邪入胞中吴茱萸,赤粘连栀青防栀,白主益气黑六味,黄淡六君或归脾。
【注】带下因六淫之邪入于胞中者,宜吴茱萸汤。若色赤、色黄而浊粘者,热也。色
黄者,加黄连、栀子;色青者,加防风、栀子。若色白、色黑而清稀者,虚寒也。色白
者,用补中益气汤;色黑者,用六味地黄汤。色黄而淡者,宜六君子汤,或加味归脾汤,分
证调治可也。
吴茱萸汤 补中益气汤 六味地黄汤 六君子汤 归脾汤(方俱见首卷汇方)
加味四物汤
胞中冷痛乃寒湿,四物附子桂姜宜,臭腥兼合知柏用,久滑升柴龙牡脂。
【注】带下而胞中热痛,乃热湿也。今胞中冷痛,乃寒湿也。宜四物汤加川附子、炮
姜、官桂服之。日久滑脱者,加升麻、柴胡举之,龙骨、牡蛎、赤石脂涩之。
四物汤(方见前调经门汇方内)
清白散
带下湿热清白散,四物姜炭草柏椿,赤榆荆芩湿二术,滑加龙牡久合君。
【注】带下,五色带下也。皆湿热所化,宜用清白散。其方即四物汤加姜炭、甘草、黄
柏、椿皮也。色赤加地榆、荆芥、黄芩;湿加苍术、白术;滑加龙骨、牡蛎。久则合四
君子汤也。
四物汤 四君子汤(俱见前调经门汇方内)
导水丸 万安丸
带下有余皆湿化,少腹胀疼污水绵,导水牵滑芩军热,万安牵椒茴木寒。
【注】五色带下,皆从湿化。若少腹胀痛,污水绵绵,属湿热者,宜用导水丸。其方即
牵牛、滑石、黄芩、生军,治热有余也。属湿寒者,宜用万安丸。其方即牵牛、胡椒、小
茴香、木香,治寒有余者也。
威喜丸 固精丸
瘀化疮脓浊淫病,虚实寒热酌其宜,威喜蜡苓固精菟,韭味桑苓龙牡脂。
【注】带下有因瘀血所化,或疮疡脓出及白浊、白淫者,皆带下类也。其虚实寒热,当
酌其宜。药用威喜丸,即黄蜡、茯苓也;固精丸,即菟丝子、韭菜子、五味子、桑螵蛸、
茯苓、龙骨、牡蛎、赤石脂也。
邪气侵入胞宫,若属寒证,宜用吴茱萸汤;若带下色赤且粘连,加栀子、青黛、防风、栀子;若色白,主益气(用补中益气汤);若色黑,用六味地黄汤;若色黄而淡,用六君子汤或归脾汤。
【注】带下病因六淫之邪侵入胞宫所致者,适宜使用吴茱萸汤。如果颜色发红、发黄且浑浊粘稠的,属于热证。颜色发黄的,加黄连、栀子;颜色发青的,加防风、栀子。如果颜色发白、发黑且清稀的,属于虚寒证。颜色发白的,使用补中益气汤;颜色发黑的,使用六味地黄汤。颜色发黄且清淡的,适宜使用六君子汤,或者加味归脾汤,分证候调理治疗即可。
吴茱萸汤、补中益气汤、六味地黄汤、六君子汤、归脾汤(方剂均见首卷汇方)。
加味四物汤。
胞宫中冷痛乃是寒湿所致,适宜使用四物汤加附子、桂枝、干姜;若伴有腥臭气味,兼用知母、黄柏;若日久滑脱不禁,加升麻、柴胡以升提,龙骨、牡蛎、赤石脂以固涩。
【注】带下病若胞中热痛,乃是湿热所致。如今胞中冷痛,乃是寒湿所致。适宜服用四物汤加川附子、炮姜、官桂。日久导致滑脱不固的,加升麻、柴胡以举陷,龙骨、牡蛎、赤石脂以收敛固涩。
带下病湿热证用清白散,由四物汤加姜炭、甘草、黄柏、椿皮组成;若色赤,加地榆、荆芥、黄芩;若湿重,加苍术、白术;若滑脱,加龙骨、牡蛎;病程久者合用四君子汤。
【注】带下病,指五色带下。皆由湿热所化生,适宜使用清白散。其方即四物汤加姜炭、甘草、黄柏、椿皮。颜色发红的加地榆、荆芥、黄芩;湿气重的加苍术、白术;滑脱的加龙骨、牡蛎。病程长久则合用四君子汤。
带下病有余之证皆由湿邪化生,少腹胀痛,污水绵绵不断。属湿热者,用导水丸,含牵牛子、滑石、黄芩、大黄,治热邪有余;属湿寒者,用万安丸,含牵牛子、胡椒、小茴香、木香,治寒邪有余。
瘀血化生疮脓及浊淫病,需斟酌虚实寒热适宜之药。威喜丸由黄蜡、茯苓组成;固精丸由菟丝子、韭菜子、五味子、桑螵蛸、茯苓、龙骨、牡蛎、赤石脂组成。
【注】带下病有因瘀血所化,或疮疡脓出以及白浊、白淫者,皆属于带下类疾病。其虚实寒热,应当酌情适宜选用药物。药用威喜丸,即由黄蜡、茯苓组成;固精丸,即由菟丝子、韭菜子、五味子、桑螵蛸、茯苓、龙骨、牡蛎、赤石脂组成。
When pathogenic factors invade the uterus, if it is a cold pattern, Wuzhuyu Decoction (Wu Zhu Yu Tang) should be used; if the leukorrhea is red and sticky, add Gardenia (Zhi Zi), Indigo Naturalis (Qing Dai), Saposhnikovia Root (Fang Feng), and Gardenia (Zhi Zi); if white, use Bu Zhong Yi Qi Tang to tonify Qi; if black, use Liuwei Dihuang Wan. If yellow and pale, use Liujunzi Tang or Guipi Tang.
