1-5. red vaginal discharge. 赤帶下 (in Fu Qing Zhu’s Gynecology, 傅靑主女科)

1-5. red vaginal discharge. 赤帶下

 

 

A woman has a vaginal discharge with red color. When it looks like blood or not and dribbling of this does not stop, this is called red vaginal discharge. Red vaginal discharge is also related with damp disease. Damp is the qi of earth, therefore this represents yellow color. But now, this red appears, this means that fire and heat is exuberant internally. The color of fire is red. Therefore the color vaginal discharge is also red. Only belt vessel ties up between lumbus and umblicus and is close to the earth of Reaching Yin, so if there is fire internally, it is inappropriate. Belt vessel is free to the kidney and the kidney is free to the liver. Too much anxiety and thought damages the spleen, and then, in addition to this, depression and anger damages the liver, the stagnant fire of liver channel accumulates in the interior, this restrains spleen earth and the spleen earth cannot transport and transform [qi], the qi of damp-heat gets to bind in the belt vessel. And the liver cannot nourish the blood, the blood percolates internally to belt vessel, damaged spleen qi is also hard to transport and transform qi, therefore the qi of damp-heat falls downward with blood. Therefore the vaginal discharge looks like blood or not. Actually it is unable to separate blood and damp, it is worng that common person assigns red vaginal discharge to heart fire. This should be treated with clearing of liver fire and supporting of spleen qi. Qing Gan Zhi Lin Tang (Clear the Liver and Stop Strangury Decoction. 淸肝止淋湯) is used.

 

Qing Gan Zhi Lin Tang (Clear the Liver and Stop Strangury Decoction. 淸肝止淋湯).

Bai Shao Yao（one liang, stir bake with vinegar）

Dang Gui（one liang, clean with wine）

Sheng Di Huang（five qian, stir bake with wine）

E Jiao（three qian, stir bake with white flour）

Mu Dan Pi (three qian）

Huang Bai （two qian）

Niu Xi（two qian）

Xiang Fu（one qian, stir bake with wine）

Hong Zao（10 pieces）

Xiao Hei Dou（one liang）

 

 

 

Decoct this with water. makes dribbling pause a little, again taking of one 一Ji also makes dribbling pause a little, and then taking of four Ji (劑) brings about recover. This formula just supplement liver blood, but do not disinhit spleen damp. This is because in the basic pathomechanism fire is sevre and damp is light. Generally the reason of exuberance of fire evil is that weak blood is unable to restrain fire. If one supplements blood enough, then the blood can restrain the fire. And water combining with blood conforms red vaginal discharge, it is impossible to distinguish whether that is damp or not. Damp also can be blood through transforming. Therefore if blood is treated, than damp is also eliminated. Thus there is no reason to disinhibit damp on purpose. This formula treats blood and there is a bit of herbs which clear fire, this is the exquisiteness of this formula. if one herb which disinhibits damp is added, this rather conduct fire to the lower part, this inhibits treat. Someone asks that you said in advance that the qi of spleen earth should be assisted, now this just supplement the blood of liver wood, why so? Shao Yao camls the liver, and then the liver qi gets to soothe, soothed liver qi is unable to restrain earth, if there is no restraining of spleen, spleen gets exuberant spontaneously. To calm the liver is to support the spleen. there is no need to add Ren Shen and Bai Zhu on purpose.

 

【outline】the major pathomechanism of red vaginal discharge is damp-heat. Liver fire is severe and damp is light. One should clear liver fire and support spleen qi. The representative formula is Qing Gan Zhi Lin Tang (Clear the Liver and Stop Strangury Decoction. 淸肝止淋湯

 

1-5. 赤帶下

 

婦人有帶下而色紅者,似血非血,淋瀝不斷,所謂赤帶也.夫赤帶亦濕病,濕是土之氣,

宜見黃白之色,今不見黃白而見赤者,火熱故也.火色赤,故帶下亦赤耳.

惟是帶脈係於腰臍之間,近乎至陰之地,不宜有火.而今見火症,豈其路通於命門,

而命門之火出而燒之耶？不知帶脈通於腎,而腎氣通於肝.婦人憂思傷脾,

又加鬱怒傷肝,於是肝經之鬱火內熾,下克脾土,脾土不能運化,致濕熱之氣蘊於帶脈之間；

而肝不藏血,亦滲於帶脈之內,皆由脾氣受傷,運化無力,濕熱之氣,隨氣下陷,同血俱下,

所以似血非血之形象,現於其色也.其實血與濕不能兩分,世人以赤帶屬之心火誤矣.

治法須淸肝火而扶脾氣,則庶幾可愈.方用淸肝止淋湯.

淸肝止淋湯

白芍（一兩,醋炒）當歸（一兩,酒洗）生地（五錢,酒炒）阿膠（三錢,白麵炒）粉丹皮（三錢）黃柏（二錢）牛膝（二錢香附（一錢,酒炒）紅棗（十個）小黑豆（一兩）

 

水煎服.一劑少止,二劑又少止,四劑全愈,十劑不再發.此方但主補肝之血,全不利脾之濕者,以赤帶之爲病,

火重而濕輕也.夫火之所以旺者,由於血之衰,補血即足以制火.且水與血合而成赤帶之症,

竟不能辨其是濕非濕,則濕亦盡化而爲血矣,所以治血則濕亦除,又何必利濕之多事哉!此方之妙,妙在純於治血,少加淸火之味,故奏功獨奇.倘一利其濕,反引火下行,轉難速效矣.或問曰, 先生前言助其脾土之氣,今但補其肝木之血何也. 不知用芍藥以平肝,則肝氣行得舒,肝氣舒自不克土,脾不受克,則脾土自旺,是平肝正所以扶脾耳,

又何必加人參,白兒之品,以致累事哉!