准绳云∶带下久而枯涸者濡之。凡大补气血，皆所以濡之。（血生于气，故有可兼四君者。）如以四物汤为末，
炼蜜
丸，梧子大，空心米饮下三四十丸，以疗年高妇人白带，良验，皆润剂也。
薛氏曰∶徐用诚先生云∶带下白属气而赤属血。东垣先生云∶血崩久则亡阳，故白滑之
物下流，未必全拘于带脉，亦有湿痰流注下焦，或肾肝阴淫之湿胜，或因惊恐而木乘土位，
浊液下流，或思慕为筋痿。戴人以六脉滑大有力，用宣导之法，此泻其实也；东垣以脉微细
沉紧，或洪大而虚，用补阳调经，乃兼责其虚也；丹溪用海石南星椿根皮之类，乃治其湿痰也（三说各主一见，
凡延医此症，当须辩别，前论五色分属五脏，而无治法，此以五脏之中，分治法，分虚实，尤见的据）
。窃谓前证皆当壮脾胃，升阳气为主，佐以各经见证之药（下数方为此翁家法）。色青者属肝，用小柴胡加山栀
、防风；湿热壅滞，小便赤涩，用龙胆泻肝汤；肝血不足，或燥热风热，用六味丸。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，用归脾汤。色黑者属肾，用六味丸；
气血俱虚，八珍汤；阳气下陷，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，四七汤送六味丸。不可拘肥人多痰，瘦人多火，而以燥湿泻火之药，轻治之也。
（肥痰瘦火之说，为丹溪先生认病总诀，何尝教人泥定一方也。虽不可轻治，而火湿二字，终莫能逃，若以此稳当之言，
不可轻则洁古之十枣，子和之汗吐下，太无之神佑、玉烛与小胃丹之类，可轻用之欤？予不敢为丹溪佞，为欲止今之佞
口耳）
一孀妇腹胀胁痛，内热晡热，月经不调，肢体酸麻，不时吐痰。或用清气化痰，喉间不
利，带下青黄，腹胁膨胀；又用行气之剂，胸膈不利，肢体如麻。此乃郁怒伤损肝脾，朝用
归脾汤，以解脾郁生脾气，夕用加味逍遥散，以生肝血清肝火，百余剂而愈。
一妇人久疟兼带，发热口干体倦，用七味白术散加麦门五味，大剂煎与恣饮。再发稍可
，乃用补中益气加茯苓、半夏，十余剂而愈。
一妇人头晕吐痰，胸满气喘，得食稍缓，苦于白带，二十余年矣，诸药不应。此气虚而
痰饮也，痰饮愈而带自愈，遂朝用六君子汤，夕用六味地黄丸，不月而愈。（立斋得力处，在认症确，未到处，在不言
脉，惟以二十余年之痰症，故可用六君以补脾治湿，用六味以治水泛为痰，皆治本而纳气归原者也，但朝夕反用，又
其独见也）
一妇人耳鸣胸痞，内热口干，喉中若有一核，吞吐不利，月经不调，兼之带下。予以为
肝脾郁结，用归脾汤加半夏、山栀、升麻、柴胡，间以四七汤下白丸子而愈。
一妇人吞酸饱满，食少便泄，月经不调，服清气化痰丸，两膝渐肿，寒热往来，带下黄
白，面萎体倦。此脾胃俱虚，湿痰下注。用补中益气，倍用参术加茯苓、半夏、炮姜而愈。
一妇人带下，四肢无力。予曰∶四肢者土也，此脾胃虚弱，湿痰下注。以补中益气、《
济生》归脾二药，治之而愈。
一妇人带下黄白，怒则胸膈不利，饮食少思，或用消导利气之药，痰喘胸满，大便下血
。予曰，此因脾气亏损，不能摄血归源。用补中益气加茯苓、半夏、炮姜，四剂顿减，又用
八珍加柴胡、山栀而痊。（以上七案，内五症皆治湿痰，而兼升补者，以立斋名盛，当时非久病，必不延之，故每以升
补为效。学立斋者，须得此解，不然徒读甫书矣）
《医学准绳》说：带下病日久导致阴液枯竭的，应当用滋润的方法治疗。凡是大力补益气血的药物，都是用来滋润身体的。（因为血由气所生，所以有时可以兼用四君子汤。）例如将四物汤制成粉末，用炼蜜做成梧桐子大小的药丸，空腹时用米汤送服三四十丸，用来治疗年老妇人的白带，效果很好，这些都属于润剂。
薛己（薛氏）说：徐用诚先生曾说：白带属于气分病变，赤带属于血分病变。李东垣先生曾说：血崩日久会导致亡阳，因此白滑的物质向下流出，未必完全局限于带脉的问题，也有可能是湿痰流注到下焦，或者是肾、肝阴寒湿气过胜；也有可能是因为惊恐导致肝木克制脾土，浊液向下流动；或者是因思慕过度导致筋痿。张子和（戴人）根据六脉滑大有力，使用宣导的方法，这是泻其实邪；李东垣根据脉象微细沉紧，或洪大而虚，使用补阳调经的方法，这是兼顾其虚证；朱丹溪使用海浮石、南星、椿根皮之类的药物，这是治疗湿痰。（这三种说法各自侧重一种情况，凡延请医生诊治此症，必须辨别清楚。前面的论述将五色分别归属于五脏，但没有治疗方法；这里在五脏之中区分了治疗方法，区分虚实，尤其有确切的依据。）我私下认为上述病症都应当以壮脾胃、升阳气为主，辅以各经络见证的药物。（下面几个方子是这位先生的家传法则。）颜色发青的属于肝，用小柴胡汤加山栀、防风；湿热壅滞，小便红涩，用龙胆泻肝汤；肝血不足，或燥热风热，用六味丸。颜色发红的属于心，用小柴胡汤加黄连、山栀、当归；思虑过度损伤，用妙香散等药。颜色发白的属于肺，用补中益气汤加山栀。颜色发黄的属于脾，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，用六味丸；气血俱虚，用八珍汤；阳气下陷，用补中益气汤；湿痰下注，在前汤基础上加茯苓、半夏、苍术、黄柏；气虚痰饮下注，用四七汤送服六味丸。不可拘泥于“肥人多痰，瘦人多火”的说法，而用燥湿泻火的药物轻率地治疗。（“肥痰瘦火”的说法，是丹溪先生认识疾病的总诀，何曾教人死守一方呢？虽然不能轻率治疗，但“火”和“湿”二字，终究无法逃脱。如果用这种稳妥的话来说，不可以轻率，那么洁古的十枣汤、子和的汗吐下法、太无的神佑丸、玉烛丹和小胃丹之类，就可以轻率使用了么？我不敢做丹溪的佞臣，只是为了制止当今那些盲目崇拜的人罢了。）
