妇人中风七八日。续来寒热。发作有时。经水适断。此为热入血室。其血必结。故使如疟状。发
作有时。小柴胡汤主之。（方见呕吐中。○来。伤寒论。太阳下编。作得。断下。有者字。）
〔程〕妇人伤寒中风。六经传变治例。与男子同法。唯经水适来适断。热入血室。与夫胎前产后。崩
漏带下。则治有殊也。妇人经行之际。当血弱气尽之时。邪气因入血室。与正气相搏。则经为之断。血为之
结也。血结则邪正分争。往来寒热。休作有时。与小柴胡解表里。而散血室之邪热。
〔尤〕仲景单用小柴
胡汤。不杂血药一味。意谓热邪解而乍结之血自行耳。（详伤寒论辑义太阳中篇。以下二条同。）
许氏本事方。小柴胡加地黄汤。治妇人室女。伤寒发热。
或发寒热。经水适来。或适断。昼则明了。夜则谵语。如见鬼状。亦治产后恶露方来。忽尔断绝。
即于小柴胡汤。加生干地黄。
辛亥中。寓居毗陵。学官王仲礼其妹病伤寒。发寒热。遇夜则如有鬼物所凭。六七日忽昏塞。涎响
如引锯。牙关紧急。瞑目不知人。疾势极危。召予视。予曰。得病之初。曾
值月经来否。其家云。月经方来。病作而经遂止。得一二日。发寒热。昼虽静。夜则有鬼祟。从昨日来。涎
生不省人事。予曰此热入血室证也。仲景云。妇人中风。发热恶寒。经水适来。昼则明了。暮则谵语。如
见鬼状。发作有时。此名热入血室。医者不晓。以刚剂与之。遂致胸膈不利。涎潮上脘。喘急息高。昏冒
不知人。当先化其涎。后除其热。予急以一呷散投之。两时顷涎下得睡。省人事。次授以小柴胡加地黄
汤。三服而热除。不汗而自解矣。（一呷散。大天南星一味。选腊辰日制。详见于本书。）
妇人伤寒。发热。经水适来。昼日明了。暮则谵语。如
见鬼状者。此为热入血室。治之无犯胃气。及上二焦。必自愈。（脉经注。二焦字疑。）
〔程〕伤寒发热。又值经水适来之时。则寒邪乘虚而入。搏于血室。夫邪去阳入阴。则昼日明了。阴
被其邪。故暮则谵语。如见鬼状也。无者。禁止之辞。犯胃气以禁下言也。上二焦以禁汗吐言也。今邪在
血室中。则非汗吐下所宜矣。上章以往来寒热如疟。故用小柴胡。以解其邪。下章以胸胁
下满。如结胸状。故刺期门。以泻其实。此章则无上下二证。似待其经行血去。邪热得以随血出而解也。
妇人中风。发热恶寒。经水适来。得七八日。热除脉迟。身凉和。
胸胁满。如结胸状。谵语者。此为热入血室也。当刺期门。随其实而取之。（太阳下编。得下。有之字。）
〔程〕发热恶寒。则风邪在表。未入于里。值经水适来。至七八日。则邪热乘虚而内入。入则表证罢。
故脉迟身凉和也。胸胁者。肝之部分。灵枢经曰。厥阴根于大敦。结于玉英。络于膻中。其正经。则
布胁肋。以肝藏血。邪入血室。故令胸胁满。如结胸状也。肝藏魂。热搏于阴。故令谵语也。
期门者。肝之募。刺之以泻其实。
许氏本事方云。一妇人患热入血室证。医者不识。用补血调气药。涵养数日。遂成血结胸。或劝用前药。
予曰。小柴胡用已迟。不可行也。无已则有一焉。刺期门穴斯可矣。予不能针。请善针者治之。如言而愈。
或者问曰。热入血室。何为而成结胸也。予曰。邪气传入经络。与正气相搏。上下流行。或遇经水适来适断。
邪气乘虚。而入血室。血为邪迫。上入肝经。肝受邪则谵语。而见鬼。复入膻中。则血结于胸也。何以言之。
妇人平居。水当养于木。血当养于肝也。方未受孕。则下行以为月水。既妊娠。则中蓄之以养胎。及已
产。则上壅之以为乳。皆血也。今邪逐血。并归肝经。聚于膻中。结于乳下。故手触之则痛。非汤剂可及。
故当刺期门也。活人书。海蛤散。治血结胸。（海蛤。滑石。甘草。各一两。芒硝半两。上为末。每
服二钱。鸡子清调下。）
阳明病。下血谵语者。此为热入血室。但头汗出。当刺
期门。随其实而泻之。 然汗出者愈。（详伤寒论辑义阳明篇。者。太阳中篇。作则。）
〔尤〕阳明之热。从气而之血。袭入胞宫。即下血而谵语。盖冲任之脉。并阳明之经。不必乘经水之
来。而后热得入之。故彼为血去而热入。此为热入而血下也。但头汗出者。阳通而闭在阴也。此虽阳明之热。
而传入血室。则仍属肝家。故亦当刺期门。以泻其实。刺已周身 然汗出。则阴之闭者亦通。故愈。
妇人咽中。如有炙脔。半夏浓朴汤主之。（脔。脉经作腐。）
〔尤〕此凝痰结气。阻塞咽嗌之间。千金。所谓咽中帖帖。如有炙肉。吞不下。吐不出者是。
〔鉴〕咽中如有炙脔。谓咽中有痰涎。如同炙肉。咯之不出。咽之不下者。即今之梅
核气病也。此病得于七情。郁气凝涎而生。故用半夏浓朴生姜。辛以散结。苦以降逆。茯苓佐半夏。以
利饮行涎。紫苏芳香。以宣通郁气。俾气舒涎去。病自愈矣。此证男子亦有。不独妇人也。
巢源云。咽中如炙肉脔者。此是胸膈痰结。与气相搏。逆上咽喉之间。结聚状如炙肉之脔也。
半夏浓朴汤方（〔原注〕千金。作胸满心下坚。咽中帖帖。如有炙肉。吐之不
出。吞之不下。○案今本。肉下。有脔字。）
半夏（一升） 浓朴（三两） 茯苓（四两○赵作二两） 生姜（五两） 干苏叶（
二两○千金云一方无干苏叶生姜）
上五味。以水七升。煮取四升。分温四服。日三夜一服。
圣惠方。半夏散。治咽喉中。如有炙腐。
于本方中。加枳壳诃黎勒皮。
王氏易简。四七汤。治喜怒悲恐惊之气。结成痰涎。状如破絮。或如梅核。在咽喉之间。咯不出。
咽不下。此七气之所为也。或中脘痞满。气不舒快。或痰涎壅盛。上气喘急。
或因痰饮中节。呕吐恶心。并宜服之。（即本方。）
又云。妇人情性执着。不能宽解。多被七气所伤。遂致气填胸臆。或如梅核。上塞咽喉。甚者满闷欲
绝。产妇尤多。此证服此剂。间以香附子药。久服取效。妇人恶阻。尤宜服
之。间以红丸子尤效。一名浓朴半夏汤。一名大七气汤。
瑞竹堂经验方。四七汤。治妇人女子。小便不顺。甚者。阴户疼痛。
于本方。加香附子甘草。煎成加琥珀末调服。
仁斋直指。桂枝四七汤。治风冷寒邪。搏心腹作痛。
于本方。合桂枝汤。加枳壳人参。
又四七汤。治惊忧气遏上喘。（即本方。）
又加减七气汤。治气郁呕吐。
于本方。合千金七气汤。（桂枝。半夏。人参。甘草。大枣。生姜。）去紫苏。
又加味四七汤。治心气郁滞。豁痰散惊。
于本方。加茯神远志甘草石菖大枣。
三因七气汤。治喜怒忧思悲恐惊七气。郁发。致五脏互
相刑克。阴阳反戾。挥霍变乱。吐利交作。寒热眩晕。痞满咽塞。
于本方。加桂枝芍药陈皮人参大枣。
孙氏三吴医案云。张溪亭乃眷。喉中梗梗有肉。如炙脔。吞之不下。吐之不出。鼻塞头运。耳常啾啾
