八瘕者,皆胞胎生产,月水往来,血脉精气不调之所生也。肾为阴,主开闭,左为胞门
,右为子户,主定月水,生子之道。胞门、子户,主子精,神气所出入,合于中黄门、玉门
四边,主持关元,禁闭子精。脐下三寸,名曰关元,主藏魂魄,妇人之胞,三焦之腑,常所
从止。然妇人经脉俞络合调,则月水以时来至,故能生子而无病。妇人荣卫经络断绝不通,
邪气便得往入,合于子脏;若经血未尽,而合阴阳,即令妇人血脉挛急,小腹重急、支满,
胸胁腰背相引,四肢酸痛,饮食不调,结牢。恶血不除,月水不时,或月前月后,因生积聚
,如怀胎状。邪气甚盛者,令人恍惚多梦,寒热,四肢不欲动,阴中生气,肿内生风,甚者
害小便涩,涩而痛,淋沥,面黄黑,成病,则不复生子。
其八瘕者,黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、鳖瘕也。
黄瘕者,妇人月水始下,若新伤堕,血气未止,卧寤未定,五脏六腑虚羸,精神不治,
因以当向大风便利,阴阳开,关节四边中于风湿,气从下上入阴里,稽留不去,名为阴阳虚
,则生黄瘕之聚,令人苦四肢寒热,身重淋露,不欲食,左胁下有血气结牢,不可得而
抑,苦腰背相引痛,月水不利,令人不产。小腹急,下引阴中如刀刺,不得小便,时苦寒热
,下赤黄汁,病苦如此,令人无子。
青瘕者,妇人新产,未满十日起行,以汤浣洗太早,阴阳虚,玉门四边皆解散,子户未
安,骨肉皆痛,手臂不举,饮食未复,五内吸吸。又当风卧,不自隐蔽,若居湿席,令人苦
寒,洒洒入腹,烦闷沉淖。恶血不除,结热,不得前后,便化生青瘕。瘕聚左右胁,藏于背
膂,上与膊,髀腰下挛,两足肿,面目黄,大小便难。其后月水为之不通利,或不复禁
,状如崩中。此自其过所致,令人少子。
燥瘕者,妇人月水下,恶血未尽,其人虚惫,而已夏月热行疾走,若举重移轻,汗出交
流,气力未平,而卒以恚怒,致猥咽不泄,经脉挛急,内结不舒,烦满少气,上达胸膈背膂
,小腹为急,月水与气俱不通,而反以饮清水快心,月水横流,衍入他脏不去,有热,因生
燥瘕之聚。大如半杯,上下腹中苦痛,还两胁下,上引心而烦,害饮食,欲吐,胸及腹中不
得大息,腰背重,喜卧盗汗,足酸疼痛,久立而痛,小便失时,居然自出若失精,月水闭塞
,大便难。病如此者,其人少子。
血瘕病,妇人月水新下,未满日数而中止,饮食过度,五谷气盛,溢入他脏;若大饥寒
,汲汲不足,呼吸未调,而自劳动,血下未定,左右走肠胃之间,留络不去,内有寒热,与
月水合会,为血瘕之聚。令人腰痛,不可以俯仰,横骨下有积气,牢如石,小腹里急苦痛,
背膂疼,深达腰腹下挛,阴里若生风冷,子门擗,月水不时,乍来乍不来,此病令人无子。
脂瘕者,妇人月水新来,若生未满三十日,其人未复,以合阴阳,络脉分,胞门伤,子
户失禁,关节散,五脏六腑,津液流行,阴道 动,百脉关枢四解,外不见其形。子
精与血气相遇,犯禁,子精化,不足成子,则为脂瘕之聚。令人支满,里急痛痹,引小腹重
,腰背如刺状,四肢不举,饮食不甘,卧不安席,左右走,腹中切痛,时瘥时甚,或时少气
头眩,身体解堕,苦寒恶风,膀胱胀,月水乍来乍去,不如常度,大小便血不止。如此者,
令人无子。
狐瘕者,妇人月水当月数来,而反悲哀忧恐,以远行逢暴风疾雨,雷电惊恐,衣被沉湿
,疲倦少气,心中 未定,四肢懈惰,振寒,脉气绝,精神游亡,邪气入于阴里
不去,生狐瘕之聚。食人脏,令人月水闭不通,小腹瘀滞,胸胁腰背痛,阴中肿,小便难,
胞门子户不受男精。五脏气盛,令嗜食,欲呕,喜唾,多所思,如有娠状,四肢不举。有此
病者,终身无子。其瘕有手足成形者,杀人也;未成者可治。
蛇瘕者,妇人月水已下新止,适闭未复,胞门子户劳伤,阴阳未平复,荣卫分行,若其
中风,暴病羸劣,饮食未调;若已起,当风行,及度泥涂,用清寒太早;若坐湿地,名阴阳
乱。腹中虚,且未饮食,若远道之余,饮污井之水,不洁之食,吞蛇鼠之精,留络不去,因
生蛇瘕之聚,上食心肝,长大,其形若漆,在脐上下,还疠左右胁,不得吐气,两股胫间苦
疼,小腹疾,小便赤黄,膀胱引阴中挛急,腰背痛,难以动作,苦寒热,之后月水有多有少
。有此病者,不复生子。其瘕手足成形者,杀人;未成者可治。
鳖瘕者,妇人月水新至,其人剧吐疲劳,衣服沉湿,不以时去;若当风睡,两足践湿地
,恍惚觉悟, 立未安,颜色未平,复见所好,心为开荡,魂魄感动,五内脱消;若
以入水浣洗沐浴,不以时出,神不守,水精与邪气俱入,至三焦之中募,玉门先闭,津液妄
行,留络不去,因生鳖瘕之聚。大如小盘,令人小腹切痛,恶气走上下,腹中苦痛,若存若
亡,持之跃手,下引阴里,腰背亦痛,不可以息,月水喜败不通,面目黄黑,脱声少气。有
此病者,令人绝子。其瘕有手足成形者杀人,未成者可治。
八瘕,都是由胞胎受损、生产经历、月经往来过程中,血脉与精气不调和所导致的疾病。肾属阴,主管开闭功能,左侧称为胞门,右侧称为子户,主要调节月经周期及生育功能。胞门和子户主管子精(生殖之精),是神气出入的通道,与中黄门、玉门四周相连,主持关元穴,以固摄子精。脐下三寸处名为关元,主管藏纳魂魄,也是妇女子宫和三焦腑常停留之处。如果妇女的经脉俞络调和,则月经能按时来潮,从而能够顺利生育而无疾病。若妇女的营卫经络断绝不通,邪气便得以侵入,汇聚于子宫;如果在经血未净时行房事,会导致妇女血脉拘挛紧急,小腹沉重急迫、胀满支撑感,胸胁腰背相互牵引疼痛,四肢酸痛,饮食失调,形成结块坚牢。恶血不能清除,月经周期紊乱,或提前或推后,进而产生积聚,状如怀孕。若邪气极盛,会导致人精神恍惚多梦,寒热交替,四肢不愿活动,阴部有气上冲,内部生肿生风,严重时导致小便涩滞,排尿疼痛,淋漓不尽,面色黄黑,一旦成病,便不再具有生育能力。
所谓的八瘕,是指黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、鳖瘕这八种。
