〔严〕巢氏《病源》论妇人有三十六疾者,七 、八瘕、九痛、十二带下也。而带
下不显其证,今人唯知赤。白二带耳。此由劳伤冲任,风冷据于胞络。妇人平居,血欲
常多,气欲常少,百疾不生。或气倍于血,气倍生寒,血不化赤,遂成白带。若气平血少,
血少生热,血不化经,遂成赤带。寒热交并,则赤白俱下。其脉右手尺浮,浮为阳,阳绝
者无子,若足冷带下,轻则漏下,甚则崩中,皆心不荣血,肝不藏血所致。其脉寸口弦而
大,弦则为减,大则为芤,减为寒,芤为虚,寒虚相搏,其脉为革,主半产漏下。又尺寸
脉虚者漏血,漏血脉浮者不可治。
〔产宝〕带下三十六疾者,是十二 、九痛、七害、五伤、三固,谓之三十六疾也。
十二 者,是所下之物,一者如膏,二者如青血,三如紫汁,四如赤皮,五如脓痂,六
如豆汁,七如葵羹,八如凝血,九如清血似水,十如米泔,十一如月浣,十二如经度不
应期也。九痛者,一阴中痛,二阴中淋痛,三小便痛,四寒冷痛,五月来时腹痛,六气满
来时足痛,七汗出阴中如虫齿痛,八胁下皮痛,九腰痛。七害者,一害食,二害气,三
害冷,四害劳,五害房,六害妊,七害睡。五伤者,一窍孔痛,二寒冷痛,三小腹痛,四
脏不仁,五子门不正,引背痛。三固者,月水闭塞不通,其余二者,文缺不载。而仲景
所说三十六种疾,皆由子脏冷热劳损而夹下起于阴内也。
〔丹〕赤白带,罗先生法,或十枣汤,(方见伤寒胁满病。)或神佑丸,(方见
杂病痰饮。)或玉烛散,即四物加调胃承气。皆可用之。虚者不可峻攻,实者可行。
血虚,加减四物汤。气虚,以术、参、陈皮间与之。赤属血,白属气,主治燥湿为先。
湿甚者,固肠丸。(方见后。)相火动者,诸药中加炒柏。滑者,加龙骨、赤石脂。
滞者,加葵花。(白者治白带,赤者治赤带。)性躁者,加黄连。寒月少加姜、附。临机应变,
先须断浓味。带下与梦遗同法治之。肥人有带,多是湿痰,用海石、半夏、南星、炒
柏、青黛、苍术、川芎。瘦人带病少,如有多是热,用炒柏、蛤粉、滑石、川芎、
青黛、樗皮。带漏俱是胃中痰积,流下渗膀胱,出于大肠、小肠。宜升提,甚者上必
用吐,以提其气,下用二陈汤加白术、苍术,仍用丸子。
〔戴〕赤白带下,皆因七情内伤,或下元虚冷,感非一端。大率下白带多间有下赤
者,并宜顺气散吞震灵丹,仍佐艾附丸,或米饮调沙参末。带下不止成 羸者,四物汤
加牡蛎粉半钱,吞固阳丸,多服取效。(固阳丸方见杂病遗精门。)有带疾愈后一二月或再
发,半年一发,先血而后下带,来不可遏,停蓄未几,又复倾泻,此名漏带,最为难治。
下截之血,小腹主之。有因血虚而虚热陷入小肠,致小便涩痛,色白如泔,或成沙粒,皆
不可作淋治,用冷剂。宜以四物汤、五苓饮
各半帖和煎。
〔良〕妇人带下,其名有五,因经行、产后,风邪入胞门传于脏腑而致之。若伤足
厥阴肝经,色如青泥;伤手少阴心经,色如红津;伤手太阴肺经,形如白涕;伤足太阴
脾经,黄如烂瓜;伤足少阴肾经,黑如 血。人有带脉横于腰间,如束带之状,病生于此,
故名为带。
〔薛〕徐用诚先生云∶前证白属气而赤属血。东垣先生云∶血崩久则亡阳,故白滑
之物下流,未必全拘于带脉。亦有湿痰流注下焦,或肾肝阴淫之湿胜,或因惊恐而木乘
土位,浊液下流,或思慕为筋痿。戴人以六脉滑大有力,用宣导之法,此泻其实也。东
垣以脉微细沉紧,或洪大而虚,用补阳调经,乃兼责其虚也。丹溪用海石、南星、椿根皮
之类,乃治其湿痰也。窃谓前证皆当壮脾胃,升阳气为主,佐以各经见证之药。色青者属
肝,用小柴胡加山栀、防风。湿热壅滞,小便赤涩,用龙胆泻肝汤。肝血不足,或燥热
风热,用六味丸。色赤者属心,用小柴胡加黄连、山栀、当归。思虑过伤,用妙香散等
药。色白者属肺,用补中益气加山栀。色黄者属脾,用六君子加山栀、柴胡;不应,用
归脾汤。色黑者属肾,用六味丸。气血俱虚,八珍汤。阳气下陷,补中益气汤。湿痰下注,
前汤加茯苓、半夏、苍术、黄柏。气虚痰饮下注,四七汤送六味丸。不可拘肥人多痰,瘦
人多火,而以燥湿泻火之药轻治之也。
〔洁〕治带下少腹冤结而痛者,先以十枣汤下之;次服苦楝丸、大玄胡散调之。是
先攻后补之法也。
治结痰白带,以小胃丹,半饥半饱,津液下数丸,候郁积行,欲服补药。
白术(一两) 苍术(半两) 红白葵花(二钱半) 白芍药(七钱半)
上蒸饼为丸,空心,煎四物汤下二十丸。
陶遵道外姑,年七十,形瘦善啖,白带。食前姜汤吞大补丸五十丸一二次,午膳后及
临卧时,各与小胃丹十五丸,愈。
〔子和〕顷,顿丘一妇人,病带下连绵不绝,白物或来,已三载矣。命予脉之,诊
其两手脉俱滑大而有力,得六七至,常上热、口干、眩晕,时呕酢水,余知其实有寒痰在
胸中,以瓜蒂散吐出冷痰二三升,皆酢水也。间如黄涎,状如烂胶。次以浆粥养其胃气,又
次用导水禹攻以泻其下,然后以淡剂渗泄之药,利其水道,不数日而愈。息城李左衙
之妻,病白带如水窈漏中,绵绵不绝,臭秽之气不可近,面黄食减,已三年矣。诸医皆
云积冷,阳起石、硫黄、姜、附之药,重重燥补,污水转多。戴人断之曰∶此带浊水本
热乘太阳经,其寒水不禁固,故如此也。夫水自高而趋下,宜先绝其上源。乃涌痰二三
升,次日下沃水斗余,行三遍,汗出周身,至明旦病患云∶污已不下矣。次用寒凉之
剂,服及半载,产一男。
〔燥剂〕
有湿痰而弱不禁攻者燥之,热湿宜凉燥,寒湿宜温燥。
樗皮丸 治赤白带有湿热者。
芍药(五钱) 良姜(三钱,烧灰) 黄柏(二钱,各炒成灰) 椿根皮(一两半)
上为末,粥丸。每服三、五十丸,空心米饮吞下。
赤白带因湿热胜而下者。
苍术(盐炒) 白芍药(各一两) 枳壳(三钱) 椿根皮(炒,二两) 干姜(煨,二两)
地榆(半两) 甘草(三钱) 滑石(一两,炒) 为末,粥丸,米饮下。
治带下。
椿根皮(二两) 神曲(炒) 麦皮曲(炒) 黄柏(炒,各一两) 芍药(一两半) 滑石
枳壳(各半两) 苍术(一两)
上为末,糊丸桐子大。每服五十丸,空心下。
固肠丸 治湿气下利,大便血,白带。去脾胃陈积之后,用此以燥下湿。亦不曾单用,
看病作汤使。
椿根皮为末,粥糊为丸。此药性凉而燥,须炒用。一方加滑石一半。
治白带因七情所伤,脉数者。
黄连(炒) 侧柏叶(酒蒸) 黄柏(炒,各半两) 香附子(醋炒) 白术(炒,各一两)
白芷(烧存性) 木香(各三钱) 椿根皮(二两,炒) 白芍药(一两)
上为末,饭粥为丸。米饮汤送下。
上五方治带,椿皮例凉燥之剂,湿热盛者宜之。后一方有黄连、香附、木香,故可治七情所伤。
〔大〕乳香散 治赤白带下。
草果(一枚,去皮,入麝香一小块,用面饼裹,火炮焦黄,留性,取出和面用之。)
