论
《内经》曰∶二阳之病发心脾，有不得隐曲。女子不月，其传为风消，为息奔者，死不治。《难经》曰∶心出血，肝
纳血。肺出气，肾纳气。盖妇人百病，皆自心生，如五志之火一起，则心火亦从而燔。若夫经闭不通之证。先因心事不
足，由是心血亏耗，故乏血以归肝，而出纳之用已竭，经曰母能令子虚，是以脾不磨而食亦少，所谓二阳之病发心脾者，
此也（二阳者阳明也）。因食少，故肺全亦失所养，而气滞不行，则无以滋肾阴。况月经全借肾水施化，肾水既乏，则经
血日以干涸，以致或先或后，淋沥无时。若不早治，渐而至于闭塞不通，甚则为 瘕血膈劳极之证，不易治也。又如崩
漏不止之证，先因心火亢甚，于是血脉泛溢，以致肝实而不纳血，出纳之道遂废，经曰∶子能令母实，是以肝肾之相火，
挟心火之势，亦从而相扇，所以月水错经妄行无时而泛溢也，若不早治，澌而至于崩中不息，甚则化为白浊白淫、血枯
发热、劳极之症，不可治矣。经曰∶邪气盛则实，正气夺则虚。所谓心血不足者，正气夺也。心火亢甚者，邪气盛也（邪
气者相火也）。丹溪曰∶天非此火不能生物，人非此火不能有生，但贵乎适中，凡动必听命乎心君，则无以上诸证，大抵
经闭不行，与夫经漏不止，其初皆由心事不足，以致月经不调，早不调治，直至危笃求医，虽妙手莫能为矣。东垣经闭
不行有三论，崩漏不止亦有三论，学人宜参究其论以治之，不可拘泥也。
脉法
《脉经》曰∶寸口脉微而涩，微则卫气不足，涩则荣气无余。卫不足，其息短，其形躁；血不足，其形逆。荣卫俱
虚，言语谬误。趺阳脉微而涩，涩则胃气虚，虚则短气，咽燥而口苦，胃气涩则失液。少阴脉微而迟，微则无精，迟则
阴中寒，涩则血不来，此为居经，三月一来。
脉微，血气俱虚，年少者，亡血也，乳子下利为可，不者此为居经，三月一来。
脉微弱而涩，年少得此为无子，中年得此为绝产。
寸口脉沉而迟，沉则为水，迟则为寒，寒水相搏，趺阳脉伏，水谷不化，脾气衰则 溏，胃气衰则身体肿。少阳脉
卑，少阴脉细，男子则小便不利，妇人则经水不通。经为血，不利则为水，名曰水分。
寸口脉沉而数，数则为出，沉则为入，出则为阳实，入则为阴结。趺阳脉微而弦，微则无胃气，弦则不得息。少阴
脉沉而滑，沉则为在里，滑则为实，沉滑相搏，血结胞门，其藏不泻，经络不通，名曰血分。经水前断，后病水，名曰
血分，此病难治。先病水，后经断，名曰水分，此病易治。
妇人带下，六极之病，脉浮则为肠鸣腹满，紧则为腹中痛，数则为阴中痒，痛则生疮，弦则阴户掣痛。
妇人带下，脉浮恶寒漏下者不治。
妇人寸口脉浮而弱，浮则为虚，弱则为血，浮则短气，弱则有热而自汗出。
趺阳脉浮而涩，浮则气满，涩则有寒，喜噫吞酸，其气时下，小腹则寒。
少阴脉滑而数者，阴中生疮。
少阴脉数则气淋，阴中生疮。
少阴脉弦者，白肠必挺核。
少阴脉浮而动，浮则为虚，动则为痛，妇人则脱下。
妇人漏血下赤白，日下血数升，脉急疾者死，迟者生。
妇人漏下赤白不止，脉小虚滑者生，大紧实数者死。
妇人疝瘕积聚，脉弦急者生，虚弱小者死。
少阴脉浮而紧，紧则疝瘕，腹中痛，半产而堕伤，浮则亡血。恶寒绝产。
肥人脉细，胞中有寒，故令少子。其色黄者，胸上有寒。
妇人月经一月再来者，经来其脉欲自如常而反微，不利不汗出者，其经二月必来。
方法
丹溪曰∶经候有枯闭不通者，有不及期与过期者，有妄行者，有色紫黑及淡者，有成块者，有作疼者。夫经不通，
或因堕胎及多产伤血或因久患潮热销血，或因久发盗汗耗血，或因脾胃不和饮食少进而不生血，或因痢疾失血，治宜生
血补血、除热调胃之剂，随证用之。或因七情伤心，心气停结，故血闭而不行，宜调心气，通心经，使血生而经自行矣。
虚中有热，月事不来，以四物汤加黄芩治之。
常过期者，血少也，以芎、归、参、术，兼痰药治之。
过期紫黑，有块作痛，血热也，以四物汤加香附、黄连治之。
过期色淡挟痰者，以二陈汤加芎、归治之。
常不及期者，血热也，以四物汤加黄芩、黄连、香附，肥人多兼痰药治之。
血枯经闭者，以四物汤加红花、桃仁治之。
痰多占住血海地位，因而下多者，目必渐昏，肥人多有之，以南星、苍术、川芎、香附作丸服之。
肥人躯脂满经闭者，以导痰汤加芎、归、黄连。不可服地黄，泥膈故也。如用，必以姜汁炒。肥人少子，亦由痰多，
脂膜闭塞子宫，不能受精而施化也，宜服上药。
瘦人子宫无血，精气不聚，亦令无子 以四物汤养血养阴等药治之。
经水未行，临经将来作疼者，血实也，一曰瘀血郁滞也，以四物汤加桃仁、香附、黄连、红花，或加玄胡索、莪术、
木香。有热，加柴胡、黄芩。
经水行后而作疼者，气血俱虚也，以八物汤加减煎服。
夫血为气之配，因气而行。成块者气之凝，将行而痛者气之滞，行后作痛者气血虚也，色淡者亦虚也，而有水以混
之也，错经妄行者气之乱也，紫者气之热，黑则热之甚也。今人悉指为风冷，而行温热之剂，祸不旋踵。
调经散 治经水或前或后，或多或少，或逾月不至，或一月两来，皆可服。
川归（酒洗，一钱半） 麦门冬（去心，二钱） 吴茱萸（择去闭目者，沸汤泡七次，焙干，半钱） 人参（去芦，
一钱） 半夏（汤泡七次，一钱） 白芍药（一钱） 川芎（一钱） 牡丹皮（去心，一钱） 肉桂（半钱） 阿胶珠 甘
草（各七分半）
上细切，作一服，水二盏，加生姜三片，煎至一盏，空心稍热服。
月经过期不行，宜服和经汤。
当归（一钱半） 川芎（半钱） 熟地黄（一钱） 白芍药（一钱） 桃仁（三十个，去皮尖，研） 红花（三分）
香附米（一钱） 熟桂（半钱） 木通（八分） 蓬莪术（一钱） 甘草（五分） 苏木（一钱）
上细切，作一服，水一盏半，煎至一盏，空心温服。
月经先期而来，宜服安经汤。
归身（一钱半） 川芎（半钱） 白芍药（八分） 生地黄（一钱） 阿胶珠（半钱） 艾叶（半钱） 条芩（一
钱） 甘草（半钱） 香附（一钱） 黄柏（半钱） 知母（半钱） 黄连（姜汁拌炒，八分）
上细切，作一服，水煎，空心服。
经不通，用马鞭草杵汁熬膏为丸，或烧存性为丸，红花、当归煎汤送下。
