论曰∶夫妇人崩中漏下者,由劳伤血气,冲任之脉虚损故也。冲脉、任脉为经脉之海,
皆起于胞内。而手太阳小肠之经也,手少阴心之经也,此二经上为乳汁,下为月水。妇人经
脉调适,则月水根据时。若劳伤冲任,气虚不能制其经脉,血非时而下,淋沥而不断,谓之漏
下也。
致五脏伤损,五脏之色,随脏不同。若五脏皆虚损者,则其色随血下。诊其脉,寸口弦
而大,弦则为脏,大则为芤;脏则为寒,芤则为虚。虚寒相搏,其脉为牢,妇人即半产而漏
下。又云∶尺脉急而弦大,风邪入少阴之经,女子漏自下赤。又漏下赤白不止,脉小虚滑者
生,脉大紧实数者死也。又漏血下赤白,日下血数斗,脉急疾者死,迟者生也。又云∶尺寸
脉虚者漏血。漏血脉浮,不可治也。
若经候过多,其色瘀黑,甚者崩下,吸吸少气,脐腹冷极则汗出如雨,尺脉微小。由冲
任虚衰,为风冷客乘胞中,气不能固,可灸关元百壮。(在脐下当中三寸)宜鹿茸丸。
鹿茸(燎去毛,酥炙) 赤石脂 禹余粮(制,各一两) 艾叶 柏叶 附子(炮,各
半两) 熟地黄(洗,焙) 当归 续断(各二两)
上为细末,酒糊丸如梧桐子大。空心,温酒下三十丸。
治妇人崩中漏下,不问年月远近。
柏叶 续断 川芎 当归 生干地黄 鳖甲 龟甲(各一两半) 禹余粮(二两半) 阿
胶赤石脂 牡蛎 地榆 艾叶 鹿茸(各一两)
上为末,每服二钱,食前,粥饮调下。
一方有丹参,如鹿茸数。炼蜜丸如梧桐子大。每服三、四十丸,空心,温酒吞下。
论述说:妇女出现崩中(经血非时暴下)或漏下(经血淋漓不断)的症状,是由于劳累损伤了气血,导致冲脉和任脉虚损的缘故。冲脉和任脉是十二经脉的海,都起源于胞宫(子宫)。手太阳小肠经和手少阴心经这两条经络,上行化为乳汁,下行化为月经。妇女的月经周期规律,则月经按时来潮。如果劳伤冲任二脉,气虚不能统摄经脉中的血液,血液在非经期流出,淋漓不尽,这就称为漏下。
这会导致五脏受损,五脏对应的面色会随脏腑的不同而显现不同颜色。如果五脏都虚损,那么血色就会随经血排出。诊察其脉象,寸口脉弦且大,弦脉主脏病,大脉主芤脉(中空如葱管);脏病则表现为寒,芤脉则表现为虚。虚与寒相互搏结,脉象表现为牢脉(沉按实大),妇女就会出现半产(小产)及漏下。又说:尺脉急迫、弦大,是风邪侵入少阴经,女子漏下血色发赤。如果漏下赤白相兼不止,脉象小、虚、滑的预后良好(生);脉象大、紧、实、数的预后不良(死)。又如:漏下赤白血液,每天出血数斗,脉象急疾的预后不良(死),脉象迟缓的预后良好(生)。又说:寸脉和尺脉均虚弱的,会出现漏血。漏下症见脉浮的,难以治愈。
如果月经量过多,血色瘀黑,严重的发生崩中,呼吸短促少气,脐腹部冷极则汗出如雨,尺脉微小。这是由于冲任二脉虚衰,风寒之邪客居于胞中,气不能固摄所致,可以灸关元穴一百壮。(关元穴位于脐下正中三寸处)适宜服用鹿茸丸。
鹿茸(燎去毛,用酥炙) 赤石脂 禹余粮(炮制,各一两) 艾叶 柏叶 附子(炮制,各半两) 熟地黄(洗净,焙干) 当归 续断(各二两)
以上药物研为细末,用酒调糊制成梧桐子大小的药丸。空腹时,用温酒送服三十丸。
治疗妇女崩中漏下,不论发病时间长短。
柏叶 续断 川芎 当归 生干地黄 鳖甲 龟甲(各一两半) 禹余粮(二两半) 阿胶 赤石脂 牡蛎 地榆 艾叶 鹿茸(各一两)
以上药物研为末,每次服用二钱,饭前,用米粥汤调服。
另一配方中有丹参,用量同鹿茸。炼蜜为丸,如梧桐子大小。每次服用三四十丸,空腹时,用温酒吞服。
Commentary states: In women, Bingzhong (sudden profuse uterine bleeding) or Louxia (persistent dripping uterine bleeding) occurs due to fatigue damaging Qi and Blood, resulting in deficiency and damage to the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). The Chong Mai and Ren Mai are the seas of the twelve meridians, both originating from the Bao Gong (Uterus). The Hand-Taiyang Small Intestine Meridian and the Hand-Shaoyin Heart Meridian, these two meridians transform upwards into breast milk and downwards into menstruation. When a woman's menstrual cycle is regulated, menstruation arrives on time. If the Chong and Ren meridians are damaged by fatigue, Qi deficiency fails to control the vessels, causing blood to flow out of season, dripping continuously without stopping; this is called Louxia.
