诸此也。至期不来。又中虚而精悍不生。下虚而气血自短所致。故亦取之耳。妇人之月水。名之曰经血者。
以其由十二经脉盈满之气。从月光之亏损。而泻下之义也。但其源委。则有两路。从胃腑发精之根。历脾肺
肝肾。以及于心。凡经过之脏腑。各私取以自润其经脉者。一也。又肝为血脏。脏中之余血。由肝络而内从血
室。以外达经络。与各脏腑所荣经脉之血会成一片者。又一也。此如潮起之象。其少火生气。潜滋暗长。至三
十日。则经脉外满。而不受两血之注。遂使外气平而内气不长。且外盛者具反注之势。故气伏潮落。而十二
经脉之血。阖归血室。而下为月水矣。此系血瘀少腹之肝络。肝脏内血。欲由血室而外达以养经。因络阻而
不得通过血室。故无期而带下。我故曰。与妊娠漏血有别。又曰。使血液归经者此也。
带下。经水不利。少腹满痛。经一月再见者。土瓜根散主之。
土瓜根散方 土瓜根 桂枝 芍药 虫（各三分）
上四味。杵为散。每服方寸匕。日三服。阴 肿亦主之。
此即上条之初症也。带下、亦指赤带。详已见。经水不利。因经脉之血。止有脾胃一路上供。而肝脏之血。陆续
漏下。以致经脉之气血亏浅。故至期之经水不畅利也。少腹满痛者。血瘀气滞之应也。经一月再见。又承带
下而言。盖谓带下一症。又致各经经气上虚。因而不能包护。以至一月再见者。二者耽延日久。俱成上条利
下等症。故宜即主此以愈之。无使渐成温经汤之候也。芍药、下引而入血分。 虫、阴性而行血结。桂枝、辛以
散之。温以行之。合三味而去瘀之功用全矣。土瓜根、为蔓引之本。其性上行。盖蔓引则走经脉。上行则托住
肝脏之血。而使上充十二经脉之义也。以其为上条之初症。阴血未伤。故于温经汤。则少用归芎胶麦。阳气
未寒。故于温经汤又少用参姜吴茱萸者。此也。夫瘀去而肝血得从血室以归经脉。故带下除。而少腹之满
痛亦止。经脉气充。而下伏于血室者有势。故经水自利。又血上滋而气自裕。则包护有力而尤能提挈。故一
月再见者亦愈矣。血下瘀、则阴 。气下郁、则阴肿。本方为行血提气之药。故亦主之。
寸口脉弦而大。弦则为减。大则为芤。减则为寒。芤则为虚。寒虚相抟。此名曰革。妇人则半产漏下。旋复花汤主
之。
旋复花汤方 旋复花（三两） 葱（十四茎） 新绛（少许）
上三味。以水三升。煮取一升。顿服之。
文义脉象。注见血门。妇人半产漏下。以上虚失提。外虚失裹之所致。葱性辛温。而先降后升。为下通肾阳以
外达之品。故白通汤之用之者。盖取诸此也。旋复花用至三两。而且以之名汤。其意有二。夫上虚者必有阴
气乘之。旋复能降逆阴。以为升阳之地者。一也。又取并力下趋葱性。以温肾阳者。二也。浅红曰绛。新绛者。新
所染之绛色也。以茧丝口吐。其性上行。而红花所染之绛。又从其色而上入心膈之义。明系一小肾气丸。
盖以辛热多气之葱茎。代桂附。以收降之旋复。代地黄、山萸。以上行心膈之新绛。代丹皮。则其先资下降。而
徐引上升。以补益其宗气。俾上提外裹者有力。而半产漏下自止矣。然本方、不过救急之劫棋。若求稳着。毕
竟以建中、肾气汤丸。为的当而无弊。千载以后。自有高明者以余言为不谬。又岂止仲景在天之灵。默为之
首肯乎哉。
妇人陷经。漏下黑不解。胶姜汤主之。（方缺。又林亿曰。臣亿等校诸本无胶姜汤方。想是妊娠中之胶艾汤。细按
胶艾汤方意。与本条之症逼对。或姜字为艾字之讹耶。今从之。）
妇人陷经。与妊娠胞阻同义。盖妇人少腹。积有死血。使肝血不由血室以养经。而漏下者曰带下。若少腹并
无瘀血阻塞。但其肝脏中。气虚而不能上蒸。血虚而不能上荫。其血刚至血室。而中路陷脱。故曰陷经。与胞
阻之无瘀阻滞。其气血因虚而自漏者同。故曰与妊娠胞阻同义也。血虚者。气自寒。而血又因寒而其色惨
黑。寒久则黑如豆汁矣。症与妊娠之胞阻同。故其主胶艾汤亦一也。汤意详胞阻下。但于胞阻。则补血温气
以养胎。此则补血温气以养经为异耳。即以胶姜汤而论。据愚鄙之见。未始不与陷经之候相对。但疑尚
有当归、芍药、桂枝、丹皮四味。盖以阿胶之皮性。善于包裹提挈者为主。而佐以苦温之当归。所以温补血虚
也。以生姜之根性。善于升浮旁达者为主。而佐以辛温之桂枝。所以温补气寒也。然后以芍药。引之入肝。以
丹皮。通之出脉。则陷经漏黑。当解于温补升行之内。有识者。或不以为好事而 妄乎。
妇人少腹满如敦状。小便微难而不渴。生后者。此为水与血结在血室也。大黄甘遂汤主之。
大黄甘遂汤方 大黄（四两） 甘遂（二两） 阿胶（二两）
上三味。以水三升。煮取一升。顿服之。血当下。
敦者。上小下大之象。妇人少腹如敦状。先就外症而言。然实包藏诸症在内。以胎气水积、血结。俱能作此状
故也。曰小便难。则积有水气。可知。曰微难。则小便尚见。而积水不多又可知。若使渴而微难。则出少不胜入
多。犹得断为纯是水气。而又不渴。则其如敦状者。非全水者更可知。又少腹满大。小便微难而不渴。颇似胎
气。今且是生产之后。则既非全是水。又不必疑为胎。而与水共结为如敦状者。非生后之瘀血而何哉。则破
结血之大黄。与逐水饮之甘遂。可直任而无疑矣。但生后血虚。攻其积水结血。恐致伤阴之弊。故以养血之
阿胶佐之者。盖血短则留连外饮。是补血亦所以替去其水。生新则推出死血。是补血又所以逐去其瘀之
义也。五句惟二十九字。文法则八面玲珑。诊法则千层透辟。西汉以后医书。乌足以语此哉。
妇人经水不利下。抵当汤主之。亦治男子膀胱满急有瘀血者。（愚按全经各条下。并无此小字添注之例。其
后人之蛇足耶。）
抵当汤方 虻虫（三十枚熬去翅足） 水蛭（二十个熬） 桃仁（二十个去皮尖） 大黄（三两酒浸）
上四味。为末。以水五升。煮取三升。去滓。温服一升。
此亦血瘀内络。以致行血之气。力绵势缓。故经水不利下也。但比前条诸症。多上中二焦之瘀。如膻中及脾
胃之孙络。或因曾经咯血。或因饮食大饱。以及形寒饮冷等类。皆能令络中血瘀。血瘀则气滞。而经水不利。
故用本天亲上之虻虫。本地亲下之水蛭。各引入死血之络。然后以桃仁破而动之。大黄逐而下之。观大黄
之用酒浸。行血之外。盖又取浮缓其性。而使之从上下扫者居多。我故曰。比前条多上中二焦之瘀者此也。
然为壮人之初症。又不可不知。壮人。故直任峻药。初症。故血未虚而全不补血也。
妇人经水闭。不利。脏坚癖不止。中有干血。下白物。矾石丸主之。
矾石丸方 矾石（三分烧） 杏仁（一分）
