戴氏曰∶赤白带下,皆因七情内伤,或下元虚冷,感非一端(元礼为丹溪弟子,而相背如此,自是一种
翻案)。大率下白带多,间有下赤
者,并宜顺气散,吞震灵丹,仍佐艾附丸,或米饮调沙参末;带下不止成 羸者,四物汤加
牡蛎粉半钱,吞固肠丸,多服取效。有带疾愈后一二月,或再发,半年一发,先血而后下
带,来不可遏,停蓄未几,又复倾泻,此名漏带,最为难治(漏带之名始此,亦或升补可愈也)。下截之血,
少腹主之,有因血
虚而虚热陷入小肠,致小便涩痛,色如白泔,或成沙粒,皆不可作淋治,用冷剂,宜以四物
汤、五苓饮各半帖,和煎。(燥湿合煎,此元礼独创,不读此,便不知用此)
产宝云∶未出女子有三病,何也?答曰∶女子一病者,经水初下,阴中热,或当风
卧,或扇风;二病者,太冲脉盛,气盛则内热,以冷水洗之;三病者,或见带下惊怖者。若
三者,一有所受,后必有带下之证也。(方用神仙聚宝丹。)
准绳云∶带下并肠,有败脓淋漏不已,腥秽殊甚,遂至脐腹更增冷痛,此盖败脓血
所致,卒无已期。须以此排脓,用白芷一两,单叶红蜀葵根二两,白芍药、白矾烧枯各半两
空腹或饭前米饮下十丸,或十五丸,候脓尽,仍别以补药佐之。(此方白芷、葵根,排脓散血;
白芍生肌;枯矾燥湿;和以蜜蜡,此生肌托里之治也。脉经曰∶
妇人肠中有脓,为荣卫相干。血为败浊,有可下不可下之异,宜参考之)
戴元礼说:赤色和白色的带下病,都是由于七情(喜、怒、忧、思、悲、恐、惊)内伤,或者下焦元气虚冷所致,病因并非只有一种。(戴元礼是朱丹溪的弟子,但观点与此相反,这自是一种翻案式的论述)。大体上白色带下较多,间或有红色带下的,都适宜服用顺气散,吞服震灵丹,同时辅以艾附暖宫丸,或者用米汤调服沙参末;如果带下病不止导致身体消瘦羸弱,可用四物汤加入半钱牡蛎粉,吞服固肠丸,多服用以取得疗效。有的带下病痊愈后一两个月,或者半年发作一次,先出血而后流出带下,来势汹涌不可遏制,停蓄不久,又再次倾泻而出,这名叫漏带,最为难治(“漏带”这一名称始于此,但也可能通过升提补益的方法治愈)。对于下部的出血,由少腹部主治,有的因为血虚导致虚热陷入小肠,致使小便涩痛,颜色像淘米水一样,或者形成沙粒状,这些都不可以当作淋证治疗,使用寒凉药物,适宜用四物汤和五苓饮各取一半剂量,混合煎煮。(这种燥湿药合煎的方法,是戴元礼独创的,不读这段文字,就不知道这样用药。)
《产宝》说:未出嫁的女子有三种病,是什么?回答说:第一种病,月经初来潮时,阴中发热,或者在风中躺卧,或者扇风受凉;第二种病,太冲脉旺盛,气盛则体内生热,用冷水清洗外阴;第三种病,或者见到带下病而惊恐害怕。如果这三种情况,只要有一种受到致病因素侵袭,后来必然会出现带下病的症状。(方剂用神仙聚宝丹。)
《准绳》说:带下病夹杂脓血,有败脓淋漓不尽,腥臭气味非常严重,以至于脐腹部更加增加冷痛,这大概是败脓血所致,短时间内没有停止的期限。必须用此方排脓,用白芷一两,单叶红蜀葵根二两,白芍药、烧枯的白矾各半两,空腹或饭前用米汤送服十丸,或者十五丸,等到脓液排尽后,再另外用补益药物辅助治疗。(此方中白芷、葵根能排脓散血;白芍能生肌;枯矾能燥湿;配合蜜蜡,这是生肌托里的治疗方法。《脉经》说:妇人肠中有脓,是因为营卫相互干扰。血液成为败浊之物,有可下与不可下的区别,应当参考研究。)
Dai Yuanli stated: Both red and white leukorrhea are caused by internal injury from the seven emotions (joy, anger, worry, thought, sadness, fear, fright) or deficiency-cold of the lower jiao (lower burner). The etiology is not singular. Generally, white discharge is more common, with occasional red discharge. For both, Shunqi San (Qi-Smoothing Powder) should be taken, along with swallowing Zhenling Dan (Vibrating Spirit Pill), assisted by Aifu Wan (Mugwort and Cinnamon Twig Pill), or taking Sand Shen Mo (Ginseng Radicle Powder) mixed with rice water. If leukorrhea persists leading to emaciation, Siwu Tang (Four Substances Decoction) added with Ban Qian of Muli Fen (Oyster Shell Powder) should be used, swallowing Guchang Wan (Intestine-Securing Pill); prolonged administration yields efficacy. In cases where leukorrhea recurs one or two months after recovery, or once every half year, presenting first with blood followed by discharge, coming uncontrollably and then stopping briefly before pouring out again, this is named Loudai (Leaking Leukorrhea), which is most difficult to treat (The name "Loudai" originates