上为细末,每服二钱,陈皮饮调下。重者三钱。
〔丹〕带下不止,用椒目、白芷。治白带,用椒目为末,米饮调服。
治带下方
上用云母粉,温水调下三钱,立见神效。
伏龙肝散 治赤白带下,久患不瘥, 悴乏力,六脉微濡。
棕榈(不拘多少,烧赤,急以盆盖,荫冷存性) 伏龙肝(于灶直下去取赤土,炒令烟尽)
屋梁上悬尘(炒令烟尽,出火毒)
上等分研匀,入脑、麝各少许,每服三钱,温酒或淡醋汤下。患十年者,半月可安。
马蹄丸 治白漏不绝。
白马蹄 禹余粮(各四两) 龙骨(三两) 乌贼鱼骨 白僵蚕 赤石脂(各二两)
上为细末,炼蜜和丸,如梧桐子大。每服十丸,空心酒送下。不止,加三十丸。
又方 治白带。
用白芷以锻石炒去皮,茜草少许,粥糊丸服。
〔大〕白芷散 治赤白带下。
白芷(二两) 海螵蛸(二个, ) 胎发(一团, )
上为细末,空心温酒调下二钱。
〔丹〕赤白带,用生狗头骨烧灰存性,酒调服或入药服。
〔润剂〕
带下久而枯涸者濡之。凡大补气血,皆所以濡之。如以四物汤为末,炼蜜丸梧子大,
空心米饮下三四十丸,以疗年高妇人白带良验,皆润剂也。以另有补剂,故止着葵花、郁
李仁之例于此条耳。
补经固真汤 白文举正室白带常漏久矣,服诸药不效。诊得心胞尺脉极微,其白
带流而不止。叔和《脉经》云∶崩中日久为白带,漏下多时骨水枯。言崩中者始病血崩
不已,久下则血少复亡其阳,故白滑之物下流不止,是本经血海将枯,津液复亡,枯干
不能滋养筋骨。以本经行经药为引,用为使;以大辛甘油腻之药,润其枯燥,而滋溢津
液。以大辛热之气味,补其阳道,生其血脉。以苦寒之药,泄其肺而救其上。热伤气,以
人参补之,以微苦温之药佐而益元气。名曰补经固真汤。
人参(二钱) 橘皮(不去白,半钱) 干姜(末,二钱) 白葵花(十六朵,去萼,碎)
柴胡 甘草(炙) 郁李仁(去皮尖,研) 生黄芩(各一钱,另锉)
上除黄芩外,以水三大盏,煎至一盏七分,再入黄芩,同煎至一盏,去滓空心带热
服,候少时,以早膳压之。
补真润肠汤 治白带下,阴户中痛,控心而急痛,身黄皮缓,身重如山,阴中如冰。
(一名助阳汤。)
柴胡(一钱二分) 良姜(二钱) 白葵花(七朵) 防风 郁李仁 干姜 甘草(各一钱)
陈皮 生黄芩(各五分)
上为细末,锉散,只作一服,水二盏,煎至一盏,去滓,食前热服。
上葵花、郁李仁之滑以润燥,盖枯涸滞着者宜之。
〔补剂〕
脉微食少,及久病曾经攻下者,俱作虚治。有热用凉补,无热用温补。
〔丹〕治白带。
龟板(炙) 枳子(各二两) 黄柏(一两,炒) 白芍药(七钱半) 干姜(炒,二钱半)
香附子 山茱萸 苦参 樗皮 贝母(各半两)
上为末,以酒糊为丸,空心米饮下。
治赤白带。
龟板(二两,涂酒炙) 黄柏(一两,炒) 干姜(炒,一钱) 枳子(二钱半)
上为末,酒糊为丸。日二服,每服七十丸。
又方 治带下脉数者。
枸杞根(一斤) 生地黄(五两)
上二味,以水一斗,煮取五升,分三服。
上三方治带,龟板、黄柏、地黄例,肾水真阴虚者宜之。
〔丹〕胡安人白带下,月经甚多,食少倦怠,面黄,经中有如血块者,有如筋膜者,
与参、术等补血气,调脾胃,后诸证皆退。惟带未止,以樗皮丸主之。(方见前。)
上法治带下虚而有热者。若虚而有寒,脉微、面白不泽,无力以言者,东垣补经固真
汤、丁香胶艾汤、香桂六合汤是也。
〔温补〕
白蔹丸 (《济生》)治室女冲任虚寒,带下纯白。
鹿茸(酒蒸焙,二两) 白蔹 狗脊(燎毛制,各一两)
上为细末,艾煎醋汁,打糯米糊丸,如梧子大。每服五十丸,空心温酒送下。
当归煎 治赤白带下,腹内疼痛,不欲饮食,日渐羸瘦。
当归(酒浸) 赤芍药 牡蛎(火 ,取粉) 熟地黄(酒蒸,焙) 阿胶 白芍药
续断(酒浸,各一两) 地榆(半两)
上为末,醋糊丸如梧子大。每五十丸,空心米饮下。
〔韩〕山妻年三十余,十八胎九殒八夭。会先君松潘难作,贱兄弟皆西奔,妻惊忧过
甚,遂昏昏不省人事,口唇舌皆疮,或至封喉,下部虚脱,白带如注。如此四十余日,或
时少醒,至欲自缢,自悲不能堪。医或投凉剂解其上,则下部疾愈甚。或投热剂,及以
汤药熏蒸其下,则热晕欲绝。四弟还,脉之,始知为亡阳证也。大哭曰∶宗嗣未立,几误
杀吾嫂。急以盐煮大附子九钱为君,制以薄荷、防风,佐以姜、桂、芎、归之属,水煎
入井,冰冷与之。未尽剂,鼾鼻熟睡通宵,觉即能识人。时止一嗣子、二女,相抱痛哭,疏
戚皆悲。执友赵宪长惊曰∶君何术也。弟曰∶方书有之,假对假,真对真尔。上乃假热,故
以假冷之药从之,下乃真冷,故以真热之药反之,斯上下和而病解矣。继后主以女金丹,
错综以二三方,不但去其疾,且调治元气。庚午生一子,今应袭也。壬申生一子。去年又
患疟疾十三月,亦主以养元气、调生气,待饮食大进,然后劫以毒药,吐下块物甚多,投
以附子汤三钱而愈,不责效旦暮间。其用女金丹,即胜金丸也,得之异人。倍加香附,而
视气血之偏者,又加姜黄、条芩,倍川芎之属,取效甚多。予念无子者往往有之,翻思
予得子之难,其苦何如。乃次第录其方,并女金丹以济人云。雪翁识。(女金丹方见求子门。)
〔薛〕一孀妇腹胀胁痛,内热晡热,月经不调,肢体酸麻,不时吐痰,或用清气化
【严用和】巢元方在《诸病源候论》中论述妇人有三十六种疾病,包括七瘕、八瘕、九痛、十二带下。而关于带下的证候表现并不明显,现在的人只知道有赤带、白带两种。这主要是由于劳累损伤了冲脉和任脉,风冷之邪盘踞在胞宫络脉所致。妇女平时生活起居,血应当常多,气应当常少,这样百病不生。如果气超过血,气盛则生寒,血液不能化赤,于是形成白带。如果气平血少,血少则生热,血液不能化为经血,于是形成赤带。寒热交杂并见,则赤白二色同时下注。其脉象右手尺部浮,浮脉属阳,阳气绝者无子,如果足冷且带下,轻则漏下(非经期少量出血),重则崩中(非经期大量出血),这都是心不能荣养血液、肝不能藏血所导致的。其脉寸口弦而大,弦脉表示阳气减损,大脉表示中空如芤,减为寒,芤为虚,寒与虚相互搏结,脉象变为革脉,主半产(小产)和漏下。又尺寸脉虚的漏血,漏血脉浮的不可治。
【《产宝》】带下三十六疾,是指十二癥、九痛、七害、五伤、三固,合称为三十六疾。十二癥,是指阴道排出的物质:一像膏状,二像青色血,三像紫色汁液,四像红色皮屑,五像脓痂,六像豆汁,七像葵菜羹,八像凝血,九像清水样的血,十像米泔水,十一像月经洗涤之物,十二像经期不按周期到来。九痛,是一阴中痛,二阴中淋痛(排尿时疼痛),三小便痛,四寒冷痛,五月来时腹痛,六气胀满来时足痛,七汗出阴中如虫咬痛,八胁下皮痛,九腰痛。七害,一是害食,二是害气,三是害冷,四是害劳,五是害房事,六是害妊娠,七是害睡眠。五伤,一是窍孔痛,二是寒冷痛,三是小腹痛,四是脏腑感觉迟钝(不仁),五是子门不正,牵引背痛。三固,是月经闭塞不通,其余二者,原文缺载未记。而张仲景所说的三十六种疾,都是由子宫冷热劳损,夹杂下焦之气从阴内发起的。
