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。（方见呕吐中。○来。伤寒论。太阳下编。作得。断下。有者字。）
〔程〕妇人伤寒中风。六经传变治例。与男子同法。唯经水适来适断。热入血室。与夫胎前产后。崩
漏带下。则治有殊也。妇人经行之际。当血弱气尽之时。邪气因入血室。与正气相搏。则经为之断。血为之
结也。血结则邪正分争。往来寒热。休作有时。与小柴胡解表里。而散血室之邪热。
〔尤〕仲景单用小柴
胡汤。不杂血药一味。意谓热邪解而乍结之血自行耳。（详伤寒论辑义太阳中篇。以下二条同。）
许氏本事方。小柴胡加地黄汤。治妇人室女。伤寒发热。
或发寒热。经水适来。或适断。昼则明了。夜则谵语。如见鬼状。亦治产后恶露方来。忽尔断绝。
即于小柴胡汤。加生干地黄。
辛亥中。寓居毗陵。学官王仲礼其妹病伤寒。发寒热。遇夜则如有鬼物所凭。六七日忽昏塞。涎响
如引锯。牙关紧急。瞑目不知人。疾势极危。召予视。予曰。得病之初。曾
值月经来否。其家云。月经方来。病作而经遂止。得一二日。发寒热。昼虽静。夜则有鬼祟。从昨日来。涎
生不省人事。予曰此热入血室证也。仲景云。妇人中风。发热恶寒。经水适来。昼则明了。暮则谵语。如
见鬼状。发作有时。此名热入血室。医者不晓。以刚剂与之。遂致胸膈不利。涎潮上脘。喘急息高。昏冒
不知人。当先化其涎。后除其热。予急以一呷散投之。两时顷涎下得睡。省人事。次授以小柴胡加地黄
汤。三服而热除。不汗而自解矣。（一呷散。大天南星一味。选腊辰日制。详见于本书。）
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。（脉经注。二焦字疑。）
〔程〕伤寒发热。又值经水适来之时。则寒邪乘虚而入。搏于血室。夫邪去阳入阴。则昼日明了。阴
被其邪。故暮则谵语。如见鬼状也。无者。禁止之辞。犯胃气以禁下言也。上二焦以禁汗吐言也。今邪在
血室中。则非汗吐下所宜矣。上章以往来寒热如疟。故用小柴胡。以解其邪。下章以胸胁
下满。如结胸状。故刺期门。以泻其实。此章则无上下二证。似待其经行血去。邪热得以随血出而解也。
妇人中风。发热恶寒。经水适来。得七八日。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。随其实而取之。（太阳下编。得下。有之字。）
〔程〕发热恶寒。则风邪在表。未入于里。值经水适来。至七八日。则邪热乘虚而内入。入则表证罢。
故脉迟身凉和也。胸胁者。肝之部分。灵枢经曰。厥阴根于大敦。结于玉英。络于膻中。其正经。则
布胁肋。以肝藏血。邪入血室。故令胸胁满。如结胸状也。肝藏魂。热搏于阴。故令谵语也。
期门者。肝之募。刺之以泻其实。
许氏本事方云。一妇人患热入血室证。医者不识。用补血调气药。涵养数日。遂成血结胸。或劝用前药。
予曰。小柴胡用已迟。不可行也。无已则有一焉。刺期门穴斯可矣。予不能针。请善针者治之。如言而愈。
或者问曰。热入血室。何为而成结胸也。予曰。邪气传入经络。与正气相搏。上下流行。或遇经水适来适断。
邪气乘虚。而入血室。血为邪迫。上入肝经。肝受邪则谵语。而见鬼。复入膻中。则血结于胸也。何以言之。
妇人平居。水当养于木。血当养于肝也。方未受孕。则下行以为月水。既妊娠。则中蓄之以养胎。及已
产。则上壅之以为乳。皆血也。今邪逐血。并归肝经。聚于膻中。结于乳下。故手触之则痛。非汤剂可及。
故当刺期门也。活人书。海蛤散。治血结胸。（海蛤。滑石。甘草。各一两。芒硝半两。上为末。每
服二钱。鸡子清调下。）
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。 然汗出者愈。（详伤寒论辑义阳明篇。者。太阳中篇。作则。）
〔尤〕阳明之热。从气而之血。袭入胞宫。即下血而谵语。盖冲任之脉。并阳明之经。不必乘经水之
来。而后热得入之。故彼为血去而热入。此为热入而血下也。但头汗出者。阳通而闭在阴也。此虽阳明之热。
而传入血室。则仍属肝家。故亦当刺期门。以泻其实。刺已周身 然汗出。则阴之闭者亦通。故愈。
妇人咽中。如有炙脔。半夏浓朴汤主之。（脔。脉经作腐。）
〔尤〕此凝痰结气。阻塞咽嗌之间。千金。所谓咽中帖帖。如有炙肉。吞不下。吐不出者是。
〔鉴〕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。
巢源云。咽中如炙肉脔者。此是胸膈痰结。与气相搏。逆上咽喉之间。结聚状如炙肉之脔也。
半夏浓朴汤方（〔原注〕千金。作胸满心下坚。咽中帖帖。如有炙肉。吐之不
出。吞之不下。○案今本。肉下。有脔字。）
半夏（一升） 浓朴（三两） 茯苓（四两○赵作二两） 生姜（五两） 干苏叶（
二两○千金云一方无干苏叶生姜）
上五味。以水七升。煮取四升。分温四服。日三夜一服。
圣惠方。半夏散。治咽喉中。如有炙腐。
于本方中。加枳壳诃黎勒皮。
王氏易简。四七汤。治喜怒悲恐惊之气。结成痰涎。状如破絮。或如梅核。在咽喉之间。咯不出。
咽不下。此七气之所为也。或中脘痞满。气不舒快。或痰涎壅盛。上气喘急。
或因痰饮中节。呕吐恶心。并宜服之。（即本方。）
又云。妇人情性执着。不能宽解。多被七气所伤。遂致气填胸臆。或如梅核。上塞咽喉。甚者满闷欲