不安。汗出如雨。心惊胆怯。不敢出门。稍见风即遍身疼。小腹时疼。小水淋沥而疼。脉两寸皆短。两
关滑大。右关尤搏指。此梅核气症也。以半夏四钱。浓朴一钱。紫苏叶一钱五分。茯苓一钱三
分。姜三分。水煎食后服。每用此汤。调理多效。
妇人脏躁。喜悲伤欲哭。象如神灵所作。数欠伸。甘麦大枣汤主之。
〔鉴〕脏。心脏也。心静则神藏。若为七情所伤。则心不得静。而神躁扰不宁也。故喜悲伤欲哭。是神
不能主情也。象如神灵所凭。是心不能神明也。即今之失志癫狂病也。数
欠伸。喝欠也。喝欠烦闷。肝之病也。母能令子实。故证及也。
案沈尤以脏为子宫。甚误。
甘草小麦大枣汤方（三因。名小麦汤。袖珍。名甘草汤。）
甘草（三两） 小麦（一升） 大枣（十枚）
上三味。以水六升。煮取三升。温分三服。亦补脾气。（案温分徐沈尤作分温。是。）
〔程〕内经曰。悲则心系急。甘草大枣者。甘以缓诸急
也。小麦者。谷之苦者也。灵枢经曰。心病者。宜食麦。是谷先入心矣。
案素问。以小麦为心之谷。千金云。小麦养心气。本方
所主。正在于此。而金鉴云。方义未详。必是伪错。此说大误。验之于病者。始知立方之妙也。
许氏本事方云。乡里有一妇人。数欠。无故悲泣不止。或谓之有祟。祈禳请祷备至。终不应。予忽
忆有一证云。妇人脏躁云云。急令治药。尽剂而愈。古人识病制方。种种妙绝如此。试而后知。
陈氏妇人良方云。乡先生程虎卿内人。妊娠四五个月。遇昼则惨戚悲伤。泪下数欠。如有所凭。医
与巫兼治。皆无益。仆年十四。正在斋中习业。见说此证。而程省元皇皇无计。仆遂告之。管先生伯同说。
记忆先人曾说此一证。名曰脏躁悲伤。非大枣汤不愈。虎卿借方看之。甚喜对证。笑而治药。一投而愈矣。
妇人吐涎沫。医反下之。心下即痞。当先治其吐涎沫。小青龙汤主之。涎沫止。乃治痞。泻心汤主之。（
妇人下。千金。有霍乱呕逆二字。泻心汤上。千金有甘草二字。）
〔尤〕吐涎沫。上焦有寒也。不与温散。而反下之。则寒内入而成痞。如伤寒下早例也。然虽痞而犹
吐涎沫。则上寒未已。不可治痞。当先治其上寒。而后治其中痞。亦如伤寒例。表解乃可攻痞也。
〔魏〕泻心汤。在伤寒论中。为方不一。亦当合伤寒论中痞证诸条。参观之。而求其治法。
小青龙汤方（见肺痈中。）
泻心汤方（见惊悸中○案惊悸所载即三黄泻心汤。此恐不然。据千金。当是甘草泻心汤。）
妇人之病。因虚积冷结气。为诸经水断绝。至有历年。血寒积结胞门。寒伤经络。凝坚在上。呕吐涎唾。
久成肺痈。形体损分。在中盘结。绕脐寒疝。或两胁疼痛。与脏相连。或结热中。痛在关元。脉数无疮。肌
若鱼鳞。时着男子。非止女身。在下未多。经候未匀。令阴掣痛。少腹恶寒。或引腰脊。下根气街。气冲急
痛。膝胫疼烦。奄忽眩冒。状如厥癫。或有忧惨。悲伤多嗔。此皆带下。非有鬼神。久则羸瘦。
脉虚多寒。三十六病。千变万端。审脉阴阳。虚实紧弦。行其针药。治危得安。其虽同病。脉各异源。子当
辩记。勿谓不然。（徐云。未多之未字。疑误。程尤作来多。程云。谓崩带之属。金鉴亦作来多。云
来字。当是未字。本条皆经水断绝之病。若系来多。则与上文不合。是传写之讹。案撰金
鉴者。何不考之正脉等本。可疑。沈魏并仍原文。令阴。赵本作冷阴。非。）
〔鉴〕此条为妇人诸病纲领。其病之所以异于男子者。以其有月经也。其月经致病之根源。则多因虚损
积冷结气也。三者一有所感。皆能使经水断绝。至有历年。寒积胞门。以致血凝气结。而不行者。先哲云。
女子以经调为无病。若经不调。则变病百出矣。以下皆言三者阻经之变病。其变病之不同。各因其人之
脏腑经络。寒热虚实之异也。如寒外伤经络。其人上焦素寒。则凝坚在上。故上焦胸肺受病也。形寒
伤肺。则气滞阻饮。故呕吐涎唾也。若其人上焦素热。寒同其化。久则成热。热伤其肺。故成肺痈。而形体
损瘦也。若其人中焦素寒。则在中盘结。故绕脐疝痛也。或两胁疼痛。是中焦之部。连及肝脏故也。或其人
中焦素热。则不病寒疝。而病结热于中矣。中热故不能为寒疝。而绕脐之痛仍在关元也。其人脉数当生疮。
若无疮则热必灼阴。皮肤失润。故肌粗若鱼鳞也。然此呕吐涎唾。寒疝疼痛。肌若鱼鳞等病。亦
时着男子。非止女子病也。在下未多。谓经候不匀。而血不
多下也。邪侵胞中。乃下焦之部。故病阴中掣痛少腹恶寒也。或痛引腰脊。下根气街急痛。腰膝疼烦。皆胞
中冲任为病。所以必然也。或痛极奄忽眩冒。状如厥癫。亦痛甚之常状也。若其人或有忧惨悲伤多嗔之遇。
而见此眩冒厥癫之证。实非有鬼神也。凡此胞中冲任血病。皆能病带。故谚曰十女九带也。然带下病久。津
液必伤。形必羸瘦。诊其脉虚。审其多寒。岂止病此三十六病。而千变万端矣。虽千变万端。然审
脉阴阳虚实紧弦。与病参究。行其针药。治危得安也。其有病虽同。而脉不同者。则当详加审辨。故曰子当辨
记。勿谓不然也。
〔尤〕甚则奄忽眩冒。状如厥癫。所谓阴病者。下行极而上也。或有忧惨悲嗔。状如鬼
神者。病在阴则多怒。及悲愁不乐也。而总之曰此皆带下。带下者。带脉之下。古人列经脉为病。凡三十六
种。皆谓之带下病。非今人所谓赤白带下也。三十六病者。十二症。九痛。七害。五伤。三痼也。
案史记扁鹊传云。过邯郸。闻贵妇人。即为带下医。知古所称带下。乃腰带以下。经血诸疾之谓也。金鉴
云。此皆带下一句。当在非有鬼神之下。文义相属。是传写之讹。此说非也。本条隔句押韵。如根据金鉴而
改之。则失上下押韵之法。不可从也。巢源云。诸方说三十六疾者。十二症。九痛。七害。五伤。三痼不通
妇人患中风病七八日，持续出现忽冷忽热的症状，且发作有固定时间。此时月经恰好中断。这是热邪侵入血室（子宫及冲脉等与月经相关的部位）。血液因此凝结，所以症状像疟疾一样，定时发作。治疗应以小柴胡汤为主。（方剂见呕吐篇中。○“来”字，《伤寒论》太阳下编作“得”字。“断”字下，“有者”二字。）
〔程〕妇女患伤寒或中风，六经传变的治法原则与男子相同。唯独遇到月经刚来或刚断、热入血室，以及胎前产后、崩漏带下等情况时，治疗方法才有所不同。妇女在行经期间，正值气血虚弱之时，邪气趁机侵入血室，与正气相搏结，导致月经中断，血液凝结。血结则邪正相争，出现往来寒热，休作有时。用小柴胡汤可以解除表里之邪，并疏散血室中的邪热。
〔尤〕张仲景仅使用小柴胡汤，不加入一味活血药，其用意在于认为热邪解除后，暂时凝结的血液自然会流通。（详见《伤寒论辑义》太阳中篇，以下两条同理。）
