妇人诸病,本与男子无异,而其有异者,则惟经水、胎、产之属,故本门亦止列此九证。曰∶经脉类、
胎孕类、产育类、产后类、带浊类、乳病类、子嗣类、 瘕类、前阴类。凡此九者,乃其最切之病,不得不另
详方论。此外杂证,但与男子相同者,自有各门论治之法,故不以男女分,而资赘于此。
谚云:“宁治十男子,莫治一妇人。”此谓妇人之病不易治也。何也?不知妇人之病,本与男子同;而妇
人之情,则与男子异。盖以妇人幽居多郁,常无所伸;阴性偏拗,每不可解。加之慈恋爱憎,嫉妒忧恚,罔知
义命,每多怨忧。或有怀不能畅遂,或有病不可告人,或信师巫,或畏药饵,故染着坚牢,根深蒂固,而治之
有不易耳。此其情之使然也。然尚有人事之难,如寇宗 引黄帝之论曰∶“凡治病,察其形气色泽,
形气相得,谓之可治;色泽以浮,谓之易已;形气相失,色夭不泽,谓之难治。”又曰∶“诊病之
道,观人勇怯、骨肉、皮肤,能知其虚实,以为诊法。”故曰∶治之要极,无失色脉,此治之大则也。
今富贵之家,居奥室之中,处帷幔之内,复有以绵帕蒙其手者,既不能行望色之神,又不能尽切脉之巧。使脉
有弗合,未免多问,问之觉繁,必谓医学不精,往往并药不信,不知问亦非易,其有善问者,正非医之善者不
能也。望闻问切,欲于四者去其三,吾恐神医不神矣。世之通患,若此最多,此妇人之所以不易也。故凡医
家、病家,皆当以此为意。
妇女的各种疾病,本质上与男子没有不同,其不同之处,仅在于月经、怀孕、分娩等方面,因此本章节也只列出这九类病证。分别是:经脉类、胎孕类、产育类、产后类、带下浊液类、乳房疾病类、子嗣类、瘕积(腹内结块)类、前阴类。凡是这九种情况,是最为切身相关的病症,不得不单独详细论述方药理论。除此之外,其他杂症如果与男子相同者,自有各门类中的论治方法,因此不因为男女而区分,也不在此处赘述。
俗话说:“宁可治疗十个男子,也不要治疗一个妇人。”这是说妇人的疾病不容易治疗。为什么呢?并不是不知道妇人的疾病本质与男子相同;而是妇人的情志心理,则与男子不同。大概因为妇人深居幽静之处多生郁结,常常心情无法舒展;女性性格偏向固执拗执,往往难以开解。加上慈爱、喜爱、憎恶、嫉妒、忧愁、愤怒等情绪,不懂得顺应天命道理,常常充满怨恨和忧愁。有的怀抱志向不能畅达实现,有的患有隐疾不便告人,有的相信巫师神鬼,有的畏惧药物服用,所以病情沾染牢固,根深蒂固,因而治疗起来就不容易了。这是由她们的情志因素导致的。然而还有人事方面的困难,如寇宗奭引用黄帝的话说:“大凡治病,要观察病人的形体、气色、光泽,形体与气机相协调,称为可治;色泽浮润明亮,称为容易痊愈;形体与气机失调,面色枯槁无光泽,称为难治。”又说:“诊断疾病的道理,观察人的勇敢或怯懦、骨骼肌肉、皮肤状况,能知道其虚证或实证,以此作为诊断方法。”所以说,治疗的最高准则,不要忽视望色和切脉,这是治疗的大原则。如今富贵人家,居住在深邃的居室中,处在帷幔之内,又有用丝帕蒙住手腕的人,既不能施展望色的神妙技巧,又不能尽善尽美地运用切脉的巧妙手法。使得脉象如果有不符合常规之处,难免要多询问,问多了觉得繁琐,必定认为医术不精,往往连药都不相信,却不知道问诊也不容易,那些善于问诊的人,正不是医术高明的人是不能做到的。望、闻、问、切四诊,想要去掉其中三项,我恐怕即使是神医也会变得不神奇了。世间的普遍弊病,像这样的最多,这就是妇人之所以不容易治疗的原因。所以凡是医生和病人家属,都应当对此在意。
Various diseases in women are essentially no different from those in men; the differences lie solely in menstruation, pregnancy, and childbirth. Therefore, this section lists only these nine categories: Menstrual Disorders (Jingmai Lei), Pregnancy (Taiyun Lei), Childbirth (Chanyu Lei), Postpartum Conditions (Chanhou Lei), Leukorrhea and Turbid Discharge (Daizhuo Lei), Breast Diseases (Rubing Lei), Infertility (Zisi Lei), Masses/Fixed Lumps (Jia Lei), and External Genital Disorders (Qianyin Lei). These nine conditions are the most pertinent to women, necessitating detailed discussion of formulas and theories. Other miscellaneous conditions that are identical to those in men have their respective treatment methods in other sections; thus, they are not distinguished by gender nor elaborated upon here.
As the proverb goes, "It is better to treat ten men than one woman." This implies that women's diseases are difficult to treat. Why? It is not that women's diseases are fundamentally different from men's; rather, it is women's emotional constitution that differs. Women often live in seclusion and harbor much depression, with their feelings frequently unexpressed. Their nature tends to be stubborn and inflexible, making them hard to reason with. Furthermore, driven by affection, love, hatred, jealousy, worry, and anger, they often fail to understand the principles of fate and destiny, leading to frequent resentment and sorrow. Some cannot fulfill their aspirations; some suffer from ailments too private to disclose; some trust in shamans and witches; some fear taking medicine. Consequently, their illnesses become entrenched and deeply rooted, making treatment difficult. This is due to the influence of their emotions. However, there are also difficulties arising from social circumstances. For instance, Kou Zongshi quoted the Yellow Emperor: "In treating diseases, one must observe the patient's form, qi, complexion, and luster. If form and qi are harmonious, it is treatable; if the complexion is bright and floating, recovery will be easy; if form and qi are discordant, and the complexion is dull and dry, it is difficult to treat." He also stated, "The way to diagnose disease involves observing a person's courage or timidity, bones and muscles, and skin, to determine deficiency or excess, which serves as the diagnostic method." Thus, it is said that the ultimate principle of treatment lies not neglecting observation of color and pulse diagnosis; this is the great rule of therapy. Nowadays, people of wealth reside in deep chambers, behind curtains, and often cover their wrists with silk handkerchiefs. This prevents the physician from performing the divine art of observing complexion and fully utilizing the skill of pulse palpation. If the pulse findings seem inconsistent, the physician must ask more questions. Excessive questioning may be perceived as tedious, leading patients to doubt the physician's proficiency and even refuse medication. Yet, effective inquiry is not easy; only a skilled physician can ask the right questions. If one were to remove three of the four diagnostic methods—Inspection (Wang), Auscultation and Olfaction (Wen), Inquiry (Wen), and Palpation (Qie)—I fear even a divine healer would lose their efficacy. Such widespread practices constitute a common societal flaw and explain why women's diseases are difficult to treat. Therefore, both physicians and patients' families should pay close attention to this matter.