here; it may also be curable through lifting and tonifying methods). Lower bleeding is governed by the Shaofu (Lower Abdomen). Some cases involve deficiency-heat sinking into the Xiaochang (Small Intestine) due to blood deficiency, causing dysuria with pain, urine resembling rice washings, or forming sand-like particles. These must not be treated as Lin syndrome (Dysuria) using cold-natured agents. Instead, Siwu Tang (Four Substances Decoction) and Wuling Yin (Five Ling Drink) should be combined in equal halves and decocted together. (This method of decocting drying-dampness herbs together was uniquely created by Dai Yuanli; without reading this, one would not know to use this approach.)
*Chanbao* (Treasures for Childbirth) states: There are three diseases affecting unmarried women. What are they? The answer is: The first disease occurs when menstruation first begins, heat arises in the yin region, lying exposed to wind, or fanning oneself; the second disease involves a flourishing Taichong Mai (Great冲 Vessel), where excess qi generates internal heat, washed with cold water; the third disease involves being frightened by the sight of leukorrhea. If any of these three conditions are contracted, leukorrhea symptoms will inevitably follow later. (The formula used is Shenxian Jubao Dan (Immortal's Treasure-Gathering Pill).)
*Zhunsuo* (Standard Mirror) states: Leukorrhea mixed with intestinal contents presents with persistent leakage of foul pus, extremely offensive odor, leading to increased cold pain in the umbilical and abdominal regions. This is caused by foul pus and blood, with no imminent end. One must use this formula to drain pus: Bai Zhi (Angelicae Dahuricae Radix) 1 liang, Danye Hong Shukui Gen (Root of Malva Verticillata) 2 liang, Bai Shao Yao (Paeoniae Radix Alba) and Bie Jian Bai Fan (Burnt Alum) calcined until dry, each 0.5 liang. Take 10 or 15 pills on an empty stomach or before meals with rice water. Wait until the pus is exhausted, then assist with tonic medicines. (In this formula, Bai Zhi and Shukui Gen drain pus and disperse blood; Bai Shao generates flesh; dried alum dries dampness; combined with beeswax, this constitutes a treatment for generating flesh and supporting the interior. *Maijing* states: Pus in the intestines of women results from conflict between Ying and Wei (Nutritive and Defensive Qi). Blood becomes turbid waste; there are distinctions between what can be purged and what cannot; reference should be made to this.)