陈良甫曰∶妇人阴中冷，因劳伤子脏，风冷客之。
薛立斋按∶阴冷有肝经有湿热，外乘风冷所致。若小便涩滞，或小腹痞痛，龙胆泻肝汤。又有妇人阴中寒
冷，小便澄清，腹中亦冷，饮食少思，大便不实，下元虚冷，治以八味丸愈。八味治血弱不能荣养脏腑，津
液枯涩，风寒客于子脏，以致阴冷，有效。
慎斋按∶以上一条，序妇人有阴冷之证也。阴中冷，非外邪风冷客于子脏，即气衰血虚，脏腑虚寒，以致
肝经失养，阴户为之寒冷也。立斋必欲断为肝经湿热，外乘风冷所致，岂有客邪之气，加于湿热之病，而变
为阴冷耶？论属未当。
《大全》曰∶妇人阴挺下脱，或因胞络伤损，或因子脏虚冷，或因分娩用力所致。
薛立斋按∶阴挺下脱，当升补元气为主。若肝脾郁结，气虚下陷，补中汤。若肝火湿热，小便赤涩，龙胆汤。
薛立斋曰∶有妇人阴中突出如菌，四围肿痛，小便数，晡热，似痒似痛、小便重坠，此肝火湿热而肿痛，
脾虚下陷而重坠也。先以补中汤加山栀、茯苓、车前、青皮，以清肝火，升脾气，更以加味归脾汤，调理脾郁，
外以生猪油和藜芦末涂之而收。
《大全》曰∶妇人阴中生一物，挺出五寸许，牵引腰腹膨痛，至不思饮食，皆因多服热药及煎 ，或犯
非理房事，兼意淫不遂，名
阴挺，三茱丸、一捻金丸主之。
慎斋按∶以上三条，序妇人有阴挺之证也。阴挺者，阴器中挺出一物，即立斋所谓舒出如蛇如菌，如鸡冠状
是也。夫妇人阴器，为足厥阴经部分，而冲任督三脉所系胞门子户在焉。其所挺之物，大约子脏肠 之属，非
湿热脾虚下陷，即是热药局事所致，此病机之属于隐曲者。在医者，似难以诊候施之者，立斋之书，每重载之，
真有不可臆度者矣。
陈良甫说：妇人阴中寒冷，是因为劳损伤及子宫（子脏），风冷之邪侵袭所致。
薛立斋按语：阴冷一证，有因肝经湿热，外受风冷所致的；也有因妇人阴中寒冷，小便清长通畅，腹部也觉寒冷，饮食减少，大便不成形，下元虚寒的，治疗用八味丸可愈。八味丸能治疗血弱不能濡养脏腑、津液枯涩、风寒客居于子宫，从而导致阴冷，疗效显著。
慎斋按语：以上一条，叙述了妇人患有阴冷这一病证的情况。阴中寒冷，并非一定是外来的风冷之邪客居于子宫，也可能是气衰血虚，脏腑虚寒，导致肝经失去濡养，阴户因此感到寒冷。薛立斋一定要将其断定为肝经湿热，外受风冷所致，难道有外来邪气作用于湿热病症，反而转变为阴冷的吗？这种论述是不恰当的。
《妇人大全良方》说：妇人阴挺下脱（阴道壁膨出或子宫脱垂），有的因为胞络受损，有的因为子宫虚冷，有的因为分娩时用力过度所致。
薛立斋按语：阴挺下脱，应当以升提补益元气为主。如果因肝脾郁结，气虚下陷，用补中益气汤治疗。如果因肝火湿热，小便赤红涩痛，用龙胆泻肝汤治疗。
薛立斋说：有一位妇人阴中突出如菌状，四周肿痛，小便频数，午后发热，似痒似痛，小便有重坠感，这是肝火湿热导致肿痛，脾虚下陷导致重坠。先用补中益气汤加山栀、茯苓、车前子、青皮，以清肝火、升脾气，再用加味归脾汤调理脾郁，外用生猪油和藜芦末涂抹患处而痊愈。
《妇人大全良方》说：妇人阴中生出一物，挺出约五寸长，牵引腰腹膨胀疼痛，甚至不思饮食，这都是因为多服用热性药物及辛辣煎炸食物，或违反常理的行房事，加上意念淫欲不得满足所致，名为阴挺，用三茱丸、一捻金丸主治。
慎斋按语：以上三条，叙述了妇人患有阴挺这一病证的情况。所谓阴挺，是指阴器中挺出一物，即薛立斋所说的舒出如蛇、如菌、如鸡冠状的东西。女性的阴器，属于足厥阴肝经的部位，而冲脉、任脉、督脉所联系的胞门子户（子宫）就在这里。其所挺出的物体，大约是子宫或肠道的范畴，不是由于湿热和脾虚下陷，就是由于热性药物及不当房事所致，这是属于隐蔽部位的病机。对于医生来说，似乎难以通过诊察来施治，薛立斋的书中常常重视记载这类疾病，确实有不可随意揣度的地方。
Chen Liangfu stated: Cold in the vagina of women is caused by labor injury to the uterus (Zi Zang), with wind-cold pathogenic factors invading.
