陆(三二)经闭数月。胸满腹胀。寒热消渴。大便燥结。脉微涩。两寸脉独大。此皆胃大肠之腑热。渐侵于心脾之
脏。即内经所谓二阳之病发心脾。不得隐曲。女子不月是也。盖消渴者。胃大肠之热也。胸满者。心病上焦不利也。腹
胀者。脾病中焦胀满也。脏腑俱病。故寒热也。考戴人治经闭逾年者。每责于心受积热为主。所有抑火升水。渗温润燥
等方。不过谓胃以示其推陈致新而已。
鲜生地(一两) 炒桃仁(三钱) 郁李仁(一钱五分) 制军(三钱) 杜牛膝(三钱) 老姜渣(五分) 浔
桂心(四分) 麦紫管一两煎汤代水五帖
周(三五)淋带起于产后。腰腹绞痛。是属冲任交伤。而带脉空隙。宜固其下。
乌贼骨(三钱) 牡蛎(三钱) 生杜仲(二钱) 当归(一钱五分) 炒白芍(二钱) 白薇(一钱) 蕲艾(一
钱)
鄂(三四)阳浮头痛。身热。带下如注。
熟地炭(三钱) 萸肉炭(一钱) 炒山药(二钱) 清阿胶(二钱)
建莲肉(三钱) 芡实(二钱) 茯神(二钱)
缪(三六)赤白带下。头晕。腰溶溶而痛。舌状如刺。面赤嘈杂。肝阴久亏。肝阳化火风上冒。致有产后淹缠之恙。
想肝为刚脏。拟以熄风法。以柔能济刚。兼以坚阴佐之。
生左牡蛎(三钱) 麦冬(一钱五分) 焦黄柏(一钱) 陈阿胶(二钱) 炒杞子(一钱五分) 炒黑樗根皮
(三钱) 细生地(三钱)
陆(三十二岁):月经闭止数月。胸部胀满,腹部膨隆。伴有寒热往来、口渴多饮的症状。大便干燥结滞。脉象微弱而涩,但两手寸脉特别盛大。这都是胃与大肠腑中热邪炽盛,逐渐侵扰心脾脏器的表现。正如《内经》所说:“二阳之病发心脾,不得隐曲,女子不月。”其中,消渴症状,是胃与大肠有热的表现;胸满症状,是心火导致上焦气机不利;腹胀症状,是脾病导致中焦气机胀满。脏腑均受病邪影响,所以出现寒热症状。考察戴人治疗经闭长达一年的病例,往往归咎于心经受积热为主。所用抑火升水、渗湿润燥等方剂,不过是通过调理胃腑来展示推陈出新的道理。
处方:鲜生地(一两)、炒桃仁(三钱)、郁李仁(一钱五分)、制军(三钱)、杜牛膝(三钱)、老姜渣(五分)、浔桂心(四分),用麦紫管一两煎汤代水,共五帖。
周(三十五岁):淋证与带下病起于产后。腰部与腹部绞痛,这是冲任二脉受损,且带脉松弛失固的表现,适宜固摄下焦。
处方:乌贼骨(三钱)、牡蛎(三钱)、生杜仲(二钱)、当归(一钱五分)、炒白芍(二钱)、白薇(一钱)、蕲艾(一钱)。
处方:熟地炭(三钱)、萸肉炭(一钱)、炒山药(二钱)、清阿胶(二钱)、建莲肉(三钱)、芡实(二钱)、茯神(二钱)。
缪(三十六岁):赤白带下,头晕,腰部酸痛无力,舌面感觉如针刺般不适,面色发红,胃脘嘈杂不安。这是由于肝阴长期亏损,肝阳化生风火向上冲冒,导致产后缠绵难愈的疾病。考虑到肝为刚脏,拟采用熄风法,以柔能济刚的原则,并辅以坚阴之法。
处方:生左牡蛎(三钱)、麦冬(一钱五分)、焦黄柏(一钱)、陈阿胶(二钱)、炒杞子(一钱五分)、炒黑樗根皮(三钱)、细生地(三钱)。
Lu (32 years old): Amenorrhea for several months. Chest fullness and abdominal distension. Accompanied by alternating chills and fever, and Xiao Ke (Wasting-Thirst Syndrome). Dry and constipated stool. The pulse is faint and choppy, yet the Cun (Inch) pulses on both hands are distinctly large. These are all manifestations of heat in the Fu organs of the Stomach and Large Intestine, gradually invading the Zang organs of the Heart and Spleen. This corresponds to what the *Nei Jing* (Classic of Internal Medicine) states: "Diseases of the Two Yangs originate from the Heart and Spleen; inability to express hidden grievances leads to amenorrhea in women." Specifically, Xiao Ke (Wasting-Thirst Syndrome) indicates heat in the Stomach and Large Intestine; chest fullness indicates Heart fire causing dysfunction in the Upper Jiao; abdominal distension indicates Spleen disease causing stagnation in the Middle Jiao. Since the Zang and Fu organs are all diseased, chills and fever occur. Examining Dai Ren's treatment of amenorrhea lasting over a year, he often attributed it primarily to accumulated heat in the Heart. The formulas used, such as those suppressing fire and raising water, or draining dampness and moistening dryness, merely demonstrated the principle of eliminating the stale and promoting the new through regulating the Stomach.