有一位寡妇腹胀胁痛，内热及傍晚发热，月经不调，肢体酸麻，不时吐痰。有人用清气化痰丸，导致喉间不利，带下青黄，腹胁膨胀；又用行气的药剂，导致胸膈不利，肢体麻木。这是郁怒损伤肝脾，早晨服用归脾汤，以解除脾郁、生发脾气，晚上服用加味逍遥散，以生肝血、清肝火，服用百余剂后痊愈。
有一位妇人久患疟疾兼带下病，发热口干体倦，用七味白术散加麦门冬、五味子，大剂量煎煮让她尽情饮用。再次发作时症状稍好，于是用补中益气汤加茯苓、半夏，十余剂后痊愈。
有一位妇人头晕吐痰，胸满气喘，进食后稍缓解，苦于白带已有二十多年，各种药物无效。这是气虚而痰饮所致，痰饮治愈则带下自愈，于是早晨服用六君子汤，晚上服用六味地黄丸，不到一个月就痊愈了。（立斋得力之处，在于辨证准确，不足之处在于不言脉象，只是凭借二十多年的痰症，所以可以用六君汤补脾治湿，用六味丸治水泛为痰，都是治本并纳气归原的方法，但早晚用药相反，又是他的独到见解。）
有一位妇人耳鸣胸痞，内热口干，喉中好像有一个核，吞吐不利，月经不调，兼之带下。我认为这是肝脾郁结，用归脾汤加半夏、山栀、升麻、柴胡，间或用四七汤送服白丸子而痊愈。
有一位妇人吞酸饱胀，食少便泄，月经不调，服用清气化痰丸后，两膝逐渐肿胀，寒热往来，带下黄白，面色萎黄身体疲倦。这是脾胃俱虚，湿痰下注。用补中益气汤，重用参、术，加茯苓、半夏、炮姜而痊愈。
有一位妇人带下，四肢无力。我说：四肢属土，这是脾胃虚弱，湿痰下注。用补中益气汤、《济生》归脾汤两种药治疗而痊愈。
有一位妇人带下黄白，发怒则胸膈不利，饮食少思，有人用消导利气的药物，导致痰喘胸满，大便下血。我说，这是因为脾气亏损，不能摄血归源。用补中益气汤加茯苓、半夏、炮姜，四剂后症状顿减，又用八珍汤加柴胡、山栀而痊愈。（以上七个医案中，五个病症都是治疗湿痰，兼用升补之法，因为立斋名声盛大，当时如果不是久病，必定不会延请他，所以他每用升补法见效。学习立斋的人，必须懂得这个道理，否则只是徒然读书罢了。）
According to *Zhunsheng* (Standard Guidelines): For leukorrhea that has persisted for a long time leading to dryness and depletion, moistening methods should be used. All substantial tonification of Qi and Blood serves to moisten the body. (Since Blood is generated by Qi, Si Jun Zi Tang [Four Gentlemen Decoction] may sometimes be combined.) For example, powdering Si Wu Tang [Four Substances Decoction], refining honey to make pills the size of a Chinese quince seed (*Wu Zi*), and taking 30-40 pills on an empty stomach with rice water effectively treats leukorrhea in elderly women; these are all moistening agents.
Xue Ji stated: Mr. Xu Yongcheng said: White leukorrhea belongs to Qi disorders, while red leukorrhea belongs to Blood disorders. Li Dongyuan stated: Prolonged metrorrhagia leads to Yang collapse; thus, the discharge of white, slippery substances downward does not necessarily strictly adhere to the Dai Mai (Girdle Vessel) pathology. It may also be due to Damp-Phlegm flowing into the Lower Jiao, or excessive Yin-Damp from Kidney and Liver deficiency. It can also result from fright causing Wood to overact on Earth, leading to turbid fluids flowing downward, or from excessive yearning causing Sinew Withering. Zhang