妇人尺脉盛,右手脉大,皆其常也。血盛气衰为从,从则百病不生,孕育自成。然妇人
见理不明,胸襟窄狭,动多郁怒,怒气伤肝,肝动克脾,脾不运化而生湿,湿生痰,痰生热,
热生风,而症瘕淋闭崩漏带下之病生。急宜治其标,风则疏之,热则清之,痰则化之,湿则
利之,诸病各从类治。缓宜治其本,平肝补脾抑其气,以行其血,此其大凡也。是故古人动
用二陈汤化痰燥湿,四物汤补血,香附破气,黄芩清热,柴胡平肝,白术补脾,虽千变万化,
不离此乎。
加减二陈汤(治杂症) 二陈橘半茯苓草,清气化痰为至宝,膈上不宽加枳桔,火旺生
痰黄芩好。参术加名六君子,健脾和胃无如此,中脘寒疼去了参,香砂配用皆能止。饮食过
餐不克消,曲柏山楂浓朴调,再加枳实黄芩炒,何愁体弱脾胃娇。咳嗽生痰分冷热,热即芩
连并枳桔,寒痰枳缩配原方,顺气胸中痰自减,风寒外感嗽何医,二陈橘半与前胡,干葛桑
杏能消导,东垣名此号参苏。二陈半夏性本燥,血虚烦渴皆不要,四物汤中不必加,贝母代
之专取效。人有风痰疾病生,天麻白芷皂南星,湿痰在胃心多嗽,二术任须配二陈。火郁胸
中老痰结,滞住咽喉咯不出,半夏蒌姜附桔连,少助玄胡痰自减。痰在经络及四肢,姜汁遂
将竹沥施,胸胃有痰须枳实,胁间白芥即能除。温胆汤加升茹实,宁神豁痰为第一,若加枳
实共南星,汤号导痰能利膈。去草陈皮四七汤,加添苏朴与生姜,散郁消痰兼理气,孕生恶
阻用之康。呕吐皆因胃火炎,脉来洪数呕连绵,急用此方加枳实,竹茹煎服炒黄连,若还药
也吞不下,槟榔须少苏木煎。五六月来痛不休,心中纳闷手难揉,多加枳朴芩连芍,便闭硝
黄一服疗。嘈杂嗳气一般看,胸中积热与停痰,石膏香附并星下,二陈加减有何难,闷胀吞
酸与吐酸,本方加入炒黄连,水停心中名为饮,枳茯猪苓利小便,此是二陈加减法,休要浪
与世人传。
加减四物汤 妇人虽则有专工,余病皆与男子同,独有胎前与产后,血崩经候滞难通。
古人故令立四物,加减君臣仔细述,血枯经闭加桃仁,苏木马鞭亦可入。躯脂满闭去地黄,
二陈再合莎连实(瘦则血枯经闭,肥则躯脂满闭)。血实不行腰腹痛,调胃承气同之用(大
黄四钱,甘草二钱,水二钟,先煎至一半,入芒硝三钱,溶化服)。或只芎归加蓬桂,血瘀
越曲丸为贵。经水过期是血虚,加入升陈柴木 。不及期兮是血热,热则紫黑并块结,俱用
参连香附切。经水涩少和葵红,过多参术与之同,适来适断发寒热,宜与小柴胡相合。经水
作痛是血实,木香玄胡与蓬术,若夏热兮加芩柴,再与桃红莎连吃,经后作痛血虚症,四君
子汤两相并。赤白滞下腹微痛,脉沉微兮姜共桂。若治血崩有异方,或入荆芥或干姜。又方
加入莎草根,蒲榆升术 与参,煎调稷灰六七分,且用续断以为君。安胎生姜参术芩,砂仁
紫苏甘与陈。胎痛香附同为末,紫苏汤调服几帖。有胎恶心名恶阻,姜炒栀连二陈佐。有胎
下血多胎漏,胶陈栀柏木甘授。孕而烦乱曰子烦,参远神栀芩术甘,子肿桔苏与滑石,大腹
枳壳黄芩入。胎上作胀名子悬,芩莎砂壳及陈甘。子痫猝倒加柴芩,汁沥莎甘术与陈。产难
前方还去地,更加益母并芷桔,热服加射两三分,烧取男发蛇蝉蜕。产后惟宜大补血,虽有
余痰从末治,去芍药兮易黄 ,恐其酸寒伐生气。气虚加参术茯甘,发热干姜为要剂。自汗
多者少川芎,渴加五味麦门冬。腹痛非芍则不可,但以酒炒不为凶。恶露不去腹作痛,香附
灵脂效若神,为末调入前汤内,甚则桃仁四五分。子宫未敛而作痛,酸炒芍甘粟壳共,入少
米醋酸以收,或只山楂入糖用。恶露不去发寒热,更加棱蓬莎乳没,灵脂干漆桃仁捷。腹痛
不息加香附,乌药陈桂良姜佐,煎入童便与米醋。月余经血淋不止,加入升麻及白芷,血余
烧灰调服之,阴痛更加防 饵。遍身浮肿加乳没,桂通大腹良姜捷,槟榔金沙并血竭。子肠
不收合四君,黄 蜜炙入防升。口眼 歪似中风,亦合四君用最工,荆芥附子还加入,少佐
羌活并防风。
四物汤轻重解∶川芎(理肝,春宜倍、弦宜倍、头痛宜倍) 白芍(理脾,夏宜倍、洪
宜倍、泄宜倍) 地黄(理肺,秋宜倍、涩宜倍、细虚宜倍) 当归(理肾,冬宜倍,沉宜
倍,寒宜倍)
四物四时使,春加防风,夏加黄芩,秋加天冬,冬加桂枝。
加减逍遥散 治脾虚发热,或潮热,或自汗盗汗,或头痛目涩,或怔忡不宁,颊赤口干
,或月水不调,或肚腹作痛;或小腹重坠,水道涩痛,或肿痛出脓,内热作渴。
当归(酒洗) 白芍(酒洗) 白术(土炒) 柴胡(酒炒) 白茯苓以上各一钱 甘
草(炙)五分 煨姜一片 薄荷少许共煎服。发热加地骨皮、知母;手颤抖,加防风、荆芥、
薄荷;咳嗽,加五味子、紫菀;气恼、胸膈痞闷,加枳实、青皮、香附;吐痰,加半夏、贝
母、栝蒌仁;饮食不消,加山楂、神曲;发渴,加麦门冬、天花粉;胸中发热,加黄连、栀
子;心慌心跳,加酸枣仁,远志肉;久泻,加黑姜;遍身痛,加羌活、防风、川芎;吐血,
加阿胶、生地、丹皮;自汗,加黄 、酸枣仁;左腹血块,加三棱、莪术、桃仁、红花;右
腹气块,加木香、槟榔;怒气伤肝,眼目昏花,加龙胆草、黄连、栀子、白豆蔻;经闭,加
桃仁、红花、苏木;小腹痛,加延胡索、香附米。
柴胡散 治妇人寒热往来,体疲肢节疼痛,心烦口干,不欲饮食。
北柴胡 白术 黄 赤茯苓各一两 人参 地骨皮 枳壳(制) 生地 桔梗 桑白
皮赤
每服一两,用生姜煎服。
小柴胡汤 治妇人伤风七八日后,寒热发作,其时经水适断,此为热入血室,其血结故
如虐
柴胡八钱 人参 甘草 黄芩 生地各三钱 半夏 麦冬各二钱。
每服八钱,姜枣煎服。
又方
用柴、参、芩、草,合芍、地、芎、归,是为柴胡四物,治虚劳寒热。
乌金丸 妇人三十六病,思虑过度变生疾,不孕崩中带下,五心烦热,口渴苦咽干,饮
食无味,身疼羸瘦,面目萎黄,手足酸软,经水不匀,脐腹胀痛,发黄落,喜卧倦起,产后
恶血上行,心腹刺痛,败血不止及子宫一切恶疾。用∶大艾叶 当归(醋煮) 茴香(炒) 熟
地(醋炒) 南木香(不见火) 吴茱萸 三棱 莪术各□两 川芎(醋炒) 芍药(醋炒)
各三两 香附子六两 玄胡索一两 紫荆皮四两(醋炒)
上先将艾、香二味,(醋五升,浸一日夜,冬月三日夜,煮干炒,令赤色)入后十二味,
同为末,米醋煮,元米糊丸,桐子大,每服七八十丸,空心盐酒汤任下,一日二服。
如崩中下血不止,加粽灰一两,绵灰五钱,蒲黄(炒)一两,百草霜七钱。
乌鸡丸 治妇人羸弱血虚有热,经水不调,崩漏带下,骨蒸等疾。用∶
白毛乌骨雄鸡一只(重二斤半许,闭死去毛肠,用艾叶四两,青蒿四两,锉碎,纳一半
在鸡腹内,将酒坛盛鸡,并余蒿艾,瀣□便和水,没鸡二寸,煮绝干取出,去骨捣烂,如薄
饼状,焙干研末) 南香附(去毛)一斤(分四分,用米泔、童便、酒、醋各浸之,春秋二
日,夏一日,冬四日,取出晒干)熟地 生地各四两 芎 归 芍 参 术各三两 黄 川
牛膝 黄连 丹皮(去心) 知母 贝母 地骨皮各二两 柴胡 秦艽各一两半 干姜 玄
胡索各一两 白茯苓(去皮)二两五钱 鳖甲三两(醋浸炙黄色)
二十四味,共为细末,醋糊丸如梧子大。服五十丸,渐加至八十丸,酒下或米饮下。忌
苋菜及煎炒辛辣之物。
经闭
妇女经脉不行,或因多产伤血,或因堕胎,或因久患潮热伤血,其因脾胃伤损而致者甚
多,
血少不行,只宜缓治。以白术为君,茯苓芍药为臣,佐以黄 、甘草、陈皮、麦芽、柴胡、
芎、归等药,补脾生血,经自行矣。亦有饮食积滞者,宜消积。若脾胃无病及无别证,果有
血块凝结,方宜行血通经。
神应丹 治经不行有实热,五心烦热,口燥咽干,心忪额赤,胸膈不利,咳唾稠痰。
大黄八两(醋二碗,煮干晒) 血竭 桃仁 红花各五钱酒糊丸如桐子大,朱砂为衣,
每服七十丸。
又医案 一妇人虚劳发热,盗汗咳嗽,面红经闭,脉数有力,以滋补药投之不效,用大
黄(
尽除
痛加玄胡、枳壳、干膝;呕吐恶,加良姜、砂仁;手足麻痹恶寒,加肉桂;咳嗽,加杏仁、
五味子、款冬花。
