痛而发黄为中湿，痛不得转侧为风湿。《活人》又以身痛脉沉为中湿，脉浮为风湿，亦通。治法见太阳病体
痛门。
妇人中风，发热恶寒，经水适来，得之七八日，热除而脉迟，身凉，胸胁下满，如结胸状，谵语者，此为
热入血室也。当刺期门，随其实而泻之。（东垣云∶妄见妄闻，夜梦亡人，皆肝木火盛而为邪也，刺期门。与此义同。）
许学士云∶有妇人患热入血室证，医者不识，用补血调气药，延养数日，遂成血结胸。或劝用前药。予曰∶
小柴胡已迟，不可行也。无已，则有一焉，刺期门穴斯可矣。予不能针，请善针者治之，如言而愈。或问曰∶
热入血室，何谓而成结胸也？予曰∶邪气传入经络，与正气相搏，上下流行，或遇经水适来适断，邪气乘虚而
入血室，血为邪迫，上入肝经，肝受邪则谵语而见鬼，复入膻中，则血结于胸也。何以言之？妇人平居，水当
养于木，血当善于肝。方未受孕，则下行之以为月水；既妊，则中蓄之以养胎；及已产，则上壅之以为乳，皆
此血也。今邪气蓄血，并归肝经，聚于膻中，结于乳下，故手触之则痛，非汤剂可及，故当刺期门也。
妇人伤寒发热，经水适来，昼日明了，夜则谵语，如见鬼状者，此为热入血室，无犯胃气及上二焦，
必自愈。（《活人》云∶小柴胡和之。犯胃气谓下之，犯上二焦谓发汗也。）
〔《衍》〕有一妇人，温病已十二日，诊之，其脉六七至而涩，寸稍大，尺稍小，发寒热，颊赤口干，不
了了，耳聋。问之，病数日经水乃行，此属少阳热入血室也。若治不对病，则必死。乃按其证与小柴胡汤，服
之二日，又与小柴胡汤加桂、干姜一日，寒热遂止。又云∶我脐下急痛。又与抵当丸微利，脐下痛痊，身渐凉，
脉渐匀，尚不了了。仍复与小柴胡汤。次日又云∶我但胸中热躁，口鼻干。又少与调胃承气汤，不得利。次日
又云∶心下痛。又与大陷胸丸半服，利三行。次日，虚烦不乐，时亦有所见，时复狂言。虽知其尚有燥屎，以
其极虚，不敢攻之。遂与竹叶汤，去其烦热。其夜大便自通，至晓两次，中有燥屎数枚，而狂言虚烦尽解。但
咳嗽唾，此肺虚也，恐乘虚而成肺痿。遂与小柴胡去人参、大枣、生姜，加干姜、五味子汤。一日咳减，二日
而病悉愈。以上皆用张仲景方。
妇人中风七八日，续得寒热，发作有时，经水适断者，此为热入血室，其血必结，故如疟状，发作
有时。小柴胡汤主之。
身体疼痛且出现黄疸，属于中湿；身体疼痛且无法翻身侧卧，属于风湿。《活人书》又认为身体疼痛而脉象沉细的为中湿，脉象浮大的为风湿，这种说法也是通顺的。治疗方法参见“太阳病体痛”门。
有汗出的称为柔痉，无汗出的称为刚痉。（治疗方法参见“柔痉”门。）
妇女感受风邪，出现发热恶寒的症状，恰逢月经来潮，病程经过七八天后，热势退去而脉搏变慢，身体转凉，胸胁下胀满，症状类似结胸证，并伴有胡言乱语，这叫做热入血室。应当针刺期门穴，根据实证的情况采用泻法。（李东垣说：胡乱看见、胡乱听见，夜间梦见已故之人，都是肝木火气过盛导致邪气干扰所致，针刺期门穴。这与上述医理相同。）许学士说：有一位妇女患热入血室证，医生不认识此病，使用了补血调气的药物，拖延调养数日后，最终形成了血结胸。有人劝我使用前面的方药。我说：此时用小柴胡汤已经太迟，不可行用了。如果不行的话，还有一个办法，就是针刺期门穴就可以了。我不会针灸，便请擅长针灸的人治疗，按照这个方法痊愈了。有人问：热入血室，为什么会形成结胸呢？我说：邪气传入经络，与正气相互搏结，上下流行，如果遇到月经正好来潮或刚结束，邪气乘虚进入血室，血液被邪气逼迫，向上进入肝经，肝脏受到邪气侵袭就会胡言乱语并看见鬼怪，邪气再进入膻中，血液就会凝结在胸部。为什么这样说呢？妇女平时，水液应当滋养肝木，血液应当由肝脏善于调节。在未受孕时，血液下行成为月经；怀孕后，血液蓄积在中部以滋养胎儿；分娩后，血液上壅成为乳汁，这些都是同样的血液。现在邪气蓄积血液，一并归入肝经，聚集在膻中，凝结在乳房下方，所以用手触摸时会疼痛，这不是汤剂可以达到的部位，所以应当针刺期门穴。
