痒证不一。疥痨作痒。当求之本门。疮疥证。血虚皮肤燥痒者。宜四物汤。加防风七钱
半。如
以四物汤半帖。水二盏。调消风散一钱重亦可。妇人血气或通身痒。或头面痒如虫行皮中。
缘月水来时。为风所吹。不然
则是产蓐中。食动风物致之。亦宜如前四物汤调消风散。有脾虚身痒。本无疥痨。素非产蓐。洁然一身。痒
不可住。此仍脾虚所因。经云。诸痛为实。诸痒为虚。又云。
脾
主身之肌肉。宜实脾为先。四兽饮。去草加藿香浓朴川芎当归各半钱重姜枣煎服。名增损资
胃饮。
妇人每月经水应期而下。不使有余。犹太阴之缺也。其有或先或后。或少或多。或欲来
先病
或遇来而断续。皆谓之不调。和气饮加香附子半钱。兼咽独附丸。经事来而腹痛者。经事
不来而腹亦痛者。皆血之不调故也。欲调其血。先调其气。四物汤加吴茱萸半钱。香附子一
钱。
和气饮加茱萸半钱。亦可用。痛甚者。玄胡索汤。然又恐感外邪。伤饮食致痛。痛不因血。
尤宜详审。和气饮却能兼治。
有经事不通。血入四肢化为水。遂成肿满。非独产后为然。名曰血分。误作水治。其害
不少。
宜调经散。因冷而节。因节而痛。宜大温经汤。冷甚者。去麦门冬。有因惊气上逆。致月经
不
通。涎多神昏。昏则不知人。或妄言歌笑。似心风。似五痫。醒时又似正人。或病来身如摇
动。手足如搐搦。四七汤大温经汤各半帖。和匀服。有经候失期。或过二三月。变生诸证者
和气饮须用桂枝者。性最动血。和气饮加苏木红花干漆各半钱。桃仁一钱。或醋或酒煎去
渣。入麝香少许。仍以醋汤调黑神散。因血节而腹内有块者。四物汤去地黄。加官桂白术各
半钱。
因经候不调。血不循故道。从后粪出。腹或疼或不疼。不可作寻常便血治。宜顺其经四
物汤去地黄。加阿胶香附子各一钱。仍以黑神散和调气散。白汤点服。
瘙痒的证候有多种。疥疮和痨病引起的瘙痒，应当在本门（皮肤科/外科）中寻求治疗。对于疮疥证，因血虚导致皮肤干燥瘙痒者，适宜使用四物汤。加入防风七钱半。如果用四物汤的一半剂量，加水两盏，调和消风散一钱重也可以。妇女因血气失调，或全身瘙痒，或头面部瘙痒如虫行于皮中，这是因为月经来潮时受风吹所致，否则就是因为在产褥期间食用了动风的食物导致的。也适宜像前面那样用四物汤调和消风散服用。有脾虚引起的身体瘙痒，原本没有疥疮痨病，平时也没有经历产褥期，全身洁净却瘙痒难忍。这仍然是由脾虚引起的。经书说：各种疼痛属于实证，各种瘙痒属于虚证。又说：脾主管身体的肌肉。适宜以补益脾气为先。使用四兽饮，去掉甘草，加入藿香、厚朴、川芎、当归各半钱重，加生姜、大枣煎服，名为增损资胃饮。
妇女每月的月经按时而下，不留有余血，就像月亮有盈亏一样。如果有提前或推后，量少或多，或者将要来潮前就生病，或者正在来潮时断断续续，都称为月经不调。使用和气饮，加入香附子半钱，同时服用独附丸。月经来潮时腹痛的，月经不来而腹部也痛的，都是血气不调的缘故。想要调血，先要调气。使用四物汤加入吴茱萸半钱，香附子一钱。和气饮加入吴茱萸半钱，也可以使用。疼痛严重的，使用玄胡索汤。然而又恐怕是感受外邪或饮食损伤导致的疼痛，这种疼痛并非由血引起，尤其需要详细审察。和气饮却能兼顾治疗。
有月经不通畅，血液流入四肢化为水湿，遂形成肿胀满闷。这不仅仅发生在产后，名称叫作“血分”。如果误当作水肿治疗，危害不少。适宜使用调经散。因为寒冷而导致月经周期紊乱，因为周期紊乱而导致疼痛的，适宜使用大温经汤。寒冷严重的，去掉麦门冬。有因为惊恐之气上逆，导致月经不通，痰涎多且神志昏迷，昏迷时不知人事，或者胡言乱语、唱歌大笑，看起来像心风病，又像五痫病，清醒时又像是正常人。或者发病时身体像摇晃，手足像抽搐痉挛，使用四七汤和大温经汤各一半剂量，混合均匀服用。有月经周期失准，或者超过两三个月，变生各种证候的，使用和气饮。必须使用桂枝的，桂枝性最能动血，在和气饮中加入苏木、红花、干漆各半钱，桃仁一钱，或者用醋或酒煎煮去渣，加入少许麝香。仍然用醋汤调和黑神散服用。因为血瘀导致腹内有结块的，使用四物汤去掉地黄，加入官桂、白术各半钱。因为月经不调，血液不循常道，从大便排出。腹部有时痛有时不痛，不可当作寻常的便血治疗。适宜顺其经脉，使用四物汤去掉地黄，加入阿胶、香附子各一钱。仍然用黑神散调和气散，用白开水送服。
There are various types of pruritus (itching). Pruritus caused by scabies (a skin disease) and phthisis (consumption/tuberculosis) should be treated within the specialized department for such conditions. For sores and scabies, when blood deficiency leads to dry and itchy skin, Siwu Tang (Four Substances Decoction) is indicated. Add Fangfeng (Saposhnikoviae Radix) 7.5 qian. Alternatively, using half a dose of Siwu Tang with two zhan of water, mixed with Xiaofeng San (Wind-Dispersing Powder) 1 qian is also acceptable. In women, due to disharmony of blood and qi, one may experience generalized itching or itching on the head and face resembling insects crawling under the skin. This occurs because wind strikes during menstruation, or alternatively, it is caused by consuming wind-aggravating foods during the postpartum confinement period. It is also appropriate to use Siwu Tang mixed with Xiaofeng San as described above. There is body itching due to Spleen deficiency, without prior scabies or phthisis, and without a history of childbirth or confinement. The body is clean yet unbearable in its itching. This is still due to Spleen deficiency. The Classics state: "All pain belongs to excess; all itching belongs to deficiency." It also states: "The Spleen governs the muscles of the body." Therefore, tonifying the Spleen should be the priority. Use Six Beasts Drink (Six Animals Decoction), remove Caoban (Glycyrrhizae Radix et Rhizoma), add Huoxiang (Pogostemonis Herba), Houpo (Magnoliae Officinalis Cortex), Chuanxiong (Ligusticum Chuanxiong Rhizoma), and Danggui (Angelicae Sinensis Radix), each 0.5 qian, decocted with Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus), named Zengsun Ziwei Yin (Modified Stomach-Nourishing Drink).