Prescription: Fresh Sheng Di Huang (Rehmanniae Radix Recens, 1 liang), Chao Tao Ren (Persicae Semen, fried, 3 qian), Yu Li Ren (Prunus mume seed, 1.5 qian), Zhi Jun (Rhei Radix et Rhizoma processed, 3 qian), Du Niu Xi (Achyranthis Bidentatae Radix, 3 qian), Lao Jiang Zha (Ginger residue, 0.5 qian), Xun Gui Xin (Cinnamomi Cortex heartwood, 0.4 qian). Decoct with Mai Zi Guan (Liriope spicata root tuber, 1 liang) as water substitute. Five doses.
Zhou (35 years old): Lin syndrome (dysuria) and Dai xia (leukorrhea) originated postpartum. Severe colic in the waist and abdomen. This belongs to injury of the Chong and Ren meridians, with laxity of the Dai meridian. It is appropriate to consolidate the Lower Jiao.
Prescription: Wu Mei Gu (Sepiae Endoconcha, 3 qian), Mu Li (Ostreae Concha, 3 qian), Sheng Du Zhong (Eucommiae Cortex, raw, 2 qian), Dang Gui (Angelicae Sinensis Radix, 1.5 qian), Chao Bai Shao (Paeoniae Radix Alba, fried, 2 qian), Bai Wei (Cynanchi Atrati Radix, 1 qian), Qi Ai (Artemisiae Argyi Folium, 1 qian).
E (34 years old): Floating Yang causing headache, body heat, and profuse leukorrhea like a gush.
Prescription: Shu Di Tan (Rehmanniae Radix Preparata charred, 3 qian), Yu Rou Tan (Corni Fructus charred, 1 qian), Chao Shan Yao (Dioscoreae Rhizoma, fried, 2 qian), Qing E Jiao (Asini Corii Colla, clear, 2 qian), Jian Lian Rou (Nelumbinis Plumula, 3 qian), Qian Shi (Euryales Semen, 2 qian), Fu Shen (Poria with Coconut Wood, 2 qian).
Miao (36 years old): Red and white leukorrhea, dizziness, soreness and weakness in the lower back, tongue sensation like pricking, flushed face, and epigastric discomfort. This is due to long-term deficiency of Liver Yin, where Liver Yang transforms into wind-fire ascending upward, resulting in lingering postparten ailments. Considering the Liver is a rigid organ, the method of extinguishing wind is proposed, using softness to nourish rigidity, assisted by methods to firm the Yin.
Prescription: Sheng Zuo Mu Li (Ostreae Concha, raw, left side preferred, 3 qian), Mai Dong (Ophiopogonis Tuber, 1.5 qian), Jiao Huang Bo (Phellodendri Cortex, scorched, 1 qian), Chen E Jiao (Asini Corii Colla, aged, 2 qian), Chao Qi Zi (Lycii Fructus, fried, 1.5 qian), Chao Hei Chu Gen Pi (Stemoniae Radix bark, fried black, 3 qian), Xi Sheng Di (Rehmanniae Radix, fine, 3 qian).