石女。不在经闭论。亦有至十七八而经自来者。妇人经闭。肥白者多痰。去痰经自行。二陈加芎、
归、川连、南星、枳实、生姜、竹沥。禀浓恣于酒食者。平胃散加姜汁炒川连、归尾、半夏、姜
汁。黑瘦者多血枯。四物加参、 、香附、丹皮。经闭脉沉弱。少腹痛。属寒结。四乌汤。芍药
用桂酒制。乌药用附子制。寡妇尼姑经闭。郁也。加味逍遥散加无灰酒、竹沥。娼妓本无经闭之
理。间或有之。劳也。十全大补中肉桂可用二三钱。血枯一证。与血隔相似。皆经闭不通之候。
然而枯之与隔。则相反有如冰炭。夫枯者枯竭之谓。血虚之极也。隔者阻隔之谓。血本不虚。而
或气或寒或积。有所逆也。病发于暂。其证或
痛或实。通之则血行而愈。可攻者也。枯者其来也渐。冲任内竭。其证无形。必不可通者也。尝
见今人之于此证。听其言。则明曰血枯经闭。察其治。则每用四物、桃仁、红花。甚至硝、朴、
棱、莪之类。无所不至。夫血既枯矣。只当补养阴气。使其血充。则弗招自至。奚俟通也。若勉
强逼之。则枯之愈枯。不死何待。或问一妇哮喘发后。必便血二三日。其喘方止。每岁常十余发。
无不皆然。经闭数年不通。而不成虚劳之病。何也。答曰。此肺移热于大肠。热得下泄。故喘嗽
止。经血从大便间道而出。虽闭而无留结之患。故不成劳。
〔诊〕凡经闭不调与胎产之病。其脉要滑实重按有力。崩漏不止与产后之病。其脉要虚濡小弱
留连。调经及安胎。虽以顺气为主。又须补脾为要。治崩及产后。虽以散血为先。又当扶虚为本。
喻嘉言治杨季登女。经闭年余。发热少食。肌削多汗而成劳怯。医见汗多。误为虚也。投以
参、术。其血愈锢。诊时见汗出如蒸笼气水。谓曰。此证可疗处。全在有汗。盖经血内闭。止有
从皮毛间透出一路。以汗即血之液也。设无汗而血不流。则皮毛槁而死矣。宜用极苦之药。敛血
入内而下通于冲脉。则热退经行而汗自止。非补药所能效也。于是以龙荟丸日进三次。月余经血
略至。汗热稍轻。姑减前丸。只日进一次。又一月经血大行。淋漓五日。而诸证全瘳矣。
带下 带下之证。起于风气寒热所伤。入于胞宫。从带脉而下。故名为带。有五色。不只赤
白。白带者属气虚。甚则腰痛。如虚不甚则不痛。若气郁甚。则腰痛头疼眼花。此虚证也。千金
内补当归建中汤加醋制香附。或萆 厘清饮。量肥瘠选用。赤带多腰痛。艾煎丸加续断、杜仲。
若肥盛苍黑而肌肉 坚者。为湿热下注。平胃散加姜制星、半。酒
炒芩、连。赤白带下。艾煎丸。随证加气血药治之。五色带下。十全大补汤加熟附、龙骨、赤石脂、
禹余粮。酒丸服。或因六淫七情。或因醉饱房劳。或因膏粱浓味。或服燥剂所致。脾胃亏损。阳气下
陷。或湿痰下注。蕴积而成。皆当壮脾胃升阳气为主。佐以各经见证之药。阳气下陷。补中益气汤。
湿热下注。加苓、半、苍术、黄柏。气虚痰饮下注。局方七气汤送肾气丸。丹溪云。带下赤白。属于
大肠小肠之分。赤属血。白属气。主治燥湿为先。漏与带俱是胃中痰积流下。渗入膀胱。无人知此。
只宜升提。甚者必用吐以升提其气。次用二陈汤加二术、升、柴丸服。肥人多是湿痰。越鞠丸加滑
石、海石、蛤粉、星、半、茯苓、椿皮。作丸服。瘦人多是热。以大补丸加滑石、海石、椿皮、龟
版灰。作丸服。必须断浓味。带下脉浮恶寒。腥臭不可近者。难治。
淫浊 小便白淫白浊。皆由劳伤于肾。故心肾不交泰。水火不升降。肾主水。开窍在阴。阴
为便溲之道。胞冷肾损。故有淫浊之证。白淫者。或一时放白水。孀尼多有此疾。乃郁火也。逍
遥散加炒黑山栀、酒炒黄柏。白浊者。混浊如脓。此膀胱经热。失治当生痈疽。清心莲子饮加萆 。
淋沥 经水淋沥不断。其故有三。有因月戒来而行房。致伤胞络。先服活血药。小腹痛者。
四物加香附、乌药。不痛。四物加胶、艾、黄 。气虚下陷。小腹喜温按者。四物加参、术、黄
、升麻、陈皮。有多气所致者。甚则胸膈饱闷。肚腹疼痛。用正气散。若肚腹不疼者。逍遥散
加熟地。当脐痛者。尤宜。饮食少者。增损四物汤加焦白术。禁用芩、连。若劳伤气血。冲任虚
损。四物加丁香、胶、艾。小腹急痛。温经汤。月水至老不断。必成淋证。补中益气。或八珍并
加香附、细辛。仍须戒气。方可治疗。否则崩淋难治也。
淋辨 淋证皆由肾虚膀胱积热所致。肾虚则小便数。膀胱热则小便涩。适遇经行时候。或涩
数淋漓。腹中时痛。其脉沉细。皆因寒热邪气客于胞中。故冲任不调而成此证。宜服归附丸。白
淋者。起于郁。多属虚寒。小腹不疼。与去血过多空痛者。俱宜人参养荣汤。香附不可缺。或补
中益气汤下归附丸。如痛者。四乌汤。白淋变为黄水。将成血淋。八物汤加减。血淋者。月事三
五日一至。积数月不愈者是也。腹痛则四乌汤加莪术、木香。甚则醋煎散。尚恐有瘀血未尽也。
去多不痛。善饮食者。八物汤加芩、连。或补中益气加黄柏。如饮食少进者。芩、连、黄柏禁用。
若少腹痛而脾胃不实。或痛而欲得按者。八珍汤加胶、艾。或逍遥散加熟地、胶、艾。如泻者。
先实脾胃。大抵治淋先治脾胃为上。此证多腰痛。虽属血亦因气所致也。沙淋者。淋下则沉积如
沙一层。有赤白二种。白属气。赤属血。不可根据书用芩、连。多不克效。当知妇人之疾。虽有湿
热。止宜调经。不可与苦寒之药。以其月事时下。多虚少实。故养荣汤治白淋而效。以有桂也。
艾煎丸亦然。以有艾也。惟赤淋不可服热药。艾煎丸亦禁用。宜八珍加芩、连、香附。误用温补。
必致躁渴引饮。加以水饮停蓄而成肿胀者。加味逍遥散加芩、连、枳、朴、泽泻、橘皮。先治其
胀。然后徐徐治本。慎勿骤补。骤补则气壅腹胀也。年老患血崩淋证。不拘痛与不痛。脾胃实与
不实。皆以八珍加胶、艾、黄 、泽泻。若遽用芩、连以伤脾胃。更何恃以祛病乎。
泄泻 经行时先泄泻者。此脾虚也。脾统血而恶湿。经水将动。脾血先注血海。然后下流为
经。脾血既亏。不能营运其湿。所以必先作泻。补中益气加炮姜。有热。兼黄连。若饮食减少。
六君、理中选用。
石顽治一薛姓妇。每遇经行。必先作泻二三日。其脉左手关尺弦细如丝。右手关上小快而滑。
服姜、桂、萸、附。则大
渴腹痛。泄泻转剧。服苓、泽、车前之属。则目暗如盲。此肝血虚寒。而脾胃有伏火也。俟经将
行作泻时。朝用理中加黄连。作汤服五六剂。暮与加减八味加紫石英。作丸常服。不终剂而数年
之疾顿除。
小便血 妇人尿血。或因膏粱炙爆。或因醉饱入房。或因饮食劳役。或因六淫七情。以致元
气亏损。不能收摄归源。若因怒动肝火者。加味逍遥散调送发灰。肝经风热者。送一味子芩丸。
久而血虚者。八珍汤送发灰。膏粱积热者。清胃散加槐花、甘草。房劳所伤者。六君子加升、柴。
风热所伤者。四君子加防风。凡久而亏损元气者。补中益气为主。郁结伤脾者。归脾汤为主。
师尼寡妇寒热 疗师尼寡妇。宜别制方药。谓独阴无阳。致血气交争。寒热如疟。或腰背作
痛。而寒热经闭白淫。痞闷咳逆。面 瘦削。久则成劳。其肝脉弦出寸口上鱼际。是其证也。若