上二味。末之。炼蜜为丸如枣核大。五内中。剧者。再纳之。
脏指阴庭而言。即方后纳脏中者是也。坚者阴脏中之肉。因气郁血滞而坚硬之谓。坚癖者。坚久而欲为痼
疾。即肠癖之义也。白物。非谓白带白淫之类。殆指形如粉渣而白。湿热之所化也。盖白带白淫。下从带脉及
肾中。其源远而象如精汁。此则从阴庭之坚癖处而下。其源近而微干色白。如积垢。故曰白物耳。经水闭不
行。乃本条领语。脏坚癖以下。方是正文。盖谓经水闭而不行。或行而不利。其或为血瘀。或为虚寒。或止下焦。
或兼上部。已各有专方正治矣。然又有一种因经闭不行。而兼致外症者。则除正病正治外。而其外症。又不
可不知外治也。比如经闭不利。则气血沉滞。从络脉而下注阴脏之肉内。遂成坚硬之癖疾。久久不止。则沉
滞之血。干于坚癖中。于是气血郁而生热。热则生湿。湿热交蒸。则下垢腻之白物。矾石气寒味酸而性燥。寒
则清火而解热。酸则消坚而散血。燥则拔干而去湿。故用之为君。佐利气之杏仁者。所以并散其沉滞之气
也。又诸症下在阴内。为服药之所未易到者。何似丸如枣核。纳脏中而以外治治之为甚便也。诸注支离混
淆。不得 窍。
妇人六十二种风。及腹中血气刺痛。红蓝花酒主之。
红蓝花酒方 红蓝花（一两）
上一味。以酒一大升。煎减半。顿服一半。未止再服。
妇人旧血行得畅。则新血生得满。而气因于血。故气亦为之温暖。充周而无病。若旧血迟滞。则生新之机自
钝。而气血俱虚矣。血虚。则偏于干热而动生内风。血虚而气虚。则疏于卫外、而易感外风。此六十二种风因
之所自来也。又腹中血虚。则失于滋润。而络脉干痛。气虚。则失于流贯而络脉拘痛。此腹中刺痛之所自来
也。红蓝花活血行气。得温浮蒸被之酒性以充之。则气行血畅。而解内外之风邪。除腹中之刺痛也宜矣。
妇人腹中诸疾痛。当归芍药散主之。（方见妊娠）
妇人腹中诸疾痛。惟真阴亏损。而留连外水二者而已。盖真阴虚。则内络急痛。外水积。则内络窒痛。当归芍
药散。能补血行饮。故主之。方义。详妊娠腹中 痛下。
妇人腹中痛。小建中汤主之。（方别见）
上条为中下二焦。阴血不足之痛。此条为上中二焦。阳气不足之痛。盖天气寒。则不能照耀。故腹中作阴沁
之痛。天气虚。则不能传送。而作积聚之痛。小建中汤。温膈而并填其气。膈气上温。则阳热下嘘。而阴沁之痛
可除。膈气上裕。则鼓弩下逼。而积聚之痛亦愈。故主之。汤义别详。
问曰。妇人病。饮食如故。烦热不得卧。而反根据息者何也。师曰。此名转胞。不得溺也。以胞系了戾。故致此病。
但利小便则愈。宜肾气丸主之。（方见虚劳）
此条。明言不得溺为本病。因而转胞。又因转胞而致烦热不卧。以及倚息。此属易解。但其所以不得溺。及所
以不用他药利小便。而独主肾气丸者。解得透彻。则略无障碍矣。盖肾中先天之气。从贴脊之后道。上熏膈
中。与饮食所生之悍气。从肺而上贮胸中者相会。则先天后天混合。而成在上之宗气。此气充满。则呵嘘蒸
被。而水道流行。今肾中鲜上熏之妙。而膈气空浅。则水行自缓。缓则气愈滞而不得溺。不得溺。则膀胱满而
拥起胞胎。令胞系松宽而微转。故曰转胞。夫膀胱之气。与胞胎之气。两皆上转。则气宇扁窄。其烦热不得卧。
及倚坐以息也宜矣。于何知之。于饮食如故。故知上中二焦。及前行之后天气道中无病。而为先天之肾气
虚微。因致胸中失传送之候也。了戾者。钉钩挂物。系松而摇拽旋纽之象。肾气丸中。茯泽渗泄以利水。山药
培土以利水。则膀胱浅软。而胞胎已有下弛之地。且得地黄、山萸。将桂附弹压。下入肝肾。而令丹皮。直从贴
脊而上引之。俾胸中氤氲之气下逼。则胞胎复安其位。而其系因直而自正。又何烦热不得卧。及倚息之患
耶。此仲景不以他药利水。而独主肾气丸之精意。安得有心人。而与之共剔长沙之灯火哉。
妇人阴寒。温中坐药。蛇床子散主之。
蛇床子散方 蛇床子仁。
上一味。末之。以白粉少许。和令相得。丸如枣大。绵裹内之。自然温。
阴寒。亦指阴庭之寒冷而言。俗解作子宫寒。非。以坐药外治。不能温子宫故也。坐药者。纳之而坐。非一时取
效之谓。故方后曰绵裹者。恐其坐久致化之义也。凡妇人一切纳药、坐药、洗药。俱与深远之脏腑无干。而为
外症。外症而治以内药。既失之迂。而且虞脏腑之喜恶不齐。先为药病也。故外症皆从外治之例。本草称蛇
虺喜卧其下。故有蛇床虺床之名。则其性之温暖可知。又味辛而甘。夫辛甘主散。则其温暖之性。为能横施
旁达又可知。用为坐药。而阴寒自温可必也。客有素读仲景之书。而难予者曰。阴非独寒。必子宫上冷而
后下阴户者。本衣冠文物主坐药。而子谓但温阴庭。而非子宫之药。毋乃所见之偏且执耶。余曰。是非客所知也。
夫金匮一书。分门立论。其就症列方者。大似玉碎珠零。金星宝片。殊无可贵。是在灵机无碍者。会其全神。譬
之重漆围屏。钳镶斗缝。则异彩奇光。照耀堂奥。而成玻璃世界。客之所见者。屑末而已矣。乌足以知此哉。诚
如客言。彼子宫之寒在先天者。肾气丸不具在乎。在后天者。理中丸不具在乎。何妨以内药先温其本。而后
以外药兼治其标耶。且云坐药可上温子宫。则亦将以漱口不下咽者。能愈中焦疾苦乎。客失笑而语塞。
少阴脉滑而数者。阴中即生疮。阴中蚀疮烂者。野狼牙汤洗之。
野狼牙汤方 野狼牙（三两）
上一味。以水四升。煮取半升。以绵缠筋如茧。浸汤沥阴中。日四遍。
滑为湿。数为热。少阴之下竟下。为阴庭之应。其脉湿热交见。故知其为阴中生疮矣。阴中蚀疮句。勿作上文
之复语。盖上两句是言诊法。亦是言其初症。下二句言疮久而湿热浸淫。以致虫生之治法也。野狼牙味苦性
寒。以寒能胜热。苦能燥湿。而尤能杀虫。故主此以洗之耳。
胃气下泄。阴吹而正失。此谷气之实也。膏发煎导之。（方见黄胆）
这些都是上述情况。到了经期该来月经却未来，又因为中焦脾胃虚弱导致精微物质不能化生，下焦肝肾亏虚导致气血自然短少所致。所以也采用（土瓜根散）治疗。妇女的月经，称为“经血”，是因为它源于十二经脉充盈的气血，随着月亮的盈亏变化而泻下的缘故。但其来源和机理，主要有两条路径：一是从胃腑发源的精气根本出发，经过脾、肺、肝、肾，最终到达心脏。凡经过的脏腑，各自私自摄取精气以滋润自己的经脉，这是一条路径。二是肝脏为藏血之脏，脏中剩余的血液，通过肝络向内进入血室，向外通达经络，与各脏腑所荣养的经脉之血汇合成一片，这是另一条路径。这就像潮水涨起的样子，少火（生理之火）生气，潜移默化地生长，到了三十天，经脉外部充盈，而不接受两股血液（指非经期的异常出血或瘀血）的灌注，于是使外气平和而内气不再过度生长，且外盛者反而具有反注的趋势，所以气机潜伏，如潮水退落，十二经脉之血闭合回归血室，向下成为月经。这是由于血瘀在少腹的肝络，肝脏内的血液想要通过血室向外通达以滋养经脉，但因为络脉阻滞而不能通过血室，所以没有固定周期而带下（此处指非经期的阴道出血）。所以我说是与妊娠漏血不同。又说，这就是使血液回归正常经脉的方法。
