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The disease of *beng lou* (metrorrhagia and metrostaxis) essentially stems from a single syndrome. The mild form is called *lou xia* (dripping down), while the severe form is called *beng zhong* (sudden collapse).

Generally, women have regular menstrual cycles and appropriate flow. However, if the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel)—two important meridians regulating menstruation and reproduction—are severely damaged, particularly due to liver injury, this condition arises. Since the Liver serves as the repository for blood, excessive anger or joy, along with physical exertion and fatigue, can injure it. When the Liver fails to store blood in the uterus, and the uterus fails to transmit blood to the Sea of Blood (referring to the Chong Mai, which acts as the reservoir of blood), *beng zhong* and *lou xia* occur.

*Lou xia* refers to vaginal bleeding that drips continuously. *Beng zhong* refers to sudden, massive hemorrhage, representing the most severe manifestation of the *lou* syndrome. The discharge may resemble dark red pig liver, appear mixed with five colors, and be expelled together with blood; or it may look like mucus resembling rice water, juice from rotting melons, bean soup broth, or the color of indigo. There are cases where black clots resembling dried blood are mixed in, or pure blood stasis is discharged. These conditions all result from deficiency and damage to the Chong and Ren meridians, compounded by emotional imbalance and overexertion. Symptoms include emaciation, mental restlessness with dry mouth, cold pain in the umbilical and abdominal regions, vomiting and inability to eat, and weakness and fatigue in the four limbs.

Regarding pulse diagnosis: a wiry (*xian*) pulse indicates excess pathogenic factors, while a weakened pulse indicates deficiency; a large pulse suggests emptiness (Kou pulse), a weak pulse indicates cold, and a Kou pulse indicates deficiency. Cold and deficiency interact mutually, leading to leakage of blood in deficiency patterns. If the pulse of a patient with leaking blood is floating and rootless, it is difficult to treat. The therapeutic method lies in nourishing and regulating the Chong and Ren meridians, and nourishing the hundred vessels. Once external menstruation returns to normal, there will naturally be no worry of *beng zhong* or *lou xia*.

Furthermore, it is discussed that the disease of *beng lou* essentially belongs to one syndrome, yet there are distinctions in severity. The mild form is called *lou xia*, which refers to continuous dripping bleeding. The severe form... [Text contains lacunae/corruptions] ...four... namely... blood... broth... Dan makes efficacy... makes efficacy... limbs, ice obtained by sun, then bakes and melts into water, blood coagulation obtains Dan and becomes smooth, the power of fire. Great efficacy. If one doubts and dares not use it lightly, first administer Yangqi Shi Wan (Yangqi Stone Pill); after two days of administration, if there is no effect, then...

At age fourteen (2x7), Tian Gui (the substance essential for reproductive maturity/menstruation) should arrive. There are cases where it should arrive but does not, or arrives only around eighteen or nineteen years old. If the patient suffers from *beng lou*, they should not take the previous two medicines. Instead, Si Wu Tang (Four Substances Decoction) should be used with Xiang Fu Zi (Cyperus Rhizome) added, Shu Di Huang (Prepared Rehmannia Root) removed, and Sheng Di Huang (Fresh Rehmannia Root) added for decoction. In clinical practice, careful judgment is required.