Xue Lizhai commented: Cold in the vagina can be due to damp-heat in the Liver channel combined with external wind-cold invasion. If there is difficult and scanty urination, or distending pain in the lower abdomen, use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver). There are also cases where women experience coldness in the vagina, clear and copious urine, coldness in the abdomen, poor appetite, and loose stools, due to deficiency-cold of the Lower Yuan; these are treated with Ba Wei Wan (Eight-Ingredient Pill) for recovery. Ba Wei Wan treats blood deficiency failing to nourish the Zang-Fu organs, dryness and stagnation of body fluids, and wind-cold lodging in the uterus, thereby causing vaginal coldness, showing effective results.
Shen Zhai commented: The above passage describes the syndrome of vaginal coldness in women. Vaginal coldness is not necessarily caused by external wind-cold pathogens lodging in the uterus; it may also result from Qi deficiency and Blood deficiency, leading to deficiency-cold of the Zang-Fu organs, causing the Liver channel to lose nourishment, thus making the vulva feel cold. Xue Lizhai insisted on diagnosing this as caused by damp-heat in the Liver channel and external wind-cold invasion. How could an exogenous pathogen acting upon a damp-heat condition transform into coldness? This discussion is inappropriate.
The *Da Quan* (Great Compendium) states: Prolapse of the vagina or uterus (Yin Ting Xia Tuo) in women may be due to damage to the uterine collaterals, deficiency-cold of the uterus, or excessive exertion during childbirth.
Xue Lizhai commented: For prolapse of the vagina or uterus, the primary treatment should be to raise and tonify Yuan Qi. If caused by Liver and Spleen Qi stagnation with Qi deficiency and sinking, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If caused by Liver fire and damp-heat with red and difficult urination, use Longdan Tang (Gentian Decoction).
Xue Lizhai said: In a case of a woman with tissue protruding from the vagina like a mushroom, accompanied by swelling and pain around the area, frequent urination, afternoon fever, sensations of itching and pain, and a heavy sensation in urination, this was due to Liver fire and damp-heat causing swelling and pain, and Spleen deficiency with Qi sinking causing the heavy sensation. Initially, Buzhong Yiqi Tang was administered with added Gardenia (Shan Zhi), Poria (Fu Ling), Plantago Seed (Che Qian Zi), and Green Tangerina Peel (Qing Pi) to clear Liver fire and raise Spleen Qi. Subsequently, Jiawei Guipi Tang (Modified Restore the Spleen Decoction) was used to regulate Spleen depression. Externally, fresh pork fat mixed with Veratrum powder was applied to achieve healing.
The *Da Quan* states: When a woman has a mass protruding from the vagina, extending about five cun, pulling and causing distending pain in the waist and abdomen, to the point of loss of appetite, this is often caused by excessive consumption of hot-natured medicines and fried foods, improper sexual intercourse, and unfulfilled lustful thoughts. This is named Yin Ting (Prolapse), and is treated with San Zhu Wan (Three Myrtles Pill) and Yi Nian Jin Wan (One Pinch Gold Pill).
Shen Zhai commented: The above three passages describe the syndrome of Yin Ting (prolapse) in women. Yin Ting refers to a mass protruding from the genitalia, which corresponds to what Xue Lizhai described as protruding like a snake, a mushroom, or a rooster's comb. The female genitalia belong to the region of the Foot Jueyin Liver channel, where the Bao Men Zi Hu (Gate of the Womb) connected by the Chong, Ren, and Du meridians is located. The protruding matter is generally related to the uterus or intestines. It is either due to damp-heat and Spleen deficiency with Qi sinking, or caused by hot medicines and improper sexual activity. This pathology belongs to hidden and private areas. For physicians, it seems difficult to diagnose and treat based on standard examination methods. Xue Lizhai’s books frequently emphasize recording such diseases, which indeed possess aspects that cannot be easily speculated upon.