Zhenren (Dai Ren), observing slippery, large, and forceful pulses in all six positions, used cathartic and guiding methods to drain excess; Li Dongyuan, observing fine, deep, tight, or large yet empty pulses, used warming Yang and regulating menstruation methods to address deficiency; Zhu Danxi used drugs such as Hai Shi [Fossilia Silex] (Sea Stone), Nan Xing [Arisaematis Rhizoma cum Bile] (Pinellia with Phlegm), and Chun Gen Pi [Toosendan Cortex] (Skimmia Bark) to treat Damp-Phlegm. (These three theories each focus on one aspect. When consulting a physician for this condition, differentiation is essential. The previous discussion attributed five colors to the Five Zang organs but lacked treatment methods; here, within the Five Zang, treatment methods are differentiated according to excess and deficiency, providing particularly solid evidence.) I privately believe that the aforementioned conditions should primarily be treated by strengthening the Spleen and Stomach and ascending Yang Qi, supplemented by herbs corresponding to the manifestations of each meridian. (The following formulas represent this gentleman's family method.) Green-colored discharge belongs to the Liver; use Xiao Chai Hu Tang [Minor Bupleurum Decoction] with Shan Zhi [Gardeniae Fructus] (Gardenia Fruit) and Fang Feng [Saposhnikoviae Radix] (Ledebouriella Root). If Damp-Heat stagnation causes red, scanty urination, use Long Dan Xie Gan Tang [Gentian Liver-Draining Decoction]. If Liver Blood is insufficient, or due to Dryness-Wind or Wind-Heat, use Liu Wei Wan [Six-Ingredient Pill with Rehmannia]. Red-colored discharge belongs to the Heart; use Xiao Chai Hu Tang with Huang Lian [Coptidis Rhizoma] (Coptis Rhizome), Shan Zhi, and Dang Gui [Angelicae Sinensis Radix] (Chinese Angelica Root). If excessive worry causes injury, use Miao Xiang San [Miraculous Incense Powder] and other medicines. White-colored discharge belongs to the Lung; use Bu Zhong Yi Qi Tang [Tonify the Middle and Augment the Qi Decoction] with Shan Zhi. Yellow-colored discharge belongs to the Spleen; use Liu Jun Zi Tang [Six-Gentleman Decoction] with Shan Zhi and Chai Hu [Bupleuri Radix] (Bupleurum Root); if