上为细末，每服二钱，酒调下，空心，食前，日三次服。即去黄芩，加桂枝一两。
〔《脉》〕问曰∶妇人年五十数，一朝而清血二三日不止，何以治之？师曰∶此妇人前绝生，经水不下，
今反清血，此为居经。不须治，当自止。经水下常五日止者，五日愈。
〔《心》〕月经不调∶阴独（三分，此穴大效，须待经定为度，在足四指间三壮。）
〔《东》〕又法∶内踝下白肉际，青脉上，灸随年壮。
〔《集》〕又法∶中极 三阴交 肾俞 气海
〔《心》〕经闭久，忽大崩，复又断绝，复又大行不调者∶丰隆（六分，止血。） 石门（五分，
断经。）
妇人五旬，经断后再行，或多或少，或瘀或红，并下腹中气满如胎孕∶天枢 中脘 气海（各五分，
立愈。）
〔《甲》〕妇人漏下，苦血闭不通，逆气胀，血海主之。女子胞中痛，月水不以时休止，天枢主之。
（《千金》作腹胀，肠鸣，气上冲胸。）小腹胀满，痛引阴中，月水至则腰脊痛，胞中瘕，子门有寒，
引髌髀，水道主之。（《千金》“引髌髀”作“大小便不通”。）
〔丹〕血枯经闭者，四物汤加桃仁、红花。阴虚经脉久不通，小便短涩身疼者，四物加苍术、牛膝、陈皮、
生甘草，作汤。又用苍莎丸加苍耳、酒芍药为丸，就煎前药、吞下。
上丹溪治血枯大法。
〔垣〕经闭不行有三，补前人之阙。妇人脾胃久虚，形体羸弱，气血俱衰，而致经水断绝不行，或病中消
胃热，善食渐瘦，津液不生。夫经者，血脉津液所化，津液既绝，为热所烁，肌肉渐瘦，时见渴燥，血海枯竭，
病名曰血枯经绝。宜泻胃之燥热，补益气血，经自行矣。此症或经适行而有子，子亦不安，为胎病者有
矣。（此中焦胃热结也。）
或心包脉洪数，躁作时见，大便秘涩，小便虽清不利，而经水闭绝不行，此乃血海干枯。宜调血脉，
除包络中火邪，而经自行矣。（此下焦胞脉热结也。）
或因劳心，心火上行，月事不来者，胞脉闭也。包脉者，属于心而络于胞中。今气上迫肺，心气不得下通，
故月事不来。宜安心补血泻火，经自行矣。（此上焦心肝肺热结也。）
裴泽之夫人病寒热，月事不至者数年，又加喘嗽，医者率以蛤蚧、桂附投之。曰∶不然。夫人病阴，为阳
所搏，温剂太过，故无益反害，投以凉剂，凉血和血药则行矣。已而果然。
〔洁〕女子月事不来者，先泻心火，血自下也。《内经》曰∶二阳之病发心脾，有不得隐曲，故女子不月，
其传为风消。王注曰∶大肠胃热也，心脾受之，心主血，心病则血不流，脾主味，脾病则主味不化，味不
化则精不足，故其病则不能隐曲。脾土已亏，则风邪胜而气愈消也。又经曰∶月事不来者，胞脉闭也。胞脉属
于心，络于胞中。今气上迫肺，心气不得下通，故月事不来。先服降心火之剂，后服《局方》中五补丸，后
以卫生汤治脾养血也。
〔《局》〕五补丸 补诸虚，安五脏，坚骨髓，养精神。
熟地 人参 牛膝（酒浸，去芦，焙干） 白茯苓 地骨皮（各等分）
上为细末，炼蜜丸如桐子大，每服三五十丸，温酒下，空心服。
卫生汤
当归 白芍药（各二两） 黄 （三两） 甘草（一两）
上为末，每服半两，水二盏，煎至一盏，温服，空心。如虚者，加人参一两。
上东垣、洁古治血枯之法，皆主于补血泻火也。补血者，四物之类。泻火者，东垣分上中下，故火在中
则善食消渴，治以调胃承气之类；火在下则大小秘涩，治以玉烛之类，玉烛者，四物与调胃承气等分也；
火在上则得于劳心，治以芩、连及三和之类，三和者，四物、凉膈、当归等分也。洁古先服降心火之剂者，
盖亦芩、连、三和、玉烛之类，后服五补、卫生者，亦补气之剂也。
〔《素》〕帝曰∶有病胸胁支满者，妨于食，病至则先闻腥臊臭，出清液，先唾血，四肢清，目眩，时时
前后血，病名为何？何以得之？岐伯曰∶病名血枯。此得之少年时有所大脱血，若醉入房中，气竭
肝伤，故月事衰少不来也。帝曰∶治之奈何？岐伯曰∶以四乌 骨、一 茹，二味并合之，丸以雀卵，
大如小豆，以五丸为后饭，饮以鲍鱼汁，利肠中及伤肝也。（腹中论 王注云∶乌 鱼骨主血闭， 茹
主散恶血，雀卵主血痿，鲍鱼主瘀血。河间《宣明论方》乌 骨、 茹各等分，雀卵不拘数，和丸小
豆大，每服五丸至十丸，煎鲍鱼汤下，食后日三服，压以美膳。）
