天台程钟龄女科一卷。悉从诸大家论说中斟酌尽善而出之。字字毫发无憾。并无近世临证指南等
纤巧习气。故根据治每收实功。兹卷大半宗此。以为女科正范。此外诸症。与方脉同治者。概不赘叙。
妇女之症。不肯对人言。与小儿之不能自言。其难治一也。医家又未便逐细询间。则更暗中
摸索矣。然大要不离乎中情郁结者近是。盖妇女阴啬之性。识见拘墟。一有逆意。即牢结胸
中。又不能散闷于外。则郁久而成病矣。主治之法。审无外感内伤别症。唯有养血疏肝四字。
用四物汤、逍遥散之类。可以得其八九。其一切杂症。与方脉同治。兹不赘叙。若胎前产后。此
生死交关处。详叙于后。慎勿忽诸。
室女天癸未至。有病从幼科论。天癸既行。则与妇人同治矣。然其神完气足。经水应无愆期。
其有时经闭者。若非血海干枯。必其经脉逆转。血枯则内热咳嗽。渐成怯症。经逆则为吐为
衄。血必妄行。皆非轻候也。须速治之。如或经水适来。偶阻溺窍。则小便不通。腹胀欲死。急宜
通其经而便自利。用调经饮。
经者常也。月行有常度。经水有常期。其愆乎常者。皆病也。方书以趱前为热。退后为寒。此说
亦难尽信。要之。察其色总以红为正。其变为紫黑者。热也。黄如米泔者。湿也。浅淡红白者。虚
也。或成块而紫黑。色黯者。寒凝也。成块而紫黑。色明者。热结也。将行而腹痛拒按者。气滞血
凝也。既行而腹痛喜按者。气虚血少也。经前发热者。为血热。经后发热者。为血虚。腹胀者。为
气滞。腹痛者。为血滞。泄泻者。是脾虚。溏泻者。是寒湿。凡逆行上溢而吐衄。错行下流而暴崩。
皆属血热妄行。而亦有络脉伤损。瘀积肝旺所致。若经水过多者。色淡为虚。色深为热。或兼
赤白带而下者。臭者为湿热。腥者为寒湿。
血枯与经逆者。并用益母胜金丹加牛膝主之。经阻溺窍者。调经饮并泽兰汤主之。经水紫黑者。
生地四物汤加丹参、丹皮、益母草。淡红者。八珍汤主之。黄如米泔者。六君子汤加苡仁、扁豆。寒
凝成块者。四物汤加桂心、牛膝。热结成块者。生地四物汤加丹参、丹皮、益母草。气血凝滞而作痛
胀者。调经饮或四物汤加延胡、香附、木香。气虚血少。而或痛或热者。四物汤加人参、白术。泄泻溏
利者。六君子汤主之。血热而上下妄行者。四物汤加丹皮、阿胶、黄芩、黑山栀。络脉伤而妄行者。或
喜怒。或过劳。八珍汤主之。瘀血积则血不归经。独圣丸主之。肝火旺不能藏血者。逍遥散主之。
其兼赤白带者。五苓散加减治之。
程钟龄所著的《女科一卷》，完全从各位名医的论述中斟酌提炼，力求完善。字字句句毫无瑕疵，没有近代《临证指南》等书中那种纤巧浮华的习气。因此，依据其理论治疗往往能收到实效。本卷大部分内容遵循这一原则，将其作为妇科的正统典范。此外，其他病症若与内科脉证同治者，概不赘述。
妇女的疾病，往往不愿对人言说，这与小儿不能自己表达病情一样，都是难以诊治的原因。医生又不便逐一详细询问，这就更加如同在黑暗中摸索了。但大致的病因不离乎内心郁结。因为妇女天性阴柔含蓄，见识往往受局限，一旦遇到不顺心的事，就会牢牢郁结在胸中，又不能向外排解闷气，于是郁久成病。主治的方法，如果排除了外感、内伤及其他杂症，只有“养血疏肝”四个字。使用四物汤、逍遥散之类的方剂，可以解决八九成的问题。其余一切杂症，治疗方法与内科相同，此处不再赘述。至于胎前产后的病症，这是关乎生死的紧要关头，将在后文详细叙述，切勿忽视。
未婚女子（室女）天癸（月经）尚未到来时，有病应从儿科论治；天癸已行之后，则与成年妇人同样治疗。然而她们精神充沛、气血充足，月经应当按时来潮。如果有闭经的情况，如果不是血海干枯，必然是经脉逆乱。血枯会导致内热咳嗽，逐渐形成虚劳怯症；经血逆乱则表现为吐血或鼻衄，血液妄行，这些都不是轻浅的病候，必须迅速治疗。如果月经刚来，偶然阻滞尿道口，导致小便不通，腹胀痛苦欲死，急需通调月经，小便自然通畅。可用调经饮。
“经”是常道的意思。月亮运行有固定的度数，月经也有固定的周期。偏离常态的，都是疾病。医书认为月经提前为热证，推后为寒证，这种说法也不能完全相信。总之，观察经色以红色为正。颜色变为紫黑色的，是热证；黄色像米泔水一样的，是湿证；颜色浅淡红白的，是虚证。或者结成块状且紫黑、色泽暗滞的，是寒凝；结成块状且紫黑、色泽明亮的，是热结。月经将行时腹痛且拒按的，是气滞血凝；月经已行时腹痛且喜按的，是气虚血少。经前发热，属于血热；经后发热，属于血虚。腹胀，属于气滞；腹痛，属于血滞。泄泻，属于脾虚；大便溏薄，属于寒湿。凡是经血逆行上溢而吐血、鼻衄，错行下流而暴崩的，都属于血热妄行，但也有因络脉损伤、瘀积、肝旺所致。如果经量过多，颜色淡为虚证，颜色深为热证。如果兼有赤白带下，气味臭秽的是湿热，气味腥膻的是寒湿。
