《良方》云∶妇人小便白浊白淫者,皆由心肾不交养、水火不升降,或因劳伤于肾,肾
气虚
冷故也。肾主水,开窍于阴,阴为溲便之道,胞冷肾损,故有白浊白淫之病(据此宜属寒,
今皆主热)。宜金锁正元丹。或因心虚而得者,宜平补镇心丹。若因思虑过多而致使阴阳不
分,清浊相干而成白浊者,思则伤脾故也,宜四七汤吞白丸子,此药极能分利阴阳耳。
按立斋云∶前症若元气下陷,用补中益气汤。脾胃亏损,用六君子汤加升、柴。脾气郁
结,
用归脾汤加丹皮、山栀。肝经怒火(怒火有虚实。实者泻之,故用龙胆。虚者补之,故用逍
遥,以逍遥有归、芍养血也)用龙胆泻肝汤。肝虚用加味逍遥散,宜与带下参看。
《纲目》云∶五劳六极七伤诸症已详于杂病门中,而今复叙者,缘妇人多因行胎产,或
饮食起
居七情重伤肝脾之所致。又或失于调摄,或过于攻伐,而亦有初因劳倦所伤,苟或失治,即
变皮聚毛落,饮食不为肌肤,骨髓中热,经闭不行,谓之劳瘵骨蒸热。其治与男子不同者,
因男以气为主,女以血为主故也(精血虽殊,而虚劳形症不远,治亦不异,宜与杂症参观)。
按戴氏云∶有病后血虚者,有本体血虚者,其人五心烦热,或往来寒热,言语无力,面
黄,头目昏晕,变生诸症,用芎归汤加羊肉少许,或十全大补汤、四物养荣汤治之。若血虚
而气旺者用抑 气汤(即香附末),若劳倦伤者用补中益气汤(补中益气是治劳倦内伤之剂,乃
初治法,非久病治法,劳瘵骨蒸所宜)。
《良方》记载:妇女出现小便白浊或白淫的症状,都是由于心肾之间不能相互滋养、水火之气不能正常升降所致;或者是因劳累损伤了肾脏,导致肾气虚弱寒冷。肾主管水液代谢,其窍穴开于前阴,前阴是排尿和排便的通道,若胞宫寒冷、肾脏受损,因此会产生白浊和白淫的疾病(根据此论述应当属于寒证,但现今多主张为热证)。适宜使用金锁正元丹治疗。如果是因心脏虚弱而引发的,适宜使用平补镇心丹。如果是因思虑过多导致阴阳不分、清浊之气相互干扰而形成白浊的,这是因为思虑过度损伤了脾脏的缘故,适宜用四七汤送服白丸子,这种药物非常能够分清利泄阴阳。
按立斋(薛己)所说:上述病症如果是因为元气下陷,应使用补中益气汤。脾胃亏损,应使用六君子汤加入升麻、柴胡。脾气郁结,应使用归脾汤加入牡丹皮、山栀。肝经有怒火(怒火分为虚实两种情况。实证应当泻之,所以使用龙胆草;虚证应当补之,所以使用逍遥散,因为逍遥散中含有当归、白芍以养血),应使用龙胆泻肝汤。肝虚则使用加味逍遥散,宜与带下病参照查看。
《本草纲目》记载:五劳、六极、七伤等各种病症已在杂病门中详细叙述,如今再次叙述的原因,是因为妇女多因怀孕、分娩,或者饮食起居中的七情(喜、怒、忧、思、悲、恐、惊)严重损伤肝脾所致。又或者疏于调养摄生,或者过度使用攻伐药物,也有起初因劳累倦怠所伤,如果失治,就会变成皮肤聚积、毛发脱落,饮食无法转化为肌肉,骨髓中有热感,月经闭止不行的症状,这称为劳瘵骨蒸热。其治疗方法与男子不同的原因,是因为男子以气为主,女子以血为主的缘故(精与血虽然不同,但虚劳的形态和症状相差不远,治疗方法也不相异,宜与杂症参照观看)。
按戴氏所说:有病后血虚的情况,有先天体质血虚的情况,这些人表现为五心烦热(手心、脚心和心口烦热),或者忽冷忽热,言语无力,面色发黄,头目昏晕,变生各种病症,使用芎归汤加入少许羊肉,或者使用十全大补汤、四物养荣汤治疗。如果是血虚而气旺的情况,使用抑气汤(即香附末);如果是因劳累倦怠损伤的,使用补中益气汤(补中益气汤是治疗劳累倦怠内伤的药剂,属于初期治疗方法,并非久病的治疗方法,适用于劳瘵骨蒸的治疗)。
According to *Liang Fang* (Excellent Prescriptions): In women, white turbidity of urine or leukorrhea (white discharge) are all caused by the failure of the Heart and Kidney to nourish each other, and the inability of Water and Fire energies to ascend and descend properly. It may also be due to kidney injury from overwork, resulting in deficiency and coldness of Kidney Qi. The Kidney governs water metabolism, and its orifice opens at the yin region (external genitalia), which is the pathway for urination and defecation. If the uterus is cold and the Kidney is damaged, diseases such as white turbidity and leukorrhea arise (Based on this description, it should belong to Cold patterns, but currently, Heat patterns are predominantly emphasized). The appropriate prescription is Jin Suo Zheng Yuan Dan (Golden Lock Correcting Origin Pill). If caused by Heart deficiency, Ping Bu Zhen Xin Dan (Calm and Supplement the Heart Pill) is appropriate. If excessive thinking leads to the separation of Yin and Yang failing, causing clear and turbid energies to interfere with each other resulting in white turbidity, this is because thinking injures the Spleen. The appropriate treatment is Si Qi Tang (Four Seven Decoction) taken with Bai Wan Zi (White Pills); this medicine is extremely effective in separating and benefiting Yin and Yang.