带下病，月经不畅利，少腹部胀满疼痛，一个月来两次月经的，用土瓜根散主治。
土瓜根散方：土瓜根、桂枝、芍药、䗪虫（各三分）
以上四味药，捣碎过筛制成散剂。每次服用一方寸匕，每日三次。阴部肿胀也主治。
这正是上一条所述的初期症状。带下，也是指赤带，详细解释已见前文。月经不畅利，是因为经脉中的血液只有脾胃这一路上供给，而肝脏的血液陆续漏下，导致经脉的气血亏虚浅薄，所以到了经期月经就不畅利。少腹胀痛，是血瘀气滞的反应。一个月来两次月经，又是承接带下而言。大概是指带下一症，又导致各经经气上部虚损，因而不能固摄保护，以至于一个月来两次月经。这两种情况拖延日久，都会形成上一条所述的利下等重症，所以应当立即用此方治愈，不要使其逐渐演变成温经汤证候。芍药，下行引导而入血分；䗪虫，性阴而行血结；桂枝，辛能发散，温能通行。合这三味药，去瘀的功效就完备了。土瓜根，是藤蔓引经的根本，其性上行。大概藤蔓牵引则走经脉，上行则托住肝脏之血，而使上充十二经脉的意思。因为它属于上一条的初期症状，阴血未受损伤，所以在温经汤中少用当归、川芎、阿胶、麦冬；阳气未寒，所以在温经汤中又少用人参、干姜、吴茱萸，就是这个原因。瘀血去除而肝血得以从血室回归经脉，所以带下停止，而少腹的胀满疼痛也止息。经脉之气充盈，而下伏于血室的血就有势态，所以月经自然通畅。又因血上滋而气自然充裕，则固摄有力而且更能提挈，所以一个月来两次月经的情况也能痊愈。血在下焦有瘀滞，则阴部瘙痒；气在下焦郁结，则阴部肿胀。本方是行血提气的药物，所以也主治这些症状。
寸口脉弦而大，弦脉表示阳气衰减，大脉表示中空如葱管（芤脉）。衰减则为寒，中空则为虚。寒与虚相互搏结，这种脉象名叫革脉。妇人出现革脉，则会发生半产（小产）后漏下不止，用旋复花汤主治。
旋复花汤方：旋复花（三两）、葱（十四茎）、新绛（少许）
以上三味药，用水三升，煮取一升，一次性服下。
文义和脉象的解释，参见血门。妇人半产后漏下不止，是由于上部虚损失去提举，外部虚损失去包裹所致。葱性味辛温，先降后升，是通达肾阳以外达的药物。所以白通汤中使用它，就是取法于此。旋复花用到三两，而且以它命名汤剂，其用意有二：一是上部虚损必然有阴气乘袭，旋复花能降逆阴气，为升发阳气提供空间，这是一点；二是取其合力下趋，配合葱的性味，以温补肾阳，这是第二点。浅红色叫绛，新绛就是新染成的绛色。用蚕茧丝吐出的丝线，其性上行，而用红花染成的绛色，又顺应其颜色而上入心膈的意思。这实际上是一个小型的肾气丸。用辛热多气的葱茎代替桂枝、附子，用收敛下降的旋复花代替地黄、山茱萸，用上行人膈的新绛代替牡丹皮，那么先资助下降，然后慢慢引导上升，以补益宗气，使得上提外裹的力量充足，半产漏下自然停止。然而本方不过是救急的权宜之计，如果追求稳妥，毕竟以建中汤、肾气丸更为恰当而无弊端。千年以后，自然有高明的医生认为我的话不谬，难道只是仲景在天之灵默默点头认可吗？
妇人陷经证，漏下黑色血液不止，用胶姜汤主治。（方剂缺失。另外林亿说：臣亿等人校勘各种版本都没有胶姜汤方，猜想可能是妊娠中的胶艾汤。仔细推敲胶艾汤方意，与本条的症状非常对应，或许“姜”字是“艾”字的讹误吧。现在依从这个说法。）
妇人陷经证，与妊娠胞阻意义相同。大概妇人少腹积聚有死血，使肝血不能通过血室以滋养经脉，而漏下的叫做带下。如果少腹并没有瘀血阻塞，只是肝脏中气虚不能上蒸，血虚不能上荫，其血刚到达血室，就在中途陷脱，所以叫做陷经。这与胞阻没有瘀血阻滞，气血因虚而自漏的情况相同。所以说与妊娠胞阻意义相同。血虚者，气自然寒，而血又因为寒而颜色惨黑。寒久了则黑得像豆汁一样。症状与妊娠的胞阻相同，所以主治也用胶艾汤，是一样的。汤剂的用意详见胞阻篇下。但在胞阻证，是补血温气以养胎；这里则是补血温气以养经，这是不同之处。就拿胶姜汤来说，据我浅陋的看法，并非不与陷经的证候相对。但怀疑其中还有当归、芍药、桂枝、丹皮四味药。大概以阿胶的皮性，善于包裹提挈为主药，而佐以苦温的当归，用来温补血虚。以生姜的根性，善于升浮旁达为主药，而佐以辛温的桂枝，用来温补气寒。然后用芍药，引导药力入肝；以丹皮，疏通药力出脉。那么陷经漏黑，应当在温补升行的过程中解除。有见识的人，或许不会认为我是好事而胡乱猜测吧。
妇人少腹部胀满，形状像敦（一种上小下大的食器），小便轻微困难但不口渴，发生在生产之后的，这是水气与瘀血结聚在血室。用大黄甘遂汤主治。
大黄甘遂汤方：大黄（四两）、甘遂（二两）、阿胶（二两）
以上三味药，用水三升，煮取一升，一次性服下。瘀血当下出。
敦，是上小下大的形状。妇人少腹像敦状，先从外在症状来说。然而实际上包藏着各种症状在内，因为胎气、水积、血结，都能造成这种状态。说小便难，就知道积有水气。说轻微困难，就知道小便尚通，而积水不多也可以知道。如果口渴而轻微困难，那就是出少不胜入多，还可以断定为纯粹是水气。如果不渴，那么像敦状的就不是全由水气造成，更可以知道了。再加上少腹满大，小便轻微困难且不渴，很像胎气。现在却是生产之后，既然不全是水，也不必怀疑是胎，而与水的结合形成像敦状的，如果不是生产后的瘀血是什么？那么破结血的大黄，与逐水饮的甘遂，就可以直接任用而没有疑问了。但是生产后血虚，攻伐其积水结血，恐怕会导致伤阴的弊端。所以用养血的金银花（注：原文阿胶，此处译文修正为阿胶）辅助它。大概血短少则留连外饮，补血也就是为了替掉水气；生新血则推出死血，补血也就是为了驱逐瘀血的意思。这五句话只有二十一个字，文法八面玲珑，诊法千层透辟。西汉以后的医书，哪里配得上谈论这个呢？
妇人月经不畅利下行，用抵当汤主治。也治疗男子膀胱满急有瘀血的情况。（我按：全经各条下，并没有这样的小字添注的例子，这是后人画蛇添足吧。）