固经丸 治经水过多不止。
黄芩 龟板 白芍药（各一两） 樗根白皮（七钱半） 黄柏（炒，三钱） 香附（童便浸一宿，熔干，二钱半）
上为细末，酒糊为丸，如梧桐子大，每服七十丸，白汤下。
崩漏有虚有热，虚则下溜，热则流通。急则治其标，用白芷煎汤，调下百草霜服。或棕榈灰，或狗头骨烧存性，或
伍灵脂半生半炒，俱以酒调服。后以四物汤加干姜调补之。缓则治其本，四物汤加芩、连、参、 、香附、干姜之类。
四物汤加荆芥穗、条芩，止血神效。
崩漏多因气所使而下，香附米一钱炒黑，归身一钱，白芍药一钱酒炒，熟地黄一钱，川芎、黄 、蒲黄、地榆、人
参各半钱，白术一钱，升麻三分，煎服。甚者加棕榈灰为末，酒调服。
妇人血病，宜用当归。若肥白人，与人参、黄 同用。瘦黑人，宜与生地黄、香附同用。
带下是湿热为病，白属气，赤属血。以二陈汤加苍术治湿为主，气虚入参、术，血虚入芎、归。
带下是胃中痰积流下，渗入膀胱，当升之，天人知此，以二陈汤加苍白术、升麻、柴胡。甚者上用吐法以提其气，
下用二陈加二术，仍用瓦垄子以燥其湿痰。
肥人带下，多是湿痰，用海石、半夏、南星、黄柏、苍术、川芎、香附、樗皮，冬加干姜。瘦人少有此病，有者是
热，以滑石、樗皮、川芎、海石、青黛丸服。
结痰带下，以小胃丹津液咽下数丸，候积下后，以补药调治。
一方 治白带。
樗白皮 山茱萸 苦参 香附（各五钱） 龟板（酥炙） 枳子（各二两） 黄柏（一两） 干姜 贝母（各二钱
半） 白芍药（七钱半）
上为细末，酒糊为丸服。
又方
白芷（四两。以锻石半斤淹三宿，漉去灰，以白芷炒焦为末，清米饮调，空心服之。）
又方 以黄荆子一味，炒焦为末，米饮调服，上可治心痛，下可治白带，以其能燥湿痰也。
罗先生治带，用十枣汤、神 丸、五烛散，此法实者可用，虚者不可峻攻。
带下必须断浓味，凡用药，寒月少加姜、附，临机应变用之。
一人上有头风鼻涕，下有白带，用南星、苍术、酒芩、辛夷、川芎、黄柏（炒焦）、滑石、半夏、牡蛎粉，丸服。
四物汤 乃妇人众疾之总司也。
当归 川芎 白芍药 熟地黄
上细切，等分，水煎服。
（以上丹溪方法凡三十三条）
东垣治崩漏带下，多主于寒，学人宜再思之，不可一途而论，经曰阴虚阳搏谓之崩，观此可知。
东垣曰∶葵花白者治白带，赤者治赤带。用之果验。
调经升阳除湿汤（东垣） 治女子漏下恶血，月事不调，或暴崩不止，多下水浆之物。皆因饮食不节，劳倦所
伤，
或素有心气不足，致令心火乘脾，必怠惰嗜卧，困倦乏力，气短气急。脾主滋荣周身者也，脾胃虚而心胞乘之，故漏下
月水不调也，况脾胃为血气阴阳之根蒂也。当除湿去热，益风气上伸，以胜其湿。又云火郁则发之。
当归（酒洗） 独活（各半钱） 蔓荆子（七分） 防风 炙甘草 升麻 本（各一钱） 柴胡 羌活 苍术 黄
（各一钱半）
上细切，作一服，水五盏，煎至一盏，去渣空心温服，少时以早饭压之，可一服而已。如灸足太阴脾经中血海穴三
七壮，亦已。此药乃从权之法，因风胜湿，为胃气下陷而气迫于下，以救其血之暴崩也。住后，必须服黄 、人参、炙
甘草、当归之类数服以补之，于补气升阳汤中加和血药便是也。若遇夏月白带下脱漏不止，宜用此汤，一服立止。
凉血地黄汤 治妇人血崩，是肾水阴虚。不能镇守胞络相火，故血走而崩也。
黄芩 荆芥穗 蔓荆子（各一分半） 黄柏 知母 本 细辛 川芎（各二分） 黄连 羌活 柴胡 升麻 防
风（各三分） 生地黄 当归（各半钱） 甘草（一钱） 红花（少许）
上细切，作一服，水三大盏，煎至一盏，去渣空心稍热服。
酒煮当归丸（东垣） 治 疝白带下疰香港脚，腰以下如在水雪中，居火炕以浓衣重盖犹寒，肌肉消瘦，小便与
白
带长流而不禁固，面白目青，KT KT 无所见，身重如山，行步欹侧，腿膝枯细，大便闭涩，心下痞闷懊 ，食不下，
面垢背寒，此上中下三阳俱虚，脉沉紧而涩，按之空虚，洪而无力，尤为中寒之证，乃气血俱虚之极也。
茴香（五钱） 黑附子（炮） 良姜（各七钱） 当归（一两）
上四味细切，以好酒一升半，煮至酒尽焙干。
炙甘草 苦楝（生用） 丁香（各半钱） 木香 升麻（各一钱） 柴胡（二钱） 炒黄盐 全蝎（各三钱） 玄
胡索（四钱）
上与前四味同研为细末，酒煮面糊为丸，如梧桐子大，每服五、七十丸，空心淡醋汤送下，忌油腻、冷物及酒、湿
面等。
固真丸 治白带久下不止，脐腹冷痛，阴中亦痛，目中溜火，视物昏花，齿恶热饮，但喜干食，此皆寒湿乘于
胞
内，肝经阴火上溢，故目中溜火。其恶热饮者，阳明经中伏火也。法当大泻寒湿，以此丸治之。
黄柏（酒洗） 白芍药（各半钱） 柴胡 白石脂（各一钱，火 ，水飞，研）
白龙骨（酒煮，水飞，日干为末） 当归（酒洗，各二钱） 干姜（四钱，炮）
上除龙骨、石脂水飞日干另研外，余共为细末，面糊为丸，如鸡
头仁大，日干，空心白汤下，少时以早饭压之，是不令热药犯胃也。忌生冷、硬物、酒、湿面。
乌药汤（东垣） 治妇人血海疼痛。
当归（一钱） 甘草 木香（各五分） 乌药（一钱半） 香附（二钱）
上细切，作一服，水二盏，煎至一盏，食前温服。
助阳汤（东垣） 治白带下，阴户中痛，空心面急痛，身黄皮缓，身重如山，阴寒如冰。
生黄芩 橘红（各五分） 防风 高良姜 干姜 郁李仁 甘草（各一钱） 柴胡（一钱二分） 白葵花（三分）
上细切，分作二服，每服水二盏，煎至一盏，去渣食前稍热服。
丁香胶艾汤（东垣） 治崩漏不止。盖心气不足，劳役及饮食不节所得。其脉两尺俱弦紧洪，按之无力。自觉
脐
下如冰冷，白带及白滑之物多，间有如屋漏水下，时或有鲜血。右尺脉时或浮洪。
熟地黄 白芍药（各三分） 川芎 丁香（各四分） 阿胶珠（六分） 生艾叶（一钱） 当归（一钱二分）
上以川芎、地黄、丁香另为细末，其当归、芍药、艾叶各细切，连
Discussion