Women's menstrual flow arrives on schedule without leaving residual blood, analogous to the waxing and waning of the moon. If the timing is early or late, the volume is scant or excessive, or illness precedes the onset, or the flow is intermittent during menstruation, all are termed irregular menstruation. Use Heqi Yin (Harmonizing Qi Drink) with Xiangfu (Cyperi Rhizoma) 0.5 qian, taken concurrently with Dufu Wan (Single Cyperi Pill). Abdominal pain during menstruation, or abdominal pain when menstruation does not occur, are both due to blood disharmony. To regulate blood, one must first regulate qi. Use Siwu Tang with Zhuyu (Evodiae Fructus) 0.5 qian and Xiangfu 1 qian. Heqi Yin with Zhuyu 0.5 qian is also usable. For severe pain, Xuansu Tang (Corydalis Decoction) is used. However, one must fear that pain may be caused by external pathogenic factors or dietary injury rather than blood issues, requiring careful examination. Heqi Yin can treat these comprehensively.
In cases where menstruation is obstructed, blood enters the limbs and transforms into fluid-dampness, resulting in swelling and fullness. This is not exclusive to the postpartum period and is named Blood Division (Xuefen). Mistaking this for edema treatment causes significant harm. Tiaojing San (Menstruation-Regulating Powder) is indicated. When cold causes menstrual cycle irregularity, and irregularity causes pain, Da Wenjing Tang (Great Warming the Menses Decoction) is appropriate. For severe cold, remove Maidong (Ophiopogonis Radix). When fright qi rebels upward causing menstrual obstruction, accompanied by excessive phlegm-saliva and coma, where the patient loses consciousness, speaks nonsense, sings, laughs, appearing similar to Heart Wind or the Five Epilepsies, but returns to normal upon waking; or when the body shakes and limbs convulse during the attack, Sizhi Tang (Seven Emotions Decoction) and Da Wenjing Tang, each half a dose, are mixed and taken evenly. For missed periods lasting two or three months with various symptoms arising, use Heqi Yin. When Guizhi (Cinnamomi Ramulus) is essential, as its nature most readily moves blood, add Sumu (Sappan Lignum), Honghua (Carthami Flos), and Ganqi (Drynariae Rhizoma processed with lac), each 0.5 qian, and Taoren (Prunus Persica Semen) 1 qian. Decoct with vinegar or wine, strain, and add a small amount of Shexiang (Moschus). Still, mix with Heishen San (Black Divine Powder) using vinegar water. For abdominal masses due to blood stasis, use Siwu Tang removing Dihuang (Rehmanniae Radix Praeparata), adding Guigui (Cinnamomi Cortex) and Baizhu (Atractylodis Macrocephalae Rhizoma), each 0.5 qian. Due to irregular menstruation, blood fails to follow its proper channel and exits via the rectum. Abdominal pain may or may not be present. Do not treat this as ordinary hematochezia. Follow the meridian pattern, using Siwu Tang removing Dihuang, adding Ejiao (Asini Corii Colla) and Xiangfu, each 1 qian. Mix Heishen San with Tiaoqi San (Regulating Qi Powder) and take with plain boiled water.