答曰。夫妇人病。多是月经乍多乍少。或前或后。时发疼痛。医者一例呼为经病。不曾说得
是阴胜阳。是阳胜阴。所以服药少得有效。盖阴气盛乘阳。则胞寒气冷。血不营运。经所谓
天寒地冻。水凝成冰。故令乍少而在月后。若阳气盛乘阴。则血流散溢。经所谓天暑地热。
经水沸溢。故令乍多而在月前。当和其阴阳。调其气血。以平为福。
阳气胜阴。月假多者。当归饮。抑阳助阴。调理经脉。
当归(去芦微炒) 熟地(净洗酒蒸焙干) 川芎 白芍 黄芩(小半) 白术(各等分)
上为粗末。每服三钱。水盏半煎至八分。食前热服。
沉香降气汤。顺气道。通气脉。
乌药 沉香 香附 甘草 砂仁(各等分)
上为细末。每服二钱。空心盐汤调下。
阴气胜阳。月假少者。七物汤。治妇人营卫气虚。经水愆期。或多或少而腹痛。
当归 芎 白芍 莪术
川姜 熟地(酒蒸焙干) 木香(各等分)
上为粗末。每服四钱。水一盏煎八分。温服不拘时。
紫石英丸。治妇人病多是月经乍少。或在月后。时发疼痛。
紫石英(水研飞) 禹余粮(烧醋淬) 人参 龙骨 川乌头(泡去皮尖脐) 桂心(不见火) 杜
仲(去皮姜制炒黑) 桑寄生 五味子 远志(去心) 泽泻 当归(去芦) 石斛(去根酒炒)
苁蓉(酒浸洗) 干姜(炮各一两) 甘草(炙半两) 川椒(去目并合口炒地上出汗) 牡蛎(固
济火烧通红各半两)
上为细末。炼蜜为丸。梧桐子大。空心米饮下三十丸。至五六十丸。
以上无求子方
金华散。治妇人经血后热。崩漏不止。口苦舌干。经候不通。并宜服之。
玄胡索 瞿麦 当归 牡丹皮 石膏(二两) 干葛(各一两) 蒲黄(半两) 桂心 威灵仙(
各三分凡方中云一分者二钱五分也)
上为粗末。每服二钱。水一盏。姜三片。煎至六分。空心服。
以上养生席判官方
通经丸。治妇人室女月候不通。疼痛。或成血瘕
桂心(不见火) 青皮(去白) 大黄(炮) 干姜 川椒(炒去目) 莪术 川乌(泡去皮尖) 干
漆(炒去烟出) 当归 桃仁(炒去皮尖以上各等分)
上为细末。将四分用米醋熬成膏。和余六分末。成剂。臼中治之。丸如桐子大。阴干。每服
二十丸。空心食前米饮汤下。加至三十丸。温酒亦得。
五灵脂散。治经候不止。拯济方。
五灵脂为末。炒令过熟出尽烟。每服二钱。当归二片。酒一中盏。煎至六分。去滓热服。连
三服立效。如血室有干血。用醋一盏煎七分。和滓空心热服。
温经汤
治冲任虚损。月候不调。或来多不断。或过期不来。或崩中去血。过多不止。又治曾经损孕
。瘀血停留。少腹急痛。发热下利。手掌烦热。唇干口燥。及少腹有寒。久不受胎。
丹皮 阿胶(碎炒) 当归(去芦) 人参(去芦) 川芎 甘草(炒) 肉桂(去粗皮) 芍药(各
二两) 半夏(各汤洗七次二两半) 吴茱萸(三两) 麦门冬(去心五两半)
上为粗末。每服三钱。水一盏半。生姜五片。煎八分。去滓。空心食前热服。
答曰:妇女的疾病,大多表现为月经量忽多忽少,或提前或推后,时常伴有疼痛。医生们通常一概称之为“经病”,却未曾阐明这是阴气胜阳气,还是阳气胜阴气,因此服药往往难以见效。
大概而言,若阴气盛而乘袭阳气,则胞宫寒冷,血液运行不畅。正如《内经》所说:“天寒地冻,水凝成冰。”所以导致月经量少且经期推后。如果阳气盛而乘袭阴气,则血液流散溢出。正如《内经》所说:“天暑地热,经水沸溢。”所以导致月经量多且经期提前。应当调和阴阳,调理气血,以恢复平衡为吉。
若是阳气胜阴气,导致月经量多者,宜用当归饮。此方旨在抑制阳热、辅助阴液,调理经脉。
处方组成:当归(去除芦头,微炒)、熟地黄(洗净,酒蒸后焙干)、川芎、白芍、黄芩(用量稍小)、白术(以上各等分)。
制法与用法:将上述药材捣成粗末。每次服用三钱,加水一盏半,煎至八分满,饭前热服。
另有沉香降气汤,用于顺调气机,通畅血脉。
