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Sweating indicates soft spasm (Rou Jing), while lack of sweating indicates stiff spasm (Gang Jing). The syndrome differentiation and treatment are detailed in Volume 5 of *Miscellaneous Diseases*, so they are not repeated here.

For women suffering from cold damage (Shang Han), the transmission and treatment examples across the six meridians are the same as for men. However, when heat enters the blood chamber (Re Ru Xue Shi) due to menstruation just starting or stopping, or in cases of pregnancy, postpartum flooding (Beng Lou), and leukorrhea (Dai Xia), the treatment methods differ specifically.

Heat Entering the Blood Chamber:
When a woman suffers from wind strike (Zhong Feng) with fever and aversion to cold, and her menstruation happens to arrive, after seven or eight days, if the heat subsides, the pulse becomes slow, the body is cool, there is fullness in the chest and hypochondrium resembling chest binding (Jie Xiong), and delirium occurs, this is heat entering the blood chamber. One should puncture the Qimen (LR-14) acupoint and apply the draining method according to the excess condition. (Li Dongyuan stated that hallucinations, hearing voices, and dreaming of deceased persons are all caused by excessive liver wood affected by pathogens; puncturing Qimen shares the same principle.)

Scholar Xu treated a woman with heat entering the blood chamber. The physician failed to recognize it and used blood-nourishing and qi-regulating medicines for several days, resulting in blood-binding chest (Xue Jie Xiong). Someone advised using the previous medicine (Xiao Chai Hu Tang), but I said, "Using Xiao Chai Hu Tang is now too late and cannot be done." If there is no other option, there is one alternative: puncturing the Qimen acupoint will suffice. I am not skilled in acupuncture, so I asked a proficient practitioner to treat her. Following this advice, she recovered. Someone asked, "Why does heat entering the blood chamber form chest binding?" I said, "The pathogenic factor enters the collaterals and fights with healthy qi, circulating up and down. If it coincides with menstruation starting or stopping, the pathogen enters the blood chamber vacuously. The blood, pressured by the pathogen, moves upward into the liver meridian. When the liver is affected, delirium and visual hallucinations occur. If it re-enters the Danzhong (Conception Vessel center), blood binds in the chest. Why do I say this? Normally, water nourishes wood, and blood nourishes the liver. Before conception, blood flows downward to become menstrual flow; during pregnancy, it accumulates in the middle to nourish the fetus; after birth, it rises to become milk. All these are functions of blood. Now, the pathogen and accumulated blood return to the liver meridian, gather at Danzhong, and bind below the breasts, causing pain upon touch. This is beyond the reach of decoctions, hence puncturing Qimen is necessary."

When a woman suffers from cold damage with fever, and her menstruation happens to arrive, if she is clear-minded during the day but delirious at night as if seeing ghosts, this is heat entering the blood chamber. Do not injure the stomach qi or the upper two jiaos, and the disease will heal itself. (*Huo Ren Shu* states: Harmonize it with Xiao Chai Hu Tang. ○ "Injuring stomach qi" refers to purging; "injuring the upper two jiaos" refers to inducing sweating.)

*Yan Yi* records: A woman suffered from warm disease for twelve days. Her pulse was rapid (6-7 beats per breath) and choppy, with the cun position slightly large and chi position slightly small. She had alternating chills and fever, flushed cheeks, dry mouth, discomfort, and deafness. Upon inquiry, her menstruation started only after being sick for several days. This belongs to Shaoyang heat entering the blood chamber. If treated incorrectly, death would ensue. Based on her symptoms, Xiao Chai Hu Tang was administered. After two days, Xiao Chai Hu Tang plus Guizhi and Ganjiang was given. After one day, the chills and fever stopped. She then complained of urgency and pain below the umbilicus. Didang Wan was given, leading to mild bowel movement and relief of pain. Her body cooled, and pulse became regular, though she still felt unwell. Xiao Chai Hu Tang was given again. The next day, she reported chest dryness and heat, and dry nose/mouth. A small dose of Tiao Wei Cheng Qi Tang was given, but no diarrhea occurred. The next day, epigastric pain appeared. Da Xian Xiong Wan was given; half a dose resulted in three bowel movements. On the third day, she experienced empty irritability, occasional hallucinations, and rambling speech. Knowing there were dry feces, but fearing her extreme deficiency, attacking was avoided. Instead, Zhu Ye Tang was used to remove irritability and heat. That night, stool passed naturally. By morning, two bowel movements contained several pieces of dry feces. Rambling and irritability resolved completely, leaving only coughing and sputum, indicating lung deficiency. Fearful of developing lung萎 (Fei Wei) due to deficiency, Xiao Chai Hu Tang minus Renshen, Dazao, and Shengjiang, plus Ganjiang and Wuweizi was given. Cough decreased in one day, and the disease cured in two days. All above used formulas from Zhang Zhongjing.