抵当汤方：虻虫（三十枚，熬去翅足）、水蛭（二十个，熬）、桃仁（二十个，去皮尖）、大黄（三两，酒浸）
以上四味药，研成末，用水五升，煮取三升，去渣滓，温服一升。
这也是血瘀在内络，导致行血之气力量微弱、势态缓慢，所以月经不畅利下行。但这比前条的各种症状，多了上中二焦的瘀血，比如膻中及脾胃的孙络，或者因为曾经咯血，或者因为饮食过饱，以及形寒饮冷等类，都能令络中血瘀。血瘀则气滞，而月经不利。所以用天性亲上的虻虫，本地亲下的水蛭，各自引入死血的络脉，然后用桃仁破开并扰动它，用大黄驱逐并导下它。看大黄用酒浸的用意，除了行血之外，大概是取其浮缓的性质，使之主要从上下扫荡。所以我说是比前条多了上中二焦的瘀血，就是这个意思。然而这是强壮之人的初期症状，又不可不知道。因为是壮人，所以直接任用峻烈药物；因为是初症，所以血未虚而完全不补血。
妇人月经闭止，不利，脏中有坚硬的癖块不止，中间有干血，下身流出白色分泌物，用矾石丸主治。
矾石丸方：矾石（三分，烧）、杏仁（一分）
以上两味药，研成细末，炼蜜为丸，大小如枣核。放入阴中，病情重的，再纳入一枚。
“脏”指阴庭而言，就是方后所说的纳药入脏中。坚硬是指阴脏中的肉，因气郁血滞而变硬。坚癖，是指坚硬久而想成为痼疾，即肠癖的意思。白物，不是说白带白淫之类，大概是指形状像粉渣而白色的，是湿热所化生的。白带白淫，从带脉及肾中下来，源头远而形象像精汁。这里是从阴庭的坚癖处下来，源头近而稍微干燥颜色白，像积垢，所以叫白物。月经闭止不行，是本条的领语，脏坚癖以下是正文。大概说月经闭止不行，或者行而不畅利，或者是血瘀，或者是虚寒，或者只在下焦，或者兼有上部，已经各有专方正治了。然而又有一种因为经闭不行，而导致外症的，那么在正病正治之外，而其外症，也不可不知外治法。比如经闭不利，则气血沉滞，从络脉而下注阴脏的肉内，遂成坚硬的癖疾。久久不止，则沉滞的血，干枯在坚癖中，于是气血郁而生热，热则生湿，湿热交蒸，则下垢腻的白物。矾石气寒味酸而性燥，寒则清火解热，酸则消坚散血，燥则拔干去湿。所以用它作为君药。佐以利气的杏仁，是为了同时消散沉滞的气。又诸症下在阴内，是服药难以到达的地方，何似做成枣核大的丸药，纳入脏中以外治法治疗最为方便。各种注解支离混淆，不得要领。
妇人患六十二种风邪，以及腹中血气刺痛，用红蓝花酒主治。
红蓝花酒方：红蓝花（一两）
以上一味药，用酒一大升，煎至减半，一次性服下一半，未止再服。
妇人旧血运行得畅，则新血生成得满，而气依附于血，所以气也随之温暖，周流全身而无病。如果旧血迟滞，则生新的机制自然迟钝，而气血都虚了。血虚，则偏于干热而动生内风；血虚而气虚，则疏于卫外，而易感外风。这六十二种风邪因此而来。又腹中血虚，则失于滋润，而络脉干痛；气虚，则失于流贯而络脉拘挛作痛。这腹中刺痛因此而来。红蓝花活血行气，得到温浮蒸被的酒性来充实它，则气行血畅，而解除内外之风邪，消除腹中的刺痛，是应该的。
妇人腹中各种疾病疼痛，用当归芍药散主治。（方剂见妊娠篇）
妇人腹中各种疾病疼痛，只有真阴亏损，以及留连外水这两者而已。大概真阴虚，则内络急痛；外水积，则内络窒塞作痛。当归芍药散，能补血行饮，所以主治它。方义，详见妊娠腹中痛下。
妇人腹中痛，用小建中汤主治。（方剂另见）
上一条是中下二焦，阴血不足的疼痛。这一条是上中二焦，阳气不足的疼痛。大概天气寒冷，则不能照耀，所以腹中作阴沁之痛；天气虚，则不能传送，而作积聚之痛。小建中汤，温膈而并填其气。膈气上温，则阳热下嘘，而阴沁之痛可除；膈气上裕，则鼓弩下逼，而积聚之痛亦愈。所以主治它。汤义别详。
问：妇人患病，饮食如常，烦热不得卧，反而倚着呼吸，这是什么病？老师说：这名叫转胞，不能排尿。因为胞系扭转错乱，所以导致这个病。只要通利小便就好了，宜用肾气丸主治。（方剂见虚劳篇）
这条明确说明不能排尿是本病，因而转胞，又因转胞而导致烦热不卧，以及倚息。这属于容易理解的。但其所以不能排尿，以及所以不用其他药利小便，而独主肾气丸的原因，解释透彻，则略无障碍了。大概肾中先天之气，从贴脊的后道，上熏膻中，与饮食所生的悍气，从肺而上贮胸中者相会，则先天后天混合，而成在上之宗气。此气充满，则呵嘘蒸被，而水道流行。现在肾中缺少上熏的妙用，而膻中气空浅，则水行自然缓慢。缓慢则气愈滞而不得排尿。不得排尿，则膀胱满而拥起胞胎，令胞系松宽而微转，所以叫转胞。夫膀胱之气，与胞胎之气，两皆上转，则气宇扁窄，其烦热不得卧，及倚坐以息也就合理了。从哪里知道的呢？从饮食如常，所以知道上中二焦，及前行之后天气道中没有病，而是先天之肾气虚微，因而导致胸中失传送的候象。了戾，是指钉钩挂物，系松而摇拽旋纽的样子。肾气丸中，茯苓泽泻渗泄以利水，山药培土以利水，则膀胱浅软，而胞胎已有下弛之地。且得地黄、山茱萸，将桂附弹压，下入肝肾，而令丹皮，直从贴脊而上引之，使胸中氤氲之气下逼，则胞胎复安其位，而其系因直而自正，又有什么烦热不得卧，及倚息的祸患呢？这是仲景不以其他药利水，而独主肾气丸的精意，怎么能有有心人，与他共同发掘长沙太守（张仲景）的灯火呢？
妇人阴部寒冷，用温中坐药，蛇床子散主治。
蛇床子散方：蛇床子仁。
以上一味药，研成末，用少许白粉，调和令相得，丸如枣大，绵裹内之，自然温热。
阴寒，也是指阴庭的寒冷而言。世俗解释作子宫寒，不对。因为坐药外治，不能温子宫的缘故。坐药，是纳药而坐，不是一时取效的意思。所以方后说绵裹，是恐怕其坐久致化的意思。凡是妇人一切纳药、坐药、洗药，都与深远的脏腑无关，而是为外症。外症而治以内药，既失之迂腐，而且忧虑脏腑的喜恶不齐，先成为药病。所以外症皆从外治的例。本草称蛇虺喜欢卧在其下，所以有蛇床虺床的名字，则其性的温暖可知。又味辛而甘。辛甘主散，则其温暖的性质，为能横施旁达又可知。用作坐药，而阴寒自然温可必了。客人中有素读仲景之书而诘难我说：阴非独寒，必须子宫上冷而后下阴户者。本是衣冠文物之主坐药，而你却说只温阴庭，而非子宫的药，莫非所见偏颇且固执耶？我说：这不是客人所知道的。夫金匮一书，分门立论，其就症列方者，大似玉碎珠零，金星宝片，殊无可贵。是在灵机无碍者，会其全神。譬之重漆围屏，钳镶斗缝，则异彩奇光，照耀堂奥，而成玻璃世界。客人所见者，屑末而已矣。哪里足以知道这个呢？诚如客人所言，那子宫之寒在先天者，肾气丸不具在吗？在后天者，理中丸不具在吗？何妨以内药先温其本，而后以外药兼治其标耶？且云坐药可上温子宫，则亦将以漱口不下咽者，能愈中焦疾苦乎？客人失笑而语塞。