上岐伯河间治血枯之法。
〔《脉》〕问曰∶妇人病下利而经水反断者，何也？师曰∶但当止利，经自当下，勿怪。所以利
不止而血断者，但下利亡津液，故经断。利止，津液复，经当自下。问曰∶妇人病经水断一二月，而反经
来，今脉反微涩，何也？师曰∶此前月中若当下利，故令妨经。利止，月经当自下，此非躯也。妇人血
下，咽干而不渴，其经必断。此荣不足，本自有微寒，故不引饮。渴而引饮者，津液得通，荣卫自和，
其经必复下。
〔仲〕妇人之病，因虚、积冷、结气，为诸经水断绝，至有历年，血寒积结，胞门寒伤，经络凝
坚。在上呕吐涎沫久成肺痈，形体损分；在中盘结，绕脐寒疝，或两胁疼痛，与脏相连，或结热中，病在
关元，脉数无疮，肌若鱼鳞，时着男子，非止女身；在下未多，经候不匀，令阴掣痛，少腹恶寒，或引
腰脊，下根气冲，气冲急痛，膝胫疼烦，奄忽眩冒，状如厥癫，或有忧惨，悲伤多嗔，此皆带下，非
有鬼神。久则羸瘦，脉虚多寒，三十六病，千变万端。审脉阴阳，虚实紧弦，行其针药，治危得安。
其虽同病，脉各异源，子当辨记，勿谓不然。
〔丹〕经候过期不行，杜牛膝捣汁大半钟，以玄胡末一钱，香附末、枳壳末各半钱，早调服。
〔《大》〕万病丸 治经事不来，绕脐痛。
干漆（杵碎，炒烟尽） 牛膝（去苗，酒浸一宿，焙干，一两）
上为末，以生地黄汁一升，入二味药末银器内，慢火熬可丸，即丸如桐子大。每服二丸，空心，
米饮或温酒下。
疗月水不利，脐下憋逆，气胀满，欲呕，不得睡。（憋，伴列切，急也。）
当归（四钱） 干漆（三钱，炒烟尽）
上为末，炼蜜丸如桐子大。空心，温酒下十五丸。
治月经壅滞，脐腹 痛。
当归 玄胡索
上为粗末，每服三钱，姜三片，水一钟半，煎至七分，去渣稍热服。
小肠移热于大肠，为伏瘕，为沉。（全文见诊病传变 王注云∶血涩不利则月事沉滞而不行。）
〔《圣》〕治妇人月水滞涩不快，结成瘕块，筋胀大欲死。用马鞭草根苗五斤，锉细，水五
斗，煎至一斗，去渣，别以净器盛，熬成膏，食前温酒调下半匙。（本草云∶马鞭草辛凉破血瘕。）
〔罗〕血极膏 治妇干血气。
以川大黄为末，用酽醋熬成膏子，丸如鸡头大，每服一丸，热酒化开，临卧温服。大便利一二
行后，红脉自下。是妇人之仙药也，加当归头。
〔仲〕妇人经水不利，抵当汤主之。（亦治男子膀胱满急有瘀血者。方见伤寒。）
上经一节，方三首，皆治污血有热而经闭。前一方轻剂，后二方重剂也。
〔云〕红花当归散 治妇人经候不行，或积瘀血，腰腹疼痛，及室女月经不通。
红花 当归尾 紫葳 牛膝 甘草 苏木（细锉。各二两） 白芷（一两半） 赤芍药（八两）
刘寄奴（五两） 桂心（一两半）
上为细末，空心，热酒调三钱服之，食前临卧再服。若久血不行，浓煎红花，酒下。孕妇休服。
牛膝散 治妇人月水不利，脐腹 痛。
牛膝（一两） 桂心 赤芍药 桃仁 玄胡索 当归 牡丹皮 川芎 木香（各七钱半）
上每服方寸匕，为极细末，温酒调下，食前。
温经汤 若经道不通，绕脐寒痛，脉沉紧，宜此及桂枝桃仁汤、万病丸。
当归 川芎 芍药 桂心 牡丹皮 蓬莪术（各半两） 人参 甘草 牛膝（各一两）
上 咀，每服五钱，水一盏半，去渣温服。
桂枝桃仁汤方（见调经。）
牡丹皮散 治妇人月水不利，脐腹疼痛。
牡丹皮 大黄（炒。各一两） 赤芍药 生地黄 桃仁 当归 桂心 赤茯苓 白术（各七钱半）
石苇（去毛） 木香（各半两）
上 咀，每服五钱，水一盏半，生姜三片，煎至七分，去渣，空心温服。
〔《本》〕治妇人室女月候不通，疼痛或成血瘕，通经丸。
桂心 青皮（去白） 大黄（炮） 干姜 川椒 川乌 蓬莪术 干漆 当归 桃仁（各等分）
上为末，先将四钱用米醋熬成膏，和余六钱末成剂臼中杵，丸如桐子大，晒干。每服二十丸，
用淡醋汤下，加至三十丸，温酒亦得，空心，食前服。
上方六首，皆治污血有寒而经闭。前四方轻剂，后二方重剂也。
〔《大》〕治月水不通，屡试有验。浓朴不以多少，姜汁炙香，细切，浓煎去渣，空心服，不
过三四剂瘥。（形实气盛者宜之。）
〔丹〕积痰伤经不行，夜则妄语。
