蛇床洗法 藜芦敷法
阴挺下脱即 疝,突物如蛇或如菌。湿热肿痛溺赤数,气虚重坠便长青。气虚补中青栀入,
湿热龙胆泻肝寻。外熬蛇床乌梅洗,猪油藜芦敷自升。
【注】妇人阴挺,或因胞络伤损,或因分娩用力太过,或因气虚下陷,湿热下注,阴
中突出一物如蛇,或如菌如鸡冠者,即古之 疝类也。属热者,必肿痛小便赤数,宜龙
胆泻肝汤;属虚者,必重坠小便清长,宜补中益气汤加青皮、栀子。外用蛇床子、乌梅
熬水熏洗之,更以猪油调藜芦末敷之,无不愈者。
逍遥散(方见首卷) 龙胆泻肝汤(方见前阴肿条)
加味四物汤
蚀成疮浓水淋,时疼时痒若虫行,少腹胀闷溺赤涩,食少体倦晡热蒸,四物柴栀丹胆草;溃
腐逍遥坠补中。
【注】妇人阴疮,名曰 。由七情郁火伤损肝脾,气血凝滞,湿热下注,久而虫生。虫
蚀成疮,脓水淋漓,时疼时痒,有若虫行。少腹胀闷,尿赤频数,食少体倦,内热晡热,经
候不调,赤白带下。种种证见,宜分治之∶肿痛者,用四物汤加柴胡、栀子、龙胆草;若
溃烂出水而痛者,用加味逍遥散;若重坠者,用补中益气汤。
加味逍遥散(方见前阴痛条)
四物汤 补中益气汤(方俱见首卷)
乌头熏法
阴中突肉名阴痔,或名茄子疾俗称,黄水易治白难治,乌头存性醋熬熏;内服逍遥与龙胆,补
中归脾酌量行。
【注】妇人阴中有肉突出者,名曰阴痔,俗称茄子疾也。流黄水者易治,流白水者难
治。用乌头烧存性,酽醋熬熏。内服逍遥散、补中益气汤、归脾汤,量其虚实,酌而行之。
逍遥散 归脾汤 补中益气汤(方俱见首卷)
蛇床洗法、藜芦敷法
阴挺下脱(子宫或阴道壁脱垂)即属于“疝”的范畴,突出物形状像蛇或者像菌类。若因湿热所致,则见肿痛、小便短赤且频数;若因气虚所致,则见重坠感、大便清稀色青。气虚证应在补中益气汤中加入青皮和栀子;湿热证应选用龙胆泻肝汤治疗。外用熬煮蛇床子和乌梅的水进行熏洗,用猪油调和藜芦末外敷,即可使脱出物自行回升。
【注】妇人阴挺(子宫或阴道壁脱垂),可能是因为胞络(连接子宫的脉络)受损,可能是因为分娩时用力过度,也可能是因为气虚下陷、湿热下注,导致阴部突出一物,形状像蛇,或者像菌类、鸡冠一样,这就是古代的“疝”类疾病。属于热证的,必然伴有肿痛、小便赤涩频数,适宜用龙胆泻肝汤;属于虚证的,必然伴有重坠感、小便清长,适宜用补中益气汤加青皮、栀子。外用蛇床子、乌梅熬水熏洗,再用猪油调藜芦末外敷,没有不痊愈的。
逍遥散(方剂见首卷)、龙胆泻肝汤(方剂见前阴肿条目)
加味四物汤
阴疮溃烂成脓水淋漓,时而疼痛时而瘙痒如虫爬行,少腹胀闷、小便赤涩,食欲不振、身体疲倦、午后潮热蒸腾,可用四物汤加柴胡、栀子、丹皮、龙胆草;若已溃烂腐坏,用逍遥散;若有重坠感,用补中益气汤。
【注】妇人阴疮(外阴溃疡或炎症),名为“妒精”(原文此处可能有缺字或异体字,通常指妒精或类似名称,依文意译为阴疮)。由于七情郁结化火损伤肝脾,气血凝滞,湿热下注,日久生虫。虫蚀形成疮疡,脓水淋漓,时而疼痛时而瘙痒,感觉像虫子在爬。少腹胀闷,尿赤频数,食少体倦,内热及午后潮热,月经不调,赤白带下。各种症状出现时,应当分型治疗:肿痛者,用四物汤加柴胡、栀子、龙胆草;若溃烂出水而痛者,用加味逍遥散;若有重坠感者,用补中益气汤。
加味逍遥散(方剂见前阴痛条目)
四物汤、补中益气汤(均见首卷)
乌头熏法
阴中突肉称为阴痔,又名茄子疾(俗称),流黄水者易治,流白水者难治,用乌头存性(烧至外部焦黑内部保留药性)醋熬后熏洗;内服逍遥散与龙胆泻肝汤,或补中益气汤、归脾汤酌情使用。
【注】妇人阴中有肉突出者,名为阴痔,俗称茄子疾。流黄水的容易治疗,流白水的难以治疗。用乌头烧至存性,用浓醋熬制后熏洗。内服逍遥散、补中益气汤、归脾汤,根据虚实情况斟酌施行。
逍遥散、归脾汤、补中益气汤(均见首卷)
Snake Bed Washing Method, Veratrum Application Method
Yinting Xiaduo (uterine or vaginal wall prolapse) belongs to the category of "Shan" (hernia), with protruding masses resembling snakes or fungi. If caused by Damp-Heat, symptoms include swelling, pain, and scanty, dark, frequent urination; if caused by Qi Deficiency, symptoms include a sensation of heaviness and falling, and clear, greenish stools. For Qi Deficiency, Qingpi (Bitter Orange Peel) and Zhizi (Gardenia Fruit) should be added to Buzhong Yiqi Tang (Spleen-Raising Qi-Replenishing Decoction); for Damp-Heat, Longdan Xiegan Tang (Gentian Liver-Draining Decoction) should be selected. Externally, wash with decoction of Shechuangzi (Cnidium Fruit) and Wumei (Mume Fruit), and apply Liilu powder mixed with lard; the prolapsed tissue will naturally retract.