刘河间曰∶心主血,心病则不流,先服降心火之剂,次用局方中五补丸,后以卫生汤理
脾养
卫生汤 黄 三两 当归 白芍各二两 甘草一两
每服五钱。如虚者,加人参,空心温服。
又丹方 蚕砂四两(沙锅炒半黄色),就入无灰酒一壶于内,沸过,以瓷器盛之,去砂
温饮一盏,即可通。
又方
大船上多年灰条,用炭火烧红,淬入烧酒,取出待干为末,每服三钱。初用酒下,次
红花酒下,次大黄酒下,三服见红,如神。
又方
治鬼胎,经闭 用芫花三两,炒黄色,为末,每服一钱,桃仁汤下,取出恶物,神效
崩漏 经已久止,忽而大下,腹痛身热,曰崩属阴,经行三十日,犹涌出不止,曰漏属
阳。
按脉数洪而疾疾,漏下候也。崩之为痛血大下,岂可为寒,但血去后,其人必虚,当大
补气
虚阳搏。
崩漏
丹溪论∶血崩当分寒热,急则治其标,用白芷汤调百草霜末。甚者用陈棕灰,后用四物
汤加
芩。
崩过多者,先用五灵脂(半生半炒)为末,酒下一服。又方同生芝麻嚼下,每日六七次,
其疾痊愈,盖五灵脂能行能止。紫色成块者热,以四物汤加黄连之类,血崩用香附,白芷丸
服。
气虚血虚,以四物汤加参 。漏下乃热而虚,四物加黄连。崩中白带用椒□末,又用白
芷(锻石炒,去灰为末)、茜草少许,粥丸服。一方用生狗头骨(烧灰存性),酒调下,或入
药服
升麻四物汤 崩漏不问虚实,用四物加升麻、防风,加荆芥穗(灯上烧)服之。如不止,
加白术、蒲黄及诸止血药。
血崩屡验方 当归、白芍、棕棕、干姜各烧灰存性,为末,醋汤调。以有节红筋,左搅
四十九
当归龙骨丸 月事失常,经水过多,及带下淋沥,无问久新、赤白诸症,并产后恶物不
止,
用当归 黄连 槐子 艾叶(炒) 茯苓各五钱 龙骨 黄柏各五钱 木香二钱滴水为
丸小豆大,每服五十丸,食前米汤送下。
固肠丸 椿根白皮(炒)为末,酒糊为丸,治湿气下利,便血及白带,去脾胃陈积之疾
(用此
苍术三钱 白芷二钱 黄连(炒)二钱 黄芩三钱 黄柏(炒)一钱五分 白芍二钱五
分椿根白皮(炒)一钱五分 山茱萸二钱五分糊丸,空心酒下五十丸。
丹方 黄芩研细末,烧秤锤淬酒调下三钱,食前服。
又方
甜杏仁上黄皮烧灰存性,空心热酒下三钱。
又方
莲蓬烧灰存性,酒下二钱。
又方
白矾(水飞过)面糊丸,如指头大,每服一丸,黄酒送下。
又方
天灵盖烧灰,每服黄酒下二钱。
又方
黑驴粪烧灰存性,面糊丸,空心酒下六七十丸。
又方
乌梅烧灰,乌梅汤下。
余论
凡血崩,乃经脉错乱。一二日不止,便有瘀血凝成窠柏,若骤用药住涩,必见增剧。宜
以五
之。
带下
赤属血,白属气。原素有湿热,产育房劳伤于营卫,浊气渗入膀胱,故流秽物。世俗之
方,多用燥热止涩,虽亦偶效,因此延绵。盖知下焦虚寒,不知中焦湿热也。治之之法,大
约宜清上实下,理脾养血清心,薄滋味,带自除矣。丹溪以燥滋先为,用二陈汤加苍术、白
术,甚者用吐以提其气。肥人多是湿痰,用海石、半夏、南星(炒)、黄柏、苍术、川芎、
椿皮;瘦人白带少,如有者多热,以炒柏、滑石、椿皮、川芎、海石(如无海石,以蛤粉亦
可,无椿皮以青黛)作丸子服。实者可下,虚者不可峻攻。如血虚者,加减四物汤;气虚者,
参术陈皮间与之。湿胜者,用固肠丸;相火动者,于诸药中少加黄柏、滑石,加龙骨、赤石
脂,滞者加葵花(白花治白带,赤花治赤带),性燥加黄连,痰气加苍术、香附、滑石、蛤
粉、半夏、茯苓丸服。寒月少加干姜,临机应变,须断浓味。
清白散 治白带。
四物加黄柏 干姜 贝母 甘草 樗根白皮 生姜煎服。肥人多湿疾,加白术、半夏。
兼赤加条芩(酒炒)、荆芥。久下加熟地、牡蛎。气虚加参 。腰腿痛加鹿角胶,若用乌鸡
丸更妙。
河间论∶湿热不散,先以十枣汤下之,后服苦楝丸,带自除矣。苦楝(碎,酒浸)、茴
香(炒)、当归各等分为末,酒糊丸如桐子大,每服三五十丸,空心酒下。如用大玄胡散调
下更妙。
(十枣汤见《局方》)
鲍氏方 治赤白带。
尺脉在女性中通常较为旺盛,右手脉象宏大,这都属于正常现象。血气旺盛而气机相对衰弱属于顺证,顺证则百病不生,自然容易受孕。然而,许多妇人见识浅陋,心胸狭窄,动不动就发怒。怒气会损伤肝脏,肝气亢盛克制脾土,导致脾的运化功能失常而生湿,湿气积聚形成痰,痰郁久化热,热极生风,从而产生症瘕(腹内结块)、淋证、闭经、崩漏、带下等病症。此时应当急治其标:有风邪则疏风,有热邪则清热,有痰则化痰,有湿则利湿,各种病症分别按照其性质治疗。待病情缓和后应治其本,通过平抑肝气、补益脾气来调节气机,进而推动血液运行,这是大概的原则。因此古人常使用二陈汤来化痰燥湿,四物汤来补血,香附来破气行滞,黄芩来清热,柴胡来平抑肝气,白术来补脾,虽然病情千变万化,但离不开这些基本方法。
加减二陈汤(治疗各种杂症):二陈汤由陈皮、半夏、茯苓、甘草组成,是清气化痰的至宝之方。如果膈间不宽畅,可加入枳壳、桔梗;如果火旺生痰,加入黄芩效果最好。加入人参、白术称为六君子汤,健脾和胃没有比它更好的了。如果是中脘部因寒疼痛,去掉人参,配合香附、砂仁使用都能止痛。饮食过量无法消化,可用神曲、黄柏、山楂、厚朴调理。再加枳实、炒黄芩,何必担心体质虚弱脾胃娇嫩呢?咳嗽生痰要分寒热,热痰用黄芩、黄连并加枳壳、桔梗;寒痰在原方基础上配伍枳壳、缩砂仁,顺气后胸中痰自减。若是风寒外感引起的咳嗽,用二陈汤加前胡,干葛、桑叶、杏仁能消导痰滞,李东垣将此方命名为参苏饮。二陈汤中的半夏性燥,血虚烦渴者不宜使用,若需加入四物汤中不必加半夏,可用贝母代替以专取疗效。人有风痰疾病发生,可用天麻、白芷、制南星;湿痰在胃心中多咳嗽,苍术、白术任选一味配合二陈汤。火郁胸中老痰凝结,阻滞咽喉咯吐不出,可用半夏、瓜蒌、生姜、附子、桔梗、黄连,稍加玄胡索,痰自减少。痰在经络及四肢,需用姜汁送服竹沥;胸胃有痰须用枳实;胁间痰饮可用白芥子消除。温胆汤加入升麻、茹实(疑为竹茹之误或特定用法),宁神豁痰为首选;若加入枳实、南星,此汤名为导痰汤,能利膈除痰。去掉甘草、陈皮即为四七汤,加入紫苏、厚朴与生姜,可散郁消痰兼理气,孕妇妊娠恶阻服用可安康。呕吐皆因胃火炎上,脉象洪数呕吐连绵,急用此方加枳实,竹茹煎服并炒黄连;如果药也吞不下,需少用槟榔,加苏木煎服。五六月间腹痛不休,心中郁闷手难揉按,多加枳壳、厚朴、黄芩、黄连、白芍,若大便闭塞,用芒硝、大黄一剂即可治愈。嘈杂嗳气与此类似看待,多为胸中积热与停痰,用石膏、香附、南星,二陈汤加减有何困难?胸闷胀满吞酸与吐酸,在本方中加入炒黄连。水饮停聚心中名为“饮”,用枳壳、茯苓、猪苓利小便,这就是二陈汤的加减法,不要随意泄露给世人。
加减四物汤:妇人虽然有专门的妇科医生,其余疾病大多与男子相同,独有胎前与产后,以及血崩、月经滞后难通等情况不同。古人因此设立四物汤,对君臣药物的加减仔细阐述。血枯经闭加入桃仁,苏木、马鞭草也可加入。身体肥胖脂肪厚导致经闭者去掉地黄,再合用二陈汤加莎草根、连翘实(瘦人则因血枯经闭,肥人则因躯脂满闭)。血瘀不行导致腰腹痛,可用调胃承气汤同用(大黄四钱,甘草二钱,水两碗,先煎至一半,入芒硝三钱,溶化服用)。或者只用川芎、当归加蓬莪术、肉桂,血瘀证越鞠丸最为珍贵。经期过期是血虚,加入升麻、陈皮、柴胡、木香。经期提前是血热,热则血色紫黑并有血块凝结,均用人参、黄连、香附切片。经水涩少可加葵根、红花;过多则与人参、白术同用。经期忽来忽断发寒热,宜与小柴胡汤相合。经水作痛是血实,用木香、玄胡索、蓬莪术;若夏季炎热加黄芩、柴胡,再与桃仁、红花、马鞭草、连翘实同吃。经后作痛属血虚症,四君子汤与之并用。赤白痢疾腹微痛,脉沉微者用干姜、肉桂。若治血崩有异方,或加入荆芥或干姜。又一方加入莎草根、蒲黄、榆皮、升麻、白术与人参,煎煮调服稷米灰六七分,且用续断作为主药。安胎用生姜、人参、白术、黄芩,砂仁、紫苏、甘草与陈皮。