栝蒌子（一两） 黄连（半两） 吴茱萸（十两） 桃仁（五十个） 红曲（二钱） 缩砂（三两）
山楂末
上生姜研，炊饼为丸。
躯脂满，经闭，导痰汤加芎、连。不可服地黄，如用，姜汁炒。（导痰汤即二陈加枳实、
黄连是也。）
杨村妇人，年二十余，两年经闭，食少，乏力。
黄连（二两） 白术（一钱半） 陈皮 滑石（各一钱） 黄芩（半两） 木通（三分） 桃仁（十二个）
甘草（炙些）
上丹溪治痰结胸腹而经闭之法，皆用轻剂导痰降火也。
经云∶气上迫肺，则心气不得下通，故月事不来，今用连、朴之类导痰降火，使不上迫于肺，故心气下通
而月事来也。丹溪治一妇人，久疟食少，经闭，两手无脉。每日与三花神佑丸十余粒，津咽之。月余食进脉出，
又半月脉愈，又一月经行，亦此意也。详见久疟。予尝体丹溪之意，治陈氏妇，二十余岁，形肥痞塞不食，每
日卧至未牌，吃一盏薄粥，吃粥后必吐水半碗，仍复卧，经不通三月矣。前番曾暗通黑色，脉之辰时寸关滑，
皆有力，午后关滑寸不滑。询之因乘怒饮食而然。遂以白术一两半，浓朴、黄连、枳实各一两，半夏、茯苓、
陈皮、山楂、人参、滑石各八钱，缩砂、香附、桃仁各半两，红花二钱，分作十帖，每日服一帖，各入姜汁二
蚬壳。间三日以神佑丸、神秘沉香丸微下之，至十二日吐止，食渐进，四十日平复如故。又汪氏妇，五十余，
形瘦，亦痞不食，吐水，经不通，以前药方加参、术、归为君，煎熟，入竹沥半盏，姜汁服之，但不用神佑丸下，
亦平复。若咳嗽寒热而经闭者，当于咳门湿痰条求之。
〔子和〕凡妇人月事不来，用茶调散吐之，次用玉烛散、芎归汤、三和汤、桂苓白术散之类降心火，
益肾水，开胃进食，分阴阳利水道之药也。
一妇人月事不行，寒热往来，口干颊赤，饮食少，旦暮间咳一二声，诸医皆用虻虫、水蛭、干漆、 砂、
芫青、红娘子、没药、血竭之类，惟戴人不然。曰∶古方虽有此法，奈病患服之必脐腹发痛，饮食不进。乃命
止药，饮食稍进。《内经》曰∶二阳之病发心脾。心受之则血不流，故女子不月。既心受积热，宜抑火升
水，流湿润燥，开胃诱食。乃涌出痰一二升，下泄水五六行，湿水上下皆去，血气自然湍流，月事不为水
湿所隔，自根据期而至矣。亦不用虻虫、水蛭之类有毒之药，如用之，则月经总来，小溲反闭，他症生矣。凡
精血不足，宜补之以食，大忌有毒之药偏胜，而致夭阏多矣。
一妇人年三十四岁，经水不行，寒热往来，面色痿黄，唇焦颊赤，时咳三二声。问其所服之药，黑神散、
乌金丸、四物汤、烧肝散、鳖甲散、建中汤、宁肺散，针艾千百，转剧。家人意倦，不欲求治。戴人悯之，先
涌痰五六升，午前涌毕，午后食进，余症悉除。后三日复轻涌之，又去痰一二升，食益进，不数日又下通经散，
泻讫一二升，后数日，去死皮数重，小者如麸片，大者如苇膜。不一月经水自行，神气大康矣。
月事不来者，胞脉闭也。胞脉者，属心而络于胞中。今气上迫肺，心气不得下通，故月事不来也。（全
文见水肿胃病，见诊病息奔条。）
〔《大》〕室女月水不来。用雄鼠屎一两，烧存性，为细末，空心，温酒调下一钱，神效。
〔海〕掌中金丸 治妇人干血气。
穿山甲（炮） 甘草 苦丁香 川椒 苦葶苈 白附子 猪牙皂角 草乌头（各三钱）
巴豆（一钱，全用，研）
上为细末，生葱绞汁，和丸弹子大。每用一丸，新绵包之，内阴中，一日即白，二日即赤，三日
即血，神效。
〔仲〕妇人经水闭不利，脏坚癖不止，中有干血，下白物，矾石丸主之。
矾石（三钱，烧） 杏仁（一分）
上二味，末之，炼蜜丸枣核大，五内中，剧者再纳之。
〔《心》〕经脉不通，已有寒热，此穴大效。三阴交（三分，立有效。如疼时乃经脉要通也。）
Grind the herbs into a fine powder. Take two qian per dose, mixed with wine, taken on an empty stomach or before meals, three times daily. Remove Huangqin (Scutellariae Radix), add Guizhi (Cinnamon Twig) one liang.
