凡妇人淋带，虽分微甚，而实为同类，盖带其微而淋其甚者也。总由命门不固，而不固
之病，其因有六∶盖一以心旌之摇之也。心旌摇则命门应，命门应则失其所守，此由于不遂
者也。一以多欲之滑之也，情欲无度，纵肆不节，则精道滑而命门不禁，此由于太遂者也。
一以房室之逆之也。凡男女相临，迟速有异，此际权由男子，而妇人情兴多致中道而止，止
则逆，逆则为浊为淋，此由于遂而不遂，乃女子之最多而最不肯言者也。以上三证，凡带浊
之由乎此者，十居八九，而三者之治，必得各清其源，庶可取效。然源未必清，而且旋触旋
发，故药饵之功，必不能与情窦争胜，此带浊之所以不易治也。此三者之外，则尚有湿热下
流者，有虚寒不固者，有脾肾亏陷而不能收摄者，当各因其证而治之。
一、心旌摇，心火不静而带下者，先当清火，宜朱砂安神丸、清心莲子饮、《直指》固
精丸之类主之。若无邪火而但见心虚带下者，宜秘丸煎、人参丸、心虚白浊歌、茯兔丸之类。
一、欲事过度、滑泄不固而带下者，宜秘丸煎、寿脾煎、固阴煎、苓术菟丝丸、《济生
》固精丸、锁精丸、金锁思仙丹之类主之。
一、人事不畅，精道逆而为浊为带者，初宜六味地黄汤，或威喜丸之属以利之；久不止
者，宜固阴煎、苓术菟丝丸之属以固之。
一、湿热下流而为带浊，脉必滑数，色见红赤，证有烦渴而多热者，宜保阴煎、加味逍
遥散，或经验猪肚丸亦佳。若热甚兼淋而赤者，宜龙胆泻肝汤。
一、元气虚弱而带下者，宜寿脾煎、固阴煎、菟丝煎、七福饮、十全大补汤、九龙丸之
属。若阳气虚寒，脉见微涩，色白清冷，腹痛多寒者，宜加姜附，或用家韭子丸。
一、脾肾气虚下陷而多带者，宜用寿脾煎、固阴煎、归脾汤、补中益气汤之属。
立斋曰∶前证或因六淫七情，或因醉饱房劳，或因膏粱浓味，或服燥剂所伤，或亏损阳
气下陷，或湿痰下注蕴积而成，故言带也。凡此皆当壮脾胃、升阳气为主，佐以各经见证之
药。若色青者属肝，用小柴胡加山栀；或湿热壅滞，小便赤涩，龙胆泻肝汤。色赤者属心，
用小柴胡加黄连、山栀、当归；思虑过伤，用妙香散等药。色白者属肺，用补中益气加山栀
。色黄者属脾，用六君子加山栀、柴胡；不应，归脾汤。色黑者属肾，用六味地黄丸。若气
血俱虚，八珍汤。阳气陷下，补中益气汤。湿痰下注，前汤加茯苓、半夏、苍术、黄柏。气
虚痰饮下注，四七汤送肾气丸。不可拘肥人多痰，瘦人多火，而以燥湿泻火之药轻治之也。
凡是妇女的淋证和带下病，虽然病情有轻有重，但实际上属于同一类疾病，带下是较轻的表现，而淋证则是较重的表现。这些病症总归是由于命门（肾与膀胱之门户，主藏精）不固所致；而导致不固的原因主要有六种：
一是因为心神动摇引起的。心神摇动则命门随之感应，命门感应就会失去其守持的功能，这是由于愿望未能实现（情志抑郁）造成的。
二是因为纵欲过度导致的滑泄。情欲没有节制，放纵无度，就会导致精道滑利而命门无法禁固，这是由于欲望过分满足造成的。
三是因为房事不当引起的逆乱。凡男女交合时，快慢节奏不同，此时主动权往往在男子一方，而女子的情兴常常导致中途停止，一旦停止就会产生逆乱，逆乱则化为浊液或淋证，这是由于既满足又未完全满足的欲望冲突造成的，这是女子中最常见却最不愿提及的情况。以上三种情况，凡是导致白带浑浊的原因，十有八九出自于此。对于这三种情况的治療，必须各自清除其根源，才可能取得疗效。然而病因未必能彻底清除，而且容易反复触发，所以药物的作用，必然不能胜过情欲的干扰，这就是带下和浊症之所以难以治疗的原因。在这三种情况之外，还有湿热下注的，有虚寒不固的，有脾肾亏虚下陷而不能收摄的，应当根据各自的证候进行治疗。
第一，因心神摇动、心火不静而导致带下的，应当先清泻心火，适宜使用朱砂安神丸、清心莲子饮、《直指方》中的固精丸等方剂为主治。如果没有邪火，只是见到心气虚弱导致的带下，适宜使用秘精煎、人参丸、心虚白浊歌方、茯兔丸等。
第二，因房事过度、滑泄不固而导致带下的，适宜使用秘精煎、寿脾煎、固阴煎、苓术菟丝丸、《济生方》中的固精丸、锁精丸、金锁思仙丹等方剂为主治。
第三，因人事不畅、精道逆乱而化为浊液或带下的，初期适宜使用六味地黄汤，或者威喜丸之类的方剂以利导；如果久治不止，适宜使用固阴煎、苓术菟丝丸之类的方剂以固涩。
第四，因湿热下注而导致的带下浑浊，脉象必定滑数，颜色呈现红赤，症状伴有烦躁口渴且多热象的，适宜使用保阴煎、加味逍遥散，或者经验方猪肚丸也很好。如果热势严重兼有淋证且尿色赤红的，适宜使用龙胆泻肝汤。
第五，因元气虚弱而导致的带下，适宜使用寿脾煎、固阴煎、菟丝煎、七福饮、十全大补汤、九龙丸等方剂。如果是阳气虚寒，脉象微涩，颜色白且清冷，腹痛且多寒象的，适宜加入干姜、附子，或者使用家韭子丸。
第六，因脾肾气虚下陷而导致的带下较多者，适宜使用寿脾煎、固阴煎、归脾汤、补中益气汤等方剂。
