治妇女经水行时多而且久,过期不止或不时漏下。
白术(六钱,炒) 生黄 (六钱) 生龙骨(六钱,捣细) 生牡蛎(六钱,捣细) 大生地(六钱)
生杭芍(三钱) 海螵蛸(四钱,捣细) 茜草(三钱) 川续断(四钱)
友人刘××其长子妇,经水行时,多而且久,淋漓八九日始断。数日又复如故。医治月余,初稍见轻,继又
不愈。延愚诊视,观所服方,即此安冲汤,去茜草、螵蛸。遂仍将二药加入,一剂即愈。又服一剂,永不反复。
刘××疑而问曰∶茜草、螵蛸,治此证如此效验,前医何为去之?答曰∶彼但知茜草、螵蛸能通经血,而未见
《内经》用此二药雀卵为丸,鲍鱼汤送下,治伤肝之病,时时前后血也。故于经血过多之证,即不敢用。不知
二药大能固涩下焦,为治崩之主药也。
一妇人,年三十余。夫妻反目,恼怒之余,经行不止,且又甚多。医者用十灰散加减,连服四剂不效。后
愚诊视,其右脉弱而且濡。询其饮食多寡,言分毫不敢多食,多即泄泻。遂投以此汤,去黄 ,将白术改用一
两。一剂血止,而泻亦愈。又服一剂,以善其后。
一妇人,年二十余。小产后数日,恶露已尽,至七八日,忽又下血。延医服药,二十余日不止。诊其脉,
洪滑有力,心中热而且渴。疑其夹杂外感,询之身不觉热,又疑其血热妄行,遂将方中生地改用一两,又加知
母一两,服后血不止,而热渴亦如故。因思此证,实兼外感无疑。遂改用白虎加人参汤以山药代粳米。方中石
膏重用生者三两。煎汤两盅,分两次温饮下。外感之火遂消,血亦见止。仍与安冲汤,一剂遂全愈。又服数剂,
以善其后。
附录∶
直隶青县张××来函∶
王氏妇,年十九岁,因殇子过痛,肝气不畅,经水行时多而且久,或不时漏下。前服逍遥、归脾等药,
皆无效。诊其脉,左关尺及右尺皆浮弦,一息五至强。口干不思食,腰疼无力,乃血亏而有热也。遵将女科方
安冲汤去 、术,加麦冬、霍石斛、香附米,俾服之。二剂血止,六剂后食量增加,口干腰疼皆愈。继将汤剂
制作丸药,徐徐服之,月事亦从此调矣。
直隶盐山孙××来函∶
一九二四年七月,友人张××之母,因筹办娶儿媳事劳心过度,小便下血不止,其血之来沥沥有声,请为
诊视,举止不定,气息微弱,右脉弦细,左脉弦硬。为开安冲汤,服后稍愈。翌日晨起,忽然昏迷,其家人甚
恐,又请诊视。其脉尚和平,知其昏迷系黄 升补之力稍过,遂仍用原方,加赭石八钱,一剂而愈。
家族婶有下血证,医治十余年,时愈时发,终未除根。一九二六年六月,病又作,请为诊视。治以《傅
青主女科》治老妇血崩方,遵师训加生地黄一两,一服即愈。七月,病又反复。治以安冲汤方,以其心中觉凉,
加干姜二钱,一剂病又愈。
斯年初秋,李姓之女,年十七岁,下血不止,面唇皆白,六脉细数。治以安冲汤,重用山萸肉,三剂而愈。
治疗妇女月经期间经量过多且持续时间过长,过期仍不止或不时有点滴出血(漏下)的情况。
白术(六钱,炒制) 生黄芪(六钱) 生龙骨(六钱,捣碎成细粉) 生牡蛎(六钱,捣碎成细粉) 大生地(六钱)
生杭芍(三钱) 海螵蛸(四钱,捣碎成细粉) 茜草(三钱) 川续断(四钱)
友人刘××的长子媳妇,月经来潮时,经量多且持续时间长,淋漓不尽达八九天才停止。几天后又复发如前。医生治疗了一个多月,起初症状稍见减轻,随后又未痊愈。请我诊治,观察他所服用的方剂,就是此安冲汤,只是去掉了茜草和海螵蛸。于是我将这两味药重新加入,服用一剂即愈。再服一剂,从此不再反复。
刘××怀疑并问道:“茜草、海螵蛸治疗这种病症如此有效,之前的医生为什么去掉它们?”我回答说:“他们只知道茜草、海螵蛸能通利经血,而没有见到《内经》中使用这两味药配合雀卵制成丸剂,用鲍鱼汤送服,治疗肝脏受损引起的时时前后阴出血的病证。因此,对于经血过多的病症,就不敢使用。不知道这两味药具有强大的固涩下焦的作用,是治疗崩漏的主药。”
有一位妇人,三十多岁。夫妻反目,在恼怒之后,月经行而不止,而且量非常大。医生使用十灰散加减,连续服用四剂无效。后来我诊治,发现她右脉弱而濡软。询问她的饮食多少,她说分毫不敢多吃,多吃就会腹泻。于是投以此汤,去掉黄芪,将白术改为一两。服用一剂血止,腹泻也好了。再服一剂,以巩固疗效。
另一位妇人,二十多岁。小产数日后,恶露已净,到了七八天,忽然又出血。延请医生服药,二十多天不止。诊其脉象,洪滑有力,心中发热且口渴。怀疑夹杂外感病邪,询问身体不觉发热;又怀疑是血热妄行,于是将方中的生地改为一两,又加知母一两,服用后血不止,热渴也无改善。因而想到此证,确实兼有外感无疑。于是改用白虎加人参汤,用山药代替粳米。方中石膏重用生石膏三两。煎取两盅汤,分两次温服。外感之火遂消,血也见止。再给予安冲汤,一剂便全愈。又服数剂,以善后调理。
附录:
直隶青县张××来信说:
王氏妇,十九岁,因丧子过于悲痛,肝气不畅,月经来潮时经量多且持续时间长,或不时有点滴出血。之前服用逍遥散、归脾汤等药,都无效。诊其脉象,左关尺及右尺皆浮弦,一息五至以上。口干不想吃东西,腰痛无力,这是血亏而有热。遵照女科方安冲汤,去掉黄芪、白术,加麦冬、霍石斛、香附米,让她服用。二剂血止,六剂后食量增加,口干腰痛皆愈。继后将汤剂制作成丸药,慢慢服用,月经从此调顺了。
直隶盐山孙××来信说:
一九二四年七月,友人张××的母亲,因筹办娶儿媳之事劳心过度,小便下血不止,其血流出来沥沥有声,请我为之诊治。举止不定,气息微弱,右脉弦细,左脉弦硬。为她开安冲汤,服用后稍有好转。第二天早晨起床,忽然昏迷,家人非常恐惧,又请我诊治。其脉尚和平,知道昏迷是黄芪升补之力稍过所致,于是仍用原方,加赭石八钱,一剂而愈。