室女出嫁愆期而寒热。或既嫁不得于夫者亦然。盖男子精盛则思室。女子血盛以怀胎。此天地自
然之理也。治宜开郁理气。其经自调。逍遥散加无灰酒、竹沥。名酒沥汤。专主尼寡寒热。肥人
用越鞠合二陈最宜。若兼怒动肝火而发热。佐以小柴胡加减。若兼郁结伤脾而寒热。佐以归脾汤。
此证多兼经候不调。当审缓急治之。妇人形瘦肉脱。胸中常想着一事而百计不解者。勿与医治。
后必成癫。凡妇人郁怒发寒热。逍遥散加丹皮、香附。脾气不运。痰气留着。结为痰癖。发则其
块上升。气逆喘促。呕吐酸水。初起元气未伤者。四七汤加枳实、黄连。虚人。香砂六君加柴胡、
白芍。下佐金丸。大抵郁证皆虚火用事。故多骨蒸寒热。经闭不调。喘咳失音等证。当详虚损例
治。但须兼调郁气。亦有阴血亏损。不胜香燥者。惟降火滋阴为首务耳。
千金云。凡人无子。当为夫妻俱有五劳七伤。虚羸百病所致。故有绝嗣之患。夫治之之法。
男服七子散。女服紫石门冬丸。无不有子也。若丈夫阳气不足。不能施化。庆云散主之。妇人立
身以来全不产。及断乳后。十年二十年不产。此胞门不净。中有瘀积结滞也。朴硝荡胞汤主之。
妇人月水不利。闭塞绝产者。白薇丸主之。
子嗣 子嗣一门。古方悉用辛热壮火之剂。若施之于气虚精寒之人。固所宜然。设概用于火
旺精伤者。得不愈伐其阴乎。窃谓男子之艰于嗣者。一如妇人经病调理。然有不生不育之不同。
大意在于补偏救弊。往往有体肥质实。偏生无子者。岂可一概归于虚寒耶。盖湿胜则气滞。气滞
则精虽至而不能冲透子宫。故尔不能成孕。惟宜行湿耗气。助其流动之势。如二陈、二妙、七气、
平胃之属。皆可选用。甚则控涎丹先行向导。最为要诀。慎勿拘于世俗温补壮阳之说也。且人之
所禀不同。勇怯各异。有因男子真火式微者。有因湿热伤精者。有因妇人胞门浊腻者。有因血海
虚寒者。有因子宫枯燥者。至如生而不育。亦自不同。有金石药毒伏于髓中者。有酒客湿热混于
髓内者。有欲勤精薄者。有得胎后不戒房室频泄母气者。有妊娠不慎起居而致胎病不育者。有男
子精髓虽冲。而督脉气衰。阳气不振。但生女不生男者。此岂一法所可治乎。历检古方中。惟葆
真丸、千金种子丹、五子衍宗丸等方。治男子阳道不振。精气寒薄。与夫斫丧太过及年老无子者。
咸为得宜。若精髓稀薄。阳气不固。聚精丸是佳。阳衰。更加人参、鹿茸尤妙。生女不生男者。
当大补督脉益阳气。鹿茸四具。人参一斤。远志四两。醇酒丸服。其有膏粱富贵。饱饫肥甘。恣
情房室。气竭精伤。不能生子者。但服炼真丹。勿令断绝。虽在耄耋之年。每多生育。然非素享
浓。形体丰盛人。服之无预也。至于妇人子宫诸证。当详经带例治。俟经正无病。随其虚实寒
热调理。自然生育。大率妇人肥盛者。多不能孕。以
中有脂膜闭塞子宫也。虽经事不调。当与越鞠、二陈抑气养胃之类。有热。随证加黄连、枳实。
瘦弱不能孕者。以子宫无血。精气不聚故也。当与四君、六味加蕲艾、香附调之。子户虚寒不摄
精者。秦桂丸最当。妇人多有气郁不调。兼子脏不净者。加味香附丸。男服聚精丸。若因瘀积胞
门。子宫不净。或经闭不通。或崩中不止。寒热体虚。而不孕者。局方皱血丸为专药。若带下少
腹不和。或时作痛者。千金大黄丸荡涤之。子户虚热。虽结而不能成实者。四物换生地加芩、连。
然此皆由气血偏沮。是可以药奏功。若夫禀赋阴阳偏绝。虽日用参、术峻补。终无回天之力也。
丹溪曰。无子之因。多起于父气之不足。岂可独归罪于母血之虚寒。况母之血病。奚止虚与寒而
已哉。然古方治妇人无子。惟秦桂丸一方。其性热。其辞确。今欲得子者。率皆服之无疑。夫求
子于阴血。何至轻用热剂耶。今得此丸。经血必转紫黑。渐成衰少。或先或后。始则饮食骤进。
久则口苦舌干。阴阳不平。血气不和。焉能成胎。纵使有成。子亦多病。以其能损真阴也。按东
垣云。李和叔中年得一子。至一岁。身生红丝瘤而死。后三四子。至三岁。皆病瘤而死。乃肾中
伏火。精气中多有红线。以气相传。生子故有此疾。俗名胎瘤是也。遂以滋肾丸数服。以泻肾中
火邪。补真阴不足。忌酒辛热之物。其妻用六味地黄丸以养阴血。受胎五月之后。以黄芩、白术
二味作散服。后生子至三岁。前证不复作矣。
胎教 胎教之说。世都未谙。妊娠能遵而行之。不特无产难之虞。且生子鲜胎毒殇夭之患。
诚为广嗣要旨。姑以大概陈之。妇人经后四十余日不转。即谨房室。慎起居。薄滋味。养性情。
刻刻存心。与执持宝玉无异。举趾必徐。行立勿仰。坐不实其前阴。卧不久偏一侧。不得耽坐嗜
卧。使气血凝滞为第一义。虽不可负重作劳。然须时时小役四体。则经络流动。胎息易于动运。
腰腹渐粗。饮食不宜过饱。茶汤更须节省。大热大凉。总非所宜。犬羊鳖蟹等一切有毒
之物。固宜切禁。即椒姜常用之品。亦须少尝。其豕肉醇酒湿面之类。纵不能屏绝不食。亦不可
恣啖。归精于胎。过于蕃长。致母临蓐难产。而子在胞中。禀质肥脆。襁褓必多羸困。即如沃壤
之草木。移植 土。枝叶得不凋委乎。甫交三月。即当满裹其腹。胎气渐长。仅可微松其束。切
勿因其气急满闷而顿放之。在夏澡洗。须避热汤。冬时寤寐。勿迫炉炭。其最甚者。尤在不节交
石女（先天子宫发育异常或闭锁的女性）。不属于经闭的讨论范围。也有到十七八岁月经自然来潮的。妇人经闭，体型肥胖面白者多因痰湿阻滞，祛除痰湿后月经可自行恢复。方用二陈汤加川芎、当归、黄连、天南星、枳实、生姜、竹沥。禀赋厚实且嗜好酒食者，用平胃散加姜汁炒黄连、当归尾、半夏、姜汁。形体黑瘦者多因血枯，用四物汤加人参、[此处原文缺字，据理推测为熟地或类似补血药，但依规则不增补，故略去或视为原文缺失]、香附、丹皮。经闭脉象沉弱，少腹疼痛，属寒邪凝结，用四乌汤。芍药用桂酒炮制，乌药用附子炮制。寡妇、尼姑经闭，是因情志抑郁所致，用加味逍遥散加无灰酒、竹沥。娼妓本不应有经闭之理，间或有之，是因劳损所致。十全大补汤中肉桂可用二三钱。血枯一证，与血隔相似，都是月经闭止不通的症状。然而“枯”与“隔”，性质相反如同冰炭。所谓“枯”，是指枯竭，是血虚到了极点；所谓“隔”，是指阻隔，血本不虚，而是或因气滞、或因寒凝、或因积滞，导致气血逆乱。病发于暂时，症状或痛或实，通利则血行而愈，属于可攻逐的病证。“枯”则是逐渐形成的，冲任二脉内部枯竭，症状无形，绝对不可通利。曾见今人治疗此证，听其言论，则明白说是血枯经闭；观察其治疗，却每用四物汤、桃仁、红花，甚至硝石、朴硝、三棱、莪术之类药物，无所不用其极。既然血已枯竭，只应当补养阴气，使血液充盈，则月经自然会来，何须通利？若勉强逼迫其下行，则枯者愈枯，不死还等什么？有人问：有一妇女哮喘发作后，必然便血两三天，喘才停止。每年常发作十余次，无不如此。经闭数年不通，却不形成虚劳病，为什么呢？回答是：这是肺将热邪移于大肠，热邪得以向下排泄，所以喘嗽停止。经血从大便的旁道而出，虽然闭止但没有留结的祸患，所以不成虚劳病。
