多清浅淡虚不摄,稠粘深红热有余,兼带时下湿热秽,形清腥秽冷湿虚。
【注】经水过多,清稀浅红,乃气虚不能摄血也。若稠粘深红,则为热盛有余。或经
之前后兼赤白带,而时下臭秽,乃湿热腐化也。若形清腥秽,乃湿瘀寒虚所化也。
四君子汤 异功散 六君子汤 香砂六君汤 七味白术散 参苓白术散 归脾汤 逍遥散
八珍汤 十全大补汤 双和饮 养荣汤 理中汤
补养元气四君子,参苓术草枣生姜。异功陈兼理气。虚痰橘半六君汤。呕吐香砂六君子。
渴泻七味藿葛香。脾泻参苓白术散,薏桔山莲砂扁方。思虑伤脾损心血,归脾归 枣远香。减参加
柴归芍薄,逍遥调肝理脾方。合物八珍兼补血。 桂十全大补汤,去参苓术双和饮。去芎加陈养
荣汤。脾胃虚寒吐且泻,理中减苓加干姜。
【注】四君子汤,补养元气虚弱通用之方,即人参、茯苓、白术、炙草,引用枣姜也。异
功散是于补气中兼理其气,即四君子汤加陈皮也。六君子汤治脾虚痰饮,即四君子汤加
橘红、半夏也。香砂六君子汤治胃虚呕吐,即六君子汤加藿香、砂仁也。七味白术散治脾
虚渴泻,即四君子汤加藿香、葛根,木香也。参苓白术散治脾胃虚泻,即四君子汤加薏苡、
桔梗、山药、莲肉、砂仁、扁豆也。归脾汤治思虑损伤心脾气血,即四君子加当归、黄
、枣仁、远志、木香也。逍遥散调肝理脾,即四君子汤减人参,加柴胡、当归、白芍、薄
荷也。八珍汤于补气中兼补其血,即四君子汤合四物汤也。十全大补汤大补气血,即八
珍汤加黄 、肉桂也。双和饮平补气血,即十全大补汤减人参、茯苓、白术也。人参养
荣汤于补气中专养荣血,即十全大补汤减川芎加陈皮也。理中汤治脾胃虚寒吐泻,即四
君子汤去茯苓加干姜也。
四物汤 桂枝四物汤 麻黄四物汤 柴胡四物汤 玉烛散
妇人血病主四物,归芎白芍熟地黄。血瘀改以赤芍药,血热易用生地黄。表热有汗合桂草,表热
无汗合麻黄,少阳寒热小柴并,阳明热合调胃汤。
【注】四物汤,乃妇人经产一切血病通用之方,故主之也。其方即当归、川芎、白芍
药、熟地黄。凡血瘀,俱减白芍药,改用赤芍药破之;血热,俱去熟地黄,易用生地黄
凉之。风感太阳卫分,发热有汗,本方合桂枝汤,以桂枝甘草解之,名桂枝四物汤。寒
伤太阳荣分,发热无汗,本方合麻黄汤,以麻黄、杏仁、桂枝、甘草发之,名麻黄四物
汤。邪传少阳半表半里,往来寒热,本方合小柴胡汤,以柴胡、黄芩、半夏、人参、甘
草和之,名柴胡四物汤,邪传阳明,里热便结,本方合调胃承气汤,以大黄、朴硝、甘
草下之,名玉烛散。
经血颜色清稀、色浅淡,多因气虚不能固摄血液所致;经血质地稠粘、颜色深红,多为热邪亢盛有余。若经期前后兼见白带,且当下分泌物臭秽,属于湿热腐化所致;若经血形态清稀且有腥臭味,则是由湿瘀、寒邪及气虚所化生。
【注】经血量过多,若经血色清稀、呈浅红色,这是气虚不能统摄血液的表现。如果经血稠粘且颜色深红,则是热邪炽盛有余。或者在月经来潮之前或之后,兼见赤白带的白带,且当下排出物气味臭秽,这是湿热腐败转化的结果。如果经血形态清稀且有腥臭味,这是由湿邪、瘀血、寒邪和气虚共同化生的。
四君子汤 异功散 六君子汤 香砂六君子汤 七味白术散 参苓白术散 归脾汤 逍遥散 八珍汤 十全大补汤 双和饮 养荣汤 理中汤
补养元气用四君子汤,由人参、茯苓、白术、甘草、大枣、生姜组成。异功散是在此基础上兼以调理气机,即四君子汤加陈皮。治疗虚证痰饮用六君子汤,即四君子汤加橘红、半夏。治疗呕吐用香砂六君子汤,即六君子汤加藿香、砂仁。治疗口渴腹泻用七味白术散,即加入藿香、葛根、木香。治疗脾虚腹泻用参苓白术散,方中包含薏苡仁、桔梗、山药、莲子肉、砂仁、扁豆。思虑过度损伤脾气并耗损心血,可用归脾汤,方中含当归、黄芪、枣仁、远志、木香。若在逍遥散中减去人参,加入柴胡、当归、白芍、薄荷,即为逍遥散,是调和肝脏、理顺脾胃的方剂。将本方与四物汤合用为八珍汤,兼能补血。十全大补汤即在八珍汤基础上加黄芪、肉桂。双和饮即十全大补汤减去人参、茯苓、白术。人参养荣汤即十全大补汤减去川芎,加入陈皮。治疗脾胃虚寒引起的呕吐和腹泻,用理中汤,即四君子汤去掉茯苓,加入干姜。
