《千金方》曰∶妇人小户嫁痛连日，方用甘草、生姜、白芍、桂心，酒煮温服。又方，疗嫁痛，一味牛膝，
或一味大黄，酒煮服。又，乌贼鱼骨烧末，酒吞之，外用青盐炒热，布裹熨之。
《良方》论曰∶妇人或肝经湿热下注，或郁怒伤损肝脾。外证或两拗小腹肿痛，或玉门 肿作痛，或寒热
往来，憎寒壮热。内证或小便滞涩，或腹内急痛，或小腹痞闷。若两拗小腹肿痛，肝经湿热壅滞也，用龙胆泻
肝汤。玉门肿胀，肝火血虚也，加味逍遥散，及龙胆泻肝汤加木香。若概投散血攻毒之剂，则误甚矣。
李氏按∶阴户两旁肿痛，手足不能舒伸者，用四物汤加乳香末捣饼，纳阴中立效。又阴肿痛极，便秘欲死，
四物加柴胡、丹皮、山栀、胆草。如时常阴肿者，四物加 本、防风。若肿痛不闭者，逍遥散加丹皮、山栀。
慎斋按∶以上二条，序妇人阴中肿痛之
证也。足厥阴经环阴器，妇人阴户为肝经之分，是经血虚火燥，则为肿为痛，痛者火也。
实则泻其子，龙胆泻肝汤、加味逍遥散，虽为本经的对之药，不若大剂导赤散加黄连，以
泻肝之子，而以六味饮滋化源，以补其母之胜也。
《千金方》记载：妇女小户嫁痛（指性交疼痛）持续数日，处方使用甘草、生姜、白芍、桂心，用酒煎煮后温服。另一个方子，治疗嫁痛，单用牛膝，或者单用大黄，用酒煎煮服用。另外，将乌贼鱼骨烧成粉末，用酒送服；外用青盐炒热，用布包裹熨烫患处。
《良方》论述道：妇女有的因肝经湿热下注，或因郁怒损伤肝脾。外证表现为两侧少腹肿痛，或玉门（阴道口）肿胀作痛，或寒热往来，憎恶寒冷且壮热。内证表现为小便滞涩不畅，或腹部急痛，或少腹痞闷胀满。如果两侧少腹肿痛，是肝经湿热壅滞所致，使用龙胆泻肝汤。玉门肿胀，是肝火兼血虚所致，使用加味逍遥散，以及龙胆泻肝汤加木香。如果一概投用散血攻毒的药物，那就错误严重了。
李氏按语：阴户两旁肿痛，手足不能舒展伸直的，使用四物汤加乳香末捣成饼状，纳入阴中，效果显著。另外，阴部肿痛剧烈，便秘痛苦难忍的，四物汤加柴胡、丹皮、山栀、胆草。如果经常阴肿的，四物汤加藁本、防风。如果肿痛但不伴闭结的，逍遥散加丹皮、山栀。
慎斋按语：以上两条，叙述妇人阴中肿痛的症状。足厥阴肝经环绕阴器，妇人的阴户属于肝经所主部位，这是经血虚火燥，就会发生肿胀和疼痛，疼痛是因为火邪。根据“实则泻其子”的原则，龙胆泻肝汤、加味逍遥散，虽然是对症于本经的药物，但不如大剂量使用导赤散加黄连，以泻肝之子（心火），并用六味地黄丸滋生化之源，以补益其母（肾水）的不足。
陈良甫说：妇人阴痒，是由虫蚀引起的。三虫在肠胃之间，因为脏腑虚弱，三虫活动，侵蚀于阴内，这些虫产生热感，轻微的表现为痒，严重的才表现为痛。
*Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) records: For women suffering from *xiaohu jiatong* (painful intercourse lasting for days), the prescription uses Gancao (Licorice Root, *Glycyrrhizae Radix et Rhizoma*), Shengjiang (Fresh Ginger, *Zingiberis Rhizoma Recens*), Baishao (White Peony Root, *Paeoniae Radix Alba*), and Guixin (Cinnamon Twig Heart, *Cinnamomi Ramulus Corda*), decocted with wine and taken warm. Another formula for treating *jiatong* uses single-herb Niuxi (Achyranthes Root, *Achyranthis Bidentatae Radix*) or single-herb Dahuang (Rhubarb Root, *Rhei Radix et Rhizoma*), decocted with wine and taken. Additionally, Ouziyu Gu (Cuttlefish Bone, *Sepiae Endoconcha*) is burnt to ash, swallowed with wine; externally, Qingyan (Green Salt) is stir-fried hot, wrapped in cloth, and applied as a hot compress to the affected area.
*Liangfang* discusses: Women may suffer from damp-heat pouring downward due to Liver channel involvement, or Liver and Spleen damage caused by depression and anger. External symptoms include swelling and pain in the lower abdomen on both sides, or swelling and pain at the Yumen (vaginal opening); alternating chills and fever, aversion to cold with high fever. Internal symptoms include stagnation and difficulty in urination, acute abdominal pain, or fullness and oppression in the lower abdomen. If there is swelling and pain in the lower abdomen on both sides, it is due to damp-heat congestion in the Liver channel; use Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver). If the Yumen is swollen, it is due to Liver fire and blood deficiency; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Longdan Xiegan Tang added with Muxiang (Aucklandia Root, *Aucklandiae Radix*). To indiscriminately administer blood-dispersing and toxin-attacking agents would be a grave error.
Li’s commentary: For swelling and pain on both sides of the Yinhu (vulva) where the limbs cannot extend, use Siwu Tang (Four Substances Decoction) added with Rushxiang powder (Frankincense Resin, *Boswelliae Resina*) pounded into a cake, inserted into the vagina, which yields effective results. Furthermore, for extreme swelling and pain of the genitals accompanied by severe constipation and distress, Siwu Tang is used with Chaihu (Bupleurum Root, *Bupleuri Radix*), Danpi (Moutan Bark, *Moutan Cortex*), Shanzhi (Gardenia Fruit, *Gardeniae Fructus*), and Danshen/Dancao (Gentiana Root, *Gentianae Radix*). For frequent genital swelling, Siwu Tang is added with Gaoben (Ligusticum Root, *Ligustici Chuanxiong Rhizoma*) and Fangfeng (Saposhnikovia Root, *Saposhnikoviae Radix*). If there is swelling and pain without obstruction/constipation, Xiaoyao San (Free and Easy Wanderer Powder) is used with Danpi and Shanzhi.
Shenzhai’s commentary: The above two paragraphs describe the symptoms of swelling and pain within the female genitals. The Foot Jueyin Liver Meridian encircles the external genitalia; the female Yinhu belongs to the domain of the Liver channel. When meridian blood is deficient and fire is dry, swelling and pain occur; pain is attributed to fire. According to the principle "when excess, drain its child," although Longdan Xiegan Tang and Jiawei Xiaoyao San are specific remedies for this channel, they are not as effective as using a large dose of Daochi San (Guide Out Red Powder, *Daochi San*) added with Huanglian (Coptis Rhizome, *Coptidis Rhizoma*) to drain the child of the Liver (Heart fire), while using Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia, *Liuwei Dihuang Wan*) to nourish the source of transformation, thereby supplementing the mother (Kidney water) to overcome the excess.
Chen Liangfu stated: Female genital itching is caused by worm erosion. The three worms reside between the intestines and stomach; due to organ deficiency, the three worms become active and erode the interior of the vagina. These worms generate heat; mild cases manifest as itching, while severe cases manifest as pain.