【歌】三十六疾为何生，七害相同十二症，九痛五伤良有说，更兼三痼得其名。白膏黑紫赤如脓，豆汁葵
羹凝血壅，清血水来如米清，愆期月浣是症宗。九痛阴疼或淋沥，溺时寒冷或临经，汁流气满如虫啮，肠下腰胯
痛不宁。七害孔痛中寒热，小腹坚痛脏不仁，子门不端引背痛，愆期害吐得其真。五伤两胁支满痛，心痛郁结气
不通，邪思泄利精神少，前后阴阳亦在中。三痼虚羸似、鹤形，从来绝产不添丁，更兼不月胞门闭，莫道医方用
不灵。食气冷劳房妊睡，亦名七害出准绳，据云产宝言如此，虚虎相传或误誊。
【论】经曰∶女子七岁肾气盛，齿更发长。二七而天癸至，任脉通，太冲脉盛，月事以时下。天者，天真
之气，癸者，壬癸之水。但壬为阳水，配丁而化木，癸为阴水，配戌而化火，女子阴类故得癸焉。冲为血海，任
主胞胎，二脉流通，经血渐盈，应时而下，天真气降，故曰天癸。常以三旬一见，象月盈亏，不失其期，又名月
信也。若遇经行，最宜谨慎，倘被惊恐，劳役、恚怒、风冷，则气血错乱，经脉不行，多致肢体酸痛，头目眩晕，
咳呕不宁，淋沥无已，渐成劳瘵，不治者有矣。犯时微若秋毫，成病重如山岳，可不畏哉。
张景岳曰∶妇人之病，因虚积冷结气为患，经水断绝，至有历年，血寒积结胞门，寒伤经络，凝结在上，
呕吐涎沫，久成肺痈，形体损分，在中盘结，绕脐寒疝，两胁疼痛，与脏相连。或结热中，痛在关元，脉数无疮，
肌若鱼鳞，时着男子，非止女身。在下来多，经候不匀，令阴掣痛，少腹恶寒，或引腰脊下根，气街气冲急痛，
膝胫酸痛，奄忽弦冒，状如厥巅，或有忧惨悲伤多嗔，此皆带下非鬼神，久则羸瘦，脉虚多寒。三十六病，千变万
端，审脉阴阳，虚实紧弦，行其针药，治危得安，其虽同病，脉各异源，子当辨记。
孙真人曰∶三十六疾者，谓十二症，九痛七害、五伤三痼是也。十二症是所下之物一曰状如膏，二曰如黑
血，三曰如紫汁，四曰如赤肉，五曰如浓痂，六曰如豆汁，七曰如葵羹，八曰如凝血，九曰如清血，血似水，十
曰如米泔，十一曰如月浣乍前乍却，十二曰经度不应期也。九痛者，一曰阴中痛伤，二曰阴中淋漓痛，三曰小便即痛，
四曰寒冷痛，五曰经来腹痛，六曰气满痛，七曰
汁出阴中如虫啮痛，八曰胁下分痛，九曰腰胯痛。七害者，一曰穷孔痛，不利，二曰中寒热痛，三曰小腹急坚痛，
四曰脏不仁，五曰子门不端引背痛，六曰月浣乍多乍少，七曰害吐。五伤者，一曰两胁支满痛，二曰心痛引胁，
三曰气结不通，四曰邪思泄利，五曰前后痛冷。三痼者，一曰羸瘦不生肌肉，二曰绝产乳，三曰经水闭塞，窍小不通。
【脉】寸口脉微而涩，微则卫气不足，涩则荣血无余，卫不足其息短，荣不足其形燥，荣卫俱虚，言语乏
力。跌阳脉微而涩为虚，虚则短气咽燥口苦，涩则津液少。少阴脉微迟而涩，微则无积，迟则阴中寒，涩则血不
流而经闭。此为居经三月一来，脉虚，气血俱虚，年少者，亡血也。脉微弱而涩，年少得此为无子，中年得此为
绝产。六脉沉弦细数者，其病已成，元气荣卫俱虚。形衰神怯者，虽药勿效。
孙真人曰∶妇人腹中十二疾，经水不时，经如清水，经水不通，不周时，生不乳，绝无子，阴阳减少，瘕
痛如刺，阴中冷，子门引背痛，经水冻如葵汁，腰急痛，凡此十二病皆因经内联虚时，或冷水洗浴，或坐卧湿地，
或当风取凉，或误食生冷，或疮痍未瘥便合阴阳，或早起作劳，衣单席薄，寒从外入也。
【方】
赤石脂丸
赤石脂（ 另研，二两） 半夏 炮姜 当归 防风 丹参（各一两） 吴茱萸（盐汤泡炒） 蜀椒 桂
心萑芦（各五钱） 白蔹（一两）
为末炼蜜丸，空心酒下十丸，日三服，不知稍加丸数，以知为度。
千金白垩丸
白垩 龙骨 芍药 黄连 当归 茯苓 黄芩 白蔹 瞿麦 石苇 细辛 牡蛎 本 甘草 甘皮 附子
大黄 人参 白石脂 禹余粮 乌贼骨
蜜丸余下二十丸。十二症倍牡蛎、龙骨、禹粮、石脂、乌贼骨。九痛倍黄连、白蔹、当归、甘草。七害
倍细辛、 本、甘皮加蜀椒、吴萸。五伤倍大黄、石苇、瞿麦。三痼倍人参加巴戟、石脂。
【歌诀】
