良方云∶妇人阴冷,因劳伤子脏,风冷客之也。薛氏曰∶阴冷属肝经有湿热,外乘风
冷所致。若小便涩滞,或小腹痞痛,用龙胆泻肝汤;若内热寒热,或经候不调,用加味逍遥
散;若寒热体倦,饮食少思,用加味四君子汤;若郁怒发热,少寐懒食,用加味归脾汤。一
妇人阴中寒冷,小便黄涩,内热寒热,口苦胁胀,此因肝经湿热,用龙胆汤,祛利湿热,用加
味逍遥散,调补气血而安。一妇人所患同前,更寒热呕吐,两股肿痛,先用小柴胡加山
栀一剂,寒热呕吐顿止,次用龙胆泻肝汤。一剂顿消。一妇人阴中寒冷,小便澄清,腹中
亦冷。饮食少思,大便不实,下元虚冷,治以八味丸,月余,饮食渐加,大便渐实,又月余,诸证悉愈。
薛氏曰∶女人交接,辄出血作痛,此肝火动脾,而不能摄血也。用补中益气汤、济生归
脾汤,若出血过多,而见他证,但用前药调补肝脾。(有一妇患此,每交感后辄面黄如蜡,亦
终身不育)
薛氏曰∶女人交接,伤丈夫头痛,当用补中益气汤、六味地黄丸,以滋化源为主。
补遗局方来复丹,治妇人与男子交接相伤,因而四肢沉重,头痛昏晕,米饮吞下五十丸。
龙胆泻肝汤 治肝经湿热,下部两拗肿 作痛,小便涩滞,阴挺如菌,或出物如虫等证。
龙胆草(酒炒) 泽泻(各一钱) 车前子(炒) 木通 当归(酒拌) 生地黄(酒炒) 山栀子
(炒) 黄芩(炒) 生甘草(各五分)
上锉,水煎服(泻肝而兼导赤,泻其子也,泻肝而用利水,肝主疏泻也,龙胆、山栀,假以
降火,当归、生地,以滋肝阴,生甘草缓肝之急,炒黄芩助肝之气)。玉门肿胀,加木香。
加味四物汤 治阴户肿痛。
当归 川芎 芍药 生地黄 柴胡 山栀子 牡丹皮 龙胆草
上锉,水煎服。
九味柴胡汤 治肝经湿热下注,便毒肿痛,或小腹胁肋结核。凡肝胆经部分一切疮
疡,或风热结核瘰 ,并皆治之。
柴胡 黄芩(炒,各一钱) 人参 山栀(炒) 半夏 龙胆草(炒焦) 当归 芍药(炒) 甘草(各五分)
上锉,水煎服。
加味小柴胡汤 治肝经下部肿胀,小便不利,或寒热往来,或晡热,或胸胁作痛。
柴胡(二钱) 黄芩(炒一钱) 人参 半夏 山栀子 牡丹皮(各七分) 甘草
上锉,加生姜水煎服。
加味逍遥散 治妇人肝脾血虚,湿热流注下部,阴内溃烂痒,发热晡热寒热等证。
当归 芍药 白术(炒) 茯苓 甘草(炙,各一钱) 山栀 牡丹皮 柴胡(各五分)
上锉,水煎服,外以鹤虱草煎汤洗。
菖蒲散 治妇人阴户肿痛,月水涩滞。
菖蒲 当归(各一两,炒) 秦艽(一两) 吴茱萸(制,五钱)
上为末,每服五钱,空心葱汤调下,或水煎服。(阴户属厥阴,肿痛则气壅血聚,故用此
四味以行心肝之气血耳,尤妙在葱汤)
麻黄汤洗方 治妇人阴肿,或疮烂。
麻黄 黄连 蛇床子(各一两) 北艾叶(一两半) 乌梅(十个)
上锉细,以水一斗,煮取五升,去滓热洗,避风冷。(其妙又在麻黄,以麻黄气悍,能开窍
而通气也,艾叶暖其下,以其疮烂,故又佐以连、床、乌梅云)
经心录方 治妇人阴中肿痛不可忍。
艾叶(五两) 防风(三两) 大戟(二两)
上锉细,以水一斗,煮取五升,热洗,日三次,宜避风冷。(阴肿者,肝木之风也,以防风
泻肝木之风邪,以艾叶温厥阴之结气,大戟泻肿消毒,故加之)
白矾散 治妇人阴肿坚痛。(治热肿)
白矾(半两) 甘草(半分,生) 大黄(一分)
上为末,水和丸如枣大,绵裹纳阴中,日两换,以愈为度。
黑白散 治妇人阴中肿痛。
小麦 朴硝 白矾 五倍子 葱白
煎汤频洗。
枳橘熨 治妇人阴肿如石,(如石者,气凝血滞也,厥阴之经环阴器,用此熨之,是行
其气耳)痛不可忍,二便不利。
枳实 陈皮(各四两)
上二味,炒令香热,以绢袋盛之,遍身从上至下,及阴肿处,频频熨之,冷则又换,直至
喉中觉枳实气,则痛止肿消便利矣。
杂方 治妇人阴中肿痛。
用枳实半斤切碎,炒热,布裹包熨之,冷即易,一方用枳壳。一方用铁精粉敷上。
一方以甘菊苗研烂,百沸汤淋洗熏浸。一方用马鞭草捣烂涂之,(铁精平肝热,甘菊清肝
热而散,马鞭草散肝血)
