答曰。带下者。繇劳伤过度。损动经血。致令体虚受冷。风冷入于胞络。搏其血之所成也。
诸方说带下三十六疾者。是十二症。九痛。七害。五伤。三因。谓之三十六疾也。十二症者
。是所下之物。一者如膏。二者如青。三者如紫。四者如赤皮。五者如脓痂。六者如豆汁。
七者如葵羹。八者如凝血。九者如青血。血似水。十者如米汁。十一者如月浣
。十二者经度不应期也。九痛者。一者阴中痛伤。二者阴中淋痛。三者小便刺痛。四者寒冷
痛。五者月水来腹痛。六者气满并痛。七者汗出。阴中如虫啮痛。八者胁下皮肤痛。九者腰
痛。七害者。一者害食。二者害冷。三者害气。四者害劳。五者害房。六者害妊。七者害睡
。五伤者。一者腹吼痛。二者阴中寒热痛。三者小便急牢痛。四者藏不仁。五者子门不正引
背痛。三因(因字一本或作固)一者月水闭塞不通。其余二固者。文阙不载。三因方论云。三
固者。形羸不生肌肉。断绪不产。经水闭塞。名品虽殊。无非血病。多因经络失于调理。
产蓐不善调护。内作七情。外感六淫。阴阳劳逸饮生冷。遂致营卫不和。新陈相干。随经败
浊淋露。凝为 瘕。流溢秽恶。痛害伤痼。犯时微若秋毫。作病重如山岳。古人所谓妇人病
比男子十倍难治。而张仲景所说三十六种疾。皆繇子脏冷热劳损。而夹带起于阴内也。条目
混混。与诸方不同。但仲景义最玄深。非愚浅者能解。恐其文虽异而义同也。
养气活血丹。治劳伤冲任。带下异色。
大艾叶 (炒焦取细末五两) 干姜(炮细末二两)
上二件。用好醋二升半。无灰好酒二升。生姜自然汁一升。艾叶末同调。于银器内慢火熬成
膏。方入后药末。
附子 白芍 白术 椒红(各三两半) 川芎 当归 人参 五味子 紫巴戟(去心糯米炒各
二两)
上为细末。入前药膏子。并炒熟白面三两半。同和匀为剂。入杵臼内捣千下。丸如桐子大。
每服五十丸。温酒或米饮。食前任下。
紫桂丸。补益血海。治冲任气虚。经脉不调。或多或少。腰疼腹冷。带下崩漏。
禹余粮(火 醋淬七次三两) 龙骨 艾叶(醋炒) 牡蛎 赤石脂 地榆(各二两) 浓朴 牡
丹皮 阿胶(蛤粉炒) 当归 白芷 吴茱萸(汤洗七次) 肉桂(各一两) 附子(半两)
上为细末。面糊丸桐子大。每服三十丸。浓煎艾醋汤空心下。常服。
答：带下病，是由于过度劳累损伤，导致经血受损，致使身体虚弱而受寒邪侵袭。风冷之邪侵入胞络，与血液搏结而成此病。
各方书所说的“带下三十六疾”，是指十二症、九痛、七害、五伤、三固，合称为三十六疾。
所谓十二症，是指阴道所排出的异常分泌物：第一种如膏状；第二种如青色；第三种如紫色；第四种如赤皮；第五种如脓痂；第六种如豆汁；第七种如葵菜羹；第八种如凝血块；第九种如青血，血色似水；第十种如米泔水；第十一种如月经淋漓不尽（月浣）；第十二种是月经周期不规律，不能按时来潮。
所谓九痛，是指：第一种阴中疼痛受伤；第二种阴中淋沥作痛；第三种小便刺痛；第四种寒冷痛；第五种月经来时腹痛；第六种气滞胀满并伴有疼痛；第七种出汗时，阴中如有虫咬般疼痛；第八种胁下皮肤疼痛；第九种腰痛。
所谓七害，是指：第一种妨碍饮食（害食）；第二种妨碍耐寒（害冷）；第三种妨碍气机运行（害气）；第四种妨碍劳作（害劳）；第五种妨碍房事（害房）；第六种妨碍怀孕（害妊）；第七种妨碍睡眠（害睡）。
所谓五伤，是指：第一种腹部雷鸣样疼痛；第二种阴中寒热交替疼痛；第三种小便急迫且涩痛难忍；第四种脏腑感觉麻木不仁；第五种子门不正牵引背部疼痛。
所谓三固（有的版本“因”字写作“固”），第一种是月经闭塞不通。其余两种“固”，原文缺失未载。《三因方》论述说，所谓的三固，表现为形体消瘦不长肌肉，断绝生育无法产子，月经闭塞不通。虽然名称不同，但无非都是血分病变。多因为经络失于调理，产后护理不当，内伤七情，外感六淫，以及阴阳失调、劳逸失度、饮用生冷之物，从而导致营卫不和，新旧气血相互干扰，随着经脉败坏浑浊，淋沥漏下，凝结成瘕积，流溢秽恶之物，造成疼痛伤害，形成顽固性疾病。发病之初轻微如秋毫，一旦致病则沉重如山岳。古人所说妇女疾病比男子难治十倍，而张仲景所说的三十六种疾，都是由子宫冷热劳损引起，并且夹杂带下病从阴内发起。条目混乱，与其他医方不同。但张仲景的义理最为深奥玄妙，不是学识浅薄的人所能理解的。恐怕其文字虽异，但义理相同。
养气活血丹：治疗劳伤冲任二脉，带下颜色异常。
大艾叶（炒焦取细末五两）、干姜（炮制后研细末二两）。
以上两味药，用好醋二升半，无灰好酒二升，生姜自然汁一升，将艾叶末调入其中，在银器内用慢火熬制成膏，然后加入以下药末。
附子、白芍、白术、椒红（各三两半）、川芎、当归、人参、五味子、紫巴戟天（去心，用糯米炒，各二两）。
以上药物研为细末，加入前面的药膏，并加入炒熟的白面三两半，一同调和均匀做成丸剂。放入杵臼中捣一千下，制成如梧桐子大小的丸药。每次服用五十丸，用温酒或米饮送服，饭前服用。
紫桂丸：补益血海，治疗冲任气虚，经脉不调，经量或多或少，腰痛腹冷，带下崩漏。
禹余粮（火烧后醋淬七次，三两）、龙骨、艾叶（醋炒）、牡蛎、赤石脂、地榆（各二两）、厚朴、牡丹皮、阿胶（蛤粉炒）、当归、白芷、吴茱萸（汤洗七次）、肉桂（各一两）、附子（半两）。