【注】四君子汤是补养元气虚弱通用的方剂,由人参、茯苓、白术、炙甘草组成,煎服时引用大枣、生姜。异功散是在补气的基础上兼以理气,即四君子汤加陈皮。六君子汤治疗脾虚导致的痰饮,即四君子汤加橘红、半夏。香砂六君子汤治疗胃虚引起的呕吐,即六君子汤加藿香、砂仁。七味白术散治疗脾虚引起的口渴和腹泻,即四君子汤加藿香、葛根、木香。参苓白术散治疗脾胃虚弱引起的腹泻,即四君子汤加薏苡仁、桔梗、山药、莲子肉、砂仁、扁豆。归脾汤治疗因思虑过度损伤心脾气血,即四君子汤加当归、黄芪、酸枣仁、远志、木香。逍遥散调理肝脏、理顺脾胃,即四君子汤减去人参,加入柴胡、当归、白芍、薄荷。八珍汤在补气的基础上兼以补血,即四君子汤合四物汤。十全大补汤大补气血,即八珍汤加黄芪、肉桂。双和饮平和地补益气血,即十全大补汤减去人参、茯苓、白术。人参养荣汤在补气中专门滋养营血,即十全大补汤减去川芎,加入陈皮。理中汤治疗脾胃虚寒引起的呕吐和腹泻,即四君子汤去掉茯苓,加入干姜。
妇女的血病主要使用四物汤,由当归、川芎、白芍药、熟地黄组成。若有血瘀,改为使用赤芍药;若有血热,容易改用生地黄。若表热伴有汗出,合用桂枝汤(桂枝、甘草);若表热无汗,合用麻黄汤;若少阳证寒热往来,合用小柴胡汤;若阳明热结,合用调胃承气汤。
【注】四物汤是妇女经期和产后各种血病的通用方剂,所以作为主方。其方剂组成即当归、川芎、白芍药、熟地黄。凡是血瘀的情况,都减去白芍药,改用赤芍药以破血;凡是血热的情况,都去掉熟地黄,改用生地黄以凉血。风邪侵袭太阳卫分,出现发热有汗的症状,本方合用桂枝汤,以桂枝、甘草解表,名为桂枝四物汤。寒邪损伤太阳营分,出现发热无汗的症状,本方合用麻黄汤,以麻黄、杏仁、桂枝、甘草发汗解表,名为麻黄四物汤。邪气传入少阳半表半里之间,出现往来寒热,本方合用小柴胡汤,以柴胡、黄芩、半夏、人参、甘草和解少阳,名为柴胡四物汤。邪气传入阳明,里热导致大便干结,本方合用调胃承气汤,以大黄、朴硝、甘草泻下,名为玉烛散。
Excessive menstrual flow with clear, thin, and pale blood indicates Qi deficiency failing to control the blood. Thick, sticky, and deep-red blood suggests excess heat. Accompanied by leukorrhea during menstruation with a foul odor, it indicates damp-heat decomposition. Clear blood with a fishy smell is transformed from dampness, stasis, cold, and deficiency.
[Note] Excessive menstrual flow with clear, thin, and pale-red blood is due to Qi deficiency failing to hold the blood. If the blood is thick, sticky, and deep-red, it signifies excessive heat. If accompanied by red and white leukorrhea before or after menstruation, with a foul-smelling discharge at present, it is caused by the transformation of damp-heat rotting. If the menstrual blood is clear in form and has a fishy odor, it is generated by dampness, blood stasis, cold, and deficiency.