〔诊法〕凡是经闭不调以及胎产方面的疾病，其脉象要滑实，重按有力。崩漏不止以及产后方面的疾病，其脉象要虚濡小弱，且持续存在。调经及安胎，虽然以顺气为主，又必须以补脾为关键。治疗崩漏及产后病，虽然以散血为先，又当以扶正固本为基础。喻嘉言治疗杨季登的女儿，经闭一年多，发热少食，肌肉消瘦多汗而成虚劳怯症。医生见其汗多，误认为是虚证，投以人参、白术，其血更加锢结。诊察时见其汗出如蒸笼上的水汽，说道：“此证可治的关键，全在有汗。”因为经血内闭，只有从皮毛间透出一路，因为汗即是血的津液。假如无汗而血不流动，则皮毛干枯而死矣。宜用极苦的药物，收敛血液入内并向下通达冲脉，则热退经行而汗自止。这不是补药所能奏效的。于是用龙荟丸每日进服三次，月余后经血略微到来，汗热稍轻，暂减前丸剂量，只隔日进服一次。又一个月后经血大量下行，淋漓五日，各种病症全部痊愈。
带下病 带下之证，起于风气寒热所伤，侵入胞宫，沿带脉而下，所以名为带。有五色，不只赤白。白带者属气虚，严重时腰痛。如果气虚不严重则不痛。若气郁严重，则腰痛、头痛、眼花。这是虚证。用千金内补当归建中汤加醋制香附。或用萆薢分清饮，根据肥瘦选用。赤带多伴腰痛，用艾煎丸加续断、杜仲。若形体肥胖苍黑且肌肉坚实者，为湿热下注，用平胃散加姜制天南星、半夏，酒炒黄芩、黄连。赤白带下，用艾煎丸，随证加入补气养血药治疗。五色带下，用十全大补汤加熟附子、龙骨、赤石脂、禹余粮，制成酒丸服用。或因六淫七情，或因醉饱房劳，或因膏粱厚味，或服燥剂所致。脾胃亏损，阳气下陷，或湿痰下注，蕴积而成。都应当以壮脾胃升阳气为主，佐以各经见证的药物。阳气下陷，用补中益气汤。湿热下注，加茯苓、半夏、苍术、黄柏。气虚痰饮下注，用局方七气汤送服肾气丸。丹溪说：带下赤白，属于大肠小肠之分。赤属血，白属气。主治以燥湿为先。漏下与带下都是胃中痰积流下，渗入膀胱，无人知道这一点。只宜升提，严重者必用吐法以升提其气，其次用二陈汤加白术、苍术、升麻、柴胡制成丸药服用。肥人多湿痰，用越鞠丸加滑石、海浮石、蛤粉、天南星、半夏、茯苓、椿皮，制成丸药服用。瘦人多热，用大补丸加滑石、海浮石、椿皮、龟版灰，制成丸药服用。必须断绝浓味饮食。带下脉浮恶寒，气味腥臭不可近者，难治。
淫浊 小便白淫白浊，皆由劳损伤肾所致，所以心肾不交泰，水火不升降。肾主水，开窍于阴部，阴部是大小便之道。胞冷肾损，所以有淫浊之证。白淫者，有时流出白水，寡妇尼姑多有此疾，乃是郁火所致。用逍遥散加炒黑山栀、酒炒黄柏。白浊者，混浊如脓，这是膀胱经热，失治当生痈疽。用清心莲子饮加萆薢。
淋沥 经水淋沥不断，原因有三。有因月经期间行房，致伤胞络。先服活血药，小腹痛者，用四物汤加香附、乌药。不痛者，用四物汤加阿胶、艾叶、黄芪。气虚下陷，小腹喜温按者，用四物汤加人参、白术、黄芪、升麻、陈皮。有多气所致者，甚则胸膈饱闷，肚腹疼痛，用正气散。若肚腹不疼者，用逍遥散加熟地。当脐痛者，尤宜。饮食少者，用增损四物汤加焦白术。禁用黄芩、黄连。若劳伤气血，冲任虚损，用四物汤加丁香、阿胶、艾叶。小腹急痛，用温经汤。月经至老不断，必成淋证。用补中益气汤，或八珍汤并加香附、细辛。仍须戒除怒气，方可治疗。否则崩漏淋证难治。
淋辨 淋证皆由肾虚膀胱积热所致。肾虚则小便频数，膀胱热则小便涩滞。适遇经期，或涩或数或淋漓，腹中时痛，其脉沉细，皆因寒热邪气客于胞中，所以冲任不调而成此证。宜服归附丸。白淋者，起于郁，多属虚寒，小腹不疼，与去血过多空痛者，俱宜人参养荣汤，香附不可缺。或用补中益气汤送服归附丸。如痛者，用四乌汤。白淋变为黄水，将成血淋，用八物汤加减。血淋者，月经三五日一至，积数月不愈者是也。腹痛则用四乌汤加莪术、木香。甚者用醋煎散，尚恐有瘀血未尽。去血多不痛，善饮食者，用八物汤加黄芩、黄连。或补中益气汤加黄柏。如饮食少进者，禁用黄芩、黄连、黄柏。若少腹痛而脾胃不实，或痛而欲得按者，用八珍汤加阿胶、艾叶。或逍遥散加熟地、阿胶、艾叶。如泻者，先实脾胃。大抵治淋先治脾胃为上策。此证多腰痛，虽属血亦因气所致。沙淋者，淋下则沉积如沙一层，有赤白二种。白属气，赤属血。不可根据书本用黄芩、黄连，多不克效。当知妇人之疾，虽有湿热，只宜调经，不可与苦寒之药，以其月事时下，多虚少实。故养荣汤治白淋而效，以有肉桂也。艾煎丸亦然，以有艾叶也。惟赤淋不可服热药，艾煎丸亦禁用。宜八珍汤加黄芩、黄连、香附。误用温补，必致躁渴引饮，加以水饮停蓄而成肿胀者，用加味逍遥散加黄芩、黄连、枳实、朴硝、泽泻、橘皮。先治其胀，然后徐徐治本。慎勿骤补，骤补则气壅腹胀也。年老患血崩淋证，不拘痛与不痛，脾胃实与不实，皆以八珍汤加阿胶、艾叶、黄芪、泽泻。若遽用黄芩、黄连以伤脾胃，更何恃以祛病乎。
泄泻 经行时先泄泻者，此脾虚也。脾统血而恶湿。经水将动，脾血先注血海，然后下流为经。脾血既亏，不能营运其湿，所以必先作泻。用补中益气汤加炮姜。有热，兼用黄连。若饮食减少，六君子汤、理中汤选用。
石顽治疗一位薛姓妇女，每逢经行，必先泄泻二三日。其脉左手关尺弦细如丝，右手关上小快而滑。服姜、桂、吴茱萸、附子，则大渴腹痛，泄泻转剧。服茯苓、泽泻、车前子之类，则目暗如盲。此肝血虚寒，而脾胃有伏火也。待经将行作泻时，早晨用理中汤加黄连，作汤服五六剂。晚上用加减八味丸加紫石英，作丸常服。未终剂而数年之疾顿除。
小便血 妇人尿血，或因膏粱炙爆，或因醉饱入房，或因饮食劳役，或因六淫七情，以致元气亏损，不能收摄归源。若因怒动肝火者，用加味逍遥散调送发灰。肝经风热者，送服一味子芩丸。久而血虚者，用八珍汤送服发灰。膏粱积热者，用清胃散加槐花、甘草。房劳所伤者，用六君子汤加升麻、柴胡。风热所伤者，用四君子汤加防风。凡久而亏损元气者，以补中益气汤为主。郁结伤脾者，以归脾汤为主。
师尼寡妇寒热 治疗师尼寡妇，宜别制方药。谓独阴无阳，致血气交争，寒热如疟，或腰背作痛，而寒热经闭白淫，痞闷咳逆，面颊瘦削，久则成劳。其肝脉弦出寸口上鱼际，是其证也。若室女出嫁愆期而寒热，或既嫁不得于夫者亦然。盖男子精盛则思室，女子血盛以怀胎，此天地自然之理也。治宜开郁理气，其经自调。用逍遥散加无灰酒、竹沥，名酒沥汤。专主尼寡寒热。肥人用越鞠丸合二陈汤最宜。若兼怒动肝火而发热，佐以小柴胡汤加减。若兼郁结伤脾而寒热，佐以归脾汤。此证多兼经候不调，当审缓急治之。妇人形瘦肉脱，胸中常想着一事而百计不解者，勿与医治。后必成癫狂。凡妇人郁怒发寒热，用逍遥散加丹皮、香附。脾气不运，痰气留着，结为痰癖，发则其块上升，气逆喘促，呕吐酸水。初起元气未伤者，用四七汤加枳实、黄连。虚人，用香砂六君汤加柴胡、白芍，下佐金丸。大抵郁证皆虚火用事，故多骨蒸寒热，经闭不调，喘咳失音等证。当详虚损例治。但须兼调郁气。亦有阴血亏损，不胜香燥者，惟降火滋阴为首务耳。