黄瘕:妇女月经刚来,如果是新近堕胎损伤,气血尚未停止,睡眠未定,五脏六腑虚弱羸弱,精神失治,此时若正对大风大小便,阴阳开放,关节四周受风湿侵袭,风气从下向上进入阴里,稽留不去,名为阴阳虚,从而产生黄瘕积聚。使人苦于四肢寒热,身体沉重出汗淋漓,不想进食,左胁下有血气结块坚牢,无法压制,苦于腰背相互牵引疼痛,月经不利,导致不孕。小腹急迫,向下牵引阴部如刀刺般疼痛,小便不通,时常苦于寒热,阴道流出赤黄色汁液,病情如此痛苦,导致无子。
青瘕:妇女新产后,未满十天就起身行走,过早用热水洗涤,导致阴阳虚损,玉门四周松懈解散,子户未安,骨肉皆痛,手臂无法举起,饮食未恢复,内脏感觉吸吸作响(空虚不适)。又若当风而卧,不自我隐蔽,或者睡在湿席上,使人苦于寒冷,寒意洒洒入腹,烦闷沉淖。恶血未能清除,郁结化热,导致大小便不通,从而化生青瘕。瘕聚位于左右胁部,藏于背部脊柱,向上连接肩膀,髀部腰部下方拘挛,双脚肿胀,面目发黄,大小便困难。此后月经变得不通利,或者不再能控制,状如崩中漏下。这是由过失所致,导致少子。
燥瘕:妇女月经来潮,恶血未尽,其人虚弱疲惫,却在夏季炎热时疾走奔跑,或者举重移轻,汗出交流,气力未平复,突然因愤怒导致咽喉哽咽之气不得发泄,经脉拘挛紧急,内部结滞不舒,烦闷短气,向上到达胸膈背部脊柱,小腹急迫,月经与气都不通,反而饮用清水以求心快,导致月经横流,渗入其他脏腑不去,产生热邪,从而生成燥瘕积聚。积块大如半杯,上下腹部苦痛,牵连两胁下,向上牵引心脏而烦躁,损害饮食,想呕吐,胸部及腹部不能深呼吸,腰背沉重,喜欢躺着盗汗,足部酸疼,久立则痛,小便失禁,自然流出如同遗精,月经闭塞,大便困难。病情如此者,其人少子。
血瘕病:妇女月经刚来,未满天数而中止,饮食过度,五谷之气过盛,溢入其他脏腑;或者极度饥饿寒冷,汲汲不足,呼吸未调,而自己从事劳动,血下未定,血液在肠胃之间左右游走,滞留络脉不去,内部有寒热,与月经相合,形成血瘕积聚。使人腰痛,不能俯仰,横骨下有积气,坚硬如石,小腹内部急迫苦痛,背部脊柱疼痛,深达腰腹下拘挛,阴内感觉如生风冷,子门收缩,月经不时,忽来忽不来,此病导致无子。
脂瘕:妇女月经刚来,或者生产未满三十天,其人未恢复,便行房事,导致络脉分离,胞门受伤,子户失禁,关节松懈,五脏六腑津液流行,阴道动摇,百脉关枢四散,外表看不出形体变化。子精与血气相遇,触犯禁忌,子精化去,不足以成胎,则形成脂瘕积聚。使人支满,内部急痛痹阻,牵引小腹沉重,腰背如针刺状,四肢无法举起,饮食无味,卧不安席,疼痛左右游走,腹部切痛,时好时坏,有时少气头晕,身体懈怠下垂,苦于寒冷厌恶风邪,膀胱胀,月经忽来忽去,不符合常规,大小便出血不止。如此者,导致无子。
狐瘕:妇女月经当月数应来,却反常地悲哀忧恐,远行遭遇暴风疾雨,雷电惊恐,衣被沉重潮湿,疲倦少气,心中未定,四肢懈惰,战栗发冷,脉气绝,精神游荡亡失,邪气进入阴里不去,生成狐瘕积聚。食人脏腑,使人月经闭止不通,小腹瘀滞,胸胁腰背痛,阴部肿胀,小便困难,胞门子户不接受男精。五脏气盛,导致嗜食,想呕吐,喜欢吐唾沫,思虑过多,如有妊娠状,四肢无法举起。有此病者,终身无子。其瘕若有手足成形者,杀人;未成形的可治。
蛇瘕:妇女月经已下新止,适逢闭合未复,胞门子户劳伤,阴阳未平复,营卫分行,若此时中风,暴病羸劣,饮食未调;或者已经起身,应当风行,以及经过泥泞涂地,过早使用清寒之物;或者坐湿地,名为阴阳乱。腹中虚,且未进食,若长途跋涉之余,饮用污井之水,吃不洁食物,吞食蛇鼠之精,滞留络脉不去,因而生成蛇瘕积聚,向上食伤心肝,长大,形状如漆,在脐上下,还疠左右胁,不能呼气,两腿胫间苦痛,小腹急迫,小便赤黄,膀胱牵引阴部拘挛急痛,腰背痛,难以动作,苦于寒热,之后月经有多有少。有此病者,不再生子。其瘕若有手足成形者,杀人;未成形的可治。
鳖瘕:妇女月经刚到,其人剧烈呕吐疲劳,衣服沉重潮湿,不及时去除;或者当风睡觉,两脚踩湿地,恍惚觉悟,站立未安,脸色未平复,又见到所喜好的人或事,心为开荡,魂魄感动,五内脱消;或者入水浣洗沐浴,不及时出来,神不守舍,水精与邪气俱入,到达三焦中的募原,玉门先闭,津液妄行,滞留络脉不去,因而生成鳖瘕积聚。大如小盘,使人小腹切痛,恶气上下走动,腹中苦痛,似存似亡,按压时跃手(跳动),向下牵引阴里,腰背也痛,不能喘息,月经喜欢败坏不通,面目黄黑,失声少气。有此病者,导致绝子。其瘕若有手足成形者杀人,未成形的可治。
Ba Jia (Eight Masses) are diseases caused by the disharmony of blood vessels and essence-qi resulting from damage to the uterus, childbirth experiences, and irregular menstruation. The Kidney belongs to Yin and governs opening and closing; the left side is called Baomen (Gate of the Womb), and the right side is called Zihu (House of the Child), which primarily regulate the menstrual cycle and reproductive function. Baomen and Zihu govern Zi Jing (reproductive essence); they are the passages for Shen Qi (spiritual energy) to enter and exit, connecting with Zhonghuangmen