薛立斋说：上述病症有的因为六淫（风、寒、暑、湿、燥、火）七情（喜、怒、忧、思、悲、恐、惊），有的因为醉酒饱食或房劳，有的因为食用膏粱厚味，有的因为服用燥烈药物所伤，有的因为亏损阳气导致下陷，有的因为湿痰下注蕴积而成，所以称为带下病。所有这些情况都应当以强壮脾胃、升举阳气为主，辅以各经见证的药物。如果白带颜色发青的属于肝经病变，用小柴胡汤加山栀；或者是湿热壅滞，小便赤涩，用龙胆泻肝汤。颜色发赤的属于心经病变，用小柴胡汤加黄连、山栀、当归；如果是思虑过度损伤，用妙香散等药。颜色发白的属于肺经病变，用补中益气汤加山栀。颜色发黄的属于脾经病变，用六君子汤加山栀、柴胡；如果无效，用归脾汤。颜色发黑的属于肾经病变，用六味地黄丸。如果是气血俱虚，用八珍汤。如果是阳气下陷，用补中益气汤。如果是湿痰下注，在前述汤剂中加入茯苓、半夏、苍术、黄柏。如果是气虚痰饮下注，用四七汤送服肾气丸。不可拘泥于“肥人多痰，瘦人多火”的说法，而轻易使用燥湿泻火的药物治疗。
For women, leukorrhea (vaginal discharge) and strangury (painful urinary difficulty), although varying in severity, are essentially of the same category; leukorrhea is the milder form, while strangury is the more severe manifestation. These conditions generally stem from the insecurity of the Mingmen (Gate of Life, governing essence storage). The causes of this insecurity are sixfold:
First, caused by the agitation of the heart spirit. When the heart spirit agitates, the Mingmen responds; when the Mingmen responds, it loses its holding function. This arises from unfulfilled desires (emotional depression).
Second, caused by excessive indulgence in sexual activity leading to slipping and leakage. Unrestrained and immoderate lust causes the spermatic pathway to become slippery and the Mingmen unable to restrain, arising from excessive fulfillment of desires.
Third, caused by improper intercourse leading to reversal. During coitus, speeds vary, and the initiative often lies with the male. However, women's sexual arousal often leads to cessation midway. Cessation causes reversal; reversal transforms into turbid fluid or strangury. This arises from a conflict between fulfilled and unfulfilled desire, which is the most common yet least willing-to-be-admitted cause among women. Among the above three conditions, nine out of ten cases of turbid leukorrhea originate here. Treatment for these three must address their respective sources to be effective. However, since sources may not be cleared and triggers recur easily, the efficacy of herbal medicine cannot compete with the influence of sexual desire, which is why leukorrhea and turbidity are difficult to treat. Beyond these three, there are also cases due to damp-heat flowing downward, deficiency-cold failing to secure, and spleen-kidney deficiency with sinking failing to grasp. Treatment should be based on specific syndromes.
