妇人中风。七八日续来寒热。发作有时。经水适断者。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。
中风七八日。寒热已止而续来。经水才行而适断者。知非风寒重感。乃热邪与血俱结于血室也。
热与血结。攻其血则热亦去。然虽结而寒热如疟。则邪既留连于血室。而亦侵淫于经络。设攻其血。
血虽去。邪必不尽。且恐血去而邪得乘虚尽入也。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。
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。
伤寒发汗过多者。邪气离表则入阳明。经水适来者。邪气离表则入血室。盖虚则易入。亦惟虚者
能受也。昼日明了。暮则谵语者。血为阴。暮亦为阴。阴邪遇阴乃发也。然热虽入而血不结。其邪必
将自解。治
之者但无犯胃气。及上二焦阳气而已。仲景盖恐人误以发热为表邪未解。或以谵语为阳明胃实。而或
攻之或汗之也。
妇人中风。发热恶寒。经水适来。得之七八日。热除脉迟身凉和。胸胁满如结胸状。谵语者。此
为热入血室也。当刺期门。随其实而取之。
热除脉迟身凉和而谵语者。病去表而之里也。血室者。冲任之脉。肝实主之。肝之脉布胁肋。上贯
膈。其支者。复从肝别上膈。注于肺。血行室空。热邪独胜。则不特入于其宫。而亦得游其部。是以
胸胁满如结胸状。许叔微云。邪气蓄血。并归肝经。聚于膻中。结于乳下。以手触之则痛。非汤剂可
及。故当刺期门。期门、肝之募。随其实而取之者。随其结之微甚。刺而取之也。
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。
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。
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。吐不出者是也。半夏、浓
朴、生姜。辛以散结。苦以降逆。茯苓佐半夏利痰气。紫苏芳香。入肺以宣其气也。
半夏浓朴汤方
半夏（一升） 浓朴（三两） 茯苓（四两） 生姜（五两） 苏叶（二两）
上五味。以水一斗。煮取四升。分温四服。日三夜一服。
妇人脏燥。喜悲伤欲哭。象如神灵所作。数欠伸。甘麦大枣汤主之。
脏燥。沈氏所谓子宫血虚。受风化热者是也。血虚脏燥。则内火扰而神不宁。悲伤欲哭。有如神
灵。而实为虚病。前五脏风寒积聚篇。所谓邪哭使魂魄不安者。血气少而属于心也。数欠伸者。经云。
肾为欠、为嚏。又肾病者。善伸、数欠、颜黑。盖五志生火。动必关心。脏阴既伤。穷必及肾也。小
麦为肝之谷。而善养心气。甘草、大枣。甘润生阴。所以滋脏气而止其燥也。
甘麦大枣汤方
甘草（三两） 小麦（一升） 大枣（十枚）
上三味。以水六升。煮取三升。分温三服。亦补脾气。
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。
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。
小青龙汤方（见肺痈）
泻心汤方（见惊悸）
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。子当辨记。勿谓不然。
此言妇人之病。其因约有三端。曰虚。曰冷。曰结气。盖血脉贵充悦。而地道喜温和。生气欲条
达也。否则血寒经绝。胞门闭而经络阻矣。而其变证。则有在上在中在下之异。在上者。肺胃受之。为
呕吐涎唾。为肺痈。为形体消损。病自下而至上。从炎上之化也。在中者。肝脾受之。或寒疝绕脐。
或胁痛连脏。此病为阴。或结热中。痛在关元。或脉数肌干。甚则并着男子。此病为热中。为阴阳之
交。故或从寒化。或从热化也。在下者。肾脏受之。为经脱不匀。为阴中掣痛。少腹恶寒。或上引腰脊。
下根气街。及膝胫疼痛。肾脏为阴之部。而冲脉与少阴之大络。并起于肾故也。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。至其阴阳虚实之机。针药安危之故。苟非医者辨之有素。乌能施之而无误耶。三十六病者。
十二 、九痛、七害、五伤、三痼也。
问曰。妇人年五十所。病下利数十日不止。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。
妇人年五十所。天癸已断而病下利。似非因经所致矣。不知少腹旧有积血。欲行而未得遽行。欲