良方记载:妇人阴部寒冷,是由于劳损伤及子宫(子脏),风冷之邪侵袭所致。薛己认为:阴冷属于肝经有湿热,外受风冷所致。如果小便涩滞不畅,或小腹部痞满疼痛,使用龙胆泻肝汤;如果内热伴有寒热往来,或月经不调,使用加味逍遥散;如果寒热、身体疲倦、饮食减少思食,使用加味四君子汤;如果因郁怒发热、睡眠少、懒于进食,使用加味归脾汤。有一位妇人阴中寒冷,小便黄且涩滞,内热伴寒热往来,口苦胁肋胀满,这是因为肝经湿热,用龙胆汤祛利湿热,再用加味逍遥散调补气血而痊愈。另一位妇人所患症状相同,更兼寒热呕吐、两腿肿痛,先用小柴胡汤加山栀子一剂,寒热呕吐立即停止,接着用龙胆泻肝汤,一剂后肿胀顿消。又一位妇人阴中寒冷,小便清亮,腹中也冷,饮食减少思食,大便不成形,这是下元虚冷,治疗用八味丸,一个月后饮食逐渐增加,大便逐渐成形,再过一个月,所有症状全部治愈。
薛己说:女子性交时,总是出血并感到疼痛,这是肝火扰动脾土,导致不能统摄血液。使用补中益气汤、济生归脾汤,如果出血过多而出现其他证候,只需用前面的药物调补肝脾。(有一位妇人患此病,每次交感后脸色蜡黄,也终身未能生育)
薛己说:女子性交,伤及丈夫导致头痛,应当使用补中益气汤、六味地黄丸,以滋生化之源为主。补遗局方中的来复丹,治疗妇人与男子性交相伤,因而四肢沉重、头痛昏晕,用米汤送服五十丸。
《脉经》说:少阴脉滑而数的,阴中生疮。少阴脉弦的,白浊必伴有息肉突出。
龙胆泻肝汤 治疗肝经湿热,下部两腿肿痛作痛,小便涩滞,阴挺如菌状,或排出物如虫等证候。龙胆草(酒炒)一钱,泽泻(各一钱),车前子(炒),木通,当归(酒拌),生地黄(酒炒),山栀子(炒),黄芩(炒),生甘草(各五分)。以上药材切碎,水煎服(此方泻肝兼导赤,是泻其子法;泻肝而用利水药,因为肝主疏泄;龙胆、山栀借以降火,当归、生地滋养肝阴,生甘草缓解肝之急迫,炒黄芩助肝之气机)。玉门肿胀,加木香。
加味四物汤 治疗阴户肿痛。当归,川芎,芍药,生地黄,柴胡,山栀子,牡丹皮,龙胆草。以上药材切碎,水煎服。
九味柴胡汤 治疗肝经湿热下注,便毒肿痛,或小腹胁肋结核。凡是肝胆经部位一切疮疡,或风热结核瘰疬,都加以治疗。柴胡,黄芩(炒,各一钱),人参,山栀子(炒),半夏,龙胆草(炒焦),当归,芍药(炒),甘草(各五分)。以上药材切碎,水煎服。
加味小柴胡汤 治疗肝经下部肿胀,小便不利,或寒热往来,或午后发热,或胸胁作痛。柴胡(二钱),黄芩(炒一钱),人参,半夏,山栀子,牡丹皮(各七分),甘草。以上药材切碎,加生姜水煎服。
加味逍遥散 治疗妇人肝脾血虚,湿热流注下部,阴内溃烂瘙痒,发热、午后发热、寒热等证候。当归,芍药,白术(炒),茯苓,甘草(炙,各一钱),山栀子,牡丹皮,柴胡(各五分)。以上药材切碎,水煎服,外用鹤虱草煎汤清洗。
菖蒲散 治疗妇人阴户肿痛,月经涩滞。菖蒲,当归(各一两,炒),秦艽(一两),吴茱萸(制,五钱)。以上研为末,每次服用五钱,空腹时用葱汤调服,或水煎服。(阴户属厥阴经,肿痛则是气壅血聚,所以用这四味药来行心肝之气血,尤其妙在用葱汤)
麻黄汤洗方 治疗妇人阴肿,或疮烂。麻黄,黄连,蛇床子(各一两),北艾叶(一两半),乌梅(十个)。以上切碎细末,用水一斗,煮取五升,去渣后趁热清洗,避风寒。(其妙处又在麻黄,因为麻黄气悍烈,能开窍通气,艾叶温暖下部,因为疮烂,所以又佐以黄连、蛇床子、乌梅)
经心录方 治疗妇人阴中肿痛不可忍受。艾叶(五两),防风(三两),大戟(二两)。以上切碎细末,用水一斗,煮取五升,趁热清洗,每日三次,宜避风寒。(阴肿是肝木之风邪,用防风泻肝木之风邪,用艾叶温通厥阴之结气,大戟泻肿消毒,所以加入)
白矾散 治疗妇人阴肿坚痛。(治疗热肿)白矾(半两),甘草(半分,生),大黄(一分)。以上研为末,用水和丸如枣大,用绵裹住纳入阴中,每日更换两次,以痊愈为度。
黑白散 治疗妇人阴中肿痛。小麦,朴硝,白矾,五倍子,葱白。煎汤频繁清洗。
枳橘熨 治疗妇人阴肿如石头般坚硬,(如石头,是气凝血滞所致,厥阴经脉环绕阴器,用此熨法,是行其气而已)痛不可忍,大小便不利。枳实,陈皮(各四两)。以上两味药,炒至香热,用绢袋盛装,遍身从上至下,以及阴肿处,频频熨烫,冷了再换,直到喉咙中感觉到枳实气味,则痛止肿消便利矣。
杂方 治疗妇人阴中肿痛。用枳实半斤切碎,炒热,布包裹熨烫,冷了即换,一方用枳壳。一方用铁精粉敷上。一方用甘菊苗研烂,用百沸汤淋洗熏浸。一方用马鞭草捣烂涂之。(铁精平肝热,甘菊清肝热而散,马鞭草散肝血)
