陈实功曰∶产后交骨未合,骤为风所侵作痒。(《正宗》)
又曰∶阴户作痒,四边黄泡,乃风湿下渗,用苦参、金银花、甘草、白芷、蛇床子煎汤熏洗。
又曰∶有抓之血出不痛者。
澄曰∶妇人阴户作痒,乃肝脾风湿流注,亦有肝火郁结而成。
冯鲁瞻曰∶阴痒阴疮,多属虫蚀所为,始因湿热,故生三虫在肠胃间,因脏虚乃
动,其虫侵蚀阴中精华,故时作痒,甚则痛痒不已,溃烂成疮。在室女、寡妇、尼
姑多犯之,因积想不遂,以致精血凝滞酿成,湿热久而不散,遂成三虫,痒不可忍,
深入脏腑即死。令人发热恶寒,与痨相似。亦有房室过伤,以致热壅肿痒内痛,外为
便毒,莫不由欲事伤损肝肾,肾阴亏而肝火旺,木郁思达,肝经郁滞之火走空窍下
注,为痒为虫,当用龙胆泻肝汤、逍遥散以主其内。外用蛇床子煎汤熏洗,再以桃
仁研膏和雄黄末、鸡肝研饼纳阴中,以制其虫。若肢体倦怠,阴中闷痒,小便赤涩
者,归脾汤加山栀、白术、甘草、丹皮。若徒以湿热为事,燥湿清热,则气血日衰,所害不止阴痒矣。
阴户作痒 取净桶内置瓦一片,以破布烧烟熏之。
银杏散 妇人湿热下注,阴中作痒,或内外生疮。
杏仁(去皮、尖) 水银(铅制) 轻粉 雄黄(各等分)
研细和匀。每用五分,枣肉一枚和丸,
用丝绵包裹,留下绵条捻线在外,先用塌痒汤煎洗,将药球纳入阴户,留线在外,如
小便取出再入,一日一换,重者用四五枚痊愈,仍宜兼服煎药。
塌痒汤
鹤虱草(一两) 苦参 威灵仙 归尾 蛇床子 野狼毒(各五钱)
用河水十碗,煎数滚,滤清贮盆内,乘热先熏后洗,临洗和入公猪胆汁二三枚同洗,更妙。
阴痒生疮 紫梢花一两,胡椒五钱,煎汤温洗数次。
阴痒三虫作祟。
大黄(微炒) 黄 (蜜炙) 黄芩(各一两) 山萸肉 元参 蛇床子 丹参 赤芍(各五钱)
共为末。每服二钱,食远温酒调服。
阴户痒极难忍 用盐涂之即止。
阴痒生疮
蛇床子(三钱) 杏仁(炒研) 白矾(各五钱)煎洗。
又方
蛇床子(一两) 花椒 白矾(各三钱) 煎洗。
又方
蛇床子(一两) 艾叶 五倍子 明矾 杏仁(各五钱) 川连(三钱) 煎洗。
陈实功说:产后交骨(耻骨联合)尚未愈合,突然遭受风邪侵袭而发痒。(出自《外科正宗》)
又说:阴户瘙痒,四周出现黄色水泡,这是风湿之邪下渗所致,可用苦参、金银花、甘草、白芷、蛇床子煎汤熏洗。
又说:有抓破后出血但不疼痛的情况。
顾世澄说:妇人阴户瘙痒,是由于肝脾风湿流注所致,也有因肝火郁结而形成的。
冯鲁瞻说:阴痒和阴疮,多属于虫蚀所为。起初是因为湿热,所以在肠胃间生出“三虫”,因为脏腑虚弱所以虫动,这些虫子侵蚀阴中的精华,所以时常发痒,严重时痛痒不止,溃烂成疮。在未婚女子、寡妇、尼姑中多见,因为积思不遂,导致精血凝滞酿成湿热,日久不散,遂成三虫,痒得难以忍受,若深入脏腑就会死亡。使人发热恶寒,症状类似痨病(结核病)。也有因房事过度损伤,导致热壅肿痒内痛,外部表现为便毒,没有不是由欲事损伤肝肾,肾阴亏虚而肝火旺盛,木气郁结需疏达,肝经郁滞之火走窜空窍下注,形成痒和虫症,应当用龙胆泻肝汤、逍遥散来主治内部病症。外用蛇床子煎汤熏洗,再用桃仁研膏混合雄黄末、鸡肝研饼纳入阴中,以制约其虫。如果肢体倦怠,阴中闷痒,小便赤涩的,用归脾汤加山栀、白术、甘草、丹皮。如果只针对湿热处理,单纯燥湿清热,那么气血日渐衰败,所害不仅仅局限于阴痒了。
阴户作痒:取一个干净的桶,里面放一片瓦,用破布烧烟熏之。
银杏散:治疗妇人湿热下注,阴中瘙痒,或内外生疮。
杏仁(去皮、尖) 水银(铅制) 轻粉 雄黄(各等分)
研细和匀。每次用五分,与一枚枣肉和丸,用丝绵包裹,留下棉条捻线在外,先用塌痒汤煎洗,将药球纳入阴户,留线在外,如小便取出再入,一日一换,重症用四五枚痊愈,仍宜兼服煎药。
塌痒汤
鹤虱草(一两) 苦参 威灵仙 归尾 蛇床子 野狼毒(各五钱)
用河水十碗,煎数滚,滤清贮盆内,乘热先熏后洗,临洗和入公猪胆汁二三枚同洗,更妙。
阴痒三虫作祟:
大黄(微炒) 黄芩(蜜炙) 黄芩(各一两) 山萸肉 元参 蛇床子 丹参 赤芍(各五钱)
共为末。每服二钱,食远温酒调服。
阴户痒极难忍:用盐涂之即止。
Chen Shigong stated: After childbirth, when the pubic symphysis (jiaogu) has not yet united, sudden invasion by wind pathogen causes itching. (From *Waike Zhengzong*)
He also stated: Itching of the yin orifice with yellow blisters on the four sides is caused by the downward infiltration of wind-dampness. Use a decoction of Kushen (Sophorae Flavescentis Radix), Jinyinhua (Lonicerae Japonicae Flos), Gancao (Glycyrrhizae Radix et Rhizoma), Baizhi (Angelicae Dahuricae Radix), and Shechuangzi (Cnidii Fructus) for fumigation and washing.