许叔微《本事方》记载的小柴胡加地黄汤，治疗妇女及未婚女子患伤寒发热，或出现寒热往来，月经刚来或刚断，白天神志清醒，夜晚则胡言乱语，如同看见鬼怪一般。也用于治疗产后恶露方来，突然中断的情况。即在原小柴胡汤基础上，加入生干地黄。
辛亥年间，我寓居毗陵。学官王仲礼的妹妹患伤寒，出现寒热往来，每到夜间就像被鬼物附身一样。六七天时突然昏厥堵塞，喉间痰声如拉锯，牙关紧闭，闭目不知人事，病情极其危重。请我去诊治。我问：“发病之初，是否正值月经来潮？”家属说：“月经刚来，生病后月经就停止了。”过了一两天，出现寒热，白天虽然安静，夜里却有鬼祟作怪。从昨天开始，痰涎涌出，不省人事。我说：“这是热入血室的证候。”张仲景说：“妇女中风，发热恶寒，月经刚来，白天神志清醒，傍晚则胡言乱语，如同看见鬼怪，发作有时，这叫做热入血室。”医生如果不明白这个道理，用峻猛的药物攻下，就会导致胸膈不利，痰涎上涌至胃脘，喘息急促，呼吸音高，昏迷不知人事。应当先化解痰涎，再清除热邪。我急忙给予一呷散服用，约两小时后，痰涎下行，患者入睡，恢复意识。接着给予小柴胡加地黄汤，服用三剂后热退，未出汗而病自愈。（一呷散由大天南星一味药组成，选用腊辰日制成，详见本书。）
妇女患伤寒，发热，月经刚来，白天神志清醒，夜晚则胡言乱语，如同看见鬼怪，这是热入血室。治疗时不要损伤胃气，也不要使用发汗和催吐的方法，病必自愈。（《脉经》注：二焦字可能有误。）
〔程〕伤寒发热，又正值月经来潮，寒邪乘虚而入，搏结于血室。邪气由阳入阴，所以白天神志清醒；阴分受邪，所以夜晚胡言乱语，如同看见鬼怪。“无”是禁止的意思。“犯胃气”指禁止使用泻下法。“上二焦”指禁止使用发汗和催吐法。现在邪气在血室中，就不适合用汗、吐、下三法了。上一章因往来寒热如疟，故用小柴胡汤以解邪；下一章因胸胁下满，像结胸状，故针刺期门穴以泻其实邪。这一章没有上述上下两证的特征，似乎是等待月经行血去，邪热随血排出而自愈。
妇女患中风，发热恶寒，月经刚来，过了七八天，热退脉迟，身体凉爽平和，但胸胁胀满，像结胸状，并有胡言乱语，这是热入血室。应当针刺期门穴，根据实邪所在进行泻法治疗。（《伤寒论》太阳下编：“得”字下，“有之”二字。）
〔程〕发热恶寒，说明风邪在表，未入里。正值月经来潮，到了七八天，邪热乘虚内入。入里则表证消失，所以脉迟身凉。胸胁是肝所主的部位。《灵枢经》说：厥阴肝经根于大敦，结于玉英，络于膻中，其正经布散于胁肋。因为肝藏血，邪气进入血室，所以导致胸胁胀满，像结胸状。肝藏魂，热邪搏结于阴分，所以导致胡言乱语。期门穴是肝的募穴，针刺它可以泻除实邪。
许叔微《本事方》记载：一位妇女患热入血室证，医生不认识，用了补血调气的药物，调养数日后，竟形成了血结胸。有人劝用前面的药方，我说：“用小柴胡汤已经太迟，不可使用了。如果没有办法，只有一个办法，就是针刺期门穴就可以了。”我不会针灸，请擅长针灸的人治疗，照此办理而痊愈。有人问：“热入血室，为什么会形成结胸？”我说：“邪气传入经络，与正气相搏，上下流行，如果遇到月经刚来或刚断，邪气乘虚进入血室。血被邪气逼迫，上行进入肝经，肝受邪则胡言乱语、见鬼，再进入膻中，则血结于胸。为什么这样说？妇女平时，水液滋养木（肝），血液滋养肝。在未受孕时，血液下行成为月经；既已怀孕，则蓄积在中以养胎；分娩后，则上壅成为乳汁，这些都是血。现在邪气追逐血液，一并归入肝经，聚于膻中，结于乳下，所以手触之则痛，非汤药所能到达，所以应当针刺期门。”《活人书》记载的海蛤散，治疗血结胸。（海蛤、滑石、甘草各一两，芒硝半两，研为末，每次服二钱，用鸡蛋清调服。）
阳明病，出现下血和胡言乱语，这是热入血室。只有头部出汗，应当针刺期门穴，根据实邪所在进行泻法治疗。如果周身濈然汗出，病就会好。（详见《伤寒论辑义》阳明篇。“者”字，《伤寒论》太阳中篇作“则”字。）
〔尤〕阳明的热邪，从气分转入血分，侵袭胞宫，就会出现下血和胡言乱语。因为冲任二脉与阳明经相连，不一定非要等到月经来潮，热邪才能进入。所以前者是血去而热入，后者是热入而血下。只有头部出汗，是因为阳气通畅但阴分闭塞。这虽然是阳明的热邪，但传入血室后，仍属于肝家的问题，所以也应当针刺期门穴以泻其实邪。针刺后周身濈然汗出，则阴分的闭塞也随之通畅，所以痊愈。
妇女咽喉中如有烤肉块堵着，用半夏厚朴汤主治。（“脔”字，《脉经》作“腐”字。）
〔尤〕这是凝痰结气，阻塞在咽喉之间。《千金方》所谓“咽中帖帖，如有炙肉，吞不下，吐不出”就是指这个。
〔鉴〕“咽中如有炙脔”，是指咽喉中有痰涎，感觉像烤肉块一样，咳不出来，咽不下去，也就是现在的梅核气病。此病多由七情（喜、怒、忧、思、悲、恐、惊）引起，郁气凝滞津液而生。所以用半夏、厚朴、生姜，辛味以散结，苦味以降逆。茯苓辅助半夏，以利饮行涎。紫苏芳香，以宣通郁气。使气机舒畅，痰涎去除，病自然痊愈。此证男子也有，不只是妇女。
《诸病源候论》说：咽喉中像有烤肉块，这是因为胸膈痰结，与气相搏，逆上咽喉之间，结聚形状像烤肉块。
半夏厚朴汤方（〔原注〕《千金方》作胸满心下坚，咽中帖帖，如有炙肉，吐之不出，吞之不下。○按今本，“肉”字下有“脔”字。）
半夏（一升） 厚朴（三两） 茯苓（四两○赵本作二两） 生姜（五两） 干苏叶（二两○《千金方》云一方无干苏叶生姜）
以上五味药，用水七升，煮取四升，分四次温服，白天服三次，晚上服一次。
《圣惠方》半夏散，治疗咽喉中如有烤肉块。
在本方中加入枳壳、诃黎勒皮。
王氏《易简方》四七汤，治疗喜怒悲恐惊之气，结成痰涎，形状像破絮，或像梅核，卡在咽喉之间，咳不出，咽不下。这是七气所致。或者中脘痞满，气机不畅，或者痰涎壅盛，上气喘急，或者因痰饮停在中焦，呕吐恶心，都适宜服用。（即本方。）
又说：妇人情性执着，不能宽解，多被七气所伤，导致气填胸臆，或者像梅核一样，塞住咽喉，严重的满闷欲绝，产妇尤其多见。此证服用此剂，间或用香附子药，久服见效。妇女妊娠恶阻，尤其适宜服用，间用红丸子更效。又名厚朴半夏汤，又名大七气汤。
《瑞竹堂经验方》四七汤，治疗妇女小便不顺，严重的，阴户疼痛。
在本方中加入香附子、甘草，煎成后加琥珀末调服。