止而不能竟止。于是下利窘急。至数十日不止。暮即发热者。血结在阴。阳气至暮。不得入于阴。而
反浮于外也。少腹里急腹满者。血积不行。亦阴寒在下也。手掌烦热。病在阴。掌亦阴也。唇口干燥。
血内瘀者。不外荣也。此为瘀血作利。不必治利。但去其瘀而利自止。吴茱萸、桂枝、丹皮。入血散
寒而行其瘀。芎、归、芍药、麦冬、阿胶。以生新血。人参、甘草、姜、夏。以正脾气。盖瘀久者营
必衰。下多者脾必伤也。
温经汤方
吴茱萸（三两） 当归 芎 芍药 人参 桂枝 阿胶 丹皮 生姜 甘草（各二两） 半
夏（半升） 麦冬（一升）
上十二味。以水一斗。煮取三升。分温三服。亦主妇人少腹寒。久不受胎。兼治崩中去血。或月
水来过多。及至期不来。
带下。经水不利。少腹满痛。经一月再见者。土瓜根散主之。
妇人经脉流畅。应期而至。血满则下。血尽复生。如月盈则亏。月晦复 也。惟其不利。则蓄泄
失常。似通非通。欲止不止。经一月而再见矣。少腹满痛。不利之验也。土瓜根主内痹瘀血月闭。
虫蠕动逐血。桂枝、芍药。行营气而正经脉也。
土瓜根散方
土瓜根 芍药 桂枝 虫（各三分）
上四味。杵为散。酒服方寸匕。日三服。
寸口脉弦而大。弦则为减。大则为芤。减则为寒。芤则为虚。寒虚相搏。此名为革。妇人则半产
漏下。旋复花汤主之。
本文已见虚劳篇中。此去男子亡血失精句。而益之曰旋复花汤主之。盖专为妇人立法也。详本草
旋复花治结气。去五脏间寒热。通血脉。葱主寒热。除肝邪。绛帛入肝理血。殊与虚寒之旨不合。然
而肝以阴脏而舍少阳之气。以生化为事。以流行为用。是以虚不可补。解其郁聚。即所以补。寒不可
温。行其血气。即所以温。固不可专补其血。以伤其气。亦非必先散结聚。而后温补。如赵氏、魏氏
之说也。
旋复花汤方
旋复花（三两） 葱（十四茎） 新绛（少许）
上三味。以水三升。煮取一升。顿服之。
妇人陷经。漏下黑不解。胶姜汤主之。
陷经。下而不止之谓。黑则因寒而色瘀也。胶姜汤方未见。然补虚温里止漏。阿胶、干姜二物已
足。林亿云。恐是胶艾汤。按千金胶艾汤有干姜。似可取用。
妇人少腹满如敦状。小便微难而不渴。生后者。此为水与血俱结在血室也。大黄甘遂汤主之。
敦、音对。按周礼注。盘以盛血。敦以盛食。盖古器也。少腹满如敦状者。言少腹有形高起。如
敦之状。与内经胁下大如覆杯之文略同。小便难。病不独在血矣。不渴。知非上焦气热不化。生后即
产后。产后得此。乃是水血并结。而病属下焦也。故以大黄下血。甘遂逐水。加阿胶者。所以去瘀浊
而兼安养也。
大黄甘遂汤方
大黄（四两） 甘遂 阿胶（各二两）
上三味。以水三升。煮取一升。顿服。其血当下。
妇人经水不利下。抵当汤主之。
经水不利下者。经脉闭塞而不下。比前条下而不利者有别矣。故彼兼和利。而此专攻逐也。然必
审其脉证并实而后用之。不然。妇人经闭。多有血枯脉绝者矣。虽养冲任。犹恐不至。而可强责之哉。
抵当汤方
水蛭（熬） 虻虫（熬各三十） 桃仁（二十） 大黄（三两酒浸）
上四味为末。水五升。煮取三升。去滓。温服一升。
妇人经水闭不利。脏坚癖不止。中有干血。下白物。矾石丸主之。
脏坚癖不止者。子藏干血。坚凝成癖而不去也。干血不去。则新血不荣。而经闭不利矣。由是蓄
泄不时。胞宫生湿。湿复生热。所积之血。转为湿热所腐。而成白物。时时自下。是宜先去其脏之湿
热。矾石却水除热。合杏仁破结润干血也。
矾石丸方
矾石（三分烧） 杏仁（一分）
上二味。末之。炼蜜丸枣核大。五内中。剧者再内之。
妇人六十二种风。腹中血气刺痛。红蓝花酒主之。
妇人经尽产后。风邪最易袭入腹中。与血气相搏而作刺痛。刺痛。痛如刺也。六十二种未详。红
蓝花苦辛温。活血止痛。得酒尤良。不更用风药者。血行而风自去耳。
红蓝花酒方
红蓝花（一两）
上一味。酒一大升。煎减半。顿服一半。未止再服。
妇人腹中诸疾痛。当归芍药散主之。
妇人以血为主。而血以中气为主。中气者。土气也。土燥不生物。土湿亦不生物。芎、归、芍药
滋其血。苓、术、泽泻治其湿。燥湿得宜。而土能生物。疾痛并蠲矣。
当归芍药散方（见妊娠）
妇人腹中痛。小建中汤主之。
营不足则脉急。卫不足则里寒。虚寒里急。腹中则痛。是必以甘药补中缓急为主。而合辛以生阳。
合酸以生阴。阴阳和而营卫行。何腹痛之有哉。
小建中汤方（见虚劳）
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。肾气丸主之。
饮食如故。病不由中焦也。了戾与缭戾同。胞系缭戾而不顺。则胞为之转。胞转则不得溺也。由
是下气上逆而倚息。上气不能下通而烦热不得卧。治以肾气者。上焦之气肾主之。肾气得理。庶缭者
