论曰∶夫妇人恶寒者,亦有阴阳二证。发热而恶寒者,发于阳也;无热而恶寒者,发于
阴也。发于阳者宜解表,脉必浮数;发于阴者宜温里,脉必沉细。又有汗后、利后恶寒及背
恶寒。以上疾证,方治并载《百问》,不复繁引。仆尝治一妇人,但恶寒别无他证,六脉
平静,遂用败毒散而安。此药能去表中风邪故也。经云∶恶寒家慎不可过当覆衣被及近火气
,寒热相搏,脉道沉伏,愈令病患寒不可遏,但去被撤火,兼以和表之药,自然不恶寒矣。
妇人恶寒尤不可近火。寒气入腹,血室结聚,针药所以不能治矣。
败毒散。(见《局方》)
夫妇人血风烦闷者,由脏腑劳伤,血气虚而风邪乘之,搏于血,使气不宣而痞涩,则生
瘀热。或肢节烦疼,口干少卧,皆因虚弱而气血壅滞,故烦闷也。
治妇人血风虚冷,月候不调,或即脚手心烦热,或即头面浮肿顽麻。川乌头丸。
川乌头(一斤,用好清油合四两一处,于铫内炭火炒,不住手搅。候裂者仍须如桑根色
为度,遂旋取出了于新瓦上。或不裂者不用,裂者则去皮、尖、脐) 五灵脂(去土石,拣
净,四两,生)
上为细末,更入臼中,或乳钵内研令停后,将蒸饼水浸后,却沥去水,渐渐入臼中和杵
,直待丸得,即丸如梧桐子大。空心,温酒或盐汤下二十丸。忌动风物。丈夫风疾亦治。
治妇人气血不和,心胸烦闷,不思饮食,四肢少力,头目昏眩,身体疼痛。赤芍药散。
论述说:妇女出现怕冷的症状,也有阴证和阳证两种情况。发热且怕冷的,属于发于阳;不发热而只怕冷的,属于发于阴。发于阳的应当采用解表法治疗,脉象必然浮数;发于阴的应当采用温里法治疗,脉象必然沉细。又有出汗后、腹泻后怕冷以及背部怕冷的情况。以上这些病证,治疗方法都记载在《百问》中,不再繁琐引用。我曾经治疗一位妇人,只是怕冷而没有其他症状,六脉平静,于是使用败毒散(Baidu San, Decoction for Overcoming Toxicity)而痊愈。这个药能祛除表中风邪的缘故。医经说:怕冷的病人千万不要过度盖衣被或靠近火源,否则寒热相互搏结,脉道沉伏,只会让病人寒冷得无法遏制,只要去掉被子撤去火源,同时配合调和表证的药物,自然就不怕冷了。妇女怕冷尤其不可靠近火源。寒气进入腹部,血室(子宫及冲任脉系统)凝结聚结,针药就无法治疗了。
败毒散。(见《太平惠民和剂局方》)
至于妇女出现血风烦闷的症状,是由于脏腑劳损受伤,气血虚弱而风邪乘虚侵入,与血相搏,导致气机不畅而痞塞涩滞,从而产生瘀热。或者肢体关节烦痛,口干少卧,都是因为虚弱而导致气血壅滞,所以产生烦闷感。
治疗妇女血风虚冷,月经不调,或者立即手脚心发热,或者立即头面浮肿麻木。川乌头丸(Chuanwu Tou Wan, Aconite Root Pill)。
川乌头(一斤,选用优质清油四两混合,放入铫子内用炭火炒制,不停地搅拌。等到裂开的药材颜色像桑根皮那样为止,随即取出放在新瓦上。如果不裂开的不要使用,裂开的则去皮、尖、脐)五灵脂(去除土石杂质,拣选干净,四两,生用)
将上述药材研成细末,再放入臼中或乳钵内研磨均匀,然后将蒸饼用水浸泡后,沥去水分,渐渐加入臼中与药粉一起杵捣,直到能做成丸子为止,制成如梧桐子大小的丸剂。空腹时,用温酒或盐汤送服二十丸。忌食动风之物。丈夫的风疾也能治疗。
治疗妇人气血不和,心胸烦闷,不想饮食,四肢无力,头目昏眩,身体疼痛。赤芍药散(Chishao Yao San, Red Peony Powder)。
It is stated that women suffering from aversion to cold may present either as a Yang syndrome or a Yin syndrome. Those who are feverish and have an aversion to cold originate from Yang; those who are not feverish but only have an aversion to cold originate from Yin. Cases originating from Yang should be treated by releasing the exterior (Jie Biao), and the pulse will necessarily be floating and rapid (Fu Shu); cases originating from Yin should be treated by warming the interior (Wen Li), and the pulse will necessarily be deep and fine (Chen Xi). There are also instances of aversion to cold after sweating, after purgation/diarrhea, and specifically aversion to cold in the back. The treatments for these conditions are recorded in "Bai Wen" (Hundred Questions), so they are not cited here at length. I once treated a woman who suffered solely from aversion to cold without any other symptoms, and her six pulses were calm. I used Baidu San (Decoction for Overcoming Toxicity) and she recovered. This is because this medicine can expel wind-pathogens from the exterior. The Classics state: Patients with aversion to cold must not be excessively covered with clothes and blankets nor brought near fire sources. If cold and heat contend with each other, the pulse channels become deep and hidden, causing the patient's coldness to become unbearable. One should simply remove the covers and fire sources, and simultaneously administer medicines that harmonize the exterior; naturally, the aversion to cold will cease. Women with aversion to cold must especially avoid proximity to fire. If cold qi enters the abdomen and condenses in the Blood Chamber (Xue Shi, referring to the uterus and Chong-Ren vessels), neither acupuncture nor medication can treat it.
Baidu San (See "Tai Ping Hui Min He Ji Ju Fang").
Regarding women suffering from blood-wind and vexation/oppresion, this arises from exhaustion and injury to the Zang-Fu organs, where deficiency of Qi and Blood allows Wind-Pathogen to invade. It contends with the Blood, causing Qi mechanism to stagnate and become obstructed, thereby generating Stasis-Heat. Symptoms may include vexing pain in the limbs and joints, dry mouth, and reduced sleep, all due to weakness leading to stagnation of Qi and Blood, thus causing vexation and oppression.
To treat women's blood-wind and deficiency-cold, irregular menstruation, sudden heat in the palms and soles, or sudden edema and numbness of the head and face, use Chuanwu Tou Wan (Aconite Root Pill).
Chuanwu Tou (Radix Aconiti Lateralis Preparata) (one jin [approx. 500g], mixed with four liang [approx. 200g] of high-quality refined sesame oil, stir-fried over charcoal fire in a ding vessel, stirring constantly. When the pieces crack and turn the color of mulberry root bark, remove them immediately onto new tiles. Do not use uncracked pieces; for cracked pieces, remove skin, tip, and navel) Wulingzhi (Trogopteri Dung) (remove soil and stones, select cleanly, four liang, raw)
Grind the above into a fine powder, then further grind in a mortar or pestle until uniform. Soak steamed wheat dough in water, drain the water, and gradually add it to the mortar to pound together until pills can be formed. Shape into pills the size of paulownia seeds. Take twenty pills on an empty stomach with warm wine or salted water. Avoid foods that generate wind. Also treats wind-diseases in men.
To treat women's disharmony of Qi and Blood, chest and heart vexation, loss of appetite, weakness in the four limbs, dizziness of head and eyes, and body pain, use Chishao Yao San (Red Peony Powder).