经云∶阴虚阳搏谓之崩。此言热迫血而妄行也。又曰∶阳络伤，则血外溢，阴络伤，则
血内溢。外溢者，从上出，内溢者，从下流也。病患过于作劳，喜怒不节，则络脉伤损而血
妄行矣。前症，若因热迫血而妄行者，用加味四物汤。若因络脉伤损者，用八珍汤。若瘀血
凝积，佐以独圣丸。若因肝经火旺，不能藏血者，加味逍遥散。若因脾气虚，不能统血者，
四君子汤加归、芍主之。若因思虑伤脾，不能摄血归经者，归脾汤。若气血两亏，血崩不止
更用十全大补汤。丹溪云∶凡血症，须用四君子之类以收功。若大吐、大下，毋以脉论，
当急用独参汤救之。若潮热、咳嗽、脉数，乃元气虚弱假热之象，尤当用参术调补脾土。若
服参术不相安者，即专以和平饮食调理之。此等症候，无不由脾气先损，故脉息虚浮而大，
须令脾胃健旺，后天根本坚固，乃为可治。设或过用寒凉，复伤胃气，反不能摄血归经，是
加味四物汤 本方内加丹皮、阿胶、黄芩、黑山栀（方见虚劳）。
八珍汤（见虚劳
治瘀血凝积，瘀血不去则新血不得归经，此丸主之。虚人以补药相间而用。
五灵脂（去土，炒烟尽）
为末，醋丸，绿豆大。每服一、二钱，淡醋水下，清酒亦得。
加味逍遥散（见类中
四君子汤 归脾汤 十全大补汤（并见虚劳）。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Yin deficiency with a pulsating Yang pulse is termed 'Beng' (metrorrhagia)." This refers to heat forcing blood to flow recklessly. It also says: "When the Yang collaterals are injured, blood overflows outward; when the Yin collaterals are injured, blood overflows inward." Outward overflow exits from the upper orifices, while inward overflow flows from the lower orifices. If patients overexert themselves and fail to regulate their emotions of joy and anger, the collateral vessels will be damaged, causing blood to flow recklessly.
For the aforementioned symptoms, if caused by heat forcing blood to flow recklessly, use Jiawei Siwu Tang (Modified Four Substances Decoction). If caused by damage to the collateral vessels, use Bazhen Tang (Eight Treasures Decoction). If there is accumulation of blood stasis, supplement with Dusheng Wan (Sole Saint Pill). If caused by excessive fire in the Liver channel preventing it from storing blood, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If caused by Spleen Qi deficiency failing to control blood, treat with Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba). If caused by overthinking injuring the Spleen, preventing it from directing blood back into the vessels, use Guipi Tang (Restore the Spleen Decoction). If there is a dual deficiency of Qi and Blood with continuous metrorrhagia, use Shiquan Dabu Tang (Ten Great Tonifying Decoction). Zhu Danxi said: "For all blood disorders, one must use formulas like Sijunzi Tang to achieve success." In cases of severe vomiting or purging, do not rely on pulse diagnosis alone; instead, urgently use Danshen Tang (Single Ginseng Decoction) for rescue. If tidal fever, coughing, and a rapid pulse appear, these are signs of false heat due to weak Yuan Qi (Original Qi); one should especially use Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) to tonify and regulate the Spleen Earth. If the patient cannot tolerate Renshen and Baizhu, then regulate solely with mild and harmonious dietary adjustments. Such syndromes invariably stem from prior damage to Spleen Qi, hence the pulse is deficient, floating, and large. The Spleen and Stomach must be strengthened, and the root of acquired constitution made solid, before treatment can succeed. If cold-natured drugs are overused, damaging Stomach Qi again, blood will fail to return to the vessels.
[Dusheng Wan]
Treats accumulated blood stasis; when blood stasis is not expelled, new blood cannot return to the vessels. This pill is indicated. For deficient individuals, alternate this with tonic medicines.
Wulingzhi (Trogopterori Faeces, cleaned of earth and stir-fried until smoke ceases)
Grind into powder, form pills with vinegar paste, sized like mung beans. Take 1–2 qian per dose, washed down with light vinegar water; clear wine is also acceptable.
[References for other formulas]
Jiawei Xiaoyao San (See Chapter on Stroke-like Syndromes)
Sijunzi Tang, Guipi Tang, Shiquan Dabu Tang (All see Chapter on Consumption Deficiency Syndromes)