顺。戾者平。而闭乃通耳。
肾气丸方
干地黄（八两） 山药 山茱萸（各四两） 泽泻 丹皮 茯苓（各三两） 桂枝 附子（炮各
一两）
上八味末之。炼蜜和丸梧子大。酒下十五丸。加至二十丸。日再服。
妇人阴寒。温阴中坐药。蛇床子散主之。
阴寒。阴中寒也。寒则生湿。蛇床子温以去寒。合白粉燥以除湿也。此病在阴中而不关脏腑。故
但内药阴中自愈。
蛇床子散方
蛇床子 上一味末之。以白粉少许。和合相得。如枣大。绵裹内之。自然温。
少阴脉滑而数者。阴中即生疮。阴中蚀疮烂者。野狼牙汤洗之。
脉滑者湿也。脉数者热也。湿热相合。而系在少阴。故阴中即生疮。甚则蚀烂不已。野狼牙味酸苦。
除邪热气。疥瘙恶疮。去白虫。故取治是病。
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。
胃气下泄。阴吹而正喧。此谷气之实也。膏发煎主之。
阴吹。阴中出声。如大便失气之状。连续不绝。故曰正喧。谷气实者。大便结而不通。是以阳明
下行之气。不得从其故道。而乃别走旁窍也。猪膏发煎润导大便。便通。气自归矣。
膏发煎方（见黄瘅）
小儿疳虫蚀齿方
雄黄 葶苈 上二味末之。取腊月猪脂熔。以槐枝绵裹头四五枚。点药烙之。
When a woman suffers from Wind-Strike (Zhong Feng), and after seven or eight days, chills and fever recur at regular intervals, while her menses happen to cease, this is Heat entering the Blood Chamber (Xue Shi). The blood must be congealed, thus causing symptoms resembling malaria with periodic attacks. Xiao Chai Hu Tang (Minor Bupleurum Decoction) should be primarily administered.
If Wind-Strike persists for seven or eight days, and the chills and fever have ceased but then recur, while the menses have just started and suddenly stop, it indicates that this is not due to a secondary invasion of Wind-Cold, but rather Heat pathogen and Blood are jointly congealed in the Blood Chamber. When Heat and Blood are congealed, attacking the Blood will eliminate the Heat. However, although there is congealment, the chills and fever resemble malaria, indicating that the pathogen has lingered in the Blood Chamber and also infiltrated the meridians. If one directly attacks the Blood, although the Blood may be removed, the pathogen will likely not be completely eliminated, and there is a risk that once the Blood is gone, the pathogen will fully enter due to deficiency. Zhang Zhongjing uses only Xiao Chai Hu Tang without adding any single blood-invigorating herb. The intention is that once the Heat pathogen is resolved, the temporarily congealed Blood will flow naturally.