三十六种疾病是如何产生的？它们与七种危害相同，包含十二种症状、九种疼痛和五种损伤，再加上三种顽固性疾病而得名。白带呈白色膏状，或黑紫色，或赤色如脓，或像豆汁，或像葵菜羹，或有凝结的血块壅塞；清稀的血水流出如同米汤水，月经延期或紊乱是这些病症的根源。九种疼痛包括阴部疼痛或淋漓不尽，小便时寒冷或临近经期发作，分泌物流出、气胀感如同虫咬，肠道下坠及腰胯部疼痛不安。七种危害包括阴道口疼痛伴中寒发热，小腹坚硬疼痛且脏腑感觉迟钝（不仁），子宫颈口不正牵引背部疼痛，月经延期并伴有呕吐症状最为典型。五种损伤表现为两胁支撑满闷疼痛，心痛郁结气机不通，思虑过度导致泄泻和精神萎靡，前阴和后阴的阴阳失调也包含在内。三种顽固性疾病表现为身体虚弱消瘦形似鹤骨，历来不孕且不添丁进口，再加上月经不来、胞门闭塞，不要说医疗方剂没有灵效。因饮食生冷、冷劳、房事妊娠期间睡眠不当等引起的，也称为七害，出自《准绳》一书，据称源自《产宝》，但“虚虎”之说相传可能是误抄。
【论述】
经典医籍记载：女子七岁时肾气旺盛，牙齿更换，头发生长。十四岁时天癸（促进生殖功能成熟的物质）到来，任脉通畅，太冲脉盛壮，月经按时来潮。“天”指天真之气，“癸”指壬癸之水（五行中壬为阳水，配丁化木；癸为阴水，配戌化火）。女子属阴类，故得癸水之精。冲脉为血海，任脉主司胞胎，这两条经脉流通顺畅，经血逐渐充盈，应时而下，天真之气下降，所以称为天癸。通常每三十天来一次月经，象征月亮的盈亏，不失其期，所以也叫月信。如果在行经期间，最宜谨慎，倘若遭遇惊恐、劳累、愤怒、风冷等因素，就会导致气血错乱，经脉运行受阻，多引起肢体酸痛，头目眩晕，咳嗽呕吐不安，淋沥不尽，逐渐形成劳瘵（慢性消耗性疾病），不治者有之。发病时轻微若秋毫，成病后沉重如山岳，怎能不畏惧呢？
张景岳说：妇女的疾病，因虚损、积冷、结气而致病，经血断绝，甚至经过多年，血寒积结于胞门，寒气损伤经络，凝结在上焦则呕吐涎沫，久则成为肺痈，形体受损；在中焦盘结，则绕脐寒疝，两胁疼痛，与脏腑相连；或结热于中，痛在关元穴处，脉数但无疮疡，肌肤如鱼鳞状，有时症状牵连男子，不仅限于女性；在下焦多见，经候不调，令阴部掣痛，少腹恶寒，或牵引腰脊下部，气街、气冲穴急痛，膝胫酸痛，突然头晕目眩，状如厥逆巅顶痛，或有忧愁惨痛悲伤易怒，这些都是带下病而非鬼神作祟，久则身体瘦弱，脉象虚而多寒。三十六种疾病，千变万端，审察脉象的阴阳、虚实、紧弦，施行针药治疗，可使危重转为平安。虽然病症相同，但脉象来源各异，应当辨别记忆。
孙思邈说：三十六种疾，是指十二症、九痛、七害、五伤和三痼。十二症是指阴道分泌物的性状：一曰状如膏脂，二曰如黑血，三曰如紫汁，四曰如赤肉，五曰如脓痂，六曰如豆汁，七曰如葵菜羹，八曰如凝血，九曰如清血，血似水样，十曰如米泔水，十一曰如月经乍前乍后，十二曰月经周期不应期。九痛者：一曰阴中痛伤，二曰阴中淋漓痛，三曰小便即痛，四曰寒冷痛，五曰经来腹痛，六曰气满痛，七曰分泌物出阴中如虫咬痛，八曰胁下分痛，九曰腰胯痛。七害者：一曰穷孔痛（阴道口疼痛），不利，二曰中寒热痛，三曰小腹急坚痛，四曰脏不仁（脏腑感觉迟钝），五曰子门不端引背痛，六曰月浣乍多乍少，七曰害吐（呕吐）。五伤者：一曰两胁支满痛，二曰心痛引胁，三曰气结不通，四曰邪思泄利（思虑过度致泄泻），五曰前后痛冷（前后二阴痛冷）。三痼者：一曰羸瘦不生肌肉，二曰绝产乳（不孕不育），三曰经水闭塞，窍小不通。
【脉诊】
寸口脉微而涩，微表示卫气不足，涩表示营血无余。卫气不足则呼吸短促，营血不足则形体干燥，营卫俱虚则言语乏力。跌阳脉微而涩为虚证，虚则短气咽燥口苦，涩则津液减少。少阴脉微迟而涩，微则无积聚，迟则阴中寒冷，涩则血不流而经闭。这是居经（三个月来一次月经），脉虚，气血俱虚，年少者多为亡血所致。脉微弱而涩，年少者得此脉为无子，中年者得此脉为绝产。六脉沉弦细数者，病情已成，元气营卫俱虚。形体衰败精神怯弱者，即使用药也无效果。
孙思邈说：妇人腹中十二种疾，经水不时，经水如清水，经水不通，不到周期，生不出孩子，绝无子嗣，阴阳减少，瘕痛如针刺，阴中冷，子门牵引背痛，经水冻凝如葵汁，腰急痛，凡此十二种病皆因经期体内空虚之时，或用冷水洗浴，或坐卧湿地，或当风取凉，或误食生冷，或疮痍未愈便行房事，或早起劳作，衣单席薄，寒气从外侵入所致。
【方剂】
赤石脂丸
赤石脂（另研，二两） 半夏 炮姜 当归 防风 丹参（各一两） 吴茱萸（盐汤泡炒） 蜀椒 桂心 萑芦（各五钱） 白蔹（一两）
研为末，炼蜜为丸，空腹时用酒送服十丸，每日三次服用，若无效稍增加丸数，以见效为度。
千金白垩丸
白垩 龙骨 芍药 黄连 当归 茯苓 黄芩 白蔹 瞿麦 石苇 细辛 牡蛎 藁本 甘草 甘皮 附子 大黄 人参 白石脂 禹余粮 乌贼骨