少阴脉滑而数者，阴中即生疮。阴中蚀疮烂者，野狼牙汤洗之。
野狼牙汤方：野狼牙（三两）
以上一味药，用水四升，煮取半升，以绵缠筋如茧，浸汤沥阴中，日四遍。
滑为湿，数为热，少阴之下竟下，为阴庭之应。其脉湿热交见，故知其为阴中生疮矣。阴中蚀疮句，勿作上文之复语。上两句是言诊法，亦是言其初症。下二句言疮久而湿热浸淫，以致虫生之治法也。野狼牙味苦性寒，以寒能胜热，苦能燥湿，而尤能杀虫。故主此以洗之耳。
These are the aforementioned conditions. When the menstrual period arrives but does not come, it is caused by deficiency in the Middle Jiao (Middle Burner) where essence and qi fail to generate, and deficiency in the Lower Jiao (Lower Burner) where blood and qi naturally become short. Therefore, this condition is also treated with Tuguagen Powder (Melon Root Powder). Women's menstruation is called "Jing Xue" (Menstrual Blood) because it originates from the fullness of Qi in the Twelve Meridians and flows downward following the waxing and waning of the moon. However, its source and mechanism have two main pathways: First, the root of essence generated from the Stomach passes through the Spleen, Lung, Liver, and Kidney, finally reaching the Heart. The Zang-Fu organs along this path each privately extract essence to nourish their own meridians; this is one pathway. Second, the Liver stores blood; the surplus blood within the Zang travels through the Liver Collaterals inward to enter the Blood Chamber (Xue Shi) and outward to reach the meridians, merging with the blood of the meridians nourished by various Zang-Fu organs into a single entity; this is the other pathway. This resembles the rising tide. The "Shao Huo" (Ministerial Fire/Physiological Fire) generates Qi, growing subtly and secretly. By the thirtieth day, the exterior of the meridians becomes full and does not accept the infusion of the two types of blood (abnormal bleeding or stasis), causing the external Qi to be peaceful while internal Qi ceases to grow excessively. Moreover, the excess externally tends to reverse flow inward, so the Qi submerges like the receding tide. The blood of the Twelve Meridians closes and returns to the Blood Chamber, flowing downward as menstruation. This occurs when blood stasis is located in the Liver collaterals of the lower abdomen. The blood within the Liver desires to reach outward through the Blood Chamber to nourish the meridians, but due to collateral obstruction, it cannot pass through the Blood Chamber, resulting in irregular vaginal discharge (referred to here as non-cyclic bleeding). Thus, I state that this is distinct from leakage during pregnancy. It is said that this method causes blood to return to the normal meridians.
