前阴所过之脉有二∶一曰肝，二曰督脉。《经》曰∶足厥阴之脉入毛中，过阴器，抵少腹。是肝脉所过也。督脉起于
小腹以下骨中央，女子系廷孔循阴器，男子循茎下至纂，与女子相等。是督脉所过也。
妇人阴肿者，有因胞络虚损，风冷客之，与血气相搏而肿者；有因郁怒伤损肝脾者；有因房劳过度，湿热下流者；
有欲胜而热甚生虫，以致肿痒并作者。皆宜戒房室而速治之，否则邪气渐盛，阴户溃烂不收矣。若气血虚弱，补中汤举
而升之；肝经湿热，龙胆泻肝汤渗而清之；肝脾郁怒，元气下陷，湿热壅滞，朝用归脾汤加升柴，解郁结、补脾气，夕
用加味逍遥散，清肝火、生肝血，除热去湿，至于阴痒阴疮，多属虫蚀所为，始因湿热，故生三虫在肠胃间，因脏虚乃
动。其虫侵蚀阴中精华，故时作痒，甚则痒痛不已，溃烂成疮。在室女、寡妇、尼姑多犯之。因情想不遂，以致精血凝
滞，酿成湿热，久而不散，遂成三虫，痒不可忍，深入脏腑即死，令人发热恶寒，与痨相似。亦有房室过伤，以致热壅，
肿痒内痛，外为便毒，莫不由欲事伤损肝肾，肾阴亏而肝火旺，木郁思达，肝经郁滞之火走空窍而下注为痒为虫。当用
龙胆泻肝汤，逍遥散，以主其内，外用蛇床子煎汤熏洗，专以桃仁研膏和雄黄末，鸡肝，研饼纳阴中，以制其虫。若肢
体倦怠，阴中闷痒，小便赤涩者，归脾汤加山栀、白术、甘草、丹皮，若徒以湿热为事，燥湿清热，则气血日衰，所害
不止阴痒矣。
妇人阴冷，因劳伤子脏，风冷客之。若小便涩滞，小腹痞痛，龙胆泻肝汤；若小便澄清，饮食少思，大便不实，治
以八味丸。八味丸治血弱不能荣养脏腑，津液枯涩，寒客子脏阴冷者甚效。
阴挺下脱，牵引腰腹膨痛者，或因胞络伤损，或因子脏虚冷，或犯非理房事，或因分娩用力所致，当以升补元气为
主。若肝脾郁结，气虚下陷，补中汤；若肝火湿热，小便赤涩，龙肝汤。有阴中突出如菌，四围肿痛，便数，晡热，似
痒似痛，小便重坠，此肝火湿热而肿痛，脾虚下陷而重坠也。先以补中汤加山栀、茯苓、青皮，以清肝火，升脾气，更
以加味归脾汤调理脾郁。外以生猪油和藜芦末涂之而收。新室嫁孔痛，宜舒郁和血，四物加香附、红花。
有交接出血者，此肝火太旺而疏泄过度，且肝虚不能藏血，脾虚不能摄血也，宜补中及归脾二汤，消息用之。若六
脉俱洪者，此肾阴虚而不能闭藏也，宜六味汤加麦冬，五味主之。
《金匮》云∶胃气下泄，阴吹而正喧，此谷气即不能上升清道，复不能循经下走后阴，阴阳乖辟，
如肠交之义是也。甚或簌簌有声，如后阴之失气状，宜补中汤加五味子主之。
前阴部位经过的经脉有两条：一是肝经，二是督脉。《内经》说：足厥阴肝经进入阴毛中，经过生殖器，抵达小腹。这是肝经所经过的部位。督脉起于小腹以下骨中央，女子联系廷孔并循行经过生殖器，男子循阴茎下行至会阴，与女子的路径相等。这是督脉所经过的部位。
妇女外阴肿胀，有的因为胞络（子宫及其附属脉络）虚损，风冷邪气侵袭，与气血相互搏结而导致肿胀；有的因为郁怒损伤肝脾；有的因为房事过度，湿热下注；有的因为欲望强烈而热盛生虫，导致肿胀和瘙痒同时发作。这些情况都应当禁止房事并迅速治疗，否则邪气逐渐强盛，阴户溃烂无法愈合。如果气血虚弱，用补中益气汤提升升举阳气；如果是肝经湿热，用龙胆泻肝汤渗利清泄湿热；如果是肝脾郁怒、元气下陷、湿热壅滞，早晨服用归脾汤加升麻、柴胡，以解郁结、补脾气，晚上服用加味逍遥散，以清肝火、生肝血，除热去湿。至于阴部瘙痒和阴疮，多属于虫蚀所致，起初是因为湿热，所以在肠胃间生出三种寄生虫，因为脏腑虚弱而活动。这些虫子侵蚀阴中的精华，所以时常发痒，严重时痒痛不止，溃烂成疮。