遗风庞 血虚嘈杂,知饥少纳,脉虚细,腰酸带下,舌色灰浓。姑宜养血、和中、平肝
当归身(钱半) 仙半夏(钱半) 遍金钗(三钱) 鸡血藤(三钱) 茯神(四钱) 左金丸(
八分) 木蝴蝶(四分) 佩兰(钱半) 丹参(三钱) 炒谷芽(四钱) 生牡蛎(四钱)
清煎五帖。
介按∶冲脉之血,系是阳明水谷所化,兹以胃液已虚,未能容纳水谷,而致知饥嘈杂。
且肝肾并亏,而致腰酸带下,故以柔肝、和胃、养血为治。
遗风庞 带下腰酸,脉关尺涩细,经停七月,腹中有形,病在冲任。宜柔肝、涩下。(三月二十三日。)
桑螵蛸(三钱) 归身(钱半) 菟丝子(三钱) 生香附(钱半) 炒杜仲(三钱) 木蝴蝶(
四分) 川断(三钱) 绿萼梅(钱半) 生牡蛎(四钱) 大腹绒(三钱) 覆盆子(三钱)
清煎四帖。
介按∶任脉通,太冲脉盛,则月事以时下。兹以冲任并亏,而经停七月,肝郁不畅,则
腹中有形,肾虚而带脉不固,则酸下腰带。治以柔肝涩下,即是摄冲任之意。
黄公 徐 小腹仍属滞痛,脉尚涩,白带未除,冲任腰胯酸痛。宜和肝涩下为稳(六月七号乙巳二十二日。)
当归(钱半,小茴香炒拌) 省头草(三钱) 覆盆子(三钱) 杜仲(三钱) 延胡(钱半) 九
香虫(一钱) 乌药(钱半) 香附(三钱) 炒小胡麻(三钱) 生牡蛎(四钱) 玫瑰花(五朵)
清煎七帖。
介按∶王叔和曰∶带脉为病,左右绕脐,腰脊痛,冲阴股也。据是以观,则此症系是带脉失司,肝逆未平之候。
盛陵徐 冲任内怯,腰疼背掣,带下,脉涩细,癸涩不调,头疼。姑宜养血、调经、涩
下。(八月二十二号戊申十四日。)
全当归(三钱) 茺蔚子(三钱) 鸡血藤(三钱) 草(三钱) 炒白芍(钱半) 炒杜仲
(三钱) 覆盆子(三钱) 化龙骨(三钱) 川芎(钱半) 生牡蛎(四钱) 桑寄生(三钱)
清煎七帖。
介按∶女人月水,由诸络之血,汇集血海而下,兹以冲任内怯,肝肾液虚,是以头疼腰
痛,背掣带下,养血补肾以调经,深得内经先其所因,伏其所主之旨。
安昌马 带下如注,小腹滞痛,脉涩左弦细,癸涩不调,舌浓腻,汗出 。宜疏泄厥阴为主。(四月二十八日。)
川楝子(三钱) 当归(钱半) 桑螵蛸(钱半) 柏子仁(三钱) 延胡(三钱) 麻子仁(四
钱) 生香附(钱半) 海金沙(四钱) 省头草(三钱) 车前子(三钱) 青木香(八分)
清煎三帖。
介按∶此系肝郁侵脾,湿热下陷,是以脾精不守,未能化为经水,反变白滑之物,直下
而为带。故治以疏泄厥阴,兼渗湿热而涩下。
患者遗风庞,血虚导致胃脘嘈杂不适,虽有饥饿感但进食量少,脉象虚细,伴有腰酸和白带增多,舌苔灰厚浓浊。暂宜采用养血、调和脾胃、平抑肝阳的方法治疗。
处方:当归身(1.5钱)、仙半夏(1.5钱)、遍金钗(3钱)、鸡血藤(3钱)、茯神(4钱)、左金丸(0.8分)、木蝴蝶(0.4分)、佩兰(1.5钱)、丹参(3钱)、炒谷芽(4钱)、生牡蛎(4钱)。水煎服,共五剂。
按语:冲脉之血,源于阳明胃经所化生的水谷精微。现因胃液已虚,无法容纳受纳水谷,从而导致虽知饥饿却感嘈杂。且肝肾俱亏,导致腰酸和白带增多,故以柔养肝阴、调和胃气、滋养血液为治法。
患者遗风庞,白带增多伴腰酸,脉象关部与尺部涩而细,月经停止七个月,腹部有包块感,病位在冲脉与任脉。宜采用柔养肝阴、固涩止带的方法。(三月二十三日)
处方:桑螵蛸(3钱)、归身(1.5钱)、菟丝子(3钱)、生香附(1.5钱)、炒杜仲(3钱)、木蝴蝶(0.4分)、川断(3钱)、绿萼梅(1.5钱)、生牡蛎(4钱)、大腹绒(3钱)、覆盆子(3钱)。水煎服,共四剂。
按语:任脉通畅,太冲脉充盛,则月经能按时来潮。现因冲任二脉俱亏,导致月经停闭七个月;肝气郁结不畅,则腹部出现有形之积;肾虚导致带脉不固,则出现腰酸及白带淋漓。治疗以柔肝涩下,即包含固摄冲任之意。
黄公徐姓,小腹仍有滞痛感,脉象尚涩,白带未除,冲任失调致腰胯酸痛。宜采用调和肝气、固涩止带的方法以求稳妥(六月七日,乙巳年二十二日)。
处方:当归(1.5钱,用小茴香炒拌)、省头草(3钱)、覆盆子(3钱)、杜仲(3钱)、延胡索(1.5钱)、九香虫(1钱)、乌药(1.5钱)、香附(3钱)、炒小胡麻(3钱)、生牡蛎(4钱)、玫瑰花(5朵)。水煎服,共七剂。
按语:王叔和说:“带脉为病,左右绕脐,腰脊痛,牵连阴股。”据此观察,此症属于带脉失于约束,肝气上逆尚未平复的证候。
盛陵徐姓,冲任气血内怯不足,腰痛伴背部牵掣感,白带增多,脉象涩细,月经迟滞不调,头痛。暂宜采用养血、调经、固涩止带的方法。(八月二十二号,戊申年十四日)
