1.石瘕寒气客胞中, 状如怀子不经行, 胞闭热气迫肺咳, 伤心气血
不流通.
【注】经曰: 石瘕生于胞中, 寒气客于子门, 子门闭寒, 气不得通,
恶血当泻不泻, 衄以留止, 日以益大, 状如怀子, 月事不以时下, 皆
生于女子, 可导而下. 此论经闭, 因寒气客于下, 故病石瘕, 而不病
肺劳也. 经曰: 月事不来者, 胞脉闭也. 胞脉者, 属心而络于胞中.
今气上迫于肺, 心气不得下通, 故月事不来也. 此论胞脉闭, 因热气
攻于上, 故迫肺作咳, 病肺劳而不病石瘕也.
2.二阳之病发心脾, 不月有不得隐曲, 血枯其传为风消, 息贲者死
不能医.
【注】二阳者, 阳明胃也. 女子有隐曲不得之情, 则心脾气郁不舒,
以致二阳胃病, 饮食日少, 血无以生, 故不月也. 血虚则生内热, 愈
热愈虚, 肌肉干瘦如风之消物, 故名曰风消也. 火盛无制, 心乘肺金
,金气不行, 不能运布, 水精留于胸中, 津液悉化为痰, 咳嗽不已,
日久成劳, 传为息贲, 则不能医矣. 息贲者, 喘也.
3.脱血过淫产乳众, 血枯渐少不行经, 骨蒸面白两颧赤, 懒食消瘦
咳嗽频.
【注】失血过多, 面与爪甲之色, 俱浅淡黄白, 乃脱血病也. 或因过
淫精竭, 或因产多乳众, 伤血血枯, 经来渐少, 二, 三月后经闭不行
,以致证见骨蒸肌热, 面色枯白, 两颧红赤, 懒于饮食, 皮干消瘦,
咳嗽频频不已, 多成虚损之证.
1. 石瘕(子宫内形成的坚硬肿块)是由于寒气侵入胞宫所致,症状表现为腹部胀大如同怀孕但月经停止来潮;若胞脉闭塞且热气上迫于肺,则会导致咳嗽,并损伤心与气血的正常运行。
【注】《黄帝内经》记载:石瘕生于胞宫之中,寒气客居于子门(子宫口),导致子门闭塞寒冷,气机无法通畅,应当排出的恶血未能排出,因而滞留体内,日渐增大,外形如同怀孕,月经不能按时来潮,这种病都发生在女性身上,可以通过导引或攻下法治疗。此处论述的是经闭,因寒气客居在下焦,所以患石瘕,而不患肺劳(肺部虚损性疾病)。《黄帝内经》又说:月经不来的原因,是胞脉闭塞。胞脉,归属于心并联络于胞宫。如今气机上逆逼迫于肺,心气无法向下通达,所以月经不来。此处论述的是胞脉闭塞,因热气攻冲于上焦,所以逼迫肺部引发咳嗽,患肺劳而不患石瘕。
2. 阳明胃(二阳)的疾病发源于心和脾,出现月经停闭或有难以启齿的情志不畅,若发展为血枯证,进而传变为风消(肌肉消瘦如被风吹干)或息贲(喘息急促),则属于死症,无法医治。
【注】“二阳”指的是阳明胃经。女子若有难以言说的情志郁结,会导致心脾气机郁滞不舒,进而引起阳明胃病,饮食日渐减少,血液生成无源,因此月经停闭。血虚则产生内热,越热越虚,肌肉干枯消瘦如同被风吹干的物体,所以称为风消。火势旺盛而无制约,心火乘袭肺金,导致肺气不行,不能运化布散,水液精华滞留于胸中,津液全部化为痰饮,咳嗽不止,日久形成劳损,传变为息贲,则无法医治了。息贲,就是喘息的意思。
3. 失血过多、房事过度、多次生产哺乳,导致血枯逐渐减少直至月经停闭,出现骨蒸潮热、面色苍白、两颧发红、食欲不振、身体消瘦、频繁咳嗽等症状。
【注】失血过多,面部和指甲的颜色都会呈现浅淡的黄白色,这是脱血病的表现。或者因为房事过度导致精竭,或者因为生产多、哺乳多,损伤血液导致血枯,月经逐渐减少,两三个月后月经停闭不行,以致出现骨蒸肌热、面色枯白、两颧红赤、懒于进食、皮肤干燥消瘦、咳嗽频频不止等症状,大多形成虚损之证。
1. Shijia (a hard mass in the uterus) arises from cold pathogenic factors invading the Bao Palace (uterus). Its manifestation is an abdominal distension resembling pregnancy accompanied by amenorrhea; if the Bao Mai (uterine vessels) are obstructed and heat pathogenic factors force upward to the Lung, it leads to coughing and impairs the normal circulation of Heart Qi and Blood.
