妇人有经前腹疼数日，而后经水行者，其经来多是紫黑块，人以为寒极而然也，谁知是热极而火不化乎！夫肝
属木，其中有火，舒则通畅，郁则不扬，经欲行而肝不应，则抑拂其气而疼生。然经满则不能内藏，而肝中之郁火焚
烧，内逼经出，则其火亦因之而怒泄。其紫黑者，水火两战之象也；其成块者，火煎成形之状也。经失其为经者，
正郁火内夺其权耳。治法似宜大泄肝中之火，然泄肝之火，而不解肝之郁，则热之标可去，而热之本未除也，其何能益！
方用宣郁通经汤。
白芍（五钱，酒炒） 当归（五钱，酒洗） 丹皮（五钱） 山栀子（三钱，炒） 白芥子（二钱，炒研） 柴胡
（一钱） 香附（一钱，酒炒） 川郁金（一钱，醋炒） 黄芩（一钱，酒炒） 生甘草（一钱）
水煎。连服四剂，下月断不先腹疼而后行经矣。此方补肝之血，而解肝之郁，利肝之气，而降肝之火，所以奏
功之速。
歌括∶经水未来腹先痛，热极不化郁火攻。
紫黑成块因怒泄，宣郁降火有奇功。
通经芍归丹栀充，白芥柴胡香附雄。
郁金黄芩生甘草，连服四剂经自通。
妇人有少腹疼于行经之后者，人以为气血之虚也，谁知是肾气之涸乎！夫经水者，乃天一之真水也，满则溢而
虚则闭，亦其常耳，何以虚能作疼哉？盖肾水一虚则水不能生木，而肝木必克脾土，木土相争，则气必逆，故尔作
疼。治法必须以舒肝气为主，而益之以补肾之味，则水足而肝气益安，肝气安而逆气自顺，又何疼痛之有哉！
方用调肝汤。
山药（五钱，炒） 阿胶（三钱，白面炒） 当归（三钱，酒洗） 白芍（三钱，酒炒） 山萸肉（三钱，蒸熟）
巴戟（一钱，盐水浸） 甘草（一钱）
水煎服。此方平调肝气，既能转逆气，又善止郁疼。经后之症，以此方调理最佳。不特治经后腹疼之症也。
眉批∶经前经后腹痛二方极妙，不可加减。若有别症亦宜此方为主，另加药味治之。原方不可减去一味。
歌括∶行经之后少腹痛，气血非虚肾水空。
无水润肝木克土，相争气逆痛自生。
调肝山药炒阿胶，当归山萸与白芍。
巴戟甘草同煎服，调平肝气此方妙。
Women who experience abdominal pain for several days before the onset of menstruation, followed by menstrual flow, often have menstrual blood containing purple-black clots. People attribute this to extreme cold; however, it is actually due to extreme heat causing the failure of transformation (blood stasis due to heat). The Liver belongs to Wood and contains Fire within. When Liver Qi is free-flowing, it is smooth; when stagnant, it fails to ascend. When menstruation is about to occur but the Liver fails to respond with its dispersing function, it suppresses and rebels against the Qi, resulting in pain. However, when the uterus is full of blood, the Liver cannot store it internally. The stagnant Fire within the Liver burns and forces the menstrual blood outward, causing the Fire to vent violently. The purple-black color represents the struggle between Water and Fire; the formation of clots is the result of Fire scorching the blood into shape. The loss of normal menstrual characteristics is precisely because the Stagnant Fire has usurped control internally. The treatment method seems to require vigorously draining the Fire from the Liver. However, if one drains the Liver Fire without resolving Liver stagnation, the branch aspect of the heat may be removed, but the root cause remains uneliminated, which is of no benefit. Therefore, Xuan Yu Tong Jing Tang (Disperse Stagnation and Unblock Menses Decoction) is used.
