1-4. black vaginal discharge (黑帶下)(in Fu Qing Zhu’s Gynecology, 傅靑主女科)

1-4. black vaginal discharge (黑帶下)

 

 

A woman has a vaginal discharge with black color. In severe case, this is as the juice of black bean and has a fish-like smell. This is called black vaginal discharge. Generally black vaginal discharge is caused by extreme fire and heat. Somebody with a distrust asks that “the original color of fire is red, why does this represent black color?” And if the somebody say that black vaginal discharge could be caused by extreme cold in the lower. The one does not know extreme fire is as like water and this is pseudo-image. The pattern will has pain in the abdomen with feeling of cutting with knife during urination, swelling in the yin gate, and red complextion. If this endures, the people gets emaciated with yellow, intake of food gets larger than other person, and there will be heat in the mouth and thirst. Drinking of cold water makes the person feel fresh. This indicates that stomach fire is greatly exuberant and  the stomach fire comebines with fire of life gate, bladder, and the three burner, leading to boiling [of water qi]. [the water qi] gets boiled and dried and then changes into gray color which extreme heat fire changes into. There is not any cold qi. Fortunately, there is absence of disease in kidney water and lung metal, endlessly engendering and working qi moistens the heart and helps the stomach, therefore the pattern does not lead to mania. But the reason of causing black vaginal discharge is because fire binds in the lower but does not flame in the upper. Treatement is to mainly drain fire, if fire and heat retreat, then damp removes spontaneously. Li Huo Tang (Regulate Fire Decoction, 利火湯) is used

 

 

 

Li Huo Tang (Regulate Fire Decoction, 利火湯)

Da Huang（three qian）

Bai Zhu（five qian, stir bake with soil）

fu ling（three qian）

Che Qian Zi（three qian,stir bake with wine）

Wang Bu Liu Xing（three qian）

Huang Lian（three qian）

Zhi Zi（three qian,stir bake）

Zhi Mu（two qian）

Shi Gao（five qian）

Liu Ji Nu（three qian）

 

 

 

Decoct this with water. Taking of one Ji (劑) make the pain in urination stops and urination inhibit. Taking of two Ji (劑) changes black vaginal discharge into white vaginal discharge. Taking reduces white vaginal discharge a little, again taking of three 三Ji (劑) brings about recover. Someone says that this formula is too harsh and precipitative, they do not know that when fire is exuberant one should extinguish the fire drastically. For example, to extinguish fire, if one move the fire a little, this only prolongs the fire force, therefore there is no pause of fire flaming. Huang Lian, Shi Gao, Zhi Zi, and Zhi Mu which are cold are used, in addition to this, if Da Huang is put in, fire force gets extinguished rapidly. And  Wang Bu Liu Xing and Liu Ji Nu disinhibits damp, this make damp and heat not to stay. As an assistant, Bai Zhu supplements earth, fu ling percolates damp, and Che Qian Zi disinhibits water, then fire retreats and water improves. After recovering from the disease, one should regulate food, avoid eating of spicy and heat food, and regulate and nourish spleen earth. If one only depends on this formula and eats this formula whenever the disease occurs, this will damages the source qi. One should be careful of using this formula.  

 

 

【outline】the basic pathomechanism of black vaginal discharge is extreme fire heat. When stomach fire is exuberant, the fire of life gate, bladder, and the three burner bind in the lower. Major treatment is to drain fire. When heat retreat, damp removes spontaneously.

1-4. 黑帶下

 

 

婦人有帶下而色黑者, 甚則如黑豆汁, 其氣亦腥, 所謂黑帶也. 夫黑帶者, 乃火熱之極也. 或疑火色本紅, 何以成黑? 謂爲下寒之極或有之. 殊不知火極似水, 乃假象也. 其症必腹中疼痛, 小便時如刀刺, 陰門必發腫, 面色必發紅, 日久必黃瘦,飮食必兼人, 口中必熱渴,飮以涼水, 少覺寬快, 此胃火太旺, 與命門,膀恍, 三焦之火合而熬煎, 所以熬乾而變爲炭色, 斷是火熱之極之變, 而非少有寒氣也. 此等之症, 不至發狂者, 全賴腎水與肺金無病,其生生不息之氣, 潤心濟胃以救之耳, 所以但成黑帶之症, 是火結於下而不炎於上也. 治法惟以洩火爲主, 火熱退而濕自除矣. 方用利火湯.

 

利火湯

大黃（三錢）白朮（五錢,土炒）茯苓（三錢）車前子（三錢,酒炒）王不留行（三錢）黃連（三錢）梔子（三錢,炒）知母（二錢）石膏（五錢,[火段]）劉寄奴（三錢）

 

 

水煎服.一劑小便疼止而通利,二劑黑帶變爲白,三劑白亦少減,再三劑全愈矣.或謂此方過於迅利,殊不知火盛之時,用不得依違之法,譬如救火之焚,而少爲遷緩,則火勢延燃,不盡不止.今用黃連,石膏,梔子,知母一派寒涼之品,入於大黃之中,則迅速掃除.而又得王不留行與劉寄奴之利濕甚急,則濕與熱俱無停住之機.佐白亢以輔土,茯苓以滲濕,車前以利水,則火退水進,便成旣濟之封矣. 病愈後當節飮食,戒辛熱之物,調養脾土.若恃有此方,病發即服,必傷元氣矣,愼之!