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Benglou (Metrorrhagia and Metrostaxis) involves both deficiency and heat patterns. Heat causes the blood to flow freely and leak; blood-heat leads to flowing, while deficiency leads to slipping and incontinence. Any non-menstrual vaginal bleeding that drips continuously is called "Louxia" (Leaking Down); sudden violent bleeding, resembling a mountain collapse, is called "Bengzhong" (Central Collapse). The five colors of blood correspond to the five Zang organs.

Deficiency patterns often result from excessive sexual activity combined with fire pathogens. If intercourse occurs during menstruation, or due to overexertion, the Chong and Ren vessels are damaged, leading to dual deficiency of Qi and Blood, which fails to restrain the menstrual blood, causing sudden violent discharge. In such cases, one should greatly tonify Qi and Blood using Dawen Jing Tang (Great Warming Meridian Decoction). For Qi deficiency, Siwu Tang (Four Substances Decoction) is used with added Renshen (Ginseng) and Huangqi (Astragalus); for Blood deficiency, Siwu Tang is used with added Ejiao (Donkey-hide Gelatin), Aye (Mugwort Leaf), and Chao Ganjiang (Fried Dried Ginger); for chronic cases that do not stop, Baizi Fugui Wan (Hundred Seeds Attaching Return Pill) or Mo Fu Wan (Ink-Attaching Pill) are indicated. For deficiency-cold presenting with cold pain in the umbilical and abdominal regions, Fulonggan San (Dragon's House Earth Powder) is used. For all deficiency patterns, Neizhi San (Internal Moxibustion Powder) may be applied. For deficiency-fire, Liangxue Dihuang Tang (Cooling Blood Rehmannia Decoction), Shengdi Qinlian Tang (Rehmannia, Scutellaria, and Coptis Decoction), or Buyin Wan (Nourishing Yin Pill) are suitable; for chronic cases, Danggui Longgu Wan (Angelica and Dragon Bone Pill) or Da/Xiao Wuji Wan (Large/Small Black Chicken Pills) are used.

Heat patterns are solely related to improper dietary regulation. Some cases arise from consuming rich and greasy foods, causing Spleen-dampness to flow downward to the Kidney, combining with Ministerial Fire to form damp-heat, which forces menstrual blood to leak down. The blood color is purple-black, foul-smelling, and putrid. Suitable formulas include Jiedu Siwu Tang (Detoxifying Four Substances Decoction), Liangxue Dihuang Tang, or Jiao'ai Siwu Tang (Gelatin and Mugwort Four Substances Decoction) added with Huangqin (Scutellaria); alternatively, Qinxin Wan (Scutellaria Heart Pill), Siwu Kanli Wan (Four Substances Kan-Li Pill), or Gujing Wan (Stabilize Menses Pill) can be used. Other cases stem from irregular eating habits, where fire pathogenic factors attack the Spleen and Stomach, causing Qi sinking. Although the patient's appearance may seem normal, external signs include Spleen-related fatigue, irritability, heat, and inability to rest. Menstrual blood arrives suddenly at irregular intervals or stops abruptly after starting. Treatment should focus on raising and nourishing the Spleen and Stomach, combined with herbs that suppress Heart-fire. By nourishing Yin and draining Yang, the bleeding will cease naturally. Shengyang Tiaojing Tang (Raising Yang Regulating Menses Decoction) or Shengyang Ju Jing Tang (Raising Yang Lifting Menses Decoction) are indicated.