If a woman suffers from wind strike, and after seven or eight days, continues to have alternating chills and fever occurring at specific times, and her menstruation has just stopped, this is heat entering the blood chamber. The blood must be bound, hence symptoms resemble malaria with periodic occurrence. Xiao Chai Hu Tang is the primary formula.

Appendix:
Yun: The treatment for women with cold damage or wind strike is identical to men, except for heat entering the blood chamber and cold damage during pregnancy. One should use Si Wu Tang to nourish fetal blood, assisted by diaphoretic or purgative herbs. For women with cold damage/wind strike presenting with spontaneous sweating, headache, stiffness of neck/back, fever, aversion to cold, and floating-slow pulse, suspecting heat entering the blood chamber, Shaoyao should be doubled.

Guizhi Jia Shaoyao Tang:
Guizhi (1.5 liang), Chi Shaoyao (3.5 liang), Shengjiang (sliced, 1.5 liang), Zhigancao (roasted, 1 liang), Dazao (6 pieces, split). Coarsely crush. Take 5 qian per dose, decoct in water.

For women with cold damage presenting with floating-tight pulse, headache, body heat, aversion to cold, and anhidrosis, if sweating therapy is used and heat entering the blood chamber is feared, Mahuang Jia Shengdihuang Tang is suitable.
Mahuang (2.5 liang), Guizhi (1.5 liang), Zhigancao (roasted, 0.5 liang), Shengdihuang (2 liang), Xingren (25 pieces, skin and tip removed). Crush. Take 5 qian per dose, decoct in water.

Huo: For women with cold damage where menstruation has just stopped, presenting with chills/fever like malaria, delirium, and hallucinations, Ganjiang Chaihu Tang is suitable.
Chaihu (4 liang), Gualougen, Guizhi (each 1.5 liang), Muli (quantity missing), Ganjiang, Zhigancao (roasted, each 1 liang). Crush. Take 5 qian per dose, decoct in 1.5 sheng water until 0.7 sheng remains. Strain and take warm. Initial dose may cause slight irritability; subsequent doses induce sweating and cure.

Luo: Xiao Chai Hu Jia Dihuang Tang. Treats women and young girls with cold damage fever, menstruation starting/stopping, clear-minded by day, delirious by night as if seeing spirits. Also treats postpartum lochia stopping suddenly with near-death sensation.
Chaihu (1.25 liang), Renshen, Huangqin, Zhigancao (roasted), Banxia (washed in boiling water 7 times), Shengdihuang (each 7 qian). Make coarse powder. Take 5 qian per dose, add Shengjiang (3 slices) and Dazao (2 pieces), decoct in water.

Yun: For women with cold damage, body heat, long-stringy pulse, belonging to Yangming/Shaoyang alternating chills/fever, night irritability/day calmness, hallucinations, stopped menstruation, heat entering blood chamber without fullness/excess, Xiao Chai Hu Jia Mudanpi Tang is indicated. For severe fullness/excess, Tao Ren Cheng Qi Tang is used to purge.
Xiao Chai Hu Jia Mudanpi Tang Formula:
Chaihu, Renshen, Mudanpi (each 2 liang), Zhigancao (roasted), Shengjiang (each 0.75 liang), Banxia (washed in boiling water, 0.6 liang), Dazao (3 pieces, split), Huangqin (0.75 liang). Coarsely crush. Take 1 liang per dose, decoct in water.

