肝家湿热成带下者,其色青绿。肝性喜润而恶湿,故有湿则性违,违则郁,郁则逆,逆则上,肝气欲上而湿欲下,
两相牵掣而停贮于中焦脂膜之间。然无形之气,不胜有质之湿,是以郁之既久,卒走带脉而下胞宫。郁浅热少者色青;
郁久热盛者色绿。治之统与傅氏加减逍遥散。
傅氏青带下加减逍遥散(〔批〕此方极妙。病不及血分,故减去当归。白术能助肝郁,故亦去之。)
白茯苓 生草 绵茵陈 陈皮 酒白芍 柴胡 黑山栀
肝素无病不郁,疏泄如常,寒湿入之,乘其气化而为淡青色,得之未久者,治宜温化。
淡吴萸 炒白芍 炒麦芽 贯众炭 细青皮 白茯苓 韭子(研) 泽泻
妇人素患白带,有时偶带青绿色者,此乃属脾湿,脾之运化,赖胆汁之助,胆郁生热,其汁溢出,湿挟之而下,故
为是证,乃偶然之事也。以六君子汤,加疏解胆郁之品治之,佐以止带之味,其上中焦有热者,酌清上中二焦,弗备赘
也。
炙党参 白茯苓 陈皮 青蒿子 贯众炭 木通 制白术 生甘草 半夏 炒竹茹 木耳炭 泽泻
黄带者,任脉之湿热也,督脉象干为天,而督率万物,故曰督,厥色白。任脉象坤为地,而任载万物,故曰任,厥
色黄,此任脉之气化所以化湿为黄带也。任脉上走唇齿,下达胞宫,水液往来其间,而不能容留,今以胞宫有热阻其水
液,化而为湿,积多下注,色如黄丹浓汁。傅青主曰∶法宜以山药、芡实补任脉即以利水,加白果为引,以黄柏清肾火,
则庶几矣,方曰易黄汤。
傅氏易黄汤
炒山药 黄柏(盐水炒) 车前子(酒炒) 炒芡实 白果(打碎)
肝经湿热导致的带下病,其分泌物颜色呈青绿色。肝脏的特性是喜欢滋润而厌恶湿气,因此一旦有湿邪侵入,就会违背肝脏的生理本性;本性相违则导致气机郁结,气机郁结则发生逆乱,气机逆乱则向上冲逆。此时,肝气想要上行,而湿邪想要下行,两者相互牵制,停滞储存在中焦的脂膜之间。然而,无形的气机无法胜过有形的湿邪,所以这种郁滞日久之后,最终会沿着带脉下行进入胞宫。郁结较浅、热邪较轻的,分泌物颜色为青色;郁结时间久、热邪炽盛的,分泌物颜色为绿色。治疗时统一使用傅氏加减逍遥散。
傅氏青带下加减逍遥散(批注:此方极为精妙。因为病情未波及血分,所以减去当归。白术能助长肝气郁结,所以也将其去掉。)
白茯苓、生甘草、绵茵陈、陈皮、酒炒白芍、柴胡、黑山栀
如果肝脏本身没有病变,疏泄功能正常,寒湿之邪侵入,趁着肝脏气化功能异常而呈现淡青色,这种情况得病不久的,治疗适宜采用温化法。
淡吴茱萸、炒白芍、炒麦芽、贯众炭、细青皮、白茯苓、韭菜子(研末)、泽泻
妇女平素患有白带,有时偶尔夹杂青绿色的,这属于脾湿所致。脾的运化功能,依赖于胆汁的帮助。胆气郁结产生热邪,胆汁溢出,湿邪挟带胆汁下行,从而形成此证,这只是偶然的现象。用六君子汤,加入疏解胆郁的药物进行治疗,并佐以止带的药物。如果上中焦有热邪,酌情清利上中二焦的热邪,不再赘述。
炙党参、白茯苓、陈皮、青蒿子、贯众炭、木通、制白术、生甘草、半夏、炒竹茹、木耳炭、泽泻
黄带病,是任脉湿热所致。督脉象征天干,统领万物,所以称为“督”,其色为白。任脉象征地坤,承载万物,所以称为“任”,其色为黄。这就是任脉的气化功能将湿气转化为黄带的原理。任脉向上走到唇齿,向下到达胞宫,水液在其中往来流动而不能停留。现在因为胞宫有热阻碍了水液的运行,水液化为湿邪,积聚过多后向下流注,颜色像黄丹浓汁一样。傅青主说:治疗方法应当用山药、芡实补益任脉同时利水,加白果作为引经药,用黄柏清泻肾火,这样差不多就能治愈了,这个方子叫做易黄汤。
When damp-heat in the Liver channel causes leukorrhea, the discharge is greenish-blue. The Liver nature prefers moistness and detests dampness; thus, when dampness is present, it contradicts the nature, leading to contradiction, then stagnation (Qi stagnation), then rebellion, and then upward movement. The Liver Qi desires to move upward, while the dampness desires to descend; these two forces pull against each other and accumulate between the fatty membranes of the Middle Jiao. However, formless Qi cannot overcome substantial dampness, so after prolonged stagnation, it eventually travels down the Dai vessel into the Uterus. When the stagnation is shallow and heat is slight, the color is blue-green; when the stagnation is long-standing and heat is intense, the color is green. Treatment uniformly employs Fu's Modified Xiaoyao San.