[Annotation] The *Huangdi Neijing* states: "Shijia originates in the Bao Palace. Cold pathogens lodge at the Zi Men (cervical os), causing closure and coldness at the Zi Men. Qi cannot flow freely. The evil blood that should be discharged remains stagnant, accumulating day by day until it enlarges, resembling pregnancy, with menstruation failing to occur on time. This condition occurs exclusively in women and can be treated by guiding or purging methods." This passage discusses amenorrhea caused by cold pathogens lodging in the lower jiao, resulting in Shijia rather than Fei Lao (pulmonary consumption). The *Huangdi Neijing* also states: "When menstruation does not arrive, it is due to the obstruction of the Bao Mai. The Bao Mai belongs to the Heart and connects to the Bao Palace. Now, if Qi forces upward upon the Lung, Heart Qi cannot descend and communicate, thus menstruation fails to arrive." This passage discusses the obstruction of the Bao Mai caused by heat pathogenic factors attacking the upper jiao, thereby forcing the Lung and inducing cough, resulting in Fei Lao rather than Shijia.
2. Diseases of the Er Yang (Yangming Stomach) originate in the Heart and Spleen. Amenorrhea may occur alongside unspoken emotional distress. If this progresses to Xue Ku (Blood Depletion) and subsequently transmits into Feng Xiao (muscular emaciation as if blown away by wind) or Xi Ben (labored breathing/wheezing), it becomes a fatal condition incurable by medical treatment.
[Annotation] "Er Yang" refers to the Yangming Stomach channel. When women experience unspoken emotional constraints, it causes stagnation and discomfort in Heart and Spleen Qi, leading to Yangming Stomach disease. Dietary intake decreases daily, leaving no source for Blood generation, hence amenorrhea ensues. Blood deficiency generates internal heat; the greater the heat, the more deficient the body becomes. Muscles become dry and emaciated, resembling objects dried by wind, hence named Feng Xiao. When Fire is excessive and uncontrolled, Heart Fire overacts upon Lung Metal. Lung Qi fails to circulate and distribute; water essence stagnates in the chest, and all body fluids transform into phlegm. Persistent coughing over a long period leads to consumption, transmitting into Xi Ben, which becomes incurable. Xi Ben refers to wheezing or labored breathing.
3. Excessive blood loss, hypersexuality, and multiple pregnancies or lactations lead to gradual depletion of Blood (Xue Ku), resulting in scanty then absent menstruation. Symptoms include bone-steaming tidal fever, pale complexion, malar flush, anorexia, emaciation, and frequent coughing.
[Annotation] Excessive blood loss results in a pale yellowish-white color of the face and fingernails, indicating the syndrome of Tuo Xue (Blood Evacuation/Depletion). This may be caused by excessive sexual activity leading to Essence exhaustion, or by numerous births and prolonged lactation damaging Blood and causing Blood Depletion. Menstruation gradually becomes scanty, and after two or three months, amenorrhea sets in. Consequently, symptoms such as bone-steaming skin heat, withered pale complexion, red malar eminences, aversion to food, dry skin, emaciation, and incessant frequent coughing appear, typically forming a Xu Sun (Deficiency Injury) syndrome.