旋覆花三两 葱十四茎 新绛少许
右三味,以水三升,煮取一升,顿服之。
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妇人陷经漏下,黑不解,胶姜汤主之。
【注】
陷经者,谓经血下陷,即今之漏下崩中病也。黑不解不成文,胶姜汤方亦缺。
【集注】
李□曰:陷经漏下,谓经脉下陷,而血漏下不止,乃气不摄血也。黑不解者,瘀血不
去,则新血不生,荣气腐败也。然气血喜温恶寒,用胶姜汤温养气血,则气盛血充,
推陈致新,而经自调矣。
【按】
此条文义,必有缺误,姑采此注,以见大意。
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妇人少腹满如敦状,小便微难而不渴,生后者,此为水与血俱结在血室也,大黄甘遂
汤主之。
【注】
敦,大也。少腹,胞之室也。胞为血海,有满大之状,是血畜也。若小便微难而不渴
者,水亦畜也。此病若在生育之后,则为水与血俱结在血室也。主之大黄甘遂汤,是
水血并攻之法也。
大黄四两 甘遂二两 阿胶二两
右三味,以水三升,煮取一升,顿服之,其血当下。
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妇人中风七、八日,续来寒热,发作有时,经水适断,此为热入血室,其血必结,故
使如疟状,发作有时,小柴胡汤主之。
【注】
详见『伤寒论·少阳篇』内,不复释。
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妇人伤寒发热,经水适来,昼日明了,暮则□语,如见鬼状者,此为热入血室,治之
无犯胃气及上二焦,必自愈。
【注】
详见『伤寒论·少阳篇』内,不复释。
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妇人中风,发热恶寒,经水适来,得之七、八日,热除,脉迟,身凉和,胸□满,如
结胸状,□语者,此为热入血室也,当刺期门,随其实而泻之。
【注】
详见『伤寒论·少阳篇』内,不复释。
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阳明病,下血,□语者,此为热入血室,但头热汗出,当刺期门,随其实而泻之,濈
然汗出即愈。
【注】
详见『伤寒论·阳明篇』内,不复释。
@@@
妇人经水不利下,抵当汤主之。
【注】
妇人经水不利下,言经行不通利快畅下也。乃妇人恒有之病,不过活瘀导气,调和冲
任,足以愈之。今曰抵当汤主之,夫抵当重剂,文内并无少腹结痛,大便黑,小便利
,发狂善忘,寒热等证,恐药重病轻,必有残缺错简,读者审之。
旋覆花三两,葱十四茎,新绛少许。
以上三味药,用水三升,煎煮取一升药液,一次性服用。
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妇女经血下陷、漏下不止且血色黑暗久不缓解者,用胶姜汤主治。
【注】
所谓“陷经”,是指经血下陷,即现在的漏下和崩中病。原文中“黑不解”三字语意不通,且胶姜汤的方剂组成也已缺失。
【集注】
李□说:陷经漏下,是指经脉之气下陷,导致血液漏下不止,这是气不能统摄血液的缘故。“黑不解”的意思是,瘀血不去除,则新血无法生成,营气发生腐败。然而气血喜欢温暖而厌恶寒冷,使用胶姜汤温养气血,使气盛血充,推陈出新,月经自然就会调和。
【按】
这条条文的文义必然存在缺失或错误,暂且采纳上述注释,以显示其大意。
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妇女小腹胀满,形状像敦(古代一种圆底器皿)一样,小便轻微困难但不口渴,如果是产后发生的,这是水和血共同结聚在血室(子宫)所致,用大黄甘遂汤主治。
【注】
敦,意为大。少腹,是胞宫所在的部位。胞宫为血海,出现胀满大的状态,说明有瘀血蓄积。如果小便轻微困难且不口渴,说明也有水湿蓄积。此病若发生在生育之后,则是水与血共同结聚在血室。主治用大黄甘遂汤,这是攻逐水血并行的治法。
大黄四两,甘遂二两,阿胶二两。
以上三味药,用水三升,煎煮取一升药液,一次性服用,瘀血应当随之排出。
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妇女患中风病七八日,持续出现寒热往来,发作有定时,月经恰好中断,这是热邪陷入血室,血液必然凝结,所以症状像疟疾一样,发作有定时,用小柴胡汤主治。
【注】
详见《伤寒论·少阳篇》内,不再解释。
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妇女患伤寒发热,月经恰好来潮,白天神志清醒,傍晚则出现谵语(胡言乱语),好像看见鬼怪一样的幻觉,这是热邪陷入血室,治疗时不要损伤胃气及上、中二焦的功能,必定会自愈。
【注】
详见《伤寒论·少阳篇》内,不再解释。
@@@
妇女患中风病,发热恶寒,月经恰好来潮,经过七八天后,发热消退,脉象迟缓,身体凉爽平和,但胸部胀满,症状如同结胸病,伴有谵语的,这是热邪陷入血室,应当针刺期门穴,根据实证的情况进行泻法治疗。
【注】
详见《伤寒论·少阳篇》内,不再解释。
@@@
阳明病患者,出现下血、谵语的症状,这是热邪陷入血室,仅头部出汗,应当针刺期门穴,根据实证的情况进行泻法治疗,周身微微持续出汗即可痊愈。
【注】
详见《伤寒论·阳明篇》内,不再解释。
@@@
妇女月经不通利难以排下的,用抵当汤主治。
【注】
妇女经水不利下,是指月经行经不畅快、不顺畅地排出。这是妇女常有的疾病,不过是通过活血祛瘀、疏导气机、调和冲任二脉,就足以治愈。现在说用抵当汤主治,抵当汤是重剂猛药,但条文内容中并没有出现少腹硬满结痛、大便色黑、小便自利、发狂善忘、寒热等证候,恐怕是药重病轻,原文必有残缺或错简,读者需仔细审察。
Sanluyue Flower (Inulae Flos) 3 liang, Scallion 14 stems, Xinjiang (Fresh Dyed Silk) a small amount.
