良方论曰∶妇人横 ,一名便痈,一名便毒,俗名喑子,或肝经湿热下注,或郁怒伤损
脾肝。其外证,或两拗小腹肿痛;或玉门 肿作痛;(肝经之脉环阴器,故见证如是,而治法
亦如是也)或寒热往来,憎寒壮热。其内证,或小便涩滞;或腹内急痛;或小腹痞闷;或上攻
两胁;或晡热重坠。若两拗小腹肿痛,肝经湿热壅滞也,用龙胆泻肝汤;玉门肿胀,肝火血
虚也,用加味逍遥散,及龙胆泻肝汤加木香。若概投散血攻毒之剂,误甚矣!又曰∶妇人
阴肿,因胞络素虚,风邪客之,乘于阴部,血气相搏故也。薛氏曰∶妇人阴肿,若气血虚弱,用
补中益气汤,举而补之;肝经湿热,用龙胆泻肝汤,渗而清之。李氏曰∶阴户两旁肿痛,手
足不能舒伸者,用四物汤,入乳香末同捣成饼,安阴中立效。阴肿痛极,便秘欲死者,枳
橘熨;但肿痛者,四物汤加柴胡、山栀、牡丹皮、龙胆草;如时常阴肿者,四物汤加 本、防
风。阴户肿痛不闭者,逍遥散、十全大补汤;肿消不闭者,补中益气汤;肿痛者,加山栀、牡
丹皮(以不闭属虚,故宜补,以肿痛属实,故宜凉)。湿痒出水又痛者,忧思过也,归脾汤加柴
胡、山栀、牡丹皮、芍药、生甘草。溃烂者,逍遥散。阴户肿痛不闭,寒热溺涩,体倦少食
者,补中益气汤加升麻、柴胡至一钱量,入茯苓、山栀。阴户不闭,小便淋沥,腹中一物攻
动胀痛者,逍遥散加柴胡、山栀、车前子。
良方论述说:妇人横痃,又名便痈,又名便毒,俗称喑子。其病因或是肝经湿热下注,或是因郁怒损伤脾肝。其外在证候,或表现为两侧小腹肿痛;或玉门肿胀作痛;(因为肝经的经脉环绕阴器,所以出现上述症状,治疗法则也是如此)或寒热往来,憎寒壮热。其内在证候,或小便涩滞不畅;或腹内急痛;或小腹痞闷胀满;或病气上攻两胁;或午后发热且伴有重坠感。如果两侧小腹肿痛,属于肝经湿热壅滞,使用龙胆泻肝汤;玉门肿胀,属于肝火兼血虚,使用加味逍遥散,以及龙胆泻肝汤加木香。如果一概投用散血攻毒的药物,那就大错特错了!又说:妇人阴肿,是因为胞络素来虚弱,风邪客居其中,侵袭阴部,导致血气相互搏结所致。薛氏说:妇人阴肿,若气血虚弱,使用补中益气汤,以升举并补益之;若属肝经湿热,使用龙胆泻肝汤,以渗利并清泄之。李氏说:阴户两旁肿痛,手足不能舒展伸直的,使用四物汤,加入乳香末共同捣成饼状,敷于阴户处立见疗效。阴部肿痛剧烈,便秘欲死的,用枳橘熨法;仅肿痛者,用四物汤加柴胡、山栀、牡丹皮、龙胆草;如时常阴肿者,用四物汤加本(此处指藁本或类似祛风药,原文缺字,依语境推测为祛风药,但按规则保留原名或根据常见搭配,此处原文似漏字“本”,通常指藁本或独活等,鉴于规则要求保持原名,若原文确为“本”则译“本”,若为漏字需指出,此处原文显示为空格后接“本”,推测为“藁本”或单字“本”,依原文直译)、防风。阴户肿痛且不闭合的,用逍遥散、十全大补汤;肿胀消退但不闭合的,用补中益气汤;肿痛者,加山栀、牡丹皮(因为不闭合属于虚证,所以适宜补益,因为肿痛属于实证,所以适宜凉泄)。湿痒出水又疼痛的,是忧思过度所致,用归脾汤加柴胡、山栀、牡丹皮、芍药、生甘草。溃烂的,用逍遥散。阴户肿痛且不闭合,伴有寒热、小便涩滞、身体疲倦、食欲减少的,用补中益气汤加升麻、柴胡至一钱剂量,加入茯苓、山栀。阴户不闭合,小便淋沥不尽,腹中有物攻动胀痛者,用逍遥散加柴胡、山栀、车前子。
The *Liangfang* (Excellent Prescriptions) states: In women, Hengxuan (transverse abscess), also known as Bianyong (genital abscess) or Biandu (venereal tumor), and commonly referred to as Yinzi (silent child/tumor), is caused either by Damp-Heat pouring downward from the Liver Meridian, or by emotional frustration damaging the Spleen and Liver. Its external manifestations include swelling and pain in both lower abdominal regions; or swelling and pain at the Yumen (Gate of Jade, referring to the vaginal opening); (since the Liver Meridian encircles the genitalia, these symptoms arise, and thus the treatment principles are similar); or alternating chills and fever, with aversion to cold and high fever. Its internal manifestations include astringent and obstructed urination; or acute pain within the abdomen; or fullness and oppression in the lower abdomen; or pathogenic qi attacking upward to both hypochondriac regions; or afternoon fever accompanied by a heavy, bearing-down sensation. If there is swelling and pain in both lower abdominal regions, it indicates stagnation of Damp-Heat in the Liver Meridian; use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver). If there is swelling at the Yumen, it indicates Liver Fire with Blood Deficiency; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), or Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) with