治妇女赤白带下。
生山药（一两） 生龙骨（六钱，捣细） 生牡蛎（六钱，捣细）海螵蛸（四钱，去净甲捣） 茜草（三钱）
单赤带，加白芍、苦参各二钱；单白带，加鹿角霜、白术各三钱。
带下为冲任之证。而名谓带者，盖以奇经带脉，原主合同束诸脉，冲任有滑脱之疾，责在带脉不能约束，
故名为带也。然其病
非仅滑脱也，若滞下然，滑脱之中，实兼有瘀滞。其所瘀滞者，不外气血，而实有因寒因热之不同。此方用龙
骨、牡蛎以固脱，用茜草、海螵蛸以化滞，更用生山药以滋真阴固元气。至临证时，遇有因寒者，加温热之药，
因热者，加寒凉之药，此方中意也。而愚拟此方，则又别有会心也。尝考《神农本草经》龙骨善开 瘕，牡蛎
善消 ，是二药为收涩之品，而兼具开通之力也。乌 鱼骨即海螵蛸，茹芦即茜草，是二药为开通之品，而
实具收涩之力也。四药汇集成方，其能开通者，兼能收涩，能收涩者，兼能开通，相助为理，相得益彰。
一妇人，年二十余，患白带甚剧，医治年余不愈。后愚诊视，脉甚微弱。自言下焦凉甚，遂用此方，加干
姜六钱，鹿角霜三钱，连服十剂全愈。
又∶一媪年六旬。患赤、白带下，而赤带多于白带，亦医治年余不愈。诊其脉甚洪滑，自言心热头昏，时
觉眩晕，已半载未起床矣。遂用此方，加白芍六钱，数剂白带不见，而赤带如故，心热、头眩晕亦如故。又加苦
参、龙胆草、白头翁各数钱。连服七八剂，赤带亦愈，而诸疾亦遂全愈。自拟此方以来，用治带下，愈者不可
胜数。而独载此两则者，诚以二证病因，寒热悬殊。且年少者用此方，反加大热之药，年老者用此方，反加苦
寒之药。欲临证者，当知审证用药，不可拘于年岁之老少也。
按∶白头翁不但治因热之带证甚效也。剖取其鲜根，以治血淋、溺血与大便下血之因热而得者甚效，诚良
药也。是以仲景治厥阴热痢有白头翁汤也。
带证，若服此汤未能除根者，可用此汤送服秘真丹一钱。
带下似滞下之说，愚向持此论。后观西法，亦谓大肠病则流白痢，子宫病则流白带，其理相同。法用儿茶、
白矾、石榴皮、没石子等水洗之。若此证之剧者，兼用其外治之法亦可。又∶其
内治白带法，用没石子一两捣烂，水一斤半，煎至一斤，每温服一两，日三次。或研细作粉，每服五分，日二
次亦可。又可单以之熬水洗之，或用注射器注射之。按∶没石子味苦而涩，苦则能开，涩则能敛，一药而具此
两长，原与拙拟清带汤之意相合。且其收敛之力最胜，凡下焦滑脱之疾，或大便滑泻、或小便不禁、或男子遗
精、或女子崩漏，用之皆效验。今之医者，多忽不知用惜哉。又东人中将汤，治白带亦甚效。玉烛汤下，载有
其方，可采用。若以治赤带，方中官桂、丁香，宜斟酌少用，苦参宜多用。
赤白二带，赤者多热，白者多凉。而辨其凉热，又不可尽在赤白也，宜细询其自觉或凉或热，参以脉之
或迟或数，有力无力，则凉热可辨矣。治法宜用收涩之品，而以化瘀通滞之药佐之。清带汤，证偏热者，加生
杭芍、生地黄；热甚者，加苦参、黄柏，或兼用防腐之药，若金银花、旱三七、鸦胆子仁皆可酌用；证偏凉者，
加白术、鹿角胶；凉甚者，加干姜、桂附、小茴香。
近阅《杭州医报》，载有俗传治白带便方，用绿豆芽连头根三斤，洗净，加水两大碗，煎透去渣，加生姜
汁三两、黄蔗糖四两，慢火收膏，每晨开水冲服。约十二日服一料。服至两料必愈。按∶此方用之数次，颇有效验。
治疗妇女赤带和白带下注。
生山药（一两） 生龙骨（六钱，捣碎成细粉） 生牡蛎（六钱，捣碎成细粉）海螵蛸（四钱，去除干净硬壳后捣碎） 茜草（三钱）
如果是单纯的赤带，加白芍、苦参各二钱；如果是单纯的白带，加鹿角霜、白术各三钱。
带下病属于冲脉和任脉的病变。之所以称为“带”，是因为奇经八脉中的带脉，原本主要功能是约束连接其他经脉，当冲脉和任脉出现滑脱不禁的疾病时，原因在于带脉不能起到约束作用，所以称之为带下病。然而这种病不仅仅是滑脱，还像痢疾一样，在滑脱之中实际上兼有瘀血阻滞。其所瘀滞的东西，不外乎是气和血，但实际上又有因寒邪或因热邪的不同。这个方子用龙骨、牡蛎来固涩止脱，用茜草、海螵蛸来化解瘀滞，再用生山药来滋养真阴并巩固元气。到了临证时，遇到因寒邪引起的，加入温热的药物，因热邪引起的，加入寒凉的药物，这是本方的用意所在。而我拟定这个方子，又另有心得。曾经考证《神农本草经》，龙骨善于消散癥瘕积聚，牡蛎善于消除痞块，这两味药虽然是收敛固涩之品，却兼具开通散结的力量。乌贼鱼骨即海螵蛸，茹芦即茜草，这两味药虽然是开通散结之品，却实在具有收敛固涩的力量。这四味药汇集成方，能开通的，同时也具备收涩的功能；能收涩的，同时也具备开通的功能，相互辅助，相得益彰。
