13.谚云妇病不易治, 盖以幽居情郁疑, 执拗不喜望闻问, 讳疾忌医
术莫施.
【注】寇宗奭曰: 宁治十男子, 莫治一妇人. 谓妇人之病多不易治也
.盖以妇人幽居情郁, 忧恚爱憎多疑, 所怀不遂, 性执偏拗, 诊时又
不令医师观形, 望色, 闻声, 问病. 富贵之家, 居奥室之中, 处帏幔
之内, 且复以帕蒙手, 既不能行望色之神, 又不能尽切脉之巧, 未免
详问, 问之觉繁, 反谓医学不精, 往往并药不信. 不知问非易事, 非
精于医者, 必不能问也. 夫望, 闻, 问, 切四者, 欲去其三, 即是神
医,亦无由施其术也. 此古今之通患, 谓之曰: 妇人不易治, 不诚然
哉!
14.未诊妇人女子病, 先问经期与妊娠, 不详误药非细事, 疑似难明
昧所因.
【注】未诊妇人女子之病, 必先问经期与有无妊娠. 若不详细审问,
倘用药误触之, 则所关匪细, 多变生他证. 疑似难明, 岂不昧其病之
所因哉!
1.三和汤
当归 川芎 大黄 朴硝 白芍 地黄 栀子 连翘 薄荷 甘草各
等分
上锉, 每服八钱, 水煎服.
2.六味地黄汤
熟地八钱 山萸肉 山药各四钱 丹皮 泽泻 茯苓各三钱
上清水煎服.
3.劫劳散
白芍六两 黄耆 ( 炙 ) 四两 甘草 ( 炙 ) 人参 ( 去芦 ) 当归 (
去芦酒洗 ) 熟地 ( 洗净焙干 ) 五味子 阿胶 ( 炒珠 ) 各一两
上?? 咀, 每服三钱. 水一盏, 生姜七片, 枣三枚, 煎至九分, 温服,
无时, 日三服.
4.芩心丸
用黄芩心枝条者三两 ( 米泔浸七日, 炙干, 又浸又炙, 如此七次 ).
上为末, 醋丸如桐子大, 每服七十丸, 空心温服送下, 日进二服.
5.益阴煎
生地三钱 知母 黄柏各二钱 龟板 ( 醋炙 ) 四钱 缩砂仁 甘草
(炙 ) 各一钱
上锉, 水煎服.
6.大黄??虫丸
大黄 赤芍 生地 桃仁 杏仁 干漆 甘草 ??虫 ??虫 蛭虫
蛴螬 黄芩各等分
上末, 炼蜜丸. 每服丸数, 量虚实增减.
7.泽兰叶汤
泽兰叶三两 当归 白芍各一两 甘草五钱
上为粗末, 每服五钱. 水二盏, 煎一盏, 温服.
8.柏子仁丸
柏子仁 ( 炒, 另研 ) 牛膝 ( 酒洗 ) 卷柏各五钱 泽兰叶 续断各
二两 熟地 ( 酒浸半日, 石臼内杵成膏 ) 三两五钱
上为细末, 炼蜜丸如桐子大. 空心米饮下三十丸.
13. 谚语说妇女的疾病不容易治疗,大概是因为她们深居简出、情绪郁结多疑,性格执拗不喜欢医生进行望、闻、问、切四诊,隐瞒疾病忌讳就医,导致医术无法施展。
【注】寇宗奭说:“宁愿治疗十个男子,也不愿治疗一个妇人。”这是说妇女的疾病大多不容易治疗。大概因为妇女深居简出、情绪郁结,忧虑怨恨、爱憎分明且多疑,心愿不能实现,性格固执偏激。就诊时又不让医师观察形体、看面色、听声音、询问病情。富贵人家居住在深室之中,处在帷幔之内,并且用帕子蒙住手腕,既不能发挥望色的神妙,又不能尽施切脉的技巧,难免要详细询问,但询问起来又觉得繁琐,反而认为医学不精湛,往往连药都不相信。不知道问诊并非易事,不是精通医道的医生,一定不能做好问诊。望、闻、问、切四种诊法,如果去掉其中三种,即使是神医,也没有办法施展医术了。这是古今共同的弊病,所以说“妇女不易治疗”,难道不是确实如此吗!