【朱丹溪】赤白带,罗先生(罗天益)的方法,或者用十枣汤(方见伤寒胁满病章节),或者用神佑丸(方见杂病痰饮章节),或者用玉烛散,即四物汤加调胃承气汤。这些都可以使用。虚证不可峻猛攻伐,实证可以行攻法。血虚,用加减四物汤。气虚,以白术、人参、陈皮交替服用。赤带属血,白带属气,治疗以燥湿为先。湿邪严重的,用固肠丸(方见后文)。相火妄动的,在诸药中加入炒黄柏。滑泄的,加龙骨、赤石脂。滞涩的,加葵花(白色者治白带,红色者治赤带)。性情急躁的,加黄连。寒冷的月份少量加入干姜、附子。临机应变,首先必须断绝浓味饮食。带下病与梦遗治疗方法相同。肥胖人患带下,多是湿痰,用海浮石、半夏、南星、炒黄柏、青黛、苍术、川芎。瘦人患带病少,如果有多是热证,用炒黄柏、蛤粉、滑石、川芎、青黛、樗根皮。带下和漏下都是胃中痰积,流下渗入膀胱,出于大肠、小肠。宜用升提法,严重的上部必用吐法,以提举其气,下部用二陈汤加白术、苍术,仍制成丸剂服用。
【戴原礼】赤白带下,都是因为七情内伤,或者下元虚冷,病因不单一。大概白带多,间或有下赤带的,都适宜吞服顺气散配合震灵丹,仍辅助艾附丸,或者用米饮送服沙参末。带下不止导致身体消瘦羸弱的,用四物汤加牡蛎粉半钱,吞服固阳丸,多服见效。(固阳丸方见杂病遗精门。)有带下病愈后一两个月或再发,半年一发,先出血而后下带,来势不可遏制,停蓄不久,又复倾泻,这名叫漏带,最为难治。下截之血,由小腹主治。有因血虚而虚热陷入小肠,导致小便涩痛,颜色白如米泔,或者结成沙粒,都不可当作淋证治疗,不能用冷剂。适宜用四物汤、五苓散各半帖合煎。
【李梴】妇人带下,其名有五,因为经期、产后,风邪侵入胞门传于脏腑而致。如果损伤足厥阴肝经,颜色像青泥;损伤手少阴心经,颜色像红津;损伤手太阴肺经,形状像白涕;损伤足太阴脾经,黄色像烂瓜;损伤足少阴肾经,黑色像瘀血。人有带脉横于腰间,像束带一样,病发生在这里,所以名为带。
【薛己】徐用诚先生说:前证白带属气而赤带属血。东垣先生(李杲)说:血崩久了则亡阳,所以白滑之物下流,未必完全拘泥于带脉。也有湿痰流注下焦,或者肾肝阴淫之湿胜,或者因惊恐而木乘土位,浊液下流,或者思慕过度导致筋痿。戴人以六脉滑大有力,用宣导之法,这是泻其实邪。东垣以脉微细沉紧,或洪大而虚,用补阳调经,这是兼责其虚证。丹溪用海浮石、南星、椿根皮之类,这是治其湿痰。我认为前证都应当以壮脾胃、升阳气为主,辅助以各经见证的药物。色青的属肝,用小柴胡汤加山栀、防风。湿热壅滞,小便赤涩,用龙胆泻肝汤。肝血不足,或燥热风热,用六味丸。色赤的属心,用小柴胡汤加黄连、山栀、当归。思虑过伤,用妙香散等药。色白的属肺,用补中益气汤加山栀。色黄的属脾,用六君子汤加山栀、柴胡;无效,用归脾汤。色黑的属肾,用六味丸。气血俱虚,用八珍汤。阳气下陷,用补中益气汤。湿痰下注,前方加茯苓、半夏、苍术、黄柏。气虚痰饮下注,用四七汤送服六味丸。不可拘泥于肥人多痰,瘦人多火,而以燥湿泻火的药物轻率治疗。
【张洁古】治疗带下少腹冤结而痛的,先用十枣汤攻下;接着服苦楝丸、大玄胡散调理。这是先攻后补的方法。
治疗结痰白带,用小胃丹,在半饥半饱时,用津液送服数丸,等待郁积运行后,欲服补药时再用。
白术(一两) 苍术(半两) 红白葵花(二钱半) 白芍药(七钱半)
上药蒸饼为丸,空心时,煎四物汤送服二十丸。
陶遵道的舅母,七十岁,形体瘦弱但食欲好,白带。饭前姜汤吞服大补丸五十丸,一至二次,午饭后及临睡前,各服小胃丹十五丸,痊愈。
【张子和】近来,顿丘一个妇人,病带下连绵不绝,白色物质有时流出,已经三年了。让我诊脉,两手脉都滑大而有力,六七至,常感到上热、口干、眩晕,时常呕吐酸水,我知其实是有寒痰在胸中,用瓜蒂散吐出冷痰二三升,都是酸水。间或有像黄涎,状如烂胶。接着用浆粥调养胃气,再次用导水禹功散以泻其下,然后用淡剂渗泄的药,利其水道,不几天就痊愈了。息城李左衙的妻子,病白带如水般从阴道漏出,绵绵不绝,臭秽之气不可靠近,面黄食减,已经三年了。众医都说积冷,用阳起石、硫黄、干姜、附子等药,重重燥补,污水反而增多。戴人判断说:这带浊水本是热邪乘袭太阳经,其寒水不禁固摄,所以如此。水自高而趋下,宜先绝其上源。于是涌吐痰涎二三升,第二天泻下水斗余,行了三遍,周身出汗,到第二天早晨病人说:污物已不再下了。接着用寒凉药剂,服用半年,生下一男婴。
【燥剂】
有湿痰而虚弱不能耐受攻伐的,用燥法。热湿宜凉燥,寒湿宜温燥。
樗皮丸 治疗赤白带下有湿热者。
芍药(五钱) 良姜(三钱,烧成灰) 黄柏(二钱,各炒成灰) 椿根皮(一两半)
上药为末,粥糊为丸。每服三、五十丸,空心米饮吞下。
赤白带因湿热胜而下注者。
苍术(盐炒) 白芍药(各一两) 枳壳(三钱) 椿根皮(炒,二两) 干姜(煨,二两)
地榆(半两) 甘草(三钱) 滑石(一两,炒) 为末,粥丸,米饮送下。
治疗带下。
椿根皮(二两) 神曲(炒) 麦麸曲(炒) 黄柏(炒,各一两) 芍药(一两半) 滑石 枳壳(各半两) 苍术(一两)
上药为末,糊丸如梧桐子大。每服五十丸,空心服。
固肠丸 治疗湿气下利,大便血,白带。去除脾胃陈积之后,用此药以燥下湿。也不曾单用,看病作汤使。
椿根皮为末,粥糊为丸。此药性凉而燥,须炒用。一方加滑石一半。
治疗白带因七情所伤,脉数者。
黄连(炒) 侧柏叶(酒蒸) 黄柏(炒,各半两) 香附子(醋炒) 白术(炒,各一两) 白芷(烧存性) 木香(各三钱) 椿根皮(二两,炒) 白芍药(一两)
上药为末,饭粥为丸。米饮汤送下。
以上五方治带,椿皮例属凉燥之剂,湿热盛者适宜。后一方有黄连、香附、木香,故可治七情所伤。
【王硕】乳香散 治疗赤白带下。
草果(一枚,去皮,入麝香一小块,用面饼包裹,火炮焦黄,留性,取出和面用之。)
上药为细末,每服二钱,陈皮饮调下。重者三钱。
【朱丹溪】带下不止,用椒目、白芷。治疗白带,用椒目为末,米饮调服。
治疗带下方
上用云母粉,温水调下三钱,立见神效。
伏龙肝散 治疗赤白带下,久患不愈,憔悴乏力,六脉微濡。
