妇人有先期经来者，其经甚多，人以为血热之极也，谁知是肾中水火太旺乎！夫火太旺则血热，水太旺则血多，
此有余之病，非不足之症也，似宜不药有喜。但过于有余，则子宫太热，亦难受孕，更恐有铄干男精之虑，过者损之，
谓非既济之道乎！然而火不可任其有余，而水断不可使之不足。治之法但少清其热，不必泄其水也。
方用清经散。
丹皮（三钱） 地骨皮（四钱） 白芍（三钱，酒炒） 大熟地（三钱，九蒸） 青蒿（二钱） 白茯苓（一钱）
黄柏（五分，盐水浸炒）
水煎服。二剂而火自平。此方虽是清火之品，然仍是滋水之味，火泄而水不与俱泄，损而益也。
又有先期经来只一、二点者，人以为血热之极也，谁知肾中火旺而阴水亏乎！夫同是先期之来，何以分虚实之
异？盖妇人之经最难调，苟不分别细微，用药鲜克有效。先期者火气之冲，多寡者水气之验，故先期而来多者，火
热而水有余也；先期而来少者，火热而水不足也。倘一见先期之来，俱以为有余之热，但泄火而不补水，或水火两
泄之，有不更增其病者乎！治之法不必泄火，只专补水，水既足而火自消矣，亦既济之道也。
方用两地汤。
大生地（一两，酒炒） 元参（一两） 白芍药（五钱，酒炒） 麦冬肉（五钱） 地骨皮（三钱） 阿胶（三钱）
水煎服。四剂而经调矣。此方之用地骨、生地，能清骨中之热。骨中之热，由于肾经之热，清其骨髓，则肾气
自清，而又不损伤胃气，此治之巧也。况所用诸药，又纯是补水之味，水盛而火自平理也。此条与上条参观，断无
误治先期之病矣。
眉批∶妇科调经尤难，盖经调则无病，不调则百病丛生。治法宜详察其病源，细审其所以不调之故，然后用
药，始能见效。此书虽有先期、后期、先后无定期之分，然须与种子、带下门参看，临症时自有进见。
歌括∶经水先期量甚多，肾中太旺水与火。
有余之水勿药喜，有余之火清其热。
清经散用大熟地，白芍茯苓地骨皮。
青蒿丹皮炒盐柏，滋水泄火损而益。
经水先期量甚少，肾中水亏火来灼。
治法当宜专补水，肾水充足火自消。
两地汤中用生地，玄参麦冬地骨皮。
阿胶白芍用酒炒，补水泄火服之宜。
Women who experience menstruation arriving ahead of schedule with a heavy flow are often thought to suffer from extreme blood heat. However, who would know that this is actually due to an excessive abundance of both fire and water in the Kidney? When fire is excessively abundant, the blood becomes heated; when water is excessively abundant, the blood volume increases. This is a disease of excess (repletion), not deficiency. It might seem advisable to leave it untreated for a favorable outcome. But if the excess is too great, the uterus becomes too hot, making conception difficult, and there is even the concern that it may scorch and dry up the male essence. When things are excessive, they must be reduced; is this not the principle of Ji Ji (successful interaction between Water and Fire)? Therefore, while the fire should not be allowed to remain excessive, the water must absolutely not be permitted to become deficient. The treatment method involves slightly clearing the heat without draining the water. Use the formula Qing Jing San (Clear the Menses Powder).
Dan Pi (3 qian) [Moutan Cortex], Di Gu Pi (4 qian) [Lycii Cortex], Bai Shao (3 qian, stir-fried with wine) [Paeoniae Radix Alba], Da Shu Di (3 qian, steamed nine times) [Rehmanniae Radix Preparata], Qing Hao (2 qian) [Artemisiae Annuae Herba], Bai Fu Ling (1 qian) [Poria], Huang Bo (5 fen, soaked in salt water and stir-fried) [Phellodendri Cortex].
Decoct in water and take orally. After two doses, the fire will naturally subside. Although this formula consists of herbs that clear fire, they are primarily nourishing to the water. The fire is drained while the water is preserved, representing a reduction that yields benefit.
There are also cases where menstruation arrives ahead of schedule but with only one or two drops. People assume this is extreme blood heat, but who knows that this is actually due to hyperactive fire in the Kidney combined with a deficiency of Yin water? Since both present as early menstruation, how can one distinguish between excess and deficiency patterns? Women's menstruation is particularly difficult to regulate; if subtle differences are not distinguished, medication rarely proves effective. Early arrival indicates the rushing of fire qi, while the volume indicates the state of water qi. Thus, early arrival with heavy flow indicates heat/fire and excess water; early arrival with scanty flow indicates heat/fire and deficient water. If one sees early menstruation and assumes all cases are due to excess heat, merely draining fire without tonifying water, or draining both fire and water, would not this exacerbate the disease? The treatment method does not require draining fire, but rather solely tonifying water. Once water is sufficient, fire will naturally dissipate; this is also the principle of Ji Ji.
Use the formula Liang Di Tang (Two Rehmannia Decoction).
Da Sheng Di (1 liang, stir-fried with wine) [Rehmanniae Radix], Yuan Shen (1 liang) [Scrophulariae Radix], Bai Shao Yao (5 qian, stir-fried with wine) [Paeoniae Radix Alba], Mai Dong Rou (5 qian) [Ophiopogonis Tuber], Di Gu Pi (3 qian) [Lycii Cortex], E Jiao (3 qian) [Colla Corii Asini].
Decoct in water and take orally. After four doses, the menstruation will regulate. The use of Di Gu Pi and Sheng Di in this formula clears heat from the bone marrow. Heat in the bone marrow stems from heat in the Kidney meridian; clearing the marrow heat cleanses the Kidney Qi without damaging Stomach Qi, which is a clever aspect of this treatment. Moreover, all the herbs used are purely for tonifying water; when water flourishes, fire naturally settles. Comparing this section with the previous one ensures no misdiagnosis of early menstruation.
Marginal Note: Regulating menstruation in gynecology is particularly difficult. Generally, regulated menstruation implies health, while irregular menstruation leads to myriad diseases. Treatment methods should carefully investigate the disease source and meticulously examine the causes of irregularity before administering medication to achieve efficacy. Although this book categorizes conditions into early, late, and irregular menstruation, it must be studied alongside sections on seed-bearing (fertility) and leukorrhea for deeper clinical insight.
Verse:
Menstruation arrives early with heavy flow,
Kidney fire and water are excessively strong.
Excess water needs no medicine, rejoice;
Excess fire requires clearing its heat.
Qing Jing San uses Da Shu Di,
Bai Shao, Fu Ling, and Di Gu Pi.
Qing Hao, Dan Pi, and Salt-processed Huang Bo,
Nourish water, drain fire, reduce yet benefit.
Menstruation arrives early with scanty flow,
Kidney water is deficient, fire scorches.
Treatment should focus solely on tonifying water,
When Kidney water is sufficient, fire dissipates.
Liang Di Tang employs Sheng Di,
Xuan Shen, Mai Dong, and Di Gu Pi.
E Jiao and Bai Shao processed with wine,
Tonify water, drain fire, suitable to take.