带下者,由劳伤过度,损动经血,致令体虚受风冷,风冷入于胞络,搏其血之所成也。
冲脉、任脉为经络之海。任之为病,女子则带下。而手太阳为小肠之经也,手少阴心之经也
,心为脏,主于里,小肠为腑,主于表。此二经之血,在于妇人,上为乳汁,下为月水,冲
任之所统也。冲任之脉既起于胞内,阴阳过度,则伤胞络,故风邪乘虚而入于胞,损冲、任
之经,伤太阳、少阴之血,致令胞络之间,秽液与血相兼,连带而下。冷则多白,热则多赤
,故名带下。
又,带下有三门∶一曰胞门,二曰龙门,三曰玉门。已产属胞门,未产属龙门,未嫁属
玉门。又,未嫁女亦有三病∶一者,经水初下,阴内热,或当风,或因扇得冷。二者,或因
以寒水洗之得病。又三者,或见月水初下,惊恐得病,皆属带下也。
又,妇人年五十所,病下利,数十日不止,暮发热,小腹里急痛,腹满,手掌烦热,唇
口干燥。此因曾经半产,瘀血在小腹不去,此疾必带下。所以知瘀血者,唇口燥,即是其证
又,妇人年五十所,病但苦背痛,时时腹中痛,少食多厌。诊其脉,阳微,关尺小紧,
形脉不相应,病如此,在下焦,此必带下。
又,妇人带下,六极之病,脉浮即肠鸣腹满,脉紧即腹中痛,脉数则阴中痒痛生疮,脉
弦即阴疼掣痛。
带下病,是由于过度劳累损伤,导致经血受损,致使身体虚弱而受风邪侵袭,风冷之邪侵入胞宫络脉,与血液搏结而形成。
冲脉和任脉是经络之海。任脉发生病变时,女子会出现带下病。手太阳经是小肠的经脉,手少阴经是心的经脉。心为脏,主里;小肠为腑,主表。这两条经脉的血,在妇人身上,上行化为乳汁,下行化为月经,均由冲脉和任脉所统摄。冲脉和任脉既起于胞宫内部,若房事过度,则会损伤胞络,因此风邪乘虚侵入胞宫,损害冲脉、任脉的经脉,伤害太阳经、少阴经的血,致使胞络之间,污秽液体与血液相兼杂,随带而下。寒盛则分泌物多呈白色,热盛则多呈红色,所以称为带下。
另外,带下病分为三门:一是胞门,二是龙门,三是玉门。已生育过的妇女属胞门,未生育过的妇女属龙门,未出嫁的妇女属玉门。此外,未出嫁的女子也有三种致病情况:其一,月经初来潮时,阴道内发热,此时若当风受凉,或因扇扇子受冷所致。其二,因用冷水洗涤外阴而患病。其三,或在月经刚来时,因惊恐而致病,这些都属于带下病的范畴。
另外,五十岁左右的妇女,出现下利(腹泻或带下淋漓),数十日不止,傍晚发热,小腹拘急疼痛,腹部胀满,手掌心烦热,嘴唇和口腔干燥。这是因为曾经有过半产(流产或小产),瘀血滞留于小腹未能去除,此病必然伴有带下。之所以判断有瘀血,嘴唇干燥就是其证候依据。
又,五十岁左右的妇女,如果只苦于背痛,时常腹中疼痛,食欲减退且厌恶食物。诊察其脉象,寸脉微弱,关尺部脉小且紧,形体表现与脉象不相符合,病情如此,病位在下焦,这必定是带下病。
又,妇女患带下病,属于“六极”(六种极度虚损)的病证。脉浮则伴有肠鸣、腹部胀满;脉紧则腹中疼痛;脉数则外阴瘙痒疼痛并生疮疡;脉弦则外阴掣痛。
Dai Xia (Leukorrhea) is caused by excessive labor and injury, which damages the menstrual blood, leading to a deficiency of the body that makes it susceptible to wind-cold. The wind-cold pathogen enters the Bao Luo (uterine collaterals), where it contends with the blood, resulting in this condition.
The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) are the seas of the meridians. When the Ren Mai is diseased, women suffer from Dai Xia (Leukorrhea). The Hand-Taiyang channel belongs to the Small Intestine, and the Hand-Shaoyin channel belongs to the Heart. The Heart is a Zang organ, governing the interior; the Small Intestine is a Fu organ, governing the exterior. The blood of these two channels, in women, transforms upward into milk and downward into menstruation, both under the control of the Chong and Ren vessels. Since the Chong and Ren vessels originate within the Bao Gong (uterus), excessive sexual intercourse can injure the Bao Luo. Consequently, wind pathogens enter the uterus due to deficiency, damaging the Chong and Ren vessels and injuring the blood of the Taiyang and Shaoyin channels. This causes turbid fluids to mix with blood between the Bao Luo, flowing down along with the leukorrhea. If cold predominates, the discharge is mostly white; if heat predominates, it is mostly red. Hence, it is named Dai Xia (Leukorrhea).
Furthermore, Dai Xia (Leukorrhea) has three gates: one is the Bao Men (Gate of the Uterus), two is the Long Men (Dragon Gate), and three is the Yu Men (Jade Gate). Women who have given birth belong to the Bao Men; those who have not given birth but are married belong to the Long Men; and unmarried women belong to the Yu Men. Additionally, unmarried women may also contract three types of diseases: first, when menstruation first begins, if there is internal heat in the vagina, or if one is exposed to wind or cooled by a fan; second, if illness is contracted from washing with cold water; third, if illness is contracted from fright during the initial flow of menstruation. All these cases belong to Dai Xia (Leukorrhea).
Moreover, for a woman around fifty years old, if she suffers from lower discharge (diarrhea or continuous leukorrhea) lasting for dozens of days without stopping, experiences evening fever, urgency and pain in the lower abdomen, abdominal fullness, vexing heat in the palms, and dryness of the lips and mouth, this is because she previously suffered a miscarriage, and blood stasis remains in the lower abdomen unremoved. This disease must involve Dai Xia (Leukorrhea). The reason we know there is blood stasis is that dry lips and mouth serve as the diagnostic sign.
Again, for a woman around fifty years old, if she suffers primarily from back pain, frequent abdominal pain, reduced appetite, and aversion to food, and her pulse is diagnosed as faint at the Cun position (distal) and small and tight at the Guan (middle) and Chi positions (proximal), indicating a mismatch between physical signs and pulse characteristics, with the pathology located in the Lower Jiao (Lower Burner), this must be Dai Xia (Leukorrhea).
Furthermore, Dai Xia (Leukorrhea) in women is a disease of the "Six Extremes" (six types of extreme deficiency). A floating pulse indicates intestinal rumbling and abdominal fullness; a tight pulse indicates abdominal pain; a rapid pulse indicates itching and pain in the genitalia with ulceration; and a wiry pulse indicates pulling pain in the genitalia.