棕榈(不拘多少,烧赤,急以盆盖,荫冷存性) 伏龙肝(于灶直下去取赤土,炒令烟尽) 屋梁上悬尘(炒令烟尽,出火毒)
上等分研匀,入脑、麝各少许,每服三钱,温酒或淡醋汤下。患十年者,半月可安。
马蹄丸 治疗白漏不绝。
白马蹄 禹余粮(各四两) 龙骨(三两) 乌贼鱼骨 白僵蚕 赤石脂(各二两)
上药为细末,炼蜜和丸,如梧桐子大。每服十丸,空心酒送下。不止,加三十丸。
又方 治疗白带。
用白芷以锻石炒去皮,茜草少许,粥糊丸服。
【王硕】白芷散 治疗赤白带下。
白芷(二两) 海螵蛸(二个,煅) 胎发(一团,煅)
上药为细末,空心温酒调下二钱。
【润剂】
带下久而枯涸的,用润法。凡大补气血,都是用来润燥的。如将四物汤为末,炼蜜丸梧子大,空心米饮下三四十丸,以疗年高妇人白带良验,都是润剂。因为另有补剂,所以只列葵花、郁李仁的例子于此条耳。
补经固真汤 白文举正室白带常漏已久,服诸药不效。诊得心包尺脉极微,其白带流而不止。叔和《脉经》说:崩中日久为白带,漏下多时骨水枯。言崩中者始病血崩不已,久下则血少复亡其阳,故白滑之物下流不止,是本经血海将枯,津液复亡,枯干不能滋养筋骨。以本经行经药为引,用为使;以大辛甘油腻之药,润其枯燥,而滋溢津液。以大辛热之气味,补其阳道,生其血脉。以苦寒之药,泄其肺而救其上。热伤气,以人参补之,以微苦温之药佐而益元气。名曰补经固真汤。
人参(二钱) 橘皮(不去白,半钱) 干姜(末,二钱) 白葵花(十六朵,去萼,碎) 柴胡 甘草(炙) 郁李仁(去皮尖,研) 生黄芩(各一钱,另锉)
上除黄芩外,以水三大盏,煎至一盏七分,再入黄芩,同煎至一盏,去滓空心带热服,候少时,以早膳压之。
补真润肠汤 治疗白带下,阴户中痛,控心而急痛,身黄皮缓,身重如山,阴中如冰。(一名助阳汤。)
柴胡(一钱二分) 良姜(二钱) 白葵花(七朵) 防风 郁李仁 干姜 甘草(各一钱) 陈皮 生黄芩(各五分)
上药为细末,锉散,只作一服,水二盏,煎至一盏,去滓,食前热服。
以上葵花、郁李仁之滑以润燥,盖枯涸滞着者适宜。
【补剂】
脉微食少,及久病曾经攻下者,俱作虚治。有热用凉补,无热用温补。
【朱丹溪】治疗白带。
龟板(炙) 枳子(各二两) 黄柏(一两,炒) 白芍药(七钱半) 干姜(炒,二钱半) 香附子 山茱萸 苦参 樗皮 贝母(各半两)
上药为末,以酒糊为丸,空心米饮下。
治疗赤白带。
龟板(二两,涂酒炙) 黄柏(一两,炒) 干姜(炒,一钱) 枳子(二钱半)
上药为末,酒糊为丸。日二服,每服七十丸。
又方 治疗带下脉数者。
枸杞根(一斤) 生地黄(五两)
上二味,以水一斗,煮取五升,分三服。
以上三方治带,龟板、黄柏、地黄例,肾水真阴虚者适宜。
【朱丹溪】胡安人白带下,月经甚多,食少倦怠,面黄,经中有如血块者,有如筋膜者,与参、术等补血气,调脾胃,后诸证皆退。惟带未止,以樗皮丸主之。(方见前。)
以上法治带下虚而有热者。若虚而有寒,脉微、面白不泽,无力以言者,东垣补经固真汤、丁香胶艾汤、香桂六合汤是也。
【温补】
白蔹丸 (《济生方》)治疗室女冲任虚寒,带下纯白。
鹿茸(酒蒸焙,二两) 白蔹 狗脊(燎毛制,各一两)
上药为细末,艾煎醋汁,打糯米糊丸,如梧子大。每服五十丸,空心温酒送下。
当归煎 治疗赤白带下,腹内疼痛,不欲饮食,日渐羸瘦。
当归(酒浸) 赤芍药 牡蛎(火煅,取粉) 熟地黄(酒蒸,焙) 阿胶 白芍药 续断(酒浸,各一两) 地榆(半两)
上药为末,醋糊丸如梧子大。每五十丸,空心米饮下。
【韩懋】山妻年三十余,十八胎九殒八夭。会先君松潘难作,贱兄弟皆西奔,妻惊忧过甚,遂昏昏不省人事,口唇舌皆疮,或至封喉,下部虚脱,白带如注。如此四十余日,或时少醒,至欲自缢,自悲不能堪。医或投凉剂解其上,则下部疾愈甚。或投热剂,及以汤药熏蒸其下,则热晕欲绝。四弟还,脉之,始知为亡阳证也。大哭曰:宗嗣未立,几误杀吾嫂。急以盐煮大附子九钱为君,制以薄荷、防风,佐以姜、桂、芎、归之属,水煎入井,冰冷与之。未尽剂,鼾鼻熟睡通宵,觉即能识人。时止一嗣子、二女,相抱痛哭,疏戚皆悲。执友赵宪长惊曰:君何术也。弟曰:方书有之,假对假,真对真尔。上乃假热,故以假冷之药从之,下乃真冷,故以真热之药反之,斯上下和而病解矣。继后主以女金丹,错综以二三方,不但去其疾,且调治元气。庚午生一子,今应袭也。壬申生一子。去年又患疟疾十三月,亦主以养元气、调生气,待饮食大进,然后劫以毒药,吐下块物甚多,投以附子汤三钱而愈,不责效旦暮间。其用女金丹,即胜金丸也,得之异人。倍加香附,而视气血之偏者,又加姜黄、条芩,倍川芎之属,取效甚多。予念无子者往往有之,翻思予得子之难,其苦何如。乃次第录其方,并女金丹以济人云。雪翁识。(女金丹方见求子门。)
[Yan Yonghe] Chao Yuanfang, in *Zhu Bing Yuan Hou Lun* (Treatise on the Pathogenesis and Manifestations of All Diseases), discusses that women have thirty-six diseases, including seven types of Jia masses (abdominal masses), eight types of Xia masses, nine types of pain, and twelve types of Dai discharge (leukorrhea). However, the manifestations of Dai discharge are not clearly distinguished; nowadays people only know of red Dai and white Dai. This is caused by fatigue damaging the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel), with wind-cold pathogens occupying the uterine collaterals. In daily life, a woman's blood should be relatively abundant while Qi should be relatively scarce, preventing various diseases. If