For women with cold damage, headache, floating pulse, if the physician mistakenly uses purgatives, pathogen enters interior due to deficiency, menstruation stops, epigastrium becomes hard/full, mouth/dry tongue, alternating chills/fever, delirium/hallucinations, deep-rapid pulse. Purging is required. Xiao Chai Hu Jia Mangxiao Dahuang Tang is indicated.
Chaihu (2 liang), Banxia (processed, 1.5 liang), Huangqin, Shengjiang (each 0.75 liang), Dahuang, Mangxiao (each 0.7 liang), Zhigancao (roasted, 0.55 liang), Dazao (3 pieces, split). Coarsely crush. Take 1 liang per dose, decoct in water, strain, add Mangxiao, boil again, take warm. If pulse is not deep-rapid, do not purge.

Xu: In Xin Hai year, residing in Piling, Scholar Wang Zhongli's sister suffered cold damage with chills/fever. At night, she seemed possessed. After 6-7 days, she became comatose with rattling phlegm, locked jaw, closed eyes, and unconsciousness. Condition critical. I examined her and asked, "Was she menstruating when the illness started?" Family replied, "Menstruation had just started, then stopped when illness began." Two days later, chills/fever returned. Quiet by day, haunted by spirits by night. Salivating since yesterday, unconscious. I diagnosed heat entering the blood chamber. Zhongjing stated: "Women with wind strike, fever/aversion to cold, menstruation arriving, clear by day, delirious by night, periodic occurrence, is heat entering blood chamber." Physicians misunderstood and used harsh drugs, causing chest discomfort, phlegm rising, asthma, high breathing, coma. First resolve phlegm, then clear heat. I urgently gave Yi Xi San. After two hours, phlegm drained, she slept, and regained consciousness. Then Xiao Chai Hu Jia Dihuang Tang was given for three doses. Heat cleared, resolved without sweating.

Yun: Women with cold damage, exterior deficiency with sweating, cool body, limb stiffness, deep-slow pulse, Taiyang marked disease, Shaoyang root disease, stopped menstruation. Use Guizhi Jia Fuzi Honghua Tang.
Guizhi (2.5 liang), Shaoyao, Shengjiang (each 1.5 liang), Zhigancao (roasted, 1 liang), Fuzi (prepared), Honghua (each 0.5 liang). Coarsely crush. Take 1 liang per dose, decoct in 3 sheng water.

For women with cold damage, Taiyang marked disease, exterior resolved by sweating, internal pathogenic heat entering blood chamber, excessive menstruation, no fullness/excess. Use Gancao Shaoyao Tang.
Gancao, Shaoyao, Shengdihuang, Chuanxiong (each 1 liang). Crush. Take 1 liang per dose, decoct in 3 sheng water until 1.5 sheng remains. Strain, add 5 qian hair ash, mix well, take warm. If bleeding persists, puncture Yinbai (SP-1).

Pregnancy Cold Damage:
Wu: Generally, six-meridian treatments for pregnancy cold damage are the same, but protecting the fetus is paramount. Avoid herbs that harm the fetus. Examples like Huoxiang Zhengqi San, Shiwei Xiongsu San, Shen Su Yin, Xiao Chai Hu Tang contain Banxia which harms the fetus; remove if used. If phlegm/vomiting requires Banxia, use Banxia Qu, or soak in boiling water 7 times, remove skin/navel, mix with fresh Shengjiang juice, and dry. Herbs like Chuanwu, Fuzi, Tianxiong, Cezi, Rougui, Ganjiang, Dahuang, Mangxiao, Yuanhua, Gansui, Daji, Shuqi, Shuizhi, Mengchong, Taoren, Mudanpi, Ganqi, Daizheshi, Qumai, Niuxi, etc., move the fetus and require careful consideration. See other sections for details. To protect the fetus in hot diseases, apply mud from well bottoms to the navel (2 cun thick), reapply when dry. Alternatively, use Baiaoyzi powder mixed with water, or Fulonggan powder mixed with water. Generally, add Huangqin and Baizhu to decoctions for pregnant women with cold damage to protect the fetus. Can be decocted separately or taken as powder with warm water (2-3 qian). For weak constitutions, add Si Wu Tang. Using Xiao Chai Hu Tang minus Banxia plus Baizhu combined with Si Wu Tang protects the fetus and clears heat effectively. Apply similarly for best results.