14. 在诊治妇女疾病之前,必须先询问月经周期和是否怀孕,如果不详细询问而误用药物,绝非小事,疑似难辨,会使人不明病因。
【注】在诊治妇女疾病之前,必须先询问月经情况以及是否有妊娠。如果不详细审问,倘若用药误触禁忌,那么关系重大,很容易变生其他证候。病情疑似难以明辨,岂不是让人不明疾病的起因吗!
1. 三和汤
当归、川芎、大黄、朴硝、白芍、地黄、栀子、连翘、薄荷、甘草各等分。
以上药材切碎,每次服用八钱,用水煎服。
2. 六味地黄汤
熟地黄八钱,山茱萸肉、山药各四钱,牡丹皮、泽泻、茯苓各三钱。
以上用清水煎服。
3. 劫劳散
白芍六两,黄芪(炙)四两,甘草(炙)、人参(去芦头)、当归(去芦头,酒洗)、熟地黄(洗净焙干)、五味子、阿胶(炒至珠状)各一两。
以上切碎,每次服用三钱。用水一盏,生姜七片,大枣三枚,煎至九分满,温服,不拘时候,每日三次服用。
4. 芩心丸
使用黄芩心的枝条三两(用米泔水浸泡七日,炙干,再浸泡再炙干,如此重复七次)。
以上研为细末,用醋制成梧桐子大小的丸剂,每次服用七十丸,空腹时温开水送下,每日两次服用。
5. 益阴煎
生地黄三钱,知母、黄柏各二钱,龟板(醋炙)四钱,缩砂仁、甘草(炙)各一钱。
以上切碎,用水煎服。
6. 大黄䗪虫丸
大黄、赤芍、生地黄、桃仁、杏仁、干漆、甘草、䗪虫、虻虫、水蛭、蛴螬、黄芩各等分。
以上研为细末,用炼蜜制成丸剂。每次服用丸剂的多少,根据虚实情况增减。
7. 泽兰叶汤
泽兰叶三两,当归、白芍各一两,甘草五钱。
以上制成粗末,每次服用五钱。用水二盏,煎至一盏,温服。
8. 柏子仁丸
柏子仁(炒,另研),牛膝(酒洗),卷柏各五钱,泽兰叶、续断各二两,熟地黄(酒浸半天,在石臼内捣成膏)三两五钱。
以上研为细末,用炼蜜制成梧桐子大小的丸剂。空腹时用米饮送下三十丸。
13. As the proverb goes, women's diseases are difficult to treat, largely because they live in seclusion, suffer from emotional depression and suspicion, are stubborn and dislike the four diagnostic methods of observation (Wang), auscultation and olfaction (Wen), inquiry (Wen), and palpation (Qie), conceal their illness, avoid medical treatment, and thus prevent medical skills from being applied.
[Annotation] Kou Zongshi said: "It is better to treat ten men than one woman." This implies that women's diseases are generally difficult to treat. This is because women live in seclusion, suffer from emotional depression, have many worries, resentments, loves, hates, and suspicions; when their desires are not fulfilled, their personalities become stubborn and biased. During diagnosis, they do not allow physicians to observe their physical form, look at their complexion, listen to their voice, or ask about their illness. Those from wealthy families reside in deep rooms, behind curtains, and cover their wrists with handkerchiefs, making it impossible to utilize the subtlety of observing complexion or fully apply the skill of pulse palpation. They inevitably require detailed inquiry, but find such inquiries tedious, and consequently doubt the physician's expertise, often refusing to trust the prescribed medicine. One must realize that inquiry is not an easy task; only a physician proficient in medicine can conduct it effectively. Among the four diagnostic methods—observation, auscultation/olfaction, inquiry, and palpation—if three are removed, even a divine physician would have no way to apply their skills. This is a common problem throughout history; hence it is said that "women's diseases are difficult to treat," which is indeed true!
14. Before diagnosing diseases in women, one must first inquire about the menstrual cycle and pregnancy. Failure to do so and administering incorrect medication is no trivial matter; ambiguity makes it hard to clarify the etiology.
[Annotation] Before diagnosing diseases in women, one must first inquire about the menstrual status and whether pregnancy exists. If this is not carefully questioned, and medication inadvertently violates contraindications, the consequences are significant, potentially leading to other syndromes. When symptoms are ambiguous and difficult to distinguish, how can one fail to understand the cause of the disease?
1. Sanhe Tang (Three-Harmony Decoction)
Danggui Radix Angelicae Sinensis, Chuanxiong Rhizoma Ligustici Chuanxiong, Dahuang Radix et Rhizoma Rhei, Puxiao Natrii Sulfas, Baishao Radix Paeoniae Alba, Dihuang Radix Rehmanniae Preparata, Zhizi Fructus Gardeniae, Lianqiao Fructus Forsythiae, Bohe Herba Menthae Haplocalycis, Gancao Radix Glycyrrhizae Preparata, each in equal parts.
Crush the herbs. For each dose, take eight qian, decoct in water, and take orally.
2. Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill Decoction)
Shudi Radix Rehmanniae Preparata 8 qian, Shanyurou Fructus Corni Officinalis and Shanyao Rhizoma Dioscoreae 4 qian each, Danpi Cortex Moutan, Zexie Rhizoma Alismatis, Fuling Sclerotium Poriae 3 qian each.
Decoct in clear water and take orally.
3. Jie Lao San (Extortion-Labor Powder)
Baishao Radix Paeoniae Alba 6 liang, Huangqi Radix Astragali Membranacei (prepared by stir-frying with honey) 4 liang, Gancao Radix Glycyrrhizae Preparata (prepared by stir-frying with honey), Ren Shen Radix Ginseng (remove rhizome), Danggui Radix Angelicae Sinensis (remove rhizome, wash with wine), Shudi Radix Rehmanniae Preparata (wash clean and bake dry), Wuweizi Fructus Schisandrae Chinensis, Ejiao Colla Corii Asini (stir-fry until bead-like), each 1 liang.
Cut into small pieces. For each dose, take 3 qian. Use one zhan of water, seven slices of fresh ginger, and three dates. Decoct until nine-tenths remains, take warm, at any time, three times daily.
4. Qin Xin Wan (Gut-Center Pill)
Use Sanghuangxin branches weighing 3 liang (soak in rice-washing water for seven days, dry by stir-frying, soak again, dry again, repeat this process seven times).
Grind into fine powder, make pills with vinegar the size of paulownia seeds. Take 70 pills per dose, warm water delivery on an empty stomach, twice daily.
5. Yiyin Jian (Benefit-Yin Decoction)
Shengdi Radix Rehmanniae Recens 3 qian, Zhimu Rhizoma Anemarrhenae and Huangbai Cortex Phellodendri 2 qian each, Guiban Carapax et Plastrum Testudinis (prepared by stir-frying with vinegar) 4 qian, Suosharen Fructus Amomi Rotundus, Gancao Radix Glycyrrhizae Preparata (prepared by stir-frying with honey) 1 qian each.
Crush the herbs, decoct in water, and take orally.
6. Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill)
Dahuang Radix et Rhizoma Rhei, Chishao Radix Paeoniae Rubra, Shengdi Radix Rehmanniae Recens, Taoren Semen Persicae, Xingren Semen Armeniacae Amarum, Ganxi Resina Lepidii, Gancao Radix Glycyrrhizae Preparata, Zhechong Aspis Eupolyphagae Seu Steleophagi, Mengchong Hirudo, Shichong Hirudo, Qicao Larva Silphidae, Huangqiao Radix Scutellariae, each in equal parts.
Grind into powder, make pills with refined honey. The number of pills per dose should be adjusted according to deficiency or excess.
7. Zelan Ye Tang (Zelan Leaf Decoction)
Zelan Ye Herba Leonuri Japonici 3 liang, Danggui Radix Angelicae Sinensis, Baishao Radix Paeoniae Alba 1 liang each, Gancao Radix Glycyrrhizae Preparata 5 qian.
Make into coarse powder. For each dose, take 5 qian. Use two zhan of water, decoct until one zhan remains, take warm.
8. Baizi Ren Wan (Biota Seed Pill)
Baizi Ren Semen Biotae (stir-fried, ground separately), Niuxku Radix et Rhizoma Achyranthis Bidentatae (wash with wine), Juanbai Herba Serpylli 5 qian each, Zelan Ye Herba Leonuri Japonici, Xu Duan Radix et Rhizoma Dipsaci 2 liang each, Shudi Radix Rehmanniae Preparata (soaked in wine for half a day, pounded into paste in a stone mortar) 3 liang 5 qian.
Grind into fine powder, make pills with refined honey the size of paulownia seeds. Take 30 pills on an empty stomach with rice drink.