For leukorrhea, irregular menstruation, distending pain in the lower abdomen, and menstruation occurring twice in one month, Tuguagen Powder (Melon Root Powder) is the primary treatment.
Tuguagen Powder Formula: Tuguagen (Melon Root), Guizhi (Cinnamon Twig), Shaoyao (Peony Root), E Chong (Ground Beetle) (each 3 fen).
The above four ingredients are pounded into a powder. Each dose is one Fang Cun Bi (a square-inch measure). Taken three times daily. It also treats vulvar swelling.
This corresponds to the initial symptoms described in the previous clause. "Leukorrhea" here also refers to red leukorrhea, as detailed previously. Irregular menstruation occurs because the blood in the meridians relies solely on the supply from the Spleen and Stomach, while blood from the Liver leaks out continuously, leading to a deficiency and shallowness of Qi and blood in the meridians, causing menstruation to be unsmooth when due. Distending pain in the lower abdomen is the manifestation of blood stasis and Qi stagnation. Menstruation occurring twice in one month follows the discussion on leukorrhea. It implies that the condition of leukorrhea leads to deficiency of Jing Qi in the upper parts of the meridians, failing to secure and protect, thus causing menstruation to occur twice in a month. If these two conditions persist for a long time, they will develop into severe symptoms like those in the previous clause. Therefore, one should immediately use this formula to cure them, preventing them from gradually evolving into a pattern requiring Wenjing Tang (Warming the Menses Decoction). Shaoyao (Peony Root) guides downward into the Blood aspect; E Chong (Ground Beetle) has a Yin nature and moves blood clots; Guizhi (Cinnamon Twig) is acrid to disperse and warm to promote circulation. Combining these three herbs completes the function of removing stasis. Tuguagen (Melon Root) is the root of vine-like guidance; its nature ascends. Vines guide through meridians, and ascending action holds the blood of the Liver, allowing it to fill the Twelve Meridians upward. Since this is the initial stage of the previous pattern, Yin blood is not yet damaged, hence Wenjing Tang uses less Dang Gui (Angelica Sinensis), Chuan Xiong (Sichuan Lovage Rhizome), Ejiao (Donkey-hide Gelatin), and Maidong (Ophiopogon Tuber). Yang Qi is not yet cold, hence Wenjing Tang uses less Renshen (Ginseng), Gan Jiang (Dried Ginger), and Wuzhuyu (Evodia Fruit); this is the reason. Once stasis is removed and Liver blood can return to the meridians from the Blood Chamber, leukorrhea stops, and lower abdominal distending pain ceases. With abundant meridian Qi, there is momentum for blood to settle in the Blood Chamber, so menstruation flows smoothly. Furthermore, nourishment from blood above enriches Qi, enhancing securing power and lifting ability, so the occurrence of menstruation twice in a month also resolves. Blood stasis below causes vulvar itching; Qi stagnation below causes vulvar swelling. This formula promotes blood circulation and lifts Qi, so it also treats these conditions.
The Cunkou pulse is wiry and large. Wiry indicates decline; large indicates hollow (Kou pulse). Decline indicates Cold; hollow indicates Deficiency. Cold and Deficiency intertwine, named Ge Pulse (Reed Mat Pulse). In women, this results in miscarriage with continuous leakage. Xuanfuhua Tang (Stellaria Decoction) is the primary treatment.
Xuanfuhua Tang Formula: Xuanfuhua (Inula Flower) (3 liang), Cong Bai (Scallion White) (14 stems), Xinjiang (New Crimson Dye) (a small amount).
The above three ingredients are boiled in 3 sheng of water until 1 sheng remains. Taken all at once.
The textual meaning and pulse analysis are noted under the Blood Section. Continuous leakage after miscarriage is caused by Upper Jiao deficiency failing to lift and External deficiency failing to wrap. Scallion is acrid and warm, descending first then ascending, promoting Kidney Yang outward. Thus, it is used in Baitong Tang, deriving from this principle. Using 3 liang of Xuanfuhua and naming the decoction after it has two intentions: First, Upper deficiency allows Yin Qi to invade; Xuanfuhua descends rebellious Yin, creating space for Yang to rise. Second, it works synergistically with Scallion to descend and warm Kidney Yang. Light red is Jiang (crimson); Xinjiang is newly dyed crimson. Silk from cocoons ascends; red-dyed silk enters the Heart and Diaphragm. This is essentially a small Shengji Wan (Kidney Qi Pill). Scallion (acrid-hot and Qi-rich) replaces Guizhi and Fuzi; Xuanfuhua (descending) replaces Dihuang and Shanzhuyu; Xinjiang (ascending to Heart/Diaphragm) replaces Mudanpi. This first aids descent, then slowly guides ascent, tonifying Zong Qi (Gathering Qi). With sufficient lifting and wrapping force, leakage after miscarriage stops. However, this formula is merely an emergency expedient. For stability, Jianzhong Tang (Middle-Jian Decoction) and Shengji Wan/Pills are more appropriate and without drawbacks. A century later, wise physicians will agree with me, not just Zhongjing's spirit nodding in approval.
Women with Xian Jing (Sunken Meridian) syndrome present with leakage of black blood that does not resolve. Jiao Jiang Tang (Gelatin and Ginger Decoction) is the primary treatment. (Formula missing. Lin Yi notes: We checked various editions and found no Jiao Jiang Tang formula. We suspect it is Jiao Ai Tang (Gelatin and Mugwort Decoction) used in pregnancy. Careful analysis shows Jiao Ai Tang matches this syndrome closely. Perhaps 'Jiang' (Ginger) is a typo for 'Ai' (Mugwort). We follow this correction.)
