为白物。是用矾石消坚癖。破干血。杏仁利气开闭。润脏之燥。蜜以佐之。内子户。
药气可直达于子宫矣。设干血在冲任之海者。必服药以下之。内之不能去也。
妇人六十二种风。及腹中血气刺痛。红蓝花酒主之。
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。未止再服。
〔衍义〕注疑非仲景方。伤寒论一部。以风寒二邪。必复言其传变。然后出方。乃云
六十二种风。尽以一药治之。宁无寒热虚实上下表里之异。其非仲景法明矣。
虽然。原其立方之旨。将谓妇人以血为主。一月一泻。然后和平。若风邪与血凝
搏。或不输血海。以阻其月事。或不流转经络。以闭其荣卫。或内触脏腑。以违其
和。因随取止。遂有不一之病。所以治之。惟有破血通经。用红花酒。则血开气行。而风亦散矣。
妇人腹中诸疾痛。当归芍药散主之。
〔衍义〕此腹痛者。由中气脾土不能升。阴阳二气乖离。肝木乘克而作痛。故用是汤补中伐木。通行阴阳也。
妇人腹中痛。小建中汤主之。
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。不得溺也。
以胞系了戾。故致此病。但利小便则愈。宜肾气丸主之。
〔衍义〕此方在虚劳中。治腰痛小便不利。小腹拘急。此亦用之何也。盖因肾虚用
之。若饮而短气者。亦用此利小便。则可见其转胞之病。为胞居膀胱之室。因下
焦气衰。惟内水湿在中。不得气化而出。遂致鼓急其胞。因转筋不正。了戾其溺
之宗。水既不出。经气遂逆。上冲于肺。肺所主之荣卫。不得入于阴。蓄积于上。故
烦热不得卧而倚息也。用此补肾则气化。气化则水行。水行则邪者降而愈矣。
然转胞之病。岂尽由下焦肾虚致耶。或中焦气虚土湿。下干害其胞。与上焦肺
气壅塞。不化于下焦。或胎重压其胞。或忍溺入房。皆足成此病。必求所因以治之也。
妇人阴寒。温中坐药蛇床子散主之。
蛇床子散方
蛇床子仁
上一味。末之。以白粉少许。和合相得。如枣大。绵裹内之。自然温。（白粉即米粉藉之以和合也）
〔衍义〕风寒入阴户。痹而或冷。或用蛇床以起其阴分之阳。阳强则痹开而温矣。
少阴脉滑而数者。阴中即生疮。阴中蚀疮烂者。野狼牙汤洗之。
野狼牙汤方
野狼牙（三两）
上一味，以水四升。煮取半升。以绵缠箸如茧。浸汤沥阴中。日四遍。
〔衍义〕少阴脉滑。阴中血热也。湿热积阴户。生疮。甚则虫出蚀烂。野狼牙味苦酸咸。
主邪热气杀虫。后人疮药多用之。
胃气下泄。阴吹而正喧。此谷气之实也。膏发煎导之。
〔衍义〕阳明脉属于宗筋。会于气街。若阳明不能升发谷气上行。变为浊邪。反泄
下利。子宫受抑。气不上通。故从阴户作声而吹出。猪脂补下焦。生血润腠理。乱
发通关格。腠理开。关格通。则中焦各得升降而气归故道已。
Discharge of white matter. This utilizes Alum (Mingfan, 明矾) to eliminate hard accumulations and break dry blood stasis; Apricot Seed (Xingren, 杏仁) unblocks qi and opens obstructions, moistening the dryness of the zang organs; Honey (Fengmi, 蜂蜜) assists the medication, which is inserted into the vagina (Zihu, 子户). The medicinal qi can directly reach the uterus. If dry blood stasis is located in the Chong and Ren meridians (Chong Ren Zhi Hai, 冲任之海), it must be expelled downward by oral medication; topical application alone cannot remove it.
Women suffering from sixty-two types of wind pathogens, as well as stabbing pain in the abdomen due to blood and qi stagnation, are primarily treated with Safflower Wine (Honglanhua Jiu, 红蓝花酒).
Safflower Wine Formula
Carthamus tinctorius L. (Honglanhua, 红蓝花) (1 liang)
Take the above single herb, decoct in one da sheng of wine until reduced by half. Consume half at one time. If symptoms persist, take again.
[Commentary on Yan Yi]: It is suspected that this is not a formula from Zhang Zhongjing. In the entire *Shanghan Lun*, for wind-cold pathogens, the transmission and transformation are invariably discussed before a formula is presented. To claim that sixty-two types of wind pathogens are all treated with a single herb ignores differences in cold/heat, deficiency/excess, upper/lower, and exterior/interior. This clearly does not conform to Zhang Zhongjing's methodology.
