妇人中风,发热恶寒,经水适来,得之七八日,热除,脉迟,身凉,胸胁满如结胸状,谵语者,
此为热入血室,当刺期门,随其实而泻之。
妇人伤寒,发热,经水适来,昼日明了,暮则谵语如见鬼状,此为热入血室,无犯胃气及上中
二焦,必自愈。
妇人中风七八日,续得寒热发作,经水适断,此为热入血室,其血必结,故如疟状,小柴胡汤。
阳明下血谵语,此为热入血室。但头汗出者,刺期门,随其实而泻之, 然汗
出而愈。
妇人热入血室,有二经水适来。二条不言药者,盖以经血方来,热气乘虚而入,经血止,则热
亦出矣,故不可用汗下药犯其胃气及上中焦。如其胸满谵语,此内实也,刺期门以泻之。若经水适
断,续得寒热,其血必结,故用小柴胡汤。若阳明热入血室,此男子失血之证,但当刺以泻热也。
妇女感受风邪,出现发热、恶寒的症状,此时月经恰好来潮。经过七八天后,热势消退,脉象变迟,身体转凉,但出现胸胁部胀满,症状类似结胸证,并伴有胡言乱语的情况,这是热邪陷入血室的表现,应当针刺期门穴,根据实证的情况采用泻法治疗。
妇女感受寒邪,出现发热症状,此时月经恰好来潮。白天神志清醒,到了傍晚则出现胡言乱语,仿佛看见鬼怪一样,这是热邪陷入血室的表现,不要损伤胃气以及上焦和中焦的气机,疾病必定会自行痊愈。
妇女感受风邪七八天后,再次出现寒热交替发作的症状,此时月经恰好停止,这是热邪陷入血室,血液必然凝结,所以症状像疟疾一样,可用小柴胡汤治疗。
阳明病出现下血并伴有胡言乱语,这也是热邪陷入血室的表现。如果只有头部出汗,应当针刺期门穴,根据实证情况采用泻法,待周身汗出后疾病即可痊愈。
妇女热邪陷入血室,有两种情况是月经恰好来潮。其中两条条文没有提及用药,是因为经血正在来潮,热气乘虚而入,等到经血停止,热邪也会随之排出,因此不可使用发汗或攻下的药物去损伤其胃气及上中焦。如果患者出现胸胁胀满和胡言乱语,这是体内实邪壅滞,应针刺期门穴以泻除实邪。如果是月经恰好停止,随后出现寒热交替,说明血液必然凝结,因此使用小柴胡汤。如果是阳明病导致的热邪陷入血室,这属于男子失血的证候,只应当通过针刺来泻除热邪。
When a woman contracts Wind-pathogen, presenting with fever and aversion to cold, and her menses happen to commence, after seven or eight days, the heat subsides, the pulse becomes slow, the body cools down, yet she experiences fullness and distension in the chest and hypochondrium resembling Chest Binding (Jie Xiong), accompanied by delirium. This is Heat entering the Blood Chamber (Xue Shi). One should puncture Qimen (LR14) and apply the reducing method according to the excess condition.
When a woman contracts Cold-pathogen, presenting with fever, and her menses happen to commence, she is lucid during the day but becomes delirious at night, as if seeing ghosts. This is Heat entering the Blood Chamber (Xue Shi). Do not injure the Stomach Qi or the Upper and Middle Jiao; the disease will resolve spontaneously.
Seven or eight days after a woman contracts Wind-pathogen, if chills and fever recur intermittently, and her menses happen to cease, this is Heat entering the Blood Chamber (Xue Shi). The blood must be congealed, hence the symptoms resemble Malaria (Nue). Xiao Chai Hu Tang (Minor Bupleurum Decoction) is indicated.
In Yangming disease, if there is bleeding from the lower orifice accompanied by delirium, this is also Heat entering the Blood Chamber (Xue Shi). If only sweat appears on the head, one should puncture Qimen (LR14) and apply the reducing method according to the excess condition. Recovery will follow when general sweating occurs.
There are two scenarios of Heat entering the Blood Chamber (Xue Shi) where menses happen to commence. The two clauses that do not mention medication imply that since menstrual blood is flowing, heat enters via the deficiency. When menstruation stops, the heat exits as well. Therefore, diaphoretic or purgative methods should not be used to injure the Stomach Qi and the Upper and Middle Jiao. If chest fullness and delirium occur, this indicates internal excess; puncture Qimen (LR14) to reduce it. If menses happen to cease and chills and fever subsequently appear, the blood is congealed, thus Xiao Chai Hu Tang (Minor Bupleurum Decoction) is used. If Heat enters the Blood Chamber (Xue Shi) due to Yangming pathology, this constitutes a syndrome of blood loss in men, and treatment should solely involve acupuncture to reduce heat.