Jie: Huangqi Jiemi Tang. Treats pregnant women with wind strike and spontaneous sweating.
Renshen, Huangqi, Danggui, Chuanxiong, Zhigancao (roasted, each 5 qian), Shaoyao (6 qian). Cangzhu and Shengdihuang can be added. Make coarse powder. Take 5 qian per dose, decoct in water, take warm anytime.

Hai: If pregnant women suffer cold damage/wind strike with exterior deficiency, sweating, headache, neck stiffness, body heat, aversion to cold, floating-weak pulse (Taiyang meridian disease), use Biaoxu Liuhe Tang.
Si Wu Tang (4 liang), Guizhi, Digupi (each 0.7 liang).

If pregnant women suffer cold damage with headache, body heat, anhidrosis, tight pulse (Taiyang meridian disease), use Biaoshi Liuhe Tang.
Si Wu Tang (4 liang), Mahuang, Xixin (each 0.5 liang).

If pregnant women suffer cold damage with wind-dampness, joint pain, floating-hot pulse, headache (Taiyang marked disease), use Fengshi Liuhe Tang.
Si Wu Tang (4 liang), Fangfeng, Cangzhu (processed, each 0.7 liang).

If pregnant women suffer cold damage, post-purgative persistent disease, damp-toxin rash like brocade (Taiyang/Shaoyang?), use Shengma Liuhe Tang.
Si Wu Tang (4 liang), Shengma, Lianqiao (each 0.7 liang).

If pregnant women suffer cold damage with chest/hypochondriac fullness/pain, stringy pulse (Shaoyang syndrome), use Chaihu Liuhe Tang.
Si Wu Tang (4 liang), Chaihu, Huangqin (each 0.7 liang).

If pregnant women suffer cold damage with hard stool, red urine, abdominal fullness, deep-rapid pulse (Yangming/Taiyang root disease), urgent purging is needed. Use Dahuang Liuhe Tang.
Si Wu Tang (4 liang), Dahuang, Taoren (skin/tip removed, bran-fried, 10 pieces).

If pregnant women suffer cold damage, post-sweat/purge persistent cough, use Renshen Liuhe Tang.
Si Wu Tang (4 liang), Renshen, Wuweizi (each 5 qian).

If pregnant women suffer cold damage post-sweat/purge with empty bloating (Yangming root deficiency), use Nongpo Liuhe Tang.
Si Wu Tang (4 liang), Houpo, Zhishi (bran-fried, each 5 qian).

If pregnant women suffer cold damage post-sweat/purge insomnia, use Zhizi Liuhe Tang.
Si Wu Tang (4 liang), Zhizi, Huangqin (each 5 qian).

If pregnant women suffer cold damage with extreme thirst, steaming irritability, long-large pulse, use Shigao Liuhe Tang.
Si Wu Tang (4 liang), Shigao, Zhimu (each 5 qian).

If pregnant women suffer cold damage with difficult urination (Taiyang root disease), use Fuling Liuhe Tang.
Si Wu Tang (4 liang), Fuling, Zexie (each 5 qian).

If pregnant women suffer cold damage, Taiyang root disease, red urine like blood, use Hupo Liuhe Tang.
Si Wu Tang (4 liang), Hupo, Fuling (each 5 qian).

If pregnant women suffer cold damage post-sweat/purge with continuous bleeding and fetal disturbance, use Jiao Ai Liuhe Tang.
Si Wu Tang (4 liang), Ejiao, Aiye (each 5 qian). Alternative: Add Gancao to the above; another alternative: Add Gancao, Ganjiang, Huangqin.

If pregnant women suffer cold damage with limb stiffness, cool body, slight sweating, abdominal pain, deep-slow pulse (Shaoyin disease), use Fuzi Liuhe Tang.
Si Wu Tang (4 liang), Fuzi (prepared, skin removed, sliced), Rougui (each 5 qian).

If pregnant women suffer cold damage with blood stasis, avoid abortifacients. Use Si Wu Dahuang Tang to purge.
Si Wu Tang (4 liang), Shengdihuang, Dahuang (wine-soaked, each 5 qian).

Poem: For pregnant women with blood stasis, do not recklessly use Didang or Taoren. Ensure mother and child remain unharmed. Divide Dahuang and Si Wu Tang equally.

