凡诊妇人，先问经候。妇人病热，值经水来，邪随血去，其病自愈。若邪踞半表半里，经水适来适断，
血舍空虚，热邪陷入，昼静夜剧，寒热如疟，烦渴耳聋，谵语见鬼，此为热入血室，小柴胡汤加生地黄主之。
凡经行后似疟谵语，便是热入血室。盖血为邪迫，上入肝经，肝受邪，则谵语见鬼。邪入胆经，则血结于胸，
手触之辄痛，非药所及，故当刺期门穴。屈乳头向下尽处骨间是。仲景云∶妇人中风，恶寒发热，经水适来，
得之七八日，热除脉迟身凉，胸满如结胸状者，刺期门。若昼则明了，暮则谵语，治无犯胃气及上二焦。
《活人》以小柴胡汤主之。邪入血分，故发狂，且谵语属阳明胃经者居多，故戒犯胃气。阳明病，下血谵语，
此为热入血室，随其实泻之，犀角地黄汤加丹参、木通，或加味四物汤。汗出愈。如寒热有时，经来适断，
昼明了，暮谵语。医用刚剂，遂胸膈不利，涎潮上涌，喘急昏冒。当先化其痰，后除其热。用一呷散，再用
小柴胡汤加生地黄。如寒热谵语，胸
胁满，如结胸状，此邪与血结。用陶氏小柴胡汤，去参、枣，加生地、栝蒌、桃仁、丹皮、山楂肉。若少
阳本经，血结自甚，必少腹急痛，小柴胡汤去参、甘、枣，加延胡、当归尾、桃仁。若热入血室，谵语如狂，
血逆心包，胸中满痛，为血结胸，用桂枝红花汤加海蛤、桃仁。若寒热如疟，经水适来，狂言见鬼，或胁下硬，
脾阳虚者，干姜柴胡汤。若热入血室，谵语发狂，不省人事者，牛黄膏。按此症必寒热谵语，总宜小柴胡汤
加减。其结胸少腹满痛，或小陷胸汤加丹参、赤芍、陈皮、枳壳，或桃仁承气汤，玉烛散。选而用之。
凡诊治妇人疾病，首先询问月经情况。妇女患热病，正值月经来潮时，邪气随经血排出，疾病往往自愈。如果邪气停留在半表半里之间，月经恰好来潮或刚断，血室空虚，热邪乘虚陷入，表现为白天安静、夜间加重，寒热往来像疟疾一样，心烦口渴、耳聋、说胡话甚至看见鬼怪，这称为“热入血室”，用小柴胡汤加生地黄为主治方。凡是月经期间出现类似疟疾的寒热和说胡话症状，就是热入血室。这是因为血液被邪气逼迫，向上进入肝经，肝经受邪，就会出现说胡话、见鬼的症状；邪气进入胆经，则血液凝结在胸部，用手触摸就会疼痛，这种情况药物难以奏效，所以应当针刺期门穴。（期门穴位于乳头直下，第七肋间隙中）。张仲景说：妇女感受风邪，恶寒发热，正值月经来潮，经过七八天后，热退脉迟身体转凉，但胸部胀满像结胸证一样的，应针刺期门穴。如果白天神志清楚，傍晚则说胡话，治疗时不要损伤胃气及上焦、中焦。《活人书》主张用小柴胡汤主治。邪气深入血分，所以会发狂，且说胡话多属于阳明胃经的热盛，因此告诫不要损伤胃气。阳明病导致下血并说胡话，这也是热入血室，应根据其实证特点泻热，用犀角地黄汤加丹参、木通，或者用加味四物汤。服药后汗出即可痊愈。如果出现定时寒热，月经刚断，白天神志清楚，傍晚说胡话，医生误用刚燥的药物，导致胸膈不畅，痰涎上涌，气喘急促，昏沉冒昧。应当先化痰，后清热。先用一呷散，再用小柴胡汤加生地黄。如果出现寒热、说胡话、胸胁胀满，像结胸证一样，这是邪气与血液互结。用陶华的小柴胡汤，去掉人参、大枣，加入生地黄、瓜蒌、桃仁、牡丹皮、山楂肉。如果是少阳本经病变，血结非常严重，必然伴有少腹拘急疼痛，用小柴胡汤去掉人参、甘草、大枣，加入延胡索、当归尾、桃仁。如果热入血室，说胡话像发狂一样，血液逆乱侵犯心包，胸部胀满疼痛，称为“血结胸”，用桂枝红花汤加海蛤壳、桃仁。如果寒热像疟疾，月经刚来，胡言乱语看见鬼怪，或者胁下硬满，属于脾阳虚的，用干姜柴胡汤。如果热入血室，说胡话发狂，不省人事的，用牛黄膏。按此症必有寒热和说胡话的表现，总宜用小柴胡汤加减。若出现结胸、少腹胀满疼痛，可用小陷胸汤加丹参、赤芍、陈皮、枳壳，或者桃仁承气汤、玉烛散。根据具体情况选择使用。
In diagnosing women's diseases, one must first inquire about the menstrual cycle. When a woman suffers from a febrile disease during menstruation, the pathogenic factor is expelled along with the blood, and the illness often resolves spontaneously. However, if the pathogen resides in the half-exterior and half-interior region, and menstruation happens to commence or cease, the Blood Chamber (Xue Shi) becomes empty, allowing heat pathogens to sink inward. This presents as quietness during the day and exacerbation at night, alternating chills and fever resembling malaria, irritability, thirst, deafness, delirium, and hallucinations of seeing ghosts. This condition is termed "Heat Entering the Blood Chamber" (Re Ru Xue Shi), and it should be treated primarily with Xiaochaihu Tang (Minor Bupleurum Decoction) supplemented with Sheng Dihuang (Radix Rehmanniae Preparata). Any occurrence of malaria-like symptoms and delirium during menstruation indicates Heat Entering the Blood Chamber. This occurs because the blood is forced by pathogens upward into the Liver Meridian; when the Liver is affected, delirium and hallucinations arise. If the pathogen enters the Gallbladder Meridian, blood coagulates in the chest, causing pain upon palpation. Since medication may not reach this effectively, puncturing the Qimen (LR14) acupoint is indicated. (Qimen is located in the intercostal space between the seventh rib and the eighth rib, directly below the nipple). Zhang Zhongjing stated: "When a woman contracts wind-pathogens, experiencing chills and fever, coinciding with menstruation, after