处方:全当归(3钱)、茺蔚子(3钱)、鸡血藤(3钱)、草(此处原文缺字,疑为某草药名,依原文保留“草”或指代不明,按常规推测可能为益母草或其他,但严格忠实原文仅列“草”,实际临床需补全,此处依指令忠实原文提取实体若为“草”则列入,但通常指代具体药,鉴于原文可能有脱漏,此处暂按原文列出,若视为通用词则忽略,但在中医方中单字“草”极少见,结合上下文及常见配伍,极可能是“益母草”或“甘草”之误,但作为翻译任务,我需忠实原文。注:原文中“草(三钱)”前无字,可能是排版遗漏,如“益母草”。但在实体提取时,若原文只有“草”,则难以归类为具体药材。考虑到这是古籍整理,通常会有校勘。此处假设原文即为“草”或者漏字。为了准确性,我将把“草”视为一个待确定的实体,或在翻译中注明。然而,查看其他条目,均为完整药名。此处暂译为“草(3钱)”,并在实体中提取时谨慎处理。*修正:仔细看图或常见版本,此处多为“益母草”或类似。但既然用户给的是纯文本“草(三钱)”,我必须基于此。在英文中我会写 "Herb (3 qian)" 并标注存疑,或者如果必须对应WHO术语,这很难。让我们再看一眼,有没有可能是“甘草”?或者是“泽兰”?无论如何,忠实原文是第一位的。*)... 实际上,很多古籍影印本中,“益母草”可能被截断。但在此处,我将严格按照提供的文本处理。*再次检查:* 在很多邵氏医案中,此处常作“益母草”。但既然输入是“草”,我将翻译为“Grass/Herb (3 qian)”并在实体中留空或标记。*为了用户体验,我将假设这是一个录入错误,但在输出中保持原样。* 等等,看下一行“炒白芍”,前面是“草”。这可能是“益母草”的漏字。但在没有确凿证据前,不擅自添加。*决定:* 翻译为“草(3钱)”,实体提取中若不明确则不列入herbs,或列入但注明。*再思考:* 题目要求提取明确出现的实体。如果原文是“草”,它不是一个标准的中药名。因此,herbs列表中不应包含“草”。
*更正策略:* 对于“草(三钱)”,由于不是标准药名,不在herbs列表中提取。翻译时直译。
处方:全当归(3钱)、茺蔚子(3钱)、鸡血藤(3钱)、[草](3钱,原文如此,疑有脱漏)、炒白芍(1.5钱)、炒杜仲(3钱)、覆盆子(3钱)、化龙骨(3钱)、川芎(1.5钱)、生牡蛎(4钱)、桑寄生(3钱)。水煎服,共七剂。
按语:女子的月经,由诸络之血汇聚于血海而下注而成。现因冲任二脉气血内怯不足,肝肾阴液亏虚,所以出现头痛、腰痛、背部牵掣感和白带增多。通过养血补肾以调理月经,深得《内经》“先其所因,伏其所主”的治疗宗旨。
安昌马姓,白带量多如注,小腹滞痛,脉象左侧弦细而涩,月经迟滞不调,舌苔浓腻,出汗。宜以疏泄厥阴肝经为主。(四月二十八日)
处方:川楝子(3钱)、当归(1.5钱)、桑螵蛸(1.5钱)、柏子仁(3钱)、延胡索(3钱)、麻子仁(4钱)、生香附(1.5钱)、海金沙(4钱)、省头草(3钱)、车前子(3钱)、青木香(0.8分)。水煎服,共三剂。
按语:此系肝气郁结侵犯脾土,湿热下陷,导致脾精不能固守,未能化为经血,反而变成白滑之物,直接下行成为白带。故治疗以疏泄厥阴肝经为主,兼以渗利湿热并固涩止带。
Shao Lansun's Medical Cases: Leukorrhea Chapter
Patient Yi Fengpang suffers from blood deficiency causing epigastric discomfort and a sensation of hunger without desire to eat (Zhi Ji Shao Na). The pulse is deficient and fine, accompanied by soreness of the lower back and leukorrhea. The tongue coating is gray and thick. Treatment should initially focus on nourishing blood, harmonizing the middle jiao, and calming the liver.
Prescription: Danggui Shen (Radix Angelicae Sinensis) - 1.5 qian; Xian Banxia (Rhizoma Pinelliae Preparatum) - 1.5 qian; Bian Jinchai (Dendrobium nobile stem) - 3 qian; Jixueteng (Caulis Spatholobi) - 3 qian; Fushen (Poria with Hostwood) - 4 qian; Zuo Jin Wan (Left Metal Pill) - 0.8 fen; Muhu Die (Membrana Pterygii) - 0.4 fen; Peilan (Herba Pogostemonis) - 1.5 qian; Danshen (Radix Salviae Miltiorrhizae) - 3 qian; Chao Guya (Frumentum Hordeum Germinatum Torrefactum) - 4 qian; Sheng Muli (Concha Ostreae) - 4 qian. Decocted in water, taken as five doses.
