《金匱要略》「女勞疸」之重新闡釋與釐訂

背景：女勞疸之闡述歷代醫家說法不一，或有大勞大熱而成，或有因房勞之說，因其詮釋紛亂，進而影響後世取方理法之臨床實用性。目的與方法：藉由經文之間對校以及各典籍校勘，釐訂經文的缺漏和錯簡，並對照現代醫學概念使條文能貼近臨床。結果與結論：釐定後經文，經文1：「……。額上黑，微汗出，手足中熱，薄暮即發，膀胱急，小便不利，名曰女勞疸。腹如水狀，不治。……」。經文2：「黃家，身盡黃，日晡所發熱，而反惡寒。膀胱急，少腹滿，額上黑，足下熱，此女勞之病，腹脹如水狀難治。大便必黑，時溏，因作黑疸。硝石礬石散主之。」經釐訂後，作者認為：1.《金匱要略》「女勞疸」經文不屬黃疸篇，理當回歸婦人雜病篇。2.融合現代醫學重新詮釋女勞疸，可意指女子因為過度勞損，導致卵巢提早功能不全或衰竭，誘發頭面部色素過度沉積，身體出現潮熱、出汗，並且伴隨泌尿生殖系統等一系列症狀，以澄清「女勞疸」應非指女子房事過度或沉溺色慾而造成黃疸。

關鍵字

女勞疸；黑疸；卵巢早期功能不足或衰竭；圍絕經期綜合徵；更年期症候群

並列摘要

There are many doubts about "Female Overloading Jaundice" in the Synopsis of the Golden Chamber. Some physicians explained "Female overloading jaundice" literally as female having excessive sexual activities. Others considered the word "female" as pleonasm so "Female overloading jaundice" should be revised to "overloading jaundice". The confusion of interpretations by physicians has affected clinical practicability. This article revises the clauses by using symmetry between clauses, scripture grammar, and collation of related classics. Also, comparing the clauses with the concept of modern medicine to make the clauses closer to clinical use. After the revision, the author considers: 1. The scripture of "Female Overloading Jaundice" is not belong to Chapter XV: Jaundice, it should return to Chapter XXII: Miscellaneous Gynecological Diseases. 2. Redefinition of "Female Overloading Jaundice" means that female overloading leads to premature ovarian insufficiency or failure, which induces pigmentation in the cheekbones of the face and forehead. 3.Therefore, "Female Overloading Jaundice" does not mean that women have jaundice caused by excessive intercourse or indulging in lust.