有一位二十多岁的妇人，患白带下注非常严重，医治了一年多没有痊愈。后来我诊视，脉象非常微弱。她自述下焦寒冷严重，于是使用此方，加干姜六钱，鹿角霜三钱，连续服用十剂后完全痊愈。
另外：一位六十岁的老妇人，患赤带和白带下注，且赤带多于白带，也医治了一年多没有痊愈。诊察她的脉象非常洪大滑数，她自述心中发热、头晕，时常感到眩晕，已经半年没有起床了。于是使用此方，加白芍六钱，几剂之后白带消失，但赤带依旧，心中发热、头晕眩晕也依旧。又加入苦参、龙胆草、白头翁各数钱。连续服用七八剂，赤带也好了，各种疾病也随之完全痊愈。自从拟定此方以来，用它治疗带下病，治愈者不可胜数。而唯独记载这两个案例，实在是因为这两个病例的病因，寒热差异悬殊。而且年轻患者用此方，反而加大热之药；年老患者用此方，反而加苦寒之药。想要临证施治的医者，应当知道审察证候用药，不可拘泥于患者的年龄老少。
按语：白头翁不仅治疗因热邪引起的带下病非常有效。剖取其新鲜根部，用来治疗因热邪引起的血淋、尿血和大便下血也非常有效，确实是良药。因此张仲景治疗厥阴热痢有白头翁汤。
带下病，如果服用此汤未能除根，可以用此汤送服秘真丹一钱。
关于带下病类似痢疾的说法，我过去持有这种观点。后来观察西医方法，也说大肠生病则流出白痢，子宫生病则流出白带，其道理是相同的。治疗方法是用儿茶、白矾、石榴皮、没石子等煎水洗患处。如果此证严重的，兼用其外治法也可以。另外：内治白带的方法，用没石子一两捣烂，水一斤半，煎至一斤，每次温服一两，每天三次。或者研细做成粉，每次服五分，每天两次也可以。又可以单用其熬水洗患处，或用注射器注射。按语：没石子味道苦涩，苦则能开通，涩则能收敛，一味药具备这两种长处，原本与我拟定的清带汤的意思相符合。而且其收敛力量最强，凡是下焦滑脱的疾病，或者大便滑泻、或者小便失禁、或者男子遗精、或者女子崩漏，使用它都有效验。现在的医生，大多忽视不知道使用，可惜啊。另外日本人的中将汤，治疗白带也很有效。玉烛汤下面记载了其方子，可以采用。如果用来治疗赤带，方中的官桂、丁香，宜斟酌少用，苦参宜多用。
赤带和白带，赤色的多属热，白色的多属寒凉。而要辨别其寒热，又不能仅仅看赤白，应该详细询问患者自觉感觉或凉或热，参考脉象的或迟或数，有力无力，那么寒热就可以辨别了。治疗方法宜用收敛固涩之品，而以化瘀通滞的药物辅助。清带汤，证候偏热的，加生杭芍、生地黄；热势严重的，加苦参、黄柏，或者兼用防腐的药物，如金银花、旱三七、鸦胆子仁都可以酌情使用；证候偏凉的，加白术、鹿角胶；寒凉严重的，加干姜、桂附、小茴香。
最近阅读《杭州医报》，载有民间流传的治疗白带的便方，用绿豆芽连同头根三斤，洗净，加大碗水两碗，煎透去渣，加生姜汁三两、红糖四两，慢火收膏，每晨开水冲服。大约十二天服完一料。服到两料必定痊愈。按语：此方使用过几次，颇有效验。
Treats leukorrhea (vaginal discharge) presenting as red or white discharge in women.
Raw Dioscoreae Rhizoma (Shanyao, 50g), Raw Longgu (Fossil Bones, 22.5g, crushed to fine powder), Raw Muli (Oyster Shell, 22.5g, crushed to fine powder), Haipiaoxiao (Cuttlebone, 15g, shell removed and crushed), Qiancao (Madder Root, 12g).
For isolated red discharge, add Baishao (White Peony Root) and Kushen (Sophora Root) 7.5g each; for isolated white discharge, add Lujiaoshuang (Deer Antler Frost) and Baizhu (Atractylodes Macrocephala Rhizome) 11.25g each.