未婚女子、寡妇、尼姑多患此病。因为情志愿望不能实现，导致精血凝滞，酿成湿热，长久不散，遂形成三虫，痒得难以忍受，深入脏腑就会死亡，使人发热恶寒，症状类似劳损病。也有因为房事过度受伤，导致热邪壅滞，肿胀瘙痒内部疼痛，外部表现为便毒（肛周脓肿等），没有不是由房事损伤肝肾，肾阴亏虚而肝火旺盛，木气郁结需要疏达，肝经郁滞之火走窜空窍而下注，导致瘙痒和生虫。应当使用龙胆泻肝汤、逍遥散内服，外用蛇床子煎汤熏洗，专门用桃仁研膏混合雄黄末、鸡肝，研成饼状纳入阴道中，以制约虫子。如果肢体倦怠，阴中闷痒，小便赤涩，用归脾汤加山栀、白术、甘草、丹皮。如果只注重清热燥湿，那么气血日渐衰弱，危害不仅仅局限于阴痒。
妇女外阴寒冷，因为劳累损伤子脏（子宫），风冷邪气侵袭。如果小便涩滞，小腹痞满疼痛，用龙胆泻肝汤；如果小便清澈，饮食减少思虑，大便不成形，用八味丸治疗。八味丸治疗血弱不能荣养脏腑，津液枯涩，寒邪客居子脏导致阴冷的情况非常有效。
阴挺下脱（子宫脱垂或阴道壁膨出），牵引腰腹部胀痛，可能是因为胞络损伤，或者因为子脏虚冷，或者犯非礼房事，或者因为分娩用力所致，应当以升提补益元气为主。如果肝脾郁结，气虚下陷，用补中益气汤；如果肝火湿热，小便赤涩，用龙胆泻肝汤。如果有物体从阴中突出如菌状，四周肿痛，尿频，午后发热，似痒似痛，小便重坠感，这是肝火湿热导致肿痛，脾虚下陷导致重坠。先用补中益气汤加山栀、茯苓、青皮，以清肝火、升脾气，再用加味归脾汤调理脾郁。外用生猪油和藜芦末涂抹以收敛。新婚嫁入后孔道疼痛，宜舒郁和血，用四物汤加香附、红花。
有性交出血的，这是肝火太旺而疏泄过度，且肝虚不能藏血，脾虚不能摄血，宜用补中益气汤和归脾汤，斟酌使用。如果六脉都洪大，这是肾阴虚而不能闭藏，宜用六味地黄汤加麦冬、五味子主治。
《金匮要略》说：胃气下泄，阴吹（阴道排气）而且声音喧响，这是因为谷气不能上升进入清道，又不能循经向下走后阴，阴阳乖违背离，就像肠交的意思一样。甚至簌簌有声，像后阴放屁的样子，宜用补中益气汤加五味子主治。
The meridians passing through the anterior yin region are two: one is the Liver Meridian, and the other is the Du Meridian (Governing Vessel). The *Classic* states: "The Foot-Jueyin Liver Meridian enters the pubic hair area, passes over the genitalia, and reaches the lower abdomen." This is the path of the Liver Meridian. The Du Meridian originates from the central bone below the lower abdomen; in women, it connects to the Ting Kong (a point near the urethra/vagina) and runs along the genitalia; in men, it runs along the penis down to the perineum, equal in length to that of women. This is the path of the Du Meridian.
