妇人有经水忽来忽断，时疼时止，寒热往来者，人以为血之凝也，谁知是肝气不舒乎！夫肝属木而藏血，最恶
风寒。妇人当行经之际，腠理大开，适逢风之吹寒之袭，则肝气为之闭塞，而经水之道路亦随之而俱闭，由是腠理
经络，各皆不宣，而寒热之作，由是而起。其气行于阳分则生热，其气行于阴分则生寒，然此犹感之轻者也。倘外
感之风寒更甚，则内应之热气益深，往往有热入血室，而变为如狂之症。若但往来寒热，是风寒未甚而热未深耳。
治法宜补肝中之血，通其郁而散其风，则病随手而效，所谓治风先治血，血和风自灭，此其一也。
方用加味四物汤。
大熟地（一两，九蒸） 白芍（五钱，酒炒） 当归（五钱，酒洗） 川芎（三钱，酒洗） 白术（五钱，土炒） 粉
丹皮（三钱） 元胡（一钱，酒炒） 甘草（一钱） 柴胡（一钱）
水煎服。此方用四物以滋脾胃之阴血；用柴胡、白芍、丹皮以宣肝经之风郁；用甘草、白术、元胡以利腰脐而和
腹疼，入于表里之间，通乎经络之内，用之得宜，自奏功如响也。
眉批∶加荆芥穗（炒黑）一钱尤妙。
歌括∶经水忽来忽断焉，痛疼发作亦如然。
经行适逢风寒袭，补肝生血风自蠲。
加味四物地芍先，当归川芎和牡丹。
白术二胡并甘草，用之得当效可观。
Women who experience menstruation that suddenly starts and stops, with pain that comes and goes intermittently, accompanied by alternating chills and fever, are often thought to suffer from blood stasis. However, this is actually due to the stagnation of Liver Qi (Liver Qi Stagnation). The Liver belongs to Wood in the Five Elements and stores Blood; it is most averse to Wind-Cold invasion. During menstruation, the Cou Li (pores and interstitial spaces) are wide open. If exposed to wind and cold at this time, the Liver Qi becomes obstructed, causing the pathways for menstruation to close as well. Consequently, both the Cou Li and meridians become blocked, leading to the onset of chills and fever. When pathogenic factors move through the Yang aspect, heat is generated; when they move through the Yin aspect, cold is generated. This represents a mild degree of external contraction. If the external Wind-Cold is more severe, the internal heat response will be deeper, often resulting in Heat entering the Blood Chamber (Xue Shi), manifesting as symptoms resembling mania. If there are only alternating chills and fever, it indicates that the Wind-Cold is not severe and the internal heat is not deep.
The treatment method should focus on nourishing the Blood within the Liver, unblocking the stagnation, and dispersing the Wind. In this way, the disease will resolve quickly, following the principle: "To treat Wind, first treat the Blood; once the Blood is regulated, the Wind extinguishes itself." This is the first scenario.
The formula used is Jia Wei Si Wu Tang (Modified Four Substances Decoction).
Prepared Rehmannia Root (Shu Di Huang) - 1 liang, steamed nine times; White Peony Root (Bai Shao) - 5 qian, stir-fried with wine; Angelica Sinensis (Dang Gui) - 5 qian, washed with wine; Szechuan Lovage Rhizome (Chuan Xiong) - 3 qian, washed with wine; Atractylodes Macrocephala Rhizome (Bai Zhu) - 5 qian, stir-fried with soil; Moutan Cortex (Mu Dan Pi) - 3 qian; Corydalis Rhizome (Yan Hu Suo) - 1 qian, stir-fried with wine; Licorice Root (Gan Cao) - 1 qian; Bupleurum Root (Chai Hu) - 1 qian.
Decoct in water and take orally. This formula uses Si Wu Tang to nourish the Yin-Blood of the Spleen and Stomach; Chai Hu, Bai Shao, and Mu Dan Pi to disperse Wind-stagnation in the Liver Meridian; Gan Cao, Bai Zhu, and Yan Hu Suo to benefit the waist and umbilical region and harmonize abdominal pain. Acting between the exterior and interior, and penetrating within the meridians, if applied appropriately, it will yield results as swiftly as an echo.
Marginal Note: Adding 1 qian of Schizonepeta Spike (Jing Jie Sui), stir-fried until black, is particularly effective.
Verse:
Menstruation suddenly starts and stops, pain arises and subsides similarly.
During menstruation, exposure to Wind-Cold occurs; nourishing Liver Blood causes Wind to dissipate.
In Modified Four Substances, Shu Di and Bai Shao come first,
Followed by Dang Gui, Chuan Xiong, and Mu Dan Pi.
Add Bai Zhu, the two 'Hu' herbs (Chai Hu, Yan Hu Suo), and Gan Cao;
When used correctly, the efficacy is remarkable.