《金匮要略》曰∶胃气下泄，阴吹而正喧，此谷气之实也，膏发煎导之。
李时珍按∶妇人胃气下泄，阴吹甚喧，宜猪膏煎乱发化服，病从小便而出。
程云来曰∶经曰，胃满则肠虚，肠满则胃虚，更虚更实，则气得上下。今胃中谷气实，则肠胃虚，虚则气
不得上下，而肾又不能为胃关，其气但走胞门而出于阴户。膏发煎者，导小便药也。使其气以化小便，则不
为阴吹之证矣。
慎斋按∶妇人阴吹证，仲景以为谷气实，胃气下泄所致。此之病机有不可解，云来注云，胃实肠虚，气走
胞门，亦是随仲景之文而诠之也。夫人谷气，胃中何尝一日不实，而见阴吹之证者，未之尝闻。千百年之书，
其阙疑可也。予甲寅岁，游峡石，有友吴禹仲来询云，此镇有一富翁室女，病阴户中时簌籁有声，如后阴之转
矢气状，遍访医者不晓，此何病也？予曰∶此阴吹证也，仲景之书有之。禹仲因叹予读书之博。
《大全》曰∶妇人阴蚀疮，凡妇人少阴脉数而滑，阴中必生疮，名曰 疮。若痛或痒，如虫行状，淋沥脓
汁，亦有阴蚀几尽者，此皆由心神烦郁，胃气虚弱，致气血凝滞耳。故经云，诸痛痒疮，皆属于心。又云，阳明
主肌肉，痛痒皆属于心，治当补心养胃，外以
熏洗坐导治之。
薛立斋曰∶妇人阴中生疮，乃七情郁火伤损，肝脾湿热下注。其外证有阴中舒出如蛇，俗呼阴挺，有翻突
如饼，俗呼阴菌，亦有如鸡冠花，亦有生诸虫，亦有肿痛湿痒，溃烂出水，胀闷脱坠者。其内证，口干内热，
倦体，经候不调，或饮食无味，晡热，胸膈不利，小腹痞胀，赤白带下，小水淋涩。其治法，肿痛者，四物汤
加柴胡、山栀、丹皮、胆草。湿痒者，归脾汤加山栀、丹皮、柴胡。涩淋者，龙胆汤加白术、丹皮。溃腐者，
加味逍遥散。肿闷脱坠者，补中汤加山栀、丹皮，佐以外治之法。
《金匮要略》说：胃气向下泄漏，前阴出气且声音喧响，这是谷气壅实所致，用膏发煎引导治疗。
李时珍按语：妇人胃气向下泄漏，前阴出气声音很响，适宜用猪脂煎化乱发服用，病邪从小便排出。
程云来说：经书说，胃满则肠空，肠满则胃空，虚实交替，气机得以升降。现在胃中谷气壅实，导致肠胃空虚，气机不能上下流通，而肾又不能为胃行使关门的功能，气只能走向胞宫之门而从阴户排出。膏发煎是引导小便的药物。使气转化为小便排出，就不会出现前阴出气的病症了。
慎斋按语：妇人前阴出气证，张仲景认为是谷气壅实、胃气下泄所致。这个病机有难以理解之处，程云来的注解称，胃实肠虚，气走胞门，也是顺着张仲景的文字进行阐释。人摄入的谷气，胃中何尝有一天不充实的，但出现前阴出气证的，我从未听说过。千百年前的书籍，保留其中的疑问是可以的。我在甲寅年，游历峡石，有位朋友吴禹仲来询问说：“这里有个富翁的女儿，患病时阴道内时常发出簌簌声响，像后阴排气一样，遍访医生都不知晓这是什么病？”我说：“这是前阴出气证，张仲景的书中有记载。”禹仲因此感叹我读书广博。
《妇人大全良方》说：妇人阴部蚀疮，凡是妇人少阴脉数而滑，阴中必定生疮，名叫阴蚀疮。如果疼痛或瘙痒，像虫爬一样，淋沥脓汁，也有阴部几乎被蚀尽的，这都是因为心神烦闷抑郁，胃气虚弱，导致气血凝滞所致。所以经书说，各种疼痛、瘙痒、疮疡，都归属于心。又说，阳明经主司肌肉，疼痛瘙痒都归属于心，治疗应当补益心脾、养胃，外用熏洗、坐药等导引方法治疗。
薛立斋说：妇人阴中生疮，是由于七情郁结化火损伤，肝脾湿热下注所致。其外在症状有阴中脱出如蛇状，俗称阴挺；有翻突如饼状，俗称阴菌；也有像鸡冠花状的；也有生出各种寄生虫的；也有肿痛湿痒、溃烂流水、胀闷脱坠的。其内在症状，有口干内热、身体疲倦、月经不调，或饮食无味、午后发热、胸膈不畅、小腹痞胀、赤白带下、小便淋漓涩痛。其治疗方法：肿痛者，用四物汤加柴胡、山栀、丹皮、龙胆草。湿痒者，用归脾汤加山栀、丹皮、柴胡。涩淋者，用龙胆汤加白术、丹皮。溃烂腐坏者，用加味逍遥散。肿闷脱坠者，用补中益气汤加山栀、丹皮，配合外治法。
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: When stomach qi descends and leaks, causing flatulence from the anterior yin with a loud noise, this is due to the excess of grain qi; it should be guided by Gao Fa Jian (Pig Fat and Hair Decoction).
