竹泉生曰∶带之为病,初无大苦,驯其极大害经水,且至有害于精与血,前论详矣。顾世人习见其目前不为大苦,
恒易之,及其积久,伤损冲任而阻碍经水。既及精血而脏腑大困,然后谋为补救之方,不已迟哉,故列治带之条目,为
女科第二义。
妇人病带,十常八九,带色之白,十中亦居八九焉,何也?湿伤气,固其正色也。病此者,胃虽强而能食,脾必不
运,而肝木亦先期疏泄之职司也。肥胖者,用傅氏完带汤,或以六君子汤加味治之。
傅氏完带汤
制白术 炙党参 制苍术 陈皮 黑芥穗 炒山药 酒白芍 车前子 甘草 柴胡
加味六君子汤
炙党参 茯苓 陈皮 制茆术 贯众炭 淡吴萸 制白术 生草 半夏 大木通 黑姜炭 泽泻
瘦弱之妇,肾虚火旺,亦有患白带者,治之不可太燥。
焦冬术 炒白芍 绵茵陈 阿胶珠 贯众炭 石苇 炒淮药 黑栀子 白茯苓 木耳炭 车前子
(〔批〕前条乃不足之证,而未不可遽补。此条则有余之候,而又不可竟泻之也。临证者总宜细心体会。)
更有壮年之妇,饮食照常,两便如故,而患白带者,是则由于水不能尽化为经,乃溢而为湿也。治之之道,勿泄有
余之肾水,但补不足之命火,交其心肾,使化为有用之精血也,是为得之。
益智仁 远志肉 黑姜 贯众炭 丹皮 补骨脂 炒当归 艾叶 车前子 泽泻
(或与桂附八味丸亦可)
竹泉生说:带下病,起初并没有太大的痛苦,但会逐渐严重地损伤经血,甚至危害精与血,前面的论述已经很详细了。然而世人因为常见此病在眼前并不造成大苦,常常轻视它,等到日久积累,损伤冲任二脉并阻碍经血运行,进而波及精血导致脏腑功能严重困顿,这时才谋求补救的方法,不是太晚了吗?所以列出治疗带下的条目,作为妇科的第二要务。
妇女患带下病,十有八九,其中白带又占其中的八九成,为什么呢?湿邪伤气,这是它的本色。患这种病的人,胃虽然强盛能进食,但脾必定不能运化,而且肝木疏泄的功能也先期失常。对于肥胖的患者,使用傅氏完带汤,或者用加味六君子汤治疗。
傅氏完带汤
制白术 炙党参 制苍术 陈皮 黑芥穗 炒山药 酒白芍 车前子 甘草 柴胡
加味六君子汤
炙党参 茯苓 陈皮 制苍术 贯众炭 淡吴茱萸 制白术 生甘草 半夏 木通 黑姜炭 泽泻
瘦弱的妇女,若肾虚火旺,也有患白带的,治疗时不可过于燥烈。
焦白术 炒白芍 绵茵陈 阿胶珠 贯众炭 石苇 炒淮山药 黑栀子 白茯苓 木耳炭 车前子
(批注:前一条属于不足之证,但不可急于进补。这一条则属于有余之候,但又不可直接攻泻。临证医生总应细心体会。)
更有壮年妇女,饮食如常,大小便正常,却患白带,这是由于水液不能完全化为经血,于是溢出成为湿邪所致。治疗的方法,不要泄去有余的肾水,只需补益不足的命门之火,使心肾相交,将水液化为有用的精血,这才是得当的。
益智仁 远志肉 黑姜 贯众炭 丹皮 补骨脂 炒当归 艾叶 车前子 泽泻
(或者也可以服用桂附八味丸)
Zhuquansheng stated: Dai disease (leukorrhea) initially causes no significant distress, but gradually it severely damages the menstrual blood and even harms the essence and blood, as detailed in previous discussions. However, since people are accustomed to seeing this condition without major suffering at present, they often underestimate it. Only after accumulation over time does it damage the Chong and Ren vessels (Penetrating and Conception Vessels), obstructing menstruation, and subsequently affecting essence and blood, causing great distress to the zang-fu organs. At that point, seeking remedial measures is already too late. Therefore, I list the items for treating Dai disease as the second priority in gynecology.
