半夏一升 厚朴三两 茯苓四两 生姜五两 干苏叶二两
右五味，以水七升，煮取四升，分温四服，日三夜一服。
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妇人藏躁，喜悲伤欲哭，象如神灵所作，数欠伸，甘麦大枣汤主之。
【按】
甘草小麦大枣汤，方义未详，必是□错。
【注】
藏，心藏也，心静则神藏。若为七情所伤，则心不得静，而神躁扰不宁也。故喜悲伤
欲哭，是神不能主情也。象如神灵所凭，是心不能神明也，即今之失志癫狂病也。数
欠伸，喝欠也，喝欠顿闷，肝之病也，母能令子实，故证及也。
甘草三两 小麦一升 大枣十枚
右三味，以水六升，煮取三升。温分三服。亦补脾气。
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妇人吐涎沫，医反下之，心下即痞，当先治其吐涎沫，小青龙汤主之。涎沫止，乃治
痞，泻心汤主之。
【注】
吐涎沫，形寒饮冷也，不温散而反下之，则寒饮虚结成痞□也。当先治其吐涎沫，以
小青龙汤治外寒内饮，俟涎沫止，以半夏泻心汤，乃治痞也。
【集注】
尤怡曰：吐涎沫，上焦有寒饮也，不与温散而反下之，则寒内入而成痞。然虽痞而犹
吐涎沫，是寒饮未已，不可治痞，当先治饮，而后治痞，亦如伤寒例，表解乃可攻痞
也。
（见肺痈中）
（见惊悸中）
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问曰：妇人年五十，所病下利，数十日不止，暮即发热，少腹里急，腹满，手掌烦热
，唇口干燥，何也？师曰：此病属带下，何以故？曾经半产，瘀血在少腹不去。何以
知之？其证唇口干燥，故知之。当之温经汤主之。
【按】
所病下利之「利」字，当是「血」字，文义相属，必是传写之□。
【注】
妇人年已五十，冲任皆虚，天癸当竭，地道不通矣。今下血数十日不止，宿瘀下也。
五心烦热，阴血虚也；唇口干燥，任冲血伤，不上荣也；少腹急满，胞中有寒，瘀不
行也。此皆曾经半产崩中，新血难生，瘀血未尽，风寒客于胞中，为带下，为崩中，
为经水愆期，为胞寒不孕。均用温经汤主之者，以此方生新去瘀，暖子宫补冲任也。
【集注】
李□曰：妇人年五十，则已过七七之期，任脉虚，太冲脉衰，天癸竭，地道不通时也
。所病下利，据本文带下观之，当是崩淋下血之病。盖血属阴，阴虚故发热，暮亦属
阴也。任主胞胎，冲为血海，二脉皆起于胞宫，而出于会阴，正当少腹部分，冲脉侠
脐上行，故冲任脉虚，则少腹里急，有干血亦令腹满。『内经』云：任脉为病，女子
带下瘕聚是也。手背为阳，掌心为阴，乃手三阴过脉之处，阴虚，故掌中烦热也。阳
明脉，侠口环唇，与冲脉会于气街，皆属于带脉。『难经』云：血主濡之。以冲脉血
阻不行，则阳明津液衰少，不能濡润，故唇口干燥。断以病属带下，以曾经半产，少
腹瘀血不去，则津液不布，新血不生，此则唇口干燥之所由生也。
半夏一升，厚朴三两，茯苓四两，生姜五两，干苏叶二两。
以上五味药，用水七升，煎煮至剩余四升，分四次温服，白天服三次，夜间服一次。
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妇女患脏躁病（内脏阴血不足所致的精神忧郁性疾病），喜欢悲伤想哭，症状像被神灵附体一样，频繁打哈欠和伸懒腰，用甘麦大枣汤主治。
【按语】
甘草小麦大枣汤，方剂的含义不详，必定是文字有脱漏或错误。
【注释】
“藏”，指心脏，心静则神志内守。如果被七情（喜、怒、忧、思、悲、恐、惊）所伤，则心不能静，而神志躁动不安。所以喜欢悲伤想哭，这是神志不能主宰情志的表现。症状像神灵凭依，这是心神不能清明，即现在的失志癫狂病。频繁打哈欠和伸懒腰，是肝的病变，因为肝属木，心属火，木能生火（母能令子实），所以病症波及到心。
甘草三两，小麦一升，大枣十枚。
以上三味药，用水六升，煎煮至剩余三升，分三次温服。此方也能补脾气。
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妇女吐涎沫，医生反而使用攻下法，导致胃脘部痞塞不通，应当先治疗吐涎沫，用小青龙汤主治。待涎沫停止后，再治疗痞证，用泻心汤主治。
【注释】
吐涎沫，是因为形寒饮冷（感受寒邪且饮用冷水），如果不采用温散之法反而使用攻下法，则寒饮虚结形成痞证。应当先治疗吐涎沫，用小青龙汤治疗外寒内饮，等到涎沫停止后，再用半夏泻心汤来治疗痞证。
【集注】
尤怡说：吐涎沫，是上焦有寒饮，不给予温散反而攻下，则寒气内入而成痞。然而虽然成痞但仍吐涎沫，说明寒饮未除，不可治痞，应当先治饮，而后治痞，这也如同伤寒病的法则，表证解除后才可攻痞。
（见肺痈篇中）
（见惊悸篇中）
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问：妇女五十岁，患病下利（此处疑为下血），几十天不止，傍晚发热，少腹内部急迫，腹部胀满，手掌烦热，嘴唇口舌干燥，这是什么原因？老师说：此病属于带下病（妇科杂病范畴），为什么？曾经有过小产，瘀血留在少腹没有去除。怎么知道的呢？其症状表现为嘴唇口舌干燥，所以知道。应当用温经汤主治。
【按语】
文中所说的“下利”的“利”字，应当是“血”字，文义才连贯，必定是传抄过程中的脱漏或错误。
【注释】