胎痛将香附研为末,紫苏汤调服几帖。怀孕恶心名为恶阻,用姜炒栀子、黄连配合二陈汤辅助。怀孕下血多属胎漏,用阿胶、陈皮、栀子、黄柏、木通、甘草授受。孕期烦乱称为子烦,用人参、远志、神曲、栀子、黄芩、白术、甘草。子肿用桔梗、紫苏与滑石,大腹皮、枳壳、黄芩加入。胎上作胀名为子悬,用黄芩、莎草根、砂仁、枳壳及陈皮、甘草。子痫猝倒加柴胡、黄芩,竹沥、莎草根、甘草、白术与陈皮。产难前方还去掉地黄,更加益母草、白芷、桔梗,热服加射干两三分,烧取男发、蛇蜕、蝉蜕。产后惟宜大补血虚,虽有剩余痰浊也从次要治疗,去掉芍药改用黄芪,恐怕其酸寒伐伤生气。气虚加人参、白术、茯苓、甘草,发热干姜为要剂。自汗多者少用川芎,口渴加五味子、麦门冬。腹痛非芍药不可,但以酒炒不为凶险。恶露不去腹部作痛,香附、五灵脂效若神明,研为末调入前汤内,严重时加桃仁四五分。子宫未收敛而作痛,炒酸芍药、甘草、粟壳共用,入少许米醋以收敛,或只用山楂加糖使用。恶露不去发寒热,更加三棱、蓬莪术、莎草根、乳香、没药,五灵脂、干漆、桃仁见效快。腹痛不息加香附,乌药、陈皮、肉桂、良姜佐助,煎入童便与米醋。月余经血淋沥不止,加入升麻及白芷,血余烧灰调服之,阴部疼痛更加防己饵服。遍身浮肿加乳香、没药,桂枝通络、大腹皮、良姜见效快,槟榔、金沙、血竭同用。子宫下垂不收合四君子汤,黄芪蜜炙加入防风、升麻。口眼歪斜似中风,亦合四君子汤用最工,荆芥、附子还加入,少佐羌活并防风。
四物汤轻重解:川芎(调理肝脏,春季宜加倍、弦脉宜加倍、头痛宜加倍);白芍(调理脾脏,夏季宜加倍、洪脉宜加倍、泄泻宜加倍);地黄(调理肺脏,秋季宜加倍、涩脉宜加倍、细虚脉宜加倍);当归(调理肾脏,冬季宜加倍、沉脉宜加倍、寒证宜加倍)。四物汤随四季变化使用:春加防风,夏加黄芩,秋加天冬,冬加桂枝。
加减逍遥散:治疗脾虚发热,或潮热,或自汗盗汗,或头痛目涩,或怔忡不宁,脸颊发红口干,或月经不调,或肚腹作痛;或小腹重坠,水道涩痛,或肿痛出脓,内热作渴。
处方:当归(酒洗)、白芍(酒洗)、白术(土炒)、柴胡(酒炒)、白茯苓(以上各一钱)、甘草(炙)五分、煨姜一片、薄荷少许,共煎服。发热加地骨皮、知母;手颤抖,加防风、荆芥、薄荷;咳嗽,加五味子、紫菀;气恼、胸膈痞闷,加枳实、青皮、香附;吐痰,加半夏、贝母、瓜蒌仁;饮食不消,加山楂、神曲;发渴,加麦门冬、天花粉;胸中发热,加黄连、栀子;心慌心跳,加酸枣仁、远志肉;久泻,加黑姜;遍身痛,加羌活、防风、川芎;吐血,加阿胶、生地、丹皮;自汗,加黄芪、酸枣仁;左腹血块,加三棱、莪术、桃仁、红花;右腹气块,加木香、槟榔;怒气伤肝,眼目昏花,加龙胆草、黄连、栀子、白豆蔻;经闭,加桃仁、红花、苏木;小腹痛,加延胡索、香附米。
柴胡散:治疗妇人寒热往来,体疲肢节疼痛,心烦口干,不欲饮食。
处方:北柴胡、白术、黄芪、赤茯苓各一两,人参、地骨皮、枳壳(制)、生地、桔梗、桑白皮、赤芍(原文赤字可能指赤芍或赤茯苓重复,依上下文推测为赤芍或泛指活血药,此处保留原意)各适量。每服一两,用生姜煎服。
小柴胡汤:治疗妇人伤风七八日后,寒热发作,此时月经刚断,此为热入血室,血液凝结故如疟疾状。
处方:柴胡八钱,人参、甘草、黄芩、生地各三钱,半夏、麦冬各二钱。每服八钱,姜枣煎服。
又方:
用柴胡、人参、黄芩、甘草,合芍药、地黄、川芎、当归,是为柴胡四物汤,治疗虚劳寒热。
乌金丸:治疗妇人三十六病,思虑过度变生疾病,不孕、崩中、带下,五心烦热,口渴苦咽干,饮食无味,身疼羸瘦,面目萎黄,手足酸软,经水不匀,脐腹胀痛,发黄脱发,喜卧倦起,产后恶血上行,心腹刺痛,败血不止及子宫一切恶疾。
处方:大艾叶、当归(醋煮)、茴香(炒)、熟地(醋炒)、南木香(不见火)、吴茱萸、三棱、莪术各若干两,川芎(醋炒)、芍药(醋炒)各三两,香附子六两,玄胡索一两,紫荆皮四两(醋炒)。
先将艾叶、香附二味,用醋五升,浸泡一日一夜(冬季三日夜),煮干炒至赤色,加入后十二味,同为细末,米醋煮,元米糊丸,梧桐子大,每服七八十丸,空心盐酒汤任下,一日二服。
如崩中下血不止,加粽灰一两,绵灰五钱,蒲黄(炒)一两,百草霜七钱。
乌鸡丸:治疗妇人羸弱血虚有热,经水不调,崩漏带下,骨蒸等疾。
处方:白毛乌骨雄鸡一只(重二斤半许,闭气杀死去毛肠,用艾叶四两,青蒿四两,锉碎,纳一半在鸡腹内,将酒坛盛鸡,并余蒿艾,加水没过鸡二寸,煮绝干取出,去骨捣烂,如薄饼状,焙干研末);南香附(去毛)一斤(分四分,用米泔水、童便、酒、醋各浸之,春秋二日,夏一日,冬四日,取出晒干);熟地、生地各四两;川芎、当归、芍药、人参、白术各三两;黄芪、川牛膝、黄连、丹皮(去心)、知母、贝母、地骨皮各二两;柴胡、秦艽各一两半;干姜、玄胡索各一两;白茯苓(去皮)二两五钱;鳖甲三两(醋浸炙黄色)。
二十四味,共为细末,醋糊丸如梧子大。服五十丸,渐加至八十丸,酒下或米饮下。忌苋菜及煎炒辛辣之物。
经闭:
妇女经脉不行,或因多产伤血,或因堕胎,或因久患潮热伤血,其因脾胃伤损而致者甚多。血少不行,只宜缓治。以白术为君药,茯苓、芍药为臣药,佐以黄芪、甘草、陈皮、麦芽、柴胡、川芎、当归等药,补脾生血,经自行矣。亦有饮食积滞者,宜消积。若脾胃无病及无别证,果有血块凝结,方宜行血通经。
神应丹:治疗经不行有实热,五心烦热,口燥咽干,心忪额赤,胸膈不利,咳唾稠痰。
处方:大黄八两(醋二碗,煮干晒),血竭、桃仁、红花各五钱,酒糊丸如桐子大,朱砂为衣,每服七十丸。
又医案:一妇人虚劳发热,盗汗咳嗽,面红经闭,脉数有力,以滋补药投之不效,用大黄……尽除……痛加玄胡、枳壳、干膝(疑为干姜或膝骨相关药,原文可能有误,依语境推测);呕吐恶,加良姜、砂仁;手足麻痹恶寒,加肉桂;咳嗽,加杏仁、五味子、款冬花。
刘河间曰:心主血,心病则不流,先服降心火之剂,次用局方中五补丸,后以卫生汤理脾养……
卫生汤:黄芪三两,当归、白芍各二两,甘草一两。每服五钱。如虚者,加人参,空心温服。
又丹方:蚕砂四两(沙锅炒半黄色),就入无灰酒一壶于内,沸过,以瓷器盛之,去砂温饮一盏,即可通。
又方:
大船上多年灰条,用炭火烧红,淬入烧酒,取出待干为末,每服三钱。初用酒下,次红花酒下,次大黄酒下,三服见红,如神。
又方:
治鬼胎,经闭。用芫花三两,炒黄色,为末,每服一钱,桃仁汤下,取出恶物,神效。
崩漏:
经已久止,忽而大下,腹痛身热,曰崩属阴,经行三十日,犹涌出不止,曰漏属阳。
按脉数洪而疾疾,漏下候也。崩之为痛血大下,岂可为寒,但血去后,其人必虚,当大补气……虚阳搏。
崩漏:
丹溪论:血崩当分寒热,急则治其标,用白芷汤调百草霜末。甚者用陈棕灰,后用四物汤加黄芩。
崩过多者,先用五灵脂(半生半炒)为末,酒下一服。又方同生芝麻嚼下,每日六七次,其疾痊愈,盖五灵脂能行能止。紫色成块者热,以四物汤加黄连之类,血崩用香附、白芷丸服。
气虚血虚,以四物汤加人参、黄芪。漏下乃热而虚,四物加黄连。崩中白带用椒……末,又用白芷(锻石炒,去灰为末)、茜草少许,粥丸服。一方用生狗头骨(烧灰存性),酒调下,或入药服。
升麻四物汤:崩漏不问虚实,用四物加升麻、防风,加荆芥穗(灯上烧)服之。如不止,加白术、蒲黄及诸止血药。
血崩屡验方:当归、白芍、棕榈、干姜各烧灰存性,为末,醋汤调。以有节红筋,左搅四十九……
当归龙骨丸:月事失常,经水过多,及带下淋沥,无问久新、赤白诸症,并产后恶物不止。
处方:当归、黄连、槐子、艾叶(炒)、茯苓各五钱,龙骨、黄柏各五钱,木香二钱,滴水为丸小豆大,每服五十丸,食前米汤送下。
固肠丸:椿根白皮(炒)为末,酒糊为丸,治湿气下利,便血及白带,去脾胃陈积之疾(用此……)。
苍术三钱,白芷二钱,黄连(炒)二钱,黄芩三钱,黄柏(炒)一钱五分,白芍二钱五分,椿根白皮(炒)一钱五分,山茱萸二钱五分,糊丸,空心酒下五十丸。