Alternatively, it may be caused by the mutual invasion of the four seasonal pathogens. When the Uterus is subjected to the combat of these four pathogens, blood becomes difficult to stop. Generally, if caused by wind-cold binding, Wuji San (Five Accumulations Powder) without Mahuang (Ephedra) is decocted with vinegar; or Buhuanjin Zhengqi San (Golden Exchange Upright Qi Powder) added with Chuanxiong (Sichuan Lovage Root) and Guigui (Cinnamon Twig); or Siwu Tang added with Jingjie (Schizonepeta). If attacked by cold pathogens, or in elderly patients with chronic benglou, Fulonggan San is used with added Fuzi (Aconite), Lurong (Deer Antler), Ejiao, and Puhuang (Pollen Typhae), formed into pills with rice paste. During summer months, Qinxin Wan alone, or Yiyuan San (Benefit Origin Powder) added with Baicaoshuang (Herb Ash), is used. For dampness, Shengyang Chushi Tang (Raising Yang Draining Dampness Decoction) is indicated.

Or it may be due to severe sorrow and worry causing heart pain. Extreme grief obstructs the Bao Luo (Uterine Collaterals); when the Bao Luo is obstructed, Yang Qi moves internally. Upon onset, this manifests as "Xin Xia Beng" (collapse of blood from below the heart, referring to heavy uterine bleeding) and frequent hematuria. Beijin San (Prepare Metal Powder), Sizhi Xiangfu Wan (Four-Processed Cyperus Pill), Wuyao Tang (Lindera Decoction), or Guju Gui Wan (Ancory Orange Angelica Pill) are suitable. Melancholy arises from a transition from wealth to poverty, or from smooth to adverse circumstances, with unfulfilled desires causing stagnant-fire to flourish within the blood vessels. Siwu Tang is used with added Xiangfu (Cyperus) and Baizhu (Atractylodes Macrocephala), each 1 qian; Diyu (Sanguisorba), Huangqin, and Renshen, each 0.5 qian; Shengma (Cimicifuga), 2 fen. In severe cases, Zonglv Hui (Palmetto Ash) is added, taken with wine. Severe heart pain is named "Shaxue Xin Tong" (Blood-Killing Heart Pain). After spontaneous abortion, if excessive bleeding causes heart pain, the treatment is the same: use Hai'epu (Cuttlefish Bone) stir-fried into powder, taken with vinegar water.

When the condition is urgent, one must first stop bleeding while promoting circulation. The classics state: "Yin pulse beats strongly while Yang pulse is deficient, this is called Beng." This indicates that most cases belong to heat patterns. Benglou involves chaotic menstrual blood that does not follow its proper pathway, overflowing and acting recklessly. If stopped abruptly, stasis will accumulate and form a nest; if not stopped, fainting may occur. Therefore, one must first administer 1 qian of Wulingzhi San (Trogopterus Dung Powder), which has the ability to move and stop blood. Then, differentiate between deficiency and heat, administering one or two doses of herbs that harmonize Qi and Blood. Afterwards, administer Dan Wulingzhi San (Single Trogopterus Dung Powder) to remove the old and generate the new. If bleeding continues, Wushamao San (Black Hat Powder), Shihui San (Ten Charcoals Powder), Gu Heishen San (Ancient Black Divine Powder), or Dan Xiakucao Gao (Single Prunella Paste) may be used; for those with fire, Gujing Wan is used; for deficiency, Nv Jin Dan (Woman's Golden Pill) is used.

By nourishing the Stomach and calming the Mind, the former blood is restored. After the cessation of metrorrhagia, Siwu Tang added with Chao Ganjiang is used for regulation. For weak Qi, add Renshen and Huangqi; for stagnation, add Xiangfu; for accompanying fire, add small amounts of Huangqin and Huanglian, followed by Er Yi Wan (Two Suitability Pill). Siwu Tang is used to restore the former blood, preventing solitary Yang hyperactivity and guarding against recurrence. For weak Spleen and Stomach Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is used; for restless Spirit, Ningshen Gao (Calming Spirit Paste) or Ziyin Ningshen Tang (Nourishing Yin Calming Spirit Decoction) are indicated. This disease involves insufficient Heart Blood or hyperactive Heart Fire. If not treated early, it may transform into Baizhuo (White Turbidity), Baiyin (White Discharge), or Xueku Refa (Blood Depletion Fever), which becomes incurable.