Si Jun Zi Tang (Four Gentlemen Decoction), Yi Gong San (Yi Gong Powder), Liu Jun Zi Tang (Six Gentlemen Decoction), Xiang Sha Liu Jun Zi Tang (Aucklandia and Amomum Six Gentlemen Decoction), Qi Wei Bai Zhu San (Seven-Ingredient Atractylodes Macrocephala Powder), Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), Gui Pi Tang (Restore the Spleen Decoction), Xiao Yao San (Free and Easy Wanderer Powder), Ba Zhen Tang (Eight Treasures Decoction), Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction), Shuang He Yin (Double Harmony Drink), Yang Rong Tang (Nourish Ying Decoction), Li Zhong Tang (Regulate the Middle Decoction).
To tonify and nourish Yuan Qi (Primal Qi), use Si Jun Zi Tang, composed of Ren Shen (Ginseng Radix), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Gan Cao (Licorice Root), Da Zao (Jujube Fruit), and Sheng Jiang (Zingiberis Rhizoma Recens). Yi Gong San regulates Qi while tonifying, which is Si Jun Zi Tang plus Chen Pi (Citri Reticulatae Pericarpium). Liu Jun Zi Tang treats Spleen deficiency with phlegm-fluid retention, which is Si Jun Zi Tang plus Ju Hong (Citri Reticulatae Pericarpium Rubrum) and Ban Xia (Pinelliae Rhizoma). Xiang Sha Liu Jun Zi Tang treats Stomach deficiency with vomiting, which is Liu Jun Zi Tang plus Huo Xiang (Pogostemonis Herba) and Sha Ren (Amomi Fructus). Qi Wei Bai Zhu San treats thirst and diarrhea due to Spleen deficiency, adding Huo Xiang, Ge Gen (Puerariae Lobatae Radix), and Mu Xiang (Aucklandiae Radix). Shen Ling Bai Zhu San treats Spleen-Stomach deficiency diarrhea, containing Yi Yi Ren (Coicis Semen), Jie Geng (Platycodonis Radix), Shan Yao (Dioscoreae Rhizoma), Lian Zi Rou (Nelumbinis Semen), Sha Ren, and Bian Dou (Dolichoris Lablab Semen). Overthinking damages Spleen Qi and depletes Heart Blood; Gui Pi Tang can be used, containing Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Suan Zao Ren (Ziziphi Spinosae Semen), Yuan Zhi (Polygalae Radix), and Mu Xiang. Removing Ren Shen from Xiao Yao San and adding Chai Hu (Bupleuri Radix), Dang Gui, Bai Shao (Paeoniae Radix Alba), and Bo He (Menthae Haplocalycis Herba) constitutes Xiao Yao San, a formula for harmonizing the Liver and regulating the Spleen. Combining this with Si Wu Tang (Four Substances Decoction) creates Ba Zhen Tang, which also tonifies Blood. Shi Quan Da Bu Tang greatly tonifies Qi and Blood, which is Ba Zhen Tang plus Huang Qi and Rou Gui (Cinnamomi Cortex). Shuang He Yin mildly tonifies Qi and Blood, which is Shi Quan Da Bu Tang minus Ren Shen, Fu Ling, and Bai Zhu. Ren Shen Yang Rong Tang specifically nourishes Ying Blood while tonifying Qi, which is Shi Quan Da Bu Tang minus Chuan Xiong (Ligustici Chuanxiong Rhizoma) plus Chen Pi. Li Zhong Tang treats vomiting and diarrhea due to Spleen-Stomach deficiency-cold, which is Si Jun Zi Tang minus Fu Ling plus Gan Jiang (Zingiberis Rhizoma).