Liang Fang records: Women's coldness of the vagina is caused by labor injury to the uterus (Zi Zang) and invasion of wind-cold pathogens. Xue Ji stated that coldness of the vagina belongs to damp-heat in the Liver channel, caused by external wind-cold. If there is difficult or painful urination, or distending pain in the lower abdomen, use Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver). If there is internal heat with alternating chills and fever, or irregular menstruation, use Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder). If there are chills and fever, physical fatigue, and poor appetite, use Jia Wei Sijunzi Tang (Modified Four Gentlemen Decoction). If there is fever due to depression and anger, insomnia, and reluctance to eat, use Jia Wei Guipi Tang (Modified Restore the Spleen Decoction). One woman had coldness in the vagina, yellow and difficult urine, internal heat with alternating chills and fever, bitter taste in the mouth, and distension in the hypochondrium; this was due to damp-heat in the Liver channel. She used Longdan Tang (Gentiana Decoction) to drain and promote the discharge of damp-heat, followed by Jia Wei Xiaoyao San to regulate and tonify Qi and Blood, resulting in recovery. Another woman suffered from the same symptoms, accompanied by alternating chills and fever, vomiting, and swelling and pain in both thighs. First, she took one dose of Xiao Chaihu Tang (Minor Bupleurum Decoction) with Gardenia, which immediately stopped the chills, fever, and vomiting. Then she took Longdan Xiegan Tang, which resolved the swelling after one dose. Another woman had coldness in the vagina, clear urine, coldness in the abdomen, poor appetite, and loose stools; this was deficiency-cold of the Lower Yuan. Treatment used Ba Wei Wan (Eight-Ingredient Pill), and after more than a month, her diet gradually increased and stools became formed. After another month, all symptoms were cured.
