张子和曰∶妇人带下,《圣惠方》与巢氏二家之说皆非也。夫治病,当先识经络。人身大经有十二,奇经
有八脉。十二经与八脉,通身往来,经络共二十道,上下流走环周,昼
夜不息。然此十二经上下周流者,止十九道耳。唯带脉起少腹季胁之端,乃章门穴也。环周一身,络腰而过,如
束带之于身。《难经》云,带之为病,溶溶如坐水中。冲任者,是经脉之海也,循腹胁,夹脐旁,传流于气冲,
属于带脉,络于督脉。督脉者,起于关元穴。任脉者,女子养胎孕之所。督脉乃是督领妇人经脉之海也。冲任督
三脉,同起而异行,一源而三歧,皆络于带脉。冲任督三脉,皆统于篡户,循阴器,行廷孔、溺孔上端。冲任
督三脉,以带脉束之。因余经上下往来,遗热于带脉之间,客热所郁,热者血也,血积多日不流,从金之化而为
白,乘少腹冤热,白物满溢,随溲而下,绵绵不绝,是为白带。多不痛,或有痛者,因壅碍而成也。经曰,少
腹冤热,溲出白液,冤者屈滞也,病非本经,为他经冤郁而成此疾。皆从湿热治之。遗热于小肠,从金化而为白,
与治痢同法。赤白痢,乃邪热传于大肠。赤白带,邪热传于小肠。故治二证,不可骤用峻热药燥之,燥之则内水
涸,内水涸则必烦渴,烦渴则小便不利,则足肿面浮,渐至不起。治法∶先以导水、禹功泻之,次以淡剂降心
火,益肾水,下小溲,利水道,则愈矣。
张子和说:关于妇女带下病,《圣惠方》与巢元方两家(《诸病源候论》)的说法都不正确。治疗疾病,应当先认识经络。人体大经脉有十二条,奇经有八条。十二条正经与八条奇经,在全身上下往来流通,经络共有二十条,上下流走环绕周身,昼夜不停息。然而这十二条正经上下周流的,实际上只有十九条而已。唯有带脉起于少腹季胁的末端,即章门穴处。它环绕身体一周,络过腰部,就像束带一样束缚着身体。《难经》说,带脉为病,感觉松弛无力如同坐在水中。冲脉和任脉,是经脉之海,它们循行于腹部和胁部,夹脐旁而行,流传至气冲穴,归属于带脉,并联络督脉。督脉,起于关元穴。任脉,是女子孕育胎儿的地方。督脉则是总督统领妇人经脉之海。冲脉、任脉、督脉这三条经脉,同一起源而不同路径运行,一源分出三支,都联络于带脉。冲脉、任脉、督脉这三条经脉,都统摄于篡户(会阴部),循行于阴器,经过廷孔、溺孔的上端。冲脉、任脉、督脉这三条经脉,被带脉所约束。由于其他经脉上下往来,将余热遗留在带脉之间,客邪之热郁结于此,热属血分,血液积聚多日不流动,随着“金”的化性转变为白色,乘着少腹冤屈郁结之热,白色分泌物满溢,随着小便排出,绵绵不绝,这就是白带。通常不疼痛,如果有疼痛的,是因为壅滞阻碍所致。经文说,少腹冤热,小便排出白液,“冤”是指屈曲阻滞,此病并非本经自病,而是由他经冤郁而成此疾。都应从湿热论治。余热遗留在小肠,随“金”化性变为白色,治疗方法与治痢疾相同。赤白痢,是邪热传于大肠。赤白带,是邪热传于小肠。所以治疗这两种证候,不可突然使用峻烈的热药来燥湿,如果燥湿,则体内津液枯竭,体内津液枯竭则必然出现烦渴,烦渴则导致小便不利,进而足肿面浮,逐渐发展到卧床不起。治疗方法:先用导水丸、禹功散泻下,接着用淡味药物降心火,益肾水,通利小便,疏通水道,病就能痊愈了。
Zhang Zihe stated: Regarding leukorrhea in women, the theories presented in *Shenghui Fang* and those of Chao Yuanfang are both incorrect. In treating diseases, one must first understand the meridians. The human body has twelve main meridians and eight extraordinary vessels. The twelve regular meridians and the eight extraordinary vessels circulate throughout the body; together there are twenty meridian pathways, flowing up and down in a continuous cycle day and night without cessation. However, among these twelve regular meridians, only nineteen pathways actually flow up and down in a cycle. Only the Dai Mai (Girdle Vessel) originates from the end of the lower abdomen and lateral hypochondrium, specifically at the Zhangmen (LR13) acupoint. It encircles the body once, passing through the waist, binding the body like a belt. As stated in the *Nan Jing*, disease of the Dai Mai presents as flaccidity and weakness, as if sitting in water. The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) are the seas of the meridians. They follow the abdomen and hypochondrium, run alongside the umbilicus, transmit to the Qichong (ST30) acupoint, belong to the Dai Mai, and connect with the Du Mai (Governor Vessel). The Du Mai originates from the Guanyuan (CV4) acupoint. The Ren Mai is the site where women nourish the fetus. The Du Mai serves as the governor and leader of the sea of women's meridians. The Chong, Ren, and Du meridians share the same origin but have different courses; they branch out from one source into three, all connecting with the Dai Mai. These three meridians are all governed by the Chuankou (perineum), follow the genitalia, and pass through the upper ends of the Tingkong (urethral opening) and Niao Kong (urinary meatus). The Chong, Ren, and Du meridians are bound by the Dai Mai. Because other meridians flow up and down, they leave residual heat within the Dai Mai. This pathogenic heat becomes stagnant. Heat relates to blood; when blood accumulates for many days without flowing, it transforms according to the nature of Metal into white discharge. Accompanied by "injustice heat" (stagnant heat) in the lower abdomen, the white substance overflows and is discharged with urine, continuously and endlessly, which constitutes leukorrhea (white discharge). It usually does not cause pain; if pain occurs, it is due to obstruction and stagnation. The classic states: "Injustice heat in the lower abdomen causes white fluid to be excreted with urine." "Injustice" refers to屈曲阻滞 (twisted stagnation). This disease does not originate from the affected meridian itself but is caused by stagnation in other meridians. All such cases should be treated based on damp-heat. Residual heat left in the Small Intestine transforms into white discharge following the nature of Metal; the treatment method is the same as that for dysentery. Red and white dysentery indicates pathogenic heat transmitted to the Large Intestine. Red and white leukorrhea indicates pathogenic heat transmitted to the Small Intestine. Therefore, when treating these two conditions, one must not abruptly use harsh hot drugs to dry dampness. If dried, internal fluids will be depleted; depletion of internal fluids leads to vexation and thirst; vexation and thirst results in difficult urination, followed by edema of the feet and face, eventually leading to bedridden state. The treatment method: First, use Daoshui Wan (Water-Guiding Pill) and Yugong San (Yu Gong Powder) to purge; subsequently, use bland-tasting agents to descend Heart Fire, tonify Kidney Water, promote urination, and unblock the water passages, then the disease will resolve.