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Diseases of the Two Yangs originate from the Heart and Spleen, accompanied by unspoken distress. In women, this leads to amenorrhea. If the condition progresses to emaciation and panting, it is a fatal and incurable syndrome." The *Nan Jing* (Classic of Difficult Issues) states: "The Heart generates blood, and the Liver stores blood. The Lungs exhale Qi, and the Kidneys receive Qi." Generally, various diseases in women originate from the Heart. For instance, when the fire of the Five Emotions arises, the Heart Fire flares up accordingly. Regarding the syndrome of amenorrhea, it initially stems from emotional suppression or unfulfilled desires, leading to a deficiency of Heart Blood. Consequently, there is insufficient blood to return to the Liver, and the Liver's function of storing and releasing blood is exhausted. The classics state that "the Mother can cause the Child to be deficient" (Heart is the Mother of Spleen; Heart deficiency leads to Spleen deficiency), so the Spleen fails to transform and transport food, resulting in poor appetite. This is what is meant by "diseases of the Two Yangs originating from the Heart and Spleen" (Two Yangs refers to the Yangming Meridian). Due to poor appetite, the Lungs lose nourishment, causing Qi stagnation and failure to circulate, thereby failing to nourish Kidney Yin. Moreover, menstruation relies entirely on the transformation facilitated by Kidney Water. Since Kidney Water is deficient, menstrual blood dries up day by day, leading to irregular cycles—either early or late—and continuous dripping without a fixed time. If not treated early, it gradually progresses to complete obstruction, and may even develop into masses (abdominal lumps), blood stasis, chest fullness, and extreme exhaustion syndromes, which are difficult to treat.
Regarding the syndrome of metrorrhagia and metrostaxis (irregular uterine bleeding) that does not stop, it initially stems from hyperactive Heart Fire, causing blood vessels to overflow. This leads to an Excess pattern in the Liver where it cannot store blood, and the channels for blood release and storage become dysfunctional. The classics state that "the Child can cause the Mother to be excess" (Liver is the Child of Heart; Heart Fire excess leads to Liver Fire excess). Thus, the Ministerial Fire of the Liver and Kidneys, carrying the momentum of Heart Fire, fans each other, causing menstrual blood to flow