千金云：凡人无子，当为夫妻俱有五劳七伤，虚羸百病所致。故有绝嗣之患。夫治之之法，男服七子散，女服紫石门冬丸，无不有子也。若丈夫阳气不足，不能施化，庆云散主之。妇人立身以来全不产，及断乳后，十年二十年不产，此胞门不净，中有瘀积结滞也。朴硝荡胞汤主之。妇人月水不利，闭塞绝产者，白薇丸主之。
子嗣 子嗣一门，古方悉用辛热壮火之剂。若施之于气虚精寒之人，固所宜然。设概用于火旺精伤者，得不愈伐其阴乎？窃谓男子之艰于嗣者，一如妇人经病调理。然有不生不育之不同。大意在于补偏救弊。往往有体肥质实，偏生无子者，岂可一概归于虚寒耶？盖湿胜则气滞，气滞则精虽至而不能冲透子宫，故尔不能成孕。惟宜行湿耗气，助其流动之势。如二陈汤、二妙散、七气汤、平胃散之属，皆可选用。甚则控涎丹先行向导，最为要诀。慎勿拘于世俗温补壮阳之说也。且人之所禀不同，勇怯各异。有因男子真火式微者，有因湿热伤精者，有因妇人胞门浊腻者，有因血海虚寒者，有因子宫枯燥者。至如生而不育，亦自不同。有金石药毒伏于髓中者，有酒客湿热混于髓内者，有欲勤精薄者，有得胎后不戒房室频泄母气者，有妊娠不慎起居而致胎病不育者，有男子精髓虽冲，而督脉气衰，阳气不振，但生女不生男者。此岂一法所可治乎？历检古方中，惟葆真丸、千金种子丹、五子衍宗丸等方，治男子阳道不振，精气寒薄，与夫斫丧太过及年老无子者，咸为得宜。若精髓稀薄，阳气不固，聚精丸是佳。阳衰，更加人参、鹿茸尤妙。生女不生男者，当大补督脉益阳气。鹿茸四具，人参一斤，远志四两，醇酒丸服。其有膏粱富贵，饱饫肥甘，恣情房室，气竭精伤，不能生子者，但服炼真丹，勿令断绝。虽在耄耋之年，每多生育。然非素享浓味，形体丰盛人，服之无预也。至于妇人子宫诸证，当详经带例治。俟经正无病，随其虚实寒热调理，自然生育。大率妇人肥盛者，多不能孕，以中有脂膜闭塞子宫也。虽经事不调，当与越鞠丸、二陈汤抑气养胃之类。有热，随证加黄连、枳实。瘦弱不能孕者，以子宫无血，精气不聚故也。当与四君子汤、六味地黄丸加蕲艾、香附调之。子户虚寒不摄精者，秦桂丸最当。妇人多有气郁不调，兼子脏不净者，用加味香附丸。男服聚精丸。若因瘀积胞门，子宫不净，或经闭不通，或崩中不止，寒热体虚，而不孕者，局方皱血丸为专药。若带下少腹不和，或时作痛者，用千金大黄丸荡涤之。子户虚热，虽结而不能成实者，用四物汤换生地加黄芩、黄连。然此皆由气血偏沮，是可以药奏功。若夫禀赋阴阳偏绝，虽日用参、术峻补，终无回天之力也。
丹溪曰：无子之因，多起于父气之不足，岂可独归罪于母血之虚寒。况母之血病，奚止虚与寒而已哉？然古方治妇人无子，惟秦桂丸一方，其性热，其辞确。今欲得子者，率皆服之无疑。夫求子于阴血，何至轻用热剂耶？今得此丸，经血必转紫黑，渐成衰少，或先或后，始则饮食骤进，久则口苦舌干，阴阳不平，血气不和，焉能成胎。纵使有成，子亦多病，以其能损真阴也。按东垣云：李和叔中年得一子，至一岁，身生红丝瘤而死。后三四子，至三岁，皆病瘤而死。乃肾中伏火，精气中多有红线，以气相传，生子故有此疾。俗名胎瘤是也。遂以滋肾丸数服，以泻肾中火邪，补真阴不足，忌酒辛热之物。其妻用六味地黄丸以养阴血。受胎五月之后，以黄芩、白术二味作散服。后生子至三岁，前证不复作矣。
胎教 胎教之说，世都未谙。妊娠能遵而行之，不特无产难之虞，且生子鲜胎毒殇夭之患，诚为广嗣要旨。姑以大概陈之。妇人经后四十余日不转，即谨房室，慎起居，薄滋味，养性情，刻刻存心，与执持宝玉无异。举趾必徐，行立勿仰，坐不实其前阴，卧不久偏一侧，不得耽坐嗜卧，使气血凝滞为第一义。虽不可负重作劳，然须时时小役四体，则经络流动，胎息易于动运。腰腹渐粗，饮食不宜过饱，茶汤更须节省。大热大凉，总非所宜。犬羊鳖蟹等一切有毒之物，固宜切禁。即椒姜常用之品，亦须少尝。其豕肉醇酒湿面之类，纵不能屏绝不食，亦不可恣啖。归精于胎，过于蕃长，致母临蓐难产，而子在胞中，禀质肥脆，襁褓必多羸困。即如沃壤之草木，移植瘠土，枝叶得不凋委乎？甫交三月，即当满裹其腹，胎气渐长，仅可微松其束，切勿因其气急满闷而顿放之。在夏澡洗，须避热汤。冬时寤寐，勿迫炉炭。其最甚者，尤在不节交
Shinv (Women with congenital uterine abnormalities or atresia). This condition is not discussed under amenorrhea. There are cases where menstruation naturally begins at the age of seventeen or eighteen. For women with amenorrhea, those who are fat and fair-complexioned often have phlegm-dampness; removing the phlegm allows menstruation to resume spontaneously. The formula is Erchen Tang (Two-Cured Decoction) plus Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Coptidis Rhizoma (Huanglian), Pinelliae Tuber Preparatum (Banxia), Aurantii Fructus Immaturus (Zhi Shi), Zingiberis Rhizoma Recens (Shengjiang), and Bambusae Succus (Zhuli). Those with robust constitutions who indulge in alcohol and rich food should use Pingwei San (Powder to Calm the Stomach) plus Huanglian stir-fried with ginger juice, Dangguiwei (Tail of Angelicae Sinensis Radix), Banxia, and ginger juice. Those who are dark and thin often suffer from blood depletion; the formula is Siwu Tang (Four-Substance Decoction) plus Ginseng Radix et Rhizoma (Renshen), [Original text missing character], Cyperi Rhizoma (Xiangfu), and Moutan Cortex (Danpi). If amenorrhea presents with a deep and weak pulse and lower abdominal pain, it belongs to cold coagulation; use Siwu Tang (Note: Text says "Si Wu Tang" but context implies a warming formula, likely a typo for "Si Wu Tang" variant or specific warming decoction, strictly translating as written: Siwu Tang). Shaoyao (Paeoniae Radix Alba/Rubra) should be processed with cinnamon wine, and Wuyao (Aquilariae Lignum Resinatum) with Fuzi (Aconiti Lateralis Radix Preparata). Amenorrhea in widows and nuns is due to emotional depression; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) plus non-fermented wine and Zhuli (Bamboo Sap). Prostitutes theoretically should not have amenorrhea; if it occurs occasionally, it is due to exhaustion. In Shiquan Dabu Tang (Decoction for Complete Great Tonification), Rougui (Cinnamomi Cortex) can be used in doses of two to three qian. The syndrome of Blood Depletion (Xueku) is similar to Blood Obstruction (Xuege); both present as amenorrhea. However, "Depletion" and "Obstruction" are opposite, like ice and charcoal. "Depletion" refers to exhaustion, extreme blood deficiency. "Obstruction" refers to blockage; the blood itself is not deficient, but qi, cold, or accumulations cause obstruction. These conditions arise temporarily, presenting with pain or excess symptoms; unblocking allows blood flow and recovery, making them treatable by purgation. "Depletion" develops gradually, with internal exhaustion of the Chong and Ren vessels, presenting without distinct有形 (form) symptoms, and absolutely must not be treated by unblocking. I have seen modern practitioners treating this syndrome: while they claim to understand it as blood depletion amenorrhea, their treatment often involves Siwu Tang, Taoren (Persicae Semen), Honghua (Carthami Flos), and even Xioashi (Natrii Sulfas), Puxiao (Natrii Sulfas Crystallinus), Sanleng (Sparganii Rhizoma), and E Zhu (Curcumae Rhizoma), leaving no method unused. Since the blood is already depleted, one should only tonify yin qi to replenish the blood, after which menstruation will arrive naturally; why resort to unblocking? Forcing it will only deepen the depletion, leading inevitably to death. Someone asked: A woman suffers hematochezia for two to three days after each asthma attack, which then subsides. This happens over ten times a year consistently. She has had amenorrhea for several years but has not developed consumptive disease (Xu Lao). Why? The answer is: This is lung heat transferring to the large intestine. The heat drains downward, stopping the asthma and cough. Menstrual blood exits via the alternative pathway of the large intestine. Although menstruation is closed, there is no stagnation or accumulation, so it does not become consumptive disease.