《仁斋直指方》桂枝四七汤，治疗风冷寒邪，搏结心腹作痛。
在本方合桂枝汤的基础上，加入枳壳、人参。
又四七汤，治疗惊忧气遏导致的上喘。（即本方。）
又加减七气汤，治疗气郁呕吐。
在本方合《千金方》七气汤（桂枝、半夏、人参、甘草、大枣、生姜）的基础上，去掉紫苏。
又加味四七汤，治疗心气郁滞，豁痰散惊。
在本方中加入茯神、远志、甘草、石菖蒲、大枣。
《三因极一病证方论》七气汤，治疗喜怒忧思悲恐惊七气郁发，导致五脏互相刑克，阴阳反戾，挥霍变乱，吐利交作，寒热眩晕，痞满咽塞。
在本方中加入桂枝、芍药、陈皮、人参、大枣。
孙氏《三吴医案》记载：张溪亭的妻子，喉中梗梗有肉，像烤肉块，吞不下，吐不出，鼻塞头晕，耳朵常嗡嗡作响不安，出汗如雨，心惊胆怯，不敢出门，稍见风就遍身疼痛，小腹时常疼痛，小便淋沥而痛，两手寸脉皆短，两手关脉滑大，右关脉尤为搏指。这是梅核气症。用半夏四钱，厚朴一钱，紫苏叶一钱五分，茯苓一钱三分，姜三分，水煎，饭后服用。每次用此汤调理，多有效验。
妇女脏躁，喜欢悲伤想哭，神情像神灵附体，频繁打哈欠伸懒腰，用甘麦大枣汤主治。
〔鉴〕“脏”，指心脏。心静则神藏，如果被七情所伤，则心不得静，而神躁扰不宁。所以喜欢悲伤想哭，这是神不能主宰情感的表现。神情像神灵附体，是心不能神明。即现在的失志癫狂病。频繁打哈欠伸懒腰，是喝欠烦闷，属肝病。母能令子实，所以病症波及到心。
按：沈明宗认为“脏”指子宫，非常错误。
甘草小麦大枣汤方（《三因方》名小麦汤，《袖珍方》名甘草汤。）
以上三味药，用水六升，煮取三升，分三次温服。也能补脾气。（按：温分徐、沈明宗、尤在泾作“分温”，是正确的。）
〔程〕《内经》说：悲则心系急。甘草、大枣味甘，能缓解各种急迫。小麦是谷类中味苦的。《灵枢经》说：心病者，宜食麦。这是谷物先入心的意思。
按：《素问》以小麦为心之谷。《千金方》说：小麦养心气。本方主治的关键就在这里，而《金鉴》说方义不详，必定是伪错，这种说法大错特错。验证于病人，才知道立方的妙处。
许叔微《本事方》记载：乡里有一位妇女，频繁打哈欠，无故悲伤哭泣不止。有人说是有鬼祟，祈祷祭祀无所不用其极，始终无效。我突然想起有一个证候叫“妇人脏躁”，急忙让人制药，全部服完后痊愈。古人识病制方，种种妙绝如此，尝试后才知。
陈氏《妇人良方》记载：乡先生程虎卿的妻子，妊娠四五个月，白天凄惨悲伤，流泪频繁打哈欠，像有所凭依。医生和巫师一起治疗，都没有效果。我十四岁，正在书房习业，听说这个证候，程省元惊慌无计可施。我就告诉他，管先生伯同说，记得先人说过这个证候，名叫脏躁悲伤，不用大枣汤不能痊愈。虎卿借方一看，很高兴对症，笑着去制药，一投药就痊愈了。
妇女吐涎沫，医生反而用泻下法，导致心下痞满，应当先治疗吐涎沫，用小青龙汤主治。涎沫止住后，再治疗痞满，用泻心汤主治。（“妇人”下，《千金方》有“霍乱呕逆”四字。“泻心汤”上，《千金方》有“甘草”二字。）
〔尤〕吐涎沫，说明上焦有寒。如果不给予温散，反而用泻下法，则寒邪内入而成痞满，如同伤寒过早泻下的例子。然而虽然有痞满但仍吐涎沫，说明上焦寒邪未除，不可治疗痞满，应当先治上焦寒邪，而后治中焦痞满。也如同伤寒例，表解乃可攻痞。
〔魏〕泻心汤，在《伤寒论》中方剂不一，也应当结合《伤寒论》中痞证诸条，参观研究，以求其治法。
泻心汤方（见惊悸篇中○按：惊悸篇所载即三黄泻心汤，此处恐怕不对，据《千金方》，应当是甘草泻心汤。）
妇女的疾病，因虚、积冷、结气，导致各种月经断绝，甚至有长达几年的。血寒积结于胞门，寒伤经络。凝坚在上部，呕吐涎唾，久则成肺痈，形体消瘦受损；盘结在中部，绕脐寒疝，或两胁疼痛，与脏腑相连；或结热于中，痛在关元，脉数但没有疮疡，皮肤像鱼鳞一样粗糙，时常发生在男子身上，不只是女人。在下部较少见，月经周期不匀，导致阴中掣痛，少腹恶寒，或者牵引腰脊，向下根部气街，气冲急痛，膝胫疼痛烦躁，忽然眩晕冒昧，状如厥证或癫证，或者有忧愁悲惨，悲伤多怒，这都是带下病，不是鬼神作怪。久则身体羸瘦，脉虚多寒。三十六种病，千变万端，审察脉象的阴阳、虚实、紧弦，施行针药，治疗危急得到安宁。虽然病名相同，但脉象根源各异，你应当辨别记录，不要说不然。（徐忠可说：“未多”的“未”字，怀疑有误。程郊倩、尤在泾作“来多”。程说：谓崩带之类。《金鉴》也作“来多”，说“来”字当是“未”字。本条都是经水断绝的病，如果是来多，则与上文不合，是传写之讹。按：撰写《金鉴》的人，为什么不考证《正脉》等版本，可疑。沈明宗、魏荔彤仍保留原文。“令阴”，赵开美本作“冷阴”，不对。）
〔鉴〕这一条是妇女各种疾病的纲领。其病之所以不同于男子，是因为有月经。其月经致病的根源，多因虚损、积冷、结气。这三者一旦感受，都能使经水断绝，甚至有长达几年的。寒积胞门，以致血凝气结而不行。先哲说：女子以月经调和为无病，如果月经不调，则变病百出。以下都讲这三者阻碍经血的变病。变病不同，各因其人的脏腑经络、寒热虚实之异。如寒邪外伤经络，其人上焦素寒，则凝坚在上，所以上焦胸肺受病。形寒伤肺，则气滞阻饮，所以呕吐涎唾。若其人上焦素热，寒同其化，久则成热，热伤其肺，所以成肺痈，而形体消瘦。若其人中焦素寒，则在中盘结，所以绕脐疝痛。或两胁疼痛，是中焦部位，连及肝脏的缘故。或其人中焦素热，则不病寒疝，而病结热于中。中热故不能为寒疝，而绕脐之痛仍在关元。其人脉数应当生疮，若无疮则热必灼阴，皮肤失润，所以肌肤粗糙像鱼鳞。然而这些呕吐涎唾、寒疝疼痛、肌若鱼鳞等病，也时常发生在男子身上，不只是女子病。在下部较少见，谓月经周期不匀，而血不多下。邪侵胞中，乃下焦部位，所以病阴中掣痛、少腹恶寒。或痛引腰脊，下根气街急痛，腰膝疼烦，都是胞中冲任为病，所以必然。或痛极忽然眩晕冒昧，状如厥癫，也是痛甚的常状。若其人或有忧愁悲惨、悲伤多怒的经历，而出现此眩晕厥癫之证，实在不是有鬼神。凡此胞中冲任血病，都能病带，所以谚语说十女九带。然而带下病久，津液必伤，形体必羸瘦，诊其脉虚，审其多寒，岂止病此三十六病，而千变万端矣。虽千变万端，然审察脉象阴阳虚实紧弦，与病参究，施行针药，治疗危急得到安宁。有病虽同，而脉不同者，则当详加审辨。所以说你应当辨别记录，不要说不然。