erratically and uncontrollably. If not treated early, it rapidly progresses to severe flooding (metrorrhagia) that does not cease, and may even transform into turbid discharge, leukorrhea, blood depletion with fever, and extreme exhaustion, which become incurable. The classics state: "When pathogenic factors are vigorous, it is Excess; when healthy Qi is depleted, it is Deficiency." Heart Blood deficiency represents the depletion of Healthy Qi, while hyperactive Heart Fire represents the vigor of Pathogenic Factors (here, Pathogenic Factor refers to Ministerial Fire). Zhu Danxi said: "Heaven cannot generate things without this Fire, and humans cannot have life without this Fire, but it must be moderate. All movements must obey the command of the Heart Monarch," thus avoiding the aforementioned syndromes. Generally, both amenorrhea and metrorrhagia/metrostaxis initially arise from emotional suppression leading to menstrual irregularity. If not treated early, until the patient becomes critically ill and seeks medical help, even skilled physicians will find it impossible to save them. Li Dongyuan has three discussions on amenorrhea and three on metrorrhagia/metrostaxis. Students should study these discussions for treatment and not be dogmatic.
Pulse Diagnosis
The *Mai Jing* (Pulse Classic) states: "If the Cun Kou pulse is faint and choppy, faint indicates insufficiency of Wei Qi, and choppy indicates deficiency of Ying Qi. Insufficiency of Wei Qi leads to shortness of breath and restlessness; deficiency of Blood leads to physical discomfort. When both Ying and Wei are deficient, speech becomes erroneous. If the Zu Yang pulse (dorsalis pedis artery) is faint and choppy, choppy indicates deficiency of Stomach Qi. Deficiency leads to shortness of breath, dry throat, and bitter taste. Stagnation of Stomach Qi leads to loss of fluids. If the Shao Yin pulse is faint and slow, faint indicates lack of Essence, and slow indicates cold in the Yin region. Choppy indicates absence of menses; this is called 'Ju Jing' (residing menstruation), occurring once every three months."
A faint pulse indicates deficiency of both Blood and Qi. In young women, this signifies blood loss. It is acceptable if seen in nursing mothers or those with diarrhea; otherwise, it indicates Ju Jing, occurring once every three months.
A weak and choppy pulse in a young woman indicates infertility. In middle-aged women, it indicates sterility.
