts "irregular/difficult"; this is a scribal error.
[Annotation] This corresponds to the earlier "scanty/irregular" pattern. Leukorrhea originates in the uterus. Old stasis transforming via Qi/cold yields white discharge; via Blood/heat yields red discharge; mixed yields colored discharge. Combined with irregular menstruation and lower abdominal pain, it indicates blood stasis. Tuguagen San is used because Tugua (Trichosanthes root) drives stasis, E chong (Ground Beetle) opens blood closures, and Guizhi-Shaoyao harmonizes Ying/Nutritive Qi. Stasis clears, blood harmonizes, menstruation regulates, and discharge stops.
Tuguagen San Formula
Tuguagen, Shaoyao, Guizhi, E chong (3 fen each)
Grind to powder. Take one cun-bi with wine, three times daily.
Cunkou pulse is wiry and large. Wiry indicates reduction (deficiency); large indicates Kou (hollow). Reduction indicates cold; Kou indicates deficiency. Cold and deficiency interacting is named Ge (Leather) pulse. In women, this causes miscarriage and dripping bleeding; Xuanfuhua Tang is indicated.
[Commentary] This passage belongs in *Shanghan Lun · Pulse Diagnosis*. "Xuanfuhua Tang" is likely misplaced. Miscarriage/dripping bleeding implies sinking Qi; using descending herbs like Xuanfu is illogical.
Xuanfuhua Tang Formula
Xuanfuhua (3 liang), Congbai (14 stems), Xinjiang (small amount)
Boil three ingredients in 3 sheng of water to obtain 1 sheng. Take in one dose.
Women with sinking menstruation and dripping black discharge that does not resolve are treated with Jiaojiang Tang.
[Annotation] "Sinking menstruation" refers to dripping bleeding/metrorrhagia. "Black does not resolve" is grammatically incomplete; Jiaojiang Tang formula is missing.
[Collected Commentary] Li states: Sinking menstruation with continuous dripping indicates Qi failing to control blood. Black discharge indicates unresolved stasis preventing new blood generation and corruption of Ying Qi. Qi/Blood prefer warmth; Jiaojiang Tang warms and nourishes, restoring Qi/Blood volume and regulating menstruation.
[Commentary] The text has errors; this annotation provides the general meaning.
If a woman's lower abdomen is full like a pot, with slight difficulty urinating but no thirst, after childbirth, this is water and blood binding in the Blood Chamber. Dahuang Gansui Tang is indicated.
[Annotation] "Dun" means large. Lower abdomen is the uterus chamber. Fullness indicates blood accumulation. Difficulty urinating without thirst indicates water accumulation. Post-partum, this is water and blood binding in the Blood Chamber. Dahuang Gansui Tang attacks both water and blood.
Dahuang Gansui Tang Formula
Dahuang (4 liang), Gansui (2 liang), Ejiao (2 liang)
Boil three ingredients in 3 sheng of water to obtain 1 sheng. Take in one dose; blood should pass.
A woman with Wind Strike for 7-8 days, recurring alternating chills and fever at specific times, with menstruation suddenly stopping, has Heat entering the Blood Chamber. Blood will clot, causing malaria-like symptoms. Xiao Chaihu Tang is indicated.
[Annotation] See *Shanghan Lun · Shaoyang Chapter* for details.
A woman with Cold Damage fever, menstruation just starting, clear during the day but delirious at night seeing ghosts, has Heat entering the Blood Chamber. Treat without violating Stomach Qi or Upper/Middle Jiao; she will recover spontaneously.
[Annotation] See *Shanghan Lun · Shaoyang Chapter* for details.
A woman with Wind Strike, fever/aversion to cold, menstruation just starting, develops fever cessation, slow pulse, cool body, chest/hypochondriac fullness resembling Jie Xiong, and delirium after 7-8 days. This is Heat entering the Blood Chamber. Puncture Qimen, draining excess according to reality.
[Annotation] See *Shanghan Lun · Shaoyang Chapter* for details.
Yangming disease with bloody stool and delirium is Heat entering the Blood Chamber. Only head sweating occurs. Puncture Qimen, draining excess; profuse sweating indicates recovery.
[Annotation] See *Shanghan Lun · Yangming Chapter* for details.
For women with difficult menstrual flow, Didang Tang is indicated.
