妇人崩漏,失血过多,由气血俱虚损,伤子宫血海也。血气之行外循经络,内荣脏腑,重则为崩,轻则
为漏。而冲任之气虚,不能约制其经血,故脾不能统血,肝不能藏血,忽然血崩暴下,此等症候皆由脾
胃气血先损,能受补者可救。误用止涩寒凉之剂,复伤脾胃生气,使血反不归经矣。
【主方】
人参(一钱) 炒白术(一钱) 白茯苓(八分) 甘草(五分,炙) 小蓟(一钱)
川芎(七分) 当归头(一钱,酒洗) 侧柏叶(一钱,炒) 生地黄(一钱,酒洗)
水二盅煎八分食远服。
加减法
血晕,加荆芥(六分,炒)、泽兰叶(六分);虚汗,加黄 (一钱蜜炙) 枣
仁(八分去壳炒);崩中日久,白带不止,加龙骨、牡蛎(火 ,各一钱,
研末,用丝绵裹入药同煎);血来多不止,加墨棕刷烧灰存性,绵灰(各三分,
盖血遇黑即止也;经血得热,崩漏不止,口苦咽干,小便短少,大便燥结,加黄连、黄芩、山
栀(各五分,俱要酒炒);血多紫黑如泥凝块者,亦当用之。
此症营卫滞气之所成也。赤者属荣,白者属卫,乃病之常。然其症皆因喜怒忧思,素有湿热伤于荣卫
胞络,使浊气渗入膀胱,故流带下。轻则来而不来,重则来而无度,使腰膝疼痛,饮食减常,精神短少,法当
清上实下,清浊自分,理脾养气,湿热自解。更能薄滋味,温补下元,则带症自除矣。
【主方】
川芎(一钱) 当归(一钱,酒洗) 白芍(一钱,酒洗) 生地(酒洗) 白术(各一
钱) 甘草(五分,炙) 莲子(一钱,去心) 白扁豆花(七分,炒) 白鸡冠花子(一钱,炒)
水二盅,煎一盅食远温服。
加减法
或加葵花五朵更妙(即一丈红也,白者治白带,赤者治赤带。)瘦人多热,
加黄柏、黄连、香附(各五分);肥人多湿痰,加苍术、天南星、半夏(各六分)、椿树皮(一钱);久
下,加熟地黄(一钱)、山茱萸(八分);气虚,加人参、黄 (各七分);赤带,加酒炒黄芩(一钱)、
荆芥(六分);腹痛,加干姜(三分)。
妇女崩漏,是由于失血过多,导致气血都虚损,损伤了子宫和血海。血液和气在体内运行,外部沿着经络循行,内部滋养脏腑。病情严重的称为“崩”,轻微的称为“漏”。由于冲脉和任脉的气虚弱,不能约束控制月经血液,所以脾脏不能统摄血液,肝脏不能贮藏血液,突然发生血崩大量出血。这类症状都是因为脾胃的气血先受损,能够接受补益治疗的可以挽救。如果错误地使用收敛止涩、寒凉的药物,反而会伤害脾胃的生气(阳气),使血液反而不能回归经脉。
【主方】
人参(一钱) 炒白术(一钱) 白茯苓(八分) 甘草(五分,炙烤) 小蓟(一钱)
川芎(七分) 当归头(一钱,用酒清洗) 侧柏叶(一钱,炒制) 生地黄(一钱,用酒清洗)
用水两盅煎煮至八分,饭后服用。
加减法
出现血晕,加荆芥(六分,炒制)、泽兰叶(六分);出虚汗,加黄 (一钱,蜜炙) 枣仁(八分,去壳炒制);崩漏日久,白带不止,加龙骨、牡蛎(火煅,各一钱,研成粉末,用丝绵包裹入药同煎);出血多且不止,加墨棕刷烧成的灰存性,绵灰(各三分,因为血遇到黑色就会停止;经血受热,崩漏不止,口苦咽干,小便短少,大便干燥结块,加黄连、黄芩、山栀(各五分,都要用酒炒制);如果血色紫黑像泥一样凝结成块,也应当使用这些药物。
这种病症是由营卫之气滞塞所形成的。红色分泌物属于营分,白色分泌物属于卫分,这是疾病的常态。然而这类症状都是因为喜怒忧思等情志因素,素有湿热之邪损伤了营卫和胞宫络脉,使得浊气渗入膀胱,所以流出带下。轻则时断时续,重则淋漓无度,导致腰膝疼痛,饮食减少,精神萎靡,治疗法则应当清上实下,清浊自然分离,调理脾脏养护正气,湿热自然解除。如果能清淡饮食,温补下元,那么带下症自然消除。
【主方】
川芎(一钱) 当归(一钱,用酒清洗) 白芍(一钱,用酒清洗) 生地(用酒清洗) 白术(各一钱) 甘草(五分,炙烤) 莲子(一钱,去心) 白扁豆花(七分,炒制) 白鸡冠花子(一钱,炒制)
用水两盅,煎煮成一盅,饭后温服。
加减法
或者加葵花五朵更好(即一丈红,白色的治疗白带,红色的治疗赤带)。瘦人多热,加黄柏、黄连、香附(各五分);肥人多湿痰,加苍术、天南星、半夏(各六分)、椿树皮(一钱);久病不止,加熟地黄(一钱)、山茱萸(八分);气虚,加人参、黄 (各七分);赤带,加酒炒黄芩(一钱)、荆芥(六分);腹痛,加干姜(三分)。
In women, metrorrhagia and metrostaxis (Beng Lou) result from excessive blood loss, leading to deficiency and damage of both Qi and Blood, injuring the uterus and the Sea of Blood. The movement of Qi and Blood circulates externally along the meridians and internally nourishes the Zang-Fu organs. Severe cases are termed "metrorrhagia" (Beng), while mild cases are termed "metrostaxis" (Lou). Due to the deficiency of Qi in the Chong and Ren vessels, which fail to constrain menstrual blood, the Spleen fails to control blood, and the Liver fails to store blood, resulting in sudden, profuse bleeding. These symptoms arise primarily from prior damage to the Qi and Blood of the Stomach and Spleen; those who can tolerate tonification may be saved. Erroneous use of astringent, cold, or cooling agents further damages the vital Qi of the Spleen and Stomach, causing blood to deviate from its vessels.
