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From Essential Prescriptions of the Golden Cabinet (金匮要略 jīn guì yào lüè). Expulsion of qì (gas) through the vagina. Vaginal flatulence is traditionally attributed to replete grain qì or center qì fall.

Patterns

Replete grain qì (谷气实 gǔ qì shí): When grain qi4 (nourishing food) in the stomach is replete, but the qì of the body is insufficient, stomach qì discharging downward is not carried through the intestine and expelled via the turbid pathways, but carried through the clear pathways from the small intestine, giving rise to vaginal flatus marked by a loud clear sound and continuous expulsions and is associated with constipation.

Medicinal therapy: Treat by moistening dryness and precipitation. Use Lard and Hair Brew (膏发煎 gāo fà jiān), which comprises pork lard (Suis Adeps, 猪脂膏 zhū zhī gāo) and human hair (Crinis, 血余 xuè yú).

Center qì fall (中气下陷 gǔ qì xià xiàn) causes vaginal flatus with shortness of breath, laziness to speak, fatigue, and lack of strength.

Medicinal therapy: Supplement the center and boost qì. Use Perfect Major Supplementation Decoction (十全大补汤 shí quán dà bǔ tāng) plus cimicifuga (Cimicifugae Rhizoma, 升麻 shēng má) and bupleurum (Bupleuri Radix, 柴胡 chái hú).

Biomedical correspondence: flatus vaginalis. Modern gynecology attributes flatus vaginalis to a number of causes: loosening of the vagina in childbirth allowing air to enter and accumulate before it is periodically expelled (e.g., when lying face downward or during physical exertion); carbohydrates resolving into gas in the vagina; deformities that cause intestinal flatus to be discharged through the vagina. These considerations may help to shed light on the traditional Chinese explanations.

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