炼蜜为丸，剩余二十丸。针对十二症加倍使用牡蛎、龙骨、禹粮、石脂、乌贼骨。针对九痛加倍使用黄连、白蔹、当归、甘草。针对七害加倍使用细辛、藁本、甘皮，加蜀椒、吴茱萸。针对五伤加倍使用大黄、石苇、瞿麦。针对三痼加倍使用人参，加巴戟天、石脂。
[Song Verse]
How are the thirty-six diseases generated? They share similarities with seven harms, encompassing twelve symptoms, nine pains, and five injuries, along with three chronic conditions. The leukorrhea may appear as white paste, black-purple color, red like pus, bean juice, or mallow soup; there may be coagulated blood blockage; clear bloody discharge resembling rice water; delayed or irregular menstruation is the root of these syndromes. The nine pains include vaginal pain or dripping discomfort, coldness during urination or approaching menstruation, discharge accompanied by qi distension feeling like insect bites, lower intestinal dragging pain, and restless pain in the waist and hips. The seven harms include pain at the vaginal orifice with interior cold-heat sensations, hardness and pain in the lower abdomen with insensibility of the zang organs, malposition of the cervical os pulling on the back pain, delayed menstruation accompanied by vomiting which is most characteristic. The five injuries manifest as fullness and pain in the two hypochondria, heart pain with stagnation and blocked qi, excessive worry leading to diarrhea and diminished spirit, and yin-yang imbalance affecting the anterior and posterior orifices. The three chronic conditions present as emaciation resembling crane bones, historical infertility without offspring, amenorrhea, and closure of the uterine gate. Do not say that medical prescriptions are ineffective. Conditions caused by diet of cold foods, cold labor, sexual activity during pregnancy, or improper sleep are also named seven harms, originating from *Zhunsheng*, allegedly derived from *Chanbao*, though the term "Xu Hu" (Deficient Tiger) may be a transcription error.