又方:
莲蓬烧灰存性,酒下二钱。
又方:
乌梅烧灰,乌梅汤下。
余论:
凡血崩,乃经脉错乱。一二日不止,便有瘀血凝成窠臼,若骤用药住涩,必见增剧。宜以五……之。
带下:
赤属血,白属气。原素有湿热,产育房劳伤于营卫,浊气渗入膀胱,故流秽物。世俗之方,多用燥热止涩,虽亦偶效,因此延绵。盖知下焦虚寒,不知中焦湿热也。治之之法,大约宜清上实下,理脾养血清心,薄滋味,带自除矣。丹溪以燥滋先为,用二陈汤加苍术、白术,甚者用吐以提其气。肥人多是湿痰,用海浮石、半夏、南星(炒)、黄柏、苍术、川芎、椿皮;瘦人白带少,如有者多热,以炒柏、滑石、椿皮、川芎、海浮石(如无海石,以蛤粉亦可,无椿皮以青黛)作丸子服。实者可下,虚者不可峻攻。如血虚者,加减四物汤;气虚者,参术陈皮间与之。湿胜者,用固肠丸;相火动者,于诸药中少加黄柏、滑石,加龙骨、赤石脂,滞者加葵花(白花治白带,赤花治赤带),性燥加黄连,痰气加苍术、香附、滑石、蛤粉、半夏、茯苓丸服。寒月少加干姜,临机应变,须断浓味。
清白散:治疗白带。
四物加黄柏、干姜、贝母、甘草、樗根白皮、生姜煎服。肥人多湿疾,加白术、半夏。兼赤加条芩(酒炒)、荆芥。久下加熟地、牡蛎。气虚加人参、黄芪。腰腿痛加鹿角胶,若用乌鸡丸更妙。
河间论:湿热不散,先以十枣汤下之,后服苦楝丸,带自除矣。苦楝(碎,酒浸)、茴香(炒)、当归各等分为末,酒糊丸如桐子大,每服三五十丸,空心酒下。如用大玄胡散调下更妙。
(十枣汤见《局方》)
The Chi pulse (pulse at the wrist root) is typically vigorous in women, and a large pulse on the right hand is also considered normal. When blood is abundant and Qi is relatively deficient, it is a favorable condition; in such cases, myriad diseases do not arise, and conception occurs naturally. However, many women lack insight, have narrow minds, and are prone to anger. Anger damages the Liver, causing Liver Qi to overact upon the Spleen. The Spleen fails to transform and transport, leading to Dampness, which condenses into Phlegm. Phlegm stagnates and generates Heat, and extreme Heat generates Wind, resulting in conditions such as masses (abdominal lumps), strangury, amenorrhea, metrorrhagia, and leukorrhea. In these acute stages, one should treat the branch (symptoms): disperse Wind if present, clear Heat if present, resolve Phlegm if present, and promote diuresis for Dampness. Each disease should be treated according to its nature. Once the condition stabilizes, one should treat the root: soothe the Liver, tonify the Spleen, regulate Qi, and thereby move Blood. This is the general principle. Therefore, ancients often used Er Chen Tang (Two-Cured Decoction) to resolve Phlegm and dry Dampness, Si Wu Tang (Four-Substance Decoction) to nourish Blood, Xiang Fu (Cyperus Rhizome) to move Qi and break stagnation, Huang Qin (Scutellaria Root) to clear Heat, Chai Hu (Bupleurum Root) to soothe the Liver, and Bai Zhu (Atractylodes Macrocephala Rhizome) to tonify the Spleen. Although conditions may change infinitely, they do not deviate from these basics.
Modified Er Chen Tang (for miscellaneous diseases): Er Chen Tang consists of Chen Pi (Tangerine Peel), Ban Xia (Pinellia Tuber), Fu Ling (Poria), and Gan Cao (Licorice Root); it is a supreme treasure for clearing Qi and resolving Phlegm. If the chest and diaphragm feel full and unrelieved, add Zhi Ke (Aurantium Fruit) and Jie Geng (Platycodon Root). If Fire is excessive generating Phlegm, Huang Qin is excellent. Adding Ren Shen (Ginseng) and Bai Zhu creates Liu Jun Zi Tang (Six-Gentlemen Decoction), which is unsurpassed for strengthening the Spleen and harmonizing the Stomach. For cold pain in the Zhong Wan region (CV12), remove Ren Shen and combine with Xiang Fu and Sha Ren (Amomum Fruit), which can alleviate pain. For indigestion due to overeating, use Qu Shen (Medicated Leaven), Huang Bo (Phellodendron Bark), Shan Zha (Hawthorn Fruit), and Hou Po (Magnolia Bark). Adding Zhi Shi (Immature Aurantium) and stir-fried Huang Qin alleviates concerns about weak constitution