妇人有经水将来三五日前而脐下作疼，状如刀刺者；或寒热交作，所下如黑豆汁，人莫不以为血热之极，谁知
是下焦寒湿相争之故乎！夫寒湿乃邪气也。妇人有冲任之脉，居于下焦；冲为血海，任主胞胎，为血室，均喜正气
相通，最恶邪气相犯；经水由二经而外出，而寒湿满二经而内乱，两相争而作疼痛，邪愈盛而正气日衰。寒气生浊，
而下如豆汁之黑者，见北方寒水之象也。治法利其湿而温其寒，使冲任无邪气之乱，脐下自无疼痛之疚矣。
方用温脐化湿汤。
白术（一两，土炒） 白茯苓（三钱） 山药（五钱，炒） 巴戟肉（五钱，盐水浸） 扁豆（炒、捣，三钱） 白
果（十枚，捣碎） 建莲子（三十枚，不去心）
水煎服。然必须经未来前十日服之。四剂而邪气去，经水调，兼可种子。此方君白术以利腰脐之气；用巴戟、
白果以通任脉；扁豆、山药、莲子以卫冲脉，所以寒湿扫除而经水自调，可受妊矣。倘疑腹疼为热疾，妄用寒凉，
则冲任虚冷，血海变为冰海，血室反成冰室，无论难于生育，而疼痛之止，又安有日哉！
眉批∶冲任之气宜通不宜降，故化湿不用苍术、薏仁。余宜类参。
歌括∶经水来前三五天，脐下疼痛若刀穿。
经下色如黑豆汁，湿寒所致非热煎。
温脐化湿宜为先，白术茯苓山药莲。
巴戟扁豆与白果，煎服经来十日前。
Women may experience pain in the lower abdomen (umbilical region) three to five days before the onset of menstruation, with a sensation like knife stabbing; or they may have alternating chills and fever, and the menstrual blood discharged resembles black bean soup. People invariably consider this to be extreme blood heat, but who would know that it is actually due to the struggle between cold-dampness in the Lower Jiao (Lower Burner)? Cold-dampness is pathogenic qi. Women have the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel), located in the Lower Jiao; the Chong Mai is known as the Sea of Blood, and the Ren Mai governs the fetus and is the Blood Chamber. Both vessels prefer the free flow of righteous qi and most detest invasion by pathogenic qi. Menstrual blood exits through these two vessels, but if cold-dampness fills these two vessels and causes internal chaos, their mutual struggle results in pain. The more vigorous the pathogenic qi, the more the righteous qi declines daily. Cold qi generates turbidity, so the discharge being black like bean soup reflects the image of Northern Cold Water. The treatment method is to promote diuresis to resolve dampness and warm to dispel cold, ensuring no pathogenic chaos in the Chong and Ren vessels, so that pain in the umbilical region will naturally cease. The formula used is Wen Qi Hua Shi Tang (Warm the Umbilicus and Transform Dampness Decoction).
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang, stir-fried with soil) Bai Fu Ling (Poria, 3 qian) Shan Yao (Dioscoreae Rhizoma, 5 qian, stir-fried) Ba Ji Rou (Morindae Officinalis Radix et Cortex, 5 qian, soaked in salt water) Bian Dou (Phaseoli Semen, 3 qian, stir-fried and crushed) Bai Guo (Ginkgonis Semen, 10 pieces, crushed) Jian Lian Zi (Nelumbinis Semen, 30 pieces, heart not removed)
Decoct in water and take orally. However, it must be taken ten days before the expected onset of menstruation. After four doses, the pathogenic qi is eliminated, the menstruation becomes regular, and conception can also be facilitated. This formula uses Bai Zhu as the sovereign herb to benefit the qi of the waist and umbilicus; Ba Ji Tian and Bai Guo are used to unblock the Ren Mai; Bian Dou, Shan Yao, and Lian Zi are used to guard the Chong Mai. Thus, cold-dampness is swept away, menstruation regulates itself, and pregnancy can be accepted. If one suspects abdominal pain is caused by a heat disease and recklessly uses cold-cooling herbs, the Chong and Ren vessels will become deficient and cold, the Sea of Blood will turn into an icy sea, and the Blood Chamber will become an icy chamber. Not only will fertility be difficult, but when will the pain ever cease?
Marginal Note: The qi of the Chong and Ren vessels should be unblocked rather than descending; therefore, Cang Zhu (Atractylodis Rhizoma) and Yi Yi Ren (Coicis Semen) are not used for transforming dampness. Other cases should be referred to similarly.
Verse:
Three to five days before menstruation comes,
Pain in the umbilical region feels like piercing knives.
The menstrual blood color is like black bean juice,
Caused by damp-cold, not by heat frying.
Warming the umbilicus and transforming dampness should be first,
With Bai Zhu, Fu Ling, Shan Yao, and Lian Zi.
Ba Ji, Bian Dou, and Bai Guo,
Decoct and take ten days before menstruation arrives.