〔尤〕严重时忽然眩晕冒昧，状如厥癫，所谓阴病者，下行极而上也。或者有忧愁悲惨、悲伤多怒，状如鬼神者，病在阴则多怒，及悲愁不乐。总之称为带下病。带下者，带脉之下。古人列经脉为病，凡三十六种，皆谓之带下病，不是今人所说的赤白带下。三十六病者，十二症、九痛、七害、五伤、三痼。
按：《史记·扁鹊仓公列传》说：经过邯郸，听说尊重妇女，就做带下医。可知古所称带下，乃腰带以下，经血诸疾之谓。《金鉴》说：此皆带下一句，应当在“非有鬼神”之下，文义相属，是传写之讹。这种说法不对。本条隔句押韵，如果根据《金鉴》而改之，则失去上下押韵之法，不可从。《诸病源候论》说：诸方说三十六疾者，十二症、九痛、七害、五伤、三痼不通。
In women, wind-stroke (Wind-Strike) has persisted for seven to eight days. There is a continuous recurrence of alternating chills and fever (alternating cold and heat), occurring at regular intervals. The menstrual flow happens to have ceased. This is termed Heat Entering the Blood Chamber (Heat entering the uterus and related vessels). The blood must be congealed, thus causing symptoms resembling malaria, with regular paroxysms. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary treatment. (The formula is found in the section on Vomiting. ○ In "Shanghan Lun" [Treatise on Cold Damage], Sun Tai Xia Bian, "lai" [comes] is written as "de" [obtains]. Under "duan" [ceases], there are two characters "you zhe" [there are].)
[Cheng] For women suffering from Shanghan (Cold Damage) or Fengzhong (Wind-Stroke), the principles of transmission and treatment through the Six Channels are the same as for men. However, when menstruation is just beginning or has just ceased, Heat enters the Blood Chamber, or during pregnancy/postpartum, metrorrhagia, leukorrhea, etc., the treatment methods differ. During menstruation, when blood is weak and qi is exhausted, pathogenic factors enter the Blood Chamber and contend with healthy qi, causing menstruation to cease and blood to congeal. When blood is congealed, pathogen and healthy qi struggle, resulting in alternating chills and fever with regular timing. Xiao Chai Hu Tang resolves exterior and interior pathogens and dissipates pathogenic heat in the Blood Chamber.
[You] Zhang Zhongjing uses only Xiao Chai Hu Tang without adding a single blood-invigorating herb. The intention is that once the pathogenic heat is resolved, the temporarily congealed blood will naturally circulate. (See detailed explanation in *Shanghan Lun Ji Yi*, Sun Tai Middle Chapter; the following two articles follow the same principle.)
Xu Shuniwei's *Benshi Fang* records Xiao Chai Hu Tang plus Rehmannia Root (Sheng Gan Di Huang), treating women and unmarried girls with Shanghan fever, or alternating chills and fever, where menstruation has just started or just ceased. They are lucid during the day but delirious at night, seeing ghosts. It also treats postpartum lochia that starts then suddenly stops. Add raw dried Rehmannia Root (Sheng Gan Di Huang) to the original Xiao Chai Hu Tang.