Dan: Lady Shi suffered unresolved wind strike, cold lower calves, cough with little sputum, dizziness. Her temperament is irritable, and she is near term.
Huangqin (0.5 qian), Chenpi, Baizhu (each 1 qian), Sujie (0.3 qian), Mutong, Zhike (fried, each 0.5 fen), Mahuang (0.3 qian), Zhigancao (roasted, 0.2 fen), Jiegeng, Cangzhu (each 0.5 qian). Decoct in water, take anytime.

Yun: Pregnant women with cold damage, floating pulse, heavy head, cutting abdominal pain. Use Guizhi Shaoyao Danggui Tang.
Guizhi, Shaoyao, Danggui (each 1 liang). Coarsely crush. Take 1 liang per dose, decoct in water.

Pregnant women with cold damage, spontaneous diarrhea, abdominal pain, inability to eat/drink, deep pulse (Taiyin disease). Use Shaoyao Tang.
Shaoyao, Baizhu, Gancao, Fuling (each 1 liang). Prepare and take as before.

Huo: To protect the fetus in pregnant women with cold damage, use Ejiao San.
Renshen, Baifuling, Ejiao (fried), Sangjisheng, Baizhu (equal parts). Powder. Take 2 qian with glutinous rice water, twice daily.

To protect the fetus in pregnant women with cold damage, use Baizhu San.
Baizhu, Huangqin (fried on new tile until fragrant, equal parts). Powder. Take 3 qian per dose with 1 zhong water, 3 slices Shengjiang, 1 split Dazao. Decoct to 0.7 portion, strain, take warm. Take at first sign of headache/fever. 2-3 doses cure. Contraindicated in cold limbs/Yin syndrome.

To induce sweating for pregnant women with cold damage and aversion to cold/fever, use Congbai Tang.
Congbai (10 stalks), Shengjiang (2 liang, sliced). Coarsely crush. Decoct in 2 sheng water to 1 sheng. Take continuously to induce sweat.

Hai: Congbai Yiwu Tang. Boil 2 bunches Congbai in 1 sheng water until reduced. Drink all juice. Protects fetus. If fetus is damaged, it expels quickly.

Zisu San. Treats disharmonious fetal qi causing upper heart/abdominal fullness/pain (Zi Xuan). Calms and saves fetus, also expels damaged fetus. Treats cold damage headache/fever/body pain.
Zisuye, Danggui (each 1 liang), Renshen, Zhigancao (roasted, each 0.5 liang), Dafupi, Chuanxiong, Baishaoyao, Chenpi (peeled, each 1 liang). Take 8 qian per dose with 1.5 zhong water, 5 slices Shengjiang, 3 stalks Congbai (with roots). Decoct to 1 zhong, strain, take hot before meals. If severe pain, add Muxiang and Yuanhusuo powder.

Xiongsu San. Treats pregnant women with cold damage headache, increased chills, high fever, body pain, neck stiffness.
Zisuye, Chuanxiong, Baishaoyao, Baizhu, Chenpi, Gange, Gancao, Maimendong (equal parts). Crush. Take 4 qian per dose with 4 slices Shengjiang, 3 stalks Congbai. Decoct hot.

Examples of prescribing for pregnant women with cold damage:
For fever/aversion to cold, always include Guizhi, Shaoyao. For alternating chills/fever, always include Chaihu, Qianhu. For extreme thirst, always include Zhimu, Shigao, Wuweizi, Maimendong. For diarrhea, always include Guizhi, Fuzi, Ganjiang, Baizhu. For constipation, always include Dahuang, Huangqin. For menstruation starting/stopping, always include Xiao Chai Hu Tang. For unstable fetus, always include Renshen, Ejiao, Baizhu, Huangqin. For sweating therapy, always include Jianchi, Shengjiang, Mahuang, Xuanfu. For headache, always include Shigao, Zhizi, Qianhu. For summerheat headache, always include Chaihu, Gancao, Shigao. For fullness/stuffiness, always include Zhishi, Chenpi. For unstable fetal qi, always include Huangqin, Maimendong, Renshen. For black spots/rash, always include Huangqin, Zhizi, Shengma.

Da: To protect the fetus in pregnant women with epidemic cold damage and high fever:
Fulonggan powder applied finely to 3 cun below navel. Replace when dry. Stop when cured.

Another formula: Well bottom mud applied to navel. Replace when dry. (From *Ben Shi Fang*, effective).