Qi exceeds Blood, excess Qi generates cold, and Blood fails to transform into red, resulting in white Dai. If Qi is balanced but Blood is deficient, deficiency of Blood generates heat, and Blood fails to transform into menstrual flow, resulting in red Dai. When cold and heat mix, both red and white discharges occur simultaneously. The pulse at the right Chi position is floating; a floating pulse indicates Yang. If Yang is exhausted, conception is impossible. If accompanied by cold feet and Dai discharge, it may manifest as mild Lou Xia (metrorrhagia/spotting) or severe Beng Zhong (metrorrhagia/heavy bleeding), all caused by the Heart failing to nourish Blood and the Liver failing to store Blood. A pulse at the Cun and Kou positions that is wiry and large: wiry indicates reduction (deficiency of Yang), large indicates hollow (Kou pulse); reduction implies cold, Kou implies deficiency. Cold and deficiency interacting result in a革 (Ge/Cord-like) pulse, indicating spontaneous abortion (Ban Chan) and Lou Xia. Furthermore, deficiency pulses at Cun and Chi indicate Lou Xue (bleeding from leakage); if the Lou Xue pulse is floating, it is incurable.
[Chen Miao's *Chan Bao*] The thirty-six Dai diseases refer to twelve types of Zheng masses, nine types of pain, seven types of harm, five types of injury, and three types of consolidation, collectively called the thirty-six diseases. The twelve Zheng masses refer to the substances discharged: one like paste, two like green blood, three like purple fluid, four like red skin flakes, five like pus crusts, six like bean juice, seven like mallow soup, eight like clotted blood, nine like clear bloody water, ten like rice washings, eleven like menstrual washing residue, twelve like irregular menstruation arriving out of cycle. The nine pains are: one pain in the yin, two painful urination in the yin, three painful urination, four cold pain, five abdominal pain during menstruation, six foot pain with qi distension during menstruation, seven sweating with insect-biting pain in the yin, eight hypochondriac skin pain, nine lower back pain. The seven harms are: harm from food, harm from qi stagnation, harm from cold, harm from labor, harm from sexual intercourse, harm from pregnancy, harm from sleep. The five injuries are: one orifice pain, two cold pain, three lower abdominal pain, four organ insensibility, five abnormal opening of the Zi Men (cervix) pulling on the back pain. The three consolidations are amenorrhea due to blockage; the other two are missing in the text. Zhang Zhongjing's thirty-six diseases are all caused by cold-heat and fatigue damaging the Zi Zang (uterus), arising from the interior of the yin.