ineffective, use Gui Pi Tang [Restore the Spleen Decoction]. Black-colored discharge belongs to the Kidney; use Liu Wei Wan. If both Qi and Blood are deficient, use Ba Zhen Tang [Eight-Treasure Decoction]. If Yang Qi sinks, use Bu Zhong Yi Qi Tang. If Damp-Phlegm flows downward, add Fu Ling [Poria] (Poria Cocos), Ban Xia [Pinelliae Rhizoma] (Pinellia Tuber), Cang Zhu [Atractylodis Rhizoma] (Atractylodes Rhizome), and Huang Bai [Phellodendri Cortex] (Amur Cork Tree Bark) to the previous decoction. If Qi deficiency with Phlegm-Fluid flows downward, use Si Qi Tang [Four Words Decoction] to deliver Liu Wei Wan. One must not rigidly adhere to the saying "fat people have much Phlegm, thin people have much Fire," and lightly treat them with drying-dampness and draining-fire medications. (The theory of "Fat-Phlegm and Thin-Fire" is Mr. Danxi's general key to disease recognition; did he ever teach people to stick rigidly to one formula? Although one should not treat lightly, the characters "Fire" and "Damp" cannot ultimately be escaped. If using this steady advice to say "do not treat lightly," then could Jiegu's Shi Zao Tang [Ten Jujube Decoction], Hezi's sweating/vomiting/purgative methods, Taiwu's Shen You Wan [Divine Aid Pill], Yu Zhu Dan [Jade Candle Pill], and Xiao Wei Dan [Small Stomach Pill] be used lightly? I dare not flatter Danxi; I only wish to stop the flatterers of today.)
A widow suffered from abdominal distension and hypochondriac pain, internal heat, afternoon fever, irregular menstruation, soreness and numbness of the limbs, and frequent expectoration of phlegm. Someone used Qing Qi Hua Tan Wan [Clear Qi Transform Phlegm Pill], resulting in throat discomfort, green-yellow leukorrhea, and abdominal/hypochondriac bloating; then someone used Qi-moving agents, resulting in chest/epigastric discomfort and limb numbness. This was Liver-Spleen damage due to depressed anger. In the morning, Gui Pi Tang was administered to resolve Spleen depression and generate Spleen Qi; in the evening, Jia Wei Xiao Yao San [Modified Free and Easy Wanderer Powder] was administered to generate Liver Blood and clear Liver Fire. After more than 100 doses, she recovered.