and delicate Spleen-Stomach. For cough with Phlegm, distinguish between Cold and Heat: for Heat, use Huang Qin, Lian Zi (Coptis Rhizome) with Zhi Ke and Jie Geng; for Cold Phlegm, add Zhi Ke and Su Su Zi (Perilla Seed) to the original formula to direct Qi downward so Phlegm diminishes. For cough due to external Wind-Cold, use Er Chen Tang plus Qian Hu (Peucedanum Root), Ge Gen (Kudzu Root), Sang Ye (Mulberry Leaf), and Xing Ren (Apricot Seed); Li Dongyuan named this Shen Su Yin (Ginseng and Perilla Decoction). Ban Xia in Er Chen Tang is drying; it is contraindicated for Blood deficiency with irritability and thirst. If adding to Si Wu Tang, do not use Ban Xia; instead, use Bei Mu (Fritillaria Bulb) for specific efficacy. For Wind-Phlegm diseases, use Tian Ma (Gastrodia Tuber), Bai Zhi (Angelica Dahurica Root), and Zhi Nan Xing (Prepared Arisaema Rhizome). For Damp-Phlegm in the Stomach causing frequent coughing, choose either Cang Zhu (Atractylodes Lancea Rhizome) or Bai Zhu combined with Er Chen Tang. For old Phlegm knotting in the chest due to constrained Fire, obstructing the throat and difficult to expectorate, use Ban Xia, Gua Lou (Trichosanthes Fruit), Sheng Jiang (Fresh Ginger), Fu Zi (Aconite Root), Jie Geng, and Huang Lian (Coptis Rhizome), with a little Yan Hu Suo (Corydalis Rhizome) to reduce Phlegm. For Phlegm in the meridians and limbs, administer Zhu Li (Bamboo Sap) with Jiang汁 (Ginger Juice). For Phlegm in the chest and Stomach, use Zhi Shi. For Phlegm in the hypochondrium, Bai Jie Zi (White Mustard Seed) is effective. Wen Dan Tang (Warm the Gallbladder Decoction) added with Sheng Ma (Cimicifuga Rhizome) and Zhu Ru (Bamboo Shavings) is first-rate for calming the Spirit and resolving Phlegm; adding Zhi Shi and Nan Xing creates Dao Tan Tang (Guiding Phlegm Out Decoction) to benefit the diaphragm. Removing Gan Cao and Chen Pi yields Si Qi Tang (Four-Qi Decoction); adding Su Ye (Perilla Leaf), Hou Po, and Sheng Jiang disperses constraint, resolves Phlegm, and regulates Qi, providing relief for pregnancy nausea (E Zu). Vomiting is caused by Stomach Fire flaring up; if the pulse is surging and rapid with continuous vomiting, urgently use this formula with Zhi Shi, Zhu Ru decocted with stir-fried Huang Lian. If medicines cannot be swallowed, use a small amount of Bing Lang (Areca Seed) decocted with Su Mu (Sandalwood). During May and June, if abdominal pain persists with inner frustration and inability to press the abdomen, add more Zhi Ke, Hou Po, Huang Qin, Huang Lian, and Bai Shao (White Peony Root); if constipation exists, Yi Fu Liao (One-Dose Cure) with Xiao Shi (Mirabilite) and Da Huang (Rhubarb Root) works instantly. Palpitations and belching are viewed similarly, often due to accumulated Heat and retained Phlegm in the chest; using Shi Gao (Gypsum), Xiang Fu, and Nan Xing makes modified Er Chen Tang easy to apply. For chest oppression, acid regurgitation, and vomiting acid, add stir-fried Huang Lian to the base formula. Water retention in the heart region is called "Yin" (Fluid Retention); use Zhi Ke, Fu Ling, and Zhu Ling (Polyporus) to promote urination. This is the method of modifying Er Chen Tang; do not disseminate it recklessly.
