〔大〕妇人小便白浊白淫者,皆由心肾不交养,水火不升降,或因劳伤于肾,肾气
虚冷故也。肾主水而开窍在阴,阴为溲便之道,胞冷肾损,故有白浊白淫。宜服《局
方》金锁正元丹。(杂病遗精。)或因心虚而得者,宜服平补镇心丹。(杂病惊。)降心丹、威喜丸。
(杂病遗精。)若因思虑过当,致使阴阳不分,清浊相干而成白浊者,然思则伤脾故也,宜用
四七汤(杂病气。)吞白丸子。(杂病中风。)此药极能分利,更宜小乌沉汤,(杂病鼻衄。)每帖加茯苓
一钱,重者益智二十枚去壳碾,盐煎服。
〔薛〕前证若元气下陷,用补中益气汤。脾胃亏损,六君加升麻、柴胡。脾经郁结,归
脾加黄柏、山栀。肝经怒火,龙胆泻肝汤。虚则用加味逍遥散。宜与带下参看主治。一
妇人善怒,或小腹痞闷,或寒热往来,或小便频数,时下白淫,药久不愈,面青口苦。余
以为积愤而不能发散所致,用龙胆泻肝汤而愈。用加味逍遥散、八珍汤而安。
姜黄散 治血脏久冷,腹胀疼痛,小便浓白如泔。
片姜黄(二两) 大附子(炮,一两) 柳桂 赤芍药 红蓝子 三棱(各半两) 木香
牡丹皮 芫花(醋浸,炒) 郁李仁(去皮) 没药(各二钱半)
上为细末,每服一钱,酒煎服。如腹痛用当归、没药为末,以水七分,酒三分,同
煎热服。
内金鹿茸丸 治妇人劳伤血脉,胞络受寒,小便白浊,日夜无度,脐腹疼痛,腰膝
无力。
鸡内金 鹿茸 黄 肉苁蓉 五味子 远志肉 牡蛎 桑螵蛸 龙骨 附子(各等分)
上为细末,炼蜜和丸,如梧子大。每服五十丸,食前用温酒或米饮送下。
二豆散 治耳鸣心躁,腰脚疼重,腹内虚鸣,脐下冷痛,频下白水如泔,名湛浊证。
(方见前赤白带下。)
乌金散 治身热口燥,气块筑痛,下黄水如葵汁。
百草霜(炒) 紫金皮(米泔浸煮,炒黄) 粉草(炙,各等分)
上为末,每服二钱,艾汤或醋汤空心调下。心嘈,猪血入盐酒下。白带,用鲤
鱼一尾,去肠不去鳞,将油发一团,入鱼肚内,黄泥固济,炭火内 存性,去泥研鱼为
末。每用一钱,以陈酒调同前药服。
四七汤煎成,送下青州白丸子,常服最效。
加味四七汤 治妇女小便不顺,甚者阴户疼痛。
半夏(汤洗七次,一两) 浓朴(姜汁制) 赤茯苓 香附子(炒,各五钱)
紫苏 甘草(各二钱)
上 咀分四帖,每服水二盅,姜五片,煎八分,去滓,加琥珀末一钱,调服。
锁精丸 治小便白浊。
破故纸(炒) 青盐 白茯苓 五味子(各等分)
为末,酒糊丸。空心盐汤或酒,任下三十丸。
固精丸 治下虚胞寒,小便白浊,或如泔,或如凝脂,腰重。
牡蛎( 粉) 菟丝子(酒蒸,焙) 韭子(炒) 龙骨 五味子 白茯苓 桑螵蛸(酒炙)
白石脂(各等分)
为末,酒糊丸梧桐子大。每服七十丸,空心盐汤下。
治妇人久积虚寒,小便白浊,滑数不禁。
上用鹿茸屑炒黄为细末,每服二钱,空心温酒调下。
又方 用鸡 炙为末,空心酒调服二钱。
[Da Yuanli] When women experience white turbidity (bai zhuo) or white discharge (bai yin) in their urine, it is due to the failure of the Heart and Kidney to nourish each other, and the inability of Water and Fire energies to ascend and descend properly. It may also result from fatigue damaging the Kidneys, leading to deficiency and coldness of Kidney Qi. The Kidney governs water metabolism and opens into the Yin region; the Yin region serves as the pathway for urination and defecation. If the uterus is cold and the Kidneys are damaged, white turbidity and white discharge occur. It is appropriate to take Jin Suo Zheng Yuan Dan (Golden Lock Correct Origin Pill) from *Ju Fang* (see Miscellaneous Diseases: Spermatorrhea). If caused by Heart deficiency, Ping Bu Zhen Xin Dan (Leveling and Tonifying Calming the Heart Pill) is appropriate (see Miscellaneous Diseases: Palpitations/Jing). Jiang Xin Dan (Descend Heart Pill) and Wei Xi Wan (Wei Xi Pill) may also be used (see Miscellaneous Diseases: Spermatorrhea). If excessive thinking leads to a blurring of Yin and Yang boundaries, causing clear and turbid energies to interfere with each other resulting in white turbidity, this is because thinking damages the Spleen. In such cases, Si Qi Tang (Four Seven Decoction) should be used to swallow Bai Wan Zi (White Pills) (see Miscellaneous Diseases: Wind-Stroke). These medicines are very effective at separating and draining turbidity. It is further advisable to use Xiao Wu Chen Tang (Minor Black Stagnation Decoction), adding one qian of Fu Ling (Poria) per dose. For severe cases, add twenty peeled and crushed Yi Zhi Ren (Alpinia Oxyphylla Fructus), decocted with salt water.
