Chapter 22, Various diseases in woman

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妇人杂病脉证并治第二十二

Chapter 22, Various diseases in woman


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,或两疼痛,与藏相连,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,经候不匀,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,子当辨记,勿谓不然。

For woman’s disease, it could be due to weakness, accumulated Cold, or accumulated and stagnated Qi movement. All can cause stop of the period. After a long time, the Cold in the blood accumulated in the uterus. The Cold damages meridian, and if the damage is in the upper part of the body, the woman has nausea, spits saliva, and has Feiyong after a long time with skinny body. The Cold also sticks to the middle of the body, causing Cold hernia with pain around the naval and on the both sides of the upper abdomen. If the woman has Fire in the middle part of the body for a long time, this time she will have no Cold hernia, but Fire in the middle part of the body. She feels pain the lower part of the abdomen. If her pulse is frequent, she will have ulcer in skin. If she has no ulcer, the Fire will burn the Yin in the body, causes dry in the skin so the skin is as fish scales. However, the above symptoms can also happen to male, not only on female. If the Cold sticks in the lower part of the body, it causes spasm pain the in the perineum area, chilly in the lower abdomen, which may connect to the lower back, or to the upper and  inside and of the thigh. She may also feel air-pushing up feeling, acute pain, annoying pain in the knee and small legs, feels cloudy and dizzy in the head from time to time as person has madness or kind of psycologic disorders. She may also feel sadness, easy to get upset. All are due to the problem in the woman’s discharge. For a long time, she will be skinny in the body. The pulse is weak and cold. Na matter what kind of the clinic manifestations it is, check her Yin and Yang condition, the pulse, to make assessment.  

妇人咽中如有炙脔,半夏厚朴汤主之。

If the woman has sticky and harsh feeling in the throat, use Banxia Houpo Tang.

 
半夏厚朴
汤方

Banxia Houpo Tang


半夏
一升,厚朴三两,茯苓四两,生姜五两,干苏叶二两

Banxia 250 gram, Houpo 45 gram, Fuling 60 gram, fresh ginger 78 gram, Souye 30 gram.


右五味,以水七升,煮取四升,分温四服,日三夜一服。

Add the herbs and 1250 ml into a herbal pot. Bring to boil and keep in mild boiling until there is about 1000 ml herbal tea left. Drink one quarter of the herbal tea, three times during the daytime and once at night.


妇人藏躁,喜悲伤欲哭,象如神灵所作,数欠伸,甘麦大枣汤主之。

If a woman has Zangzao disease, feels happiness but soon sadness, smile but soon crying, as there is ghost in her body, and she tends to yawn, use Ganmai Dazao Tang.

甘草小麦大枣汤方

Ganmai Dazao Tang


甘草
三两,小麦 一升,大枣 十枚

Gancao 45 gram, wheat 250 gram, Chinese date 10 badges.


右三味,以水六升,煮取三升。温分三服。亦补脾气。

Add the herbs and 1500 ml into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml herbal tea left. Drink one quarter of the herbal tea each time, three times a day.

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。

If a woman spits saliva, it is a Cold condition and needs warm herbal formula to solve the problem. However, if she is given a bowel-cleansing therapy, she will develop fullness in the upper abdomen. To solve the spiting saliva, use Xiao Qinglong Tang. After the stop of the spiting, start to treatment the fullness, using Xiexin Tang.

小青龙汤方

Xiao Qinglong Tang (see the chapter for Feiyong)  (见肺痈中)

 泻心汤方

Xiexin Tang (see the chapter for Scaring and palpitation) (见惊悸中)
问曰:妇人年五十,所病下血[1],数十日不止,暮即发热,少腹里急,腹满,手掌烦热,唇口干燥,何也?师曰:此病属带下,何以故?曾经半产,瘀血在少腹不去。何以知之?其证唇口干燥,故知之。当之温经汤主之。

Asked: a woman at 50 years of old has continuous diarrhea tens times a day. She has fever in the evening, feels spasm in the lower abdomen, fullness in the abdomen, hot in the palm and sole, dry in the lips of mouth. What condition it is? She has had abortion before. How do we know if she has stagnated dead blood in the lower abdomen? Master: The dry lips and dry mouth indicate the hosting dead blood in her lower abdomen. This belongs to a Discharge disease in woman. Use Wenjing Tang.

 
温经汤方

Wenjing Tang


吴茱萸 
三两,当归,芎藭,芍药各二两,人参桂枝牡丹皮阿胶生姜  各二两,甘草  二两,半夏  半升,麦冬(去心)一升

Wuzhuyu 45 gram, Danggui 30 gram, Chuanqiong 30 gram, Shaoyao 30 gram, Renshen 30 gram,


右十二味,以水一斗,煮取三升,分温三服。亦主妇人少腹寒,久不受胎,兼取崩中去血,或月水来过多,及至期不来。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 750 ml herbal tea left. Drink one third of the tea each time, three times a day. This formula also works for woman with cold feeling in the lower abdomen, difficult to have a pregnancy, and for women who has heavy bleeding from uterus, or has too much period blood, or has delayed period.  