[Diagnosis] For amenorrhea, irregular menstruation, and pregnancy/delivery diseases, the pulse should be slippery and solid, forceful upon heavy pressure. For metrorrhagia/metrostaxis that does not stop and postpartum diseases, the pulse should be deficient, soggy, small, and weak, lingering. Regulating menstruation and calming the fetus primarily relies on smoothing qi, but supplementing the spleen is crucial. Treating metrorrhagia and postpartum conditions prioritizes dispersing blood stasis, yet supporting deficiency is fundamental. Yu Jiayan treated the daughter of Yang Jideng, who had amenorrhea for over a year, fever, poor appetite, emaciation, and excessive sweating, developing into Xu Qie (consumptive weakness). The physician saw excessive sweating and mistakenly diagnosed deficiency, administering Renshen (Ginseng) and Baizhu (Atractylodis Macrocephalae Rhizoma), which further bound the blood. Upon examination, seeing sweat rising like steam from a steamer, he said, "The key to treating this case lies in the presence of sweat." Because menstrual blood is internally closed, the only exit is through the skin pores, as sweat is the fluid of blood. If there were no sweat and blood did not flow, the skin would dry up and death would ensue. It is appropriate to use extremely bitter medicines to draw blood inward and connect downward to the Chong vessel, thereby reducing fever, inducing menstruation, and stopping sweat. This cannot be achieved with tonics. Thus, Longhui Wan (Dragon Gall Pill) was administered three times daily. After more than a month, menstrual blood slightly appeared, and sweat/fever lightened. The pill dosage was reduced to once every other day. One month later, menstrual blood flowed heavily for five days, and all symptoms resolved completely.
Leukorrhea (Daixia). This syndrome arises from wind-cold-heat pathogens injuring the body, entering the uterus, and flowing down along the Dai vessel, hence named "Dai". There are five colors, not just red and white. White leukorrhea belongs to qi deficiency; severe cases involve lower back pain. If qi deficiency is mild, there is no pain. If qi stagnation is severe, there is lower back pain, headache, and blurred vision. This is a deficiency syndrome. Use Qianjin Neibu Danggui Jianzhong Tang (Danggui Jianzhong Decoction for Internal Supplementation from Thousand Golden Prescriptions) plus Xiangfu processed with vinegar. Or use Bixie Qingfen Yin (Bixie Clearing Decoction), selected based on fat/thin constitution. Red leukorrhea often accompanies lower back pain; use Ai Jian Wan (Mugwort Decoction Pill) plus Duxuan (Dipsaci Radix) and Duzhong (Eucommiae Cortex). If the person is fat, dark, and has firm muscles, it is damp-heat pouring downward; use Pingwei San plus Banxia and Tian Nanxing processed with ginger, and Huangqin (Scutellariae Radix) and Huanglian stir-fried with wine. For red and white leukorrhea, use Ai Jian Wan, adding qi and blood tonifying herbs according to symptoms. For five-color leukorrhea, use Shiquan Dabu Tang plus Shu Fuzi (Prepared Aconite), Longgu (Fossilia Ossis Mastodi), Chishizhi (Halloysit Rubrum), and Yuyuliang (Kaolinites), taken as wine pills. Causes include six excesses and seven emotions, drunkenness/fullness and sexual indulgence, rich/greasy foods, or drying agents. Spleen-stomach damage leads to sinking of yang qi or downward pouring of damp-phlegm accumulation. Treatment should primarily strengthen the spleen and stomach and raise yang qi, assisted by herbs for specific meridian manifestations. For sinking yang qi, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For damp-heat pouring downward, add Fuling (Poria), Banxia, Cangzhu (Atractylodis Rhizoma), and Huangbai (Phellodendri Cortex). For qi deficiency with phlegm-fluid pouring downward, use Ju Fang Qi Qi Tang (Seven-Qi Decoction from the Official Formulary) to deliver Shenqi Wan (Kidney Qi Pill). Danxi stated: Red and white leukorrhea belongs to the Large Intestine and Small Intestine divisions. Red belongs to blood, white to qi. Treatment prioritizes drying dampness. Metrorrhagia and leukorrhea both result from gastric phlegm accumulation flowing down and seeping into the Bladder, a fact unknown to many. Only lifting methods are suitable; in severe cases, vomiting must be used to lift the qi, followed by Erchen Tang plus Baizhu, Cangzhu, Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix) as pills. Fat people mostly have damp-phlegm; use Yueju Wan (Suppress Anger Pill) plus Huashi (Talcum), Haishi (Floating Quartz), Ge Fen (Shell Powder), Tian Nanxing, Banxia, Fuling, and Chunpi (Toosendan Cortex) as pills. Thin people mostly have heat; use Dabu Wan (Great Tonification Pill) plus Huashi, Haishi, Chunpi, and Gui Ban Hui (Ash of Tortoise Shell) as pills. Rich flavors must be avoided. Leukorrhea with floating pulse, aversion to cold, and foul odor is difficult to treat.
Yin Zhuo (Spermatorrhea/Leukorrhea-like discharge). White spermatorrhea and turbid urine are caused by kidney injury from overexertion, leading to failure of heart-kidney interaction and non-interaction of water and fire. The Kidney governs water and opens into the yin organs, which are the pathways for stool and urine. Cold uterus and damaged kidney cause Yin Zhuo. Bai Yin (White Spermatorrhea) involves occasional discharge of clear white fluid, common in widows and nuns, caused by depressed fire. Use Xiaoyao San plus Shan Zhi (Gardeniae Fructus) stir-fried until black and Huangbai stir-fried with wine. Bai Zhuo (White Turbidity) is turbid like pus, caused by heat in the Bladder Meridian; untreated, it may develop into carbuncles. Use Qingxin Lianzi Yin (Clear Heart Lotus Seed Decoction) plus Bixie.
Lin Li (Dribbling Urination/Menstruation). Menstrual dribbling without cessation has three causes. One is intercourse during menstruation, damaging the uterine collaterals. First administer blood-invigorating herbs. If lower abdomen hurts, use Siwu Tang plus Xiangfu and Wuyao (Linderae Radix). If no pain, use Siwu Tang plus Ejiao (Donkey-hide Gelatin) and Aiyè (Artemisiae Argyi Folium), and Huangqi (Astragali Radix). For qi deficiency sinking, with lower abdomen preferring warmth and pressure, use Siwu Tang plus Renshen, Baizhu, Huangqi, Shengma, and Chenpi (Citri Reticulatae Pericarpium). Caused by excessive anger, leading to chest/diaphragm fullness and abdominal pain, use Zhengqi San. If no abdominal pain, use Xiaoyao San plus Shudi (Rehmanniae Radix Praeparata). Pain at the umbilicus is particularly suited to this. For poor appetite, use Zengsun Siwu Tang plus Jiaobaizhu (Charred Atractylodis Rhizoma). Huangqin and Huanglian are contraindicated. For qi-blood injury and Chong-Ren deficiency, use Siwu Tang plus Dingxiang (Caryophylli Flos), Ejiao, and Aiyè. For urgent lower abdominal pain, use Wenjing Tang (Warming the Menses Decoction). Menstruation continuing into old age will inevitably become Lin syndrome. Use Buzhong Yiqi Tang, or Bazhen Tang plus Xiangfu and Xixin (Asari Radix et Rhizoma). Anger must be restrained for treatment; otherwise, Bing Lin (flooding and dribbling) is difficult to treat.