妇女年已五十，冲脉和任脉都虚弱，天癸（促进性发育和维持生殖功能的物质）应当枯竭，月经应当停止了。现在下血几十天不止，是宿有的瘀血下行。五心烦热，是阴血虚损；嘴唇口舌干燥，是任脉和冲脉血液受伤，不能上行荣养；少腹急迫胀满，是胞宫中有寒，瘀血不行。这些都是曾经有小产或崩中（非经期大量出血），新血难以生成，瘀血未尽，风寒客居于胞宫，导致带下病、崩中病、月经延期、胞寒不孕等症。均用温经汤主治的原因，是因为此方能生新血去瘀血，温暖子宫并补益冲任二脉。
【集注】
李□说：妇女五十岁，已经过了七七四十九岁的时期，任脉虚，太冲脉衰，天癸竭，是月经应当停止的时候。所谓的“下利”，根据本文提到的带下病来看，应当是崩淋下血的病。因为血属阴，阴虚故发热，傍晚也属阴。任脉主胞胎，冲脉为血海，这两条脉都起于胞宫，出于会阴，正当少腹部位，冲脉夹脐上行，所以冲任脉虚，则少腹内部急迫，有干血也会导致腹部胀满。《内经》说：任脉为病，女子带下瘕聚。手背为阳，掌心为阴，是手三阴经经过的地方，阴虚，所以掌中烦热。阳明脉，夹口环唇，与冲脉会合于气街，都属于带脉。《难经》说：血主濡润。因为冲脉血阻不行，则阳明津液衰少，不能濡润，所以嘴唇口舌干燥。断定为病属带下，是因为曾经小产，少腹瘀血不去，则津液不布散，新血不生，这就是嘴唇口舌干燥产生的原因。
Banxia (Pinelliae Rhizoma) one sheng, Houpo (Magnoliae Officinalis Cortex) three liang, Fuling (Poria), Siangjiang (Zingiberis Recens Rhizoma) five liang, Gansuye (Perillae Folium) two liang.
The above five herbs are boiled in seven sheng of water until four sheng remain. Divide into four warm doses: take three times during the day and once at night.
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Women suffering from Zangzao syndrome (a depressive disorder caused by deficiency of yin and blood in the internal organs) often feel sorrowful and desire to cry, their symptoms resembling those possessed by spirits, accompanied by frequent yawning and stretching. Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction) is the primary formula for treatment.
[Note]
The rationale behind Gancao Xiaomai Dazao Tang (Licorice, Wheat, and Jujube Decoction) is unclear; there must be missing or erroneous text.
[Commentary]
"Zang" refers to the Heart. When the heart is calm, the Shen (Spirit) is contained. If injured by the Seven Emotions (joy, anger, worry, thought, sadness, fear, fright), the heart cannot remain calm, and the Shen becomes restless and agitated. Therefore, the desire to cry out of sorrow indicates that the Shen fails to govern emotions. The appearance of being possessed by spirits indicates that the Heart Spirit lacks clarity, which corresponds to modern cases of manic-depressive psychosis. Frequent yawning and stretching indicate a Liver pathology. Since the Liver (Wood) is the mother of the Heart (Fire), the pathology extends to the Heart.
Gancao (Glycyrrhizae Radix et Rhizoma) three liang, Xiaomai (Tritici Fructus) one sheng, Dazao (Jujubae Fructus) ten pieces.