绝。产妇尤多。此证服此剂。间以香附子药。久服取效。妇人恶阻。尤宜服
之。间以红丸子尤效。一名浓朴半夏汤。一名大七气汤。
瑞竹堂经验方。四七汤。治妇人女子。小便不顺。甚者。阴户疼痛。
于本方。加香附子甘草。煎成加琥珀末调服。
仁斋直指。桂枝四七汤。治风冷寒邪。搏心腹作痛。
于本方。合桂枝汤。加枳壳人参。
又四七汤。治惊忧气遏上喘。（即本方。）
又加减七气汤。治气郁呕吐。
于本方。合千金七气汤。（桂枝。半夏。人参。甘草。大枣。生姜。）去紫苏。
又加味四七汤。治心气郁滞。豁痰散惊。
于本方。加茯神远志甘草石菖大枣。
三因七气汤。治喜怒忧思悲恐惊七气。郁发。致五脏互
相刑克。阴阳反戾。挥霍变乱。吐利交作。寒热眩晕。痞满咽塞。
于本方。加桂枝芍药陈皮人参大枣。
孙氏三吴医案云。张溪亭乃眷。喉中梗梗有肉。如炙脔。吞之不下。吐之不出。鼻塞头运。耳常啾啾
不安。汗出如雨。心惊胆怯。不敢出门。稍见风即遍身疼。小腹时疼。小水淋沥而疼。脉两寸皆短。两
关滑大。右关尤搏指。此梅核气症也。以半夏四钱。浓朴一钱。紫苏叶一钱五分。茯苓一钱三
分。姜三分。水煎食后服。每用此汤。调理多效。
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。
〔鉴〕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。喝欠烦闷。肝之病也。母能令子实。故证及也。
案沈尤以脏为子宫。甚误。
甘草小麦大枣汤方（三因。名小麦汤。袖珍。名甘草汤。）
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。（案温分徐沈尤作分温。是。）
〔程〕内经曰。悲则心系急。甘草大枣者。甘以缓诸急
也。小麦者。谷之苦者也。灵枢经曰。心病者。宜食麦。是谷先入心矣。
案素问。以小麦为心之谷。千金云。小麦养心气。本方
所主。正在于此。而金鉴云。方义未详。必是伪错。此说大误。验之于病者。始知立方之妙也。
许氏本事方云。乡里有一妇人。数欠。无故悲泣不止。或谓之有祟。祈禳请祷备至。终不应。予忽
忆有一证云。妇人脏躁云云。急令治药。尽剂而愈。古人识病制方。种种妙绝如此。试而后知。
陈氏妇人良方云。乡先生程虎卿内人。妊娠四五个月。遇昼则惨戚悲伤。泪下数欠。如有所凭。医
与巫兼治。皆无益。仆年十四。正在斋中习业。见说此证。而程省元皇皇无计。仆遂告之。管先生伯同说。
记忆先人曾说此一证。名曰脏躁悲伤。非大枣汤不愈。虎卿借方看之。甚喜对证。笑而治药。一投而愈矣。
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。（
妇人下。千金。有霍乱呕逆二字。泻心汤上。千金有甘草二字。）
〔尤〕吐涎沫。上焦有寒也。不与温散。而反下之。则寒内入而成痞。如伤寒下早例也。然虽痞而犹
吐涎沫。则上寒未已。不可治痞。当先治其上寒。而后治其中痞。亦如伤寒例。表解乃可攻痞也。
〔魏〕泻心汤。在伤寒论中。为方不一。亦当合伤寒论中痞证诸条。参观之。而求其治法。
小青龙汤方（见肺痈中。）
泻心汤方（见惊悸中○案惊悸所载即三黄泻心汤。此恐不然。据千金。当是甘草泻心汤。）
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。在下未多。经候未匀。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
辩记。勿谓不然。（徐云。未多之未字。疑误。程尤作来多。程云。谓崩带之属。金鉴亦作来多。云
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。是传写之讹。案撰金
鉴者。何不考之正脉等本。可疑。沈魏并仍原文。令阴。赵本作冷阴。非。）
〔鉴〕此条为妇人诸病纲领。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。所以必然也。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。
而见此眩冒厥癫之证。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。
〔尤〕甚则奄忽眩冒。状如厥癫。所谓阴病者。下行极而上也。或有忧惨悲嗔。状如鬼
神者。病在阴则多怒。及悲愁不乐也。而总之曰此皆带下。带下者。带脉之下。古人列经脉为病。凡三十六
种。皆谓之带下病。非今人所谓赤白带下也。三十六病者。十二症。九痛。七害。五伤。三痼也。
案史记扁鹊传云。过邯郸。闻贵妇人。即为带下医。知古所称带下。乃腰带以下。经血诸疾之谓也。金鉴
云。此皆带下一句。当在非有鬼神之下。文义相属。是传写之讹。此说非也。本条隔句押韵。如根据金鉴而
改之。则失上下押韵之法。不可从也。巢源云。诸方说三十六疾者。十二症。九痛。七害。五伤。三痼不通
