蛔厥者,当吐蛔,今病者静而复时烦,此〔非〕为脏寒,蛔上入膈,故烦,须臾复止,
得食而呕又烦者,蛔闻食臭出,其人当自吐蛔。蛔厥者,乌梅丸主之。
【按】“此为脏寒”之“此”字,当是“非”字,若是“此”字,何以辨寒厥,当改
之。
产后七八日,无太阳证,少腹坚痛,此恶露不尽,(热在里,结在膀胱也)。不大便
烦躁发热,切脉微实,再倍发热,日晡时烦躁者不食,食则谵语,至夜即愈,宜大承气
汤主之。
【按】“热在里,结在膀胱也”之八字,当在本条上文“恶露不尽”之下,未有大承气
汤下膀胱血之理,当移之。“再倍”二字,当是衍文。
产后中风,(病痉者),发热面正赤,喘而头痛,竹叶汤主之。
【按】“产后中风”之下,当有“病痉者”三字,始与方合。若无此三字,则人参。附子
施之于中风发热可乎?而又以竹叶命名者何所谓也?且方内有“颈项强用大附子”之文,本篇有
证尤方,则可知必有脱简,当补之。
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〔未〕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,膝胫疼痛,奄忽眩冒,状如厥癫;或有忧惨,悲伤多嗔。
非有鬼神,(此皆带下)。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】“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,当改之。又本条内“此皆带下”四字,当在
非有鬼神之下,文义始属,当移之。
妇人脏躁,喜悲伤欲哭,象如神灵所作,数欠伸,甘草小麦大枣汤主之。
【按】甘草小麦大枣汤方,义未详,必是讹错。
问曰∶妇人年五十,所病下利〔血〕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,文义始属,当改之。
带下经水不利,少腹满痛,经一月再〔不〕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,当改
之。
寸口脉弦而大,弦则为减,大则为芤;减则为寒,芤则为虚;寒虚相抟,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,焉有再用旋复花下气之理?
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。
【按】此条注详见《伤寒论·少阳篇》内,故不复释。
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。
【按】此条注详见《伤寒论·少阳篇》内,故不复释。
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,结
胸状,谵语者,此为热入血室也,当刺期门,随其实而泻之。
【按】此条注详见《伤寒论·少阳篇》内,故不复释。
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
汗出则愈。
【按】此条注详见《伤寒论·阳明篇》内,故不复释。
胃气下泄,阴吹而正喧,此谷气之实也,膏发煎导之,(长服诃黎勒丸)。
【按】“膏发煎导之”五字,当是衍文。此“谷气之实也”之下,当有“长服诃黎勒丸”
之六字。后阴下气谓之气利,用诃黎勒散;前阴下气谓之阴吹,用诃黎勒丸,文义始属。盖
诃黎勒丸以诃黎勒固下气之虚,以浓朴、陈
皮平谷气之实,药病相合,此方错简在《杂疗篇》内。下小儿疳虫蚀齿一方,杀虫解毒,
或另有小儿门,或列在杂方内,兹列于妇人杂病之末,亦错简也。
In cases of ascariasis syncope (Jue syndrome caused by roundworms), vomiting of roundworms should occur. Currently, the patient is quiet but experiences intermittent irritability. This is not due to cold in the zang organs, but rather because the roundworms have moved upward into the diaphragm, causing irritability; this subsides after a short while. If vomiting and renewed irritability occur upon eating, it is because the roundworms emerge in response to the odor of food, and the person will naturally vomit them out. For treating ascariasis syncope, Wumei Wan (Mume Pill) is the primary formula.
[Commentary] The character "ci" (this) in "ci wei zang han" (this is cold in the zang organs) should be "fei" (not). If it were "ci," how could one distinguish cold Jue? It should be corrected.
Seven or eight days postpartum, with no Taiyang syndrome symptoms, hardness and pain in the lower abdomen indicate that lochia (postpartum discharge) has not been fully expelled (heat is in the interior, stagnating in the Bladder). Constipation, irritability, and fever are present; palpation reveals a slightly excess pulse. With doubled fever and irritability at the Dingwu time (3-5 PM), inability to eat, and delirium upon eating, which resolves at night, Da Cheng Qi Tang (Major Order the Qi Decoction) is indicated.
