论曰∶经脉不通日久,此非细事,实为沉病。若是室女经脉不通,初因贪食酸咸之物,
遂致血脉干涸,变成劳疾。若因经脉正行,误食热面、生冷、房室,遂成此疾。腹内颗块,
误认为胎,时日稍深,必见困笃。
初虞世云∶女子十四,天癸至,任脉通,月事以时下,故令有子。天癸者,物之自然。
月者,以月至;经者,有常也。其来不可过与不及、多与少,反此皆谓之病。不行犹甚,百
疾生焉。血既不能滋养百体,则发落面黄,身羸瘦。血虚则发热,故身多热。水不足则燥气
燔,燥气燔则金受邪,金受邪则肺家嗽,嗽则为肺痈、肺痿必矣。医见经不行,则用虻虫、
水蛭等行血药,见热则用除热诸寒药,实出妄意。就中不行,以药行之,为害滋大。经水枯
竭,则无以滋养,其能行乎?譬犹索万金于乞丐之人,虽捶楚并下,不可得也。但服以养气
益血诸药,天癸自行。又有一种妇人盛实,月经瘀闭,利之则行。自有证候,学人宜审焉。
治血脉不通。
当归 穿山甲(灰炒) 蒲黄(各半两,炒) 辰砂(一钱) 麝香(少许)
上为细末研停,每服二钱,热酒调下。如不吃酒,薄荷、醋汤亦可。
治心膈迷闷,腹脏撮痛,气急气闷,月信不通等疾。
天台乌药(二两) 当归 莪术(各一两)
上为细末,每服二钱,温酒调下,服后以食压之。大忌生冷、油腻等物。若产后诸疾,
用炒姜、酒调下。(以上出《妇人经验方》)
《救急》疗妇人月经不调,或一月不来,或隔月不来,或多或少,脐下绞痛,面色痿黄
,四体虚吸,羸瘦不能食方。
当归 川牛膝 牡丹皮 桃仁(各一两半) 大黄 芎 土瓜根 芍药 朴硝 桂心
虻虫(去翅足,炒) 水蛭(各半两,炒)
上 咀。以水九升,煮取三升,分温五服。忌如常法。
疗月经不通,腹中痛。(见《产宝方》)
牛膝(六分) 大黄 桃仁(去皮尖、双仁,炒) 细辛(各五分) 川芎 当归(各
四两) 水蛭(三分,糯米炒黄)
上为末,炼蜜丸如梧桐子大。每服二十丸,空心温酒下。
治月水不通。(出《梅师方》,已试有验)
浓朴(姜汁炙香,细切)不以多少,浓煎去滓,空心温服。
治妇人经候不来数月,脐腹 痛,或有一块上下相拄,饮食减少,腹满恶心,大便秘涩
者,宜服《局方》北亭丸。用石菖蒲、马鞭草煎汤送下三、四十丸,两服必通。
论述说:经脉不通日久,这不是小事,实际上是沉疴痼疾。如果是未婚女子经脉不通,起初是因为贪吃酸咸的食物,导致血脉干涸,演变成虚劳疾病。如果是在月经正常来潮期间,误食热性面食、生冷食物或进行房事,从而形成这种疾病。腹内有结块,容易被误认为是怀孕,时日稍久,必然出现困顿危重的症状。
初虞世说:女子十四岁,天癸(指促进生殖机能成熟的物质)至,任脉通畅,月经按时来潮,所以能够受孕。天癸是事物自然生成的。月,是指按月而至;经,是指有常规规律。月经的来潮不可过多或过少、量多或量少,违背这些情况都称为病。月经不行最为严重,百病由此而生。血液既然不能滋养全身,就会出现头发脱落、面色萎黄、身体消瘦的症状。血虚则发热,所以身体多有热感。水液不足则燥气炽盛,燥气炽盛则肺金受邪,肺金受邪则肺部咳嗽,咳嗽进而发展为肺痈、肺痿是必然的。医生见到月经不行,就用虻虫、水蛭等活血药;见到发热,就用清热寒凉药,这实在是出于妄加揣测。其中对于月经不行的情况,强行用药通利,危害更大。经血枯竭,就没有东西可以滋养,怎么能行得通呢?这就好比向乞丐索要万金,即使鞭打拷问,也无法得到。只要服用补气益血的药物,天癸自然会自行运行。又有一种妇人体质壮实,月经瘀闭,用泻下法就能通行。自有其证候表现,学习中医的人应当仔细审察。
治疗血脉不通。
当归、穿山甲(灰炒)、蒲黄(各半两,炒)、辰砂(一钱)、麝香(少许)。
以上研成细末并混合均匀,每次服用二钱,用热酒调服。如果不喝酒,薄荷汤、醋汤也可以。
治疗心膈部迷闷、腹部脏腑撮痛、气急气闷、月经不通等疾病。
天台乌药(二两)、当归、莪术(各一两)。
以上研成细末,每次服用二钱,用温酒调服,服药后用食物压住药力。大忌生冷、油腻等食物。如果是产后各种疾病,用炒姜、酒调服。(以上出自《妇人经验方》)
《救急方》治疗妇人月经不调,或者一个月不来,或者隔月不来,或多或少,脐下绞痛,面色萎黄,四肢虚弱吸缩,消瘦不能进食的方子。
当归、川牛膝、牡丹皮、桃仁(各一两半)、大黄、川芎、土瓜根、芍药、朴硝、桂心、虻虫(去翅足,炒)、水蛭(各半两,炒)。
以上切碎。用水九升,煮取三升,分五次温服。禁忌如常法。
治疗月经不通,腹中痛。(见《产宝方》)
牛膝(六分)、大黄、桃仁(去皮尖、双仁,炒)、细辛(各五分)、川芎、当归(各四两)、水蛭(三分,糯米炒黄)。
以上研成细末,炼蜜制成梧桐子大小的丸剂。每次服用二十丸,空腹时温酒送服。
治疗月水不通。(出自《梅师方》,已试用有效)
浓朴(姜汁炙香,细切),用量不限,浓煎去渣,空腹温服。
治疗妇人月经数月不来,脐腹疼痛,或者有一块肿块上下抵撞,饮食减少,腹部胀满恶心,大便秘涩者,适宜服用《局方》北亭丸。用石菖蒲、马鞭草煎汤送下三、四十丸,两次服药后必然通畅。
