准绳云∶五劳六极七伤诸证治,已见杂病虚劳门,兹不赘叙。妇人致此,多因经行胎产,
或饮食起居七情,重伤肝脾之所致,又或失于调摄,或过于攻伐而成,与男子治法,稍有不
同。故汇集古禁方专治妇人者于此,若欲究其源流,更当稽之彼籍。
良方云∶骨蒸劳者,由积热附于骨而然也(此至脉之病也,夫肾主骨,骨至于蒸,真阴竭
矣,阳何以根据)。亦曰传尸、 、伏连、无辜,其名不一,此病皆由脾胃亏损所致。其形
羸瘦,腹胀泄痢,肢体无力。传于肾,则盗汗不止,腰膝冷痛,梦鬼交侵,小便赤黄;传于心,
则心神忪悸,喜怒不时,颊唇赤色,乍热乍寒;传于肺,则胸满短气,咳嗽吐痰,皮肤甲错;传
于肝,则两目昏暗,胁下妨痛,闭户忿怒。五脏既病,则难治疗。
大全云∶妇人血风劳证(肝热生风,故病名血风,曰劳者,病久血虚月候不行,而发热
不止也),因气血素虚,经候不调,或外伤风邪,内挟宿冷,致使阴阳不和,经络痞涩,腹中
坚痛,四肢酸疼,月水或断或来,面色萎黄羸瘦。又有因产后未满百日,不谨将护,脏腑虚
肿,百脉枯竭,遂致劳损(此是肝肾之阴不足,当从至脉主治)。久不瘥则变寒热,休作有时,
饮食减少,肌肤瘦瘁,遇经水当至,即头目昏眩,胸背拘急,四肢疼痛,身体烦热,足重面
浮,或经水不通,故谓之血风劳气也。
薛氏曰∶东垣云∶喜怒不节,起居不时,有所劳伤,皆损其气,气衰则火旺,火旺则乘其
脾土,脾主四肢,故因热懒言,动作喘乏,表热自汗,心烦不安。当病之时,宜安心静坐,存养
其气,以甘寒泻其热气,以酸味收其散气,以甘温补其中气。经言劳者温之,损者温之。要
略云∶平人脉大为劳,以黄 建中汤治之。
一妇人劳则足跟热痛,此足三阴血虚,用圣愈汤而痊。后遍身瘙痒,误服风药,发热抽
搐,肝脉洪数,此肝家血虚,火盛而生风,以天竺黄、胆星为丸,用四物麦冬、五味、芩、连、炙
草、山栀、柴胡煎送而愈。
一妇素清苦,勤于女工,因感风邪(此所谓风劳也,当从损脉治),自用表散之剂,反朝
寒暮热,自汗盗汗,形气虚甚,其脉或浮洪或微细,其面或青白或萎黄,此邪去而气血愈虚
也,用十全大补汤三十余剂,渐愈,又用加味逍遥散,兼治半载而痊。
《医学准绳六要》记载:五劳、六极、七伤等各种证候的治疗,已在杂病虚劳门中详细论述,此处不再重复叙述。妇人导致这些病症,多是因为经期、怀孕、分娩,或者饮食起居、七情(喜、怒、忧、思、悲、恐、惊)过度,严重损伤了肝脾所致;也有的是因为缺乏调养,或者过度使用攻伐药物而形成的。这与男子的治疗方法稍有不同。因此,在此汇集专门治疗妇人的古代禁方,如果想要探究其源流,应当再查阅那些相关的典籍。
《良方》记载:骨蒸劳(一种以骨节间发热如蒸笼为特征的虚劳病),是由于积热附着在骨骼上而产生的(这是属于至脉的病证,肾主骨,骨骼出现蒸热,说明真阴已经枯竭,阳气还有什么可以依附的呢)。这种病也被称为传尸、尸疰、伏连、无辜,名称不一,但这些病都是由脾胃亏损所导致的。患者身体消瘦,腹部胀满,腹泻痢疾,肢体无力。如果病邪传入肾脏,就会盗汗不止,腰膝冷痛,梦中与鬼魅交合侵扰,小便赤黄;如果传入心脏,就会心神不宁悸动,喜怒无常,脸颊嘴唇发红,忽冷忽热;如果传入肺脏,就会胸满气短,咳嗽吐痰,皮肤干枯如鳞甲;如果传入肝脏,就会两眼昏暗,胁下胀痛,关起门来容易发怒。五脏既然都已经患病,就很难治疗了。