Commentary: The blood of the Chong Mai (Penetrating Vessel) is transformed from the water and grain essence of the Yangming Stomach channel. Currently, due to deficiency of stomach fluids, the body cannot accommodate food and drink, leading to the sensation of knowing hunger yet feeling uncomfortable (Zao Za). Furthermore, simultaneous deficiency of the Liver and Kidney results in lower back soreness and leukorrhea. Therefore, the treatment employs softening the liver, harmonizing the stomach, and nourishing blood.
Patient Yi Fengpang presents with leukorrhea and lower back soreness. The pulse at the Guan (Bar) and Chi (Cubit) positions is choppy and fine. Menstruation has ceased for seven months, and there is a palpable mass in the abdomen. The pathology lies in the Chong and Ren vessels. Treatment should soften the liver and astringe discharge. (March 23rd)
Prescription: Sangpiaoxiao (Coco Sacculus Mantidis) - 3 qian; Guishen (Radix Angelicae Sinensis) - 1.5 qian; Tusizi (Semen Cuscutae) - 3 qian; Sheng Xiangfu (Rhizoma Cyperi) - 1.5 qian; Chao Duzhong (Cortex Eucommiae Torrefacta) - 3 qian; Muhu Die (Membrana Pterygii) - 0.4 fen; Chuanduan (Radix Dipsaci) - 3 qian; Lue Mei (Flos Pruni Mume Viridis) - 1.5 qian; Sheng Muli (Concha Ostreae) - 4 qian; Dafurong (Fructus Citri Reticulatae Viridis) - 3 qian; Fupenzi (Fructus Rubi) - 3 qian. Decocted in water, taken as four doses.
Commentary: When the Ren Mai (Conception Vessel) is unobstructed and the Taichong Mai (Great Surge Vessel) is abundant, menstruation occurs on time. Currently, deficiency of both Chong and Ren vessels causes amenorrhea for seven months. Liver qi stagnation leads to abdominal masses. Kidney deficiency causes insecurity of the Dai Mai (Girdle Vessel), resulting in lower back soreness and leukorrhea. Treating by softening the liver and astringing discharge embodies the intent of securing the Chong and Ren vessels.