Discourse states: Prolonged obstruction of the meridians is not a trivial matter; it is actually a deep-seated and chronic disease. If an unmarried woman experiences amenorrhea, it may initially be caused by greedily consuming sour and salty foods, leading to dryness and depletion of the blood vessels, eventually transforming into a consumptive disease (Lao Ji). If menstruation was regular but becomes obstructed due to mistakenly consuming hot noodles, raw and cold foods, or engaging in sexual intercourse, this disease arises. A mass within the abdomen may be mistaken for pregnancy; as time passes, symptoms will inevitably become severe and critical.
Chu Yushi stated: At age fourteen, Tian Gui (substances that promote reproductive maturation) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and menstruation occurs on schedule, enabling conception. Tian Gui is naturally generated. "Yue" (Moon/Month) refers to its arrival monthly; "Jing" (Menstruation/Channel) refers to its regularity. The flow of menstruation should not be excessive or deficient, nor too abundant or scanty; deviations from these norms are considered pathological. Amenorrhea is particularly serious, giving rise to myriad diseases. Since blood fails to nourish the body, hair loss, sallow complexion, and emaciation occur. Blood deficiency generates heat, resulting in a sensation of warmth throughout the body. Insufficiency of fluids leads to blazing Dryness Qi; when Dryness Qi blazes, Metal suffers pathogenic invasion; when Metal is invaded, the Lung suffers coughing, which inevitably progresses to Lung Abscess (Fei Yong) or Lung Flaccidity (Fei Wei). Physicians seeing amenorrhea may use blood-invigorating herbs such as Leech (Sheng Chong) and Leech (Shui Zhi); seeing heat, they may use cooling herbs to clear heat. This is merely presumptuous speculation. Forcing blood circulation with drugs when menstruation does not occur causes significant harm. If menstrual blood is exhausted, there is nothing to nourish, so how can it flow? It is like demanding ten thousand gold pieces from a beggar; even under beating and torture, it cannot be obtained. Simply taking herbs that tonify Qi and benefit Blood will allow Tian Gui to function naturally. There is another type of woman who is robust, suffering from blood stasis and closure of menstruation; purgatives will restore flow. Each has specific manifestations; students of medicine must examine them carefully.
