《金匮要略》曰∶妇人伤寒发热，经水适
来，昼日明了，暮则谵语，如见鬼状，此为热入血室，治之无犯胃气及上二焦，必自愈也。
徐注曰∶此言热入血室，不必血结，初即抟邪为患，曰伤寒，即所谓无汗恶寒也。曰发热，病之初也。曰
经水适来，是经水初行时也。邪盛则经气亦盛，适相值，寒邪必伤营，故汗与血抟，血属阴主夜，故昼则热虽
发而明了，暮则入阴分，邪挟阴气而为谵语。如见鬼状者，谵之甚也。此为热入血室者，言血室虽在内，表邪实
未尝犯胃及上二焦，故治法亦唯和表邪，略兼清血室之热足矣。误以为客邪入内攻之，则所伤实多，故曰无犯
胃气及上二焦，必自愈也。
按∶此条是言经行不断，则热不留结，勿谓谵语，误用硝、黄。犯其胃气，刺动荣血，犯其中焦，柴胡和解，
犯其上焦。但不妄犯，热随血散，自愈也。
《金匮要略》曰∶妇人中风，发热恶寒，经水适来，得七八日，热除脉迟，身凉，胸胁满，如结胸状，谵
语者，此为热入血室也。当刺期门，随其实而取之。
徐注曰∶此言经与病值，不即为患，病解后，反抟邪在胸胁作楚，谓中风病。虽稍异于前之伤寒，然发热
恶寒，经水适来，与前之邪盛经亦盛无二。后七八日，热除脉迟，身凉，是经在病中行而不碍也。却七八日后，
反胸胁满，如结胸状，谵语，是入血室之热，不窜于经，而结于肝之府，故脉所过处为满，
甚则如结胸状，阴火盛则谵语也。然胸胁虽满，非少阳表邪。虽如结胸，非太阳表邪入里。虽谵语，非胃实。
故曰此热入血室，亦见不可误攻胃及上二焦，当刺期门。期门，肝之分也。此肝实病，泻其实而取之。
按∶此条言适来即断，血结在里为实证，故刺期门以泻之。不善刺者，小柴胡去人参，加桃仁、丹皮、归
尾、山甲以行之。
《金匮要略》说：妇女患伤寒发热，月经正好来潮，白天神志清醒，傍晚则出现胡言乱语，好像看见鬼怪一样，这是热邪陷入血室（子宫及肝经相关部位），治疗时不要损伤胃气以及上焦和中焦，病一定会自愈。
徐忠可注释说：这里说的是热入血室，并不一定伴有瘀血凝结，起初就是邪气搏结为患。所说的“伤寒”，就是指无汗、恶寒的症状。所说的“发热”，是疾病的初期表现。所说的“月经正好来潮”，是指月经刚开始行经的时候。邪气盛则经气也盛，两者恰好相遇，寒邪必然损伤营血，所以汗与血相互搏结。血属阴而主夜间，所以白天虽然发热但神志清楚，到了傍晚邪气进入阴分，邪气挟带阴气而导致胡言乱语。所谓“像看见鬼怪一样”，是胡言乱语严重的表现。这称为热入血室，是说血室虽然在体内深处，但表邪实际上并没有侵犯胃气以及上焦和中焦，所以治疗方法也只是调和表邪，略微兼清血室的热邪就足够了。如果错误地认为客邪入内而使用攻下法，那么受到的伤害就很多了，所以说不要损伤胃气以及上焦和中焦，病一定会自愈。
按语：这一条是说经期持续不断，热邪就不会留滞凝结，不要因为出现胡言乱语，就误用芒硝、大黄等峻下药。这样会损伤胃气，扰动营血，侵犯中焦；若用柴胡和解少阳，则会侵犯上焦。只要不妄加触犯，热邪随着血液消散，病就会自愈。
《金匮要略》又说：妇女患中风，发热恶寒，月经正好来潮，经过七八天后，热退脉迟，身体转凉，胸胁部胀满，像结胸证（胸胁苦满）的样子，并出现胡言乱语，这是热入血室。应当针刺期门穴，根据实证的情况进行泻法治疗。
徐忠可注释说：这里说的是月经与疾病同时发生，并不立即造成危害，病解之后，反而使邪气搏结在胸胁引起疼痛，这指的是中风病。虽然与前文的伤寒略有不同，但发热恶寒、月经正好来潮，与前文所述邪盛经亦盛的机理没有两样。过了七八天，热退脉迟，身体转凉，说明月经在疾病过程中运行而没有受到阻碍。然而在七八天之后，反而出现胸胁胀满，像结胸证的样子，并胡言乱语，这是因为陷入血室的热邪，没有窜入经脉，而是结聚在肝脏的府库（肝经所过之处），所以脉道经过的地方感到胀满，严重时就像结胸证，阴火旺盛就会导致胡言乱语。然而胸胁虽然胀满，却不是少阳表的邪气；虽然像结胸证，却不是太阳表邪入里；虽然胡言乱语，却不是胃家实。所以说这是热入血室，也表明不可误攻胃气以及上焦和中焦，应当针刺期门穴。期门穴是肝脏的分野。这是肝实之证，泻其邪实即可治愈。
按语：这一条说的是月经刚来就停止，瘀血凝结在体内形成实证，所以针刺期门穴以泻其实邪。如果不善于针刺的人，可以用小柴胡汤去掉人参，加入桃仁、丹皮、当归尾、穿山甲来活血行气。
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: When a woman suffers from Shanghan (Cold Damage) with fever, and her menses happen to arrive, she is clear-minded during the day but experiences delirium (confused speech) at dusk, as if seeing ghosts. This is termed Re Ru Xue Shi (Heat entering the Blood Chamber). In treatment, one must not harm the Stomach Qi or the Upper and Middle Jiao; the condition will heal itself.