In women, wind-stroke (Wind-Strike) has persisted for seven to eight days. There is a continuous recurrence of alternating chills and fever (alternating cold and heat), occurring at regular intervals. The menstrual flow happens to have ceased. This is termed Heat Entering the Blood Chamber (Heat entering the uterus and related vessels). The blood must be congealed, thus causing symptoms resembling malaria, with regular paroxysms. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment. (The formula is found in the section on Vomiting. ○ In "Shanghan Lun" [Treatise on Cold Damage], Sun Tai Xia Bian, "lai" [comes] is written as "de" [obtains]. Under "duan" [ceases], there are two characters "you zhe" [there are].)
[Cheng] For women suffering from Shanghan (Cold Damage) or Fengzhong (Wind-Stroke), the principles of transmission and treatment through the Six Channels are the same as for men. However, when menstruation is just beginning or has just ceased, Heat enters the Blood Chamber, or during pregnancy/postpartum, metrorrhagia, leukorrhea, etc., the treatment methods differ. During menstruation, when blood is weak and qi is exhausted, pathogenic factors enter the Blood Chamber and contend with healthy qi, causing menstruation to cease and blood to congeal. When blood is congealed, pathogen and healthy qi struggle, resulting in alternating chills and fever with regular timing. Xiao Chai Hu Tang resolves exterior and interior pathogens and dissipates pathogenic heat in the Blood Chamber.
[You] Zhang Zhongjing uses only Xiao Chai Hu Tang without adding a single blood-invigorating herb. The intention is that once the pathogenic heat is resolved, the temporarily congealed blood will naturally circulate. (See detailed explanation in *Shanghan Lun Ji Yi*, Sun Tai Middle Chapter; the following two articles follow the same principle.)
Xu Shuniwei's *Benshi Fang* records Xiao Chai Hu Tang plus Rehmannia Root (Sheng Gan Di Huang), treating women and unmarried girls with Shanghan fever, or alternating chills and fever, where menstruation has just started or just ceased. They are lucid during the day but delirious at night, seeing ghosts. It also treats postpartum lochia that starts then suddenly stops. Add raw dried Rehmannia Root (Sheng Gan Di Huang) to the original Xiao Chai Hu Tang.