[Discussion]
The classics state: At age seven, a girl's kidney qi becomes abundant, teeth change, and hair grows. At fourteen, Tian Gui (substances promoting reproductive maturity) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes vigorous, causing menstruation to occur on time. "Tian" refers to Heavenly True Qi; "Gui" refers to the Water of Ren and Gui (in Wu Xing, Ren is Yang Water pairing with Ding to transform into Wood; Gui is Yin Water pairing with Xu to transform into Fire). Since women belong to the Yin category, they obtain Gui essence. The Chong Mai is the Sea of Blood, and the Ren Mai governs the fetus. When these two vessels flow smoothly, menstrual blood accumulates and descends on schedule due to the descent of Heavenly True Qi, hence called Tian Gui. Typically occurring every thirty days, mirroring the waxing and waning of the moon, maintaining its cycle, it is also called Yue Xin (Monthly Trust). During menstruation, utmost caution is required. If subjected to fright, fatigue, anger, or wind-cold, qi and blood become disordered, meridians fail to circulate, often resulting in limb soreness, dizziness, coughing and vomiting, continuous dripping, gradually forming Lao Zhai (chronic consumptive disease), some of whom cannot be cured. What begins slightly like an autumn feather can become heavy as a mountain when illness sets in; how can one not fear this?
Zhang Jingyue stated: Women's diseases arise from deficiency, accumulated cold, and stagnant qi, leading to cessation of menstruation, sometimes lasting years. Cold blood accumulates in the Bao Men (uterine gate); cold damages the meridians. Accumulation in the upper jiao causes vomiting of saliva and foam, eventually becoming Lung Abscess and damaging the body; accumulation in the middle jiao causes umbilical cold hernia, hypochondriac pain connected to the zang organs; heat accumulation in the center causes pain at Guanyuan point, rapid pulse without sores, skin resembling fish scales, symptoms sometimes affecting men, not just women; accumulation in the lower jiao causes irregular menstruation, pulling pain in the yin, coldness in the lower abdomen, radiating to the lower spine, urgent pain at Qichong points, soreness in knees and shins, sudden vertigo resembling Jue syndrome or vertex pain, sorrow, sadness, and irritability. These are all Dai Xia (leukorrhea) diseases, not ghostly influences, leading to emaciation and a deficient, cold pulse over time. The thirty-six diseases are myriad in variation; examine the pulse for yin/yang, deficiency/excess, tight/string-like qualities, apply acupuncture and herbs to turn danger into safety. Although diseases may be similar, their pulse origins differ; one must distinguish and remember.
Sun Simiao stated: The thirty-six diseases refer to twelve symptoms, nine pains, seven harms, five injuries, and three chronic conditions. The twelve symptoms refer to the nature of vaginal discharge: 1. Like paste; 2. Like black blood; 3. Like purple fluid; 4. Like red flesh; 5. Like purulent scab; 6. Like bean juice; 7. Like mallow soup; 8. Like coagulated blood; 9. Like clear blood, resembling water; 10. Like rice wash water; 11. Menstruation coming early or late intermittently; 12. Menstrual cycle not adhering to the period. The nine pains are: 1. Pain injury in the yin; 2. Dripping pain in the yin; 3. Pain upon urination; 4. Cold pain; 5. Abdominal pain during menstruation; 6. Qi-fullness pain; 7. Discharge from yin feeling like insect bites; 8. Hypochondriac pain; 9. Waist and hip pain. The seven harms are: 1. Pain at the vaginal orifice with difficulty; 2. Interior cold-heat pain; 3. Urgent hardness pain in the lower abdomen; 4. Insensibility of zang organs; 5. Malposition of the cervical os pulling on back pain; 6. Menstrual flow varying greatly in amount; 7. Harmful vomiting. The five injuries are: 1. Fullness and pain in the two hypochondria; 2. Heart pain radiating to the hypochondria; 3. Qi knotting and blockage; 4. Excessive worry leading to diarrhea; 5. Cold pain in the anterior and posterior orifices. The three chronic conditions are: 1. Emaciation with failure to generate muscle; 2. Infertility and inability to lactate; 3. Amenorrhea with small orifices and blockage.