《女科大全》记载:妇人血风劳证(肝热生风,所以病名叫做血风;称为劳的,是因为病程长久,血虚导致月经停止,而发热不止),是因为气血本来虚弱,月经不调,或者外受风邪侵袭,内挟宿有的寒邪,致使阴阳不和,经络阻滞涩滞,腹中坚硬疼痛,四肢酸痛,月经有时断绝有时来潮,面色萎黄消瘦。又有因为产后未满一百天,不注意调养护理,导致脏腑虚肿,百脉枯竭,于是造成劳损(这是肝肾之阴不足,应当从至脉主治)。久治不愈就会变成寒热往来,发作有定时,饮食减少,肌肤瘦弱憔悴,遇到月经该来的时候,就头目昏眩,胸背拘急,四肢疼痛,身体烦热,脚重面浮,或者月经不通,所以称之为血风劳气。
薛己(薛氏)说:李东垣(东垣)说:喜怒没有节制,起居没有规律,有所劳伤,都会损伤元气,气衰则火旺,火旺就会乘袭脾土(五行中火克土,此处指心火或相火过盛克制脾土)。脾主四肢,所以因热而懒言,动作时气喘乏力,体表发热自汗,心烦不安。在患病期间,应当安心静坐,涵养元气,用甘寒的药物清泻热气,用酸味的药物收敛耗散之气,用甘温的药物补益中气。《内经》说:劳损的用温法治疗,亏损的用温法治疗。《金匮要略》说:平人脉象大为劳损,用黄芪建中汤治疗。
有一位妇女,劳累后足跟发热疼痛,这是足三阴经血虚,用圣愈汤治愈。后来全身瘙痒,误服祛风药,出现发热抽搐,肝脉洪数,这是肝家血虚,火盛而生风,用天竺黄、胆星做成丸药,配合四物汤加麦冬、五味子、黄芩、黄连、炙甘草、山栀、柴胡煎汤送服而痊愈。
有一位妇女平时生活清苦,勤于女红,因为感受风邪(这就是所说的风劳,应当从损脉治疗),自己服用发散表邪的药物,反而出现早晨怕冷晚上发热,自汗盗汗,形体和元气非常虚弱,脉象有时浮洪有时微细,面色有时青白有时萎黄,这是邪气虽去但气血更加虚弱了,用了三十多剂十全大补汤,逐渐好转,又用加味逍遥散,兼治半年而痊愈。
*Medical Standard Six Essentials* records: The treatment of various syndromes such as Five Exhaustions (Wu Lao), Six Extremities (Liu Ji), and Seven Injuries (Qi Shang) has been discussed in detail in the section on miscellaneous diseases regarding deficiency consumptive disorders, so it will not be repeated here. For women, these conditions are mostly caused by menstruation, pregnancy, childbirth, or excessive dietary habits, daily routine, and Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright), which severely damage the Liver and Spleen. It may also result from lack of proper care or overuse of purgative/attacking treatments. This differs slightly from the treatment methods for men. Therefore, ancient secret formulas specifically for treating women are collected here. If one wishes to investigate their origins, they should consult those relevant texts.