In the year Xin Hai, residing in Piling, the sister of Wang Zhongli, an academic official, suffered from Shanghan with alternating chills and fever. At night, she seemed possessed by spirits. After six or seven days, she suddenly became comatose and blocked, with rattling phlegm sounds like sawing, locked jaw, closed eyes, and unconsciousness. The condition was extremely critical. I was summoned to examine her. I asked, "At the onset of the illness, did menstruation occur?" The family replied, "Menstruation had just started, but stopped when the illness began." A day or two later, alternating chills and fever appeared. She was quiet during the day but plagued by spirits at night. From yesterday, excessive saliva flowed, and she lost consciousness. I said, "This is the syndrome of Heat Entering the Blood Chamber." Zhang Zhongjing stated: "Women with wind-stroke, fever and chills, menstruation just started, lucid during the day, delirious at dusk, seeing ghosts, with regular paroxysms, is named Heat Entering the Blood Chamber." If doctors do not understand this and administer harsh purgatives, it leads to chest and diaphragm discomfort, phlegm flooding the upper jiao, panting with high-pitched breathing, and coma. One must first resolve the phlegm, then clear the heat. I urgently administered Yi Xi San (One-Sip Powder). Within two hours, phlegm drained, she slept, and regained consciousness. Then I prescribed Xiao Chai Hu Tang plus Rehmannia Root. After three doses, the fever subsided, and she recovered spontaneously without sweating. (Yi Xi San consists solely of large Tian Nan Xing [Arisaema Cum Bile], processed on the La Chen day. See the book for details.)
Women with Shanghan, fever, and menstruation just starting, who are lucid during the day but delirious at night, seeing ghosts, suffer from Heat Entering the Blood Chamber. Treatment should avoid damaging Stomach Qi and using methods for the Upper and Middle Jiao (sweating and vomiting); the disease will heal itself. (*Mai Jing* note: The character "er jiao" [second jiao] is likely erroneous.)
[Cheng] With Shanghan fever coinciding with menstruation, cold pathogen enters due to deficiency and contends in the Blood Chamber. As pathogen moves from Yang to Yin, the patient is lucid during the day. Yin being affected causes night delirium and hallucinations. "Wu" [no/avoid] is a prohibitive term. "Fan Wei Qi" [invade Stomach Qi] prohibits purgation. "Shang Er Jiao" [Upper and Middle Jiao] prohibits sweating and emesis. Since the pathogen is in the Blood Chamber, sweating, vomiting, and purging are unsuitable. The previous chapter used Xiao Chai Hu Tang for alternating chills/fever like malaria to resolve the pathogen. The next chapter used needling Qimen (Liv 14) for fullness in the hypochondrium resembling Jie Xiong (Chest Binding) to drain excess. This chapter lacks these upper/lower signs, suggesting waiting for menstruation to expel blood and pathogenic heat to exit with it.
Women with wind-stroke, fever and chills, menstruation just starting, after seven to eight days, with heat gone, slow pulse, cool body, but chest/hypochondriac fullness resembling Jie Xiong, and delirium, suffer from Heat Entering the Blood Chamber. Needling Qimen (Liv 14) according to the excess location is indicated. (*Shanghan Lun* Sun Tai Xia Bian: under "de", there are characters "you zhi".)
[Cheng] Fever and chills indicate Wind pathogen in the exterior, not yet in the interior. Coinciding with menstruation, after seven to eight days, pathogenic heat enters internally due to deficiency. Upon entering, exterior signs vanish, hence slow pulse and cool body. The chest and hypochondrium are the Liver's domain. *Ling Shu* states: Jueyin [Liver Pericardium channel] roots at Dazhun (Liv 1), knots at Yuying, connects to Danzhong. Its main meridian spreads to the hypochondrium. Since the Liver stores blood, pathogen entering the Blood Chamber causes chest/hypochondriac fullness like Jie Xiong. The Liver houses the Hun [Ethereal Soul]; heat contending in Yin causes delirium. Qimen (Liv 14) is the Front-Mu point of the Liver; needling it drains excess.