He also stated: There are cases where scratching leads to bleeding without pain.
Gu Shicheng stated: Itching of the female yin orifice is caused by the flow and accumulation of wind-dampness in the Liver and Spleen; it can also be formed due to the stagnation of Liver fire.
Feng Luzhan stated: Yin itching and yin sores are mostly caused by worm erosion. Initially, it arises from damp-heat, generating "three worms" in the intestines and stomach. Due to visceral deficiency, these worms become active, eroding the essence of the yin, causing frequent itching. In severe cases, unceasing pain and itching occur, leading to ulceration and sore formation. This condition is common among unmarried women, widows, and nuns, resulting from unfulfilled desires that cause stagnation of essence and blood, brewing damp-heat which persists for a long time, eventually forming three worms. The itching becomes unbearable; if the worms penetrate deep into the viscera, death ensues. Symptoms include fever and aversion to cold, resembling tuberculosis (lao disease). Some cases result from excessive sexual activity, causing heat congestion, swelling, itching, internal pain, and external manifestation as perineal abscesses (biandu). All such conditions stem from damage to the Kidney and Liver by sexual excess. Kidney yin deficiency leads to hyperactive Liver fire; Wood qi stagnation requires dispersion, and stagnant fire in the Liver meridian flows through hollow orifices downward, manifesting as itching and worms. Internally, one should use Longdan Xiegan Tang (Gentiana Decoction to Drain the Liver) and Xiaoyao San (Free and Easy Wanderer Powder). Externally, fumigate and wash with Shechuangzi decoction, then apply a paste made from Tao Ren (Persicae Semen) ground with Xionghuang (Realgar powder) and chicken liver pressed into a cake, inserted into the yin to control the worms. If accompanied by limb fatigue, stifling itching in the yin, and dark, scanty urination, use Guipi Tang (Restore the Spleen Decoction) added with Zhizi (Gardeniae Fructus), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma), and Danpi (Moutan Cortex). If treatment focuses solely on damp-heat, using only drying-dampness and clearing-heat methods, Qi and Blood will daily decline, and the harm will extend beyond mere yin itching.
For yin itching: Place a tile inside a clean bucket, burn rags to produce smoke, and fumigate the area.
Yinxing San (Ginkgo Powder): Treats damp-heat flowing downward in women, causing yin itching or sore formation internally and externally.
Xingren (Apricot Seed, peeled and de-husked) Shuiyin (Mercurius, lead-prepared) Qingfen (Calomelas) Xionghuang (Realgar) (equal parts)
Grind finely and mix evenly. Use 0.5 fen each time, combine with one jujube flesh pill, wrap in raw silk, leaving a silk thread outside. First wash with Tayang Tang (Itch-Relieving Decoction), insert the medicine ball into the yin orifice, keeping the thread outside. Remove upon urination and reinsert. Change once daily. Severe cases require four to five balls for recovery. Concurrent oral decoction is still advisable.
Tayang Tang (Itch-Relieving Decoction)
Heshen Cao (Pyrularia Herb) Ku Shen (Sophorae Flavescentis Radix) Weilingxian (Syneilesis Aconitifoliae Herba) Gui Wei (Angelicae Sinensis Radix) Shechuangzi (Cnidii Fructus) Yelangdu (Daphne Genkwa Bark) (each 5 qian)
Use ten bowls of river water, boil several times, filter clear, and store in a basin. While hot, first fumigate, then wash. Just before washing, add two or three gallbladders from a male pig for better effect.
Yin itching with sore formation: Zi Shaohua (1 liang), Hu Jiao (5 qian), decoct in water and wash warmly several times.
Yin itching caused by three worms:
Da Huang (Rhei Radix et Rhizoma, lightly stir-fried) Huang Qin (Scutellariae Radix, honey-fried) Huang Qin (Scutellariae Radix) (each 1 liang) Shan Yu Rou (Corni Fructus) Yuan Shen (Scrophulariae Radix) Shechuangzi (Cnidii Fructus) Dan Shen (Salviae Miltiorrhizae Radix) Chi Shao (Paeoniae Radix Rubra) (each 5 qian)
Grind into powder. Take 2 qian each time, mixed with warm wine taken well after meals.
Extreme yin itching unbearable: Apply salt to stop it immediately.
Yin itching with sore formation:
Shechuangzi (Cnidii Fructus, 3 qian) Xingren (Apricot Seed, stir-fried and ground) Bai Fan (Alumen, 5 qian) Decoct for washing.
Another prescription:
Shechuangzi (Cnidii Fructus, 1 liang) Hua Jiao (Zanthoxyli Pericarpium) Bai Fan (Alumen, 3 qian each) Decoct for washing.
Another prescription:
Shechuangzi (Cnidii Fructus, 1 liang) Ai Ye (Artemisiae Argyi Folium) Wu Bei Zi (Galla Chinensis) Ming Fan (Alumen) Xingren (Apricot Seed, 5 qian each) Chuan Lian (Coptidis Rhizoma, 3 qian) Decoct for washing.