[Note] Leukorrhea caused by the invasion of the six excess pathogens into the uterus should be treated with Wuzhuyu Decoction (Wu Zhu Yu Tang). If the color is red or yellow and turbid and sticky, it indicates Heat. For yellow color, add Coptis Rhizome (Huang Lian) and Gardenia Fruit (Zhi Zi); for green color, add Saposhnikovia Root (Fang Feng) and Gardenia Fruit (Zhi Zi). If the color is white or black and clear and thin, it indicates Deficiency-Cold. For white color, use Bu Zhong Yi Qi Tang; for black color, use Liuwei Dihuang Wan. For yellow and pale color, Liujunzi Tang or Jiawei Guipi Tang is appropriate, treating according to syndrome differentiation.
Wuzhuyu Decoction (Wu Zhu Yu Tang), Bu Zhong Yi Qi Tang, Liuwei Dihuang Wan, Liujunzi Tang, Guipi Tang (formulas are listed in the first volume's compiled formulas).
Jiawei Siwu Tang.
Cold pain in the uterus is due to Cold-Dampness; Siwu Tang added with Aconite Lateralis Radix Praeparata (Chuan Fuzi), Cinnamon Twig (Gui Zhi), and Gingeris Rhizoma Recens (Gan Jiang) is suitable. If accompanied by a fishy odor, combine with Anemarrhenae Rhizoma (Zhi Mu) and Phellodendri Cortex (Huang Bai). If slipping and incontinence persist for a long time, add Bupleuri Radix (Sheng Ma), Bupleuri Radix (Chai Hu) to lift, and Longum Os Fossile (Long Gu), Ostreae Concha (Mu Li), and Halloysit Rubrum (Chishi Zhi) to astringe.
[Note] Leukorrhea with hot pain in the uterus is due to Damp-Heat. Now, cold pain in the uterus is due to Cold-Dampness. It is suitable to take Siwu Tang added with Prepared Aconite Lateralis Radix (Chuan Fuzi), Prepared Ginger (Pao Jiang), and Cassia Twig (Guan Gui). For cases lasting long with slipping and incontinence, add Bupleuri Radix (Sheng Ma) and Bupleuri Radix (Chai Hu) to raise sunken Qi, and Longum Os Fossile (Long Gu), Ostreae Concha (Mu Li), and Halloysit Rubrum (Chishi Zhi) to consolidate and astringe.
