劉完素婦科學術思想之研究

Study on Gynecological thought by Liu-Wan-Su

劉完素為金元時代的著名醫家，其婦科治病思想，認為婦人月經來源於天癸，若「天癸未行」之月經病，為青春期卵巢功能尚未發育成熟所引起的，皆屬於少陰，治療當以補腎為主；若「天癸既行」之月經病，發生於生育年齡的婦女，皆屬厥陰，當從肝論治；若「天癸已絕」之月經病，為更年期卵巢功能衰退所引起的，皆屬太陰，當從脾論治。其治婦人經閉的思想，認為心火上炎導致胞脈閉，而引起月事不來，故倡言宜「降心火養脾血」。其論帶下乃濕熱鬱結引起，主張用辛苦寒藥治療。完素強調妊娠期間用藥有三條禁忌，禁過度發汗、瀉下和利小便；婦人孕胎不安，提倡以「白朮黃芩」安胎。其治療產後諸病及經病，創四物湯增損治療模式，並強調應透過辨證來用藥，影響後世很大，成為治療婦人月調經失調的典範。

Liu-Wan-Su was a famous physician in Jin-Yuan Dynasty. In his ideas on gynecology, he thought that the menses was originated from Tian-Gui. If the menses disease resulted from the non-arrival of Tian-Gui it belonged to Lesser Yin which indicated ovary physiological function immaturity in the adolescent period, the major treatment was supplementing the kidney. If the menstrual disease occurred during the period of Tian-Gui arrival, it belongs to Reverting Yin, which often occurred in the period of reproductive age, the major treatment was regulating the liver qi. If the menstrual disease resulted of Tian-Gui closed was belong to Greater Yin which indicated ovary function failure in the menopause period, the major treatment was supplementing the spleen. Liu believed that amenorrhea resulting from the uterus channels obstruction caused by upflaming heart fire, could be treated by downbearing heart fire and nourishing the spleen. He treated leukorrhea due to damp-heat binding depression with acrid, bitter and cold herbs. He appreciated the three key points of contrinedication during pregnancy that excessive promotion of sweat, excessive precipitation and excessive diuresis should be prevented. He suggested that pregnancy fetal distress treated with ovate atractylodes (baizhu) and scutellaria (huang qin) herbs to quiet the fetus. He treated postpartum diseases and menses diseases with Four Agents Decoction (Si-wu Tang) as a model to decreased an any Agents and increased some other Agents that should be identified pattern. this concept had a great influence on the future generations and became to a criteria for treating menstrual irregularities.