A woman suffering from chronic malaria complicated by leukorrhea presented with fever, dry mouth, and fatigue. Seven Wei Bai Zhu San [Seven-Ingredient Atractylodes Macrocephala Decoction] with Mai Men Dong [Ophiopogonis Radix] (Ophiopogon Root) and Wu Wei Zi [Schisandrae Fructus] (Schisandra Berry) was decocted in large quantities for her to drink freely. Upon recurrence, symptoms improved slightly, so Bu Zhong Yi Qi Tang with Fu Ling and Ban Xia was used, curing her after more than ten doses.
A woman suffered from dizziness, expectoration of phlegm, chest fullness, and shortness of breath, which relieved slightly after eating. She had suffered from leukorrhea for over twenty years without response to various medicines. This was Qi deficiency with Phlegm-Fluid. Once the Phlegm-Fluid was cured, the leukorrhea healed spontaneously. Thus, Liu Jun Zi Tang was taken in the morning, and Liu Wei Di Huang Wan [Six-Ingredient Pill with Rehmannia] in the evening, curing her in less than a month. (Lizhai's strength lay in accurate syndrome differentiation; his weakness was omitting pulse diagnosis. Relying solely on the twenty-year history of Phlegm syndrome, Liu Jun Zi Tang was used to tonify the Spleen and treat Dampness, and Liu Wei Wan to treat Water Overflowing as Phlegm; both treat the root and return Qi to its origin. However, reversing the timing of administration was his unique insight.)
A woman suffered from tinnitus, chest oppression, internal heat, dry mouth, a sensation of a lump in the throat with difficulty swallowing or spitting, irregular menstruation, and leukorrhea. I diagnosed it as Liver-Spleen depression and constriction. Gui Pi Tang with Ban Xia, Shan Zhi, Sheng Ma [Cimicifugae Rhizoma] (Black Cohosh Rhizome), and Chai Hu was used, interspersed with Si Qi Tang delivering Bai Wan Zi [White Pills] until she recovered.
A woman suffered from acid regurgitation, fullness, poor appetite, loose stools, and irregular menstruation. After taking Qing Qi Hua Tan Wan, her knees gradually swelled, she experienced alternating chills and fever, yellow-white leukorrhea, sallow complexion, and fatigue. This was dual deficiency of the Spleen and Stomach with Damp-Phlegm flowing downward. Bu Zhong Yi Qi Tang with increased amounts of Ren Shen [Ginseng Radix] (Ginseng Root) and Bai Zhu [Atractylodis Macrocephalae Rhizoma] (Atractylodes Macrocephala Rhizome), plus Fu Ling, Ban Xia, and Pao Jiang [Zingiberis Rhizoma Preparatum] (Prepared Ginger) cured her.
A woman with leukorrhea presented with weak limbs. I said: The limbs belong to Earth; this is Spleen-Stomach deficiency with Damp-Phlegm flowing downward. Treatment with Bu Zhong Yi Qi Tang and *Jisheng* Gui Pi Tang [Restore the Spleen Decoction from *Prescriptions for Women*] cured her.
A woman with yellow-white leukorrhea experienced chest/epigastric discomfort upon anger, poor appetite, and was given digestion-promoting and Qi-moving drugs, resulting in phlegm-wheezing, chest fullness, and hematochezia. I said this was due to Spleen Qi damage failing to control blood and return it to its source. Bu Zhong Yi Qi Tang with Fu Ling, Ban Xia, and Pao Jiang reduced symptoms drastically after four doses; subsequently, Ba Zhen Tang with Chai Hu and Shan Zhi cured her. (Among the above seven cases, five involved treating Damp-Phlegm with ascending and tonifying methods. Because Lizhai was famous, patients with chronic illnesses would consult him, so ascending and tonifying often proved effective. Those studying Lizhai must understand this; otherwise, reading his books is futile.)