Lin Bian (Differentiation of Lin Syndrome). Lin syndromes are caused by kidney deficiency and bladder heat accumulation. Kidney deficiency causes frequent urination; bladder heat causes dysuria. Occurring during menstruation, with dysuria, frequency, dribbling, and intermittent abdominal pain, and a deep-thin pulse, it is due to cold-heat pathogens lodging in the uterus, causing Chong-Ren disharmony. Use Guifu Wan (Guifu Pill). White Lin originates from depression, mostly deficiency-cold, with no lower abdominal pain; similar to pain from empty feeling after excessive blood loss, both suit Renshen Yangrong Tang (Renshen Nourishing the Vigor Decoction). Xiangfu is essential. Alternatively, use Buzhong Yiqi Tang to deliver Guifu Wan. If painful, use Siwu Tang (Note: Context implies a different formula, likely Siwu Tang variant or specific warming formula, strictly translating as written). If White Lin turns into yellow fluid, impending Hematuria Lin, use Babawu Tang (Eight-Substance Decoction) modified. Hematuria Lin is characterized by menstruation occurring every three to five days, persisting for months without cure. If painful, use Siwu Tang plus Ezhu (Curcumae Rhizoma) and Muxiang (Aucklandiae Radix). In severe cases, use Cu Jian San (Vinegar-Decoction Powder), fearing residual blood stasis. If excessive bleeding without pain and good appetite, use Babawu Tang plus Huangqin and Huanglian. Or Buzhong Yiqi Tang plus Huangbai. If poor appetite, Huangqin, Huanglian, and Huangbai are contraindicated. If lower abdominal pain with weak spleen-stomach, or pain relieved by pressure, use Bazhen Tang plus Ejiao and Aiyè. Or Xiaoyao San plus Shudi, Ejiao, and Aiyè. If diarrhea, first strengthen the spleen-stomach. Generally, treating Lin by first treating the spleen-stomach is superior. This syndrome often involves lower back pain; although related to blood, it is also caused by qi. Sha Lin (Sand Lin) presents with sediment like sand upon urination, in red and white varieties. White belongs to qi, red to blood. Do not blindly follow books using Huangqin and Huanglian; it is often ineffective. Understand that women's diseases, even with damp-heat, should only regulate menstruation; avoid bitter-cold herbs because menstruation involves much deficiency and little excess. Thus, Yangrong Tang treats White Lin effectively due to Rougui (Cinnamon Twig). Ai Jian Wan is effective due to Aiyè (Mugwort Leaf). Only Chi Lin (Red Lin) should not take hot medicines; Ai Jian Wan is also contraindicated. Use Bazhen Tang plus Huangqin, Huanglian, and Xiangfu. Misusing warm-tonics causes restlessness, thirst, and water retention leading to swelling. Use Jiawei Xiaoyao San plus Huangqin, Huanglian, Zhishi, Poxiao (Mirabilite), Zexie (Alismatis Rhizoma), and Pechen (Tangerine Peel). Treat the swelling first, then slowly treat the root. Avoid sudden tonification, which causes qi stagnation and abdominal distension. For elderly women with Bing Lin (flooding and dribbling), regardless of pain or spleen-stomach strength, use Bazhen Tang plus Ejiao, Aiyè, Huangqi, and Zexie. Using Huangqin/Huanglian hastily damages the spleen-stomach, leaving no basis for curing the disease.
Xie Xie (Diarrhea). Diarrhea preceding menstruation indicates spleen deficiency. The Spleen governs blood and dislikes dampness. As menstruation approaches, spleen blood first flows to the Sea of Blood, then downflows as menses. With spleen blood depleted, it cannot transport dampness, causing diarrhea first. Use Buzhong Yiqi Tang plus Paojiang (Prepared Ginger). If heat is present, add Huanglian. If appetite is poor, choose Liu Jun Zi Tang (Six-Gentlemen Decoction) or Lizhong Tang (Regulate the Middle Decoction).
Shiwan treated a surnamed Xue woman who suffered diarrhea for two to three days before every menstruation. Her left Guan-Chi pulses were string-thin and thread-like; right Guan was slightly rapid and slippery. Taking Jiang (Ginger), Gui (Cinnamon), Yuzhu (Cornus), and Fuzi caused severe thirst, abdominal pain, and worsened diarrhea. Taking Fuling, Zexie, Cheqianzi (Plantaginis Semen) caused blindness-like dimness. This is liver blood deficiency-cold with latent fire in the spleen-stomach. When diarrhea precedes menstruation, take Lizhong Tang plus Huanglian in decoction morning and evening for five to six doses. At night, take Jiawei Bawei Wan (Modified Eight-Ingredient Pill) plus Zhi Yanshi (Hematitum) as pills for regular use. The multi-year illness was cured before finishing the course.
Xiaobian Xue (Hematuria). Women's hematuria may be caused by rich/fried foods, drunkenness/sexual indulgence, dietary labor, or six excesses/seven emotions, leading to yuan qi deficiency and failure to retain blood. If caused by anger stirring liver fire, use Jiawei Xiaoyao San delivered with Fahui (Hair Ash). If liver meridian wind-heat, deliver Yiweizi Qin Wan (Single-Herb Scutellaria Pill). If chronic blood deficiency, use Bazhen Tang delivered with Fahui. If rich-food accumulated heat, use Qingwei San (Clear Stomach Powder) plus Huaigua (Stemonae Radix - *Correction: Huaihua is Sophorae Flos, text says Huaihua*) and Gancao (Licorice). If injured by sexual exhaustion, use Liujun Zi Tang plus Shengma and Chaihu. If injured by wind-heat, use Sijun Zi Tang plus Fangfeng (Saposhnikoviae Radix). For chronic yuan qi deficiency, prioritize Buzhong Yiqi Tang. For depression injuring spleen, prioritize Guipi Tang (Restore the Spleen Decoction).
Shini Guawa Hanre (Monks/Nuns/Widows Cold-Heat). Treatment for monks, nuns, and widows requires special formulas. They possess yin without yang, causing blood-qii conflict, cold-heat alternating like malaria, or back pain, accompanied by cold-heat, amenorrhea, Bai Yin, chest stuffiness, cough/counterflow qi, emaciated cheeks, eventually becoming consumptive disease. Liver pulse string-taut extending above the cunkou to the fish-mouth area confirms this. Similar cold-heat occurs in unmarried women delayed in marriage or married women ill-treated by husbands. Men with abundant essence desire sex; women with abundant blood conceive; this is natural law. Treatment should open depression and regulate qi, allowing menstruation to normalize. Use Xiaoyao San plus non-fermented wine and Zhuli, named Jiuli Tang (Wine-Zhuli Decoction), specifically for nun/widow cold-heat. For fat persons, Yueju Wan combined with Erchen Tang is best. If accompanied by anger-stirred liver fire fever, assist with Xiao Chai Hu Tang modified. If accompanied by depression-injuring spleen cold-heat, assist with Guipi Tang. This syndrome often accompanies irregular menstruation; treat according to urgency. Women who are emaciated, constantly obsessed with one matter, should not be treated; they will eventually develop mania. For women with depression-anger induced cold-heat, use Xiaoyao San plus Danpi (Moutan Cortex) and Xiangfu. If spleen qi fails to transport, phlegm-qi lingers forming Tan Pi (Phlegm Mass), rising with attacks causing wheezing and sour vomiting. If early stage with intact yuan qi, use Siqi Tang plus Zhishi and Huanglian. For deficient persons, use Xiangsha Liujun Zi Tang plus Chaihu and Baishao (Paeoniae Radix Alba), delivering Zuojin Wan. Generally, depression syndromes involve deficient fire, causing bone-steaming cold-heat, amenorrhea, wheezing/cough/aphonia. Treat according to deficiency examples, but must also regulate depression qi. Some have yin-blood deficiency intolerant to aromatic-drying herbs; lowering fire and nourishing yin is paramount.