Fu's Modified Xiaoyao San for Blue-Green Leukorrhea [Comment: This prescription is extremely effective. Since the disease has not affected the Blood level, Dang Gui is removed. Bai Zhu can aggravate Liver stagnation, so it is also removed.]
Bai Fu Ling (Poria), Sheng Cao (Raw Licorice), Mian Yin Chen (Artemisiae Scopariae Herba), Chen Pi (Citri Reticulatae Pericarpium), Jiu Bai Shao (White Peony Root stir-fried with wine), Chai Hu (Bupleuri Radix), Hei Shan Zhi (Gardeniae Fructus charred).
If the Liver itself is free of disease and its dispersing and draining functions are normal, but cold-dampness invades, taking advantage of abnormal Qi transformation to present a pale blue-green color, if the condition is recent, treatment should favor warming and transforming methods.
Dan Wu Yu (Evodiae Fructus), Chao Bai Shao (White Peony Root stir-fried), Chao Mai Ya (Hordei Fructus Germinatus stir-fried), Guan Zhong Tan (Cyathulae Radix charred), Xi Qing Pi (Tangerine Peel stir-fried), Bai Fu Ling (Poria), Jiu Zi (Seed of Allii Tuberosi, ground), Ze Xie (Alismatis Rhizoma).
Women who normally suffer from white leukorrhea occasionally having mixed blue-green discharge belong to Spleen dampness. The Spleen's transportation and transformation rely on the assistance of Gallbladder juice. When Gallbladder Qi stagnates and generates heat, the juice overflows, and dampness carries it downward, causing this syndrome; this is merely an occasional occurrence. Treat with Liu Jun Zi Tang (Six Gentlemen Decoction), adding herbs that soothe and resolve Gallbladder stagnation, assisted by herbs that stop leukorrhea. If there is heat in the Upper and Middle Jiao, clear the heat of the Upper and Middle Jiao as appropriate; no further details are added.
Zhi Dang Shen (Codonopsis Root processed with honey), Bai Fu Ling (Poria), Chen Pi (Citri Reticulatae Pericarpium), Qing Hao Zi (Artemisiae Annuae Semen), Guan Zhong Tan (Cyathulae Radix charred), Mu Tong (Akebiae Caulis), Zhi Bai Zhu (Atractylodis Macrocephalae Rhizoma processed), Sheng Gan Cao (Raw Glycyrrhizae Radix et Rhizoma), Ban Xia (Pinelliae Tuber), Chao Zhu Ru (Bambusae Caulis in Taeniam stir-fried), Mu Er Tan (Auriculariae Judae Charcoal), Ze Xie (Alismatis Rhizoma).
Yellow leukorrhea is caused by damp-heat in the Ren vessel. The Du vessel symbolizes Heaven (Qian) and commands all things, hence called "Du," and its color is white. The Ren vessel symbolizes Earth (Kun) and bears all things, hence called "Ren," and its color is yellow. This is why the Qi transformation of the Ren vessel transforms dampness into yellow leukorrhea. The Ren vessel ascends to the lips and teeth and descends to the Uterus; fluids flow back and forth within it without staying. Now, because heat in the Uterus obstructs the fluid flow, the fluid transforms into dampness. Accumulating excessively, it flows downward, resembling thick yellow cinnabar juice. Fu Qingzhu said: The method should use Shan Yao (Dioscoreae Rhizoma) and Qian Shi (Euryales Semen) to tonify the Ren vessel and promote urination simultaneously, add Bai Guo (Ginkgo Seed) as a guiding herb, and use Huang Bo (Phellodendri Cortex) to clear Kidney fire, which would likely be curative. This formula is called Yi Huang Tang.
Fu's Yi Huang Tang
Chao Shan Yao (Dioscoreae Rhizoma stir-fried), Huang Bo (Phellodendri Cortex stir-fried with salt water), Che Qian Zi (Plantaginis Semen stir-fried with wine), Chao Qian Shi (Euryales Semen stir-fried), Bai Guo (Ginkgo Seed, crushed).