血枯和经逆的病症，并用益母胜金丹加牛膝主治。经血阻滞尿道的，用调经饮并泽兰汤主治。经色紫黑的，用生地四物汤加丹参、丹皮、益母草。颜色淡红的，用八珍汤主治。黄色像米泔水的，用六君子汤加薏苡仁、扁豆。寒凝成块的，用四物汤加桂心、牛膝。热结成块的，用生地四物汤加丹参、丹皮、益母草。气血凝滞导致疼痛胀满的，用调经饮或四物汤加延胡索、香附、木香。气虚血少，时而疼痛时而发热的，用四物汤加人参、白术。泄泻溏利的，用六君子汤主治。血热导致上下妄行的，用四物汤加丹皮、阿胶、黄芩、黑山栀。络脉损伤导致妄行的，或因喜怒过度，或因过劳，用八珍汤主治。瘀血积聚导致血不归经的，用独圣丸主治。肝火旺盛不能藏血的，用逍遥散主治。兼有赤白带下的，用五苓散加减治疗。
Cheng Zhongling's *Nüke Yi Juan* (One Volume on Gynecology) is entirely refined from the discussions of various renowned physicians, striving for perfection. Every word and phrase is flawless, lacking the delicate and frivolous habits found in modern works such as *Linzheng Zhinan* (Guide to Clinical Practice). Therefore, treatments based on this work often yield practical results. This volume largely follows this principle, establishing it as the orthodox model for gynecology. Other conditions that are treated similarly to internal medicine pulse diagnoses are not repeated here.
Women's ailments are often kept secret, similar to how children cannot speak for themselves; both present difficulties in treatment. Physicians find it inconvenient to inquire in minute detail, making diagnosis akin to groping in the dark. However, the primary cause generally lies in emotional depression. Due to their yin-natured reserve and limited perspectives, any dissatisfaction becomes firmly lodged in the chest. Unable to vent this frustration externally, prolonged stagnation leads to disease. The main therapeutic approach, after excluding external contraction, internal injury, or other miscellaneous conditions, consists of four characters: "nourishing blood and soothing the liver" (Yangxue Shugan). Formulas such as Siwu Tang (Four Substances Decoction) and Xiaoyao San (Free and Easy Wanderer Powder) can address eight or nine out of ten cases. All other miscellaneous conditions are treated identically to internal medicine, so they are not elaborated upon here. As for conditions before and after childbirth, which involve life-and-death stakes, these will be detailed later; do not neglect them.