家族婶母有下血证,医治十余年,时好时发,终未除根。一九二六年六月,病又发作,请我为之诊治。治疗采用《傅青主女科》治疗老妇血崩的方子,遵照师训加生地黄一两,一服即愈。七月,病又反复。治疗采用安冲汤方,因其心中觉凉,加干姜二钱,一剂病又愈。
Treating women with excessive menstrual flow that lasts for an extended period, continuing beyond the expected duration or presenting as intermittent spotting (Lou Xia).
Baizhu (Atractylodis Macrocephalae Rhizoma, 6 qian, stir-fried), Sheng Huangqi (Astragali Radix, 6 qian), Sheng Longgu (Fossilia Ossis Mastodi, 6 qian, crushed into fine powder), Sheng Muli (Concha Ostreae, 6 qian, crushed into fine powder), Da Shengdi (Rehmanniae Radix, 6 qian),
Sheng Hangshao (Paeoniae Radix Alba, 3 qian), Haipiaoxiao (Endoconcha Sepiae, 4 qian, crushed into fine powder), Qiancao (Rubiae Cordifoliae Radix et Rhizoma, 3 qian), Chuan Xuduan (Dipsaci Radix, 4 qian).
The eldest son's wife of my friend Liu XX had a menstrual period characterized by heavy flow and prolonged duration, dripping continuously for eight to nine days before stopping. A few days later, it recurred. She was treated by other physicians for over a month; initially, symptoms slightly improved, but subsequently did not resolve. I was invited to examine her. Observing the prescription she had taken, it was this Anchong Tang (Stabilize the Flow Decoction), but with Qiancao and Haipiaoxiao removed. I therefore re-added these two herbs. After one dose, she was cured. After taking another dose, there was no recurrence.
Mr. Liu XX questioned doubtfully: "Qiancao and Haipiaoxiao are so effective for this condition; why did the previous physician remove them?" I replied: "They only knew that Qiancao and Haipiaoxiao can promote blood circulation and unblock menstruation, but they had not seen the usage of these two herbs in the *Neijing* (Classic of Internal Medicine), where they are combined with quail eggs to form pills, taken with Abalone Soup, to treat liver injury causing bleeding from both anterior and posterior orifices. Therefore, for conditions with excessive menstrual blood, they dared not use them. They did not know that these two herbs have strong astringent properties for the Lower Jiao (Lower Burner) and are primary medicines for treating Bing Lou (Metrorrhagia and Metrostaxis)."