[Pulse Diagnosis]
The Cun Kou (Radial) pulse is faint and choppy. Faint indicates insufficiency of Wei Qi (Defensive Qi); choppy indicates exhaustion of Ying Blood (Nutritive Blood). Insufficient Wei Qi leads to short breath; insufficient Ying Blood leads to dryness of form. Deficiency of both Ying and Wei results in lack of strength in speech. The Di Yang pulse being faint and choppy indicates deficiency; deficiency leads to shortness of breath, dry throat, and bitter taste; choppy indicates reduced body fluids. The Shao Yin pulse being faint, slow, and choppy: faint indicates no accumulation; slow indicates cold in the yin; choppy indicates blood stasis and amenorrhea. This describes Ju Jing (menstruation occurring once every three months). A deficient pulse with qi and blood deficiency in the young suggests loss of blood. A faint, weak, and choppy pulse in the young indicates infertility; in middle age, it indicates absolute infertility. Six pulses being deep, string-taut, fine, and rapid indicate established disease with deficiency of Yuan Qi, Ying, and Wei. If the form is emaciated and spirit timid, medication will be ineffective.
Sun Simiao stated: The twelve diseases in the female abdomen include irregular menstruation, clear watery menstruation, obstructed menstruation, menstruation not arriving on schedule, inability to bear children, absolute infertility, reduction of yin and yang, stabbing pain from masses (Jia), coldness in the yin, cervical os pulling on back pain, frozen menstruation resembling mallow juice, and urgent waist pain. All these twelve diseases arise because during menstruation, the interior is empty; bathing in cold water, sitting/lying on damp ground, exposing oneself to wind for cooling, mistakenly eating raw/cold foods, engaging in intercourse before wounds have healed, rising early to work, wearing thin clothes/sleeping on thin mats, allowing cold to enter from the exterior.
[Formulas]
Chishizhi Wan (Red Halloysite Pill)
Chishi Zhi (Red Halloysite, separately ground, 2 liang), Ban Xia (Pinellia Rhizome), Pao Jiang (Prepared Ginger), Dang Gui (Angelica Sinensis), Fang Feng (Saposhnikovia Root), Danshen (Salvia Miltiorrhiza) (each 1 liang), Wu Zhu Yu (Evodia Fruit, soaked in salt water and stir-fried), Shu Jiao (Sichuan Pepper), Gui Xin (Cinnamon Twig Heart), Huan Lu (Reed Catkin) (each 5 qian), Bai Lian (Ampelopsis Radix) (1 liang).
Grind into powder, refine honey to make pills. Take 10 pills with wine on an empty stomach, three times daily. If ineffective, slightly increase the number of pills until efficacy is achieved.
Qianjin Bai'e Wan (Thousand Gold White Kaolin Pill)
Bai E (Kaolin), Long Gu (Fossilized Bones), Shao Yao (Peony Root), Huang Lian (Coptis Rhizome), Dang Gui (Angelica Sinensis), Fu Ling (Poria), Huang Qin (Scutellaria Root), Bai Lian (Ampelopsis Radix), Qu Mai (Dianthus Herb), Shi Wei (Pyrrosiae Leaf), Xi Xin (Asarum Root), Mu Li (Oyster Shell), Gao Ben (Ligusticum Wallichii), Gan Cao (Licorice Root), Gan Pi (Citrus Peel), Fu Zi (Aconite Lateral Root), Da Huang (Rhubarb Root), Ren Shen (Ginseng Root), Baishi Zhi (White Halloysite), Yuyuliang (Yuzhou Hematite), Wumei Gu (Cuttlefish Bone).
Refine honey to make pills. For the twelve symptoms, double the dosage of Mu Li, Long Gu, Yuliang, Shizhi, and Wumeigu. For the nine pains, double Huanglian, Bailian, Danggui, and Gancao. For the seven harms, double Xixin, Gaoben, Ganpi, and add Shujiao and Wuzhuyu. For the five injuries, double Dahuang, Shiwei, and Qumai. For the three chronic conditions, double Renshen, and add Bajitian and Shizhi.