陆(四八)肝肾久损。冲任交伤。崩漏。暴下如注。
龟甲心(五钱) 女贞实(一钱) 淡天冬(二钱) 清阿胶(三钱) 旱莲(二钱) 柏子仁(二钱) 熟地炭
(三钱)
归(五二)崩漏暴下不止。脉动。冲任交损。方议潜阳。
龟甲心(五钱) 归身(一钱五分) 阿胶(二钱) 川断(二钱) 炙黑甘草(四分) 蕲艾(五分) 炒枯熟
地(三钱)
斯(廿六)脉左迟右濡。寒热腰痛。脊酸楚。足缓腹痛。漏淋不止。肝阴虽属久亏。而昨议益阴镇肝之药。未尝不
是。然淋沥已久。而疏泄逐瘀之法。既不可进。于理必得血脱益气之方。使其阳生阴长。冀其寒热痛淋渐止。拟内经乌
贼丸意。
乌贼骨(四钱) 清阿胶(一钱五分) 女贞子(一钱五分) 茜草(一钱) 淡天冬(一钱五分) 旱莲草(一
钱五分) 人参(六分) 黄 (二钱) 如不用人参用党参(二钱)
斯(廿六)经漏。皮膜刺痛。养肝阴。泄肝阳。
生牡蛎(三钱) 小生地(三钱) 川楝子(一钱) 清阿胶(二钱五分)
拣麦冬(三钱) 小川连(三分) 柏子仁(一钱)
王(三○)经漏半月一至。大便必两日始通。此属肝肾内衰。八脉无气拥护。经旨有胞络移热于膀胱之论。议三才
汤参入益肝阴。养心液。
人参(另煎冲,四分) 原熟地(四钱) 柏子霜(二钱) 拣麦冬(二钱) 小清胶(二钱) 淡天冬(二钱) 云
茯神(二钱) 制女贞(一钱五分)
陆(四十八岁):肝肾长期受损,冲脉与任脉同时受伤,导致崩漏。经血突然大量下泄,如注水般汹涌。
龟甲心(五钱) 女贞实(一钱) 淡天冬(二钱) 清阿胶(三钱) 旱莲(二钱) 柏子仁(二钱) 熟地炭(三钱)
归(五十二岁):崩漏暴下不止,脉搏跳动明显,冲脉与任脉双重损伤。处方思路在于潜镇阳气。
龟甲心(五钱) 归身(一钱五分) 阿胶(二钱) 川断(二钱) 炙黑甘草(四分) 蕲艾(五分) 炒枯熟地(三钱)
斯(二十六岁):脉象左侧迟缓、右侧濡软,伴有寒热往来、腰痛、脊柱酸痛、足部无力及腹痛,漏下淋沥不止。肝阴虽然长期亏虚,之前讨论的益阴镇肝药物并非不对。然而淋沥日久,疏泄逐瘀的方法已不可用,从医理上讲必须采用“血脱益气”的方剂,使其阳气生发而阴血增长,希望寒热、疼痛和淋症逐渐停止。拟定《内经》乌贼丸之意。
乌贼骨(四钱) 清阿胶(一钱五分) 女贞子(一钱五分) 茜草(一钱) 淡天冬(一钱五分) 旱莲草(一钱五分) 人参(六分) 黄芪(二钱) 如不用人参可用党参(二钱)
斯(二十六岁):经期漏下,皮肤膜状组织刺痛。治疗以滋养肝阴、疏泄肝阳为主。
生牡蛎(三钱) 小生地(三钱) 川楝子(一钱) 清阿胶(二钱五分)
拣麦冬(三钱) 小川连(三分) 柏子仁(一钱)
王(三十岁):经期漏下半月一次,大便必然要两天才通畅。这属于肝肾内部衰弱,奇经八脉没有气机来拥护。医经中有“胞络移热于膀胱”的论述。建议在三才汤中加入药物以益肝阴、养心液。
人参(另煎冲服,四分) 原熟地(四钱) 柏子霜(二钱) 拣麦冬(二钱) 小清胶(二钱) 淡天冬(二钱) 云茯神(二钱) 制女贞(一钱五分)
Lu (48 years old): Long-term damage to the Liver and Kidney. Simultaneous injury to the Chong and Ren vessels, resulting in metrorrhagia and metrostaxis (Beng Lou). Sudden profuse bleeding, gushing like a stream.
