妇人伤寒。当经水适来适断之时。热邪乘虚而入血室。其证昼日明了。夜则谵语。
如见鬼状。若发热恶寒。日轻夜重。小腹胀满者。血为热瘀也。当用柴芩、紫苏、荆芥、
当归、川芎、益母、香附、楂肉、丹参、丹皮等。和血散邪药。下咽即得汗而解。有汗者为
表虚。前方去紫苏。加桂枝和解之。寒热如疟者。前方亦加桂枝和解之。若厥而下
利者。此非热邪。乃为寒邪所袭也。前方去黄芩。加桂枝、干姜温散之。烦渴者。属里
热。去紫苏、香附。加黑栀子清之。若小腹硬满作痛。当以逐瘀为急。前方去紫苏。加
桃仁、红花、延胡、牛膝等。攻以行之。（合参金鉴第一书）
邵评∶血室者。营血停留之所。经脉集会之处。即冲脉所谓血海是也。其脉起于
气街。并少阴之经。挟脐上行。至胸中而散。妇人经水来。则血下行。血下则经脉
空虚。热邪乘虚而入血室也。昼属阳而主气。暮阴而主血。热邪入血室而为病。
故昼轻而暮重。夫血室虽冲脉所属。而心君属血室之主。热入其室。其主必昏。
故有谵语。肝藏血而藏魂。血去热入则肝虚。魂不安而妄见。故如见鬼状。少腹
是冲之部分。邪入于卫。冲血室。血与热邪积蓄于中。故小腹胀满也。用散邪行
血之剂。邪去经调。其病自解。
又评∶热入血室而谵语。其病由肝。故仲圣有刺期门穴法。以泻肝之募。恐人见
谵语。误认阳明胃腑之症。故又戒曰。无犯胃气及上焦。必自愈。
妇女患伤寒病。正值月经来潮或刚结束之时。热邪趁虚侵入血室（指冲脉，为血液汇聚之处）。其症状表现为白天神志清醒，夜间则胡言乱语。
如同看见鬼怪一般。如果伴有发热恶寒，且白天较轻、夜间加重，小腹胀满的，这是血液被热邪瘀滞所致。应当使用柴胡、黄芩、紫苏、荆芥、当归、川芎、益母草、香附、山楂肉、丹参、牡丹皮等药物。这些是和血散邪的药物。服药后随即出汗而病愈。如果有汗出的，属于表虚证。前方去掉紫苏。加入桂枝以和解表里。如果寒热往来像疟疾一样的，前方也加入桂枝以和解表里。如果出现四肢厥冷并下利的，这不是热邪，而是被寒邪侵袭所致。前方去掉黄芩。加入桂枝、干姜以温通发散。如果心烦口渴的，属于里热证。去掉紫苏、香附。加入黑栀子以清热。如果小腹硬满疼痛的，应当以逐瘀为急务。前方去掉紫苏。加入桃仁、红花、延胡索、牛膝等。攻逐瘀血以行气活血。（参考《医宗金鉴》）
邵评：血室，是营血停留的地方，经脉集会之处，也就是冲脉所说的血海。它的脉气起于气街（腹股沟动脉搏动处），与足少阴肾经并行，挟着肚脐上行，至胸中而分散。妇女月经来潮时，血液下行，血下行则经脉空虚，热邪便趁虚侵入血室。白天属阳而主气，夜晚属阴而主血。热邪侵入血室致病，所以白天轻而晚上重。虽然血室归属于冲脉，但心主血脉，是血室的主宰。热邪进入血室，主宰者必受昏扰，所以出现胡言乱语。肝藏血而藏魂，血去热入则肝虚，魂不安定而妄见幻象，所以如同看见鬼怪一样。少腹是冲脉所主的部位，邪气侵入卫分，冲犯血室，血与热邪积蓄在体内，所以小腹胀满。使用散邪行血的药剂，邪气去除，经脉调和，病自然痊愈。
又评：热入血室导致胡言乱语，病根在于肝，所以张仲景有针刺期门穴的方法，以泻肝之募穴。担心人们见到胡言乱语的症状，误认为是阳明胃腑的病证，所以又告诫说：不要损伤胃气及上焦，病必定自愈。
A woman suffering from Shanghan (Cold Damage) disease, at the time when her menses are just beginning or have just ceased. The pathogenic heat enters the Blood Chamber (Chong Mai, the sea of blood) taking advantage of the deficiency. Her symptoms present as lucidity during the day, but delirium at night.
