半夏厚朴汤
8.妇人咽中如炙脔, 或如梅核结咽间, 半夏厚朴汤最效, 半朴苏茯
姜引煎.
【注】『千金方』云: 咽中帖帖如有炙肉, 吐之不出, 吞之不下, 即
所谓咽中如有炙脔也, 俗名梅核气. 盖因内伤七情, 外伤寒冷所致,
宜用金匮半夏厚朴汤主之, 即半夏, 厚朴, 苏叶, 茯苓, 生姜煎也.
加味逍遥散
9.遍身???? 如丹毒, 痒痛无时搔作疮, 血风风湿兼血燥, 加味逍遥
连地方. 愈后白屑肌肤强, 血虚不润养荣汤.
【注】妇人血风疮证, 遍身起????, 如丹毒状, 或痒或痛, 搔之则成
疮,由风湿血燥所致. 宜用加味逍遥散加黄连, 生地. 如疮结痂而愈
,复起白屑, 肌肤强硬者, 乃血少不润也, 宜服益气养荣汤.
加味逍遥散 方见前阴痛条 益气养荣汤 方见首卷
桂附地黄丸
10.忧思郁怒肝脾损, 湿热生疮长两??, 外属三阳为易治, 内属三阴
治每难. 初起红肿败毒散, 浓水淋漓补中煎, 晡热阴虚宜六味, 食少
畏寒桂附丸.
【注】妇人忧思, 郁怒, 伤损肝, 脾, 或饮食不调, 损其胃气, 则湿
热下注; 更被寒湿外邪所客, 则必两?? 生疮. 外?? 足三阳经, 尚属
易治; 若生于内?? 属足三阴经, 每多难愈. 初起红肿, 宜人参败毒
散;溃后浓水淋漓, 宜补中益气汤; 若更晡热, 是为阴亏, 宜兼服六
味地黄丸; 若食少体倦畏寒, 则为真阳不足, 宜服桂附地黄丸, 即六
味地黄丸加肉桂, 附子也.
人参败毒散 方见产后痢条 补中益气汤 方见首卷血崩条
六味地黄丸 方见首卷
8. 妇女咽喉中感觉像有烤肉块堵着,或者像梅核卡在咽喉之间,使用半夏厚朴汤最为有效。方药组成:半夏、厚朴、紫苏叶、茯苓、生姜,加水煎服。
【注】《千金方》记载:咽喉中贴滞不适,好像有烤肉块堵在那里,吐不出来,咽不下去,这就是所说的“咽喉中有炙脔”的感觉,俗称梅核气。这通常是因为内伤情志(七情),外感寒邪所致,适宜使用《金匮要略》中的半夏厚朴汤主治,即由半夏、厚朴、紫苏叶、茯苓、生姜煎煮而成。
9. 全身出现红斑丘疹,状如丹毒,瘙痒疼痛无时不发作而抓破成疮,这是由于血分风邪、风湿兼有血燥所致,宜用加味逍遥散加黄连治疗。若疮愈后皮肤出现白屑且肌肤僵硬,这是血虚不能濡养所致,应服用养荣汤。
【注】妇女血风疮证候,全身起红斑丘疹,状如丹毒,或痒或痛,搔抓后则形成疮疡,由风湿和血燥引起。适宜使用加味逍遥散加入黄连、生地黄。如果疮口结痂愈合后,又生出白屑,肌肤变得强硬,这是血液亏少不能滋润的表现,适宜服用益气养荣汤。
加味逍遥散 方剂见前文“阴痛”条;益气养荣汤 方剂见首卷。
10. 忧思郁怒损伤肝脾,湿热下注生疮于两阴部,病位在外属三阳经者容易治疗,在内属三阴经者治疗往往困难。初起红肿时用人参败毒散解毒,脓水淋漓时用补中益气汤升提,午后发热阴虚者宜用六味地黄丸,食少畏寒者用桂附地黄丸。
【注】妇女因忧思、郁怒,损伤肝、脾,或因饮食不调,损伤胃气,导致湿热下注;再加上寒湿外邪侵袭,必然导致两阴部生疮。外阴属于足三阳经,尚属容易治疗;若生于内阴,属于足三阴经,往往难以痊愈。初起红肿,适宜用人参败毒散;溃破后脓水淋漓,适宜用补中益气汤;如果伴有午后发热,这是阴液亏损,适宜兼服六味地黄丸;如果食欲减退、身体疲倦、畏寒,这是真阳不足,适宜服用桂附地黄丸,即六味地黄丸加上肉桂、附子。
人参败毒散 方剂见产后痢疾条;补中益气汤 方剂见首卷血崩条;六味地黄丸 方剂见首卷。
Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction)
8. In women, a sensation of a roasted meat lump stuck in the throat, or like a plum pit lodged between the throat and pharynx, is most effectively treated with Banxia Houpo Tang (Pinellia and Magnolia Bark Decoction). The prescription consists of Banxia (Pinelliae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Suye (Perillae Folium), Fuling (Poria), and Shengjiang (Zingiberis Rhizoma Recens), decocted in water.
