《病源论》云∶诸方说,三十六疾者,是十二症、九痛、七害、五伤,三固,谓之三十
六疾也。十二 者,所下之物,一如膏白,二如清血,三如紫汁,四如赤肉,五如脓痂,六
如豆汁,七如葵羹,八如凝血,九如清血,血似水,十如米汁,十一如月浣,十二经废不应
期也。九痛者,一阴中痛伤,二阴中淋痛,三小便来即痛,四寒冷痛,五月水来腹痛,月水
止则不止,六气满崩痛,七汗出,阴中如虫啮痛,八胁下引痛,九腰痛也。七害者,一害食,
二害气,三害冷,四害劳,五害房,六害妊,七害睡也。五伤者,一穷孔痛,二中寒热痛,
三少腹急 痛,四脏不仁,五子门不正,引背痛。三固者,一月水闭塞不通,其余二固者,
谓子阙不载。(今按∶《千金方》云∶三固者,一羸瘦不生肌肤,二绝产乳,三月水闭塞也。
七害者,一穷孔痛不利,二中寒热痛,三少腹急坚痛,四脏不仁,五子门不端,六浣乍多乍
少,七喜吐阳精也。五邪伤者,一两胁支满痛,二心痛引胁,三气结不通,四邪恶泄利,五
前后固塞也云云。)
《千金方》白恶丸主妇人三十六疾病各异同。疗之方∶
白恶(三分) 龙骨(三分) 夕药(二分) 黄连(二分) 当归(二分) 茯苓(二
分) 黄芩(二分) 瞿麦(二分) 白蔹(二分) 石苇(二分) 甘草(二分) 牡蛎
(二分) 细辛(二分) 附子(二分) 禹余粮(二分) 白石脂(二分) 人参(二分)
乌贼骨(二分) 甘皮(二分) 本(二分) 大黄(二分)
二十一味,下筛,蜜丸如梧子,未食服十丸,日二,不知,稍增。服药,二十日知,三
十日百病悉愈。(今按∶《短剧方》有桂心四分、白芷四分,无甘皮、 本。)
《诸病源候论》记载:各方书所述,所谓的“三十六疾”,是指十二症、九痛、七害、五伤和三固,合称为三十六疾。
十二症,指阴道排出的异常分泌物:第一种如膏状白色液体,第二种如清稀血液,第三种如紫色汁液,第四种如红色肉块,第五种如脓痂,第六种如豆汁,第七种如葵菜羹汤,第八种如凝固的血块,第九种如清稀血液且状似水,第十种如米泔水,第十一种如月经期(经血淋漓不尽),第十二种为月经停闭不按期来潮。
九痛,指九种疼痛症状:第一种是阴中疼痛伴损伤感,第二种是阴中淋沥涩痛,第三种是小便排出时立即感到疼痛,第四种是寒冷引起的疼痛,第五种是行经期间腹痛且经期结束后疼痛仍不止,第六种是气滞胀满导致的崩漏疼痛,第七种是出汗时阴中如有虫咬般的疼痛,第八种是胁下牵引作痛,第九种是腰痛。
七害,指七种致病因素或身体受损状态:第一种是饮食所害,第二种是气机失调所害,第三种是受寒所害,第四种是劳倦所害,第五种是房事过度所害,第六种是妊娠所害,第七种是睡眠不安所害。
五伤,指五种身体损伤:第一种是前后二阴疼痛,第二种是寒热交替引起的疼痛,第三种是少腹拘急疼痛,第四种是脏腑感觉迟钝(麻木不仁),第五种是子门不正,牵引背部疼痛。
三固,指三种闭塞不通的症状:第一种是月经闭塞不通;其余两种三固的说法,是指子宫不能承载受孕。(按语:《千金方》记载:三固是指一为形体消瘦不长肌肉,二为绝育无子,三为月经闭塞不通。)
关于七害,《千金方》记载为:一是前后二阴疼痛且排泄不利,二是寒热交替疼痛,三是少腹拘急坚硬疼痛,四是脏腑感觉迟钝,五是子门不正,六是月经量忽多忽少,七是容易呕吐出精微物质(此处指精气外泄或类似症状)。
关于五邪伤,《千金方》记载为:一是两胁支撑胀满疼痛,二是心痛牵引至胁部,三是气结阻滞不通,四是恶邪导致的泄泻痢疾,五是前后二阴闭塞不通等。
《千金方》中的白恶丸主治妇人三十六疾,各种病症虽有不同但均可治疗。处方如下:
白恶(三分) 龙骨(三分) 芍药(二分) 黄连(二分) 当归(二分) 茯苓(二分) 黄芩(二分) 瞿麦(二分) 白蔹(二分) 石苇(二分) 甘草(二分) 牡蛎(二分) 细辛(二分) 附子(二分) 禹余粮(二分) 白石脂(二分) 人参(二分) 乌贼骨(二分) 甘皮(二分) 藁本(二分) 大黄(二分)
以上二十一味药,研筛成细粉,用蜂蜜制成梧桐子大小的丸剂。饭前服用十丸,每日两次。若疗效不明显,可酌情增加剂量。服药二十天可见效,三十天各种疾病即可痊愈。(按语:《短剧方》中有桂心四分、白芷四分,没有甘皮和藁本。)
The *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases) states: Various medical texts describe the "Thirty-Six Diseases" as comprising twelve types of leukorrhea, nine types of pain, seven types of harm, five types of injury, and three types of obstruction, collectively known as the Thirty-Six Diseases.