Modified Si Wu Tang: Although women have specialized physicians, most diseases are the same as men's, except for prenatal and postnatal conditions, metrorrhagia, and menstrual stagnation/difficulty. Ancients established Si Wu Tang (Four-Substance Decoction), carefully detailing modifications of sovereign and minister herbs. For Blood depletion and amenorrhea, add Tao Ren (Peach Kernel); Su Mu and Ma Bian Cao (Verbena Herb) can also be added. For obesity-related amenorrhea due to fat accumulation, remove Di Huang (Rehmannia Root) and combine with Er Chen Tang plus Sha Cao Gen (Cyperus Rotundus Rhizome) and Lian Qiao Shi (likely referring to a specific fruit/seed, context implies clearing heat/stasis). For Blood stasis causing lower back and abdominal pain, use Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction) together (Da Huang 4 qian, Gan Cao 2 qian, water 2 zhong, boil to half, add Mang Xiao 3 qian, dissolve and take). Or simply use Xiong Gui (Chuan Xiong and Dang Gui) with Peng Ze (Curcuma Zedoaria) and Rou Gui (Cinnamon Bark); Yue Ju Wan (Six-Stagnation Pill) is precious for Blood stasis. Menstruation arriving late indicates Blood deficiency; add Sheng Ma, Chen Pi, Chai Hu, and Mu Xiang. Menstruation arriving early indicates Blood Heat; Heat causes dark purple color and clots, treating all with Ren Shen, Lian Zi, and Xiang Fu. Scanty menstruation adds Kui Gen (Hibiscus Root) and Hong Hua (Safflower); excessive flow combines with Ren Shen and Bai Zhu. Irregular onset with chills and fever suggests combining with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Painful menstruation indicates Blood excess; use Mu Xiang, Yan Hu Suo, and Peng Ze. In summer heat, add Huang Qin and Chai Hu, along with Tao Ren, Hong Hua, Ma Bian Cao, and Lian Qiao Shi. Pain after menstruation indicates Blood deficiency; combine with Si Jun Zi Tang (Four-Gentlemen Decoction). For dysentery with slight abdominal pain and deep, faint pulse, use Gan Jiang (Dried Ginger) and Rou Gui. For metrorrhagia, there are different formulas: add Jing Jie (Schizonepeta) or Gan Jiang. Another formula adds Sha Cao Gen, Pu Huang (Typha Pollen), Yu Pi (Ulmus Bark), Sheng Ma, Bai Zhu, and Ren Shen, decocted with Ji Hui (Millet Ash) 6-7 fen, using Xu Duan (Dipsacus Root) as sovereign. For calming the fetus, use Sheng Jiang, Ren Shen, Bai Zhu, Huang Qin, Sha Ren, Zi Su, Gan Cao, and Chen Pi. For fetal pain, powder Xiang Fu and take with Zi Su Tang for several doses. Nausea during pregnancy is called E Zu; use stir-fried Zhi Zi (Gardenia Fruit), Huang Lian, assisted by Er Chen Tang. Vaginal bleeding during pregnancy is Tai Lou (Fetal Leakage); use Ejiao (Donkey-hide Gelatin), Chen Pi, Zhi Zi, Huang Bo, Mu Tong, and Gan Cao. Restlessness during pregnancy is Zi Fan (Fetal Agitation); use Ren Shen, Yuan Zhi (Polygala Root), Shen Qu (Medicated Leaven), Zhi Zi, Huang Qin, Bai Zhu, and Gan Cao. For Zi Zhong (Fetal Edema), use Jie Geng, Zi Su, and Hua Shi (Talcum); add Da Fu Pi (Areca Peel), Zhi Ke, and Huang Qin. Distension rising to the chest is Zi Xuan (Fetal Suspension); use Huang Qin, Sha Cao Gen, Sha Ren, Zhi Ke, Chen Pi, and Gan Cao. For Zi Xian (Fetal Eclampsia) with sudden collapse, add Chai Hu, Huang Qin, Zhu Li, Sha Cao Gen, Gan Cao, Bai Zhu, and Chen Pi. For difficult labor, remove Di Huang from the previous formula, add Yi Mu Cao (Motherwort Herb), Bai Zhi, and Jie Geng; take hot with She Gan (Belamcanda Rhizome) 2-3 fen, and burnt Male Hair, Snake Skin, and Cicada Slough. Postpartum requires major Blood tonification; even if there is residual Phlegm, treat it secondarily. Remove Shao Yao (Peony Root) and replace with Huang Qi (Astragalus Root), lest its sour-cold nature damage vital Qi. For Qi deficiency, add Ren Shen, Bai Zhu, Fu Ling, and Gan Cao; for fever, Gan Jiang is essential. For spontaneous sweating, reduce Chuan Xiong; for thirst, add Wu Wei Zi (Schisandra Berry) and Mai Dong (Ophiopogon Tuber). Abdominal pain requires Shao Yao, but wine-fried is safer. For lochia retention with abdominal pain, Xiang Fu and Wu Ling Zhi (Trogopterus Dung) are miraculous; powder them and mix into the decoction, or add Tao Ren 4-5 fen for severe cases. For uterine involution pain, use stir-fried Sour Shao Yao, Gan Cao, and Su Ke (Corn Silk), adding a little rice vinegar to astringe, or simply use Shan Zha with sugar. For lochia retention with chills and fever, add San Leng (Burreed Tuber), Peng Ze, Sha Cao Gen, Ru Xiang (Frankincense), Mo Yao (Myrrh), Wu Ling Zhi, Gan Xi (Drynaria Rhizome), and Tao Ren for quick results. For incessant abdominal pain, add Xiang Fu, Wu Yao (Lindera Root), Chen Pi, Rou Gui, and Liang Jiang (Zingiber Officinale) as assistants; decoct with Tong Bian (Child's Urine) and rice vinegar. For menstrual dripping for over a month, add Sheng Ma and Bai Zhi, and take Xue Yu (Burnt Human Hair) powder. For genital pain, add Fang Ji (Stephania Root). For generalized edema, add Ru Xiang, Mo Yao, Gui Zhi (Cinnamon Twig), Da Fu Pi, Liang Jiang, Bing Lang, Jin Sha (Gold Dust), and Xue Jie (Dragon's Blood). For uterine prolapse, combine with Si Jun Zi Tang, add honey-fried Huang Qi, Fang Feng (Saposhnikovia Root), and Sheng Ma. For facial paralysis resembling stroke, combine with Si Jun Zi Tang, add Jing Jie and Fu Zi, with minor amounts of Qiang Huo (Notopterygium Rhizome) and Fang Feng.
Explanation of Si Wu Tang Dosages: Chuan Xiong (regulates Liver, double dose in Spring, for wiry pulse, for headache); Bai Shao (regulates Spleen, double dose in Summer, for surging pulse, for diarrhea); Di Huang (regulates Lung, double dose in Autumn, for choppy pulse, for fine-deficiency pulse); Dang Gui (regulates Kidney, double dose in Winter, for deep pulse, for cold syndrome).
Si Wu Tang seasonal additions: Spring add Fang Feng (Saposhnikovia Root); Summer add Huang Qin; Autumn add Tian Dong (Asparagus Root); Winter add Gui Zhi (Cinnamon Twig).
Modified Xiao Yao San: Treats Spleen deficiency with fever, tidal fever, spontaneous or night sweats, headache and dry eyes, palpitations and restlessness, red cheeks and dry mouth, irregular menstruation, abdominal pain, heavy sensation in the lower abdomen, painful difficulty in urination, swelling/pain with pus discharge, internal heat with thirst.