She sees things as if ghosts were present. If accompanied by fever and aversion to cold, with symptoms lighter during the day and heavier at night, and fullness in the lower abdomen, this indicates blood stasis due to heat. One should use herbs such as Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), Zi Su Ye (Perillae Folium), Jing Jie (Schizonepetae Spica), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Yi Mu Cao (Leonuri Herba), Xiang Fu (Cyperi Rhizoma), Shan Zha (Crataegi Fructus), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), and Mu Dan Pi (Moutan Cortex). These are herbs that harmonize the blood and scatter pathogens. After ingestion, sweating occurs immediately, and the disease resolves. If there is already sweating, it indicates exterior deficiency. Remove Zi Su Ye from the previous formula. Add Gui Zhi (Cinnamomi Ramulus) to harmonize the exterior and interior. If chills and fever alternate like malaria, add Gui Zhi to the previous formula to harmonize. If there is cold extremities with diarrhea, this is not due to pathogenic heat, but rather an invasion by cold pathogens. Remove Huang Qin from the previous formula. Add Gui Zhi and Gan Jiang (Zingiberis Rhizoma) to warm and disperse. If there is irritability and thirst, it belongs to interior heat. Remove Zi Su Ye and Xiang Fu. Add Hei Zhi Zi (Gardeniae Fructus, stir-fried black) to clear heat. If the lower abdomen is hard, full, and painful, removing stasis should be the urgent priority. Remove Zi Su Ye from the previous formula. Add Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), Yan Hu Suo (Corydalis Rhizoma), and Niu Xi (Achyranthis Bidentatae Radix). Attack the stasis to promote movement. (Referenced from *Yi Zong Jin Jian*)
Shao's Commentary: The Blood Chamber is where Ying Blood (Nutritive Blood) stays and where meridians converge; it is what Chong Mai refers to as the Sea of Blood. Its vessel originates at Qi Jie (the groin area where the femoral artery pulses), runs parallel to the Foot-Shaoyin Kidney Meridian, ascends flanking the navel, and disperses in the chest. When a woman’s menses arrive, blood flows downward; as blood descends, the meridians become empty, allowing pathogenic heat to enter the Blood Chamber taking advantage of the deficiency. Day belongs to Yang and governs Qi; night belongs to Yin and governs Blood. Since pathogenic heat enters the Blood Chamber to cause illness, symptoms are lighter during the day and heavier at night. Although the Blood Chamber is associated with Chong Mai, the Heart (Emperor Mind) governs Blood and is the master of the Blood Chamber. When heat enters its chamber, the master must become confused, hence delirium occurs. The Liver stores Blood and houses the Hun (Ethereal Soul); loss of blood and entry of heat lead to Liver deficiency. With the Hun unsettled, hallucinations occur, hence seeing things as if ghosts were present. The lower abdomen is the region governed by Chong Mai. Pathogens enter the Wei (Defensive) level and assault the Blood Chamber; blood and heat accumulate within, causing lower abdominal fullness. Using agents that scatter pathogens and move blood, once pathogens are eliminated and meridians regulated, the disease resolves spontaneously.
Further Commentary: Delirium caused by heat entering the Blood Chamber stems from the Liver; therefore, Zhang Zhongjing prescribed needling the Qimen (LR14) acupoint to drain the Front-Mu point of the Liver. This is done to prevent people from mistaking delirium for a Yangming Stomach-Fu syndrome. Hence, he warns: Do not damage the Stomach Qi and the Upper Jiao; the disease will heal itself.