To treat blood vessel obstruction:
Dang Gui (Angelicae Sinensis Radix), Chuan Shan Jia (Pangolin Scales, ash-fried), Pu Huang (Typhae Pollen, each 0.5 liang, fried), Chen Sha (Cinnabar, 1 qian), She Xiang (Musk, a small amount).
Grind into a fine powder and mix well. Take 2 qian per dose, mixed with hot wine. If alcohol is not consumed, Bo He (Menthae Haplocalycis Herba) decoction or vinegar water may be used.
To treat mental confusion and oppression in the chest and diaphragm, cramping pain in the abdominal organs, shortness of breath and stifling sensation, and amenorrhea:
Tian Tai Wu Yao (Lithospermi Fructus), Dang Gui (Angelicae Sinensis Radix), E Zhu (Curcumae Rhizoma, each 1 liang).
Grind into a fine powder. Take 2 qian per dose, mixed with warm wine. After ingestion, eat food to settle the medicine. Strictly avoid raw, cold, and greasy foods. For various postpartum conditions, mix with fried ginger and wine. (Above from *Fu Ren Jing Yan Fang*)
*Jiu Ji* treats irregular menstruation in women, where menstruation may not come for one month, or skip months, varying in amount, accompanied by colicky pain below the umbilicus, sallow complexion, weakness and retraction of the four limbs, emaciation, and inability to eat:
Dang Gui (Angelicae Sinensis Radix), Chuan Niu Xi (Cyathulae Radix), Mu Dan Pi (Moutan Cortex), Tao Ren (Persicae Semen, each 1.5 liang), Da Huang (Rhei Radix et Rhizoma), Xiong (Chuanxiong Rhizome), Tu Gua Gen (Trichosanthes Root), Shao Yao (Paeoniae Radix), Po Xiao (Natrii Sulfas), Gui Xin (Cinnamomi Ramulus), Meng Chong (Asio/Bloodsucker insect, wings and feet removed, fried), Shui Zhi (Hirudo, each 0.5 liang, fried).
Cut into pieces. Decoct in nine sheng of water until three sheng remain. Divide into five warm doses. Observe usual dietary restrictions.
To treat amenorrhea and abdominal pain. (See *Chan Bao Fang*)
Niu Xi (Achyranthis Bidentatae Radix, 6 fen), Da Huang (Rhei Radix et Rhizoma), Tao Ren (Persicae Semen, peeled, remove pointed ends and double kernels, fried), Xi Xin (Asari Radix et Rhizoma, each 5 fen), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Dang Gui (Angelicae Sinensis Radix, each 4 liang), Shui Zhi (Hirudo, 3 fen, fried with glutinous rice until yellow).
Grind into powder. Make pills using refined honey, sized like paulownia seeds. Take 20 pills per dose, with warm wine on an empty stomach.
To treat amenorrhea. (From *Mei Shi Fang*, tested and effective)
Hou Po (Magnoliae Officinalis Cortex, stir-baked with ginger juice until fragrant, finely cut), quantity as needed. Decoct strongly, strain, and take warm on an empty stomach.
To treat women whose menstruation has been absent for several months, with pain in the umbilical and abdominal regions, or a palpable mass moving up and down, decreased appetite, abdominal fullness, nausea, and constipation: It is appropriate to take *Ju Fang* Bei Ting Wan. Administer 30-40 pills washed down with a decoction of Shi Chang Pu (Acori Tatarinowii Rhizoma) and Ma Bian Cao (Verbenae Herba). Two doses will surely restore flow.