Xue Ji said: When women have intercourse, they often experience bleeding and pain; this is Liver Fire disturbing the Spleen, failing to control the blood. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Jisheng Guipi Tang (Jisheng Restore the Spleen Decoction). If excessive bleeding occurs with other syndromes, simply use the aforementioned medicines to tonify the Liver and Spleen. (One woman suffered from this; after every sexual encounter, her face turned yellow like wax, and she remained sterile for life.)
Xue Ji said: When women have intercourse, injuring the husband causing headache, one should use Buzhong Yiqi Tang and Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), focusing on nourishing the source of transformation and generation. Lai Fu Dan (Reviving Pellet) from the Supplementary Bureau Formulas treats injuries from intercourse between women and men, resulting in heavy limbs, headache, and dizziness; take fifty pills with rice water.
Mai Jing (Pulse Classic) states: If the Shaoyin pulse is slippery and rapid, sores will grow in the vagina. If the Shaoyin pulse is wiry, leukorrhea will definitely be accompanied by prolapse of tissue.
Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver) treats damp-heat in the Liver channel, swelling and pain in the lower body/thighs, difficult urination, vaginal prolapse resembling a mushroom, or discharge resembling worms. Radix Gentianae Scabrae (Longdan Cao, stir-fried with wine) 1 qian, Alisma Rhizoma (Zexie, 1 qian), Semen Plantaginis (Cheqian Zi, stir-fried), Akebia Caulis (Mutong), Angelica Sinensis Radix (Danggui, mixed with wine), Rehmanniae Radix (Sheng Dihuang, stir-fried with wine), Fructus Gardeniae (Shanzhizi, stir-fried), Scutellariae Radix (Huangqin, stir-fried), Glycyrrhizae Radix et Rhizoma (Sheng Gancao, 0.5 qian each). Decoct these ingredients in water and take orally. (This formula drains the Liver and also guides out fire via the Small Intestine, draining the "child" organ; it uses diuretics to drain the Liver because the Liver governs free flow; Gentiana and Gardenia are borrowed to descend fire, Angelica and Rehmannia nourish Liver Yin, Raw Licorice relieves Liver urgency, and Stir-fried Scutellaria assists Liver Qi). For swelling of the Yu Men (vaginal opening), add Costus Root (Muxiang).
Jia Wei Siwu Tang (Modified Four Substances Decoction) treats swelling and pain of the vulva. Angelica Sinensis Radix (Danggui), Ligusticum Chuanxiong Rhizome (Chuanxiong), Paeonia Lactiflora Radix (Shaoyao), Rehmanniae Radix (Sheng Dihuang), Bupleuri Radix (Chaihu), Fructus Gardeniae (Shanzhizi), Moutan Cortex (Mudanpi), Radix Gentianae Scabrae (Longdancao). Decoct these ingredients in water and take orally.
Jiuwei Chaihu Tang (Nine-Ingredient Bupleurum Decoction) treats damp-heat pouring downward from the Liver channel, causing swelling and pain in the groin (biandu), or nodules in the lower abdomen and hypochondrium. It treats all sores/ulcers in the Liver and Gallbladder channels, as well as wind-heat nodules and scrofula. Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin, stir-fried, 1 qian each), Ginseng Radix et Rhizoma (Renshen), Fructus Gardeniae (Shanzhizi, stir-fried), Pinelliae Tuber (Banxia), Radix Gentianae Scabrae (Longdancao, stir-fried until scorched), Angelica Sinensis Radix (Danggui), Paeonia Lactiflora Radix (Shaoyao, stir-fried), Glycyrrhizae Radix et Rhizoma (Gancao, 0.5 qian each). Decoct these ingredients in water and take orally.
Jia Wei Xiao Chaihu Tang (Modified Minor Bupleurum Decoction) treats swelling in the lower part of the Liver channel, difficult urination, alternating chills and fever, afternoon fever, or pain in the chest and hypochondrium. Bupleuri Radix (Chaihu, 2 qian), Scutellariae Radix (Huangqin, stir-fried, 1 qian), Ginseng Radix et Rhizoma (Renshen), Pinelliae Tuber (Banxia), Fructus Gardeniae (Shanzhizi), Moutan Cortex (Mudanpi, 0.7 fen each), Glycyrrhizae Radix et Rhizoma (Gancao). Decoct these ingredients with fresh ginger in water and take orally.
Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder) treats Liver and Spleen Blood deficiency in women, with damp-heat flowing downward to the lower part, causing ulceration and itching inside the vagina, fever, afternoon fever, and alternating chills. Angelica Sinensis Radix (Danggui), Paeonia Lactiflora Radix (Shaoyao), Atractylodis Macrocephalae Rhizoma (Baizhu, stir-fried), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao, roasted, 1 qian each), Fructus Gardeniae (Shanzhizi), Moutan Cortex (Mudanpi), Bupleuri Radix (Chaihu, 0.5 fen each). Decoct these ingredients in water and take orally. Externally, wash with decoction of Carpesium Orientalis Herba (Heshi Cao).
Changpu San (Acorus Powder) treats swelling and pain of the vulva and scanty menstrual flow. Acori Tatarinowii Rhizoma (Changpu), Angelica Sinensis Radix (Danggui, 1 liang each, stir-fried), Gentianae Macrophyllae Radix (Qinjiao, 1 liang), Evodiae Fructus (Wuzhuyu, processed, 5 qian). Grind into powder. Take 5 qian per dose, mixed with green onion soup on an empty stomach, or decoct in water and take orally. (The vulva belongs to the Jueyin channel; swelling and pain indicate Qi stagnation and Blood accumulation, so these four herbs move Qi and Blood of the Heart and Liver. The brilliance lies especially in using green onion soup.)
Mahuang Tang Wash Formula treats vaginal swelling or ulceration in women. Ephedrae Herba (Mahuang), Coptidis Rhizoma (Huanglian), Cnidii Fructus (Shechuangzi, 1 liang each), Artemisia Argyi Folium (Bei Aiye, 1.5 liang), Pruni Mume Fructus (Wumei, 10 pieces). Cut finely. Boil in 1 dou of water until 5 sheng remain. Strain and wash with the hot liquid, avoiding wind and cold. (Its efficacy lies especially in Mahuang, whose potent Qi can open orifices and circulate Qi; Aiye warms the lower part; since there is ulceration, Huanglian, Shechuangzi, and Wumei are added as assistants.)
Jingxin Lu Formula treats unbearable swelling and pain in the vagina of women. Artemisia Argyi Folium (Aiye, 5 liang), Saposhnikoviae Radix (Fangfeng, 3 liang), Euphorbiae Pekinensis Radix (Daji, 2 liang). Cut finely. Boil in 1 dou of water until 5 sheng remain. Wash with the hot liquid three times daily, avoiding wind and cold. (Vaginal swelling is Wind of Liver Wood; Fangfeng drains Wind of Liver Wood, Aiye warms and resolves stagnation in Jueyin, and Daji reduces swelling and detoxifies, hence its addition.)
Bai Fan San (White Alum Powder) treats hard and painful vaginal swelling (treating heat-type swelling). Alum (Baifan, 0.5 liang), Raw Glycyrrhizae Radix et Rhizoma (Gancao, raw, 0.5 fen), Rheum Palmatum Radix et Rhizoma (Dahuang, 1 fen). Grind into powder. Mix with water to form pills the size of a jujube. Wrap in cotton, insert into the vagina, change twice daily, until healed.
Hei Bai San (Black and White Powder) treats swelling and pain in the vagina of women. Tritici Semen (Xiaomai), Natrii Sulfas (Puxiao), Alum (Baifan), Gambir (Wubeizi), Allii Fistulosi Bulbus (Congbai). Decoct in water and wash frequently.
Zhiju Yun (Citrus and Immature Bitter Orange Compress) treats vaginal swelling as hard as stone (hardness indicates Qi stagnation and Blood stasis; the Jueyin channel encircles the genitalia; this compress method moves Qi). Unbearable pain, difficulty in urination and defecation. Immature Bitter Orange (Zhishi), Tangerine Peel (Chenpi, 4 liang each). Stir-fry the two ingredients until fragrant and hot. Place in a silk bag. Apply compress from head to toe, and specifically to the swollen area, frequently changing when cool. Continue until the smell of Zhishi is felt in the throat, then pain stops, swelling subsides, and urination/defecation normalize.
Miscellaneous Formulas treat swelling and pain in the vagina of women. Use 0.5 jin of chopped Zhishi, stir-fry until hot, wrap in cloth, and apply compress; change when cool. One formula uses Chenqiao (immature tangerine peel). One formula applies Tiejing Fen (Iron Essence Powder). One formula uses Ganju Miaos (Chrysanthemum indicum seedlings) ground into paste, washed and fumigated with boiling water. One formula uses Peucedani Japonici Radix (Mabiancao) crushed and applied. (Tiejing pacifies Liver Heat, Ganju clears Liver Heat and disperses, Mabiancao disperses Liver Blood.)