Formula: Dang Gui (wine-washed), Bai Shao (wine-washed), Bai Zhu (soil-fried), Chai Hu (wine-fried), Bai Fu Ling (each 1 qian), Gan Cao (roasted, 0.5 qian), Roasted Ginger (1 slice), Bo He (Mint, a little). Decoct and take. Add Gu Pi (Groundcherry Root Bark) and Zhi Mu (Anemarrhena Rhizome) for fever; add Fang Feng, Jing Jie, and Bo He for hand tremors; add Wu Wei Zi and Zi Wan (Aster Root) for cough; add Zhi Shi, Qing Pi (Green Tangerine Peel), and Xiang Fu for anger/chest stuffiness; add Ban Xia, Bei Mu, and Gua Lou Ren (Trichosanthes Seed) for phlegm; add Shan Zha and Shen Qu (Medicated Leaven) for indigestion; add Mai Dong and Tian Hua Fen (Trichosanthes Root) for thirst; add Huang Lian and Zhi Zi for chest heat; add Suan Zao Ren (Ziziphus Seed) and Yuan Zhi for palpitations; add Hei Jiang (Charred Ginger) for chronic diarrhea; add Qiang Huo, Fang Feng, and Chuan Xiong for body pain; add E Jiao, Sheng Di (Rehmannia Root), and Mu Dan Pi (Tree Peony Bark) for hematemesis; add Huang Qi and Suan Zao Ren for spontaneous sweating; add San Leng, E Zhu (Curcuma Longa Rhizome), Tao Ren, and Hong Hua for left-sided abdominal mass; add Mu Xiang and Bing Lang for right-sided abdominal mass; add Long Dan Cao (Gentian Root), Huang Lian, Zhi Zi, and Bai Dou Kou (Cardamom) for Liver injury from anger causing blurred vision; add Tao Ren, Hong Hua, and Su Mu for amenorrhea; add Yan Hu Suo and Xiang Fu Mi for lower abdominal pain.
Chai Hu San: Treats alternating chills and fever in women, fatigue, joint pain, irritability, dry mouth, and loss of appetite.
Formula: Bei Chai Hu, Bai Zhu, Huang Qi, Chi Fu Ling (each 1 liang), Ren Shen, Gu Pi, Zhi Ke (processed), Sheng Di, Jie Geng, Sang Bai Pi (Mulberry Root Bark), Chi Shao (each appropriate amount). Take 1 liang per dose, decoct with fresh ginger.
Xiao Chai Hu Tang: Treats wind-cold in women for 7-8 days with alternating chills and fever, where menstruation has just stopped. This is Heat entering the Blood Chamber, causing Blood coagulation resembling malaria.
Formula: Chai Hu 8 qian, Ren Shen, Gan Cao, Huang Qin, Sheng Di (each 3 qian), Ban Xia, Mai Dong (each 2 qian). Take 8 qian per dose, decoct with ginger and jujube.
Another Formula:
Combine Chai Hu, Ren Shen, Huang Qin, Gan Cao with Shao Yao, Di Huang, Chuan Xiong, Dang Gui. This is Chai Hu Si Wu Tang, treating deficiency consumption with alternating chills and fever.
Wu Jin Wan: Treats thirty-six diseases in women, illnesses arising from excessive worry, infertility, metrorrhagia, leukorrhea, five-palm heat, bitter dry mouth, loss of taste, body ache and emaciation, sallow complexion, sore limbs, irregular menstruation, umbilical and abdominal distension/pain, hair loss, lethargy, ascending evil blood postpartum, stabbing heart/abdominal pain, unstoppable败血 (decayed blood), and all uterine evils.
Formula: Da Ai Ye (Mugwort Leaf), Dang Gui (vinegar-boiled), Hui Xiang (Fennel, fried), Shu Di (vinecar-fried), Nan Mu Xiang (Wood Aromatic, avoid fire), Wu Zhu Yu (Evodia Fruit), San Leng, E Zhu (amount unspecified), Chuan Xiong (vinegar-fried), Shao Yao (vinegar-fried, each 3 liang), Xiang Fu Zi (Cyperus Rhizome, 6 liang), Yan Hu Suo (1 liang), Zi Jing Pi (Cercis Bark, vinegar-fried, 4 liang).
First, soak Ai Ye and Xiang Fu in 5 sheng of vinegar for one day and night (three days in winter), boil until dry, stir-fry until red. Add the remaining twelve herbs, grind to powder, make pills with vinegar paste and Yuan Mi (rice) starch, size of paulownia seeds. Take 70-80 pills on an empty stomach with salted wine broth, twice daily.
For unstoppable metrorrhagia, add Zong Hui (Rice Dumpling Ash, 1 liang), Mian Hui (Cotton Ash, 5 qian), Chao Pu Huang (Fried Typha Pollen, 1 liang), and Bai Cao Shuang (Soot from Chimneys, 7 qian).
Wu Ji Wan: Treats women with emaciation, Blood deficiency with Heat, irregular menstruation, metrorrhagia, leukorrhea, bone-steaming fever, etc.
Formula: White-feathered Black-boned Rooster (approx. 2.5 jin, killed without bleeding, gutted, stuffed with half of Ai Ye and Qing Hao (Artemisia Annua), placed in a wine jar with remaining herbs, covered with water 2 cun above chicken, boiled until completely dry, bones removed, pounded like thin pancakes, dried and powdered); Nan Xiang Fu (de-haired, 1 jin, divided into four parts, soaked in rice wash, child's urine, wine, and vinegar respectively for 2 days in spring/autumn, 1 day in summer, 4 days in winter, then dried); Shu Di and Sheng Di (each 4 liang); Chuan Xiong, Dang Gui, Shao Yao, Ren Shen, Bai Zhu (each 3 liang); Huang Qi, Chuan Niu Xi (Cyathula Root), Huang Lian, Mu Dan Pi (heart removed), Zhi Mu, Bei Mu, Gu Pi (each 2 liang); Chai Hu, Qin Jiao (Gentiana Macrophylla Root) (each 1.5 liang); Gan Jiang, Yan Hu Suo (each 1 liang); Bai Fu Ling (skin removed, 2.5 liang); Bie Jia (Softshell Turtle Shell, vinegar-soaked and roasted yellow, 3 liang).
Twenty-four ingredients, finely powdered, made into pills with vinegar paste, size of wu zi (walnut seed). Take 50 pills, gradually increasing to 80, taken with wine or rice drink. Avoid amaranth and fried/spicy foods.
Amenorrhea:
Women's menstruation stops due to multiple births damaging Blood, abortion, prolonged tidal fever damaging Blood, or mostly due to Spleen-Stomach damage. For low Blood volume, treat slowly. Use Bai Zhu as sovereign, Fu Ling and Shao Yao as ministers, assisted by Huang Qi, Gan Cao, Chen Pi, Mai Ya (Barley Sprout), Chai Hu, Chuan Xiong, and Dang Gui to tonify Spleen and generate Blood, allowing menstruation to resume naturally. For food stagnation, resolve stagnation. If Spleen-Stomach is healthy and no other symptoms exist, and blood clots are confirmed, then promote Blood circulation to unblock menstruation.
Shen Ying Dan: Treats amenorrhea with excess Heat, five-palm heat, dry mouth/throat, irritability, red forehead, chest discomfort, and thick phlegm cough.
Formula: Da Huang 8 liang (boiled dry in 2 bowls of vinegar, then sun-dried), Xue Jie (Dragon's Blood), Tao Ren, Hong Hua (each 5 qian). Make pills with wine paste, size of paulownia seeds, coat with Cinnabar. Take 70 pills per dose.
Another Medical Case: A woman with deficiency consumption fever, night sweats, cough, red face, amenorrhea, and rapid forceful pulse did not respond to tonics. Used Da Huang... [text incomplete] ...pain add Yan Hu Suo, Zhi Ke, Gan Xi (likely Gan Jiang); vomiting/nausea add Liang Jiang, Sha Ren; numbness/chills add Rou Gui; cough add Xing Ren, Wu Wei Zi, Kuan Dong Hua (Coltsfoot Flower).
Liu Hejian said: The Heart governs Blood; Heart disease causes stagnation. First take herbs to descend Heart Fire, then use Wu Bu Wan (Five-Tonifying Pill) from the Bureau Formulary, followed by Wei Sheng Tang (Health Preservation Decoction) to regulate Spleen and nourish...
Wei Sheng Tang: Huang Qi 3 liang, Dang Gui and Bai Shao (each 2 liang), Gan Cao 1 liang. Take 5 qian per dose. For deficiency, add Ren Shen, take warm on an empty stomach.