[Zhu Danxi] For red and white Dai, Master Luo's methods include using Shi Zao Tang (Ten Jujube Decoction) [see Shaoyang Hypochondriac Fullness disease chapter], Shen You Wan (Divine Protection Pill) [see Miscellaneous Disease Phlegm-Fluids chapter], or Yu Zhu San (Jade Candle Powder), which is Si Wu Tang (Four Substances Decoction) added with Tiao Wei Cheng Qi Tang (Regulate the Stomach and Order the Qi Decoction). These can all be used. Deficiency patterns must not be treated with harsh purgatives; excess patterns can undergo purgation. For Blood deficiency, use Modified Si Wu Tang. For Qi deficiency, alternate Bai Zhu (Atractylodis Rhizoma), Ren Shen (Ginseng Radix), and Chen Pi (Citri Reticulatae Pericarpium). Red Dai belongs to Blood, White Dai belongs to Qi; treatment prioritizes drying dampness. For severe dampness, use Gu Chang Wan (Intestine-Securing Pill) [see later]. For hyperactive Ministerial Fire, add Chao Huang Bo (Fried Phellodendri Cortex) to the formulas. For slipping/leakage, add Long Gu (Fossilia Ossis Mastodi) and Chi Shi Zhi (Halloysitum Rubrum). For stagnation, add Kui Hua (Hibisci Rosa-Sinensis Flos) [White for white Dai, Red for red Dai]. For irritable temperaments, add Huang Lian (Coptidis Rhizoma). In cold months, add small amounts of Gan Jiang (Zingiberis Rhizoma) and Fu Zi (Aconiti Lateralis Radix Praeparata). Adapt to circumstances, but first must eliminate rich flavors. Dai discharge is treated similarly to nocturnal emission. Obese patients with Dai usually have damp-phlegm, using Hai Shi (Calcitum), Ban Xia (Pinelliae Rhizoma), Nan Xing (Arisaematis Rhizoma), Chao Huang Bo, Qing Dai (Indici Folium), Cang Zhu (Atractylodis Rhizoma), and Chuan Xiong (Chuanxiong Rhizome). Thin patients rarely get Dai; if they do, it is mostly heat, using Chao Huang Bo, Ge Fen (Talcum), Hua Shi (Talcum), Chuan Xiong, Qing Dai, and Chu Pi (Toosendanii Cortex). Dai and Lou are both stomach phlegm accumulation flowing down to permeate the Bladder and exit via the Large and Small Intestines. Use lifting methods; for severe cases, induce vomiting above to lift Qi, and below use Er Chen Tang (Two-Cured Decoction) added with Bai Zhu and Cang Zhu, still made into pills.
[Dai Yuanli] Red and white Dai discharge are all caused by internal injury from the Seven Emotions or deficiency-cold of the Lower Origin; the etiology is not singular. Generally, white Dai is common, with occasional red Dai; all are suitable for swallowing Shun Qi San (Qi-Promoting Powder) combined with Zhen Ling Dan (Spirit-Shaking Pellet), assisted by Ai Fu Wan (Mugwort and Asarum Pill), or taking Sha Shen (Glehniae Radix) powder mixed with rice drink. If Dai discharge continues leading to emaciation, use Si Wu Tang added with Mu Li Fen (Ostreae Concha Pulvis) half qian, swallowing Gu Yang Wan (Yang-Securing Pill), taken frequently for effect. (Gu Yang Wan formula see Impotence/Emission chapter.) Some Dai cases recur one or two months after cure, or every half year, starting with bleeding then Dai discharge, unstoppable, accumulating briefly then pouring out again; this is named Lou Dai (Leaking Dai), most difficult to treat. Bleeding from the lower section is governed by the lower abdomen. Some cases involve Blood deficiency with deficient heat sinking into the Small Intestine, causing dysuria with white turbid urine like rice washings or sand grains; these must not be treated as Lin syndrome (strangury) with cold agents. Use Si Wu Tang and Wu Ling Yin (Five-Ingredient Powder with Poria) half doses each, decocted together.
[Li Chen] Women's Dai discharge has five names, caused by wind pathogens entering the Bao Men (uterine gate) during menstruation or postpartum and transmitting to the Zang-Fu organs. Injury to the Foot-Jueyin Liver Meridian results in color like green mud; injury to the Hand-Shaoyin Heart Meridian results in color like red saliva; injury to the Hand-Taiyin Lung Meridian results in form like white nasal mucus; injury to the Foot-Taiyin Spleen Meridian results in yellow color like rotten melon; injury to the Foot-Shaoyin Kidney Meridian results in black color like stasis blood. There is a Dai Mai (Belt Vessel) crossing the waist like a belt; disease occurring here is named Dai.
[Xue Ji] Mr. Xu Yongcheng said: Previous symptoms, white belongs to Qi and red belongs to Blood. Master Dongyuan (Li Gao) said: Long-term blood flooding leads to loss of Yang, so white slippery substances flow down; this is not solely restricted to the Dai Mai. It can also be damp-phlegm flowing to the Lower Jiao, or excessive dampness from Kidney/Liver Yin, or Wood overacting on Earth due to fright/fear causing turbid fluids to flow down, or longing leading to Sinew Withering. Dai Ren treated with slippery-large-forceful six pulses using guiding/discharging methods, clearing excess. Dongyuan treated with fine-deep-tight or large-empty pulses using Yang-tonifying and menstruation-regulating methods, addressing deficiency. Danxi used Hai Shi, Nan Xing, Chun Gen Pi, etc., treating damp-phlegm. I believe previous symptoms should primarily strengthen Spleen/Stomach and raise Yang Qi, assisted by herbs for specific meridian symptoms. Green belongs to Liver, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Shan Zhi (Gardeniae Fructus) and Fang Feng (Saposhnikoviae Radix). Damp-heat congestion with red-dysuria, use Long Dan Xie Gan Tang (Gentian Liver-Draining Decoction). Liver Blood deficiency or dry-heat/wind-heat, use Liu Wei Wan (Six-Ingredient Pill). Red belongs to Heart, use Xiao Chai Hu Tang plus Huang Lian, Shan Zhi, Dang Gui (Angelicae Sinensis Radix). Overthinking injury, use Miao Xiang San (Wonderful Incense Powder). White belongs to Lung, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Shan Zhi. Yellow belongs to Spleen, use Liu Jun Zi Tang (Six-Gentleman Decoction) plus Shan Zhi, Chai Hu (Bupleuri Radix); if ineffective, use Gui Pi Tang (Restore the Spleen Decoction). Black belongs to Kidney, use Liu Wei Wan. Qi and Blood dual deficiency, use Ba Zhen Tang (Eight-Treasure Decoction). Yang Qi sinking, use Bu Zhong Yi Qi Tang. Damp-phlegm sinking, former formula plus Fu Ling (Poria), Ban Xia, Cang Zhu, Huang Bo. Qi deficiency with phlegm-fluids sinking, use Si Qi Tang delivering Liu Wei Wan. Do not rigidly adhere to "obese have much phlegm, thin have much fire," lightly treating with drying-damp/fire-draining herbs.