and the four sides of Yumen, governing the Guanyuan point to secure Zi Jing. Three cun below the umbilicus is named Guanyuan, which stores Hun and Po souls, and is also the usual resting place for the female uterus and the Sanjiao (Triple Burner). If a woman's meridians and Shu-Luo (collaterals) are harmonious, menstruation arrives on time, enabling smooth reproduction without disease. However, if a woman's Ying-Wei (Defensive-Nutritive) meridians are severed and blocked, pathogenic factors can invade and gather in the Zangfu of the uterus; if intercourse occurs while menstrual blood has not cleared, it causes the woman's blood vessels to spasm and tighten, leading to heaviness and urgency in the lower abdomen, distension and fullness, mutual pulling pain in the chest, hypochondrium, waist, and back, soreness and pain in the four limbs, dietary irregularity, and the formation of firm masses. If evil blood is not removed, menstruation becomes irregular, occurring either before or after the expected time, leading to the formation of accumulations resembling pregnancy. If pathogenic factors are extremely severe, it causes mental vagueness and excessive dreaming, alternating chills and fever, unwillingness to move the four limbs, rising qi in the vagina, internal swelling and wind generation, and in severe cases, dysuria with painful, dribbling urination, yellow-black complexion; once such a disease forms, fertility is lost.
The so-called Ba Jia refer to Huang Jia (Yellow Mass), Qing Jia (Green Mass), Zao Jia (Dry Mass), Xue Jia (Blood Mass), Zhi Jia (Fat Mass), Hu Jia (Fox Mass), She Jia (Snake Mass), and Bie Jia (Turtle Mass).
Huang Jia: When a woman’s menstruation first begins, if she has recently suffered an abortion or injury, and blood and qi have not yet stopped, and her sleep is unsettled, with the five Zang and six Fu organs weak and emaciated, and spirit poorly regulated, if she then relieves herself facing a strong wind with yin and yang open, allowing wind-dampness to invade the joints, qi enters the interior of the yin from below and lingers there, named Yin-Yang Deficiency, thereby generating a Huang Jia accumulation. This causes suffering from cold and heat in the four limbs, heavy body with sweating, loss of appetite, and a firm mass of blood and qi under the left hypochondrium that cannot be suppressed, causing pulling pain in the waist and back, difficult menstruation, and infertility. Urgency in the lower abdomen pulls down to the vagina like a knife刺, inability to urinate, frequent chills and fever, discharge of red-yellow fluid from the vagina; such painful conditions lead to childlessness.