A woman in her thirties experienced continuous and heavy menstrual bleeding following marital discord and anger. Physicians used Shihui San (Ten Ash Powder) with modifications, administered for four doses without effect. Upon my examination, her Right pulse was weak and soggy (Ru). Inquiring about her diet, she stated she dared not eat much, as overeating led to diarrhea. I prescribed this decoction, removing Huangqi and increasing Baizhu to 1 liang. After one dose, the bleeding stopped, and the diarrhea also resolved. Another dose was taken to consolidate the treatment.
Another woman, in her twenties, experienced sudden bleeding seven to eight days after a spontaneous abortion, despite lochia having ceased previously. She had been under medical care for over twenty days without cessation. Her pulse was surging (Hong), slippery (Hua), and forceful. She felt heat in the heart and thirst. Suspecting an external pathogenic factor, I asked if she had fever; she reported none. Suspecting Blood Heat forcing blood recklessly, I increased Shengdi to 1 liang and added Zhi Mu 1 liang. However, bleeding persisted, and heat/thirst remained unchanged. I then reasoned that this condition certainly involved an external pathogen. I switched to Baihu Jia Renshen Tang (White Tiger Plus Ginseng Decoction), substitining Shanyao (Dioscoreae Rhizoma) for Jingmi (Oryzae Semen). I heavily used raw Shigao (Gypsum Fibrosum) at 3 liang. The decoction was prepared to yield two bowls, taken warm in two divided doses. The fire of the external pathogen subsided, and bleeding stopped. Subsequently, AnChong Tang was administered, resulting in complete cure after one dose. Several more doses were taken for convalescence.
Appendix:
Letter from Zhang XX of Qingxian County, Zhili:
Wang's wife, aged nineteen, suffered from excessive and prolonged menstrual flow or intermittent spotting due to grief over the loss of a child leading to stagnant Liver Qi. Previous treatments with Xiaoyao San (Free and Easy Wanderer Powder) and Guipi Tang (Restore the Spleen Decoction) were ineffective. Her pulse was floating and wiry (Xian) at the Left Guan-Chi and Right Chi positions, beating five times per breath or faster. She had dry mouth, no appetite, lower back pain, and weakness, indicating Blood deficiency with Heat. Following the Gynecological formula AnChong Tang, I removed Huangqi and Baizhu, adding Maidong (Ophiopogonis Radix), Huo Shihu (Dendrobii Nobile Caulis), and Xiangfumi (Cyperi Rhizoma). After two doses, bleeding stopped. After six doses, appetite increased, and dry mouth/back pain resolved. The decoction was subsequently processed into pills for slow administration, regulating her menses thereafter.
Letter from Sun XX of Yanshan County, Zhili:
In July 1924, the mother of my friend Zhang XX suffered from persistent hematuria (blood in urine) with audible dripping sounds due to excessive mental exertion arranging her son's wedding. Her demeanor was unsettled, breath was faint, Right pulse was wiry-thin (Xian-Xi), and Left pulse was wiry-hard (Xian-Ying). I prescribed AnChong Tang. She improved slightly after ingestion. The next morning, she suddenly fell into a coma, frightening her family. Upon re-examination, her pulse was peaceful. I determined the coma was caused by the ascending and tonifying power of Huangqi being slightly excessive. I retained the original formula but added Zheshi (Haematitum, 8 qian). She recovered after one dose.
My family aunt suffered from lower body bleeding for over ten years, recurring intermittently without a permanent cure. In June 1926, the illness recurred. I treated her using the formula for metrorrhagia in elderly women from Fu Qingzhu Nu Ke (Fu Qingzhu's Gynecology), adding Sheng Dihuang (Rehmanniae Radix Recens, 1 liang) according to my master's instructions. She recovered after one dose. In July, the illness recurred. I treated her with AnChong Tang. Since she felt cold in the epigastrium/heart region, I added Ganjiang (Zingiberis Rhizoma, 2 qian). She recovered after one dose.
In early autumn of that year, Li's daughter, aged seventeen, suffered from persistent lower body bleeding, pale face and lips, and a fine-rapid (Xi-Shu) pulse throughout all six positions. I treated her with AnChong Tang, heavily using Shanzhuyu (Corni Fructus). She recovered after three doses.