妇女患伤寒发热，恰逢月经来潮，白天神志清醒，夜晚则胡言乱语，像看见鬼怪一样，这叫做热入血室，不要损伤胃气以及上、中二焦的功能，疾病一定会自愈。（《活人书》说：用小柴胡汤调和它。所谓犯胃气是指使用攻下法，所谓犯上二焦是指使用发汗法。）
〔《衍义》〕记载有一位妇女，患温病已经十二天，诊察其脉象，一息六七至且涩，寸脉稍大，尺脉稍小，出现寒热往来，脸颊发红口干，神志不清，耳聋。询问病情，得知患病几天后月经才来，这属于少阳热入血室证。如果治疗不对症，必定死亡。于是根据证候给予小柴胡汤，服用两天后，又给予小柴胡汤加桂枝、干姜，服用一天，寒热症状随即停止。病人又说：我感到脐下拘急疼痛。又给予抵当丸轻微通便，脐下疼痛痊愈，身体逐渐凉爽，脉象逐渐均匀，但神志仍不清爽。再次给予小柴胡汤。第二天又说：我只觉得心中烦热躁动，口鼻干燥。又少量给予调胃承气汤，未能通便。第二天又说：心下部疼痛。又给予大陷胸丸半服，排便三次。第三天，感到虚弱心烦不乐，时而有所幻觉，时而说疯话。虽然知道体内还有燥屎，但因为病人极度虚弱，不敢使用攻下法。于是给予竹叶汤，去除其烦热。当天夜里大便自然通畅，到早晨共两次，排出几枚燥屎，狂言和虚烦全部解除。只是咳嗽吐痰，这是肺气虚的表现，恐怕会乘虚发展成肺痿。于是给予小柴胡汤去掉人参、大枣、生姜，加入干姜、五味子的方剂。一天后咳嗽减轻，两天后疾病完全痊愈。以上都使用了张仲景的方剂。
妇女感受风邪七八天后，持续出现寒热往来，发作有定时，月经刚刚结束，这叫做热入血室，血液必然凝结，所以症状像疟疾一样，发作有定时。以小柴胡汤为主治。
Pain accompanied by jaundice indicates dampness obstructing the middle (Zhong Shi); pain with inability to turn or lie on one's side indicates wind-dampness. The *Liu Ren Shu* (Book of Vitality) further states that body pain with a deep pulse indicates dampness obstructing the middle, while body pain with a floating pulse indicates wind-dampness; this interpretation is also valid. For treatment methods, refer to the section on "Body Pain in Taiyang Disease" (Taiyang Bing Ti Tong).
Sweating characterizes Soft Spasm (Rou Jing), while absence of sweating characterizes Stiff Spasm (Gang Jing). (For treatment methods, refer to the section on "Soft Spasm".)