Siwu Tang (formula seen in the previous Menstrual Regulation section's compiled formulas).
Qingbai San.
For leukorrhea with Damp-Heat, use Qingbai San, which consists of Siwu Tang added with Carbonized Ginger (Jiang Tan), Licorice Root (Gan Cao), Phellodendri Cortex (Huang Bai), and Toona Seed (Chun Pi). If red, add Sanguisorbae Radix (Di Yu), Schizonepeta Spike (Jing Jie), and Scutellariae Radix (Huang Qin); if dampness is heavy, add Atractylodis Rhizoma (Cang Zhu) and Atractylodis Macrocephalae Rhizoma (Bai Zhu); if slipping, add Longum Os Fossile (Long Gu) and Ostreae Concha (Mu Li). For chronic cases, combine with Sijunzi Tang.
[Note] Leukorrhea refers to leukorrhea of five colors. All are transformed from Damp-Heat, so Qingbai San is suitable. The formula is Siwu Tang added with Carbonized Ginger (Jiang Tan), Licorice Root (Gan Cao), Phellodendri Cortex (Huang Bai), and Toona Seed (Chun Pi). For red color, add Sanguisorbae Radix (Di Yu), Schizonepeta Spike (Jing Jie), and Scutellariae Radix (Huang Qin); for heavy dampness, add Atractylodis Rhizoma (Cang Zhu) and Atractylodis Macrocephalae Rhizoma (Bai Zhu); for slipping, add Longum Os Fossile (Long Gu) and Ostreae Concha (Mu Li). For long-standing cases, combine with Sijunzi Tang.
Siwu Tang, Sijunzi Tang (both seen in the previous Menstrual Regulation section's compiled formulas).
Daoshui Wan, Wan'an Wan.
Leukorrhea with excess syndromes is all transformed from Dampness. If there is distending pain in the lower abdomen and continuous flow of turbid water, it belongs to Damp-Heat, and Daoshui Wan is suitable. Its formula contains Nigellae Semen (Qianniu), Talcum (Huashi), Scutellariae Radix (Huang Qin), and Rheum Palmatum (Jun), treating excess Heat. If it belongs to Damp-Cold, Wan'an Wan is suitable. Its formula contains Nigellae Semen (Qianniu), Piperis Fructus (Hu Jiao), Foeniculi Fructus (Xiao Hui Xiang), and Aucklandiae Radix (Mu Xiang), treating excess Cold.
Weixi Wan, Gujing Wan.
If transformed from blood stasis into ulcer pus, or turbid discharge and white spermatorrhea, these are all categories of leukorrhea. One must consider the suitability of deficiency/excess and cold/heat. Medicines include Weixi Wan, composed of Beeswax (Huang La) and Poria (Fu Ling); Gujing Wan, composed of Dodder Seed (Tusizi), Leek Seed (Jiucai Zi), Schisandrae Fructus (Wuweizi), Sangxiansheng (Sang Piaoxiao), Poria (Fu Ling), Longum Os Fossile (Long Gu), Ostreae Concha (Mu Li), and Halloysit Rubrum (Chishi Zhi).
[Note] Leukorrhea can be transformed from blood stasis, or result from pus discharge from ulcers, as well as white turbid discharge and white spermatorrhea; all belong to the category of leukorrhea. Their deficiency/excess and cold/heat patterns should be judged appropriately. Use Weixi Wan, which consists of Beeswax (Huang La) and Poria (Fu Ling); Gujing Wan, which consists of Dodder Seed (Tusizi), Leek Seed (Jiucai Zi), Schisandrae Fructus (Wuweizi), Sangxiansheng (Sang Piaoxiao), Poria (Fu Ling), Longum Os Fossile (Long Gu), Ostreae Concha (Mu Li), and Halloysit Rubrum (Chishi Zhi).