When a woman suffers from Cold Damage (Shang Han) with fever, and her menses happen to arrive, she is clear-minded during the day but delirious at night, seeing things as if ghosts were present. This is Heat entering the Blood Chamber. Treatment should avoid damaging Stomach Qi and should not interfere with the Upper and Middle Jiao; the disease will heal itself.
Excessive sweating in Cold Damage causes the pathogen to leave the exterior and enter the Yangming channel. If menses happen to arrive, the pathogen leaves the exterior and enters the Blood Chamber. Deficiency makes entry easy, and only the deficient can receive the pathogen. Clear-mindedness by day and delirium by night occur because Blood is Yin, evening is Yin, and Yin pathogens manifest when encountering Yin time. Although Heat enters, if the Blood does not congeal, the pathogen will resolve spontaneously. Treatment requires only avoiding damage to Stomach Qi and the Yang of the Upper and Middle Jiao. Zhang Zhongjing likely feared that people would mistakenly treat fever as unresolved exterior pathogen or delirium as Yangming Stomach excess, leading to erroneous purgation or diaphoresis.
When a woman suffers from Wind-Strike with fever and aversion to cold, and her menses happen to arrive, after seven or eight days the fever subsides, the pulse becomes slow, the body feels cool and harmonious, yet she experiences fullness in the chest and hypochondrium resembling Chest Binding (Jie Xiong), accompanied by delirium. This is Heat entering the Blood Chamber. One should puncture Qimen (LR14) and apply reduction according to the excess condition.
The subsidence of fever, slow pulse, cool body, and presence of delirium indicate the pathogen moving from exterior to interior. The Blood Chamber refers to the Chong and Ren vessels, primarily governed by the Liver. The Liver meridian distributes along the costal region, passes through the diaphragm, and its branch ascends through the diaphragm to connect with the Lung. After blood circulation, the Blood Chamber is empty, and Heat pathogen prevails alone, invading not only the uterus but also wandering through the Liver meridian's territory, causing chest and hypochondriac fullness resembling Chest Binding. Xu Shuwei stated: Pathogen accumulating in blood returns to the Liver meridian, gathering at Danzhong (CV17) and knotting below the breasts, causing pain upon touch, which cannot be reached by decoctions; thus, puncturing Qimen is necessary. Qimen is the Front-Mu point of the Liver. "Reducing according to excess" means puncturing based on the severity of the knotting.
In Yangming disease, if bleeding occurs accompanied by delirium, this is Heat entering the Blood Chamber. Only head sweating occurs. One should puncture Qimen and reduce the excess. If generalized sweating follows, the patient will recover.
Yangming Heat moves from Qi to Blood, invading the Uterus, causing bleeding and delirium. Since the Chong and Ren vessels run parallel to the Yangming meridian, Heat can enter without waiting for menstruation. Thus, the previous case was Heat entering after blood loss, whereas this case is Heat entering causing blood descent. Head-only sweating indicates Yang is open but blocked by Yin. Although this is Yangming Heat, upon entering the Blood Chamber, it belongs to the Liver; thus, puncturing Qimen to reduce excess is appropriate. After puncturing, if generalized mild sweating occurs, the Yin blockage is cleared, and recovery ensues.
When a woman feels as if there is a roasted meat lump in her throat, Ban Xia Hou Po Tang (Pinellia and Magnolia Bark Decoction) should be administered.
This is condensed Phlegm and stagnant Qi blocking the throat, described in *Qian Jin Fang* as feeling like roasted meat stuck in the throat, impossible to swallow or spit out. Ban Xia, Hou Po, and Sheng Jiang use pungent flavors to dissipate knots and bitter flavors to direct rebellious Qi downward. Fu Ling assists Ban Xia in draining Phlegm Qi. Zi Su Ye is aromatic, enters the Lung, and promotes Qi diffusion.
**Ban Xia Hou Po Tang Formula**
Ban Xia (1 sheng), Hou Po (3 liang), Fu Ling (4 liang), Sheng Jiang (5 liang), Zi Su Ye (2 liang).
These five ingredients are boiled in 1 dou of water to obtain 4 sheng. Divide into four warm doses: three times daily and once at night.