Nevertheless, investigating the intent behind this prescription, it seems to posit that women are governed by blood, requiring monthly discharge to maintain harmony. If wind pathogens congeal and struggle with blood, or if the blood sea is not discharged thereby obstructing menstruation, or if circulation in the collaterals is blocked thereby closing Ying and Wei, or if internal organs are disturbed thereby violating harmony, various diseases arise depending on the specific manifestation. Therefore, treatment involves breaking blood stasis and unblocking the meridians. Using Safflower Wine allows blood to open and qi to move, causing wind to dissipate.
Various pains in the abdomen of women are primarily treated with Angelica-Sophora Powder (Danggui Shaoyao San, 当归芍药散).
[Commentary on Yan Yi]: This abdominal pain arises because the central qi and spleen earth fail to ascend, leading to the discordance of yin and yang qi, with liver wood overacting upon spleen earth to cause pain. Thus, this decoction tonifies the center, subdues liver wood, and unblocks yin and yang.
Abdominal pain in women is primarily treated with Minor Construct the Middle Decoction (Xiao Jianzhong Tang, 小建中汤).
Question: A woman suffers from illness where her diet remains normal, yet she experiences irritability, heat, inability to lie flat, and instead leans forward with labored breathing. What is the cause? The Master said: This is called "Zhuan Bao" (displaced bladder/uterus), resulting in urinary retention. Because the ligaments of the bladder are twisted and inverted, this disease occurs. Only by promoting urination will she recover; Kidney Qi Pill (Shenqi Wan, 肾气丸) is appropriate.
[Commentary on Yan Yi]: This formula appears in the Deficiency Cold chapter to treat lower back pain, difficult urination, and spasm/constriction of the lower abdomen. Why use it here? It is used due to kidney deficiency. If drinking water leads to shortness of breath, this formula is also used to promote urination. This reveals that "Zhuan Bao" occurs because the bladder chamber is affected by declining qi in the lower jiao. Internal damp-water remains without being transformed by qi, causing the bladder to swell and tighten. Consequently, tendons twist abnormally, inverting the pathway of urine. Since water cannot exit, meridian qi rebels upward to the lungs. The Ying and Wei governed by the lungs cannot enter the yin, accumulating in the upper jiao, causing irritability, heat, inability to lie flat, and leaning with labored breathing. Tonifying the kidney with this formula restores qi transformation; once qi transforms, water moves; once water moves, pathogenic factors descend and recovery ensues.
However, is "Zhuan Bao" solely caused by lower jiao kidney deficiency? It may also result from middle jiao qi deficiency and dampness affecting the bladder, or upper jiao lung qi congestion failing to transform in the lower jiao, or fetal weight pressing on the bladder, or holding urine during intercourse. All these can cause this disease. One must seek the root cause to treat it.
Coldness in the female genitalia is primarily treated with the warming sitz medicine, Cnidium Powder (Shechuangzi San, 蛇床子散).
Cnidium Powder Formula
Cnidium monnieri (L.) Cuss. fruit (Shechuangzi, 蛇床子)
Grind the above single herb into powder. Mix with a small amount of rice flour (Baifen, 白粉) until well combined. Form into pills the size of a jujube. Wrap in silk and insert into the vagina. It will naturally produce warmth. (Rice flour is used for binding).
[Commentary on Yan Yi]: Wind-cold invading the vaginal orifice causes bi obstruction or coldness. Cnidium can raise the yang of the yin aspect. When yang becomes strong, bi obstruction opens and warmth returns.
If the Shaoyin pulse is slippery and rapid, sores will appear in the vagina. If there are erosive sores in the vagina, wash with Agrimony Decoction (Yelangya Tang, 野狼牙汤).
Agrimony Decoction Formula
Agrimony (Yelangya, 野狼牙) (3 liang)
Decoct the above single herb in four sheng of water until half a sheng remains. Wrap cotton around a chopstick like a silkworm cocoon, dip in the decoction, and drip/wash the vagina. Do this four times daily.
[Commentary on Yan Yi]: A slippery Shaoyin pulse indicates blood heat in the vagina. Damp-heat accumulating in the vaginal orifice causes sores, which may even lead to worms emerging and erosion. Agrimony has bitter, sour, and salty flavors, treating pathogenic heat and killing parasites. Later generations often use it in wound medicines.
Stomach qi leaking downward causes "Yin Chuī" (flatulence from the vagina) with loud noise. This is due to excess grain qi. Guide it with Paste and Hair Decoction (Gaofa Jian, 膏发煎).
[Commentary on Yan Yi]: The Yangming meridian belongs to the sinews and converges at the Qichong point. If Yangming fails to ascend grain qi, transforming it into turbid pathogens that leak downward, the uterus is suppressed, and qi cannot ascend. Thus, sound and air are expelled from the vaginal orifice. Pig fat tonifies the lower jiao, generates blood, and moistens the interstices. Human hair (Luafa, 乱发) unblocks obstruction. When interstices open and obstruction clears, the middle jiao regains its ascending and descending functions, and qi returns to its proper pathway.