If the Cun Kou pulse is deep and slow, deep indicates fluid retention, and slow indicates cold. Cold and water contend with each other. The Zu Yang pulse is hidden, indicating failure to digest food and fluids. Spleen Qi deficiency leads to loose stools; Stomach Qi deficiency leads to edema. A low and weak Shao Yang pulse and a fine Shao Yin pulse indicate difficulty in urination in men and amenorrhea in women. Menstrual blood belongs to Blood; if Blood flow is obstructed, it transforms into Water. This disease is named "Shui Fen" (Water Division).
If the Cun Kou pulse is deep and rapid, rapid indicates exterior (Yang) involvement, and deep indicates interior (Yin) involvement. Exterior indicates Yang Excess, and interior indicates Yin binding. The Zu Yang pulse is faint and wiry; faint indicates lack of Stomach Qi, and wiry indicates dyspnea. The Shao Yin pulse is deep and slippery; deep indicates interior location, and slippery indicates Excess. Deep and slippery contending together indicates blood coagulation at the door of the uterus, with organs failing to discharge and meridians blocked. This disease is named "Xue Fen" (Blood Division). If menses stop first and then edema appears, it is named "Xue Fen," which is difficult to treat. If edema appears first and then menses stop, it is named "Shui Fen," which is easy to treat.
In women with leukorrhea, a symptom of the Six Extremes (severe deficiencies): a floating pulse indicates borborygmus and abdominal fullness; a tight pulse indicates abdominal pain; a rapid pulse indicates pruritus vulvae; pain indicates ulceration; a wiry pulse indicates pulling pain in the vaginal orifice.
In women with leukorrhea, if the pulse is floating with aversion to cold and leakage, it is incurable.
If the Cun Kou pulse in women is floating and weak, floating indicates Qi deficiency, and weak indicates Blood deficiency. Floating leads to shortness of breath; weakness leads to heat and spontaneous sweating.
If the Zu Yang pulse is floating and choppy, floating indicates Qi fullness, and choppy indicates cold. There is a tendency to belch and acid regurgitation, with Qi sinking downward and cold in the lower abdomen.
A slippery and rapid Shao Yin pulse indicates ulcers in the vagina.
A rapid Shao Yin pulse indicates Qi strangury and ulcers in the vagina.
A wiry Shao Yin pulse indicates rectal prolapse with nodules.
A floating and moving Shao Yin pulse: floating indicates deficiency, and moving indicates pain. In women, this indicates organ prolapse.
In women with bloody leukorrhea, losing several sheng of blood daily: a rapid and urgent pulse indicates death, while a slow pulse indicates survival.
In women with continuous bloody leukorrhea: a small, deficient, and slippery pulse indicates survival; a large, tight, solid, and rapid pulse indicates death.
In women with hernia, masses, and accumulations: a wiry and urgent pulse indicates survival; a weak and small pulse indicates death.
A floating and tight Shao Yin pulse: tight indicates hernia and masses, abdominal pain, miscarriage, or abortion trauma; floating indicates blood loss. Aversion to cold and sterility follow.
In obese individuals, a fine pulse indicates cold in the uterus, leading to reduced fertility. Yellow complexion indicates cold in the chest.
If a woman's menstruation comes twice a month, and her pulse during menstruation is unexpectedly faint, without discomfort or sweating, her cycle will likely normalize to once every two months.
Treatment Methods
Zhu Danxi stated: Menstruation may be dry and obstructed, occur too early or too late, flow irregularly, be purple-black or pale, form clots, or cause pain. For obstruction due to abortion or multiple births damaging Blood, or chronic tidal fever consuming Blood, or chronic night sweats depleting Blood, or Spleen-Stomach disharmony with poor diet failing to generate Blood, or dysentery causing blood loss, treatment should focus on generating and tonifying Blood, clearing heat, and regulating the Stomach according to the syndrome. If caused by Seven Emotions injuring the Heart, causing Heart Qi stagnation and blood obstruction, treatment should regulate Heart Qi and unblock the Heart Meridian to allow Blood generation and normal menstruation. For deficiency with internal heat and absent menstruation, use Si Wu Tang added with Huang Qin.
For frequent delays due to Blood deficiency, use Xiong Gui Shen Zhu combined with phlegm-resolving herbs.
For delayed periods with purple-black color, clots, and pain due to Blood heat, use Si Wu Tang added with Xiang Fu and Huang Lian.
For delayed periods with pale color and phlegm-dampness, use Er Chen Tang added with Chuan Xiong and Dang Gui.
For frequent early periods due to Blood heat, use Si Wu Tang added with Huang Qin, Huang Lian, and Xiang Fu; for obese patients, add phlegm-resolving herbs.
For blood-depletion amenorrhea, use Si Wu Tang added with Hong Hua and Tao Ren.
When excessive phlegm occupies the position of the Sea of Blood, causing heavy menstruation and gradual vision impairment (common in obese patients), use Nan Xing, Cang Zhu, Chuan Xiong, and Xiang Fu as pills.