Li Zhai (Xue Ji) noted: For the aforementioned symptoms, if there is sinking of Yuan Qi (Primal Qi), Bu Zhong Yi Qi Tang (Decoction to Tonify the Middle and Augment the Qi) should be used. For Spleen and Stomach damage, Liu Jun Zi Tang (Six Gentlemen Decoction) with Sheng Ma (Cimicifugae Rhizoma) and Chai Hu (Bupleuri Radix) should be used. For Spleen Qi stagnation and knotting, Gui Pi Tang (Restore the Spleen Decoction) with Mu Dan Pi (Moutan Cortex) and Shan Zhi (Gardeniae Fructus) should be used. For Liver Meridian Fire Wrath (Fire wrath has deficiency and excess types. Excess is drained, hence Long Dan Cao is used; deficiency is tonified, hence Xiao Yao San is used, as Xiao Yao San contains Dang Gui and Bai Shao to nourish blood), Long Dan Xie Gan Tang (Gentian Decoction to Drain the Liver) should be used. For Liver deficiency, Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) is used, and it should be consulted alongside leukorrhea disorders.
According to *Ben Cao Gang Mu* (Compendium of Materia Medica): Various syndromes of Wu Lao (Five Exhaustions), Liu Ji (Six Extremes), and Qi Shang (Seven Injuries) have been detailed in the Miscellaneous Diseases section. They are narrated again here because women often suffer severe injury to the Liver and Spleen due to pregnancy and childbirth, or due to the Seven Emotions (Joy, Anger, Worry, Thought, Sadness, Fear, Fright) affecting diet and daily life. Or, due to lack of proper regulation or excessive use of draining therapies, initial injuries from fatigue and exhaustion, if left untreated, can transform into skin accumulation and hair loss, food failing to transform into flesh, heat in the bone marrow, and amenorrhea. This is called Lao Zhai (Consumption Disease) with Gu Zheng Re (Bone-steaming Fever). The treatment differs from men because men prioritize Qi, while women prioritize Blood (Although Essence and Blood differ, the manifestations and symptoms of Xu Lao (Deficiency Consumption) are not far apart, and treatments are similar; it should be viewed alongside miscellaneous diseases).
Dai Shi noted: There are cases of Blood deficiency after illness, and cases of constitutional Blood deficiency. These individuals present with five-palm heat (heat in the palms, soles, and chest), alternating chills and fever, weak speech, sallow complexion, dizziness of the head and eyes, and various other symptoms. They are treated with Xiong Gui Tang (Angelica and Ligusticum Decoction) with a small amount of mutton, or Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) or Si Wu Yang Rong Tang (Four Substance Nourishing Nutrient Decoction). If there is Blood deficiency with flourishing Qi, Yi Qi Tang (Qi-Subduing Decoction, i.e., Cyperi Rhizoma powder) is used. If injured by fatigue and exhaustion, Bu Zhong Yi Qi Tang is used (Bu Zhong Yi Qi Tang is a formula for treating internal injury from fatigue and exhaustion, serving as an initial treatment method, not for chronic disease; it is suitable for Lao Zhai Gu Zheng Re).