[Zhang Jiegu] For Dai discharge with lower abdomen oppression/pain, first use Shi Zao Tang to purge; then take Ku Lian Wan (Quinine Pill) and Da Xuan Hu San (Major Corydalis Powder) to regulate. This is a method of attacking first, tonifying later.
For condensed phlegm white Dai, use Xiao Wei Dan (Small Stomach Pill), taken between hunger and fullness with saliva, waiting for stagnation to move before administering tonics.
Bai Zhu (1 liang), Cang Zhu (0.5 liang), Hong/Bai Kui Hua (2.5 qian), Bai Shao Yao (7.5 qian).
Make pills with steamed dough, take 20 pills on an empty stomach with Si Wu Tang decoction.
Tao Zundao's aunt, age 70, thin but good appetite, white Dai. Before meals, swallow 50 Da Bu Wan (Great Tonification Pills) with ginger tea, 1-2 times; after lunch and before bed, take 15 Xiao Wei Dan each, cured.
[Zhang Zihe] Recently, a woman from Dunqiu suffered continuous Dai discharge for three years, sometimes discharging white matter. Her pulse was slippery-large-forceful in both hands, 6-7 beats per breath, with upper heat, dry mouth, dizziness, and occasional vomiting of sour water. I knew there was cold phlegm in the chest, so I used Gua Di San (Melon Trichosanthes Powder) to vomit 2-3 sheng of cold phlegm/sour water, some like yellow saliva resembling rotten glue. Then nourished stomach Qi with grain broth, followed by Dao Shui Yu Gong San (Water-Guiding Great Effort Powder) to purge below, then used mild diuretics to promote urination, curing her in a few days. Wife of Li Zuoya from Xicheng had white Dai leaking like water, foul-smelling, yellow face, poor appetite for three years. Doctors attributed it to accumulated cold, using heavy warming/drying herbs (Yang Qi Shi, Liu Huang, Gan Jiang, Fu Zi), increasing discharge. Dai Ren diagnosed: This turbid water is heat attacking the Taiyang Meridian, unable to be retained by cold water. Water flows down from high; cut off the source above. Vomited 2-3 sheng of phlegm, next day purged over a dou of water, three rounds, profuse sweating, by morning discharge stopped. Then took cold-cooling agents for half a year, gave birth to a son.
[Drying Agents]
For damp-phlegm with weakness intolerant to purging, use drying methods. Heat-damp uses cool-drying; Cold-damp uses warm-drying.
Chu Pi Wan (Toosendan Bark Pill) treats red/white Dai with damp-heat.
Shao Yao (5 qian), Liang Jiang (3 qian, burnt to ash), Huang Bo (2 qian, fried to ash), Chun Gen Pi (1.5 liang).
Powder, pill with congee. Take 30-50 pills on empty stomach with rice drink.
Red/white Dai due to excess damp-heat:
Cang Zhu (salt-fried), Bai Shao Yao (1 liang each), Zhi Ke (3 qian), Chun Gen Pi (fried, 2 liang), Gan Jiang (roasted, 2 liang), Di Yu (0.5 liang), Gan Cao (3 qian), Hua Shi (fried, 1 liang).
Powder, pill with congee, rice drink.
Treating Dai discharge:
Chun Gen Pi (2 liang), Shen Qu (fried), Mai Pi Qu (fried), Huang Bo (fried, 1 liang each), Shao Yao (1.5 liang), Hua Shi, Zhi Ke (0.5 liang each), Cang Zhu (1 liang).
Powder, honey-pill. Take 50 pills on empty stomach.
Gu Chang Wan treats damp diarrhea, bloody stool, white Dai. After removing spleen/stomach old accumulation, use this to dry lower dampness. Not used alone, but as decoction adjunct.
Chu Pi powder, pill with congee paste. Cool-drying nature, must be fried. One formula adds half Hua Shi.
Treating white Dai from Seven Emotions with rapid pulse:
Huang Lian (fried), Ce Bai Ye (wine-steamed), Huang Bo (fried, 0.5 liang each), Xiang Fu Zi (vinegar-fried), Bai Zhu (fried, 1 liang each), Bai Zhi (burnt to retain nature), Mu Xiang (3 qian each), Chun Gen Pi (fried, 2 liang), Bai Shao Yao (1 liang).
Powder, pill with rice porridge. Rice drink delivery.
The above five formulas use Chu Pi as cool-drying for damp-heat. The last includes Huang Lian, Xiang Fu, Mu Xiang for emotional injury.
[Wang Shuo] Ru Xiang San (Frankincense Powder) treats red/white Dai.
Cao Guo (1 piece, peeled, with musk, wrapped in dough, fire-roasted yellow, retain nature, mix with dough).
Fine powder, take 2 qian with Chen Pi drink. Severe cases 3 qian.
[Zhu Danxi] For unceasing Dai, use Jiao Mu (Semen Zanthoxyli) and Bai Zhi. For white Dai, powder Jiao Mu, mix with rice drink.
Formula for Dai:
Use Yun Mu Fen (Mica Powder), 3 qian with warm water, immediate effect.
Fu Long Gan San (Dragon Sitting Earth Powder) treats red/white Dai, chronic non-healing, emaciation, weak-pulse.
Zong Lv (burnt red, covered to cool, retain nature), Fu Long Gan (soot from stove, fried smokeless), Wu Liang Shang Xuan Chen (dust from roof beam, fried smokeless).
Equal parts powder, add少许 Nao (Camphor) and She (Musk). Take 3 qian with warm wine or light vinegar water. Ten-year case, safe in half month.
Ma Ti Wan (Horse Hoof Pill) treats continuous white leakage.
Bai Ma Ti, Yu Yu Liang (4 liang each), Long Gu (3 liang), Wu Zei Gu, Bai Jiang Can, Chi Shi Zhi (2 liang each).
Fine powder, honey-pill. Take 10 pills on empty stomach with wine. If uncontrolled, add 30 pills.
Another formula for white Dai:
Bai Zhi fried with Duan Shi (Burnt Lime) to remove skin, Qian Cao (Rubiae Radix et Rhizoma)少许, pill with congee.
[Wang Shuo] Bai Zhi San (Angelica Dahurica Powder) treats red/white Dai.
Bai Zhi (2 liang), Hai Piao Xiao (2 pieces, calcined), Tai Fa (clump of baby hair, calcined).
Fine powder, 2 qian with warm wine on empty stomach.
[Zhu Danxi] Red/white Dai, use raw dog skull bone burnt to ash, taken with wine or in medicine.