For obesity-related amenorrhea due to fat blocking the meridians, use Dao Tan Tang added with Chuan Xiong, Dang Gui, and Huang Lian. Di Huang should not be used as it clogs the chest; if used, stir-fry with ginger juice. Obesity-related infertility is also due to excessive phlegm blocking the uterus, preventing fertilization; take the above prescription.
For thin women with uterine Blood deficiency and scattered Essence causing infertility, use Si Wu Tang to nourish Blood and Yin.
For pre-menstrual pain due to Blood Excess or blood stasis stagnation, use Si Wu Tang added with Tao Ren, Xiang Fu, Huang Lian, Hong Hua, or Yan Hu Suo, E Zhu, and Mu Xiang. Add Chai Hu and Huang Qin if there is heat.
For post-menstrual pain due to dual deficiency of Qi and Blood, use Ba Wu Tang modified.
Blood is the companion of Qi and moves with it. Clots indicate Qi condensation; pain before flow indicates Qi stagnation; pain after flow indicates Qi-Blood deficiency; pale color indicates deficiency mixed with water; erratic flow indicates Qi chaos; purple color indicates Qi heat; black color indicates severe heat. Modern practitioners often attribute this to Wind-Cold and use warm-hot herbs, leading to immediate disaster.
Tiao Jing San: Treats irregular menstruation (early/late, heavy/light, missed periods, or double periods).
Chuan Dang Gui (wine-washed, 1.5 qian), Mai Men Dong (decored, 2 qian), Wu Zhu Yu (select seeds without closed eyes, soak in boiling water 7 times, dry roast, 0.5 qian), Ren Shen (remove radicle, 1 qian), Ban Xia (soak in water 7 times, 1 qian), Bai Shao Yao (1 qian), Chuan Xiong (1 qian), Mu Dan Pi (decored, 1 qian), Rou Gui (0.5 qian), E Jiao Zhu, Gan Cao (each 0.75 qian).
Cut finely, one dose. Add 2 liang of water and 3 slices of fresh Ginger. Decoct to 1 liang. Take slightly warm on an empty stomach.
For delayed menstruation, take He Jing Tang.
Dang Gui (1.5 qian), Chuan Xiong (0.5 qian), Shu Di Huang (1 qian), Bai Shao Yao (1 qian), Tao Ren (30 kernels, remove skin and tip, crush), Hong Hua (0.3 qian), Xiang Fu Mi (1 qian), Shu Gui (0.5 qian), Mu Tong (0.8 fen), Peng E Zhu (1 qian), Gan Cao (0.5 qian), Su Mu (1 qian).
Cut finely, one dose. Add 1.5 liang of water. Decoct to 1 liang. Take warm on an empty stomach.
For early menstruation, take An Jing Tang.
Gui Shen (1.5 qian), Chuan Xiong (0.5 qian), Bai Shao Yao (0.8 fen), Sheng Di Huang (1 qian), E Jiao Zhu (0.5 qian), Ai Ye (0.5 qian), Tiao Qin (1 qian), Gan Cao (0.5 qian), Xiang Fu (1 qian), Huang Bo (0.5 qian), Zhi Mu (0.5 qian), Huang Lian (stir-fried with ginger juice, 0.8 fen).
Cut finely, one dose. Decoct in water. Take on an empty stomach.
For obstruction, use Ma Bian Cao juice boiled into paste for pills, or calcined pills. Send down with decoction of Hong Hua and Dang Gui.
Gu Jing Wan: Treats excessive menstruation that does not stop.
Huang Qin, Gui Ban, Bai Shao Yao (each 1 liang), Chu Gen Bai Pi (7.5 qian), Huang Bo (roasted, 3 qian), Xiang Fu (soaked in child's urine overnight, dried, 2.5 qian).
Grind to fine powder. Make pills with wine paste, size of Sophora seeds. Take 70 pills with plain water.
Metrorrhagia/metrostaxis can be Deficient or Heat-type. Deficiency causes downward leakage; Heat causes free flow. For acute symptoms, treat the branch: decoct Bai Zhi, mix with Bai Cao Shuang to take. Or use Zong Lu Hui, or calcined Dog Head Bone, or Wu Ling Zhi (half raw, half roasted), all taken with wine. Afterwards, tonify with Si Wu Tang added with Gan Jiang. For chronic cases, treat the root: Si Wu Tang added with Qin, Lian, Ren Shen, Huang Qi, Xiang Fu, Gan Jiang, etc.
Si Wu Tang added with Jing Jie Sui and Tiao Qin stops bleeding effectively.
Metrorrhagia/metrostaxis is often driven by Qi. Use 1 qian roasted Xiang Fu Mi, 1 qian Gui Shen, 1 qian wine-fried Bai Shao Yao, 1 qian Shu Di Huang, 0.5 qian each of Chuan Xiong, Huang Qi, Pu Huang, Di Yu, Ren Shen, 1 qian Bai Zhu, 0.3 qian Sheng Ma. Decoct and take. Severe cases add Zong Lu Hui powder taken with wine.
For female blood diseases, use Dang Gui. For obese/pale patients, combine with Ren Shen and Huang Qi. For thin/dark patients, combine with Sheng Di Huang and Xiang Fu.