In the year Xin Hai, residing in Piling, the sister of Wang Zhongli, an academic official, suffered from Shanghan with alternating chills and fever. At night, she seemed possessed by spirits. After six or seven days, she suddenly became comatose and blocked, with rattling phlegm sounds like sawing, locked jaw, closed eyes, and unconsciousness. The condition was extremely critical. I was summoned to examine her. I asked, "At the onset of the illness, did menstruation occur?" The family replied, "Menstruation had just started, but stopped when the illness began." A day or two later, alternating chills and fever appeared. She was quiet during the day but plagued by spirits at night. From yesterday, excessive saliva flowed, and she lost consciousness. I said, "This is the syndrome of Heat Entering the Blood Chamber." Zhang Zhongjing stated: "Women with wind-stroke, fever and chills, menstruation just started, lucid during the day, delirious at dusk, seeing ghosts, with regular paroxysms, is named Heat Entering the Blood Chamber." If doctors do not understand this and administer harsh purgatives, it leads to chest and diaphragm discomfort, phlegm flooding the upper jiao, panting with high-pitched breathing, and coma. One must first resolve the phlegm, then clear the heat. I urgently administered Yi Xi San (One-Sip Powder). Within two hours, phlegm drained, she slept, and regained consciousness. Then I prescribed Xiao Chai Hu Tang plus Rehmannia Root. After three doses, the fever subsided, and she recovered spontaneously without sweating. (Yi Xi San consists solely of large Tian Nan Xing [Arisaema Cum Bile], processed on the La Chen day. See the book for details.)
Women with Shanghan, fever, and menstruation just starting, who are lucid during the day but delirious at night, seeing ghosts, suffer from Heat Entering the Blood Chamber. Treatment should avoid damaging Stomach Qi and using methods for the Upper and Middle Jiao (sweating and vomiting); the disease will heal itself. (*Mai Jing* note: The character "er jiao" [second jiao] is likely erroneous.)
[Cheng] With Shanghan fever coinciding with menstruation, cold pathogen enters due to deficiency and contends in the Blood Chamber. As pathogen moves from Yang to Yin, the patient is lucid during the day. Yin being affected causes night delirium and hallucinations. "Wu" [no/avoid] is a prohibitive term. "Fan Wei Qi" [invade Stomach Qi] prohibits purgation. "Shang Er Jiao" [Upper and Middle Jiao] prohibits sweating and emesis. Since the pathogen is in the Blood Chamber, sweating, vomiting, and purging are unsuitable. The previous chapter used Xiao Chai Hu Tang for alternating chills/fever like malaria to resolve the pathogen. The next chapter used needling Qimen (Liv 14) for fullness in the hypochondrium resembling Jie Xiong (Chest Binding) to drain excess. This chapter lacks these upper/lower signs, suggesting waiting for menstruation to expel blood and pathogenic heat to exit with it.
Women with wind-stroke, fever and chills, menstruation just starting, after seven to eight days, with heat gone, slow pulse, cool body, but chest/hypochondriac fullness resembling Jie Xiong, and delirium, suffer from Heat Entering the Blood Chamber. Needling Qimen (Liv 14) according to the excess location is indicated. (*Shanghan Lun* Sun Tai Xia Bian: under "de", there are characters "you zhi".)
[Cheng] Fever and chills indicate Wind pathogen in the exterior, not yet in the interior. Coinciding with menstruation, after seven to eight days, pathogenic heat enters internally due to deficiency. Upon entering, exterior signs vanish, hence slow pulse and cool body. The chest and hypochondrium are the Liver's domain. *Ling Shu* states: Jueyin [Liver Pericardium channel] roots at Dazhun (Liv 1), knots at Yuying, connects to Danzhong. Its main meridian spreads to the hypochondrium. Since the Liver stores blood, pathogen entering the Blood Chamber causes chest/hypochondriac fullness like Jie Xiong. The Liver houses the Hun [Ethereal Soul]; heat contending in Yin causes delirium. Qimen (Liv 14) is the Front-Mu point of the Liver; needling it drains excess.
Xu Shuniwei's *Benshi Fang* records: A woman with Heat Entering the Blood Chamber was misdiagnosed and treated with blood-nourishing and qi-regulating herbs for several days, resulting in Blood Jie Xiong. Someone advised using the previous method. I said, "Using Xiao Chai Hu Tang is too late; it cannot be used. If no other option exists, one can needle the Qimen acupoint." I could not needle, so I asked a skilled practitioner to treat her. She recovered as instructed. Someone asked, "Why does Heat Entering the Blood Chamber form Jie Xiong?" I said, "Pathogen enters meridians, contends with healthy qi, circulates up and down. If menstruation starts or stops, pathogen enters Blood Chamber due to deficiency. Blood is forced upward into the Liver Meridian. Liver involvement causes delirium and hallucinations. Re-entering Danzhong causes blood to knot in the chest. Why? Normally, water nourishes Wood [Liver], and blood nourishes the Liver. Before pregnancy, blood flows down as menses; during pregnancy, it accumulates to nourish the fetus; after birth, it rises to become milk—all are blood. Now pathogen chases blood, gathering in the Liver Meridian, condensing at Danzhong and below the breasts, causing pain on touch. Decoctions cannot reach here, so one must needle Qimen." *Huo Ren Shu* records Hai Ge San (Clam Shell Powder) for Blood Jie Xiong. (Hai Ge [Clam Shell], Hua Shi [Talc], Gan Cao [Licorice] each 1 liang, Mang Xiao [Mirabilite] 0.5 liang. Powdered, take 2 qian per dose, mixed with egg white.)
Yangming Disease, with bleeding and delirium, is Heat Entering the Blood Chamber. Only the head sweats. Needling Qimen (Liv 14) to drain excess is indicated. If profuse sweating ensues throughout the body, the patient recovers. (*Shanghan Lun Ji Yi* Yangming Chapter. "Zhe" [particle], *Shanghan Lun* Sun Tai Zhong Pian writes "ze".)
[You] Yangming heat moves from Qi to Blood, invading the Uterus, causing bleeding and delirium. The Chong and Ren meridians connect with the Yangming Meridian; heat can enter without waiting for menstruation. Thus, the former is heat entering after blood loss; this is blood flowing due to heat entering. Head-only sweating indicates Yang is open but Yin is closed. Although Yangming heat, upon entering the Blood Chamber, belongs to the Liver system, so needling Qimen (Liv 14) to drain excess is required. After needling, if profuse sweating occurs, Yin closure is resolved, and recovery follows.
Women with a sensation of a roasted meat lump in the throat are treated with Ban Xia Hou Po Tang (Pinellia and Magnolia Bark Decoction). ("Luan" [lump], *Mai Jing* writes "fu" [rotten].)
[You] This is condensed phlegm and stagnant Qi blocking the throat. *Qian Jin Fang* describes it as "throat feeling tight, like roasted meat, unable to swallow or spit out."
[Jian] "Sensation of roasted meat in throat" refers to phlegm-saliva in the throat feeling like roasted meat, unable to expectorate or swallow. This is now known as Plum-Pit Qi (Globus Hystericus). This disease arises from Seven Emotions [Joy, Anger, Worry, Thought, Sorrow, Fear, Fright], where stagnant Qi condenses fluids. Therefore, Ban Xia [Pinellia], Hou Po [Magnolia Bark], and Sheng Jiang [Fresh Ginger] are used; pungent flavors to scatter nodules, bitter flavors to direct rebellion downward. Fu Ling [Poria] assists Ban Xia to promote fluid metabolism and move phlegm. Zi Su Ye [Perilla Leaf] is aromatic to diffuse stagnant Qi. Once Qi flows freely and phlegm clears, the disease heals. Men also suffer this, not just women.