Qianjin states: Childlessness is caused by both husband and wife having Five Exhaustions and Seven Injuries,虛羸 (deficiency-emaciation) and hundred diseases, leading to lineage extinction. Treatment: Men take Qizi San (Seven-Seeds Powder); women take Zishi Mudong Wan (Zishi Winter Sweet Pill); all will have children. If husband's yang qi is insufficient for transformation, Qingyun San (Qingyun Powder) is indicated. If a woman has never conceived since birth, or ten-to-twenty years after weaning, this is impure Bao Men (uterine gate) with blood stasis accumulation; Xiaoning Tangpao Bao Tang (Mirabilite Uterus-Cleansing Decoction) is indicated. If menstrual flow is unfavorable, blocked leading to sterility, Baiwei Wan (Baiwei Pill) is indicated.
Zisi (Progeny). Ancient formulas for progeny all use pungent-hot fire-strengthening agents. Suitable for qi-deficient essence-cold persons, but harmful for those with fire-excess and essence-injury. Men's infertility should be regulated like women's menstrual diseases, though differences exist between non-conception and non-nurturing. The principle is correcting imbalance. Often, fat and solid men are childless; can this all be attributed to deficiency-cold? Dampness excess causes qi stagnation; qi stagnation prevents essence from penetrating the uterus despite arrival, causing infertility. Treatment should move dampness and consume qi to aid flow. Erchen Tang, Ermiao San, Qi Qi Tang, Pingwei San are selectable. In severe cases, Kongyan Dan (Control Phlegm Pill) guides first, a key technique. Do not adhere to secular warm-tonic yang-strengthening theories. Constitutions vary. Causes include declining true fire in men, damp-heat injuring essence, turbid grease in uterus, deficiency-cold in Blood Sea, dryness of uterus. Post-birth non-nurturing varies: metallic poison in marrow, damp-heat in drinkers' marrow, frequent sex with thin essence, post-conception sexual indulgence depleting mother's qi, negligent pregnancy care causing fetal disease, or male essence strong but Du vessel qi weak/yang不振 resulting in only female births. How can one method treat all? Ancient formulas like Baozhen Wan, Qianjin Zhongzi Dan, Wuzi Yanzong Wan suit men with weak potency, cold-thin essence, over-indulgence, or old age childlessness. For thin essence and insecure yang, Ju Jing Pill is good. For yang decline, adding Renshen and Lurong (Deer Antler) is excellent. For only female births, strongly tonify Du vessel and benefit yang: Lurong (4 units), Renshen (1 jin), Yuanzhi (4 liang), pill with pure wine. For wealthy/gluttonous individuals exhausting qi/essence through sex, take Lianzhen Dan continuously; even in old age, they often sire children. But this suits only those with rich constitutions; others gain nothing. Women's uterine diseases should be treated per menstruation/leukorrhea examples. Once cycles normalize, regulate by deficiency/excess/cold-heat for natural conception. Fat women often cannot conceive due to fatty membrane blocking uterus. Even with irregular periods, use Yueju Wan or Erchen Tang to suppress qi and nourish stomach. Add Huanglian/Zhishi if heat. Thin/weak women cannot conceive due to lack of uterine blood/essence gathering; use Sijun Zi Tang or Liuwei Dihuang Wan plus Qiai (Qi Mugwort) and Xiangfu. For cold uterus failing to grasp essence, Qin Gui Wan is best. For women with qi depression and impure uterus, Jiawei Xiangfu Wan. Men take Ju Jing Pill. For uterine impurity/stasis, amenorrhea, flooding, cold-heat weakness causing infertility, Ju Fang Zhou Xue Wan is specific. For leukorrhea with lower abdominal discomfort/pain, Qianjin Dahuang Wan cleanses. For uterine deficiency-heat with clumping but no solidity, use Siwu Tang replacing Shudi with Shengdi plus Huangqin/Huanglian. These respond to medicine due to qi-blood imbalance. However, constitutional yin-yang extremity cannot be reversed by massive Renshen/Baizhu tonification.
Danxi said: Childlessness often stems from father's qi insufficiency; blame should not fall solely on mother's blood deficiency-cold. Mother's blood disease exceeds mere deficiency-cold. Ancient formulas for female childlessness rely solely on Qin Gui Wan, which is hot. Modern seekers take it unquestioningly. Seeking conception via yin-blood, why use hot agents lightly? This pill turns blood purple-black, reduces volume, irregular timing, initially increases appetite, later causes bitter taste/dry tongue, yin-yang imbalance, qi-blood disharmony, preventing conception. Even if conceived, offspring are sickly due to true yin damage. Dongyuan recorded: Li Heshu had a son at middle age; died at one year from red-thread tumors. Subsequent sons died at three years from same. This was latent fire in kidney, red lines in essence transmitted via qi,俗称胎瘤 (fetal tumor). Treated with Zishen Wan to drain kidney fire and tonify true yin, avoiding alcohol/spicy-hot foods. Wife took Liuwei Dihuang Wan to nourish yin-blood. After five months gestation, took Huangqin/Baizhu powder. Son lived past three years, recurrence prevented.
Taijiao (Fetal Education). Fetal education is unknown to the world. Pregnant women following it avoid difficult labor and reduce infant mortality from fetal toxins. It is key to expanding progeny. Briefly: Forty days after menstruation stops, abstain from sex, regulate起居 (daily life), avoid rich flavors, cultivate temperament, keep mind focused as if holding jade. Walk slowly, stand upright, sit properly, sleep without favoring one side, avoid excessive sitting/lying to prevent qi-blood stagnation. Avoid heavy labor but gently exercise limbs to keep meridians flowing and fetus active. As waist/abdomen thicken, avoid overeating; limit tea/water. Extreme hot/cold are unsuitable. Toxic animals (dog, sheep, turtle, crab) are forbidden. Common spices (pepper, ginger) should be limited. Pork, wine, damp noodles should not be overeaten. Excessive nourishment harms mother during delivery and makes fetus fat/fragile, leading to infant weakness. Like plants in fertile soil transplanted to barren land, branches wither. By three months, wrap abdomen tightly; loosen slightly as fetus grows; do not release suddenly due to breathlessness. Summer bathing avoids hot water; winter sleeping avoids proximity to stove. Worst violation is immoderate intercourse.