Bai Shao (Radix Paeoniae Alba, 5 qian, stir-fried with wine) Dang Gui (Radix Angelicae Sinensis, 5 qian, washed with wine) Dan Pi (Cortex Moutan, 5 qian) Shan Zhi Zi (Fructus Gardeniae, 3 qian, stir-fried) Bai Jie Zi (Semen Sinapis Albae, 2 qian, stir-fried and ground) Chai Hu (Radix Bupleuri, 1 qian) Xiang Fu (Rhizoma Cyperi, 1 qian, stir-fried with wine) Chuan Yu Jin (Rhizoma Curcumae Longae, 1 qian, stir-fried with vinegar) Huang Qin (Radix Scutellariae, 1 qian, stir-fried with wine) Sheng Gan Cao (Radix Glycyrrhizae Preparata, 1 qian)
Decoct in water. Take continuously for four doses; next month, abdominal pain will certainly not precede menstruation. This formula nourishes Liver Blood, resolves Liver stagnation, benefits Liver Qi, and descends Liver Fire, thus achieving rapid efficacy.
Verse: Abdominal pain precedes menstruation, extreme heat fails to transform, driven by stagnant Fire.
Purple-black clots form due to violent venting, dispersing stagnation and descending Fire yields miraculous results.
Unblocking menses relies on abundant Bai Shao, Dang Gui, Dan Pi, and Zhi Zi; Bai Jie Zi, Chai Hu, and Xiang Fu are potent.
Yu Jin, Huang Qin, and Sheng Gan Cao combined; take four doses consecutively, and menses will naturally flow smoothly.
Women who experience lower abdominal pain after menstruation is thought by people to be due to deficiency of Qi and Blood; however, it is actually due to exhaustion of Kidney Qi. Menstrual blood is the True Water generated by Tian Yi (One from Heaven). When full, it overflows; when deficient, it closes. This is the normal state. Why should deficiency cause pain? Generally, when Kidney Water is deficient, it cannot generate/nourish Liver Wood, causing Liver Wood to overact upon Spleen Earth. The struggle between Wood and Earth causes Qi to rebel, resulting in pain. The treatment must primarily focus on soothing Liver Qi, supplemented by herbs that tonify the Kidneys. Then, Water will be sufficient, Liver Qi will be peaceful, and rebellious Qi will naturally become smooth, eliminating pain. Therefore, Tiao Gan Tang (Regulate the Liver Decoction) is used.
Shan Yao (Rhizoma Dioscoreae, 5 qian, stir-fried) E Jiao (Colla Corii Asini, 3 qian, stir-fried with white flour) Dang Gui (Radix Angelicae Sinensis, 3 qian, washed with wine) Bai Shao (Radix Paeoniae Alba, 3 qian, stir-fried with wine) Shan Yu Rou (Fructus Corni, 3 qian, steamed) Ba Ji Tian (Radix Morindae Officinalis, 1 qian, soaked in salt water) Gan Cao (Radix Glycyrrhizae, 1 qian)
Decoct in water and take orally. This formula harmoniously regulates Liver Qi, reverses rebellious Qi, and effectively stops pain caused by stagnation. For post-menstrual conditions, this formula is best for regulation. It is not only effective for post-menstrual abdominal pain.
Marginal Note: The two formulas for pre- and post-menstrual abdominal pain are extremely excellent and should not be modified. If other symptoms exist, these formulas should still serve as the base, with additional herbs added for treatment. No herb should be omitted from the original prescription.
Verse: Lower abdominal pain after menstruation is not due to Qi and Blood deficiency, but empty Kidney Water.
Without Water to moisten, Liver Wood attacks Earth; their struggle causes Qi rebellion and pain arises.
Tiao Gan Tang contains stir-fried Shan Yao, E Jiao, Dang Gui, Shan Yu Rou, and Bai Shao.
Ba Ji Tian and Gan Cao decocted together; harmonizing and leveling Liver Qi makes this formula wonderful.