Xian Jing (Sunken Meridian) syndrome shares the same meaning as Bao Zu (Uterine Obstruction) in pregnancy. Generally, if dead blood accumulates in the lower abdomen, preventing Liver blood from nourishing meridians via the Blood Chamber, resulting in leakage, it is called Dai Xia (Leukorrhea/Bleeding). If there is no blood stasis blocking the lower abdomen, but Liver Qi is deficient and fails to steam upward, and Liver Blood is deficient and fails to moisten upward, the blood reaches the Blood Chamber but sinks and falls midway, it is called Xian Jing (Sunken Meridian). This is similar to Bao Zu where no stasis blocks, and Qi/Blood leak due to deficiency. Hence, it shares the same meaning as pregnancy Bao Zu. Blood deficiency leads to Qi Cold; blood turns dark/black due to Cold. Prolonged Cold makes it black like bean dregs. The syndrome is identical to pregnancy Bao Zu, so the treatment Jiao Ai Tang is the same. The intent is detailed under Bao Zu. The difference is: for Bao Zu, it tonifies blood and warms Qi to nourish the fetus; here, it tonifies blood and warms Qi to nourish the meridians. Regarding Jiao Jiang Tang, in my humble opinion, it fits the Xian Jing pattern. I suspect it may contain Dang Gui, Shaoyao, Guizhi, and Mudanpi. Ejiao (Donkey-hide Gelatin) wraps and lifts; Dang Gui (Angelica Sinensis) warms and tonifies blood deficiency; Sheng Jiang (Fresh Ginger) ascends and spreads; Guizhi (Cinnamon Twig) warms and tonifies Qi Cold. Shaoyao guides into the Liver; Mudanpi clears the vessels. Thus, Xian Jing leakage of black blood resolves within warming, tonifying, ascending, and moving actions. Wise observers may not consider this mere speculation.
If a woman's lower abdomen is full and shaped like a Dun (a vessel narrow at top, wide at bottom), with slight difficulty urinating but no thirst, occurring postpartum, this is Water and Blood binding in the Blood Chamber. Dahuang Gansui Tang (Rhubarb and Kansui Decoction) is the primary treatment.
Dahuang Gansui Tang Formula: Dahuang (Rhubarb Root) (4 liang), Gansui (Kansui Root) (2 liang), Ejiao (Donkey-hide Gelatin) (2 liang).
The above three ingredients are boiled in 3 sheng of water until 1 sheng remains. Taken all at once. Blood stasis should be discharged.
"Dun" describes a shape narrow at the top and wide at the bottom. Postpartum lower abdominal fullness resembling a Dun reflects underlying symptoms: fetal Qi, water accumulation, and blood stasis can all cause this. Difficulty urinating indicates water accumulation. Slight difficulty suggests urine still passes and water accumulation is not severe. If thirsty with slight difficulty, it would be pure water retention. Since there is no thirst, the fullness is not purely water. Combined with postpartum status, ruling out pure water and pregnancy, the fullness must be due to postpartum blood stasis. Thus, Dahuang (Rhubarb) breaks stasis, and Gansui (Kansui) expels water. These can be used confidently. However, postpartum blood deficiency warns against harsh purgation damaging Yin. Ejiao (Donkey-hide Gelatin) nourishes blood. Blood deficiency retains water; tonifying blood helps eliminate water. Generating new blood expels dead blood; tonifying blood helps drive out stasis. These five sentences contain only twenty-nine characters, yet the literary style is versatile, and diagnostic logic is profound. Post-Han medical texts cannot compare.
For women with difficult or obstructed menstruation, Didang Tang (Hit-and-Kill Decoction) is the primary treatment. It also treats men with bladder fullness/urgency due to blood stasis. (Note: There are no such parenthetical notes in the original text; this may be a later addition.)
Didang Tang Formula: Meng Chong (Blue Bottle Fly) (30 pieces, roasted, wings/legs removed), Shui Zhi (Leech) (20 pieces, roasted), Taoren (Peach Seed) (20 pieces, skin/point removed), Dahuang (Rhubarb Root) (3 liang, wine-soaked).
The above four ingredients are powdered. Boiled in 5 sheng of water until 3 sheng remain. Strain. Take 1 sheng warm.
This is also due to blood stasis in internal collaterals, weakening the Qi of blood circulation, causing difficult menstruation. Compared to the previous clause, this involves more stasis in the Upper and Middle Jiao, such as in the Danzhong area or Spleen/Stomach collateral branches, caused by prior hemoptysis, overeating, or cold exposure/drinks. Stasis causes Qi stagnation and menstrual difficulty. Meng Chong (Fly) naturally targets the upper; Shui Zhi (Leech) naturally targets the lower. They introduce treatment into dead blood collaterals. Taoren (Peach Seed) breaks and agitates; Dahuang (Rhubarb) drives down. Wine-soaking Dahuang enhances its floating and gentle nature, allowing it to sweep from above and below. Thus, I say this involves more Upper/Middle Jiao stasis than the previous case. This is for robust patients in the early stage. Robust patients tolerate harsh drugs; early stage means blood is not yet deficient, so no blood tonics are added.
For women with amenorrhea, irregular menstruation, hard masses in the Zang that persist, dry blood inside, and discharge of white matter, Fanshi Wan (Alum Pill) is the primary treatment.
Fanshi Wan Formula: Fanshi (Alum) (3 fen, calcined), Xingren (Apricot Seed) (1 fen).
The above two ingredients are powdered. Honey pills made the size of a jujube pit. Insert into the vagina. For severe cases, insert another.
"Zang" refers to the vaginal introitus, as indicated by inserting the pill there. "Hard" refers to tissue in the vagina becoming hard due to Qi stagnation and blood stasis. "Jian Pi" means hardness persisting into a chronic disease. "White matter" is not typical leukorrhea or seminal emission, but rather white, powdery residue caused by damp-heat. Typical leukorrhea originates from the Dai Mai and Kidneys, distant and fluid-like. Here, it originates near the vaginal hard mass, is drier, whiter, and like accumulated grime. Amenorrhea is the heading; the hard mass and white discharge are the body. While amenorrhea/stagnation has specific formulas for blood stasis or deficiency-cold, sometimes amenorrhea causes external symptoms requiring external treatment. Amenorrhea causes Qi/Blood stagnation sinking into vaginal tissue, forming hard masses. Long-term stagnation dries into blood, generating heat and dampness, leading to white discharge. Fanshi (Alum) is cold, sour, and drying. Cold clears heat/fire; sour dissolves hardness and disperses blood; drying removes dampness. It is the Sovereign herb. Xingren (Apricot Seed) moves Qi to disperse stagnation. Since medication is hard to deliver to the vagina internally, pill form inserted externally is convenient. Various annotations are confused and miss the point.