以上药物研为细末，用面糊制成如梧桐子大小的丸药。每次服用三十丸，浓煎艾草醋汤空腹送服。经常服用。
Answer: Leukorrhea (dai xia) arises from excessive labor and injury, damaging the menstrual blood, leading to a deficiency of the body's constitution and susceptibility to cold pathogens. Wind-cold enters the uterus collateral network (bao luo), struggling with the blood to form this condition.
Various medical texts refer to "thirty-six leukorrheal diseases" as comprising twelve types of discharge (zheng), nine types of pain (tong), seven types of harm (hai), five types of injury (shang), and three types of obstruction/consolidation (gu).
The twelve types of discharge refer to the abnormal substances discharged: First, like paste; second, green in color; third, purple in color; fourth, like red skin; fifth, like pus crusts; sixth, like bean juice; seventh, like mallow soup; eighth, like coagulated blood; ninth, like dark blood, resembling water; tenth, like rice washings; eleventh, like prolonged menstrual dripping (yue huan); twelfth, irregular menstrual cycles failing to arrive on time.
The nine types of pain are: First, pain and injury in the vagina; second, dripping pain in the vagina; third, stinging pain during urination; fourth, cold pain; fifth, abdominal pain during menstruation; sixth, distension and pain due to qi stagnation; seventh, sweating accompanied by itching/biting pain in the vagina as if bitten by insects; eighth, pain in the skin under the hypochondrium; ninth, lower back pain.
The seven types of harm refer to: First, hindering food intake (harm to eating); second, hindering tolerance to cold (harm to cold); third, hindering qi movement (harm to qi); fourth, hindering physical labor (harm to labor); fifth, hindering sexual intercourse (harm to intercourse); sixth, hindering pregnancy (harm to conception); seventh, hindering sleep (harm to sleep).
The five types of injury are: First, rumbling abdominal pain; second, alternating cold and hot pain in the vagina; third, urgent and difficult painful urination; fourth, numbness and insensitivity of the zang organs; fifth, misalignment of the cervical os (zi men) pulling into the back pain.