Women suffer from Dai disease in eight or nine out of ten cases; among these, white leukorrhea accounts for eight or nine out of ten. Why? Because dampness injures qi, which corresponds to its characteristic color. Those afflicted with this condition may have a strong stomach capable of eating, but the spleen fails to transform and transport, and the liver's function of coursing and discharging is also prematurely impaired. For obese patients, use Fu's Wanda Decoction (Complete Dai Decoction by Master Fu) or modified Liujunzi Decoction (Six Gentlemen Decoction).
Fu's Wanda Decoction
Processed Atractylodis Macrocephalae Rhizoma (Zhi Baizhu), Honey-fried Codonopsis Radix (Zhi Dangshen), Processed Atractylodis Rhizoma (Zhi Cangzhu), Exocarpium Citri Reticulatae (Chenpi), Charred Schizonepetae Spica (Hei Jiesui), Stir-fried Dioscoreae Rhizoma (Chao Shanyao), Wine-processed Paeoniae Radix Alba (Jiu Baishao), Semen Plantaginis (Cheqianzi), Licorice Root (Gancao), Bupleuri Radix (Chaihu)
Modified Liujunzi Decoction
Honey-fried Codonopsis Radix (Zhi Dangshen), Poria (Fuling), Exocarpium Citri Reticulatae (Chenpi), Processed Atractylodis Rhizoma (Zhi Cangzhu), Charred Cibotii Rhizoma (Guanzhong Tan), Light Evodiae Fructus (Dan Wuzhu), Processed Atractylodis Macrocephalae Rhizoma (Zhi Baizhu), Raw Licorice Root (Sheng Cao), Pinelliae Tuber (Banxia), Akebiae Caulis (Damutong), Charred Zingiberis Rhizoma Scorch (Hei Jiangtan), Alismatis Rhizoma (Zexie)
For thin women with kidney deficiency and hyperactive fire, who also suffer from white leukorrhea, treatment should not be overly drying.
Charred Atractylodis Macrocephalae Rhizoma (Jiao Baizhu), Stir-fried Paeoniae Radix Alba (Chao Baishao), Herba Epimedii (Mian Yinchén - *Note: Context suggests Yinchen Hao Artemisiae Scopariae Herba, but text says Mian Yinchén*), Fritillariae Thunbergii Bulb beads (Ejiao Zhu), Charred Cibotii Rhizoma (Guanzhong Tan), Hierachae Herba (Shiwei), Stir-fried Dioscoreae Rhizoma (Chao Huaiyao), Charred Gardeniae Fructus (Hei Zhizi), White Poria (Bai Fuling), Charred Auricularia Auricula-Judae (Mu'er Tan), Semen Plantaginis (Cheqianzi)
(Preface comment: The preceding case belongs to a deficiency syndrome, yet one should not rush to tonify. This case presents an excess pattern, yet one should not directly purge. Clinicians must carefully contemplate these nuances.)
Furthermore, there are women in their prime whose diet remains normal and bowel/bladder functions are unchanged, yet they suffer from white leukorrhea. This arises because fluids cannot be fully transformed into menstrual blood, thus overflowing to become dampness. The method of treatment is not to drain the excessive kidney water, but rather to tonify the insufficient Mingmen Fire (Gate of Life fire), facilitating the interaction between the heart and kidney, thereby transforming fluids into useful essence and blood. This is the correct approach.
Seed of Yizhiren (Yizhiren), Flesh of Yuanzhi (Yuanzhi Rou), Charred Ginger (Hei Jiang), Charred Cibotii Rhizoma (Guanzhong Tan), Cortex Moutan (Danpi), Psoraleae Fructus (Buguzhi), Stir-fried Angelicae Sinensis Radix (Chao Danggui), Folium Artemisiae Argyi (Aiye), Semen Plantaginis (Cheqianzi), Alismatis Rhizoma (Zexie)
(Alternatively, Guifu Bawei Wan [Cinnamon Twig and Aconite Pill of Eight Ingredients] may also be used.)