Xu Zhongke commented: This refers to Heat entering the Blood Chamber, which does not necessarily involve blood stasis binding; initially, it is the pathogenic factor clumping together to cause disease. "Shanghan" here refers to the absence of sweating and aversion to cold. "Fever" indicates the beginning of the illness. "Menses happening to arrive" means the menstrual flow has just begun. When the pathogen is strong, the Jing Qi (Meridian Qi) is also strong; they meet exactly. The Cold pathogen inevitably damages Ying Blood (Nutritive Blood), so sweat and blood bind together. Since blood belongs to Yin and governs the night, although fever occurs during the day, the mind remains clear. At dusk, the pathogen enters the Yin aspect, and the pathogen, carrying Yin Qi, causes delirium. "As if seeing ghosts" describes severe delirium. This is called Heat entering the Blood Chamber, meaning that although the Blood Chamber is located internally, the exterior pathogen has not actually invaded the Stomach Qi or the Upper and Middle Jiao. Therefore, the treatment method only needs to harmonize the exterior pathogen and slightly clear the heat in the Blood Chamber. If mistakenly treated as an internal invading pathogen using purgatives, the damage would be significant. Hence, it is said not to harm the Stomach Qi or the Upper and Middle Jiao, and the condition will heal itself.
Note: This clause discusses continuous menstruation, where heat does not linger and condense. One should not use harsh purgatives such as Mangxiao (Natrii Sulfas) and Huanglian (Coptidis Rhizoma) [Note: Text says Xiao/Huang, likely referring to Mangxiao and Dahuang] due to delirium. Doing so harms Stomach Qi, disturbs Ying Blood, and invades the Middle Jiao; using Chaihu (Bupleuri Radix) to harmonize Shaoyang invades the Upper Jiao. As long as one does not recklessly interfere, the heat dissipates with the blood, and the disease heals spontaneously.
The *Jingui Yaolue* also states: When a woman suffers from Fengzhong (Wind Strike) with fever and aversion to cold, and her menses happen to arrive, after seven or eight days, the fever subsides, the pulse becomes slow, the body cools down, there is fullness in the chest and hypochondrium resembling Jie Xiong (Chest Binding syndrome), and delirium occurs. This is Heat entering the Blood Chamber. One should puncture Qimen (Liv 14) and treat according to the excess pattern by draining.
Xu Zhongke commented: This refers to the coincidence of menstruation and illness, which does not immediately cause harm. After the illness resolves, the pathogen instead binds in the chest and hypochondrium causing pain, referring to Fengzhong. Although slightly different from the previous Shanghan case, the presence of fever, aversion to cold, and coincident menstruation shares the same mechanism as the previous case where both pathogen and Jing Qi were strong. After seven or eight days, the fever subsides, the pulse slows, and the body cools, indicating that menstruation proceeded through the illness without obstruction. However, after these seven or eight days, fullness in the chest and hypochondrium appears, resembling Jie Xiong, accompanied by delirium. This is because the heat entering the Blood Chamber did not wander into the meridians but condensed in the Liver's mansion (Liver Meridian area). Thus, the areas traversed by the pulse feel full, and severely, it resembles Jie Xiong. Excessive Yin fire leads to delirium. Although there is chest and hypochondriac fullness, it is not Shaoyang exterior pathogen; although it resembles Jie Xiong, it is not Taiyang exterior pathogen entering the interior; although there is delirium, it is not Stomach Excess. Therefore, this is Heat entering the Blood Chamber, indicating that one must not mistakenly attack the Stomach or the Upper and Middle Jiao. One should puncture Qimen. Qimen is the sector of the Liver. This is a Liver Excess pattern; drain the excess to cure it.
Note: This clause discusses menstruation that stops upon arrival, where blood stasis condenses internally forming an Excess pattern. Therefore, puncturing Qimen drains the excess. Those unskilled in acupuncture may use Xiaochaihu Tang (Minor Bupleurum Decoction) minus Renshen (Ginseng Radix), adding Taoren (Prunus Semen), Danpi (Moutan Cortex), Guiwei (Angelicae Sinensis Radix), and Shanjiya (Squama Manis) to promote blood circulation.