When a woman contracts Wind Pathogen, presenting with fever and aversion to cold, and her menses happen to commence, after seven or eight days, if the heat subsides and the pulse becomes slow, the body feels cool, there is fullness and distension below the chest and hypochondrium resembling Chest Binding (Jie Xiong), and she speaks deliriously, this is called Heat Entering the Blood Chamber (Re Ru Xue Shi). One should puncture Qimen (LR14) and apply the reducing method according to the excess condition. (Li Dongyuan stated: Hallucinations of seeing and hearing things, and dreaming of deceased persons at night, are all caused by excessive Liver Wood Fire generating pathogenic factors; puncturing Qimen applies here. This shares the same principle.) Xu Xueshi said: A woman suffered from Heat Entering the Blood Chamber. The physician failed to recognize the condition and administered blood-nourishing and qi-regulating herbs. After several days of neglectful care, it developed into Blood Chest Binding (Xue Jie Xiong). Someone advised using the aforementioned prescription. I said: Using Xiao Chai Hu Tang (Minor Bupleurum Decoction) is now too late and cannot be applied. If forced to choose another method, puncturing the Qimen acupoint would suffice. I am not skilled in acupuncture, so I requested an expert to treat her. Following this advice, she recovered. Someone asked: Why does Heat Entering the Blood Chamber result in Chest Binding? I said: The pathogenic factor enters the meridians and contends with healthy Qi, circulating up and down. If it coincides with the onset or cessation of menstruation, the pathogen enters the Blood Chamber due to deficiency. The blood is forced by the pathogen to ascend into the Liver Meridian. When the Liver is affected by the pathogen, delirium occurs and hallucinations of ghosts appear. If the pathogen re-enters the Danzhong (Chest Center), blood coagulates in the chest. Why do I say this? In women, water nourishes Wood, and blood is managed by the Liver. Before conception, blood descends to become menstrual flow; during pregnancy, it accumulates centrally to nourish the fetus; after childbirth, it ascends to form milk. All these are the same blood. Now, pathogenic factors accumulate blood, directing it together into the Liver Meridian, gathering at Danzhong, and knotting below the breasts. Thus, palpation causes pain. This location is beyond the reach of herbal decoctions, hence puncturing Qimen is required.
When a woman suffers from Cold Damage with fever, and her menses happen to commence, if she is lucid during the day but delirious at night, appearing as if seeing ghosts, this is Heat Entering the Blood Chamber. Do not damage the Stomach Qi or the Upper and Middle Jiao; the disease will resolve spontaneously. (*Liu Ren Shu* states: Harmonize it with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Damaging Stomach Qi refers to purgation; damaging the Upper and Middle Jiao refers to diaphoresis.)
[From *Yan Yi*] There was a woman who had suffered from Warm Disease for twelve days. Her pulse was rapid (six to seven beats per breath) and choppy; the Cun position was slightly large, and the Chi position slightly small. She presented with alternating chills and fever, flushed cheeks, dry mouth, unclear consciousness, and deafness. Upon inquiry, it was found that her menses began several days into the illness. This belongs to Shaoyang Heat Entering the Blood Chamber. If treated incorrectly, death is certain. Based on the syndrome, Xiao Chai Hu Tang (Minor Bupleurum Decoction) was administered. After two days, Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Guizhi (Cinnamon Twig) and Ganjiang (Dried Ginger) was given for one day, and the chills and fever ceased. The patient then complained of urgency and pain below the umbilicus. Didang Wan (Didang Pill) was given to induce mild purgation. The abdominal pain resolved, the body cooled gradually, and the pulse became even, though consciousness remained unclear. Xiao Chai Hu Tang (Minor Bupleurum Decoction) was administered again. The next day, she reported only chest heat and restlessness, with dry mouth and nose. A small dose of Tiaowei Chengqi Tang (Regulate the Stomach and Direct Downward Decoction) was given, but no stool was passed. The next day, she complained of pain in the epigastrium. Half a dose of Daxianxiong Wan (Major Draining the Chest Pill) was given, resulting in three bowel movements. The next day, she felt weak, irritable, and occasionally hallucinated or spoke madly. Although dry feces were suspected, due to her extreme deficiency, aggressive purgation was avoided. Zhuye Tang (Bamboo Leaf Decoction) was given to clear residual heat and irritability. That night, stool passed naturally. By morning, two bowel movements occurred, passing several pieces of dry feces. Delirium and irritability completely resolved. However, she coughed and expectorated phlegm, indicating Lung Qi deficiency, with a risk of developing Lung萎 (Fei Wei/Lung Atrophy) due to deficiency. Thus, Xiao Chai Hu Tang (Minor Bupleurum Decoction) was modified by removing Renshen (Ginseng), Dazao (Jujube), and Shengjiang (Fresh Ginger), and adding Ganjiang (Dried Ginger) and Wuweizi (Schisandra Berry). Cough decreased after one day, and the disease was fully cured after two days. All the above cases utilized formulas from Zhang Zhongjing.
When a woman contracts Wind Pathogen for seven or eight days, subsequently developing alternating chills and fever with regular timing, and her menses have just ceased, this is Heat Entering the Blood Chamber. The blood must be knotted, hence the symptoms resemble malaria with regular paroxysms. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment.