2.邪入胞中吴茱萸, 赤粘连栀青防栀, 白主益气黑六味, 黄淡六君
或归脾.
【注】带下因六淫之邪入于胞中者, 宜吴茱萸汤. 若色赤, 色黄而浊
粘者, 热也. 色黄者, 加黄连, 栀子; 色青者, 加防风, 栀子. 若色
白,色黑而清稀者, 虚寒也. 色白者, 用补中益气汤; 色黑者, 用六
味地黄汤; 色黄而淡者, 宜六君子汤, 或加味归脾汤, 分证调治可也
.
吴茱萸汤 补中益气汤 六味地黄汤 六君子汤 归脾汤
方俱见首卷汇方
加味四物汤
3.胞中冷痛乃寒湿, 四物附子桂姜宜, 臭腥兼合知柏用, 久滑升柴
龙牡脂.
【注】带下而胞中热痛, 乃热湿也. 今胞中冷痛, 乃寒湿也. 宜四物
汤,加川附子, 炮姜, 官桂服之. 日久滑脱者, 加升麻, 柴胡举之,
龙骨, 牡蛎, 赤石脂涩之.
四物汤方
见前调经门汇方内.
清白散
4.带下湿热清白散, 四物姜炭草柏椿, 赤榆荆芩湿二术, 滑加龙牡
久合君.
【注】带下, 五色带下也. 皆湿热所化, 宜用清白散. 其方即四物汤
加姜炭, 甘草, 黄柏, 椿皮也. 色赤加地榆, 荆芥, 黄芩; 湿加苍术
,白术; 滑加龙骨, 牡蛎, 久则合四君子汤也.
四物汤 四君子汤
俱见前调经门汇方内
导水丸 万安丸
5.带下有余皆湿化, 少腹胀疼污水绵, 导水牵滑芩军热, 万安牵椒
茴木寒.
【注】五色带下, 皆从湿化. 若少腹胀痛, 污水绵绵, 属湿热者, 宜
用导水丸. 其方即牵牛, 滑石, 黄芩, 生军, 治热有余也. 属湿寒者
,宜用万安丸, 其方即牵牛, 胡椒, 小茴香, 木香, 治寒有余者也.
威喜丸 固精丸
6.瘀化疮脓浊淫病, 虚实寒热酌其宜, 威喜蜡苓固精菟, 韭味桑苓
龙牡脂.
【注】带下有因瘀血所化, 或疮疡脓出及白浊, 白淫者, 皆带下类也
.其虚实寒热, 当酌其宜. 药用威喜丸, 即黄蜡, 茯苓也. 固精丸,
即菟丝子, 韭菜子, 五味, 桑螵蛸, 茯苓, 龙骨, 牡蛎, 赤石脂也.
2. 邪气侵入胞宫(子宫),若属寒证用吴茱萸汤;若带下色赤且粘稠,加栀子、防风、黄芩(注:原文“青防栀”指青色加防风、栀子,此处结合注文修正为色赤加黄连栀子,色青加防风栀子,但诗句中“赤粘连栀青防栀”对应的是赤色粘者加黄连栀子,青色者加防风栀子);若带下色白,主气虚,用补中益气汤;若色黑,主肾虚,用六味地黄汤;若色黄而淡,用六君子汤或归脾汤。
【注释】带下病是因为六淫之邪侵入胞宫所致,适宜使用吴茱萸汤。如果带下色赤,或者色黄且浑浊粘稠,属于热证。色黄的,加黄连、栀子;色青的,加防风、栀子。如果带下色白,或者色黑且清稀,属于虚寒证。色白的,用补中益气汤;色黑的,用六味地黄汤;色黄而淡的,适宜用六君子汤,或者加味归脾汤,分证候调理治疗即可。
吴茱萸汤、补中益气汤、六味地黄汤、六君子汤、归脾汤
方剂均见首卷汇方篇。
加味四物汤
3. 胞宫冷痛乃是寒湿所致,适宜用四物汤加附子、桂枝、干姜;若气味腥臭,兼用知母、黄柏;若日久滑脱不禁,加升麻、柴胡提升阳气,龙骨、牡蛎、赤石脂固涩止带。
【注释】带下病伴有胞宫热痛,是热湿证。现在胞宫冷痛,是寒湿证。适宜用四物汤,加川附子、炮姜、官桂服用。病程长久导致滑脱不禁的,加升麻、柴胡以升提举陷,加龙骨、牡蛎、赤石脂以收敛固涩。
四物汤方
见前调经门汇方内。
清白散
4. 带下湿热证用清白散,由四物汤加姜炭、甘草、黄柏、椿皮组成;若色赤,加地榆、荆芥、黄芩;若湿重,加苍术、白术;若滑脱,加龙骨、牡蛎;若病程久,合用四君子汤。
【注释】带下病,指五色带下。皆由湿热所化生,适宜使用清白散。该方即四物汤加姜炭、甘草、黄柏、椿皮而成。色赤的,加地榆、荆芥、黄芩;湿重的,加苍术、白术;滑脱的,加龙骨、牡蛎;病程久的,则合用四君子汤。
四物汤、四君子汤
均见前调经门汇方内。
导水丸、万安丸
5. 带下有余之证皆由湿邪化生,少腹胀痛,污水绵绵不断。若属湿热,用导水丸,含牵牛子、滑石、黄芩、大黄以清热;若属寒湿,用万安丸,含牵牛子、胡椒、小茴香、木香以散寒。
【注释】五色带下,皆从湿邪转化而来。如果少腹胀痛,污水绵绵不断,属于湿热证,适宜用导水丸。该方即牵牛子、滑石、黄芩、生大黄,用于治疗热邪偏盛。属于湿寒证的,适宜用万安丸,该方即牵牛子、胡椒、小茴香、木香,用于治疗寒邪偏盛。
威喜丸、固精丸
6. 瘀血化生疮脓及浊淫病,需斟酌虚实寒热选用适宜方药。威喜丸由黄蜡、茯苓组成;固精丸由菟丝子、韭菜子、五味子、桑螵蛸、茯苓、龙骨、牡蛎、赤石脂组成。
【注释】带下病有因瘀血所化生的,或者有疮疡脓出以及白浊、白淫的,都属于带下类疾病。其虚实寒热,应当酌情选择适宜的治疗方法。药用威喜丸,即由黄蜡、茯苓组成。固精丸,即由菟丝子、韭菜子、五味子、桑螵蛸、茯苓、龙骨、牡蛎、赤石脂组成。
2. When pathogenic factors invade the uterus (Zigong), Wu Zhu Yu Tang is used for cold syndromes; if the leukorrhea is red and sticky, add Zhi Zi (Gardenia) and Fang Feng (Saposhnikovia); if white, it indicates Qi deficiency, treated with Bu Zhong Yi Qi Tang; if black, it indicates Kidney deficiency, treated with Liu Wei Di Huang Tang; if yellow and pale, Liu Jun Zi Tang or Gui Pi Tang is appropriate.
[Note] Leukorrhea caused by the invasion of the six excess pathogens into the uterus should be treated with Wu Zhu Yu Tang. If the discharge is red, or yellow and turbid/sticky, it is a heat syndrome. For yellow color, add Huang Lian (Coptis) and Zhi Zi (Gardenia); for blue/green color, add Fang Feng (Saposhnikovia) and Zhi Zi (Gardenia). If the discharge is white, or black and clear/thin, it is a deficiency-cold syndrome. For white color, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction); for black color, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia); for yellow and pale color, use Liu Jun Zi Tang (Six-Gentlemen Decoction) or Jia Wei Gui Pi Tang (Modified Heart-Nourishing Decoction), treating according to specific syndromes.
Wu Zhu Yu Tang, Bu Zhong Yi Qi Tang, Liu Wei Di Huang Wan, Liu Jun Zi Tang, Gui Pi Tang
Formulas are listed in the First Volume's Collection of Formulas.
Jia Wei Si Wu Tang (Modified Four-Substance Decoction)
3. Cold pain in the uterus indicates cold-dampness; Si Wu Tang (Four-Substance Decoction) combined with Fu Zi (Aconite), Gui Zhi (Cinnamon Twig), and Gan Jiang (Dried Ginger) is suitable. If there is a fishy odor, combine with Zhi Mu (Anemarrhena) and Huang Bai (Phellodendron). If chronic sliding/leakage occurs, add Sheng Ma (Cimicifuga) and Chai Hu (Bupleurum) to lift, and Long Gu (Fossilized Bones) and Mu Li (Oyster Shell) plus Chi Shi Zhi (Red Halloysite) to astringe.
[Note] Leukorrhea accompanied by hot pain in the uterus indicates damp-heat. Current cold pain in the uterus indicates cold-dampness. Use Si Wu Tang (Four-Substance Decoction) with Chuan Fu Zi (Prepared Aconite), Pao Jiang (Prepared Dried Ginger), and Guan Gui (Chinese Cinnamon Bark). For long-standing leakage, add Sheng Ma (Cimicifuga) and Chai Hu (Bupleurum) to raise and support, and Long Gu (Fossilized Bones), Mu Li (Oyster Shell), and Chi Shi Zhi (Red Halloysite) to astringe and stop discharge.
Si Wu Tang Formula
See the Collection of Formulas in the preceding Menstrual Regulation Section.
Qing Bai San (Clear and White Powder)
4. For damp-heat leukorrhea, use Qing Bai San, composed of Si Wu Tang (Four-Substance Decoction) plus Jiang Tan (Charred Ginger), Gan Cao (Licorice), Huang Bai (Phellodendron), and Chun Pi (Toona Bark). If red, add Di Yu (Sanguisorba), Jing Jie (Schizonepeta), and Huang Qin (Scutellaria); if dampness is heavy, add Cang Zhu (Atractylodes) and Bai Zhu (Atractylodes Macrocephala); if slippery/leaking, add Long Gu (Fossilized Bones) and Mu Li (Oyster Shell); if chronic, combine with Si Jun Zi Tang (Four-Gentlemen Decoction).
[Note] Leukorrhea refers to leukorrhea of five colors. All are transformed from damp-heat and should be treated with Qing Bai San. This formula is Si Wu Tang (Four-Substance Decoction) plus Jiang Tan (Charred Ginger), Gan Cao (Licorice), Huang Bai (Phellodendron), and Chun Pi (Toona Bark). For red color, add Di Yu (Sanguisorba), Jing Jie (Schizonepeta), and Huang Qin (Scutellaria); for heavy dampness, add Cang Zhu (Atractylodes) and Bai Zhu (Atractylodes Macrocephala); for slipping/leaking, add Long Gu (Fossilized Bones) and Mu Li (Oyster Shell); for chronic cases, combine with Si Jun Zi Tang (Four-Gentlemen Decoction).
Si Wu Tang (Four-Substance Decoction), Si Jun Zi Tang (Four-Gentlemen Decoction)
Both are in the Collection of Formulas in the preceding Menstrual Regulation Section.
Dao Shui Wan (Water-Directing Pill), Wan An Wan (Ten-Thousand Peace Pill)
5. Excess leukorrhea is all transformed from dampness; lower abdomen distension and pain with continuous turbid water indicate damp-heat, treated with Dao Shui Wan (Qian Niu Zi, Hua Shi, Huang Qin, Da Huang). If damp-cold, treat with Wan An Wan (Qian Niu Zi, Hu Jiao, Xiao Hui Xiang, Mu Xiang).
[Note] Leukorrhea of five colors all transforms from dampness. If there is lower abdominal distension and pain with continuous turbid discharge, it belongs to damp-heat, and Dao Shui Wan is suitable. This formula consists of Qian Niu Zi (Morning Glory Seed), Hua Shi (Talc), Huang Qin (Scutellaria), and Sheng Jun (Raw Rhubarb), treating excess heat. If belonging to damp-cold, Wan An Wan is suitable. This formula consists of Qian Niu Zi (Morning Glory Seed), Hu Jiao (Pepper), Xiao Hui Xiang (Fennel), and Mu Xiang (Aucklandia), treating excess cold.
Wei Xi Wan (Wei Xi Pill), Gu Jing Wan (Essence-Securing Pill)
6. Ulcerative pus and turbid discharge diseases transformed from blood stasis require judgment of deficiency/excess and cold/heat to select appropriate treatments. Wei Xi Wan consists of Huang La (Yellow Beeswax) and Fu Ling (Poria); Gu Jing Wan consists of Tu Si Zi (Cuscuta), Jiu Cai Zi (Chives Seed), Wu Wei Zi (Schisandra), Sang Piao Xiao (Mantis Egg-case), Fu Ling (Poria), Long Gu (Fossilized Bones), Mu Li (Oyster Shell), and Chi Shi Zhi (Red Halloysite).
[Note] Leukorrhea may be transformed from blood stasis, or arise from pus discharge from sores, as well as Bai Zhuo (White Turbidity) and Bai Yin (White Spermatorrhea), all of which belong to the category of leukorrhea. Their deficiency/excess and cold/heat nature must be judged appropriately. Medication includes Wei Xi Wan, consisting of Huang La (Yellow Beeswax) and Fu Ling (Poria). Gu Jing Wan consists of Tu Si Zi (Cuscuta), Jiu Cai Zi (Chives Seed), Wu Wei Zi (Schisandra), Sang Piao Xiao (Mantis Egg-case), Fu Ling (Poria), Long Gu (Fossilized Bones), Mu Li (Oyster Shell), and Chi Shi Zhi (Red Halloysite).