In women, vulvar swelling may be caused by deficiency and damage to the Bao Luo (uterine collateral vessels), where wind-cold pathogens invade and contend with Qi and Blood, leading to swelling; or by depression and anger damaging the Liver and Spleen; or by excessive sexual activity causing damp-heat to flow downward; or by intense desire generating excessive heat and parasites, resulting in simultaneous swelling and itching. All these conditions require abstention from sexual intercourse and prompt treatment; otherwise, the pathogenic factors will gradually intensify, leading to ulceration and non-healing of the vaginal opening. If Qi and Blood are deficient, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to lift and raise Yang Qi. If there is damp-heat in the Liver Meridian, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) to drain and clear damp-heat. If there is Liver-Spleen depression and anger, sinking of Yuan Qi, and stagnation of damp-heat, administer Guipi Tang (Spleen-Restoring Decoction) with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) in the morning to resolve depression and tonify Spleen Qi, and Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) in the evening to clear Liver Fire, generate Liver Blood, remove heat, and eliminate dampness. As for vulvar itching and ulcers, they mostly belong to parasitic erosion. Initially caused by damp-heat, three types of parasites arise in the intestines and stomach and become active due to Zang organ deficiency. These parasites erode the essence of the vagina, causing intermittent itching; severely, they cause unceasing itching and pain, ulcerating into sores. Virgins, widows, and nuns are prone to this condition. Unfulfilled emotional desires lead to stagnation of essence and blood, brewing damp-heat that persists for a long time, forming parasites. The unbearable itching can penetrate deep into the Zang organs, leading to death, accompanied by fever and aversion to cold, resembling consumptive disease. Some cases result from excessive sexual injury causing heat stagnation, swelling, itching, internal pain, and external presentation as biandu (perianal abscesses). None are not caused by sexual activity damaging the Kidney and Liver, where Kidney Yin is deficient and Liver Fire is hyperactive. Wood Qi is depressed and needs dispersal; the stagnant fire of the Liver Meridian travels through hollow orifices and sinks downward, causing itching and parasite formation. Internal treatment should use Longdan Xiegan Tang and Xiaoyao San. External treatment involves fumigating and washing with a decoction of Chuangzi (Cnidii Fructus), and specifically applying a paste made of Tao Ren (Persicae Semen) ground into ointment, mixed with Xionghuang (Realgar) powder and Ji Gan (Gallus Gallus Domesticus Hepat et Testis), formed into a cake and inserted into the vagina to control parasites. If limbs are fatigued, there is stifling itching in the vagina, and urine is red and scanty, use Guipi Tang with Zhizi (Gardeniae Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), and Danpi (Moutan Cortex). If one only focuses on clearing heat and drying dampness, Qi and Blood will daily decline, and the harm will extend beyond mere vulvar itching.
Vulvar coldness in women is caused by labor injuring the Zi Zang (uterus), allowing wind-cold pathogens to invade. If urination is obstructed and the lower abdomen is distended and painful, use Longdan Xiegan Tang. If urine is clear, appetite is poor, and stools are loose, treat with Bawei Wan (Eight-Ingredient Pill). Bawei Wan is highly effective for treating blood deficiency failing to nourish Zang organs, dryness of body fluids, and cold pathogens residing in the uterus causing vulvar coldness.
Prolapse of the uterus or vaginal walls (Yinting Xiaduo), pulling and causing abdominal pain, may be due to damage to the Bao Luo, deficiency-cold of the Zi Zang, improper sexual conduct, or exertion during childbirth. The primary treatment should be lifting and tonifying Yuan Qi. If there is Liver-Spleen depression and sinking of Qi due to deficiency, use Buzhong Yiqi Tang. If there is Liver Fire and damp-heat with red, scanty urine, use Longdan Xiegan Tang. If a mass protrudes from the vagina like a mushroom, surrounded by swelling and pain, with frequent urination, afternoon fever, sensation of itching and pain, and heavy sensation in urination, this indicates Liver Fire and damp-heat causing swelling and pain, and Spleen deficiency with sinking causing heaviness. First, use Buzhong Yiqi Tang with Zhizi, Fuling (Poria), and Qingpi (Citri Reticulatae Pericarpium Viride) to clear Liver Fire and ascend Spleen Qi, followed by Jiawei Guipi Tang to regulate Spleen depression. Externally, apply fresh pig lard mixed with Lili powder to astringe. Pain in the vaginal introitus after marriage should be treated by soothing depression and harmonizing blood, using Siwu Tang with Xiangfu (Cyperi Rhizoma) and Honghua (Carthami Flos).
Bleeding during intercourse is caused by excessive Liver Fire leading to over-dispersal, combined with Liver deficiency failing to store blood and Spleen deficiency failing to control blood. Use Buzhong Yiqi Tang and Guipi Tang, adjusting usage as needed. If all six pulses are surging, this indicates Kidney Yin deficiency failing to secure and store, treated with Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) plus Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus).
The *Jingui Yaolue* states: "When Stomach Qi leaks downward, causing flatulence through the vagina (Yinchui) with loud noise, it means that grain Qi cannot ascend to the clear pathways, nor can it follow the meridians to exit through the posterior yin. This is a deviation of Yin and Yang, similar to the concept of intestinal crossing." In severe cases, there may be rustling sounds, resembling flatus from the anus. Treat with Buzhong Yiqi Tang plus Wuweizi.