This leads to damage of the Five Zang Organs, and the colors associated with the five Zang organs manifest differently depending on the organ. If all five Zang organs are deficient and damaged, the color of the blood will be discharged with the menstrual flow. Upon pulse diagnosis, the Cun Kou (Radial Artery at the wrist) pulse is Xian (Wiry) and Da (Large); Xian indicates Zang disease, while Da indicates Kou (Hollow) pulse; Zang disease implies Cold, and Kou pulse implies Deficiency. Deficiency and Cold combine, resulting in a Lao (Firm) pulse; in women, this presents as Ban Chan (miscarriage) and Louxia. It is also stated: The Chi pulse (at the wrist) is Ji (Rapid/Tight), Xian (Wiry), and Da (Large), indicating Wind-Evil invading the Shaoyin Meridian, causing women to have red Louxia. If red and white discharge continues without stopping, a Xiao (Small), Xu (Deficient), and Hua (Slippery) pulse indicates survival (favorable prognosis), whereas a Da (Large), Jin (Tight), Shi (Excess), and Shu (Rapid) pulse indicates death (unfavorable prognosis). Furthermore, if red and white blood is discharged, with several dou (ancient unit of volume) of blood lost daily, an Ji Ji (Rapid/Restless) pulse indicates death, while a Chi (Slow) pulse indicates survival. It is also said: If both the Cun and Chi pulses are Xu (Deficient), it indicates Louxue (bleeding leakage). A floating pulse in cases of Louxia is difficult to treat.
If menstruation is excessive, the blood is dark and瘀 (stagnant), and in severe cases, Bingxia (profuse bleeding) occurs. The patient experiences shortness of breath (Xi Xi Shao Qi), extreme cold in the umbilical and abdominal regions leading to sweating like rain, and a Xiao Wei (Small and Fine) Chi pulse. This is caused by deficiency and decline of the Chong and Ren meridians, allowing Wind-Cold evil to invade the Bao Zhong (uterus), where Qi fails to consolidate. Moxibustion can be applied to Guan Yuan (CV4) for one hundred Zhu (moxa cones). (Guan Yuan is located three cun directly below the umbilicus). The Lu Rong Wan (Deer Antler Pill) is suitable.
Lu Rong (Deer Antler, hair removed by scorching, fried with butter) 1 liang, Chishi Zhi (Red Halloysite) 1 liang, Yuyuliang (Illite) 1 liang (processed), Ai Ye (Mugwort Leaf) 0.5 liang, Bai Ye (Cacumen Platycladi) 0.5 liang, Fuzi (Aconiti Lateralis Radix Praeparata, processed) 0.5 liang, Shu Dihuang (Prepared Rehmannia Root) washed and dried, Dang Gui (Angelicae Sinensis Radix) 2 liang, Xuduan (Dipsaci Radix) 2 liang.
Grind the above ingredients into fine powder, mix with wine paste to form pills the size of Sophora seeds. Take thirty pills orally with warm wine on an empty stomach.
To treat women's Bingzhong and Louxia, regardless of how long the condition has persisted.
Bai Ye (Cacumen Platycladi) 1.5 liang, Xuduan (Dipsaci Radix) 1.5 liang, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 1.5 liang, Dang Gui (Angelicae Sinensis Radix) 1.5 liang, Sheng Gan Dihuang (Raw Dried Rehmannia Root) 1.5 liang, Bie Jia (Carapax et Plastrum Testudinis) 1.5 liang, Gui Jia (Plastrum Testudinis) 1.5 liang, Yuyuliang (Illite) 2.5 liang, Ejiao (Colla Corii Asini) 1 liang, Chishi Zhi (Red Halloysite) 1 liang, Muli (Concha Ostreae) 1 liang, Di Yu (Sanguisorbae Radix) 1 liang, Ai Ye (Mugwort Leaf) 1 liang, Lu Rong (Deer Antler) 1 liang.
Grind the above into powder. Take two qian per dose, before meals, mixed with rice gruel liquid.
Another prescription includes Danshen (Salviae Miltiorrhizae Radix et Rhizoma) in the same quantity as Lu Rong. Form pills with refined honey, the size of Sophora seeds. Take thirty to forty pills orally with warm wine on an empty stomach.