Library

Yin Ting Syndrome. Surgical texts printed in bookshops discuss this in considerable detail. Generally, it is not beyond the pathology of Damp-Heat pouring downward. Xue Lizhai used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), and Zhibai Bawei Wan (Anemarrhena, Phellodendron, and Eight-Ingredient Pill) as main prescriptions, with Danggui Lvwana Wan (Angelica Sinensis and Gardenia Pill) and Longdan Xiegan Tang (Gentian Liver-Draining Decoction) as auxiliaries. This could be considered a step ahead of others. However, upon investigation, none of the treatments yielded any effect. Why? It is likely that they were misled by the previous generations' emphasis on "Warmth" and "Heat." When I was at home, my medical skills were quite acceptable to others. Having practiced medicine for thirty-seven years, my experience was not insignificant, yet I had never seen a single case of Yin Ting syndrome. I suppose the ancients were thorough in their thinking; they merely recorded the disease name based on what they had heard. Later, in the Xin You year, I was dispatched to Zhili as a county magistrate awaiting appointment. During my spare time from official duties, I occasionally attended to this branch of medicine. I then learned that among women in Zhili, about three or four out of ten suffered from this disease. In severe cases, the prolapse protruded one or two cun, or even three or four cun, thick as a finger or large as a fist. The shape varied like a snake, a melon, an edible fungus, or a toad. Some had continuous bleeding and discharge, some were dry and unmoistened, some experienced pain and itching, while others felt numbness and insensitivity. This led to menstrual cessation, sallow complexion, poor appetite, emaciation, coughing, hemoptysis, alternating chills and fever, spontaneous sweating, and night sweats, eventually resulting in death due to consumption and injury. In mild cases, there was only a sensation of obstruction in the vagina without visible prolapse; if visible, it was not prominent, causing little pain or harm. If menstruation was regular, fertility remained possible. Contemporary physicians named this condition "Yin Zhi" (Yin Hemorrhoid), also known as "Chi Xue Lao" (Blood-Eating Consumption). None of the medications used proved effective. Some resorted to surgical excision, which provided temporary relief but soon worsened. I too attempted treatment according to previous methods without success, wondering why. Later, after reading classics such as *Neijing* (The Inner Canon), *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet), and *Qianjin Fang* (Prescriptions Worth a Thousand Gold), as well as various secret manuscripts, and seeking their underlying meanings while combining them with my observations, I gained significant insight. I came to know that people in the South do not suffer from this disease; even if they do, it is easily cured. People in the North often suffer from it, and treatments are invariably ineffective, for specific reasons. The Yin Ting of Southerners arises from pathological changes; books contain formulas for it, and following the methods yields frequent results. The Yin Ting of Northerners arises from "Qi Xi" (habitual lifestyle and environmental factors). Although the clinical manifestations are similar, the etiology differs, hence the ineffectiveness. What is meant by "Qi Xi"? Northern customs involve sitting on damp ground during the day and sleeping on earthen kang beds at night, leading to the gradual accumulation of Cold-Dampness, which goes without saying. Men engage in labor and dissipate essence, while women remain static and often lie prone. During spring, summer, and late summer, dampness is steamed by summer heat, rising like steam from cooking rice. When women have their menses, the Blood Sea is empty; emptiness makes one susceptible to pathogens. Sitting on damp ground all day and diligently doing needlework generates body heat that dries the ground, allowing dampness to enter the body along with the body's qi. This aligns with the concept of "Cold Injury to the Bao Men (Uterine Gate)" in *Jinkui Yaolue*. Even more so, in late summer, dry soil, after rain, causes worms within the earth to wriggle. Upon smelling blood, these worms raise their heads and inhale the air. Worms belong to the Yin category, and blood is Yin fluid. Yin follows Yin, and toxic vapors combine, becoming the root cause of Yin Ting. Extending this logic, even without sitting on damp ground, if women squat in toilets to defecate or urinate instead of using chamber pots, the toilet, being a filthy and hidden place, harbors many damp worms. Their toxic vapors can ascend and invade along with the scent of blood. In my mountain residence, I often see children sitting on damp ground suffering from penile swelling, pain, or itching, commonly called "Earthworm Blowing." Treaters would open a duck's bill and let the child suckle it, as ducks like earthworms; or wash with a decoction of Sichuan pepper and alum, as pepper overcomes cold and alum dries dampness. Understanding this, the root cause of Yin Ting becomes clear as day. Physicians who fail to investigate the cause and merely apply standard formulas cannot be blamed for the worsening condition. Furthermore, there are profit-seeking individuals who administer harsh pills containing drugs for draining water, reducing swelling, and attacking toxins internally, and apply external pastes made of Toad Venom, Borax, Mirabilite, Musk, Realgar, Borneol, Asafoetida, and White Arsenic, causing even greater harm. Therefore, I could not bear to sit idly by. For patients newly afflicted with this syndrome, I used the ingredients of Wuling San (Five-Ingredient Powder with Poria), adding Sichuan Pepper, Phellodendron Bark, Fennel Seed, Aconite Root, Glehnia Root, Ligusticum Chuanxiong Rhizome, and Safflower, processed into honey pills. Each dose was 4 qian, taken twice daily. Externally, I used a decoction of Sichuan Pepper, Sophora Root, Atractylodes Macrocephala Rhizome, and Sophora Flower, added with Mirabilite, for fumigation and washing. Additionally, I prepared pills from Calcined Alum (6 liang), Copper Green (4 qian), Schisandra Berry (5 qian), Realgar (5 qian), and Peach Kernel (1 liang), finely powdered and bound with refined honey into 4-qian pills, coated with Realgar, inserted into the vagina, yielding miraculous effects. For chronic cases progressing to consumption with irregular menstruation, I treated with Wenjing Tang (Warming the Menses Decoction) or Shenqi Wan (Kidney Qi Pill), modifying with Tortoise Shell, Turtle Shell, and Tribulus Fruit according to symptoms, achieving cures. Words on paper cannot fully exhaust this topic. By carefully analyzing the text of the *Jinkui Yaolue*, specifically the chapters on miscellaneous diseases of women and the entire work, extracting even a single word or phrase to inspire understanding, there is no doubt that no case is incurable.