自妇女前阴、疮 、菌挺,一切皆汇于此部中,以便检阅参治。
《金匮》云∶胃气下泄,阴吹而正喧,此谷气既不能上升清道,复不能循经下走
后阴,阴阳乖僻,如肠交之义是也。甚或簌簌有声,如后阴之失气状,宜补中益气汤加五味子主之。
《见闻随录》云∶产妇不得食葱,如误食之,必成阴吹。
王肯堂曰∶阴器属足厥阴肝经、任脉之会。(《准绳》)
又曰∶运气阴疮皆属寒。经云∶太阳之湿,阴中乃疡,隐曲不利,治以苦热是也。
《素问》云∶厥阴之脉络阴器,系于肝。
又云∶督脉者,其络循阴器合纂间是也。至于足太阳外合清水,内属膀胱而通
水道,手太阳外合淮水,内属小肠而水道出焉,则又属手足太阳也。肾主水则又属
足少阴也。饮入于胃,游溢精气,上输于脾,脾气散精,上归于肺,通调水道,下
输膀胱,则又属手太阴也。《素问》又谓前阴者,宗筋之所聚,太阳阳明之所合,则
又属脾与肾矣。痈疮生其间,须细心求而责之,不可专主一厥阴肝经,而惟清肝导湿之为事,斯无误矣。
《灵枢》云∶筋者聚于阴器,而脉络于舌本,肝者筋之会也,又属督脉。
张仲景云∶少阴脉滑而数者,阴中即生疮,阴中蚀烂者,野狼牙汤洗之。(用野狼牙二两,
以水四升煮至半升,以绵缠箸如茧,浸汤沥阴中茧二遍。)
岐天师曰∶大约暗疾,妇人十居其九,或生于儿门之外,或生于儿门之中,止可
陈说,然犹有羞愧而不肯尽言者,止可意会,而默思之也。大约儿门之病,非痒则
痛,当以默治汤主之,此汤皆是平肝去湿之品,毋论有火无火,有风有湿,俱奏奇
功,正不必问其若何痒,若何肿,若何痛,若何烂也。(《秘录》)
陈实功曰∶妇人阴疮乃七情郁火伤损肝脾,湿热下注为患,形多不一,总由邪火所化也。(《正宗》)
薛立斋曰∶阴户毛际正中发毒名曰阴盖毒,红肿疼痛,此乃肝火郁结而成。治
当清肝养血,外用敷消,如已成脓,治同痈疽法。
又曰∶阴户一边结肿,亦有两边结肿,其形如茧,名曰阴茧。内脓成自溃头,得
之于肝火湿热,或新婚伤损,或交合不洁染毒,均成此证。
又曰∶阴户内子宫肿痛溃烂,名廷孔毒。肝火郁结者重,交合所伤者轻,俱用
海浮散油调灌入,仰卧良久,后换玉红膏调海浮散,以绵润透,插入自效。
妇女的前阴部位,以及阴疮、菌挺(一种阴道赘生物)等病症,全部汇集在这一章节中,以便于查阅和参考治疗。
《金匮要略》记载:胃气向下泄漏,导致阴吹(阴道排气并发出声音)且声响喧闹,这是因为谷气既不能向上输送到清窍,又不能顺着经络向下从后阴排出,阴阳之气乖违偏颇,就像肠道交结不通的意思一样。严重时甚至发出簌簌的声音,如同后阴放屁的样子,适宜用补中益气汤加入五味子来主治。
《见闻随录》记载:产妇如果吃葱,一旦误食,必定会导致阴吹。
王肯堂说:阴器是足厥阴肝经与任脉交会的地方。(出自《医宗必读·准绳》)
他又说:运气学说中的阴疮都属于寒证。经文说:太阳之湿邪侵袭,阴部就会生疮疡,出现隐曲处不利索的症状,治疗应当用苦热性质的药物,就是这个道理。
《素问》说:厥阴经的脉络连接阴器,系属于肝脏。
又说:督脉的络脉沿着阴器运行,汇合于会阴之间。至于足太阳膀胱经外合清水,内属膀胱而通调水道;手太阳小肠经外合淮水,内属小肠而水道由此而出,这又涉及手足太阳经。肾主水液代谢,所以又涉及足少阴肾经。饮水进入胃中,游溢精气,向上输送给脾,脾气散布精微物质,向上归于肺,肺通调水道,向下输送到膀胱,这又涉及手太阴肺经。《素问》又说前阴是宗筋汇聚之处,也是太阳经与阳明经会合的地方,所以又涉及脾脏与肾脏。痈疮生在阴器之间,必须细心探求病因并追究责任,不能只专注于足厥阴肝经,仅仅把清肝利湿作为唯一的治疗手段,这样才不会出错。
《灵枢》说:筋脉汇聚于阴器,并且脉络联系到舌根,肝是筋脉的聚会之处,同时也属于督脉。
张仲景说:少阴脉象滑而数的,阴中就会生疮,阴中腐蚀溃烂的,用野狼牙汤清洗。(用法是用野狼牙二两,加水四升煮至半升,用棉絮缠绕筷子如蚕茧状,蘸取药汤冲洗阴部,每次浸洗两遍。)
岐天师说:大约隐秘的疾病,妇人占了十分之九,有的生在肛门之外,有的生在肛门之中,只能陈述大概,但仍有羞愧而不肯详尽说明的,只能意会,默默思考罢了。大约肛门部位的疾病,不是痒就是痛,应当用默治汤来主治,这个方剂都是平肝祛湿的药物,不论是有火还是无火,有风还是有湿,都能奏效奇功,正不必去问它究竟是怎么痒、怎么肿、怎么痛、怎么溃烂。(出自《秘录》)
