武叔卿曰∶断下汤治冲任气虚,崩中漏下,脐腹痛,渐减饮食,四肢无力。此胶艾四物之变例也。彼有芍
药,此有人参、干姜、艾。大概血虚而不敛者,宜芍药酸寒以收之。气脱而不温者,宜参、姜、乌贼之类,温
补而涩之。阿胶者,益金水,以成收藏之用也。阳虚则寒,阴虚则热,故以此主之。而腹痛一证,人皆以为瘀
血者多,此以为漏不止者,服熟附丸,正元礼所谓崩而腹痛者,崩止而痛除也。
武叔卿曰∶五灵脂散,治血崩不止,不拘多少,炒令烟尽,研末,加当归酒,或童便调下三钱,一名抽刀
散,治产后恶血,心腹痛不可忍,其效如神,真救急之良方也。人家不可不备。并治蛇、蝎、蜈蚣咬,涂伤处
立愈。
《济阴纲目》曰∶气血,人身之阴阳也。阳主升,阴主降。阳根乎阴,阴根乎阳。一动一静,互为其根,
则一升一降,循经而行,无崩漏之患。若阳有余,则升者胜,血从上窍而出;阳不足,则降者胜,血从下窍而
出。是丸也,肉桂、人参、 、术、甘草,壮阳益气之品也;二活、柴、防、 、细、川芎,升阳举经之品也;
归、地、白芍、桃仁、红花,滋阴入血之品也。壮阳则气不虚,举经则血不陷,滋阴则血不燥,如是则血为气
之守,气为血之卫,血荣于中,气卫于外,升降上下,一循乎经,胡自而崩哉。
武叔卿说:断下汤用于治疗冲任二脉气虚导致的崩中漏下(经血非时暴下或淋漓不断),伴有脐腹部疼痛,食欲逐渐减退,四肢无力。这是胶艾四物汤的变方。原方中有芍药,此方用人参、干姜、艾叶代替。大抵而言,若是血虚而不能收敛者,适宜用酸寒的芍药来收摄;若是气脱而不能温煦者,适宜用人参、干姜、乌贼骨之类,进行温补并固涩。阿胶能益补肺金和肾水,以完成收藏的功能。阳虚则生寒,阴虚则生热,所以以此方为主治。至于腹痛这一症状,人们大多认为是瘀血所致,但此处认为对于漏下不止的患者,服用熟附丸(即前文提到的含附子之剂),正如正元礼所说,崩漏伴随腹痛的情况,当崩止之时,疼痛自然消除。
武叔卿说:五灵脂散,用于治疗血崩不止,用量不拘多少,炒至烟尽,研成粉末,加当归酒送服,或用童便调服三钱。该方又名抽刀散,用于治疗产后恶露不尽引起的心腹剧烈疼痛,效果如神,真是救急的良方。家中不可不常备。同时也能治疗蛇、蝎、蜈蚣咬伤,涂抹于伤口处立即痊愈。
《济阴纲目》说:气血,就是人身体的阴阳。阳主升发,阴主沉降。阳根源于阴,阴根源于阳。一动一静,互为根本,那么一升一降,沿着经脉运行,就不会有崩漏的祸患。如果阳气有余,则升的力量占优势,血液从上窍流出;如果阳气不足,则降的力量占优势,血液从下窍流出。这个丸剂中,肉桂、人参、白术、甘草,是壮阳益气的药物;羌活、独活、柴胡、防风、细辛、川芎,是升阳举陷、调理经脉的药物;当归、地黄、白芍、桃仁、红花,是滋阴入血的药物。壮阳则气不虚,举陷则血不陷,滋阴则血不燥,像这样,血成为气的守御者,气成为血的护卫,血荣养于内,气卫护于外,升降上下,完全遵循经脉规律,怎么会发生崩漏呢?
Wu Shuqing stated: Duanxia Tang (Decoction to Stop Bleeding) is used to treat Chong and Ren Mai Qi deficiency (deficiency of Qi in the Penetrating and Conception vessels) leading to Benzhong Louxia (sudden heavy bleeding or persistent spotting), accompanied by pain in the umbilical and abdominal region, gradual loss of appetite, and weakness in the four limbs. This is a variation of Jiao'ai Siwu Decoction (Colla Corii Asini and Four Substances Decoction). The original formula contains Shaoyao (White Peony Root); this formula uses Renshen (Ginseng Root), Ganjiang (Dried Ginger Rhizome), and Aiye (Mugwort Leaf) instead. Generally speaking, for those with Blood deficiency unable to consolidate, it is appropriate to use the sour and cold Shaoyao to astringe; for those with Qi collapse unable to warm, it is appropriate to use Renshen, Ganjiang, Hai Piao Xiao (Cuttlefish Bone), etc., to tonify warmly and astringe. Ejiao (Colla Corii Asini) benefits Metal (Lung) and Water (Kidney), thereby fulfilling the function of storage and consolidation. Yang deficiency leads to cold; Yin deficiency leads to heat; thus, this formula serves as the primary treatment. Regarding the symptom of abdominal pain, most people attribute it to Blood stasis, but here it is considered that for patients with persistent spotting, taking Shufu Wan (Pill with Prepared Aconite Root)—as Zheng Yuanli mentioned regarding abdominal pain accompanying Benbing—when the bleeding stops, the pain will also cease.
Wu Shuqing stated: Wulingzhi San (Powder of Trogopterus Dung) is used to treat uncontrollable uterine bleeding. The dosage is not fixed; it should be stir-fried until smoke disappears, ground into powder, and taken with Danggui wine or mixed with child's urine, three qian per dose. It is also known as Choudao San (Sword-Removing Powder), used to treat unbearable epigastric and abdominal pain caused by postpartum lochia retention. Its efficacy is miraculous, making it an excellent emergency prescription. It is essential for households to keep it in stock. It also treats bites from snakes, scorpions, and centipedes; applying it to the wound results in immediate healing.
Jiyin Gangmu states: Qi and Blood are the Yin and Yang of the human body. Yang governs ascending; Yin governs descending. Yang is rooted in Yin, and Yin is rooted in Yang. Movement and stillness serve as each other's root; thus, ascending and descending follow the meridians, preventing any risk of Benlou (metrorrhagia and metrostaxis). If Yang is excessive, the ascending force prevails, and blood flows out from the upper orifices; if Yang is insufficient, the descending force prevails, and blood flows out from the lower orifices. In this pill, Rougui (Cinnamon Bark), Renshen, Baizhu (Atractylodes Macrocephala Rhizome), and Gancao (Licorice Root) are herbs that strengthen Yang and benefit Qi; Qianghuo (Notopterygium Rhizome), Duhuo (Angelica Pubescens Root), Chaihu (Bupleurum Root), Fangfeng (Saposhnikovia Root), Xixin (Asarum Root), and Chuanxiong (Ligusticum Chuanxiong Rhizome) are herbs that raise Yang and lift sinking Qi to regulate the meridians; Danggui (Angelica Sinensis Root), Dihuang (Rehmannia Root), Baishao (White Peony Root), Taoren (Peach Seed), and Honghua (Carthamus Flower) are herbs that nourish Yin and enter the Blood level. Strengthening Yang ensures Qi is not deficient; lifting Qi ensures Blood does not sink; nourishing Yin ensures Blood is not dry. In this manner, Blood becomes the guardian of Qi, and Qi becomes the defender of Blood; Blood nourishes internally, and Qi defends externally; ascending and descending follow the meridians completely. How could Benlou occur?