Li Shizhen noted: In women, when stomach qi descends and leaks, causing loud flatulence from the anterior yin, it is appropriate to use Pig Fat Decoction with human hair dissolved for ingestion, allowing the pathogen to exit via the urine.
Cheng Yunlai stated: The classics say, "When the stomach is full, the intestines are empty; when the intestines are full, the stomach is empty." Through alternating emptiness and fullness, qi moves up and down. Now, if grain qi in the stomach is excessive, the stomach and intestines become empty. Due to this emptiness, qi cannot move up and down, and since the kidney fails to act as the gatekeeper for the stomach, the qi merely flows toward the womb's gate and exits through the vaginal orifice. Gao Fa Jian is a formula that guides urination. By transforming the qi into urine for excretion, the condition of anterior yin flatulence will cease.
Shen Zhai noted: Regarding the condition of anterior yin flatulence in women, Zhang Zhongjing attributed it to excess grain qi and descending stomach qi. This pathogenesis is somewhat difficult to explain. Cheng Yunlai’s annotation suggests that "stomach excess and intestinal emptiness cause qi to flow toward the womb," which is an interpretation following Zhang Zhongjing’s text. However, the grain qi ingested by humans—has the stomach ever been without fullness for even a day? Yet, cases presenting with anterior yin flatulence have never been heard of by me. For books from thousands of years ago, it is acceptable to leave doubts unexplained. In the year Jiayin, while traveling in Xiashi, a friend named Wu Yuzhong asked me, saying, "There is a maiden in the household of a wealthy man here who suffers from intermittent rustling sounds in her vagina, resembling flatus from the rectum. After visiting many physicians, none could identify this disease. What is it?" I replied, "This is the condition of anterior yin flatulence, recorded in Zhang Zhongjing’s book." Yuzhong then sighed, marveling at my extensive reading.
The *Daquan* (Compendium) states: Regarding vulval erosion sores in women, whenever the Shaoyin pulse is rapid and slippery, sores will inevitably form in the vagina, named Yinshi Chuang (Vulval Erosion Sore). If there is pain or itching, feeling like insects crawling, with dripping pus, or even severe erosion nearly consuming the vulva, all these are caused by mental distress and depression, weak stomach qi, leading to stagnation of qi and blood. Thus, the classics state, "All pain, itching, and sores belong to the Heart." It also says, "The Yangming channel governs the muscles, and pain and itching belong to the Heart." Treatment should tonify the Heart and nourish the Stomach, supplemented by external fumigation, washing, and suppository therapies.
Xue Lizhai stated: Vulval sores in women result from damage caused by fire generated from emotional stagnation, with damp-heat from the Liver and Spleen sinking downward. External manifestations include prolapse resembling a snake, commonly called Yinting (Yin Prolapse); protrusion resembling a cake, commonly called Yinjun (Yin Fungus); shapes resembling cockscomb flowers; growth of various parasites; swelling, pain, dampness, itching, ulceration with discharge, distension, and sensation of falling. Internal manifestations include dry mouth with internal heat, fatigue, irregular menstruation, loss of appetite, afternoon fever, chest and diaphragm discomfort, abdominal fullness, red and white leukorrhea, and dysuria with dribbling and涩 (astringency/obstruction). Treatment methods: For swelling and pain, use Siwu Tang (Four Substances Decoction) added with Chaihu (Bupleuri Radix), Shanzhi (Gardeniae Fructus), Danpi (Moutan Cortex), and Danshencao (Gentianae Radix). For dampness and itching, use Guipi Tang (Restore the Spleen Decoction) added with Shanzhi, Danpi, and Chaihu. For dysuria and obstruction, use Longdan Tang (Gentian Decoction) added with Baizhu (Atractylodis Macrocephalae Rhizoma) and Danpi. For ulceration and putrefaction, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). For swelling, distension, and prolapse, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Shanzhi and Danpi, assisted by external treatments.