The three types of consolidation (in some editions, the character 'yin' is written as 'gu'): The first is amenorrhea or blocked menstruation. The remaining two types of consolidation are missing from the text. The *San Yin Fang* discusses that the so-called three consolidations manifest as emaciation without muscle growth, infertility, and blocked menstruation. Although the names differ, they are all blood disorders. They mostly arise from neglecting the regulation of meridians and collaterals, improper postpartum care, internal emotional disturbances (seven emotions), external contraction of six exogenous pathogens, imbalance of yin and yang, improper work and rest, and consumption of raw and cold foods/drinks. This leads to disharmony between Ying (nutritive) and Wei (defensive) qi, interference between new and old blood, leakage of turbid敗败 material along the meridians, condensation into masses (jia), flow of foul matter, causing pain, damage, and chronic stubborn diseases. Initially slight as autumn down, once the disease forms, it is heavy as a mountain. As the ancients said, women's diseases are ten times harder to treat than men's. Zhang Zhongjing's description of thirty-six kinds of diseases attributes them all to cold-heat and labor-damage of the uterus (zi zang), accompanied by leukorrhea originating internally from the vagina. The categories are mixed and differ from other medical texts. However, Zhang Zhongjing's principles are profound and mysterious, not understandable to those with shallow knowledge. It is feared that although the text differs, the underlying principle is the same.
Yang Qi Huo Xue Dan (Nourishing Qi and Invigorating Blood Pill): Treats labor-damage to the Chong and Ren meridians, and abnormal colored leukorrhea.
Mugwort Leaf (Ai Ye, 艾叶) (stir-fried until charred, fine powder, 5 liang), Dried Ginger (Gan Jiang, 干姜) (processed, fine powder, 2 liang).
Take the above two ingredients, add 2.5 sheng of good vinegar, 2 sheng of clear wine (without ash residue), and 1 sheng of fresh ginger juice. Mix with the mugwort powder, slowly simmer in a silver vessel until it becomes a paste. Then add the following powdered herbs:
Aconite Root (Fu Zi, 附子), White Peony Root (Bai Shao, 白芍), Atractylodes Macrocephala Rhizome (Bai Zhu, 白术), Red Pepper Seeds (Jiao Hong, 椒红) (each 3.5 liang), Szechwan Lovage Rhizome (Chuan Xiong, 川芎), Angelica Sinensis Root (Dang Gui, 当归), Ginseng Radix (Ren Shen, 人参), Schisandra Berry (Wu Wei Zi, 五味子), Morinda Officinalis Root (Zi Ba Ji, 紫巴戟) (decored, stir-fried with glutinous rice, each 2 liang).
Grind all into fine powder, mix with the previous paste, and add 3.5 liang of well-roasted wheat flour. Knead uniformly into pills. Pound in a mortar and pestle for one thousand strikes. Shape into pills the size of paulownia seeds. Take 50 pills per dose, with warm wine or rice drink, before meals.
Zi Gui Wan (Purple Cinnamon Pill): Tonifies the Sea of Blood, treats deficiency of Qi in the Chong and Ren meridians, irregular menstruation (varying amounts), lower back pain, cold abdomen, leukorrhea, and metrorrhagia/metrostaxis (beng lou).
Hematitum (Yu Yu Liang, 禹余粮) (calcined, quenched in vinegar seven times, 3 liang), Longbone (Long Gu, 龙骨), Mugwort Leaf (Ai Ye, 艾叶) (stir-fried with vinegar), Oyster Shell (Mu Li, 牡蛎), Kaolinite (Chi Shi Zhi, 赤石脂), Sanguisorba Root (Di Yu, 地榆) (each 2 liang), Magnolia Bark (Hou Po, 厚朴), Moutan Cortex (Mu Dan Pi, 牡丹皮), Donkey-hide Gelatin (E Jiao, 阿胶) (stir-fried with clamshell powder), Angelica Sinensis Root (Dang Gui, 当归), Angelica Dahurica Root (Bai Zhi, 白芷), Evodia Fruit (Wu Zhu Yu, 吴茱萸) (washed seven times in hot water), Cinnamon Twig (Rou Gui, 肉桂) (each 1 liang), Aconite Root (Fu Zi, 附子) (0.5 liang).
Grind all into fine powder, use wheat paste to make pills the size of paulownia seeds. Take 30 pills per dose, with strong decoction of mugwort and vinegar tea, on an empty stomach. For regular use.