For Zang Dryness (Zang Zao) in women, characterized by frequent sadness and desire to cry, appearing as if possessed by spirits, with frequent yawning and stretching, Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) should be administered.
Zang Dryness, as described by Shen, refers to uterine Blood deficiency receiving Wind transforming into Heat. Blood deficiency leads to Zang dryness, internal Fire disturbs, and Spirit becomes restless, causing sadness and crying, seemingly spirit-induced but actually a deficiency pattern. As mentioned in the "Five Zang Wind-Cold Accumulation" chapter, "evil weeping makes Hun and Po uneasy" is due to low Blood and Qi belonging to the Heart. Frequent yawning and stretching relate to the Kidney governing yawning and sneezing; Kidney disease manifests as preference for stretching and frequent yawning with dark complexion. Five Emotions generate Fire, affecting the Heart; Zang Yin injury eventually reaches the Kidney. Wheat is the grain of the Liver, nourishing Heart Qi. Gan Cao and Da Zao are sweet and moistening, generating Yin to nourish Zang Qi and stop dryness.
**Gan Mai Da Zao Tang Formula**
Gan Cao (3 liang), Xiao Mai (1 sheng), Da Zao (10 pieces).
These three ingredients are boiled in 6 sheng of water to obtain 3 sheng. Divide into three warm doses. It also tonifies Spleen Qi.
When a woman vomits saliva and froth, and the physician erroneously applies purgation, resulting in epigastric fullness (Pi), one should first treat the vomiting of saliva and froth using Xiao Qing Long Tang (Minor Green Dragon Decoction). Once the saliva and froth stop, treat the Pi using Xie Xin Tang (Drain the Epigastrium Decoction).
Vomiting saliva and froth indicates Cold in the Upper Jiao. Failing to use warming dispersion and instead purging allows Cold to enter internally, forming Pi, similar to premature purgation in Cold Damage. Even with Pi, if saliva and froth continue, Upper Cold remains unresolved; Pi should not be treated yet. Treat Upper Cold first, then Middle Pi, following the principle that exterior resolution precedes Pi treatment.
*Xiao Qing Long Tang Formula (See Lung Abscess chapter)*
*Xie Xin Tang Formula (See Palpitations chapter)*
Women's diseases arise from deficiency, accumulated Cold, and Qi stagnation, leading to cessation of menstruation, sometimes lasting years. Cold Blood accumulates in the Bao Men (Uterine Gate), damaging meridians. Knots form above, causing vomiting of saliva and froth, potentially becoming Lung Abscess over time, wasting the body. Knots form in the middle, causing peri-umbilical Cold Hernia or hypochondriac pain connecting to Zang organs. Heat knots in the center, causing pain at Guanyuan (CV4), rapid pulse without ulceration, and fish-scale-like dry skin. This condition can affect men as well as women. Below, menstrual irregularities cause vaginal pulling pain, cold sensation in the lower abdomen, radiating to the waist and spine, extending to the Qichong point, with acute pain in the knee and shin, sudden dizziness and vertigo resembling syncope or mania, or sorrowful and angry emotions. These are all Dai Xia diseases (diseases below the Belt Vessel), not caused by ghosts. Over time, emaciation occurs, with weak and cold pulses. The thirty-six diseases change endlessly. Examine Yin-Yang, deficiency-excess, tight-string pulses, and apply acupuncture and herbs to stabilize critical conditions. Although diseases may appear similar, their pulse origins differ; students must distinguish and record them.
This section discusses women's diseases, citing three main causes: Deficiency, Cold, and Qi Stagnation. Blood vessels require fullness and luster; the female pathway prefers warmth and harmony, and vital Qi desires free flow. Otherwise, Cold Blood causes menstrual cessation, Bao Men closes, and meridians block. Variations occur in the Upper, Middle, and Lower regions. Upper: Lung and Stomach are affected, causing vomiting of saliva/froth, Lung Abscess, and wasting; disease moves upward from inflammation. Middle: Liver and Spleen are affected, causing peri-umbilical Cold Hernia or hypochondriac pain connecting to Zang (Yin disease); or Heat knotting in the center, pain at Guanyuan, rapid pulse, dry skin, potentially affecting men (Heat in the middle, Yin-Yang interaction, transforming to Cold or Heat). Lower: Kidney is affected, causing menstrual irregularity, vaginal pulling pain, cold lower abdomen, radiating to waist/spine/Qichong/knees. Kidney is the Yin region; Chong and Shaoyin collaterals originate here. Severe cases involve sudden dizziness/syncope (Yin disease descending to extreme then ascending). Emotional sorrow/anger relates to Yin pathology. "Dai Xia" refers to diseases below the Dai Vessel, encompassing thirty-six types, distinct from modern leukorrhea. Understanding Yin-Yang deficiency-excess and needle/herb safety requires prior diagnostic proficiency. The thirty-six diseases include twelve masses, nine pains, seven harms, five injuries, and three chronic conditions.