[Note] Si Jun Zi Tang is a general formula for tonifying deficient Yuan Qi, consisting of Ren Shen, Fu Ling, Bai Zhu, and Zhi Gan Cao (Prepared Licorice Root), decocted with Da Zao and Sheng Jiang. Yi Gong San regulates Qi within the context of tonification, which is Si Jun Zi Tang plus Chen Pi. Liu Jun Zi Tang treats Spleen deficiency with phlegm-fluids, which is Si Jun Zi Tang plus Ju Hong and Ban Xia. Xiang Sha Liu Jun Zi Tang treats Stomach deficiency with vomiting, which is Liu Jun Zi Tang plus Huo Xiang and Sha Ren. Qi Wei Bai Zhu San treats Spleen deficiency with thirst and diarrhea, which is Si Jun Zi Tang plus Huo Xiang, Ge Gen, and Mu Xiang. Shen Ling Bai Zhu San treats Spleen-Stomach deficiency diarrhea, which is Si Jun Zi Tang plus Yi Yi Ren, Jie Geng, Shan Yao, Lian Zi Rou, Sha Ren, and Bian Dou. Gui Pi Tang treats damage to Heart and Spleen Qi and Blood due to overthinking, which is Si Jun Zi Tang plus Dang Gui, Huang Qi, Suan Zao Ren, Yuan Zhi, and Mu Xiang. Xiao Yao San regulates the Liver and Spleen, which is Si Jun Zi Tang minus Ren Shen, plus Chai Hu, Dang Gui, Bai Shao, and Bo He. Ba Zhen Tang tonifies Blood while tonifying Qi, which is Si Jun Zi Tang combined with Si Wu Tang. Shi Quan Da Bu Tang greatly tonifies Qi and Blood, which is Ba Zhen Tang plus Huang Qi and Rou Gui. Shuang He Yin gently tonifies Qi and Blood, which is Shi Quan Da Bu Tang minus Ren Shen, Fu Ling, and Bai Zhu. Ren Shen Yang Rong Tang focuses on nourishing Ying Blood while tonifying Qi, which is Shi Quan Da Bu Tang minus Chuan Xiong plus Chen Pi. Li Zhong Tang treats vomiting and diarrhea due to Spleen-Stomach deficiency-cold, which is Si Jun Zi Tang minus Fu Ling plus Gan Jiang.
Si Wu Tang (Four Substances Decoction), Gui Zhi Si Wu Tang (Cinnamon Twig Four Substances Decoction), Ma Huang Si Wu Tang (Ephedra Four Substances Decoction), Chai Hu Si Wu Tang (Bupleurum Four Substances Decoction), Yu Zhu San (Jade Candle Powder).
For women's blood diseases, Si Wu Tang is primarily used, composed of Dang Gui, Chuan Xiong, Bai Shao Yao (Paeoniae Radix Alba), and Shu Di Huang (Rehmanniae Radix Praeparata). For blood stasis, change to Chi Shao Yao (Paeoniae Radix Rubra); for blood heat, easily switch to Sheng Di Huang (Rehmanniae Radix). For exterior heat with sweating, combine with Gui Zhi Tang (Cinnamon Twig Decoction); for exterior heat without sweating, combine with Ma Huang Tang (Ephedra Decoction); for Shaoyang alternating chills and fever, combine with Xiao Chai Hu Tang (Minor Bupleurum Decoction); for Yangming heat with constipation, combine with Tiao Wei Cheng Qi Tang (Regulate the Stomach and Direct Downward Decoction).
[Note] Si Wu Tang is a general formula for all blood diseases related to menstruation and childbirth in women, hence it serves as the principal formula. The prescription consists of Dang Gui, Chuan Xiong, Bai Shao Yao, and Shu Di Huang. In cases of blood stasis, reduce Bai Shao Yao and replace it with Chi Shao Yao to break the stasis; in cases of blood heat, remove Shu Di Huang and replace it with Sheng Di Huang to cool the blood. When wind invades the Taiyang Wei (Defensive) level, presenting with fever and sweating, combine this formula with Gui Zhi Tang, using Gui Zhi and Gan Cao to resolve the exterior, named Gui Zhi Si Wu Tang. When cold injures the Taiyang Ying (Nutritive) level, presenting with fever and no sweating, combine this formula with Ma Huang Tang, using Ma Huang, Xing Ren (Armeniacae Semen Amarum), Gui Zhi, and Gan Cao to induce sweating, named Ma Huang Si Wu Tang. When pathogenic factors transmit to the Shaoyang half-exterior half-interior level, presenting with alternating chills and fever, combine this formula with Xiao Chai Hu Tang, using Chai Hu, Huang Qin (Scutellariae Radix), Ban Xia, Ren Shen, and Gan Cao to harmonize, named Chai Hu Si Wu Tang. When pathogenic factors transmit to the Yangming level, with interior heat and constipation, combine this formula with Tiao Wei Cheng Qi Tang, using Da Huang (Rhei Radix et Rhizoma), Po Xiao (Natrii Sulfas), and Gan Cao to purge downward, named Yu Zhu San.