Mr. Huang Xu complains of persistent dull pain in the lower abdomen. The pulse remains choppy, and leukorrhea has not cleared. There is soreness and pain in the waist and hips due to Chong and Ren disharmony. Harmonizing the liver and astringing discharge is advisable for stability. (June 7th, Yisi Year, 22nd day)
Prescription: Danggui (Radix Angelicae Sinensis) - 1.5 qian (stir-fried with Xiaohuixiang); Shentoucao (Herba Houttuyniae) - 3 qian; Fupenzi (Fructus Rubi) - 3 qian; Duzhong (Cortex Eucommiae) - 3 qian; Yanhu (Rhizoma Corydalis) - 1.5 qian; Jiuxiangchong (Insectus Aspongopus) - 1 qian; Wuyao (Radix Linderae) - 1.5 qian; Xiangfu (Rhizoma Cyperi) - 3 qian; Chao Xiaohuma (Semen Sesami Nigrum Torrefactum) - 3 qian; Sheng Muli (Concha Ostreae) - 4 qian; Meiguihua (Flos Rosae Rugosae) - 5 flowers. Decocted in water, taken as seven doses.
Commentary: Wang Shuhe stated: "Disease of the Dai Mai involves pain winding around the umbilicus, affecting the lower back and spine, and radiating to the inner thighs." Based on this, this case represents dysfunction of the Dai Mai and uncalmed rebellious Liver qi.
Xu from Shengling suffers from weakness in the Chong and Ren vessels, lower back pain with pulling sensations in the back, leukorrhea, choppy and fine pulse, irregular menstruation, and headache. Initially, nourish blood, regulate menstruation, and astringe discharge. (August 22nd, Wushen Year, 14th day)
Prescription: Quandonggui (Radix Angelicae Sinensis) - 3 qian; Chongweizi (Fructus Leonuri) - 3 qian; Jixueteng (Caulis Spatholobi) - 3 qian; [Caoyao] (Herb - *Note: Original text says 'Grass', likely missing character such as Yimucao*) - 3 qian; Chao Baishao (Radix Paeoniae Alba Torrefacta) - 1.5 qian; Chao Duzhong (Cortex Eucommiae Torrefacta) - 3 qian; Fupenzi (Fructus Rubi) - 3 qian; Huagu Long (Os Draconis Calcinarum) - 3 qian; Chuanxiong (Rhizoma Chuanxiong) - 1.5 qian; Sheng Muli (Concha Ostreae) - 4 qian; Sangjisheng (Ramulus Taxilli) - 3 qian. Decocted in water, taken as seven doses.
Commentary: Women's menstruation is formed by blood from various collaterals gathering in the Sea of Blood and flowing downward. Currently, due to deficiency in the Chong and Ren vessels and depletion of Liver and Kidney fluids, headaches, lower back pain, back pulling, and leukorrhea occur. Nourishing blood and tonifying the kidney to regulate menstruation deeply follows the principle of the *Neijing*: "Address the root cause first, and subdue the governing factor."
Ma from Anchang presents with profuse leukorrhea like a gush, dull pain in the lower abdomen, choppy and wiry-fine pulse on the left side, irregular menstruation, thick greasy tongue coating, and sweating. Treatment should primarily focus on dispersing and draining the Jueyin Liver channel. (April 28th)
Prescription: Chuanlianzi (Fructus Toosendan) - 3 qian; Danggui (Radix Angelicae Sinensis) - 1.5 qian; Sangpiaoxiao (Coco Sacculus Mantidis) - 1.5 qian; Baiziren (Semen Biotae) - 3 qian; Yanhu (Rhizoma Corydalis) - 3 qian; Maziren (Semen Cannabis) - 4 qian; Sheng Xiangfu (Rhizoma Cyperi) - 1.5 qian; Haijinsha (Spora Lygodii) - 4 qian; Shentoucao (Herba Houttuyniae) - 3 qian; Cheqianzi (Semen Plantaginis) - 3 qian; Qingmuxiang (Radix Aucklandiae) - 0.8 fen. Decocted in water, taken as three doses.
Commentary: This is caused by Liver qi stagnation invading the Spleen, with damp-heat sinking downward. Consequently, Spleen essence fails to be retained and does not transform into menstrual blood, but instead becomes white and slippery matter, flowing directly down as leukorrhea. Thus, treatment focuses on dispersing and draining the Jueyin Liver, while simultaneously leaching out damp-heat and astringing discharge.