Question: A woman around fifty suffers from diarrhea for dozens of days without stopping, fever in the evening, urgency and fullness in the lower abdomen, hot palms, and dry lips/mouth. What is the cause? Master says: This belongs to Dai Xia. Why? Because of a previous miscarriage, Blood stasis remains in the lower abdomen. How do we know? The symptom of dry lips/mouth indicates this. Wen Jing Tang (Warming the Menses Decoction) should be administered.
At fifty, Tian Gui (menstrual essence) has ceased, yet diarrhea occurs, seemingly unrelated to menstruation. However, old accumulated Blood in the lower abdomen wants to exit but cannot, wanting to stay but unable to stop, causing urgent diarrhea for dozens of days. Evening fever occurs because Blood stasis is in Yin; Yang Qi at evening cannot enter Yin and floats externally. Lower abdominal urgency/fullness is due to stationary Blood and Yin Cold below. Hot palms indicate Yin pathology (palms are Yin). Dry lips/mouth result from internal Blood stasis failing to nourish externally. This is diarrhea caused by Blood stasis; do not treat diarrhea directly, but remove stasis, and diarrhea will stop. Wu Zhu Yu, Gui Zhi, and Mu Dan Pi enter Blood to scatter Cold and move stasis. Xiong Dui, Dang Gui, Bai Shao, Mai Dong, and E Jiao generate new Blood. Ren Shen, Gan Cao, Sheng Jiang, and Ban Xia regulate Spleen Qi. Long-term stasis depletes Ying Blood; excessive diarrhea injures Spleen Qi.
**Wen Jing Tang Formula**
Wu Zhu Yu (3 liang), Dang Gui, Xiong Dui (Chuan Xiong), Bai Shao, Ren Shen, Gui Zhi, E Jiao, Mu Dan Pi, Sheng Jiang, Gan Cao (each 2 liang), Ban Xia (0.5 sheng), Mai Dong (1 sheng).
Twelve ingredients boiled in 1 dou of water to obtain 3 sheng. Divide into three warm doses. Also treats cold lower abdomen preventing conception, metrorrhagia, heavy menstruation, or amenorrhea.
For Dai Xia with difficult menstruation, lower abdominal fullness/pain, and menstruation occurring twice a month, Tu Gua Gen San (Trichosanthes Root Powder) should be administered.
Normal menstruation flows smoothly, arriving on schedule, draining when full, regenerating when empty, like the moon waxing and waning. Difficulty causes abnormal storage/drainage, seeming open but closed, stopping but continuing, resulting in two periods a month. Lower abdominal fullness/pain confirms obstruction. Tu Gua Gen treats internal Bi, Blood stasis, and amenorrhea; E Chong (Ground Beetle) moves Blood; Gui Zhi and Bai Shao circulate Ying Qi and regulate meridians.
**Tu Gua Gen San Formula**
Tu Gua Gen, Bai Shao, Gui Zhi, E Chong (each 3 fen).
Four ingredients crushed into powder. Take one cun bi with wine, three times daily.
Cunkou pulse is wiry and large. Wiry indicates decline (Han/Cold); large indicates hollow (Kou/Xu/Deficiency). Cold and Deficiency combine, named Ge (Leather) pulse. In women, this causes miscarriage or dripping hemorrhage. Xuan Fu Hua Tang (Inula Flower Decoction) should be administered.