The above three ingredients are decocted in 3 sheng of water to obtain 1 sheng of liquid, which is taken at one time.
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For women suffering from sinking menses with continuous metrorrhagia and dark blood that does not resolve, Jiao Jiang Tang (Gelatin and Ginger Decoction) is the primary treatment.
[Note]
"Sinking menses" refers to the descent of menstrual blood, corresponding to modern conditions of metrorrhagia and menorrhagia. The phrase "dark blood does not resolve" is grammatically incomplete, and the formula for Jiao Jiang Tang is also missing.
[Collected Notes]
Li □ stated: Sinking menses with metrorrhagia refers to the descent of meridian qi, causing continuous bleeding due to the failure of Qi to control Blood. The meaning of "dark blood does not resolve" is that if stasis is not eliminated, new blood cannot be generated, leading to the corruption of Ying Qi. However, Qi and Blood prefer warmth and dislike cold. Using Jiao Jiang Tang to warm and nourish Qi and Blood will make Qi abundant and Blood full, promoting the elimination of the old and generation of the new, thereby regulating menstruation naturally.
[Commentary]
The text of this clause must have omissions or errors. We tentatively adopt the above note to convey the general idea.
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When a woman's lower abdomen is full and distended like a Dun (an ancient round-bottomed vessel), with slightly difficult urination but no thirst, and this occurs postpartum, it indicates that Water and Blood are jointly bound in the Blood Chamber (uterus). Da Huang Gan Sui Tang (Rhubarb and Kansui Decoction) is the primary treatment.
[Note]
"Dun" means large. The lower abdomen is the chamber of the Bao (uterus). The Bao is the Sea of Blood; a state of fullness and enlargement indicates the accumulation of Blood. If there is slightly difficult urination without thirst, it also indicates the accumulation of Water. If this condition occurs after childbirth, it signifies that Water and Blood are jointly bound in the Blood Chamber. The use of Da Huang Gan Sui Tang represents a method of attacking both Water and Blood simultaneously.
Da Huang (Rhei Radix et Rhizoma) 4 liang, Gan Sui (Kansui Radix) 2 liang, E Jiao (Colla Corii Asini) 2 liang.
The above three ingredients are decocted in 3 sheng of water to obtain 1 sheng of liquid, which is taken at one time. The blood stasis should then be discharged.
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A woman suffering from Wind-Cold pathogen for seven or eight days presents with alternating chills and fever occurring at regular intervals, and her menses happen to cease. This is Heat entering the Blood Chamber, causing the blood to coagulate. Consequently, the symptoms resemble malaria with regular paroxysms. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment.
[Note]
See details in the Shaoyang Chapter of Shanghan Lun (Treatise on Cold Damage); further explanation is omitted.
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A woman suffering from Cold Damage with fever, whose menses happen to begin, is lucid during the day but experiences delirium (speaking as if seeing ghosts) at night. This is Heat entering the Blood Chamber. Treatment should avoid damaging Stomach Qi and the Upper and Middle Jiao; the condition will heal spontaneously.
[Note]
See details in the Shaoyang Chapter of Shanghan Lun (Treatise on Cold Damage); further explanation is omitted.
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A woman suffering from Wind pathogen with fever and aversion to cold, whose menses happen to begin, presents seven or eight days later with resolved fever, slow pulse, cool and peaceful body temperature, chest fullness resembling Jie Xiong (Chest Binding) syndrome, and delirium. This is Heat entering the Blood Chamber. One should puncture Qi Men (LR14) and apply the reducing method according to the excess pattern.
[Note]
See details in the Shaoyang Chapter of Shanghan Lun (Treatise on Cold Damage); further explanation is omitted.
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A patient with Yangming Disease presents with bloody stool and delirium. This is Heat entering the Blood Chamber. There is sweating only on the head. One should puncture Qi Men (LR14) and apply the reducing method according to the excess pattern. Continuous mild sweating throughout the body indicates recovery.
[Note]
See details in the Yangming Chapter of Shanghan Lun (Treatise on Cold Damage); further explanation is omitted.
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For women with obstructed and difficult menstruation, Di Dang Tang (Di Dang Decoction) is the primary treatment.
[Note]
"Menstruation difficult to discharge" refers to irregular and unsmooth menstrual flow. This is a common ailment in women, usually curable by activating blood to remove stasis, guiding Qi, and harmonizing the Chong and Ren meridians. The statement that Di Dang Tang is used here is problematic because Di Dang Tang is a heavy, potent formula, yet the text lacks typical indications such as lower abdominal hardness and pain, black stools, free urination, mania, forgetfulness, or chills and fever. It is likely that the prescription is too strong for the described illness, implying textual damage or misordering. Readers should examine this carefully.