Guijia Xin (Tortoise Plastron Heart, 5 qian) Nüzhen Shi (Ligustrum Lucidum Fruit, 1 qian) Dan Tiandong (Asparagus Cochinchinensis Rhizome, 2 qian) Qing Ejiao (Donkey-hide Gelatin, 3 qian) Hanlian (Eclipta Prostrata, 2 qian) Baiziren (Biota Seed, 2 qian) Shudi Tan (Charred Rehmannia Root, 3 qian)
Gui (52 years old): Profuse metrorrhagia and metrostaxis that does not stop. Pulsation is evident. Dual damage to the Chong and Ren vessels. The prescription strategy proposes subduing Yang Qi.
Guijia Xin (Tortoise Plastron Heart, 5 qian) Guishen (Angelica Sinensis Root Body, 1.5 qian) Ejiao (Donkey-hide Gelatin, 2 qian) Chuanduan (Dipsacus Asper, 2 qian) Zhihei Gancao (Honey-fried Black Licorice, 0.4 qian) Qiai (Ai Leaf from Qichun, 0.5 qian) Chaoku Shudi (Stir-fried Charred Rehmannia Root, 3 qian)
Si (26 years old): The pulse is slow on the left and soggy on the right. Symptoms include alternating chills and fever, lower back pain, spinal soreness and stiffness, weak legs, abdominal pain, and continuous dripping metrorrhagia. Although Liver Yin has been deficient for a long time, the previously discussed herbs for nourishing Yin and suppressing Liver Yang were not incorrect. However, given the prolonged dripping nature, methods of dispersing and removing blood stasis are no longer applicable. From a theoretical standpoint, a formula based on "tonifying Qi in cases of blood loss" (Xue Tuo Yi Qi) is necessary to promote the generation of Yang and the growth of Yin, hoping that the chills, fever, pain, and dripping will gradually cease. The intention follows the Wutai Wan from the *Neijing*.
Wutai Gu (Cuttlefish Bone, 4 qian) Qing Ejiao (Donkey-hide Gelatin, 1.5 qian) Nüzhen Zi (Ligustrum Lucidum Fruit, 1.5 qian) Qiancao (Madder Root, 1 qian) Dan Tiandong (Asparagus Cochinchinensis Rhizome, 1.5 qian) Hanlian Cao (Eclipta Prostrata, 1.5 qian) Renshen (Ginseng Root, 0.6 qian) Huangqi (Astragalus Membranaceus Root, 2 qian) If Renshen is not used, Dangshen (Codonopsis Pilosula Root, 2 qian) may be substituted.
Si (26 years old): Intermenstrual bleeding during menstruation, with stabbing pain in the skin and membranes. Treatment focuses on nourishing Liver Yin and draining Liver Yang.
Sheng Muli (Raw Oyster Shell, 3 qian) Xiao Shengdi (Rehmannia Glutinosa Root, 3 qian) Chuanlianzi (Evodia Fruit, 1 qian) Qing Ejiao (Donkey-hide Gelatin, 2.5 qian)
Jian Maidong (Ophiopogon Japonicus Tuber, 3 qian) Xiao Chuanlian (Coptis Chinensis Rhizome, 0.3 qian) Baiziren (Biota Seed, 1 qian)
Wang (30 years old): Menstrual leakage occurs once every half month. Bowel movements only occur after two days. This belongs to internal decline of the Liver and Kidney, with the Eight Extraordinary Vessels lacking Qi support. The medical classics mention the theory of "heat transferring from the uterine collaterals to the bladder." It is proposed to modify the Sancai Tang by adding herbs to benefit Liver Yin and nourish Heart fluids.
Renshen (Decocted separately and taken with the main decoction, 0.4 qian) Yuan Shudi (Prepared Rehmannia Root, 4 qian) Baizi Shuang (Biota Seed Powder, 2 qian) Jian Maidong (Ophiopogon Japonicus Tuber, 2 qian) Xiao Qingjiao (Light Donkey-hide Gelatin, 2 qian) Dan Tiandong (Asparagus Cochinchinensis Rhizome, 2 qian) Yun Fushen (Poria Cocos with Hostwood, 2 qian) Zhi Nüzhen (Processed Ligustrum Lucidum Fruit, 1.5 qian)