This text appears in the Deficiency Consumption chapter, omitting male blood loss/essence loss and adding Xuan Fu Hua Tang for women. Detailed materia medica states Inula treats Qi stagnation, removes Cold/Heat between Zang-Fu, and unites vessels; Scallion treats Cold/Heat and removes Liver evil; Crimson Silk enters Liver to regulate Blood. This seems inconsistent with Deficiency-Cold principles. However, the Liver, though a Yin organ, houses Shaoyang Qi, focusing on transformation and flow. For deficiency, unblocking stagnation is tonification; for Cold, moving Blood/Qi is warming. One should not solely tonify Blood harming Qi, nor merely disperse before warming, contrary to Zhao and Wei's views.
**Xuan Fu Hua Tang Formula**
Xuan Fu Hua (3 liang), Cong Bai (Scallion White, 14 stems), Xin Jiang (Crimson Silk, a little).
Three ingredients boiled in 3 sheng of water to obtain 1 sheng. Take in one dose.
For Xian Jing (Sinking Meridian) with black dripping hemorrhage that does not resolve, Jiao Jiang Tang (Gelatin and Ginger Decoction) should be administered.
Xian Jing refers to downward flow without stopping. Black color indicates Cold-induced Blood stasis. The formula is missing, but E Jiao and Gan Jiang suffice for tonifying deficiency, warming interior, and stopping bleeding. Lin Yi suggests it might be Jiao Ai Tang, which contains Gan Jiang in *Qian Jin Fang*, making it usable.
When a woman's lower abdomen is full like a Dun (ancient vessel), with slight difficulty urinating but no thirst, especially postpartum, this is Water and Blood congealing in the Blood Chamber. Da Huang Gan Sui Tang (Rhubarb and Kansui Decoction) should be administered.
"Dun" is an ancient vessel for food. Fullness like a Dun indicates a palpable mass. Urinary difficulty implies pathology beyond Blood. No thirst rules out Upper Jiao Qi-Heat failure to transform. Postpartum onset indicates Water-Blood conjunction in Lower Jiao. Da Huang purges Blood; Gan Sui drains Water; E Jiao removes turbidity and nourishes.
**Da Huang Gan Sui Tang Formula**
Da Huang (4 liang), Gan Sui, E Jiao (each 2 liang).
Three ingredients boiled in 3 sheng of water to obtain 1 sheng. Take in one dose. Blood should pass.
For difficult menstruation that fails to descend, Di Dang Tang (Di Dang Decoction) should be administered.
Failure of menstruation to descend indicates meridian closure, differing from "descending but difficult." Thus, this case requires aggressive purgation rather than harmonizing. Use only after confirming excess via pulse and symptoms. Amenorrhea often involves Blood depletion and pulse extinction; forcing purgation is dangerous.
**Di Dang Tang Formula**
Shui Zhi (Leech, processed), Meng Chong (Dragonfly Larva, processed, 30 each), Tao Ren (Peach Kernel, 20), Da Huang (3 liang, wine-soaked).
Four ingredients powdered. Boiled in 5 sheng water to obtain 3 sheng. Strain. Take 1 sheng warm.
For amenorrhea with hard masses in the Zang, dry Blood inside, and white discharge, Fan Shi Wan (Alum Pill) should be administered.
Hard masses indicate dry Blood congealed in the uterus. Dry Blood prevents new Blood nourishment, causing amenorrhea. Stagnation leads to dampness and Heat in the Baogong, corrupting Blood into white discharge. First, clear Zang Damp-Heat. Alum drains Water and clears Heat; Xing Ren breaks knots and moistens dry Blood.
**Fan Shi Wan Formula**
Fan Shi (Alum, 3 fen, calcined), Xing Ren (Apricot Kernel, 1 fen).
Two ingredients powdered. Honey-pilled to date-seed size. Insert vaginally. Repeat if severe.
For sixty-two types of Wind causing stabbing abdominal pain from Blood-Qi conflict, Hong Lan Hua Jiu (Safflower Wine) should be administered.
Post-menstrual or postpartum, Wind easily invades the abdomen, conflicting with Blood-Qi to cause stabbing pain. Safflower is bitter, pungent, and warm, invigorating Blood and stopping pain, enhanced by wine. No wind-dispersing herbs are needed because moving Blood expels Wind.
**Hong Lan Hua Jiu Formula**
Hong Lan Hua (Safflower, 1 liang).
One ingredient boiled in 1 da sheng of wine until half remains. Take half in one dose. Repeat if necessary.