Qing Jia: After new childbirth, if a woman walks around before ten days have passed, washes too early with hot water, causing Yin-Yang deficiency, loosening of the four sides of Yumen, instability of Zihu, pain in bones and flesh, inability to raise arms, incomplete recovery of diet, and a sucking sensation in the internal organs. If she lies facing the wind without covering herself, or sleeps on wet mats, she suffers from cold penetrating the abdomen, causing stifling depression and heaviness. If evil blood is not removed, heat binds, blocking bowel and bladder movements, transforming into Qing Jia. The mass gathers in the left and right hypochondria, hides in the back spine, extends upward to the shoulders, causes spasms below the hips and waist, swelling of both feet, yellow face, and difficulty in urination and defecation. Subsequently, menstruation becomes obstructed or uncontrollable, resembling Bingzhong (uterine bleeding). This results from negligence, leading to reduced fertility.
Zao Jia: When menstruation flows and evil blood is not fully cleared, and the person is weak and exhausted, if she runs fast in summer heat or lifts heavy objects, sweating profusely, before strength recovers, and suddenly becomes angry causing throat constriction and unexpressed qi, leading to meridian spasms, internal stagnation, stifling fullness, shortness of breath, extending up to the chest, diaphragm, and back spine, with urgency in the lower abdomen where both menstruation and qi are blocked. If she drinks clear water to soothe her heart, menstruation flows horizontally, infiltrating other organs without leaving, generating heat, thus forming a Zao Jia accumulation. The mass is as large as half a cup, causing severe pain in the upper and lower abdomen, radiating to the hypochondria, pulling up to the heart causing irritability, impairing diet, inducing vomiting, inability to take deep breaths in the chest and abdomen, heavy waist and back, preference for lying down with night sweats, sore and painful legs, pain upon standing for long periods, urinary incontinence resembling seminal emission, closed menstruation, and difficult defecation. Such patients have reduced fertility.