For unmarried women (Shinv), if Tian Gui (menstrual essence) has not yet arrived, diseases should be discussed according to pediatric principles. Once Tian Gui begins, treatment aligns with that of adult women. However, since their spirit is complete and qi and blood are abundant, menstruation should occur without delay. If amenorrhea occurs, unless it is due to the dryness of the Blood Sea (Xuehai), it must be due to the reversal of meridians. Blood dryness leads to internal heat and coughing, gradually developing into consumptive disease (Qiezheng). Meridian reversal manifests as hematemesis or epistaxis, with blood flowing recklessly; these are not mild conditions and require prompt treatment. If menstruation has just started but accidentally obstructs the urethral orifice, causing urinary retention and severe abdominal distension and pain, it is urgent to regulate the menses, after which urination will naturally resume. Use Tiaojing Yin (Regulate Menses Decoction).
"Jing" (menses) implies constancy. The moon has a fixed orbit, and menstruation has a fixed cycle. Deviations from this norm indicate disease. Medical texts state that early menstruation indicates heat, while late menstruation indicates cold; however, this view cannot be fully trusted. In summary, observing the color, red is considered normal. A change to purple-black indicates heat; yellow like rice washings indicates dampness; pale red or white indicates deficiency. Clumps that are purple-black and dark in luster indicate cold coagulation; clumps that are purple-black and bright in luster indicate heat accumulation. Abdominal pain during pre-menstruation that refuses pressure indicates qi stagnation and blood coagulation; abdominal pain after menstruation that welcomes pressure indicates qi deficiency and blood insufficiency. Fever before menstruation indicates blood heat; fever after menstruation indicates blood deficiency. Abdominal distension indicates qi stagnation; abdominal pain indicates blood stagnation. Diarrhea indicates spleen deficiency; loose stools indicate cold-dampness. Any upward regurgitation of blood resulting in hematemesis or epistaxis, or downward flooding resulting in sudden metrorrhagia, belongs to reckless bleeding due to blood heat, though some cases are caused by collateral damage, blood stasis accumulation, or hyperactive liver. If menstrual flow is excessive, pale color indicates deficiency, while deep color indicates heat. If accompanied by leukorrhea (red and white discharge), an foul odor indicates damp-heat, while a fishy odor indicates cold-dampness.
For blood dryness and meridian reversal, Yimu Shengjin Dan (Motherwort Golden Pill) combined with Niuxi (Achyranthes Root) is used. For obstruction of the urinary tract by menstrual blood, Tiaojing Yin combined with Zelan Tang (Lycopus Decoction) is used. For purple-black menstrual blood, Shengdi Siwu Tang (Rehmannia Four Substances Decoction) added with Danshen (Salvia Root), Danpi (Moutan Bark), and Yimucao (Motherwort Herb) is used. For pale red blood, Bazhen Tang (Eight Treasures Decoction) is used. For yellow, rice-wash-like discharge, Liujunzi Tang (Six Gentlemen Decoction) added with Yiren (Coix Seed) and Biandou (Hyacinth Bean) is used. For cold coagulation forming clumps, Siwu Tang added with Guixin (Cinnamon Heart) and Niuxi is used. For heat accumulation forming clumps, Shengdi Siwu Tang added with Danshen, Danpi, and Yimucao is used. For pain and distension due to qi-blood stagnation, Tiaojing Yin or Siwu Tang added with Yanhu (Corydalis Rhizome), Xiangfu (Cyperus Rhizome), and Muxiang (Aucklandiae Radix) is used. For qi deficiency and blood insufficiency causing intermittent pain or fever, Siwu Tang added with Renshen (Ginseng Root) and Baizhu (Atractylodes Macrocephala Rhizome) is used. For diarrhea and loose stools, Liujunzi Tang is used. For reckless bleeding above and below due to blood heat, Siwu Tang added with Danpi, Ejiao (Donkey-Hide Gelatin), Huangqin (Scutellaria Root), and Heishanzhi (Black Gardenia Fruit) is used. For reckless bleeding due to collateral damage, whether from excessive anger/joy or overwork, Bazhen Tang is used. For blood returning to its vessels improperly due to blood stasis accumulation, Dusheng Wan (Single Holy Pill) is used. For hyperactive liver fire failing to store blood, Xiaoyao San is used. For cases complicated by red and white leukorrhea, Wuling San (Five Ling Powder) modified is used.