[Commentary] The eight characters "re zai li, jie zai pang guang ye" (heat is in the interior, stagnating in the Bladder) should be placed below "luo bu jin" (lochia not fully expelled) in the preceding text. There is no rationale for using Da Cheng Qi Tang to purge blood from the Bladder; the position should be shifted. The two characters "zai bei" (doubled) are likely interpolations (superfluous text).
Postpartum wind-strike, [if accompanied by spasm disease], presents with fever, bright red face, wheezing, and headache. Zhuye Tang (Bamboo Leaf Decoction) is indicated.
[Commentary] Below "postpartum wind-strike," the three characters "bing jing zhe" (suffering from spasm) should be added to align with the formula. Without these three characters, would Ginseng Radix et Rhizoma (Renshen) and Aconiti Lateralis Radix Praeparata (Fuzi) be appropriate for wind-strike with fever? Furthermore, what is the significance of naming the formula with Bamboo Leaves (Zhuye)? Additionally, the formula text mentions "use large Fuzi for neck stiffness." Since this chapter contains both syndromes and formulas, it is evident that there are missing passages (lacunae) that should be supplemented.
Women's diseases arise from deficiency, accumulated cold, and qi stagnation, leading to the cessation of menstruation across various meridians, sometimes lasting for years. Cold blood accumulates at the Bao Men (Gate of the Uterus). Cold damages the meridians, coagulating firmly in the upper body, causing vomiting of saliva and sputum, eventually developing into Lung abscess (Fei Yong), resulting in physical wasting. In the middle, knotting occurs around the umbilicus causing Han Shan (Cold Colic); or pain in both hypochondria connecting to the zang organs; or heat knotting in the center, pain at the Guanyuan point, rapid pulse without sores, and skin resembling fish scales. This condition may also affect men, not just women. In the lower part, [there is] not much [bleeding], irregular menstruation causes pulling pain in the yin, and cold sensation in the lower abdomen; or pain radiating to the waist and spine, extending down to the Qigao region, urgent pain in the Chong vessel, pain in the knees and shins, sudden dizziness and vertigo resembling Jue or Dian-Kuang (epilepsy); or sorrow, grief, excessive weeping, and anger. This is not due to ghosts or spirits, [these all belong to Dai Xia (leukorrhea)]. Over time, emaciation occurs, with a deficient pulse indicating much cold. The thirty-six diseases undergo myriad changes; examine the pulse for yin/yang, deficiency/excess, tight/string-like qualities, and apply acupuncture and herbs to treat critical conditions and restore peace. Although the diseases may appear similar, their pulse origins differ; you must discern and record them, do not dismiss this.
[Commentary] The character "lai" (come) in "zai xia lai duo" should be "wei" (not). This passage concerns menstrual cessation; if it referred to "lai duo" (heavy flow), it would contradict the preceding text and the subsequent mention of irregular cycles. It should be corrected. Also, the four characters "ci jie dai xia" (these all belong to leukorrhea) should be placed below "fei you gui shen" (not due to ghosts/spirits) for logical coherence; the position should be shifted.
For Zang Zao (Visceral Agitation) in women, characterized by frequent sadness and desire to cry, appearing as if possessed by spirits, with frequent yawning and stretching, Gancao Xiao Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) is indicated.
[Commentary] The rationale for the Gancao Xiao Mai Da Zao Tang formula is unclear; it is likely an error.
Question: A fifty-year-old woman suffers from bleeding [corrected from diarrhea] for dozens of days without stopping, evening fever, urgency and fullness in the lower abdomen, palm heat, and dry lips and mouth. What is the cause? The Master said: This disease belongs to Dai Xia (leukorrhea/menstrual disorders). Why? She previously had a miscarriage, and blood stasis remains in the lower abdomen. How do we know? The symptom of dry lips and mouth indicates this. Wen Jing Tang (Warm the Meridians Decoction) is indicated.
[Commentary] The character "li" (diarrhea) in "suo bing xia li" should be "xue" (blood) for the meaning to make sense; it should be corrected.
For Dai Xia with difficult menstruation, lower abdominal fullness and pain, where menstruation does not occur twice [corrected from "occurs twice"] within a month, Tugua Gen San (Trichosanthes Root Powder) is indicated.