陈实功说:妇人阴疮是由于七情郁结化火,损伤肝脾,湿热下注造成的危害,形态多种多样,总归是由邪火转化而成。(出自《外科正宗》)
薛立斋说:阴户毛际正中发生的毒疮叫做阴盖毒,红肿疼痛,这是肝火郁结而成的。治疗应当清肝养血,外用敷药消散,如果已经成脓,治疗方法同痈疽法相同。
他又说:阴户一边结肿,也有两边结肿,形状像蚕茧,叫做阴茧。内部脓液形成后自然溃破,这是由于肝火湿热,或者新婚损伤,或者性交不洁染毒,都造成这种病症。
他又说:阴户内子宫肿痛溃烂,叫做廷孔毒。肝火郁结严重的,性交损伤轻微的,都用海浮散油调匀灌入,仰卧很久,之后换玉红膏调和海浮散,用棉条润透,插入即可见效。
The anterior yin of women, along with conditions such as yin sores (ulcers of the vulva/vagina) and jun ting (vaginal polyps/prolapse), are all compiled in this section for easy reference and treatment consultation.
*Jingui Yaolue* states: "When stomach qi descends abnormally, causing yin blowing (flatulence from the vagina) with loud noise, it is because grain qi cannot ascend to the clear orifices, nor can it follow the meridians downward to exit through the posterior yin. The yin and yang qi are deviant and disordered, similar to the meaning of intestinal entanglement." In severe cases, there may be rustling sounds resembling flatulence from the anus. The appropriate treatment is Buzhong Yiqi Tang (Supplement the Middle and Boost Qi Decoction) added with Wuweizi (Schisandra Berry).
*Jianwen Suilu* records: "If a postpartum woman consumes green onions, accidental ingestion will inevitably lead to yin blowing."
Wang Kentang stated: "The external genitalia are the convergence point of the Foot-Jueyin Liver Meridian and the Ren Mai (Conception Vessel)." (*Zhunsheng*)
He further stated: "According to the theory of influencing factors (Yunqi), yin sores belong to cold patterns. The classic text says: 'With dampness of Taiyang, ulcers occur in the yin region, accompanied by difficulty in private functions; treat with bitter-hot herbs.' This refers to the use of bitter and hot natured medicines."