Xu Shuniwei's *Benshi Fang* records: A woman with Heat Entering the Blood Chamber was misdiagnosed and treated with blood-nourishing and qi-regulating herbs for several days, resulting in Blood Jie Xiong. Someone advised using the previous method. I said, "Using Xiao Chai Hu Tang is too late; it cannot be used. If no other option exists, one can needle the Qimen acupoint." I could not needle, so I asked a skilled practitioner to treat her. She recovered as instructed. Someone asked, "Why does Heat Entering the Blood Chamber form Jie Xiong?" I said, "Pathogen enters meridians, contends with healthy qi, circulates up and down. If menstruation starts or stops, pathogen enters Blood Chamber due to deficiency. Blood is forced upward into the Liver Meridian. Liver involvement causes delirium and hallucinations. Re-entering Danzhong causes blood to knot in the chest. Why? Normally, water nourishes Wood [Liver], and blood nourishes the Liver. Before pregnancy, blood flows down as menses; during pregnancy, it accumulates to nourish the fetus; after birth, it rises to become milk—all are blood. Now pathogen chases blood, gathering in the Liver Meridian, condensing at Danzhong and below the breasts, causing pain on touch. Decoctions cannot reach here, so one must needle Qimen." *Huo Ren Shu* records Hai Ge San (Clam Shell Powder) for Blood Jie Xiong. (Hai Ge [Clam Shell], Hua Shi [Talc], Gan Cao [Licorice] each 1 liang, Mang Xiao [Mirabilite] 0.5 liang. Powdered, take 2 qian per dose, mixed with egg white.)
Yangming Disease, with bleeding and delirium, is Heat Entering the Blood Chamber. Only the head sweats. Needling Qimen (Liv 14) to drain excess is indicated. If profuse sweating ensues throughout the body, the patient recovers. (*Shanghan Lun Ji Yi* Yangming Chapter. "Zhe" [particle], *Shanghan Lun* Sun Tai Zhong Pian writes "ze".)
[You] Yangming heat moves from Qi to Blood, invading the Uterus, causing bleeding and delirium. The Chong and Ren meridians connect with the Yangming Meridian; heat can enter without waiting for menstruation. Thus, the former is heat entering after blood loss; this is blood flowing due to heat entering. Head-only sweating indicates Yang is open but Yin is closed. Although Yangming heat, upon entering the Blood Chamber, belongs to the Liver system, so needling Qimen (Liv 14) to drain excess is required. After needling, if profuse sweating occurs, Yin closure is resolved, and recovery follows.
Women with a sensation of a roasted meat lump in the throat are treated with Ban Xia Hou Po Tang (Pinellia and Magnolia Bark Decoction). ("Luan" [lump], *Mai Jing* writes "fu" [rotten].)
[You] This is condensed phlegm and stagnant Qi blocking the throat. *Qian Jin Fang* describes it as "throat feeling tight, like roasted meat, unable to swallow or spit out."
[Jian] "Sensation of roasted meat in throat" refers to phlegm-saliva in the throat feeling like roasted meat, unable to expectorate or swallow. This is now known as Plum-Pit Qi (Globus Hystericus). This disease arises from Seven Emotions [Joy, Anger, Worry, Thought, Sorrow, Fear, Fright], where stagnant Qi condenses fluids. Therefore, Ban Xia [Pinellia], Hou Po [Magnolia Bark], and Sheng Jiang [Fresh Ginger] are used; pungent flavors to scatter nodules, bitter flavors to direct rebellion downward. Fu Ling [Poria] assists Ban Xia to promote fluid metabolism and move phlegm. Zi Su Ye [Perilla Leaf] is aromatic to diffuse stagnant Qi. Once Qi flows freely and phlegm clears, the disease heals. Men also suffer this, not just women.
*Bing Yuan Zhi Zhu* states: Sensation of roasted meat in throat is due to phlegm-knotting in chest/diaphragm contending with Qi, rising to the throat, forming a lump like roasted meat.
Ban Xia Hou Po Tang Formula ([Original Note] *Qian Jin Fang* writes: chest fullness, hardness below heart, throat feeling tight, like roasted meat, unable to spit out or swallow. ○ Current edition adds "luan" [lump] after "rou" [meat].)
Ban Xia [Pinellia Tuber] (1 sheng) Hou Po [Magnolia Bark] (3 liang) Fu Ling [Poria] (4 liang ○ Zhao writes 2 liang) Sheng Jiang [Fresh Ginger] (5 liang) Gan Su Ye [Dried Perilla Leaf] (2 liang ○ *Qian Jin Fang* says one version has no Gan Su Ye or Sheng Jiang)
These five ingredients are boiled in 7 sheng of water to yield 4 sheng. Divide into four warm doses. Take three times daily and once at night.