[Main Formula]
Ren Shen (Ginseng Radix, 1 qian)
Chao Bai Zhu (Fried Atractylodis Macrocephalae Rhizoma, 1 qian)
Bai Fu Ling (Poria, 8 fen)
Zhi Gan Cao (Honey-fried Licorice Root, 5 fen)
Xiao Ji (Cirsii Herba, 1 qian)
Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 7 fen)
Dang Gui Tou (Radix Angelicae Sinensis Head, 1 qian, washed with wine)
Ce Bai Ye (Biota Tops, 1 qian, fried)
Sheng Di Huang (Rehmanniae Radix, 1 qian, washed with wine)
Decoct with two shengs of water until reduced to eight-tenths; take after meals.
Modifications
For syncope due to blood loss, add Jing Jie (Schizonepetae Spica, 6 fen, fried) and Ze Lan Ye (Leonuri Herba, 6 fen); for spontaneous sweating due to deficiency, add Huang Qi (Astragali Radix, 1 qian, honey-fried) and Suan Zao Ren (Ziziphi Spinosae Semen, 8 fen, dehusked and fried); for prolonged metrorrhagia/metrostaxis with persistent leukorrhea, add Long Gu (Fossilized Bones, fire-calcined) and Mu Li (Oyster Shell, fire-calcined, each 1 qian, ground to powder, wrapped in silk and decocted with the medicine); for excessive bleeding that does not stop, add Mo Zong Shui Hui (Ash of Ink-brown Bristle Brush, preserved nature) and Mian Hui (Cotton Ash, each 3 fen; blood stops upon contact with black substances; if menstrual heat causes unceasing bleeding accompanied by bitter taste, dry throat, scanty urine, and dry constipation, add Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), and Shan Zhi (Gardeniae Fructus, each 5 fen, all wine-fried); these should also be used if the blood is purple-black and clotted like mud.
This condition arises from stagnation of Ying and Wei Qi. Red discharge belongs to Ying (Nutritive Qi), and white discharge belongs to Wei (Defensive Qi), which is the normal pattern. However, these symptoms are caused by emotional factors such as anger, joy, worry, and overthinking, combined with pre-existing damp-heat injuring the Ying, Wei, and uterine collaterals, allowing turbid Qi to seep into the Bladder, thus flowing out as leukorrhea. Mild cases come and go intermittently; severe cases are continuous and uncontrollable, causing pain in the lower back and knees, reduced appetite, and diminished spirit. The treatment principle is to clear the upper and solidify the lower, so that clear and turbid separate naturally; regulate the Spleen and nourish Qi, so that damp-heat resolves spontaneously. Furthermore, consuming bland flavors and warming/tonifying the Lower Yuan will eliminate leukorrhea.
[Main Formula]
Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 qian)
Dang Gui (Angelicae Sinensis Radix, 1 qian, washed with wine)
Bai Shao (Paeoniae Radix Alba, 1 qian, washed with wine)
Sheng Di Huang (Rehmanniae Radix, washed with wine)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, each 1 qian)
Zhi Gan Cao (Honey-fried Licorice Root, 5 fen)
Lian Zi (Nelumbinis Semen, 1 qian, heart removed)
Bai Bian Dou Hua (Fried White Lablab Flower, 7 fen)
Bai Ji Guan Hua Zi (Fried White Celosia Seed, 1 qian)
Decoct with two shengs of water until reduced to one sheng; take warm after meals.
Modifications
Adding five sunflowers (Kui Hua, i.e., Celosia Cristata; white treats leukorrhea, red treats hemometrorrhagia) is even better. For thin individuals prone to heat, add Huang Bo (Phellodendri Cortex), Huang Lian (Coptidis Rhizoma), and Xiang Fu (Cyperi Rhizoma, each 5 fen); for obese individuals prone to damp-phlegm, add Cang Zhu (Atractylodis Rhizoma), Tian Nan Xing (Arisaematis Rhizoma Preparatum), and Ban Xia (Pinelliae Rhizoma Preparatum, each 6 fen), plus Chun Pi (Toona Bark, 1 qian); for chronic discharge, add Shu Di Huang (Prepared Rehmanniae Radix, 1 qian) and Shan Zhu Yu (Corni Fructus, 8 fen); for Qi deficiency, add Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix, each 7 fen); for red leukorrhea, add Jiu Chao Huang Qin (Wine-fried Scutellariae Radix, 1 qian) and Jing Jie (Schizonepetae Spica, 6 fen); for abdominal pain, add Gan Jiang (Zingiberis Rhizoma, 3 fen).