[Xue Ji] For the aforementioned conditions, if there is sinking of Yuan Qi (Primal Qi), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. For Spleen and Stomach damage, Liu Jun Zi Tang (Six Gentlemen Decoction) with Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) added is suitable. For stagnation in the Spleen Meridian, Gui Pi Tang (Restore the Spleen Decoction) with Huang Bo (Phellodendri Cortex) and Shan Zhi (Gardeniae Fructus) added is appropriate. For Liver Meridian fire anger, Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver) is used. For deficiency patterns, Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) is indicated. Treatment should be referenced alongside the management of leukorrhea. A certain woman who was prone to anger, sometimes experiencing lower abdominal fullness and stuffiness, alternating chills and fever, frequent urination, and occasional white discharge, had not recovered after long-term medication. Her face was green and her mouth bitter. I considered this caused by accumulated resentment that could not be dispersed. She was cured using Long Dan Xie Gan Tang. She was then stabilized using Jia Wei Xiao Yao San and Ba Zhen Tang (Eight Treasures Decoction).
Jiang Huang San (Turmeric Powder): Treats long-standing cold in the Blood Viscera, abdominal distension and pain, and urine thick and white like rice wash water.
Pian Jiang Huang (Curcumae Longae Rhizoma) (2 liang), Da Fu Zi (Aconiti Lateralis Radix Praeparata, prepared) (1 liang), Liu Gui (Cinnamomi Ramulus), Chi Shao Yao (Paeoniae Radix Rubra), Hong Lan Zi (unknown herb, likely Broussonetiae fructus or similar local name), San Leng (Sparganii Rhizoma) (each 0.5 liang), Mu Xiang (Aucklandiae Radix), Mu Dan Pi (Moutan Cortex), Yuan Hua (Genkwa Flos, soaked in vinegar, stir-fried), Yu Li Ren (Prunus japonica seed, skin removed), Mo Yao (Myrrha) (each 2.5 qian).
Grind all ingredients into fine powder. Take 1 qian per dose, decocted with wine. If abdominal pain occurs, grind Dang Gui (Angelicae Sinensis Radix) and Mo Yao into powder, decoct together with 7 parts water and 3 parts wine, and take hot.
Nei Jin Lu Rong Wan (Chicken Gizzard Membrane and Deer Antler Pill): Treats women suffering from blood vessel damage due to overwork, cold invading the uterine collaterals, white turbidity in urine day and night without limit, umbilical and abdominal pain, and weakness in waist and knees.