[Moistening Agents]
For long-term Dai with dryness, use moistening. All great Qi/Blood tonification moistens. E.g., Si Wu Tang powder, honey-pill, 30-40 pills on empty stomach with rice drink for elderly women's white Dai is effective; these are moistening agents. Only Kui Hua and Yu Li Ren examples are listed here due to separate tonification categories.
Bu Jing Gu Zhen Tang (Tonify Meridian Secure True Decoction) for Bai Wenju's wife, chronic white Dai leakage, ineffective with other meds. Pulse at Xin Bao Chi extremely faint, white Dai flows ceaselessly. He Su's *Mai Jing* says: Long-term Beng becomes Dai; long-term Lou dries bone-water. Initial blood flooding leads to blood loss and Yang loss, so white slippery substances flow; blood sea is drying, fluids lost, unable to nourish sinews/bones. Use meridian-guiding herbs as guides; use pungent-sweet-greasy herbs to moisten dryness and generate fluids. Use pungent-hot aromatics to tonify Yang channels and generate blood vessels. Use bitter-cold to drain Lung and rescue upper burner. Heat injures Qi, tonify with Ren Shen, assist with slightly bitter-warm to benefit Yuan Qi. Named Bu Jing Gu Zhen Tang.
Ren Shen (2 qian), Ju Pi (with white, 0.5 qian), Gan Jiang (powder, 2 qian), Bai Kui Hua (16 flowers, de-sepaled, crushed), Chai Hu, Zhi Gan Cao, Yu Li Ren (de-husk/radicle, ground), Sheng Huang Qin (1 qian each, separately cut).
Decoct all except Huang Qin in 3 cups water to 1.7 cups, add Huang Qin, decoct to 1 cup, strain, take hot on empty stomach, suppress with breakfast shortly after.
Bu Zhen Run Chang Tang (Tonify True Moisten Intestine Decoction) treats white Dai, vulvar pain radiating to heart/urgent pain, yellow skin/laxity, heavy body, cold yin. (Also named Zhu Yang Tang.)
Chai Hu (1.2 qian), Liang Jiang (2 qian), Bai Kui Hua (7 flowers), Fang Feng, Yu Li Ren, Gan Jiang, Zhi Gan Cao (1 qian each), Chen Pi, Sheng Huang Qin (0.5 fen each).
Fine powder, decoct in 2 cups water to 1 cup, strain, take hot before meal.
Kui Hua and Yu Li Ren slide/moisten dryness for stagnant dryness.
[Tonification Agents]
Weak pulse, poor appetite, post-purgative long illness: treat as deficiency. Heat use cool-tonification; No heat use warm-tonification.
[Zhu Danxi] Treat white Dai:
Gui Ban (calcined), Zhi Zi (2 liang each), Huang Bo (1 liang, fried), Bai Shao Yao (7.5 qian), Gan Jiang (fried, 2.5 qian), Xiang Fu Zi, Shan Zhu Yu, Ku Shen, Chu Pi, Bei Mu (0.5 liang each).
Powder, wine-paste pill, rice drink on empty stomach.
Treat red/white Dai:
Gui Ban (2 liang, wine-calcined), Huang Bo (1 liang, fried), Gan Jiang (fried, 1 qian), Zhi Zi (2.5 qian).
Powder, wine-paste pill. Twice daily, 70 pills each time.
Another formula for rapid-pulse Dai:
Gou Qi Gen (1 jin), Sheng Di Huang (5 liang).
Boil in 10 dou water to 5 sheng, divide 3 doses.
These three formulas use Gui Ban, Huang Bo, Di Huang for Kidney Water/True Yin deficiency.
[Zhu Danxi] Hu Anren had white Dai, heavy menstruation, poor appetite/lethargy, yellow face, clots/membranes in menses. Given Ren/Shen/Zhu to tonify Blood/Qi and regulate Spleen/Stomach; symptoms receded except Dai. Treated with Chu Pi Wan. (Formula see above.)
Above treats deficiency-with-heat Dai. For deficiency-with-cold (weak pulse, pale dull face, weak speech), use Dongyuan's Bu Jing Gu Zhen Tang, Ding Xiang Jiao Ai Tang, or Xiang Gui Liu He Tang.
[Warm Tonification]
Bai Lian Wan (*Ji Sheng Fang*) treats virgin Chong/Ren deficiency-cold, pure white Dai.
Lu Rong (wine-steamed/dried, 2 liang), Bai Lian, Gou Ji (hair burned/treated, 1 liang each).
Powder, mugwort-vinegar decoction glutinous rice paste pill. 50 pills warm wine on empty stomach.
Dang Gui Jian (Angelica Decoction) treats red/white Dai, abdominal pain, anorexia, wasting.
Dang Gui (wine-soaked), Chi Shao Yao, Mu Li (fire-calcined powder), Shu Di Huang (wine-steamed/dried), E Jiao, Bai Shao Yao, Xu Duan (wine-soaked, 1 liang each), Di Yu (0.5 liang).
Powder, vinegar-paste pill. 50 pills rice drink on empty stomach.
[Han Mao] Mountain wife, 30+, 18 pregnancies, 9 miscarriages, 8 infant deaths. During Songpan turmoil, brothers fled west; wife overly frightened/anxious, unconscious, ulcers on lips/tongue/throat, lower depletion, white Dai like pouring. For 40+ days, occasionally awake, suicidal. Doctors used cooling agents for upper heat worsening lower disease; heating agents/cautions causing fainting. Fourth brother returned, pulse indicated Yang Collapse. Cried: Lineage not established, nearly killed sister-in-law. Urgently used salt-boiled Da Fu Zi (9 qian) as sovereign, processed with Bo He/Fang Feng, assisted by Gan Gui/Xiong Gui, decocted in well-water (ice cold) given. Before finishing dose, slept soundly, woke recognizing people. Only one adopted son, two daughters weeping. Friend Zhao Xianzhang asked skill. Brother said: Formulas say fake matches fake, true matches true. Upper was fake heat, matched with fake cold; lower was true cold, countered with true heat. Harmony restored. Later used Nu Jin Dan (Woman's Golden Pill), varying formulas, removed disease and regulated Yuan Qi. Gengwu year born son, inheritor. Renshen year born son. Last year malaria 13 months, nourished Yuan Qi, waited for appetite, then purged toxins, many clots expelled, cured with 3 qian Fu Zi Tang, not expecting quick effect. Nu Jin Dan is Sheng Jin Wan, obtained from strange person. Added double Xiang Fu, adjusted for Qi/Blood bias with Jiang Huang/Tiao Qin, doubled Chuan Xiong, very effective. Reflecting on difficulty of having children, recorded formulas to help others. Xue Weng records. (Nu Jin Dan see Seeking Children chapter.)
[Xue Ji] A widow with abdominal distension/hypochondriac pain, internal/afternoon fever, irregular menstruation, limb numbness, frequent phlegm, used Qing Qi Hua...