Leukorrhea is a disorder of the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). It is named "Dai" (Belt) because the Dai Mai (Girdling Vessel), one of the extraordinary vessels, originally functions to bind and constrain the other vessels. When the Chong and Ren vessels suffer from slipping and loss of control, the responsibility lies with the Dai Mai's inability to constrain them, hence the name. However, this disease is not merely about slipping and loss of control; like dysentery (Li Xia), amidst the slipping there is actually stasis and obstruction. The stasis involves Qi and Blood, but it differs depending on whether the cause is Cold or Heat. This formula uses Longgu and Muli to secure and stop slipping, Qiancao and Haipiaoxiao to resolve stasis, and Raw Shanyao to nourish True Yin and consolidate Yuan Qi (Primal Qi). In clinical practice, if the cause is Cold, warm herbs are added; if the cause is Heat, cooling herbs are added. This is the intent of the formula. My formulation of this prescription has another insight. I have examined the *Shennong Bencao Jing* (Divine Farmer's Materia Medica), which states that Longgu is good at dispersing masses (Zheng Jia), and Muli is good at eliminating痞块 (Pi Kuai). These two drugs are astringents but also possess the power to open and unblock. Wuzuyu Gu (Cuttlebone) is Haipiaoxiao, and Rulu is Qiancao; these two drugs are opening agents but truly possess astringent power. The four drugs combined in this formula: those that open also astringe, and those that astringe also open. They assist each other, enhancing each other's effects.
A woman in her twenties suffered severely from white discharge, treated for over a year without cure. Later, I examined her pulse, which was very weak and faint. She stated she felt severe cold in the lower jiao (Lower Burner). Thus, I used this formula, adding Ganjiang (Dried Ginger) 22.5g and Lujiaoshuang 11.25g. After taking ten doses continuously, she was completely cured.