Another Prescription: Can Sha (Silkworm Frass) 4 liang (stir-fry in clay pot until half-yellow), add 1 hu of non-grain wine, boil, store in porcelain, remove frass, drink warm one cup to promote flow.
Another Formula:
Old ash-straw from large ships, burn red with charcoal, quench in burning wine, take out, dry, powder. Take 3 qian. First with wine, then with Hong Hua wine, then with Da Huang wine. After three doses, redness appears, miraculous.
Another Formula:
Treats Ghost Fetus and Amenorrhea. Use Yuan Hua (Genkwa Flower) 3 liang, stir-fry yellow, powder. Take 1 qian with Tao Ren decoction to expel evil matter, miraculous.
Metrorrhagia and Metrostaxis:
Menstruation had stopped long ago, suddenly heavy bleeding with abdominal pain and fever is called Beng (Collapse/Yin); menstruation flowing for 30 days without stopping is called Lou (Leakage/Yang).
If the pulse is rapid, surging, and swift, it indicates leakage. Collapse involves massive bleeding; how can it be Cold? But after blood loss, the person becomes deficient; must greatly tonify Qi... to counter deficient Yang pulsation.
Metrorrhagia and Metrostaxis:
Danxi argued: Metrorrhagia must distinguish Cold and Heat. Acute stage treat the branch: use Bai Zhi Tang to mix Bai Cao Shuang powder. Severe cases use Chen Zong Hui (Old Palm Ash), followed by Si Wu Tang added with Huang Qin.
For excessive bleeding, first use Wu Ling Zhi (half raw, half fried) powder, taken with wine. Another method: chew raw Sesame Seeds, 6-7 times daily, curing the disease as Wu Ling Zhi can both move and stop bleeding. Purple clots indicate Heat; use Si Wu Tang added with Huang Lian. For metrorrhagia, use Xiang Fu and Bai Zhi pills.
For Qi and Blood deficiency, use Si Wu Tang added with Ren Shen and Huang Qi. Leakage due to Heat and deficiency uses Si Wu Tang added with Huang Lian. For metrorrhagia with leukorrhea, use Pepper... powder, or Bai Zhi (roasted with lime, ash removed, powdered) and a little Qian Cao (Madder Root), made into pills with congee. One formula uses raw Dog Skull Bone (burnt to ash preserving nature), taken with wine or mixed in medicine.
Sheng Ma Si Wu Tang: For metrorrhagia regardless of deficiency/excess, use Si Wu Tang added with Sheng Ma, Fang Feng, and Jing Jie Sui (burnt on lamp). If bleeding continues, add Bai Zhu, Pu Huang, and other hemostatics.
Proven Formula for Metrorrhagia: Dang Gui, Bai Shao, Zong Zong (Palm Fiber), Gan Jiang, all burnt to ash preserving nature, powdered, mixed with vinegar broth. Stir leftwards 49 times with knotted red tendon...
Dang Gui Long Gu Wan: For irregular menstruation, heavy flow, dripping leukorrhea, regardless of duration or red/white nature, and postpartum lochia retention.
Formula: Dang Gui, Huang Lian, Huai Zi (Sophora Fruit), Ai Ye (fried), Fu Ling (each 5 qian), Long Gu (Fossilized Bones), Huang Bo (each 5 qian), Mu Xiang 2 qian. Make pills with drop water, size of mung bean. Take 50 pills before meals with rice broth.
Gu Chang Wan: Chun Gen Bai Pi (Toona Root Bark, fried) powdered, made into pills with wine paste. Treats dampness-induced diarrhea, hematochezia, and leukorrhea, removing chronic accumulations in Spleen-Stomach.
Cang Zhu 3 qian, Bai Zhi 2 qian, Huang Lian (fried) 2 qian, Huang Qin 3 qian, Huang Bo (fried) 1.5 qian, Bai Shao 2.5 qian, Chun Gen Bai Pi (fried) 1.5 qian, Shan Zhu Yu (Cornus Fruit) 2.5 qian. Make pills with paste, take 50 pills on empty stomach with wine.
Prescription: Huang Qin powdered, quench a heated hammer in wine, mix and take 3 qian before meals.
Another Formula:
Sweet Almond skin burnt to ash preserving nature, taken with hot wine on empty stomach, 3 qian.
Another Formula:
Lotus Pod burnt to ash preserving nature, taken with wine, 2 qian.
Another Formula:
Bai Fan (Alum, water-washed) made into pills with flour paste, size of finger, take one pill with yellow wine.
Another Formula:
Tian Ling Gai (Human Scalp/Cranium) burnt to ash, take 2 qian with yellow wine.
Another Formula:
Black Donkey Manure burnt to ash preserving nature, made into pills with flour paste, take 60-70 pills on empty stomach with wine.
Another Formula:
Wu Mei (Dark Plum) burnt to ash, taken with Wu Mei decoction.
Remaining Discussion:
All metrorrhagia is due to meridian disorder. If it lasts 1-2 days, blood stasis forms nests; if abruptly stopped with astringents, it will worsen. Should use Five... [text incomplete].
Leukorrhea:
Red indicates Blood, White indicates Qi. Originally having Damp-Heat, childbirth/labor/fatigue damages Ying and Wei, turbid Qi penetrates Bladder, flowing as foul discharge. Secular formulas often use drying-hot astringents; though occasionally effective, they prolong the disease. One knows Lower Jiao deficiency-cold but ignores Middle Jiao Damp-Heat. Treatment generally requires clearing Upper, solidifying Lower, regulating Spleen, nourishing Blood, purifying Heart, avoiding rich flavors, and leukorrhea will cease. Danxi advocated starting with drying-moistening, using Er Chen Tang added with Cang Zhu and Bai Zhu; severe cases induce vomiting to lift Qi. Obese people mostly have Damp-Phlegm; use Hai Shi (Flint/Pyrite), Ban Xia, Nan Xing (fried), Huang Bo, Cang Zhu, Chuan Xiong, Chun Pi. Thin people have less leukorrhea; if present, it is mostly Heat; use fried Bai, Hua Shi, Chun Pi, Chuan Xiong, Hai Shi (or Ge Fen if no Hai Shi, or Qing Dai if no Chun Pi) made into pills. Excess can be purged, deficiency cannot be harshly attacked. For Blood deficiency, Modified Si Wu Tang; for Qi deficiency, alternate Ren Shen, Bai Zhu, Chen Pi. For Damp dominance, use Gu Chang Wan; for Minister Fire movement, add minor Huang Bo, Hua Shi, Long Gu, Chi Shi Zhi; for stagnation, add Kui Hua (White flower for white discharge, Red flower for red discharge); if dry nature, add Huang Lian; for Phlegm-Qi, add Cang Zhu, Xiang Fu, Hua Shi, Ge Fen, Ban Xia, Fu Ling pills. In cold months, add minor Gan Jiang; adapt flexibly, must avoid rich flavors.
Qing Bai San: Treats leukorrhea.
Si Wu Tang added with Huang Bo, Gan Jiang, Bei Mu, Gan Cao, Chu Gen Bai Pi (Toona Root Bark), Sheng Jiang. Decoct and take. For obese with Damp diseases, add Bai Zhu, Ban Xia. If mixed with red, add Tiao Qin (Jing Jie/Huang Qin mixture, wine-fried), Jing Jie. For chronic discharge, add Shu Di, Mu Li (Oyster Shell). For Qi deficiency, add Ren Shen, Huang Qi. For waist/leg pain, add Lu Jiao Jiao (Deer Antler Glue); Wu Ji Wan is even better.
Hejian argued: If Damp-Heat does not dissipate, first purge with Shi Zao Tang (Ten-Jujube Decoction), then take Ku Lian Wan (Melia Pill), and leukorrhea ceases. Ku Lian (crushed, wine-soaked), Hui Xiang (fried), Dang Gui equal parts powdered, made into pills with wine paste, size of paulownia seeds. Take 30-50 pills on empty stomach with wine. Better if taken with Da Xuan Hu San.
(Shi Zao Tang seen in *Ju Fang*).
Bao Shi Formula: Treats red and white leukorrhea.