*Sheng Hui Fang* Ban Xia San (Pinellia Powder) treats sensation of roasted meat in throat.
Add Zhi Ke [Aurantii Fructus] and He Li Le Pi [Chebulic Myrobalan Peel] to this formula.
Wang Shi *Yi Jian Fang* Si Qi Tang (Four Qi Decoction) treats Qi結 from Joy, Anger, Sorrow, Fear, Fright condensing into phlegm-saliva, shaped like broken cotton or plum pits, stuck in throat, unable to spit or swallow. Caused by Seven Qi. Also suitable for epigastric fullness, Qi stagnation, excessive phlegm, panting, or vomiting due to Phlegm-Fluid in Middle Jiao. (This is the same formula.)
It also states: Women with stubborn temperaments, unable to relax, are often injured by Seven Qi, leading to Qi filling the chest, sensation of plum pit blocking throat, severe oppression. Common in postpartum women. Taking this formula, occasionally with Cyperi Rhizoma (Xiang Fu) medicine, yields long-term results. Especially suitable for pregnant women with nausea/vomiting (E Zu). Occasionally combined with Hong Wan Zi (Red Pill) is effective. Also named Hou Po Ban Xia Tang or Da Qi Tang.
*Rui Zhu Tang Jing Yan Fang* Si Qi Tang treats women with difficult urination, severe cases with vulvar pain.
Add Xiang Fu [Cyperi Rhizoma] and Gan Cao [Licorice] to this formula. Boil and add Hu Po [Amber] powder to mix.
Ren Zhai *Zhi Zhi Fang* Gui Zhi Si Qi Tang treats Wind-Cold pathogen contending in Heart/Abdomen causing pain.
Combine this formula with Gui Zhi Tang (Cinnamon Twig Decoction), add Zhi Ke [Aurantii Fructus] and Ren Shen [Ginseng].
Another Si Qi Tang treats panting caused by Shock/Worry Qi obstruction. (This is the same formula.)
Another Modified Qi Tang treats Qi-Stagnation Vomiting.
Combine this formula with *Qian Jin Fang* Qi Tang (Gui Zhi [Cinnamon Twig], Ban Xia [Pinellia], Ren Shen [Ginseng], Gan Cao [Licorice], Da Zao [Jujube], Sheng Jiang [Fresh Ginger]). Remove Zi Su [Perilla].
Another Added-Ingredient Si Qi Tang treats Heart-Qi Stagnation, resolving phlegm and dispelling fright.
Add Fu Shen [Poria with Hostwood], Yuan Zhi [Polygalae Radix], Gan Cao [Licorice], Shi Chang Pu [Acori Tatarinowii Rhizoma], Da Zao [Jujube] to this formula.
*San Yin Ji Yi Bing Zheng Fang Lun* Qi Tang treats Seven Emotions [Joy, Anger, Worry, Thought, Sorrow, Fear, Fright] stagnation causing mutual overacting of Five Zang, Yin-Yang reversal, sudden chaos, vomiting/diarrhea, alternating chills/fever, dizziness, fullness, throat blockage.
Add Gui Zhi [Cinnamon Twig], Shao Yao [Peony Root], Chen Pi [Citrus Peel], Ren Shen [Ginseng], Da Zao [Jujube] to this formula.
Sun Shi *San Wu Yi An* records: Mrs. Zhang Xiting felt a lump in throat like roasted meat, unable to swallow/spit, nasal congestion, dizziness, tinnitus, profuse sweating, palpitations, fear of going out, body pain upon slight wind exposure, intermittent lower abdominal pain, painful dribbling urine. Both Cun pulses were short; Guan pulses were slippery and large, especially Right Guan which was forceful. This is Plum-Pit Qi Syndrome. Use Ban Xia [Pinellia] 4 qian, Hou Po [Magnolia Bark] 1 qian, Zi Su Ye [Perilla Leaf] 1.5 qian, Fu Ling [Poria] 1.3 qian, Jiang [Ginger] 0.3 qian. Decoct in water, take after meals. This decoction is often effective for regulation.
Women with Zang Zao (Visceral Restlessness) frequently feel sad and want to cry, appearing possessed by spirits, with frequent yawning and stretching. Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) is the primary treatment.
[Jian] "Zang" refers to the Heart. When the Heart is calm, the Spirit resides. If injured by Seven Emotions, the Heart cannot remain calm, and the Spirit becomes restless. Hence sadness/crying, indicating Spirit cannot govern emotions. Appearing possessed indicates Heart-Spirit cannot illuminate. This is now known as Loss-of-Vision Mania. Frequent yawning/stretching indicates irritability, a Liver disease. Mother generates Son, so the condition affects the Heart.