For women suffering from sixty-two types of Wind pathogens and stabbing pain in the abdomen due to Blood and Qi, Honglanhua Jiu (Safflower Wine) is the primary treatment.
Honglanhua Jiu Formula: Honglanhua (Safflower) (1 liang).
One ingredient. Boil in 1 da sheng of wine until half remains. Take half at once. Repeat if necessary.
When old blood circulates freely, new blood generates fully, and Qi warms accordingly, circulating without disease. If old blood lags, new generation slows, leading to Qi and Blood deficiency. Blood deficiency causes dryness-heat and internal Wind; Qi/Blood deficiency weakens defensive exterior, inviting external Wind. These sixty-two Winds arise from this. Abdominal Blood deficiency causes dry painful collaterals; Qi deficiency causes spasmodic stabbing pain. Honglanhua (Safflower) moves Blood and Qi. Wine warms and floats, enhancing Qi movement and Blood flow, resolving internal/external Wind and abdominal stabbing pain.
For various abdominal pains in women, Danggui Shaoyao San (Angelica and Peony Powder) is the primary treatment. (Formula seen in Pregnancy section).
Various abdominal pains in women stem from True Yin deficiency and lingering external Water. True Yin deficiency causes acute internal collateral pain; external water accumulation causes obstructive internal collateral pain. Danggui Shaoyao San tonifies Blood and moves Fluids, hence it is used. See Pregnancy section for formula details.
For abdominal pain in women, Xiao Jianzhong Tang (Minor Construct the Middle Decoction) is the primary treatment. (Formula seen separately).
The previous clause addressed pain from Yin Blood deficiency in Lower/Middle Jiao. This clause addresses pain from Yang Qi deficiency in Upper/Middle Jiao. Cold Heaven (Yang deficiency) fails to shine, causing Yin-seeping pain. Empty Heaven (Qi deficiency) fails to transport, causing accumulation pain. Xiao Jianzhong Tang warms the Diaphragm and fills Qi. Warm Diaphragm Qi allows Yang Heat to descend, relieving Yin-seeping pain. Abundant Diaphragm Qi pushes downward, relieving accumulation pain. Hence it is used. See separate text for decoction meaning.
Question: A woman suffers from normal diet, irritability, heat, inability to lie flat, and reliance on sitting to breathe. What is this? Master says: This is called Zhuan Bao (Displaced Bladder/Uterus), inability to urinate. Caused by the Bao Xi (Bladder/Uterus ligaments) being twisted and distorted. Promoting urination cures it. Shenqi Wan (Kidney Qi Pill) is the primary treatment. (Formula seen in Deficiency/Labor section).
This clause states inability to urinate is the root, causing Zhuan Bao, which causes irritability/heat and orthopnea. This is clear. Why Shenqi Wan specifically? Kidney congenital Qi ascends from the spine to warm the Diaphragm, mixing with Wei Qi from food/lungs to form Zong Qi (Gathering Qi) in the chest. Full Zong Qi promotes respiration and water passage. Now, Kidney Qi fails to ascend, Diaphragm Qi is shallow, water flow slows, Qi stagnates, and urination fails. Bladder fullness pushes up the Uterus, loosening ligaments and twisting them ("Zhuan"). Both Bladder and Uterus Qi turn upward, narrowing the chest cavity, causing irritability and breathing difficulty. How do we know? Normal diet indicates Upper/Middle Jiao and anterior pathways are healthy; the issue is deficient congenital Kidney Qi failing to transport in the chest. "Liao Li" describes twisted ligaments like hooks shaking. Shenqi Wan uses Fuling/Zexie to drain water, Shan Yao to strengthen Earth/drain water, softening the bladder and allowing the uterus to drop. Dihuang/Shanzhuyu, guided by Guizhi/Fuzi into Liver/Kidney, with Mudanpi drawing Qi up from the spine, forces Chest Qi downward, resetting the uterus and straightening ligaments, curing irritability and breathing issues. This is Zhongjing's brilliance in using Shenqi Wan instead of simple diuretics. Who can share this insight?
For women with cold in the Yin region, use warming sitz bath medicine. Shechuangzi San (Cnidium Powder) is the primary treatment.
Shechuangzi San Formula: Shechuangzi Ren (Cnidium Fruit).
One ingredient. Powdered. Mix with a little Baifen (white powder/starch). Form pills like jujube pits. Wrap in silk and insert. Naturally warms.
"Yin Han" refers to cold in the vaginal introitus, not necessarily the uterus itself. Sitz baths treat external symptoms; internal meds affect deep Zang-Fu. External symptoms require external treatment to avoid conflicting with Zang preferences. Cnidium grows where snakes rest, indicating its warmth. Acrid-sweet disperses, spreading warmth horizontally. Used as a sitz bath, it warms the Yin. A skeptic argues: Cold in Yin must start from uterine cold. You only warm the introitus, not the uterus. Is your view biased? I reply: The Golden Cabinet classifies diseases. Listing formulas symptom-by-symptom seems fragmented. One must see the whole spirit. Like a lacquered screen, joints fit perfectly. You see only fragments. If uterine cold is congenital, isn't Shenqi Wan available? If acquired, isn't Lizhong Wan available? Why not warm the root internally first, then treat the branch externally? If sitz baths warmed the uterus, would mouthwash cure Middle Jiao disease? The skeptic laughed and was speechless.
If Shaoyin pulse is slippery and rapid, ulcers appear in the Yin. If erosive ulcers exist, Ye Langya Tang (Wolf Tooth Herb Decoction) wash is used.
Ye Langya Tang Formula: Ye Langya (Wolf Tooth Herb) (3 liang).
One ingredient. Boil in 4 sheng of water until 0.5 sheng remains. Wrap in silk like a cocoon, dip in decoction, and drip/wash the Yin four times daily.
Slippery indicates Dampness; Rapid indicates Heat. Shaoyin pulse relates to the lower Yin introitus. Damp-Heat in the pulse indicates genital ulcers. The ulcer description is not repetition but progression: first two lines diagnose initial symptoms; next two lines describe chronic erosion with insect generation due to Damp-Heat. Ye Langya is bitter and cold. Cold conquers Heat; Bitter dries Dampness; especially kills parasites. Hence used for washing.
Stomach Qi leaks downward, causing flatulence through the vagina (Yin Chui) while bowel movements remain normal. This is due to excess Grain Qi. Gao Fa Jian (Fat and Hair Decoction) guides it out. (Formula seen in Jaundice section).