*Suwenn* states: "The meridians of Jueyin connect to the external genitalia and are tied to the Liver."
It also states: "The Luo (Connecting) vessels of the Du Mai (Governing Vessel) circulate along the external genitalia and converge between the perineum." As for the Foot-Taiyang Bladder Meridian, it externally corresponds to clear water, internally belongs to the Bladder, and regulates water passages; the Hand-Taiyang Small Intestine Meridian externally corresponds to Huai water, internally belongs to the Small Intestine, and water passages emerge from it. Thus, these involve the Hand and Foot Taiyang meridians. Since the Kidney governs water metabolism, this also involves the Foot-Shaoyin Kidney Meridian. When drink enters the Stomach, its essence floats up, is transported upward to the Spleen, the Spleen scatters the essence, which returns upward to the Lung; the Lung regulates water passages and transports them downward to the Bladder. Thus, this involves the Hand-Taiyin Lung Meridian. *Suwenn* further states that the anterior yin is where the Zongjin (Major Sinews) gather, and is the convergence of the Taiyang and Yangming meridians; thus, it also involves the Spleen and Kidney. When abscesses and sores arise in this area, one must carefully investigate the cause and determine responsibility. One should not focus solely on the Foot-Jueyin Liver Meridian, treating only by clearing Liver heat and draining dampness, to avoid errors.
*Lingnu* states: "Sinews gather at the external genitalia and their meridians connect to the root of the tongue. The Liver is the assembly of sinews, and it also relates to the Du Mai."
Zhang Zhongjing stated: "When the Shaoyin pulse is slippery and rapid, sores will appear in the yin region. If the yin region is eroded and ulcerated, wash it with Yelangya Tang (Wolf's Tooth Decoction). [Usage: Use two liang of Yelangya (Tetracentron sinense stem bark), boil in four sheng of water until reduced to half a sheng. Wrap cotton around a chopstick like a silkworm cocoon, dip in the decoction, and irrigate the yin region twice.]"
Qian Tianshi said: "Roughly, nine out of ten hidden diseases affect women. They may occur outside or inside the Ermen (anus). These can only be described generally, yet many feel ashamed and unwilling to speak fully. They can only be understood intuitively and contemplated silently. Generally, diseases of the Ermen present as either itching or pain. They should be treated with Mozhi Tang (Silent Treatment Decoction). This formula consists of herbs that soothe the Liver and remove dampness. Regardless of whether there is fire or no fire, wind or dampness, it achieves miraculous results. There is no need to ask specifically how it itches, swells, hurts, or ulcerates." (*Milu*)
Chen Shigong stated: "Women's yin sores are caused by emotional stagnation transforming into fire, damaging the Liver and Spleen, with damp-heat pouring downward. The manifestations vary, but all originate from evil fire transformation." (*Zhengzong*)
Xue Lizhai stated: "A toxic sore arising in the center of the hairline of the yin opening is called Yingai Du (Yin Cover Toxin), characterized by redness, swelling, and pain. This is formed by stagnant Liver fire. Treatment should involve clearing the Liver and nourishing blood, with external applications to dissipate swelling. If pus has formed, treat according to the methods for carbuncles and sores."
He further stated: "Swelling nodules on one side of the yin opening, or on both sides, shaped like a silkworm cocoon, are called Yin Jian (Yin Cocoon). Internal pus forms and eventually ruptures spontaneously. This condition results from Liver fire and damp-heat, or injury from new marriage, or infection from unclean intercourse."
He also stated: "Swelling, pain, and ulceration of the uterus within the yin opening are called Tingkong Du (Palace Hole Toxin). Severe cases stem from stagnant Liver fire; mild cases from sexual injury. For both, Hai Fu San (Sea Floating Powder) mixed with oil should be instilled. The patient should lie supine for a long time, then apply Yu Hong Gao (Jade Red Ointment) mixed with Hai Fu San, soaked into a cotton tampon, and inserted for effectiveness."