Note: Shen Mingzong considers "Zang" to mean Uterus, which is very incorrect.
Gan Cao Xiao Mai Da Zao Tang Formula (*San Yin Fang* names it Xiao Mai Tang; *Xiu Zhen Fang* names it Gan Cao Tang.)
Gan Cao [Licorice Root] (3 liang) Xiao Mai [Common Wheat] (1 sheng) Da Zao [Jujube] (10 pieces)
These three ingredients are boiled in 6 sheng of water to yield 3 sheng. Divide into three warm doses. It also tonifies Spleen Qi. (Note: Wen Fen Xu, Shen Mingzong, You Zaijing write "Fen Wen" [divide warm], which is correct.)
[Cheng] *Nei Jing* states: Sorrow makes Heart-Tendons contract. Gan Cao and Da Zao are sweet to relieve spasms. Xiao Mai is bitter among grains. *Ling Shu* states: Heart diseases benefit from eating wheat. Grains enter the Heart first.
Note: *Su Wen* considers Wheat the grain of the Heart. *Qian Jin Fang* states: Wheat nourishes Heart-Qi. The efficacy of this formula lies precisely here. *Jin Jian* claims the formula's rationale is unknown and likely erroneous; this view is greatly mistaken. Clinical verification reveals the brilliance of the prescription.
Xu Shuniwei's *Benshi Fang* records: A village woman yawned frequently and cried uncontrollably without cause. Others suggested spirit possession, resorting to prayers and rituals, all to no avail. I suddenly recalled the syndrome "Women's Zang Zao," urgently ordered medicine preparation. After finishing the dose, she recovered. Ancient physicians' diagnosis and prescription skills were thus miraculous. Trial confirms this.
Chen Shi *Fu Ren Liang Fang* records: Mr. Cheng Huqing's wife, pregnant 4-5 months, felt miserable and sad during the day, crying and yawning frequently, as if possessed. Doctors and shamans failed. I was 14, studying in the academy. Hearing of this case, Mr. Cheng was anxious. I told him Mr. Guan Botong mentioned his father spoke of this syndrome, named Zang Zao Sadness, curable only with Da Zao Tang. Mr. Cheng borrowed the formula, was pleased it matched the syndrome, smiled, prepared medicine, and cured after one dose.
Women spitting saliva-phlegm, treated erroneously with purgatives, develop Epigastric Fullness (Pi). First treat the spitting with Xiao Qing Long Tang (Minor Blue Dragon Decoction). Once saliva-phlegm stops, then treat the Pi with Xie Xin Tang (Drain the Epigastrium Decoction). ("Women" down, *Qian Jin Fang* has "Huo Luan Ou Ni" [Cholera Vomiting/Reverse]).
[You] Spitting saliva-phlegm indicates Cold in Upper Jiao. Not warming/dispersing, but purging, allows Cold to enter internally forming Pi, similar to premature purging in Shanghan. Although Pi exists, ongoing spitting indicates Upper Cold persists; do not treat Pi yet. Treat Upper Cold first, then Middle Pi, similar to Shanghan principle: resolve exterior before attacking Pi.
[Wei] Xie Xin Tang varies in *Shanghan Lun*. Consult Shanghan Pi-syndrome articles to find treatment methods.
Xiao Qing Long Tang Formula (See Lung Abscess section.)
Xie Xin Tang Formula (See Palpitations section ○ Note: Palpitations section lists San Huang Xie Xin Tang [Three Yellow Drain Epigastrium Decoction]. This is likely incorrect; according to *Qian Jin Fang*, it should be Gan Cao Xie Xin Tang [Licorice Drain Epigastrium Decoction].)