*Good Prescriptions* records: Bone-steaming consumption (Gu Zheng Lao, a type of consumptive disorder characterized by heat steaming from the bones) arises from accumulated heat attaching to the bones (this belongs to the category of Zhi Mai pathologies; the Kidney governs the bones, and if the bones exhibit steaming heat, it indicates that True Yin is exhausted, leaving Yang with no foundation). This disease is also known as Chuan Shi (Transmitting Corpse), Shi Zhu (Corpse Puncture), Fu Lian (Hidden Connection), and Wu Gu (Innocent), with various names. All these diseases are caused by the deficiency and damage of the Spleen and Stomach. The patient appears emaciated, with abdominal distension, diarrhea, dysentery, and limb weakness. If the pathology transmits to the Kidney, there will be incessant night sweats, cold pain in the lower back and knees, dreams of sexual intercourse with spirits, and dark yellow urine. If it transmits to the Heart, there will be palpitations and mental restlessness, inappropriate laughter or anger, red cheeks and lips, and alternating hot and cold sensations. If it transmits to the Lung, there will be chest fullness, shortness of breath, coughing with phlegm, and skin resembling fish scales (Jia Cuo). If it transmits to the Liver, there will be dim vision, painful obstruction under the ribs, and irritability when behind closed doors. Once the Five Zang Organs are diseased, it becomes difficult to treat.
*Complete Gynecology* records: Women's Blood-Wind Consumption Syndrome (Liver Heat generates Wind, hence named Blood-Wind; termed "Consumption" because prolonged illness leads to Blood deficiency, cessation of menstruation, and persistent fever). This occurs due to inherent Qi and Blood deficiency, irregular menstruation, external invasion of Wind pathogens, and internal retention of old Cold, causing disharmony of Yin and Yang and stagnation/blockage of the meridians. Symptoms include hard and painful abdomen, soreness and pain in the four limbs, intermittent menstruation, sallow and emaciated complexion. Additionally, if postpartum care is neglected within 100 days, leading to visceral edema and exhaustion of all vessels, consumption results (This indicates insufficiency of Liver and Kidney Yin, and should be treated according to Zhi Mai principles). If not cured for a long time, it transforms into alternating chills and fever with regular intervals, reduced appetite, emaciated skin and flesh. When menstruation is due, dizziness and blurred vision occur, rigidity in the chest and back, pain in the four limbs, body irritability and heat, heavy legs, and facial edema, or amenorrhea. Hence it is called Blood-Wind Qi Consumption.
Xue Ji (Xue Shi) states: Li Dongyuan (Dong Yuan) said: Unregulated emotions, irregular daily routines, and any form of overexertion damage Qi. When Qi declines, Fire flares up; when Fire flares, it attacks the Spleen Earth (Fire overacting on Earth). Since the Spleen governs the four limbs, symptoms include reluctance to speak due to heat, panting and fatigue upon movement, surface heat with spontaneous sweating, and mental restlessness. During the illness, one should sit quietly, nourish and preserve Qi, use Sweet-Cold herbs to drain Heat, Sour herbs to consolidate scattered Qi, and Sweet-Warm herbs to tonify Middle Qi. The *Classic of Internal Medicine* states: "Tonify deficiency with warmth." The *Synopsis of Golden Chamber* states: "A large pulse in a healthy person indicates consumption; treat with Huangqi Jianzhong Tang."
A woman experienced heat and pain in her heels after exertion, indicating Blood deficiency of the Three Yin Meridians of the Foot. She was cured using Shengyu Tang. Later, she suffered from generalized pruritus. After mistakenly taking Wind-dispelling drugs, she developed fever and convulsions. Her Liver pulse was surging and rapid, indicating Liver Blood deficiency with excess Fire generating Wind. She was cured by administering pills made of Tianzhu Huang (Bambusa Textilis Tuber) and Dan Xing (Arisaema Cum Bile), taken with a decoction of Siwu Tang plus Maidong, Wuweizi, Huangqin, Huanglian, Zhigancao, Shanzhi, and Chaihu.
Another woman, living ascetically and diligent in needlework, contracted Wind pathogens (this is referred to as Wind-Consumption, to be treated according to Sun Mai principles). She self-administered diaphoretic agents, resulting in morning chills and evening fevers, spontaneous and night sweats, severe deficiency of form and Qi. Her pulse was sometimes floating and surging, sometimes faint and fine; her complexion was sometimes bluish-white, sometimes sallow. This indicated that although the pathogen had departed, Qi and Blood were further depleted. She took more than thirty doses of Shiquan Dabu Tang and gradually improved. Subsequently, she used Jiawei Xiaoyao San and was cured after half a year of combined treatment.