处方组成:乌药、沉香、香附、甘草、砂仁(以上各等分)。
制法与用法:将上述药材研为细末。每次服用二钱,空腹时用盐开水调服。
若是阴气胜阳气,导致月经量少者,宜用七物汤。此方治疗妇人营卫之气虚弱,月经周期紊乱,经量或多或少并伴有腹痛。
处方组成:当归、川芎、白芍、莪术、干姜、熟地黄(酒蒸后焙干)、木香(以上各等分)。
制法与用法:将上述药材捣成粗末。每次服用四钱,加水一盏,煎至八分满,随时温服。
另有紫石英丸,治疗妇人疾病多为月经量少,或经期推后,时常伴有疼痛。
处方组成:紫石英(水飞处理)、禹余粮(烧红后用醋淬)、人参、龙骨、川乌头(炮制,去皮尖及脐)、桂心(不经过火烤)、杜仲(去皮,姜汁制后炒黑)、桑寄生、五味子、远志(去心)、泽泻、当归(去芦头)、石斛(去根,酒炒)、肉苁蓉(酒浸洗)、干姜(炮制,以上各一两)、甘草(炙制,半两)、川椒(去目及合口处,炒至出油)、牡蛎(密封煅烧至通红,以上各半两)。
制法与用法:将上述药材研为细末,用炼蜜制成梧桐子大小的丸剂。空腹时米饮送下三十丸,逐渐加至五六十丸。
以上均为无求子方的治疗方案。
金华散,治疗妇人经血后期发热,崩漏不止,口苦舌干,月经不通畅,均适宜服用。
处方组成:玄胡索、瞿麦、当归、牡丹皮、石膏(二两)、干葛(以上各一两)、蒲黄(半两)、桂心、威灵仙(以上各三分。注:凡方中云一分者,相当于二钱五分)。
制法与用法:将上述药材捣成粗末。每次服用二钱,加水一盏,生姜三片,煎至六分满,空腹服用。
以上为养生席判官方验方。
通经丸,治疗妇人少女月经不通,疼痛,或形成血瘕。
处方组成:桂心(不经过火烤)、青皮(去白)、大黄(炮制)、干姜、川椒(炒去目)、莪术、川乌(炮制,去皮尖)、干漆(炒至烟尽)、当归、桃仁(炒,去皮尖,以上各等分)。
制法与用法:将上述药材研为细末。取四分药粉用米醋熬成膏状,与剩余六分药粉混合,在臼中捣匀,制成梧桐子大小的丸剂,阴干。每次服用二十丸,空腹食前米饮汤送下,可加至三十丸,温酒送服亦可。
五灵脂散,治疗月经淋漓不止,出自拯济方。
制法与用法:将五灵脂研为末,炒至熟透无烟。每次服用二钱,配当归两片,酒水一中盏,煎至六分满,去渣热服。连服三剂立见疗效。若血室有干血瘀滞,可用醋一盏煎至七分,和渣空腹热服。
温经汤
主治冲任二脉虚损,月经失调。症状包括:经量过多不止,或过期不来,或崩漏下血过多不止。又治曾受损流产,瘀血停留,少腹拘急疼痛,发热腹泻,手掌烦热,唇干口燥,以及少腹有寒,久不受孕。
处方组成:牡丹皮、阿胶(碎炒)、当归(去芦头)、人参(去芦头)、川芎、甘草(炒)、肉桂(去粗皮)、芍药(以上各二两)、半夏(汤洗七次,二两半)、吴茱萸(三两)、麦门冬(去心,五两半)。
制法与用法:将上述药材捣成粗末。每次服用三钱,加水一盏半,生姜五片,煎至八分满,去渣,空腹食前热服。
Answer: Women's diseases often manifest as menstrual flow varying from heavy to light, occurring either early or late, accompanied by intermittent pain. Physicians generally categorize these simply as "menstrual disorders" without distinguishing whether it is Yin prevailing over Yang or Yang prevailing over Yin; consequently, medication often proves ineffective.