The twelve types of leukorrhea refer to abnormal vaginal discharge: the first is like white paste; the second is like clear blood; the third is like purple fluid; the fourth is like red flesh; the fifth is like pus crusts; the sixth is like bean soup; the seventh is like mallow broth; the eighth is like coagulated blood; the ninth is like clear blood resembling water; the tenth is like rice washings; the eleventh refers to menstrual flow that is prolonged or irregular ("washing of the moon"); the twelfth is amenorrhea where menstruation does not occur at the expected time.
The nine types of pain are: first, pain and injury in the vagina; second, dripping and painful sensation in the vagina; third, immediate pain upon urination; fourth, pain caused by cold; fifth, abdominal pain during menstruation that persists after the period ends; sixth, pain from metrorrhagia due to qi distension; seventh, sweating accompanied by a stinging pain in the vagina as if bitten by insects; eighth, radiating pain from the hypochondrium; ninth, lower back pain.
The seven types of harm are: first, harm from diet; second, harm from qi disharmony; third, harm from cold; fourth, harm from overwork; fifth, harm from sexual intercourse; sixth, harm from pregnancy; seventh, harm from sleep disturbances.
The five types of injury are: first, pain in both the anterior and posterior orifices; second, pain alternating with chills and fever; third, acute pain in the lower abdomen; fourth, insensibility of the zang organs; fifth, malposition of the zi men (cervical os), causing radiating pain to the back.
The three types of obstruction are: first, amenorrhea with blockage; the other two types of obstruction refer to the uterus's inability to conceive. (Note: The *Qianjin Fang* states: the three obstructions are: first, emaciation with failure to build flesh; second, infertility; third, amenorrhea.)
Regarding the seven harms, the *Qianjin Fang* records: first, pain in both orifices with difficult urination/defecation; second, pain alternating with chills and fever; third, acute and hard pain in the lower abdomen; fourth, insensibility of the zang organs; fifth, malposition of the zi men; sixth, fluctuating volume of menstrual flow; seventh, frequent vomiting of essence (referring to loss of vital essence).
Regarding the five types of pathogenic injuries, the *Qianjin Fang* records: first, fullness and pain in the hypochondrium; second, heart pain radiating to the hypochondrium; third, qi stagnation and blockage; fourth, dysentery/diarrhea caused by evil pathogens; fifth, blockage of both the anterior and posterior orifices, etc.
The Bai'e Wan (White Malady Pill) from the *Qianjin Fang* treats the Thirty-Six Diseases in women, addressing various symptoms regardless of their differences. The prescription is as follows:
Bai'e (3 fen) Longgu (Dragon Bone, 3 fen) Shaoyao (Peony Root, 2 fen) Huanglian (Coptis Rhizome, 2 fen) Danggui (Angelica Sinensis Radix, 2 fen) Fuling (Poria, 2 fen) Huangqin (Scutellaria Root, 2 fen) Qumai (Dianthus Herba, 2 fen) Bailian (Belamcanda Rhizome, 2 fen) Shiwei (Pyrola Leaf, 2 fen) Gancao (Licorice Root, 2 fen) Muli (Oyster Shell, 2 fen) Xixin (Asarum Root, 2 fen) Fuzi (Aconite Lateral Root, 2 fen) Yuyuliang (Hematitum, 2 fen) Baishizhi (Kaolin, 2 fen) Renshen (Ginseng Root, 2 fen) Wumeigu (Cuttlebone, 2 fen) Ganpi (Pericarpium Citri Reticulatae, 2 fen) Bencao (Ligusticum Chuanxiong Rhizome, 2 fen) Dahuang (Rhubarb Root, 2 fen)
These twenty-one herbs are ground into fine powder and mixed with honey to form pills the size of wu zi (cherry seeds). Take ten pills before meals, twice daily. If the effect is insufficient, gradually increase the dose. After twenty days of medication, improvement will be seen; after thirty days, all diseases will be cured. (Note: The *Duanju Fang* includes Guixin (Cinnamon Twig) 4 fen and Baizhi (Angelica Dahurica Root) 4 fen, but lacks Ganpi and Bencao.)