[Note] Yinting in women may result from damage to the Bao Luo (uterine collaterals), excessive exertion during childbirth, or sinking of Qi with downward flow of Damp-Heat, causing a mass to protrude from the vagina, resembling a snake, fungus, or cockscomb. This corresponds to the ancient concept of "Shan." Cases classified as Heat will present with swelling, pain, and dark, frequent urination, suitable for treatment with Longdan Xiegan Tang; cases classified as Deficiency will present with a heavy, falling sensation and clear, copious urine, suitable for Buzhong Yiqi Tang augmented with Qingpi and Zhizi. Externally, fumigate and wash with decoction of Shechuangzi and Wumei, then apply Liilu powder mixed with lard; recovery is assured.
Xiaoyao San (Formula see Volume 1), Longdan Xiegan Tang (Formula see section on Anterior Genital Swelling)
Modified Siwu Tang
Yinchuang (vulvar ulcer/inflammation) ulcerates with dripping pus, alternating pain and itching like insects crawling, lower abdominal distension and stuffiness, dark and difficult urination, poor appetite, physical fatigue, and steaming afternoon tidal fever. Use Siwu Tang augmented with Chaihu (Bupleurum Root), Zhizi, Danpi (Moutan Cortex), and Longdancao (Gentiana Root). If ulcerated and rotting, use Xiaoyao San; if there is a heavy, falling sensation, use Buzhong Yiqi Tang.
[Note] Yinchuang in women, also known as "Du Jing," arises from emotional stagnation transforming into Fire, damaging the Liver and Spleen, leading to Qi and Blood stasis and downward flow of Damp-Heat. Over time, parasites generate. Parasitic erosion causes ulcers with dripping pus, alternating pain and itching, feeling like insects crawling. Lower abdominal distension, dark frequent urination, poor appetite, fatigue, internal heat, afternoon tidal fever, irregular menstruation, and red-and-white leukorrhea occur. Various symptoms require differentiated treatment: for swelling and pain, use Siwu Tang augmented with Chaihu, Zhizi, and Longdancao; for ulceration with oozing and pain, use Jia Wei Xiaoyao San (Modified Free Wanderer Powder); for heavy, falling sensations, use Buzhong Yiqi Tang.
Jia Wei Xiaoyao San (Formula see section on Anterior Genital Pain)
Siwu Tang, Buzhong Yiqi Tang (Both see Volume 1)
Aconite Fumigation Method
Fleshy protrusions in the vagina are named Yin Zhi (vaginal hemorrhoids), also commonly called Qiezi Ji (Eggplant Disease). Discharge of yellow fluid is easy to treat; discharge of white fluid is difficult. Use Aconitum carmichaelii (Wutou) preserved by burning (charred externally but retaining medicinal properties), boiled in strong vinegar for fumigation. Internally, administer Xiaoyao San and Longdan Xiegan Tang, or Buzhong Yiqi Tang and Guipi Tang,酌情 (judiciously) according to deficiency or excess.
[Note] Fleshy protrusions in the vagina of women are named Yin Zhi, commonly called Qiezi Ji. Those discharging yellow fluid are easy to treat; those discharging white fluid are difficult to treat. Use Wutou burned to preserve its nature, boiled in thick vinegar for fumigation. Internally, administer Xiaoyao San, Buzhong Yiqi Tang, and Guipi Tang, adjusting based on deficiency or excess.
Xiaoyao San, Guipi Tang, Buzhong Yiqi Tang (All see Volume 1)