Women's diseases, due to Deficiency, Accumulated Cold, and Stagnant Qi, lead to cessation of menstruation, sometimes lasting years. Blood-Cold accumulates in Bao Men (Uterine Gate), Cold injures meridians. Congealing firmly in Upper Jiao causes vomiting saliva-phlegm, eventually becoming Lung Abscess, wasting the body. Knotting in Middle Jiao causes Umbilical Cold Hernia or Hypochondriac Pain connected to Zang organs. Or Heat knots in Middle, pain at Guan Yuan (CV 4), rapid pulse without ulcer, skin rough like fish scales. This affects men too, not just women. Lower Jiao issues are less common: irregular menstruation, pulling pain in Yin, cold in Lower Abdomen, radiating to Waist/Spine, down to Qi Jie (Groin), urgent Qi Chong (CV 29) pain, knee/shin pain/restlessness, sudden dizziness/fainting resembling Jue or Dian syndromes, or sorrow/grief/anger. These are all Dai Xia (Leukorrhea/Lower Burner diseases), not ghostly. Long-term leads to emaciation, deficient pulse, much Cold. Thirty-Six Diseases change endlessly. Examine pulse Yin/Yang, Deficiency/Excess, Tight/String-taut. Apply acupuncture/herbs to save critical cases. Same disease, different pulse origins; you must distinguish and record. Do not say otherwise. (Xu Yun doubts "Wei Duo" [not much]; Cheng/You read "Lai Duo" [much coming]. Cheng says: refers to Metrorrhagia/Leukorrhea. *Jin Jian* also reads "Lai Duo", saying "Lai" should be "Wei". This article discusses cessation of menses; "Lai Duo" contradicts text, likely scribal error. *Jin Jian* authors didn't check *Zheng Mai* editions, questionable. Shen/Wei keep original. "Ling Yin" [causes Yin], Zhao Ben writes "Leng Yin" [Cold Yin], incorrect.)
[Jian] This article is the general outline for women's diseases. Difference from men is menstruation. Causes include Deficiency, Accumulated Cold, Stagnant Qi. Any can stop menses for years. Cold accumulates in Bao Men, congealing blood/Qi. Ancients say: Women are healthy if menses regulate; irregularity leads to myriad diseases. Below describes variations obstructing menses. Variations depend on individual Zang/Meridian, Cold/Heat, Deficiency/Excess. External Cold injuring meridians + Upper Jiao Cold = Congealing Upper Jiao → Chest/Lung disease → Qi stagnation/Fluid retention → Vomiting saliva-phlegm. If Upper Jiao originally Hot, Cold transforms to Heat → Heat injures Lung → Lung Abscess → Emaciation. If Middle Jiao originally Cold = Knotting Middle → Umbilical Hernia/Hypochondriac Pain (Liver connection). If Middle Jiao originally Hot = No Cold Hernia, but Heat Knotting Middle → Pain at Guan Yuan. Rapid pulse usually means Ulcer; no ulcer means Heat burns Yin → Skin dry/scaly. These symptoms also affect men. "Lower Jiao not much" means irregular menses, scant flow. Pathogen invades Bao Zhong (Lower Jiao) → Pulling Yin pain, Lower Abdomen Cold, radiating to Waist/Spine/Groin/Knees. Severe pain causes dizziness/fainting (Jue/Dian). Sorrow/Anger with these signs is not supernatural. All Bao/Zhong/Chong/Ren Blood diseases can cause Dai Xia (Leukorrhea). Proverb: Ten women, nine Dai Xia. Long-term Dai Xia damages fluids/body → Emaciation, deficient pulse, Cold. Beyond Thirty-Six Diseases, changes are endless. Yet, examining pulse Yin/Yang/Deficiency/Excess/Tight/String-taut alongside symptoms, applying acupuncture/herbs saves lives. Same disease, different pulses require careful distinction. Hence, "You must distinguish and record."
[You] Severe cases: sudden dizziness/fainting resembling Jue/Dian. Yin diseases rise from extreme descent. Sorrow/Anger resembling spirits: Yin diseases cause anger/sadness. All called Dai Xia. Dai Xia refers to below the Belt Vessel (Dai Mai). Ancients listed 36 Meridian diseases as Dai Xia, not modern Red/White Leukorrhea. Thirty-Six Diseases: 12 Syndromes, 9 Pains, 7 Harms, 5 Injuries, 3 Chronic Conditions.
Note: *Shi Ji · Bian Que Zhuan* says: Passing Handan, hearing respect for women, became a Dai Xia doctor. Ancient Dai Xia meant diseases below the belt, specifically menstrual disorders. *Jin Jian* argues "Ci Jie Dai Xia" sentence should follow "Fei You Gui Shen" for logical flow, claiming scribal error. This is incorrect. The text rhymes every other line. Changing it breaks rhyme scheme. *Bing Yuan Zhi Zhu* says: Thirty-Six Diseases: 12 Syndromes, 9 Pains, 7 Harms, 5 Injuries, 3 Chronic Obstructions.