Library

In women who are deeply depressed in spirit, presenting with dry mouth and tongue, thirst, vomiting, and acid regurgitation, accompanied by severe lower bleeding (metrorrhagia), people often treat it with fire-clearing methods. Sometimes effective, sometimes not, why is this? It is because they fail to recognize it as a condition caused by the stagnation of Liver Qi. The Liver stores blood; when Qi stagnates, blood also stagnates. Why does it then lead to severe metrorrhagia and uterine bleeding? This is likely due to the nature of the Liver being urgent and quick-tempered. When Qi stagnates, this urgency becomes even more pronounced. Excessive urgency prevents the blood from being stored properly, thus inevitably leading to metrorrhagia. The treatment method should primarily focus on resolving stagnation. If one merely resolves stagnation without calming the Liver, the Liver Qi will rise excessively, Liver Fire will become more intense, and the bleeding cannot be stopped.

The formula used is Pinggan Kaiyu Zhixue Tang (Calming the Liver, Resolving Stagnation, and Stopping Bleeding Decoction).
Bai Shao (Radix Paeoniae Alba, 1 liang, stir-fried with vinegar) Bai Zhu (Rhizoma Atractylodis Macrocephalae, 1 liang, stir-fried with soil) Dang Gui (Radix Angelicae Sinensis, 1 liang, washed with wine) Dan Pi (Cortex Moutan, 3 qian) San Qi Radix Notoginseng, 3 qian, ground into powder) Sheng Di Huang (Radix Rehmanniae Preparata, 3 qian, stir-fried with wine) Gan Cao (Radix Glycyrrhizae, 2 qian) Hei Jie Sui (Flos Artemisiae Argyi Carbonized, 2 qian) Chai Hu (Radix Bupleuri, 1 qian)
Decoct with water and take orally. After one dose, vomiting stops; after two doses, dryness and thirst are relieved; after four doses, metrorrhagia is cured. The brilliance of this formula lies in Bai Shao's ability to calm the Liver, Chai Hu's ability to resolve stagnation, and Bai Zhu's ability to benefit the waist and umbilical region, thereby avoiding the risk of blood accumulation. Jing Jie (Herba Schizonepetae) unblocks the collaterals, allowing blood to return to its proper course. Dan Pi clears heat from the bone marrow. Sheng Di Huang clears inflammation from the zang-fu organs. Dang Gui and San Qi employ hemostatic methods within the context of nourishing blood, naturally causing the stagnation to dissipate and the bleeding to stop.
Marginal note: Adding 3 qian of Guan Zhong Tan (Carbonized Rhizoma Cyathiulae) to this formula enhances its efficacy.
Song verse: Metrorrhagia due to stagnation resides in the Liver; dry tongue, thirst, vomiting, and acid regurgitation occur.
Treatment should calm the Liver and resolve stagnation simultaneously; administering correct medication brings peace.
Pinggan Kaiyu Zhixue Tang contains Dang Gui, Bai Shao, Bai Zhu, Dan Pi, and Sheng Di Huang.
San Qi, Chai Hu, Gan Cao, and Hei Jie Sui; adding Guan Zhong Tan makes the effect more prominent.

In women who have fallen from heights or suffered sprains and injuries, leading to the flow of evil blood downwards, resembling the appearance of metrorrhagia, treating it as simple metrorrhagia is not only useless but harmful. The symptoms of this condition must include pain upon palpation; over time, the complexion becomes sallow, and the body appears emaciated and withered. This is caused by blood stasis, which is not comparable to ordinary metrorrhagia. If one fails to resolve the stasis and instead uses tonifying and astringent herbs, the blood stasis will attack internally, causing endless pain. Consequently, new blood cannot be generated, and old blood cannot be transformed. Dying without understanding this is truly lamentable! The treatment method must promote blood circulation to remove stasis and invigorate blood to alleviate pain, so that the bleeding will naturally stop and recovery will occur.

The formula used is Zhuyu Zhixue Tang (Expelling Stasis and Stopping Bleeding Decoction).
Sheng Di Huang (Radix Rehmanniae Preparata, 1 liang, stir-fried with wine) Da Huang (Radix et Rhizoma Rhei, 3 qian) Chi Shao (Radix Paeoniae Rubra, 3 qian) Dan Pi (Cortex Moutan, 1 qian) Dang Gui Wei (Cauda Radicis Angelicae Sinensis, 5 qian) Zhi Ke (Fructus Aurantii, 5 qian, stir-fried) Gui Ban (Carapax et Plastrum Testudinis, 3 qian, stir-fried with vinegar) Tao Ren (Semen Persicae, 10 grains, soaked, stir-fried, and ground)
Decoct with water and take orally. After one dose, pain lightens; after two doses, pain stops; after three doses, bleeding completely ceases, and no further administration is needed. The brilliance of this formula lies in its combination of blood-invigorating herbs with agents that direct downward stagnation. Thus, expelling stasis is like sweeping, and stopping bleeding is miraculous. One might suspect that falls, sprains, and drops cause internal injury from external trauma. Although not as severe as internal injuries per se, since metrorrhagia has occurred, the internal damage is not light. Why treat only the stasis while ignoring Qi? It is unknown that falls, sprains, and drops differ from conditions where internal injury leads to external manifestations. Since the root remains intact, addressing the branch disease suffices. Hence, it is said: "In acute cases, treat the branch."
Marginal note: For hematemesis or hemoptysis caused by bruises and fractures, this treatment method is generally suitable. If blood accumulates in the stomach, add 1.5 qian of Chuan Niu Pu (Cortex Magnoliae Officinalis) stir-fried with ginger juice.
Song verse: Falling, spraining, and twisting cause metrorrhagia; sallow complexion, emaciation, and pain upon pressing.
Blood stasis acting as the culprit; invigorating blood and resolving stasis generates new blood.
Zhuyu Zhixue Tang uses Sheng Di Huang, Da Huang, Chi Shao, and Dan Pi.
Dang Gui Wei, Zhi Ke, and Gui Ban (stir-fried); use 10 grains of Tao Ren (soaked and stir-fried).