Generally speaking, if Yin Qi (Yin energy) is excessive and overwhelms Yang Qi (Yang energy), the uterus becomes cold, and blood circulation fails. As stated in the *Classic of Internal Medicine*: "When heaven is cold and earth frozen, water condenses into ice." Thus, menstrual flow becomes scanty and delayed. Conversely, if Yang Qi is excessive and overwhelms Yin Qi, blood flows and spills excessively. As stated in the *Classic of Internal Medicine*: "When heaven is hot and earth warm, menstrual water boils and overflows." Thus, menstrual flow becomes profuse and occurs early. One must harmonize Yin and Yang, regulate Qi and Blood, aiming for balance as the ideal state.
If Yang prevails over Yin, resulting in heavy menstruation, use Danggui Yin (Angelica Decoction). This formula suppresses Yang heat, supports Yin fluids, and regulates the meridians.
Ingredients: Danggui (Radix Angelicae Sinensis, remove rhizome, slightly stir-fry), Shudihuang (Prepared Radix Rehmanniae, wash clean, steam with wine, dry), Chuanxiong (Rhizoma Chuanxiong), Baishao (Radix Paeoniae Alba), Huangqin (Radix Scutellariae, smaller amount), Baizhu (Rhizoma Atractylodis Macrocephalae, equal parts of all above except Huangqin).
Preparation and Administration: Grind into coarse powder. Take 3 qian per dose, decoct with 1.5 cups of water until reduced to 0.8 cup, take hot before meals.
Alternatively, Chenxiang Jiangqi Tang (Agarwood Qi-Descending Decoction) is used to smooth Qi mechanism and unblock vessels.
Ingredients: Wuyao (Lithospermum Root), Chenxiang (Aquilaria Lignum), Xiangfu (Rhizoma Cyperi), Gancao (Radix Glycyrrhizae), Sharen (Fructus Amomi), equal parts.
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mix with salted water on an empty stomach.
If Yin prevails over Yang, resulting in scanty menstruation, use Qiwu Tang (Seven-Ingredient Decoction). This treats deficiency of Ying (Nutritive) and Wei (Defensive) Qi in women, causing irregular menstrual cycles, variable flow, and abdominal pain.
Ingredients: Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Baishao (Radix Paeoniae Alba), Ezhu (Rhizoma Curcumae), Jiangtang (Dried Ginger), Shudihuang (Prepared Radix Rehmanniae, steamed with wine and dried), Muxiang (Radix Aucklandiae), equal parts.
Preparation and Administration: Grind into coarse powder. Take 4 qian per dose, decoct with 1 cup of water until reduced to 0.8 cup, take warm at any time.
Alternatively, Zhiyanshi Wan (Purple Quartz Pill) treats women's diseases characterized by scanty menstruation, delayed periods, and intermittent pain.
Ingredients: Zhiyanshi (Hematitum, water-flown), Yuyuliang (Argillula Rubra, calcined and quenched with vinegar), Renshen (Radix Ginseng), Longgu (Fossilia Ossis Mastodi et Femoris), Chuanwutou (Radix Aconiti Kusnezoffii, processed, peel tip and navel removed), Guixin (Cortex Cinnamomi, not exposed to direct fire), Duzhong (Cortex Eucommiae, peel removed, processed with ginger juice, stir-fried black), Sangjisheng (Ramulus Taxilli), Wuweizi (Fructus Schisandrae), Yuanzhi (Radix Polygalae, heart removed), Zexie (Rhizoma Alismatis), Danggui (Radix Angelicae Sinensis, remove rhizome), Shihu (Herba Dendrobii, remove roots, stir-fry with wine), Rongsheng (Caulis Cistanches, soak in wine and wash), Jiangtang (Dried Ginger, processed, each 1 liang), Gancao (Radix Glycyrrhizae, honey-fried, half liang), Chuanjiao (Pericarpium Zanthoxyli, remove eyes and closed ends, stir-fry until oil appears), Mumian (Concha Ostreae, sealed and fired red-hot, each half liang).