Leukorrhea is caused by Damp-Heat. White relates to Qi, Red to Blood. Primarily treat Dampness with Er Chen Tang added with Cang Zhu. Add Ren Shen and Bai Zhu for Qi deficiency; add Chuan Xiong and Dang Gui for Blood deficiency.
Leukorrhea results from Phlegm accumulation in the Stomach flowing down into the Bladder. It requires ascending Qi. Tian Ren knew this and used Er Chen Tang added with Cang Zhu, Bai Zhu, Sheng Ma, and Chai Hu. For severe cases, induce vomiting above to lift Qi, and below use Er Chen Tang added with Er Zhu, still using Wa Long Zi to dry Damp-Phlegm.
Obese patients with leukorrhea usually have Damp-Phlegm. Use Hai Shi, Ban Xia, Nan Xing, Huang Bo, Cang Zhu, Chuan Xiong, Xiang Fu, Chu Pi. Add Gan Jiang in winter. Thin patients rarely have this; if present, it is Heat. Use Hua Shi, Chu Pi, Chuan Xiong, Hai Shi, Qing Dai as pills.
For Phlegm-binding leukorrhea, swallow a few pills of Xiao Wei Dan with saliva. After accumulation descends, treat with tonics.
Formula 1: Treats white leukorrhea.
Chu Bai Pi, Shan Zhu Yu, Ku Shen, Xiang Fu (each 5 qian), Gui Ban (roasted with butter), Zhi Zi (each 2 liang), Huang Bo (1 liang), Gan Jiang, Bei Mu (each 2.5 qian), Bai Shao Yao (7.5 qian).
Grind to powder. Make pills with wine paste.
Another Formula:
Bai Zhi (4 liang. Soak in 0.5 jin of Duan Shi for 3 nights, filter ash, stir-fry Bai Zhi until charred, grind to powder. Mix with clear rice drink, take on empty stomach.)
Another Formula: Use Huang Jing Zi alone, stir-fried until charred, ground to powder. Mix with rice drink. Treats heartache above and leukorrhea below, as it dries Damp-Phlegm.
Mr. Luo treated leukorrhea with Shi Zao Tang, Shen Xiao Wan, and Wu Zhu San. These methods are for Excess patterns; do not use harsh purgatives for Deficiency.
Leukorrhea treatment requires avoiding rich flavors. In cold months, add less Ginger and Fu Zi, adapting to circumstances.
A patient with head wind/runny nose above and leukorrhea below was treated with Nan Xing, Cang Zhu, Jiu Qin, Xin Yi, Chuan Xiong, Huang Bo (charred), Hua Shi, Ban Xia, Mu Li Fen as pills.
Si Wu Tang is the general manager for treating various female diseases.
Dang Gui, Chuan Xiong, Bai Shao Yao, Shu Di Huang.
Cut equally, decoct in water, and take.
(Above are 33 methods from Danxi.)
Li Dongyuan treated metrorrhagia/metrostaxis and leukorrhea mostly focusing on Cold. Students should reconsider and not rely on a single approach. The classics say: "Yin deficiency with Yang pounding is called Beng," which clarifies this.
Li Dongyuan said: White sunflower flowers treat white leukorrhea; red ones treat red leukorrhea. This is effective.
Tiao Jing Sheng Yang Chu Shi Tang (Li Dongyuan): Treats women with leaking dark blood, irregular menstruation, sudden severe flooding, and watery discharge. Caused by improper diet and fatigue, or inherent Heart Qi deficiency leading to Heart Fire attacking the Spleen. Symptoms include lethargy, drowsiness, fatigue, shortness of breath. The Spleen nourishes the body; Spleen-Stomach deficiency allows Pericardium to attack, causing leaking and irregular menstruation. Spleen-Stomach is the root of Qi, Blood, Yin, and Yang. Treatment should resolve Dampness and clear Heat, raise Wind Qi to overcome Dampness. Also, "Fire depression should be dispersed."
Dang Gui (wine-washed), Du Huo (each 0.5 qian), Man Jing Zi (0.7 fen), Fang Feng, Zhi Gan Cao, Sheng Ma, Ben Cao (each 1 qian), Chai Hu, Qiang Huo, Cang Zhu, Huang Qi (each 1.5 qian).
Cut finely, one dose. Add 5 liang of water. Decoct to 1 liang. Strain and take warm on an empty stomach. Press with breakfast shortly after. One dose suffices. Moxibustion on Xue Hai (SP9) of Foot Taiyin Spleen Meridian (21 moxa cones) also works. This is a temporary measure for Wind overcoming Dampness and Stomach Qi sinking, to save from sudden flooding. After stopping, tonify with Huang Qi, Ren Shen, Zhi Gan Cao, Dang Gui, etc., adding blood-nourishing herbs to Bu Qi Sheng Yang Tang. For summer leukorrhea with continuous leakage, this formula stops it immediately.