带下经水不利,少腹满痛,经一月不见者[2],土瓜根散主之。

For woman with discharge problem has irregular period, fullness and pain in the lower abdomen, or has twice period within the same month, use Tuguagen San.

土瓜根散方

Tuguagen San


土瓜根,芍药,桂枝,蟅虫各三钱

Tuguagen, Shaoyao, Guizhi and Zhechong, equal amount.


右四味,杵为散,酒服方寸匕,日三服。

Prepare the herbs into powder. Drink 1 gram each time, three times a day.


寸口脉弦而大,弦则为减,大则为芤,减则为寒,芤则为虚,寒虚相搏,此名曰革,妇人则半产漏下,旋覆花汤主之。

(hard to translate this paragraph)

旋覆花汤方

Xuanfuhua Tang


旋覆花
三两,葱十四茎,新绛少许

Xuanfuhua 45 gram, Onion green 14 stems, new jiang little amount.


右三味,以水三升,煮取一升,顿服之。

Add the herbs and 750 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 250 ml herbal tea left. Drink all the tea once.


妇人陷经漏下,黑不解,胶姜汤主之。

If the woman has heavy bleeding from uterus, use Jiao Jiang Tang.


 (the herbal formula for the Jiao Jiang Tang is missing).


妇人少腹满如敦状,小便微难而不渴,生后者,此为水与血俱结在血室也,大黄甘遂汤主之。

If the woman has fullness in the lower abdomen as there is a basin there, has slight difficult in urine but no thirsty, and if this condition happens after baby delivery, it is due to the hosting of both Water and Blood in the uterus. Use Dahuang Gansui Tang.

大黄甘遂汤方

Dahuang Gansui Tang


大黄 
四两,甘遂  二两,阿胶  二两

Dahuang 60 gram, Gansui 30 gram, Ajiao 30 gram.


右三味,以水三升,煮取一升,顿服之,其血当下。

Add the herbs and 750 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 250 ml herbal tea left. Drink all the tea once. The blood should be depleted out.


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。

If a woman got Wind-invasion, after seven to eight days, she feels hot and chilly again and again, and the period stops. This condition suggests that the invaded Fire has invaded into the uterus. The blood must be clotted[3], so to make the hot-cold repeat as a malaria. Xiao Chaihu Tang is to be used. [4]


妇人伤寒发热,经水适来,昼日明了,暮则语,如见鬼状者,此为热入血室,治之无犯胃气及上二焦,必自愈。

If a woman has Cold-invasion, feels hot. At this movement, her period comes. She is normal during the day time, but has Chattering syndrome at night, seeming to meet a ghost. This condition suggests a Fire into the uterus too, no any meaning to the Weiqi or The Upper and Middle Jiao Cavity. This condition can cure by itself. 


妇人中风,发热恶寒,经水适来,得之七、八日,热除,脉迟,身凉和,胸满,如结胸状,语者,此为热入血室也,当刺期门,随其实而泻之。


If a woman got Wind-invasion, feels hot and chilly, when she has period. After seven to eight days, she feels no hot, but cold in the body and has slow pulse, feels fullness in the chest and side of upper stomach (similar to a Jiexiong condition), and has Chattering syndrome, indicating that she has Fire in the uterus. Acupuncture should be applied, using Qimen point with depletion manner. [5]


阳明病,下血,语者,此为热入血室,但头热汗出,当刺期门,随其实而泻之,濈然汗出即愈。

In the Yangming stage, the woman has bleeding from uterus, Chattering syndrome, it is the Fire in the uterus condition. She has hot in the head and has sweat. Use acupuncture on the Qimen point using depletion manner on the needle. When she has sweat, the condition will be improved.


妇人经水不利下,(少腹结痛,大便黑,小便利,发狂善忘,寒热), 抵当汤主之。

If the woman has irregular period, (has solid and pain feeling in the lower abdomen, has dark stool, has easy urine, appears madness, easy to forget things, feels chilly and hot), use Didang Tang.

抵当汤方


Didang Tang

水蛭(熬)三十个,蟅虫(熬,去翅、足)三十枚,桃仁(去皮、尖)二十个,大黄(酒浸)三两

Shuizhi (processed) 30 badges, Zhechong (processed, remove wings and feets) 30 badges, Taoren (remove tip and peel) 20 badges, Dahuang 45 gram.


右四味为末,以水五升,煮取三升,去滓,温服一升。

Add the herbs and 1250 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is about 750 ml herbal tea left. Drink one third of the tea.