1. For leukorrhea caused by heart spirit agitation and restless heart fire, clear the fire first. Suitable formulas include Zhusha Anshen Wan (Cinnabar Calming the Spirit Pill), Qingxin Lianzi Yin (Heart-Clearing Lotus Seed Decoction), or Gujing Wan (Essence-Securing Pill) from *Zhizhi Fang*. If there is no pathogenic fire but only heart deficiency causing leukorrhea, suitable formulas include Mijing Jian (Secret Essence Decoction), Renshen Wan (Ginseng Pill), Xin Xu Bai Zhuo Ge (Heart Deficiency White Turbidity Song), or Futu Wan (Poria and Rabbit Pill).
2. For leukorrhea caused by excessive sexual activity and insecure slipping/leakage, suitable formulas include Mijing Jian, Shoupi Jian (Spleen-Nourishing Decoction), Guyin Jian (Yin-Securing Decoction), Lingzhu Tusizi Wan (Poria, Atractylodes, and Dodder Seed Pill), Gujing Wan from *Jisheng Fang*, Suojing Wan (Sperm-Locking Pill), or Jinluo Sixian Dan (Golden Lock Thinking Immortal Pill).
3. For turbidity and leukorrhea caused by obstructed interpersonal relations and reversed spermatic pathways, initially use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) or Weixi Wan (Weixi Pill) to guide and drain. If persistent, use Guyin Jian or Lingzhu Tusizi Wan to secure.
4. For leukorrhea and turbidity caused by damp-heat flowing downward, the pulse is typically slippery and rapid, color is red, and symptoms include irritability, thirst, and heat. Use Baoyin Jian (Yin-Preserving Decoction), Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), or Jingyan Zhudu Wan (Experience Pig Stomach Pill). If heat is severe with strangury and red urine, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction).
5. For leukorrhea caused by yuanqi (original qi) deficiency, use Shoupi Jian, Guyin Jian, Tusiji Jian (Dodder Seed Decoction), Qifu Yin (Seven Blessings Drink), Shiquan Dabu Tang (Ten Complete Tonifying Decoction), or Jiulong Wan (Nine Dragons Pill). If yang qi is deficient and cold, with a faint and choppy pulse, white and cold discharge, and abdominal pain with cold sensations, add Ganjiang (Dried Ginger) and Fuzi (Prepared Aconite), or use Jiajiu Zi Wan (Leek Seed Pill).
6. For excessive leukorrhea due to spleen-kidney qi deficiency and sinking, use Shoupi Jian, Guyin Jian, Guipi Tang (Restore the Spleen Decoction), or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
Xue Lizhai stated: The aforementioned conditions may arise from the six excesses (wind, cold, summerheat, dampness, dryness, fire) and seven emotions, drunkenness, overeating, sexual fatigue, rich/greasy diet, damage from drying/hot medicines, loss of yang qi with sinking, or accumulation of damp-phlegm flowing downward. Thus, they are termed leukorrhea. All such cases should primarily strengthen the spleen and stomach and raise yang qi, supplemented by herbs addressing specific channel manifestations. If the color is green, it belongs to the liver; use Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Zhizi (Gardenia). If damp-heat stagnation causes red, scanty, painful urination, use Longdan Xiegan Tang. If the color is red, it belongs to the heart; use Xiao Chaihu Tang plus Huanglian (Coptis), Zhizi, and Danggui (Angelica Sinensis). If injury from excessive thinking, use Miaoxiang San (Wonderful Incense Powder). If the color is white, it belongs to the lung; use Buzhong Yiqi Tang plus Zhizi. If the color is yellow, it belongs to the spleen; use Liujunzi Tang (Six-Gentleman Decoction) plus Zhizi and Chaihu (Bupleurum); if ineffective, use Guipi Tang. If the color is black, it belongs to the kidney; use Liuwei Dihuang Wan. If both qi and blood are deficient, use Bazhen Tang (Eight-Treasure Decoction). If yang qi sinks, use Buzhong Yiqi Tang. If damp-phlegm flows downward, add Fuling (Poria), Banxia (Pinellia), Cangzhu (Atractylodes Rhizome), and Huangbai (Phellodendron Bark) to the previous decoctions. If qi deficiency with phlegm-fluid flows downward, administer Shenqi Wan (Kidney Qi Pill) with Sizi Tang (Four-Seven Decoction). Do not rigidly adhere to the notion that "fat people have much phlegm, thin people have much fire," and lightly treat them with drying-dampness or draining-fire herbs.