[Annotation] "Difficult flow" means obstruction. While common, mild stasis-guiding and Chong/Ren harmonizing usually suffice. Didang Tang is a strong purgative; the text lacks typical indications like lower abdominal mass, dark stool, clear urine, mania, or fever. The prescription may be too heavy for the condition, suggesting textual loss or error.
Didang Tang Formula
Shuizhi (boiled, 30), Mengchong (boiled, wings/legs removed, 30), Taoren (skin/kernel removed, 20), Dahuang (wine-soaked, 3 liang)
Grind to powder. Boil in 5 sheng water to obtain 3 sheng. Strain. Take 1 sheng warm.
For women with amenorrhea, hard masses in the viscera, dry blood inside, and white discharge, Fanshi Wan is indicated.
[Annotation] "Zang" refers to the vagina/uterus. "Not stopping" means persistent. Amenorrhea with hard masses indicates dried blood. White discharge is transformed blood becoming leukorrhea. Fanshi Wan is applied locally. It treats damp-based discharge but may not resolve hard dry blood.
[Collected Commentary] You Yi states: Hard masses indicate dried blood congealed in the uterus. Unresolved dry blood prevents new blood nourishment, causing amenorrhea. Irregular accumulation and moisture in the uterus transform blood into white discharge. Remove uterine dampness first. Fanshi dries dampness; Xingren moistens dry blood.
Fanshi Wan Formula
Fanshi (calcined, 3 fen), Xingren (1 fen)
Grind. Mix with honey into pills date-seed size. Insert vaginally. Repeat if severe.
For women affected by sixty-two types of Wind and stabbing pain from blood/qi in the abdomen, Honglanhua Jiu is indicated.
[Annotation] The sixty-two Winds are unrecordable. For stabbing blood/qi pain, Honglanhua Jiu promotes menstruation and blood circulation, an important formula.
Honglanhua Jiu Formula
Honglanhua (1 liang)
Decoct in 1 da sheng of wine until half remains. Take half in one dose; repeat if unresolved.
For various abdominal pains in women, Danggui Shaoyao San is indicated.
[Annotation] "Various pains" implies cold, heat, deficiency, excess, qi, food pathogens. One formula cannot treat all; this placement is likely erroneous.
Danggui Shaoyao San Formula (See Pregnancy Section)
For abdominal pain in women, Xiao Jianzhong Tang is indicated.
[Annotation] For Liver overacting on Spleen, middle deficiency, and urgent pain, this tonifies deficiency and relieves pain.
Xiao Jianzhong Tang Formula (See Deficiency Consumption Section)
Question: A woman eats normally but has vexatious heat, inability to lie flat, and relies on support to breathe. Why? Master says: This is Zhuan Bao (Displaced Bladder), inability to urinate. Due to twisted bladder ligaments. Promoting urination cures it. Shengqi Wan is indicated.
[Annotation] Disease is not in Stomach, so appetite is normal. Disease is in Bladder, so inability to urinate. Yang Qi fails to transform, causing heat. Water cannot descend, causing orthopnea. Named Zhuan Bao due to twisted ligaments. Promote urination to cure. Shengqi Wan warms lower jiao Yang, enabling transformation and urination. "Bao" here refers to urinary bladder, not uterus.
[Collected Commentary] Zhao Liang asks: This formula treats backache and difficult urination in Deficiency Consumption. Why use it here? Because of Kidney deficiency. Tonifying Kidney restores Qi transformation and water flow. However, Zhuan Bao is not solely due to lower jiao Kidney deficiency. Spleen deficiency failing to transport essence, Lung deficiency failing to distribute fluids, heavy fetus pressing bladder, or holding urine during intercourse can also cause it. Identify the cause to treat.
Shengqi Wan Formula
Gan Dihuang (8 liang), Shuyu (4 liang), Shanzhuyu (4 liang), Zexie (3 liang), Fuling (3 liang), Mudanpi (3 liang), Guizhi, Fuzi (processed, 1 liang each)
Grind eight ingredients. Mix with honey into pills walnut-size. Take 15-25 pills with wine, twice daily.
[Collected Commentary] Li states: Named Shengqi Wan, it tonifies true Yang Qi. It contains Liuwei Dihuang Wan to strengthen Kidney Water...