*Bing Yuan Zhi Zhu* states: Sensation of roasted meat in throat is due to phlegm-knotting in chest/diaphragm contending with Qi, rising to the throat, forming a lump like roasted meat.
Ban Xia Hou Po Tang Formula ([Original Note] *Qian Jin Fang* writes: chest fullness, hardness below heart, throat feeling tight, like roasted meat, unable to spit out or swallow. ○ Current edition adds "luan" [lump] after "rou" [meat].)
Ban Xia [Pinellia Tuber] (1 sheng) Hou Po [Magnolia Bark] (3 liang) Fu Ling [Poria] (4 liang ○ Zhao writes 2 liang) Sheng Jiang [Fresh Ginger] (5 liang) Gan Su Ye [Dried Perilla Leaf] (2 liang ○ *Qian Jin Fang* says one version has no Gan Su Ye or Sheng Jiang)
These five ingredients are boiled in 7 sheng of water to yield 4 sheng. Divide into four warm doses. Take three times daily and once at night.
*Sheng Hui Fang* Ban Xia San (Pinellia Powder) treats sensation of roasted meat in throat.
Add Zhi Ke [Aurantii Fructus] and He Li Le Pi [Chebulic Myrobalan Peel] to this formula.
Wang Shi *Yi Jian Fang* Si Qi Tang (Four Qi Decoction) treats Qi結 from Joy, Anger, Sorrow, Fear, Fright condensing into phlegm-saliva, shaped like broken cotton or plum pits, stuck in throat, unable to spit or swallow. Caused by Seven Qi. Also suitable for epigastric fullness, Qi stagnation, excessive phlegm, panting, or vomiting due to Phlegm-Fluid in Middle Jiao. (This is the same formula.)
It also states: Women with stubborn temperaments, unable to relax, are often injured by Seven Qi, leading to Qi filling the chest, sensation of plum pit blocking throat, severe oppression. Common in postpartum women. Taking this formula, occasionally with Cyperi Rhizoma (Xiang Fu) medicine, yields long-term results. Especially suitable for pregnant women with nausea/vomiting (E Zu). Occasionally combined with Hong Wan Zi (Red Pill) is effective. Also named Hou Po Ban Xia Tang or Da Qi Tang.
*Rui Zhu Tang Jing Yan Fang* Si Qi Tang treats women with difficult urination, severe cases with vulvar pain.
Add Xiang Fu [Cyperi Rhizoma] and Gan Cao [Licorice] to this formula. Boil and add Hu Po [Amber] powder to mix.
Ren Zhai *Zhi Zhi Fang* Gui Zhi Si Qi Tang treats Wind-Cold pathogen contending in Heart/Abdomen causing pain.
Combine this formula with Gui Zhi Tang (Cinnamon Twig Decoction), add Zhi Ke [Aurantii Fructus] and Ren Shen [Ginseng].
Another Si Qi Tang treats panting caused by Shock/Worry Qi obstruction. (This is the same formula.)
Another Modified Qi Tang treats Qi-Stagnation Vomiting.
Combine this formula with *Qian Jin Fang* Qi Tang (Gui Zhi [Cinnamon Twig], Ban Xia [Pinellia], Ren Shen [Ginseng], Gan Cao [Licorice], Da Zao [Jujube], Sheng Jiang [Fresh Ginger]). Remove Zi Su [Perilla].
Another Added-Ingredient Si Qi Tang treats Heart-Qi Stagnation, resolving phlegm and dispelling fright.
Add Fu Shen [Poria with Hostwood], Yuan Zhi [Polygalae Radix], Gan Cao [Licorice], Shi Chang Pu [Acori Tatarinowii Rhizoma], Da Zao [Jujube] to this formula.
*San Yin Ji Yi Bing Zheng Fang Lun* Qi Tang treats Seven Emotions [Joy, Anger, Worry, Thought, Sorrow, Fear, Fright] stagnation causing mutual overacting of Five Zang, Yin-Yang reversal, sudden chaos, vomiting/diarrhea, alternating chills/fever, dizziness, fullness, throat blockage.
Add Gui Zhi [Cinnamon Twig], Shao Yao [Peony Root], Chen Pi [Citrus Peel], Ren Shen [Ginseng], Da Zao [Jujube] to this formula.
Sun Shi *San Wu Yi An* records: Mrs. Zhang Xiting felt a lump in throat like roasted meat, unable to swallow/spit, nasal congestion, dizziness, tinnitus, profuse sweating, palpitations, fear of going out, body pain upon slight wind exposure, intermittent lower abdominal pain, painful dribbling urine. Both Cun pulses were short; Guan pulses were slippery and large, especially Right Guan which was forceful. This is Plum-Pit Qi Syndrome. Use Ban Xia [Pinellia] 4 qian, Hou Po [Magnolia Bark] 1 qian, Zi Su Ye [Perilla Leaf] 1.5 qian, Fu Ling [Poria] 1.3 qian, Jiang [Ginger] 0.3 qian. Decoct in water, take after meals. This decoction is often effective for regulation.
Women with Zang Zao (Visceral Restlessness) frequently feel sad and want to cry, appearing possessed by spirits, with frequent yawning and stretching. Gan Mai Da Zao Tang (Licorice, Wheat, and Jujube Decoction) is the primary treatment.
[Jian] "Zang" refers to the Heart. When the Heart is calm, the Spirit resides. If injured by Seven Emotions, the Heart cannot remain calm, and the Spirit becomes restless. Hence sadness/crying, indicating Spirit cannot govern emotions. Appearing possessed indicates Heart-Spirit cannot illuminate. This is now known as Loss-of-Vision Mania. Frequent yawning/stretching indicates irritability, a Liver disease. Mother generates Son, so the condition affects the Heart.
Note: Shen Mingzong considers "Zang" to mean Uterus, which is very incorrect.
Gan Cao Xiao Mai Da Zao Tang Formula (*San Yin Fang* names it Xiao Mai Tang; *Xiu Zhen Fang* names it Gan Cao Tang.)
Gan Cao [Licorice Root] (3 liang) Xiao Mai [Common Wheat] (1 sheng) Da Zao [Jujube] (10 pieces)
These three ingredients are boiled in 6 sheng of water to yield 3 sheng. Divide into three warm doses. It also tonifies Spleen Qi. (Note: Wen Fen Xu, Shen Mingzong, You Zaijing write "Fen Wen" [divide warm], which is correct.)
[Cheng] *Nei Jing* states: Sorrow makes Heart-Tendons contract. Gan Cao and Da Zao are sweet to relieve spasms. Xiao Mai is bitter among grains. *Ling Shu* states: Heart diseases benefit from eating wheat. Grains enter the Heart first.
Note: *Su Wen* considers Wheat the grain of the Heart. *Qian Jin Fang* states: Wheat nourishes Heart-Qi. The efficacy of this formula lies precisely here. *Jin Jian* claims the formula's rationale is unknown and likely erroneous; this view is greatly mistaken. Clinical verification reveals the brilliance of the prescription.