For various abdominal pains in women, Dang Gui Shao Yao San (Angelica and Paeonia Powder) should be administered.
Women rely on Blood, which depends on Middle Qi (Earth/Spleen). Earth too dry or wet fails to generate. Xiong Dui, Dang Gui, and Bai Shao nourish Blood; Fu Ling, Bai Zhu, and Ze Xie treat Dampness. Proper drying/wetting allows Earth to generate, resolving pain.
*Dang Gui Shao Yao San Formula (See Pregnancy Chapter)*
For abdominal pain, Xiao Jian Zhong Tang (Minor Construct the Middle Decoction) should be administered.
Insufficient Ying causes tense pulses; insufficient Wei causes interior Cold. Deficient Cold and interior tension cause pain. Sweet herbs should tonify Middle and relieve tension, combined with Pungent to generate Yang and Sour to generate Yin. Harmony of Yin-Yang ensures smooth Ying-Wei flow, eliminating pain.
*Xiao Jian Zhong Tang Formula (See Deficiency Consumption Chapter)*
Question: A woman eats normally but suffers from irritability, heat, inability to lie flat, and orthopnea. What is the cause? Master says: This is called Zhuan Bao (Turning Bladder), causing urinary retention. The Bao tie is twisted. Shen Qi Wan (Kidney Qi Pill) should be administered.
Normal eating excludes Middle Jiao pathology. "Liao Li" means twisted. Twisted Bao tie causes bladder turning and urinary retention. Lower Qi rebels upward causing orthopnea; Upper Qi cannot descend causing irritability/heat. Shen Qi Wan regulates Kidney Qi, which governs Upper Jiao Qi. Regulating Kidney Qi straightens the twist, allowing passage.
**Shen Qi Wan Formula**
Shu Di Huang (8 liang), Shan Yao, Shan Zhu Yu (each 4 liang), Ze Xie, Mu Dan Pi, Fu Ling (each 3 liang), Gui Zhi, Fu Zi (processed, each 1 liang).
Eight ingredients powdered. Honey-pilled to wisteria seed size. Take 15 pills with wine, increasing to 20. Twice daily.
For Yin Cold, use a sitz bath medication: She Chuang Zi San (Cnidium Powder) should be administered.
Yin Cold refers to cold in the vagina. Cold generates Dampness. She Chuang Zi warms to dispel Cold; Bai Fen (Lead Powder) dries to remove Dampness. Since the pathology is local and not related to Zang-Fu, local application suffices.
**She Chuang Zi San Formula**
She Chuang Zi.
Powder the single ingredient. Mix with a little Bai Fen. Form into date-seed sized pills wrapped in silk. Insert vaginally. Will feel naturally warm.
If Shaoyin pulse is slippery and rapid, sores will appear in the vagina. If erosion and ulceration occur, Ye Lang Ya Tang (Wild Wolf Tooth Decoction) should be used for washing.
Slippery pulse indicates Dampness; rapid pulse indicates Heat. Damp-Heat combining in Shaoyin causes vaginal sores. Severe cases lead to erosion. Wild Wolf Tooth is sour and bitter, clearing Heat, treating sores/ulcers, and removing parasites.
**Ye Lang Ya Tang Formula**
Ye Lang Ya (3 liang).
One ingredient boiled in 4 sheng water to obtain 0.5 sheng. Wrap cotton around a chopstick like a cocoon, dip in decoction, and irrigate the vagina four times daily.
If Stomach Qi leaks downward, causing Yin Blow (noisy flatulence from the vagina), this is excess Grain Qi (constipation). Gao Fa Jian (Fat and Hair Decoction) should be administered.
Yin Blow is noisy flatulence from the vagina, continuous like bowel gas. Excess Grain Qi means constipation. Yangming descending Qi cannot exit normally and takes a side route (vagina). Pig fat and human hair lubricate the bowels. Once stool passes, Qi returns to normal.
*Gao Fa Jian Formula (See Jaundice Chapter)*
**Formula for Children's Malnutrition Worms Eroding Teeth**
Xiong Huang (Realgar), Ting Li (Descurainia Seed).
Powder both. Melt December pig fat. Dip a槐枝 (Locust branch) wrapped cotton tip (4-5 strands) into the medicine and cauterize the teeth.