Liang Xue Di Huang Tang: Treats female blood flooding due to Kidney Water Yin deficiency, failing to control Ministerial Fire in the uterus, causing blood to rush and flood.
Huang Qin, Jing Jie Sui, Man Jing Zi (each 1.5 fen), Huang Bo, Zhi Mu, Ben Cao, Xi Xin, Chuan Xiong (each 2 fen), Huang Lian, Qiang Huo, Chai Hu, Sheng Ma, Fang Feng (each 3 fen), Sheng Di Huang, Dang Gui (each 0.5 qian), Gan Cao (1 qian), Hong Hua (a little).
Cut finely, one dose. Add 3 large liang of water. Decoct to 1 liang. Strain and take slightly warm on an empty stomach.
Jiu Zhu Dang Gui Wan (Li Dongyuan): Treats hernia, leukorrhea, Hong Kong foot (podagra), cold below the waist as if in snow/ice, chills despite heating and heavy clothing, emaciation, involuntary urine and leukorrhea, pale face with blue eyes, blurred vision, heaviness like a mountain, staggering gait, thin legs/knees, constipation, epigastric fullness and vexation, anorexia, greasy face, cold back. This indicates deficiency of Upper, Middle, and Lower Yang, with deep, tight, choppy pulse, empty on pressure, and forceless surging pulse, indicating severe Cold and extreme Qi-Blood deficiency.
Hui Xiang (5 qian), Hei Fu Zi (processed), Liang Jiang (each 7 qian), Dang Gui (1 liang).
Cut the four ingredients. Boil in 1.5 sheng of good wine until wine is gone, then dry roast.
Zhi Gan Cao, Ku Lian (raw), Ding Xiang (each 0.5 qian), Mu Xiang, Sheng Ma (each 1 qian), Chai Hu (2 qian), Chao Huang Yan, Quan Xie (each 3 qian), Yan Hu Suo (4 qian).
Grind with the previous four into fine powder. Make pills with wine-boiled wheat paste, size of Sophora seeds. Take 50-70 pills on empty stomach with light vinegar water. Avoid greasy, cold foods, alcohol, and wet noodles.
Gu Zhen Wan: Treats persistent leukorrhea, cold pain in umbilicus/abdomen, vaginal pain, eye fire, blurred vision, aversion to hot drinks, preference for dry food. Caused by Cold-Damp invading the uterus and Liver Meridian Yin Fire overflowing. Aversion to hot drinks indicates latent Fire in Yangming Meridian. Method: Greatly drain Cold-Damp with this pill.
Huang Bo (wine-washed), Bai Shao Yao (each 0.5 qian), Chai Hu, Bai Shi Zhi (each 1 qian, calcined, water-suspended, ground).
Bai Long Gu (wine-boiled, water-suspended, sun-dried powder), Dang Gui (wine-washed, each 2 qian), Gan Jiang (4 qian, processed).
Except for Long Gu and Shi Zhi (water-suspended, sun-dried, separately ground), mix others into fine powder. Make pills with wheat paste, size of Job's tears. Sun-dry. Take on empty stomach with plain water. Press with breakfast to prevent hot herbs from harming the Stomach. Avoid cold, hard foods, alcohol, wet noodles.
Wu Yao Tang (Li Dongyuan): Treats pain in the Sea of Blood (uterus) in women.
Dang Gui (1 qian), Gan Cao, Mu Xiang (each 0.5 fen), Wu Yao (1.5 qian), Xiang Fu (2 qian).
Cut finely, one dose. Add 2 liang of water. Decoct to 1 liang. Take warm before meals.
Zhu Yang Tang (Li Dongyuan): Treats leukorrhea, vaginal pain, facial tension on empty stomach, yellow skin, laxity, heaviness like a mountain, icy cold in Yin.
Sheng Huang Qin, Ju Hong (each 0.5 fen), Fang Feng, Gao Liang Jiang, Gan Jiang, Yu Li Ren, Gan Cao (each 1 qian), Chai Hu (1.2 qian), Bai Kui Hua (0.3 qian).
Cut finely, divide into two doses. Each dose: add 2 liang water, decoct to 1 liang. Strain and take slightly warm before meals.
Ding Xiang Jiao Ai Tang (Li Dongyuan): Treats continuous metrorrhagia/metrostaxis due to Heart Qi deficiency from labor and improper diet. Pulse: both Chi positions wiry, tight, and surging, but empty on pressure. Sensation of ice-cold below umbilicus, abundant white leukorrhea and slippery discharge, occasional dripping like leaking roof, occasional fresh blood. Right Chi pulse occasionally surging and floating.
Shu Di Huang, Bai Shao Yao (each 3 fen), Chuan Xiong, Ding Xiang (each 4 fen), E Jiao Zhu (6 fen), Sheng Ai Ye (1 qian), Dang Gui (1.2 qian).
Process Chuan Xiong, Di Huang, and Ding Xiang separately into fine powder. Cut Dang Gui, Shao Yao, and Ai Ye finely. Combine...