Another formula: Fuping, Lan Gen, Poxiao, Ge Fen, Dahuang (lightly fried). Powder. Mix with water, apply to navel. Excellent for protecting fetus and clearing heat.

Another formula: Baiaoyzi powder mixed with water, applied to abdomen.

Two formulas for pregnancy cholera (attached to Shaoyin vomiting/diarrhea section).

For pregnancy rash turning black, use Zhizi Daqing Tang.
Huangqin, Shengma, Zhiren (each 2 liang), Daqing, Xingren (each 0.5 liang). Crush. Take 5 qian per dose with 1.5 sheng water, 3 cun sliced Congbai. Decoct to 1 sheng, strain, take warm.

Postpartum Cold Damage:
Wu: New mothers with cold damage should not be lightly induced to sweat. Causes of fever include labor injury, excessive blood loss, retained lochia, lactation fever (day 3), early exertion, or food stagnation. All mimic cold damage. Careful differentiation is essential; do not sweat indiscriminately. Postpartum blood is deficient. Sweating causes muscle twitching, depression/coma, convulsions, or constipation. These harms are serious. Be precise. For any fever, start with Si Wu Tang. Use Chuanxiong and Danggui as chief herbs, maximize Shaoyao (fried), support with Jiushudi Huang (wine-steamed). If feverish, add Ruanmiao Chaihu, Renshen, Ganjiang. Most effective because Ganjiang's pungent-warm nature guides blood herbs into blood level and qi herbs into qi level, removes evil, nourishes new, follows Yang generating Yin, and treats heat with heat, aligning with *Neijing*. I have used it successfully. Record to advise others. If lochia remains, combine Yimu Wan or Heishen San. If stomach deficiency/poor appetite, add Baizhu, Fuling. If phlegm/vomiting, add Chenpi, Banxia. Other six-meridian treatments are same, but always add Si Wu Tang as base to nourish blood, the root.

Postpartum wind strike lasting dozens of days, slight headache, aversion to cold, occasional internal heat, epigastric stuffiness, dry retching, sweating (even if profuse), Yang Dan syndrome. Give Yang Dan Tang (i.e., Guizhi Tang, see Taiyang disease).

Postpartum wind strike with fever, red face, asthma, headache. Zhuye Tang is indicated.
Zhuye (1 bundle), Gegen (3 liang), Fangfeng, Jiegeng, Guizhi, Renshen, Zhigancao (roasted, each 1 liang). Crush. Take 5 qian per dose with 1 Dazao, 5 slices Shengjiang, 1.5 sheng water. Decoct to 1 sheng, strain, take warm. Cover to sweat. If neck stiffness, add 0.5 qian Da Fuzi, boil medicine, skim foam. If vomiting, add 1 qian Banxia.

Dan: Postpartum fever/aversion to cold belong to blood/qi deficiency. Left pulse insufficient → nourish blood. Right pulse insufficient → tonify qi. If chills/fever + abdominal pain, remove bad blood. If chills/fever + blocked lactation + distension (no children), reduce using 2 liang fried Yanmai (barley) powder, mixed with clear soup, divided into 4 doses. If pregnant, purge using Mutong, Tongcao, pig trotter juice decoction.

Just after delivery, if fever appears, do not use diaphoretics or bitter-cold herbs. Must use Ganjiang to strongly dissipate heat. Mild cases use Fuling to leach out heat.

Da: Postpartum fever, headache, body pain should not be treated as common cold. Mostly blood deficiency or bad blood obstruction. Use mild agents. Yu Lu San or Si Wu Tang plus Bei Chaihu (equal parts) decocted works. Many fail when using Xiao Chai Hu Tang or Zhuye Shigao Tang directly.

Yu Lu San. Treats postpartum blocked lactation, high fever, pain, dizziness, constipation. Clears chest, suppresses heat, promotes lactation.
Renshen, Fuling, Gancao (each 0.5 liang), Kugeng (fried), Chuanxiong, Baizhi (each 1 liang), Danggui (0.25 liang), Shaoyao (0.75 liang). Crush. Take 5 qian per dose, decoct in 1 sheng water to 0.7 portion, take warm. If severe irritability/constipation, add 0.25 liang Dahuang.