Xu Shuniwei's *Benshi Fang* records: A village woman yawned frequently and cried uncontrollably without cause. Others suggested spirit possession, resorting to prayers and rituals, all to no avail. I suddenly recalled the syndrome "Women's Zang Zao," urgently ordered medicine preparation. After finishing the dose, she recovered. Ancient physicians' diagnosis and prescription skills were thus miraculous. Trial confirms this.
Chen Shi *Fu Ren Liang Fang* records: Mr. Cheng Huqing's wife, pregnant 4-5 months, felt miserable and sad during the day, crying and yawning frequently, as if possessed. Doctors and shamans failed. I was 14, studying in the academy. Hearing of this case, Mr. Cheng was anxious. I told him Mr. Guan Botong mentioned his father spoke of this syndrome, named Zang Zao Sadness, curable only with Da Zao Tang. Mr. Cheng borrowed the formula, was pleased it matched the syndrome, smiled, prepared medicine, and cured after one dose.
Women spitting saliva-phlegm, treated erroneously with purgatives, develop Epigastric Fullness (Pi). First treat the spitting with Xiao Qing Long Tang (Minor Blue Dragon Decoction). Once saliva-phlegm stops, then treat the Pi with Xie Xin Tang (Drain the Epigastrium Decoction). ("Women" down, *Qian Jin Fang* has "Huo Luan Ou Ni" [Cholera Vomiting/Reverse]).
[You] Spitting saliva-phlegm indicates Cold in Upper Jiao. Not warming/dispersing, but purging, allows Cold to enter internally forming Pi, similar to premature purging in Shanghan. Although Pi exists, ongoing spitting indicates Upper Cold persists; do not treat Pi yet. Treat Upper Cold first, then Middle Pi, similar to Shanghan principle: resolve exterior before attacking Pi.
[Wei] Xie Xin Tang varies in *Shanghan Lun*. Consult Shanghan Pi-syndrome articles to find treatment methods.
Xiao Qing Long Tang Formula (See Lung Abscess section.)
Xie Xin Tang Formula (See Palpitations section ○ Note: Palpitations section lists San Huang Xie Xin Tang [Three Yellow Drain Epigastrium Decoction]. This is likely incorrect; according to *Qian Jin Fang*, it should be Gan Cao Xie Xin Tang [Licorice Drain Epigastrium Decoction].)
Women's diseases, due to Deficiency, Accumulated Cold, and Stagnant Qi, lead to cessation of menstruation, sometimes lasting years. Blood-Cold accumulates in Bao Men (Uterine Gate), Cold injures meridians. Congealing firmly in Upper Jiao causes vomiting saliva-phlegm, eventually becoming Lung Abscess, wasting the body. Knotting in Middle Jiao causes Umbilical Cold Hernia or Hypochondriac Pain connected to Zang organs. Or Heat knots in Middle, pain at Guan Yuan (CV 4), rapid pulse without ulcer, skin rough like fish scales. This affects men too, not just women. Lower Jiao issues are less common: irregular menstruation, pulling pain in Yin, cold in Lower Abdomen, radiating to Waist/Spine, down to Qi Jie (Groin), urgent Qi Chong (CV 29) pain, knee/shin pain/restlessness, sudden dizziness/fainting resembling Jue or Dian syndromes, or sorrow/grief/anger. These are all Dai Xia (Leukorrhea/Lower Burner diseases), not ghostly. Long-term leads to emaciation, deficient pulse, much Cold. Thirty-Six Diseases change endlessly. Examine pulse Yin/Yang, Deficiency/Excess, Tight/String-taut. Apply acupuncture/herbs to save critical cases. Same disease, different pulse origins; you must distinguish and record. Do not say otherwise. (Xu Yun doubts "Wei Duo" [not much]; Cheng/You read "Lai Duo" [much coming]. Cheng says: refers to Metrorrhagia/Leukorrhea. *Jin Jian* also reads "Lai Duo", saying "Lai" should be "Wei". This article discusses cessation of menses; "Lai Duo" contradicts text, likely scribal error. *Jin Jian* authors didn't check *Zheng Mai* editions, questionable. Shen/Wei keep original. "Ling Yin" [causes Yin], Zhao Ben writes "Leng Yin" [Cold Yin], incorrect.)
[Jian] This article is the general outline for women's diseases. Difference from men is menstruation. Causes include Deficiency, Accumulated Cold, Stagnant Qi. Any can stop menses for years. Cold accumulates in Bao Men, congealing blood/Qi. Ancients say: Women are healthy if menses regulate; irregularity leads to myriad diseases. Below describes variations obstructing menses. Variations depend on individual Zang/Meridian, Cold/Heat, Deficiency/Excess. External Cold injuring meridians + Upper Jiao Cold = Congealing Upper Jiao → Chest/Lung disease → Qi stagnation/Fluid retention → Vomiting saliva-phlegm. If Upper Jiao originally Hot, Cold transforms to Heat → Heat injures Lung → Lung Abscess → Emaciation. If Middle Jiao originally Cold = Knotting Middle → Umbilical Hernia/Hypochondriac Pain (Liver connection). If Middle Jiao originally Hot = No Cold Hernia, but Heat Knotting Middle → Pain at Guan Yuan. Rapid pulse usually means Ulcer; no ulcer means Heat burns Yin → Skin dry/scaly. These symptoms also affect men. "Lower Jiao not much" means irregular menses, scant flow. Pathogen invades Bao Zhong (Lower Jiao) → Pulling Yin pain, Lower Abdomen Cold, radiating to Waist/Spine/Groin/Knees. Severe pain causes dizziness/fainting (Jue/Dian). Sorrow/Anger with these signs is not supernatural. All Bao/Zhong/Chong/Ren Blood diseases can cause Dai Xia (Leukorrhea). Proverb: Ten women, nine Dai Xia. Long-term Dai Xia damages fluids/body → Emaciation, deficient pulse, Cold. Beyond Thirty-Six Diseases, changes are endless. Yet, examining pulse Yin/Yang/Deficiency/Excess/Tight/String-taut alongside symptoms, applying acupuncture/herbs saves lives. Same disease, different pulses require careful distinction. Hence, "You must distinguish and record."
[You] Severe cases: sudden dizziness/fainting resembling Jue/Dian. Yin diseases rise from extreme descent. Sorrow/Anger resembling spirits: Yin diseases cause anger/sadness. All called Dai Xia. Dai Xia refers to below the Belt Vessel (Dai Mai). Ancients listed 36 Meridian diseases as Dai Xia, not modern Red/White Leukorrhea. Thirty-Six Diseases: 12 Syndromes, 9 Pains, 7 Harms, 5 Injuries, 3 Chronic Conditions.
Note: *Shi Ji · Bian Que Zhuan* says: Passing Handan, hearing respect for women, became a Dai Xia doctor. Ancient Dai Xia meant diseases below the belt, specifically menstrual disorders. *Jin Jian* argues "Ci Jie Dai Xia" sentence should follow "Fei You Gui Shen" for logical flow, claiming scribal error. This is incorrect. The text rhymes every other line. Changing it breaks rhyme scheme. *Bing Yuan Zhi Zhu* says: Thirty-Six Diseases: 12 Syndromes, 9 Pains, 7 Harms, 5 Injuries, 3 Chronic Obstructions.