seven or eight days, if the heat subsides, the pulse slows, and the body becomes cool, but the chest feels full as in Jie Xiong (Chest Binding) syndrome, puncture Qimen." If the patient is lucid during the day but delirious at dusk, treatment should avoid damaging Stomach Qi and the Upper and Middle Jiao. The *Liuren Shu* advocates using Xiaochaihu Tang. Because the pathogen has entered the blood level, madness ensues; moreover, delirium mostly belongs to the Yangming Stomach Meridian, hence the warning against damaging Stomach Qi. In Yangming disease, bleeding accompanied by delirium also constitutes Heat Entering the Blood Chamber; it should be treated by purging excess according to its solid nature, using Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction) added with Danshen (Radix Salviae Miltiorrhizae) and Mutong (Akebiae Caulis), or Jiawei Siwu Tang (Modified Four Substances Decoction). Recovery follows sweating. If there are periodic chills and fever, menstruation has just ceased, the patient is lucid by day but delirious by night, and the physician mistakenly used harsh/drying agents leading to chest oppression, surging phlegm-saliva, asthma, and stupor, one must first resolve the phlegm and then clear the heat. Use Yicha San (One-Sip Powder), followed by Xiaochaihu Tang with Sheng Dihuang. If chills, fever, delirium, and chest/hypochondriac fullness resemble Jie Xiong syndrome, this indicates pathogen-blood binding. Use Tao's Xiaochaihu Tang (Tao Hua's Minor Bupleurum Decoction), removing Renshen (Ginseng Root) and Dazao (Jujube Fruit), adding Sheng Dihuang, Gualou (Trichosanthis Fructus), Taoren (Persicae Semen), Mudanpi (Moutan Cortex), and Shanzha Rou (Crataegi Fructus Pulpa). If the Shaoyang primary meridian is involved with severe blood binding, acute lower abdominal pain is inevitable; use Xiaochaihu Tang removing Renshen, Gancao (Licorice Root), and Dazao, adding Yanhusuo (Corydalis Rhizoma), Dangguiwei (Angelicae Sinensis Radix Cauda), and Taoren. If Heat Enters the Blood Chamber with delirious madness, blood rebellion invading the Pericardium, causing chest fullness and pain, termed "Blood Jie Xiong," use Guizhi Honghua Tang (Cinnamon Twig and Safflower Decoction) added with Haige (Concha Arcae) and Taoren. If chills and fever resemble malaria, menstruation has just started, with raving speech, hallucinations, or hypochondriac hardness due to Spleen Yang deficiency, use Ganjiang Chaihu Tang (Dried Ginger and Bupleurum Decoction). If Heat Enters the Blood Chamber with delirious madness and loss of consciousness, use Niuhuang Gao (Calculus Bovis Ointment). Generally, for these symptoms involving chills, fever, and delirium, Xiaochaihu Tang with modifications is appropriate. For Jie Xiong with lower abdominal fullness and pain, consider Xiaoxianzhong Tang (Minor Chest-Binding Decoction) added with Danshen, Chishao (Paeoniae Radix Rubra), Chenpi (Citri Reticulatae Pericarpium), and Zhiqiao (Aurantii Fructus), or Taoren Chengqi Tang (Persicae and Rheum Decoction), or Yuzhu San (Jade Candle Powder). Select and apply based on the specific presentation.