Another case: An elderly woman in her sixties suffered from red and white discharge, with red discharge exceeding white discharge. She was treated for over a year without cure. Her pulse was very surging and slippery. She stated she had heart heat and dizziness, often feeling vertigo, and had not gotten out of bed for half a year. I used this formula, adding Baishao 22.5g. After several doses, the white discharge disappeared, but the red discharge remained, along with heart heat and dizziness. I then added Kushen, Longdancao (Gentiana Root), and Baitouweng (Pulsatilla Root) several qian each. After taking seven or eight doses continuously, the red discharge also healed, and all ailments were completely cured. Since formulating this prescription, I have used it to treat leukorrhea, with countless cures. I record only these two cases because the etiology of the two conditions differs significantly in terms of Cold and Heat. Moreover, for the young patient, large amounts of hot herbs were added; for the old patient, bitter-cold herbs were added. Clinicians should understand how to select medications based on syndrome differentiation, rather than being constrained by the age of the patient.
Note: Baitouweng is not only very effective for treating heat-induced leukorrhea. Its fresh root, when extracted, is also very effective for treating hematuria (Xue Lin), blood in urine (Niao Xue), and bloody stool due to heat. It is indeed a good medicine. Therefore, Zhang Zhongjing used Baitouweng Tang (Pulsatilla Decoction) to treat Jueyin heat-dysentery.
If leukorrhea is not rooted out after taking this decoction, one can take Mizhen Dan (Secret True Pill) 3g, washed down with this decoction.
The theory that leukorrhea resembles dysentery was my previous view. Later, observing Western methods, they also state that diseases of the large intestine result in white dysentery, while diseases of the uterus result in white discharge; the principle is the same. The method involves washing with solutions of Ercha (Kino), Baifan (Alum), Shiliupi (Pomegranate Peel), and Meishi Zi (Myrobalan) etc. For severe cases of this condition, external treatment methods can be used concurrently. Additionally, for internal treatment of white discharge, use Meishi Zi 50g, crushed, boiled in 750ml water until reduced to 500ml. Take 30ml warm, three times daily. Or grind into fine powder, take 1.5g twice daily. It can also be boiled alone for washing, or injected using a syringe. Note: Meishi Zi tastes bitter and astringent. Bitterness opens, astringency consolidates. One herb possesses both strengths, which aligns with the intent of my Qingdai Tang. Furthermore, its astringent power is supreme. For any lower jiao slipping disorders, such as loose stools, urinary incontinence, nocturnal emission in men, or metrorrhagia in women, it is effective. Current physicians often neglect its use, which is a pity. Additionally, the Japanese "Zhongjiang Tang" is also very effective for white discharge. Its formula is recorded under Yuzhu Tang and can be adopted. If used for red discharge, Guigui (Cinnamon Bark) and Dingxiang (Clove) in the formula should be used sparingly, and Kushen should be used in larger amounts.
Red and white discharges: Red indicates more heat, white indicates more cold/cool. To distinguish cold and heat, one cannot rely solely on the color. One must carefully inquire about the patient's subjective sensation of cold or heat, and refer to the pulse being slow or rapid, forceful or feeble. Then cold and heat can be distinguished. Treatment should use astringent substances, assisted by herbs that transform stasis and unblock obstruction. For Qingdai Tang, if the syndrome leans towards heat, add Sheng Hangshao (Raw Paeonia Lactiflora) and Sheng Dihuang (Raw Rehmannia); if heat is severe, add Kushen and Huangbai (Phellodendron Bark), or concurrently use anti-septic herbs like Jinyinhua (Honeysuckle Flower), Hanzhangsan (Notoginseng), or Yadanzi Ren (Brucea Fruit Seed). If the syndrome leans towards cold, add Baizhu and Lujiaojiao (Deer Antler Glue); if cold is severe, add Ganjiang, Guifu (Cinnamon Twig and Aconite), and Xiaohuixiang (Fennel).
Recently, I read the *Hangzhou Medical Journal*, which carried a folk remedy for white discharge: use 1.5kg of mung bean sprouts including roots, wash clean, add two large bowls of water, boil thoroughly, remove dregs, add 45g ginger juice and 200g brown sugar, reduce slowly over low heat to make a paste. Take mixed with boiling water every morning. Approximately twelve days per dose. Two doses will surely cure it. Note: I have used this formula several times with considerable efficacy.