[Note] The *Qianjin Fang* (Prescriptions Worth a Thousand Gold) states: "There is a sticky sensation in the throat as if there were a piece of roasted meat; it cannot be spat out, nor can it be swallowed." This is referred to as having a "roasted meat lump" in the throat, commonly known as Plum-pit Qi (Meiheqi). This condition is generally caused by internal injury from the Seven Emotions (Seven Affects) and external contraction of Cold pathogens. It is appropriate to use Banxia Houpo Tang from the *Jin Gui Yao Lue* (Essential Prescriptions from the Golden Cabinet) as the principal formula, which consists of Banxia (Pinelliae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Suye (Perillae Folium), Fuling (Poria), and Shengjiang (Zingiberis Rhizoma Recens) decocted together.
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder)
9. Red macules and papules appear all over the body, resembling Erysipelas (Dan Du); itching and pain occur incessantly, leading to sores upon scratching. This is caused by Wind-Heat in the Blood level, combined with Dampness-Wind and Blood Dryness. It should be treated with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) added with Huanglian (Coptidis Rhizoma). If, after healing, white scales appear on the skin and the skin becomes stiff, this indicates Blood Deficiency failing to nourish; Yangrong Tang (Nourishing Qi and Blood Decoction) should be taken.
[Note] In the syndrome of Women's Blood-Wind Sores, red macules and papules erupt all over the body, resembling Erysipelas, with either itching or pain, forming sores when scratched. This is caused by Dampness-Wind and Blood Dryness. It is appropriate to use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) added with Huanglian (Coptidis Rhizoma) and Shengdi Huang (Rehmanniae Radix). If the sores scab over and heal, but white scales reappear and the skin becomes hard, this signifies that insufficient Blood fails to moisten. It is appropriate to take Yiqi Yangrong Tang (Decoction for Replenishing Qi and Nourishing Blood).
Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder): See the section on Vulvar Pain.
Yiqi Yangrong Tang (Decoction for Replenishing Qi and Nourishing Blood): See Volume One.
Guifu Dihuang Wan (Cinnamon Twig and Aconite Pill Rehmanniae)
10. Worry, thought, depression, and anger damage the Liver and Spleen; Damp-Heat generates sores in the genital region. Lesions located externally belong to the Three Yang meridians and are easy to treat; those located internally belong to the Three Yin meridians and are often difficult to cure. At the initial stage of redness and swelling, Rendren Baidu San (Ginseng Antidote Powder) is used to resolve toxicity; if pus and fluid ooze profusely, Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) is used; if there is afternoon fever indicating Yin Deficiency, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmanniae) is appropriate; if there is poor appetite and aversion to cold, Guifu Dihuang Wan (Cinnamon Twig and Aconite Pill Rehmanniae) is indicated.
[Note] Due to worry, thought, depression, and anger, the Liver and Spleen are damaged; or due to irregular diet, the Stomach Qi is impaired, leading to Damp-Heat sinking downward. Furthermore, if invaded by external Cold-Damp pathogens, sores will inevitably arise in the genital region. External lesions involve the Foot Three Yang meridians and are relatively easy to treat; however, lesions arising in the internal genitalia involve the Foot Three Yin meridians and are often difficult to heal. At the initial stage of redness and swelling, Rendren Baidu San (Ginseng Antidote Powder) is appropriate. After ulceration with profuse oozing of pus, Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) is appropriate. If accompanied by afternoon fever, this indicates Yin deficiency, and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmanniae) should be taken concurrently. If there is poor appetite, physical fatigue, and aversion to cold, this indicates insufficiency of True Yang, and Guifu Dihuang Wan (Cinnamon Twig and Aconite Pill Rehmanniae) is appropriate, which is Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmanniae) added with Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata).
Rendren Baidu San (Ginseng Antidote Powder): See the section on Postpartum Dysentery.
Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi): See Volume One, section on Metrorrhagia.
Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmanniae): See Volume One.