Preparation and Administration: Grind into fine powder, bind with refined honey into pills the size of paulownia seeds. Take 30 pills on an empty stomach with rice drink, gradually increasing to 50-60 pills.
The above are formulas for those not seeking pregnancy.
Jinhua San (Jinhua Powder) treats post-menstrual heat, metrorrhagia that does not stop, bitter taste in mouth, dry tongue, and obstructed menstruation.
Ingredients: Yanhusuo (Rhizoma Corydalis), Qumai (Herba Dianthi), Danggui (Radix Angelicae Sinensis), Mudanpi (Cortex Moutan), Shigao (Gypsum Fibrosum, 2 liang), Gange (Radix Puerariae Lobatae, each 1 liang), Puhuang (Pollen Typhae, half liang), Guixin (Cortex Cinnamomi), Weilingxian (Radix Saposhnikoviae, each 3 fen. Note: In this text, 1 fen equals 2.5 qian).
Preparation and Administration: Grind into coarse powder. Take 2 qian per dose, decoct with 1 cup of water and 3 slices of fresh ginger until reduced to 0.6 cup, take on an empty stomach.
The above are official prescriptions from the Health Preservation Department.
Tongjing Wan (Menstruation-Unblocking Pill) treats amenorrhea in married or unmarried women, pain, or formation of blood masses (Xue Jia).
Ingredients: Guixin (Cortex Cinnamomi, not exposed to direct fire), Qingpi (Pericarpium Citri Reticulatae, remove white pith), Dahuang (Radix et Rhizoma Rhei, processed), Jiangtang (Dried Ginger), Chuanjiao (Pericarpium Zanthoxyli, stir-fry remove eyes), Ezhu (Rhizoma Curcumae), Chuanwu (Radix Aconiti Kusnezoffii, processed, peel tip and navel removed), Ganqi (Resina Draconis, stir-fry until smoke ceases), Danggui (Radix Angelicae Sinensis), Taoren (Semen Persicae, stir-fry, peel and remove tips, equal parts of all above).
Preparation and Administration: Grind into fine powder. Take 4/10 of the powder, boil with rice vinegar into a paste, mix with the remaining 6/10 powder, pound in a mortar, form into pills the size of paulownia seeds, dry in shade. Take 20 pills on an empty stomach before meals with rice drink, can increase to 30 pills. Warm wine may also be used.
Wulingzhi San (Trogopterus Dung Powder) treats persistent menorrhagia, from the Zhengji Formula.
Preparation and Administration: Grind Trogopterus Dung (Wulingzhi) into powder, stir-fry until thoroughly cooked and smoke-free. Take 2 qian per dose, with 2 slices of Danggui, decoct with one cup of wine-water mixture until reduced to 0.6 cup, strain and take hot. Three doses yield immediate results. If there is dried blood in the blood chamber, decoct with one cup of vinegar until reduced to 0.7 cup, mix with dregs and take hot on an empty stomach.
Wenjing Tang (Warming the Meridians Decoction)
Indications: Deficiency and damage to the Chong and Ren meridians, irregular menstruation. Symptoms include: excessive flow that does not stop, delayed onset, metrorrhagia with excessive bleeding, history of miscarriage with retained blood stasis causing lower abdominal urgency and pain, fever with diarrhea, vexatious heat in palms, dry lips and mouth, cold in lower abdomen, and infertility due to long-term inability to conceive.
Ingredients: Danpi (Cortex Moutan), Ejiao (Colla Corii Asini, crushed and stir-fried), Danggui (Radix Angelicae Sinensis, remove rhizome), Renshen (Radix Ginseng, remove rhizome), Chuanxiong (Rhizoma Chuanxiong), Gancao (Radix Glycyrrhizae, stir-fried), Rougui (Cortex Cinnamomi, remove rough bark), Shaoyao (Radix Paeoniae Alba, each 2 liang), Banxia (Rhizoma Pinelliae, washed seven times in boiling water, 2.5 liang), Wuzhuyu (Fructus Evodiae, 3 liang), Maimendong (Radix Ophiopogonis, remove heart, 5.5 liang).
Preparation and Administration: Grind into coarse powder. Take 3 qian per dose, decoct with 1.5 cups of water and 5 slices of fresh ginger until reduced to 0.8 cup, strain and take hot on an empty stomach before meals.