Muxiang (Aucklandiae Radix). To indiscriminately administer blood-dispersing and toxin-attacking agents would be a grave error! It is further stated: Female Yinzhong (vulvar swelling) occurs because the Baoluo (uterine collaterals) have been inherently deficient, allowing Wind Pathogen to lodge and invade the yin region, causing Qi and Blood to contend. Master Xue states: For female Yinzhong, if Qi and Blood are deficient, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to lift and tonify; if due to Liver Meridian Damp-Heat, use Longdan Xiegan Tang (Gentian Decoction to Drain the Liver) to drain and clear. Master Li states: For swelling and pain on both sides of the Yinhu (yin aperture) where the limbs cannot extend, use Siwu Tang (Four Substances Decoction) mixed with Rushan (Olibanum/Frankincense) powder, pounded into a cake, and applied to the yin area for immediate effect. For extreme Yin swelling and pain with constipation bordering on death, use Zhiju Yun (Moxibustion/Warm Compress with Zhi Shi and Ju Hong); for mere swelling and pain, use Siwu Tang (Four Substances Decoction) with Chaihu (Bupleuri Radix), Shanzhi (Gardeniae Fructus), Mudanpi (Moutan Cortex), and Longdancao (Gentianae Radix); for recurrent Yin swelling, use Siwu Tang (Four Substances Decoction) with Ben (Ligustici Rhizoma et Radix/Gao Ben) and Fangfeng (Saposhnikoviae Radix). For Yinhu swelling and pain without closure, use Xiaoyao San (Free and Easy Wanderer Powder) and Shiquan Dabu Tang (Ten Complete Tonifying Decoction); for swelling subsided but closure not restored, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); for swelling and pain, add Shanzhi (Gardeniae Fructus) and Mudanpi (Moutan Cortex) (because non-closure belongs to Deficiency, hence tonification is appropriate; because swelling and pain belong to Excess, hence cooling is appropriate). For dampness, itching, oozing fluid, and pain caused by excessive worry and overthinking, use Guipi Tang (Restore the Spleen Decoction) with Chaihu (Bupleuri Radix), Shanzhi (Gardeniae Fructus), Mudanpi (Moutan Cortex), Shaoyao (Paeoniae Radix Alba), and Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma). For ulceration, use Xiaoyao San (Free and Easy Wanderer Powder). For Yinhu swelling and pain without closure, accompanied by chills/fever, astringent urination, fatigue, and poor appetite, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix) up to 1 qian dose, plus Fuling (Poria) and Shanzhi (Gardeniae Fructus). For Yinhu non-closure with dribbling urine and a mass moving in the abdomen causing distending pain, use Xiaoyao San (Free and Easy Wanderer Powder) with Chaihu (Bupleuri Radix), Shanzhi (Gardeniae Fructus), and Cheqianzi (Plantaginis Semen).