The above three herbs are boiled in six sheng of water until three sheng remain. Divide into three warm doses. This formula also tonifies Spleen Qi.
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A woman vomits saliva and froth. The physician erroneously applies purgation, resulting in epigastric fullness and obstruction (Pi). One should first treat the vomiting of saliva and froth using Xiao Qinglong Tang (Minor Blue Dragon Decoction). Once the discharge stops, then treat the Pi syndrome using Xiexin Tang (Drain the Epigastrium Decoction).
[Commentary]
Vomiting saliva and froth is caused by external cold and consumption of cold drinks. Instead of warming and dispersing, purgation was used, causing cold-fluid retention to bind and form Pi (obstruction). One must first treat the vomiting of saliva and froth with Xiao Qinglong Tang (Minor Blue Dragon Decoction) to address external cold and internal fluid retention. After the discharge ceases, Banxia Xiexin Tang (Pinellia Decoction to Drain the Epigastrium) is used to treat the Pi.
[Collected Commentary]
You Yi stated: Vomiting saliva and froth indicates cold-fluid retention in the Upper Jiao. Applying purgation instead of warming and dispersing allows cold to enter internally and form Pi. However, since Pi persists alongside continued vomiting of saliva and froth, the cold-fluid retention has not yet resolved. One must not treat the Pi immediately but should first resolve the fluid retention, then treat the Pi. This follows the principle of Shaoyang disease: only after the exterior is resolved can the interior excess be attacked.
(See section on Lung Abscess)
(See section on Palpitations)
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Question: A fifty-year-old woman suffers from diarrhea (likely hemorrhage) lasting dozens of days without cessation, evening fever, urgency and tightness in the lower abdomen, abdominal fullness, vexatious heat in the palms, and dry lips and mouth. What is the cause? The Master said: This disease belongs to Dai Xia (leukorrhea/gynecological disorders). Why? She previously suffered a miscarriage, leaving blood stasis in the lower abdomen that has not been expelled. How do we know this? The symptom of dry lips and mouth confirms it. Wenjing Tang (Warming the Menses Decoction) should be administered.
[Note]
The character "Li" (diarrhea) in "Xia Li" likely should be "Xue" (blood); the meaning would then be coherent. This is certainly a transcription error.
[Commentary]
At age fifty, the Chong and Ren meridians are deficient, Tian Gui (reproductive essence) is exhausted, and menstruation should have ceased. Now, bleeding continues for dozens of days, indicating the expulsion of old stasis. Heat in the five centers (palms, soles, and chest) indicates Yin-blood deficiency. Dry lips and mouth indicate injury to Ren and Chong blood, failing to nourish upwards. Urgency and fullness in the lower abdomen indicate cold in the uterus and stagnation of blood stasis. These conditions arise from previous miscarriages or metrorrhagia, where new blood is difficult to generate, residual stasis remains, and wind-cold invades the uterus, leading to Dai Xia, metrorrhagia, menstrual irregularities, and infertility due to uterine cold. All these are treated with Wenjing Tang (Warming the Menses Decoction) because this formula generates new blood, dispels stasis, warms the uterus, and tonifies the Chong and Ren meridians.
[Collected Commentary]
Li [Name Missing] stated: At age fifty, past the period of seven sevens (49 years), the Ren meridian is deficient, the Tai Chong merience declines, Tian Gui is exhausted, and menstruation should stop. Regarding "Xia Li," based on the context of Dai Xia, it should refer to metrorrhagia or leukorrhea with bleeding. Blood belongs to Yin; Yin deficiency causes fever, and evening time also belongs to Yin. The Ren meridian governs the fetus, and the Chong meridian is the Sea of Blood. Both originate from the uterus and emerge at the Huiyin point, corresponding to the lower abdomen. The Chong meridian ascends along the umbilicus; thus, deficiency of Chong and Ren leads to urgency in the lower abdomen, and dry blood causes abdominal fullness. The *Neijing* states: Disease of the Ren meridian in women includes leukorrhea and masses. The back of the hand is Yang, the palm is Yin, where the Three Yin meridians of the hand pass. Yin deficiency causes vexatious heat in the palms. The Yangming meridian flanks the mouth and encircles the lips, meeting the Chong meridian at Qichuan, all belonging to the Dai meridian. The *Nanjing* states: Blood provides moistening. Because Chong meridian blood flow is obstructed, Yangming fluids become scarce and fail to moisten, causing dry lips and mouth. Diagnosing this as Dai Xia is because previous miscarriage left stasis in the lower abdomen unexpelled, preventing fluid distribution and new blood generation, which is the origin of dry lips and mouth.