Ji Nei Jin (Galli Gigerii Endothelium Corneum), Lu Rong (Cornu Cervi Pantotrichum), Huang Qi (Astragali Radix), Rou Cong Rong (Cistanches Herba), Wu Wei Zi (Schisandrae Chinensis Fructus), Yuan Zhi Rou (Polygalae Radix flesh), Mu Li (Ostreae Concha), Sang Piao Xiao (Mantidis Oötheca), Long Gu (Fossilia Ossis Mastodi et Scapulae), Fu Zi (Aconiti Lateralis Radix Praeparata) (equal parts).
Grind into fine powder, mix with refined honey to form pills the size of mulberry seeds. Take 50 pills per dose before meals, delivered with warm wine or rice drink.
Er Dou San (Two Beans Powder): Treats tinnitus, mental restlessness, heavy pain in waist and legs, empty rumbling in abdomen, cold pain below the umbilicus, and frequent passage of white water like rice wash, known as Zhan Zhuo Syndrome. (Formula seen previously under Leukorrhea.)
Wu Jin San (Black Gold Powder): Treats body heat, dry mouth, pain from qi masses striking, and passage of yellow water like okra juice.
Bai Cao Shuang (Carbonis Folii Betulae, stir-fried), Zi Jin Pi (unknown bark, soaked in rice water, boiled, stir-fried until yellow), Fen Cao (Glycyrrhizae Radix et Rhizoma Praeparata, honey-fried) (equal parts).
Grind into powder. Take 2 qian per dose, mixed with mugwort tea or vinegar tea on an empty stomach. For heart palpitations/irritability, take with pig blood and salt wine. For leukorrhea, take one carp, remove intestines but keep scales, place a ball of fried oil inside the fish belly, seal tightly with yellow mud, calcine in charcoal fire until preserved nature remains, remove mud, and grind the fish into powder. Take 1 qian, mixed with aged wine and taken with the previous medicine.
Si Qi Tang decocted, followed by swallowing Qingzhou Bai Wan Zi (Qingzhou White Pills), is most effective for regular use.
Jia Wei Si Qi Tang (Modified Four Seven Decoction): Treats women with difficult urination, and in severe cases, pain in the vaginal orifice.
Ban Xia (Pinelliae Rhizoma, washed seven times in hot water) (1 liang), Hou Po (Magnoliae Officinalis Cortex, processed with ginger juice), Chi Fu Ling (Poria with Red Wood), Xiang Fu Zi (Cyperi Rhizoma, stir-fried) (each 5 qian), Zi Su (Perillae Folium), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 2 qian).
Cut into pieces, divide into four doses. For each dose, use two zhong of water and five slices of ginger, decoct until reduced to eight fen, strain, add 1 qian of Hu Po (Amberum) powder, and take mixed.
Suo Jing Wan (Lock Essence Pill): Treats white turbidity in urine.
Po Gu Zhi (Psoraleae Fructus, stir-fried), Qing Yan (Natrii Chloridum), Bai Fu Ling (Poria), Wu Wei Zi (Schisandrae Chinensis Fructus) (equal parts).
Grind into powder, bind with wine paste to form pills. Take 30 pills on an empty stomach with salt tea or wine.
Gu Jing Wan (Solidify Essence Pill): Treats lower deficiency and cold uterus, white turbidity in urine, resembling rice wash water or congealed fat, with heavy sensation in the waist.
Mu Li (Ostreae Concha, calcined with flour), Tu Si Zi (Cuscutae Semen, steamed in wine, baked), Jiu Zi (Allii Tuberosi Semen, stir-fried), Long Gu (Fossilia Ossis Mastodi et Scapulae), Wu Wei Zi (Schisandrae Chinensis Fructus), Bai Fu Ling (Poria), Sang Piao Xiao (Mantidis Oötheca, wine-roasted), Bai Shi Zhi (Halloysit Alba) (equal parts).
Grind into powder, bind with wine paste to form pills the size of mulberry seeds. Take 70 pills on an empty stomach with salt tea.
To treat women with long-standing accumulation of deficiency-cold, white turbidity in urine, and uncontrollable slippery frequency:
Take the above mentioned Lu Rong (Deer Antler) dust, stir-fry until yellow, grind into fine powder. Take 2 qian per dose on an empty stomach, mixed with warm wine.
Another prescription: Roast Ji Nei Jin (Chicken Gizzard Membrane), grind into powder, take 2 qian on an empty stomach mixed with wine.