Xue Jia Disease: When menstruation has just started but stops before the usual number of days, due to overeating causing excessive grain qi overflowing into other organs; or due to extreme hunger and cold, insufficient intake, unregulated breathing, and self-exertion while blood flow is unstable, blood wanders between the intestines and stomach, lingering in the collaterals, creating internal cold and heat that combines with menstruation to form a Xue Jia accumulation. This causes lower back pain preventing bending and stretching, accumulated qi under the Henggu bone hard as stone, urgent and painful lower abdomen, back spine pain, deep spasms reaching the lower waist and abdomen, feeling of wind-cold in the yin interior, contraction of Zimen, irregular menstruation coming and going intermittently; this disease leads to childlessness.
Zhi Jia: When menstruation has just arrived, or within thirty days postpartum, before recovery, if intercourse occurs, causing collateral separation, injury to Baomen, loss of control in Zihu, joint laxity, free flow of fluids in the five Zang and six Fu organs, movement in the vaginal channel, dispersion of the pivot of hundred vessels, with no external change in appearance. When Zi Jing meets blood and qi, violating taboos, Zi Jing transforms and fails to conceive, forming a Zhi Jia accumulation. This causes distension, internal urgent pain and bi-syndrome, pulling heaviness in the lower abdomen, stabbing pain in the waist and back, inability to raise limbs, lack of taste in food, restless sleep, wandering pain in the abdomen, fluctuating severity, occasional shortness of breath and dizziness, body sagging, aversion to cold and wind, bladder distension, irregular menstruation deviating from normal patterns, and continuous bleeding from bowels and bladder. Such cases lead to childlessness.
Hu Jia: When menstruation should arrive according to the monthly cycle, but instead the woman feels sorrowful and fearful, travels far encountering violent storms, rain, thunder, lightning, and fright, wearing heavy wet clothes, becoming fatigued and short of breath, mind unsettled, limbs slack, shivering with cold, pulse qi cut off, spirit wandering, pathogenic factors enter the yin interior and do not leave, generating a Hu Jia accumulation. It consumes the viscera, causing amenorrhea, lower abdominal stasis, chest, hypochondriac, waist, and back pain, vaginal swelling, difficult urination, and inability of Baomen and Zihu to receive male essence. Excessive qi in the five Zang organs causes craving for food, desire to vomit, excessive salivation, excessive thinking, resembling pregnancy, and inability to raise limbs. Those with this disease will be sterile for life. If the mass has formed hands and feet, it is fatal; if unformed, it is treatable.
She Jia: When menstruation has newly ceased, closure has not recovered, Baomen and Zihu are injured by labor, Yin-Yang not restored, Ying-Wei dividing, if one contracts wind, suffers sudden illness and emaciation, diet unregulated; or if getting up, walking in wind, passing through mud, using cold substances too early; or sitting on wet ground, named Yin-Yang disorder. With a hollow abdomen and empty stomach, if after a long journey one drinks from dirty wells, eats unclean food, or swallows essence of snakes and rats, lingering in collaterals, generating a She Jia accumulation. It ascends to consume the heart and liver, growing large, shape like lacquer, located above and below the umbilicus, affecting the left and right hypochondria, inability to exhale, severe pain in the thighs and calves, urgency in the lower abdomen, red-yellow urine, bladder pulling the vagina into spasm, waist and back pain, difficulty moving, suffering from chills and fever, followed by variable menstrual flow. Those with this disease will not bear children. If the mass has formed hands and feet, it is fatal; if unformed, it is treatable.
Bie Jia: When menstruation has just arrived, the person suffers severe vomiting and fatigue, wears heavy wet clothes without timely removal; or sleeps facing the wind, steps on wet ground with both feet, wakes from trance, stands unsteadily, complexion not stabilized, sees desired objects/people, heart opens and agitates, soul moves, internal organs deplete; or enters water to wash and bathe, does not exit promptly, spirit fails to guard, water essence and pathogenic factors enter together, reaching the Mu-yuan of the Sanjiao, Yumen closes first, fluids flow recklessly, lingering in collaterals, generating a Bie Jia accumulation. As large as a small plate, causing sharp lower abdominal pain, evil qi moving up and down, severe abdominal pain that seems present and absent, jumping sensation upon pressure, pulling down to the yin interior, waist and back pain, inability to rest, menstruation prone to blockage and decay, yellow-black face, loss of voice and shortness of breath. Those with this disease become sterile. If the mass has formed hands and feet, it is fatal; if unformed, it is treatable.