妇人经水闭不利,藏坚癖不止,中有干血,下白物,矾石丸主之。

If the woman has irregular period, has solid mass in the uterus, and has white color discharged material form the uterus,[6] use Fanshi Wan.

矾石丸方

Fanshi Wan


矾石(烧)三分,   杏仁 一分

Fanshi (burned) three parts, Xinren, 1 part.


右二味,末之,炼蜜和丸,如枣核大,内藏中,剧者,再内之。

Prepare the herbs into powder then into pills with honey as 1 cm in diameter. Put the pill in the vagina. For severe case, use more pills in.

妇人六十二种风及腹中血气刺痛,红蓝花酒主之。

If woman has various Wind condition and sharp pain in the abdomen, use Honlanhua Jiu.

红蓝花酒方

Honlanhua Jiu


红蓝花 一两

Honlanhua  15 gram.


右一味,以酒一大升,煎减半,顿服一半,末去再服。

Add the herbs into 300 ml liquor. Bring to boil until the volume is half. Drink half the herb liquor. If the pain remains, drink the remaining part.


妇人腹中诸疾痛,当归芍药散主之。

For woman with various pain in abdomen, use Danggui Shaoyao San.

当归芍药方


Danggui Shaoyao San (see the chapter for pregnancy)
(见妊娠中)

妇人腹中痛,小建中汤主之。

For woman with pain in abdomen, can also use Xiao Jianzhong Tang

小建中汤方


Xiao Jianzhng Tang (see the chapter for Weakness condition)
(见虚劳中)

问曰:妇人病。饮食如故,烦热不得卧,而反倚息不得卧者,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。

Asked: if a woman is sick, she has normal appetite, but feels annoying hot and feels hard to fall into sleep, or even feels hard to lie body down, what is this condition? Master: this is Zhuangbao[7] condition, meaning the position of the uterus is wrong now, which prevents urine. For the treatment, use urine therapy with Shenqi Wan.

肾气丸方

Shenqi Wan


干地黄八两,薯蓣四两,山茱萸四两,泽泻三两,茯苓三两,牡丹皮三两,桂枝附子(炮)各一两

Shendihuang 125 gram, Shanyao 60 gram, Shanzhuyu 60 gram, Zexie 45 gram, Fuling 45 gram, Mudanpi 45 gram, Guizhi 15 gram, Fuzi 15 gram.

右八味,末之,炼蜜和丸,梧子大,酒下十五丸,加至二十五丸,日再服。

Prepare the herbs into pills with honey as a size of 0.5 cm diameter. Drink 15 pills with wine. Gradually increase the number of pills to 25 pills each time. Twice a day.

 
妇人阴寒,温中坐药,蛇床子散主之。

If woman feels cold in her perineum and vagina, use warm herb therapy in the vagina with Shechuongzi San.

蛇床子散方

Shechuangzi San


蛇床子

Shechuangzi


右一味末,以白粉少许,和合相得,如枣大,绵裹内之,自然温。

Grind the herb into powder. Mix it with Jianfeng little. Make pills as 2 cm in diameter. Fold it into gauze. Put it into the vagina.


少阴脉滑而数者,阴中即生疮,阴中蚀疮,烂者,狼牙汤洗之。

For woman, if the pulse is slippery and frequent in the Chi position, there is ulcer in the vagina and front perineum, use Langya Tang to wash. 

狼牙汤方

Langya Tang


狼牙 四两

Langya 60 gram.


右一味,以水四升,煮取半升,以绵缠如茧,浸沥汤阴中,日四遍。

Add the herb and 1000 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 120 ml left. Use a cotton ball to rinse in the herbal juice. Put it then into the vagina. Repeat four times a day.


胃气下泄,阴吹而正喧,此谷气之实也,(长服诃梨勒丸) 膏发煎导之

If the Weiqi goes down, the woman feels fart from the vagina, use Kelile Wan.



[1]所病下利之「利」字,当是「血」字,文义相属,必是传写之误。

[2] 「再」字当是「不」字,若是「再」字,一月两来,与上文不利不合,是传写之误.

[3] But not develops into typical Jiexiong condition yet.

[4] When treat a menopause syndrome, be careful to exclude this condition.

[5] For women, the period is associated with the development of a disease. If the period comes, the Xieqi could move down into the uterus causing complex clinic conditions. Here, the condition of cold body, slow pulse, should be distinguished with Xiao Chaihu Tang (Shaoyang paragraph 15) and Sini San conditions. Note: this condition is pretty much seen in patients with hysteria.

[6] It suggests the presence of Wetness in the uterus.

[7] Zhuangbao: Zhuang here means turning, bao: uterus. So Zhuangbao means the turns of the uterus.