[Commentary] The character "zai" (again/twice) should be "bu" (not). If it were "zai," implying two periods in a month, it would contradict the preceding "difficult menstruation"; it should be corrected.
The Cun Kou (Inch) pulse is wiry and large. Wiry indicates reduction (deficiency); large indicates hollow (Kou). Reduction implies cold; hollow implies deficiency. Cold and deficiency intertwining is named Ge (Leather) pulse. In women, this leads to spontaneous abortion and continuous uterine bleeding (Lou Xia), [Xuan Fu Hua Tang (Inula Flower Decoction) is indicated].
[Commentary] This passage is detailed in the *Shanghan Lun · Bian Mai Fa Pian* (Differentiating Pulse Methods Chapter); its placement here is a textual disorder (Cuo Jian). The phrase "Xuan Fu Hua Tang Zhu Zhi" is also likely misplaced. In cases of spontaneous abortion and Lou Xia, qi has already sunk downward; why would Xuan Fu Hua (Inula Flower), which directs qi downward, be used?
Seven or eight days into wind-strike in women, persistent alternating chills and fever occurring at regular times, coinciding with the abrupt cessation of menstruation, indicates Re Ru Xue Shi (Heat Entering the Blood Chamber). The blood must be knotted, causing malaria-like symptoms with regular onset. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated.
[Commentary] Commentary on this passage is detailed in the *Shanghan Lun · Shao Yang Pian* (Shaoyang Chapter), so it is not repeated here.
In women with Shanghan (cold damage) and fever, coinciding with the onset of menstruation: clear consciousness during the day, but delirium and hallucinations of seeing ghosts at night, indicates Heat Entering the Blood Chamber. Treatment should avoid damaging Stomach Qi and the Upper Two Jiaos; it will heal spontaneously.
[Commentary] Commentary on this passage is detailed in the *Shanghan Lun · Shao Yang Pian*, so it is not repeated here.
In women with wind-strike, fever and aversion to cold, coinciding with the onset of menstruation. After seven or eight days, the fever subsides, the pulse becomes slow, the body feels cool and harmonious, but chest and hypochondriac fullness resembles Jie Xiong (Chest Binding), accompanied by delirium. This is Heat Entering the Blood Chamber. One should puncture Qi Men (Liv 14) and drain according to the excess pattern.
[Commentary] Commentary on this passage is detailed in the *Shanghan Lun · Shao Yang Pian*, so it is not repeated here.
In Yangming disease, with rectal bleeding and delirium, this is Heat Entering the Blood Chamber. Only sweating from the head occurs. Puncture Qi Men (Liv 14) and drain according to the excess pattern. Generalized sweating indicates recovery.
[Commentary] Commentary on this passage is detailed in the *Shanghan Lun · Yang Ming Pian*, so it is not repeated here.
Stomach Qi leaks downward, causing Yin Chui (noisy flatulence from the vagina) which is loud and frequent. This is due to excess Gu Qi (grain qi/food residue). Gao Fa Jian (Fat and Hair Decoction) guides the treatment, [long-term use of Hel Lei Le Wan (Areca Seed Pill) is recommended].
[Commentary] The five characters "Gao Fa Jian Dao Zhi" are likely interpolations. Below "Gu Qi Zhi Shi Ye" (excess of grain qi), the six characters "Chang Fu He Lei Le Wan" should be inserted. Downward expulsion of qi from the posterior orifice is called Qi Li, treated with He Lei Le San; downward expulsion from the anterior orifice is called Yin Chui, treated with He Lei Le Wan, making the text coherent. Hel Lei Le Wan uses Areca Seed (He Lei Le) to secure deficient descending qi, and Magnolia Bark (Hou Po) and Tangerine Peel (Chen Pi) to calm excess grain qi. The medicine matches the pathology. This formula is misplaced in the *Za Liao Pian* (Miscellaneous Treatment Chapter). The following formula for pediatric malnutrition with tooth-eating worms, which kills parasites and detoxifies, might belong in a separate pediatric section or miscellaneous formulas section; listing it at the end of Women's Miscellaneous Diseases is also a textual disorder.