[Maiching] Question: A woman in her fifties suddenly experiences non-menstrual bleeding (Qingxue) for two to three days without stopping. How should it be treated? The Master said: This woman previously ceased childbearing and her menses stopped. Now she has vaginal bleeding; this is called "Ju Jing" (menses occurring once every three months). No treatment is needed; it will stop spontaneously. If her menses usually last five days, they will heal in five days.
[Qianjin Fang] Irregular menstruation: Needle the Duxue point (located between the four toes of the foot; moxa three Zhu, this point is highly effective, determine the location during menstruation. Moxa three Zhu.)
[Dongyuan] Another method: Moxibustion on the blue veins at the white flesh margin below the medial malleolus, according to the patient's age (Sui Nian Zhuang).
[Jisheng Fang] Another method: Acupuncture at Zhongji (CV3), Sanyinjiao (SP6), Shenshu (BL23), Qihai (CV6).
[Qianjin Fang] For long-standing amenorrhea suddenly followed by severe metrorrhagia, then cessation, followed again by heavy and irregular bleeding: Needle Fenglong (ST40) (depth six fen, stops bleeding.) Shimen (CV5) (depth five fen, unblocks menses.)
For a woman aged fifty whose menses have stopped and then restarted, with varying amounts, either stasis or bright red blood, accompanied by abdominal fullness as if pregnant: Needle Tianshu (ST25), Zhongwan (CV12), Qihai (CV6) (each depth five fen, immediate cure.)
[Jiayi Jing] For women with metrorrhagia, obstruction of foul blood, rebellious Qi causing distension, Xuehai (SP10) governs. For women with uterine pain and menses not stopping at the proper time, Tianshu (ST25) governs. (Qianjin records abdominal distension, borborygmus, Qi rushing up to the chest.) For lower abdominal distension and pain radiating to the vulva, lumbar and spinal pain upon menstruation, uterine masses, cold at the Zi Men (cervix) radiating to the patella and thigh, Shuidao (ST28) governs. (Qianjin records "radiating to patella and thigh" as "obstipation and urinary retention".)
[Zhu Danxi] For amenorrhea due to Blood deficiency (Xue Ku), use Siwu Tang (Four Substances Decoction) plus Taoren (Persicae Semen) and Honghua (Carthami Flos). For Yin deficiency with long-standing meridian obstruction, scanty and painful urination, and body ache, use Siwu Tang plus Cangzhu (Atractylodis Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Chenpi (Citri Reticulatae Pericarpium), and Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), decocted as a soup. Additionally, use Cangsha Wan (Cangsha Pill) plus Cang'erzi (Xanthii Fructus) and Jiubaoyao (Wine-processed Polygoni Multiflori Radix) as pills, taken while decocting the previous medicine.
This is Danxi's general method for treating amenorrhea due to Blood deficiency.
[Li Dongyuan] There are three types of amenorrhea, supplementing previous knowledge. Women with long-term Spleen and Stomach deficiency, emaciation, and depletion of Qi and Blood may experience cessation of menses. Or, suffering from Xiao Ke (Wasting and Thirsting syndrome, characterized by gastric heat and polyphagia), they become progressively thinner with no generation of Body Fluids. Menses are transformed from Blood vessels and Body Fluids; when Body Fluids are exhausted and scorched by Heat, muscles waste away, thirst and dryness occur, and the Sea of Blood becomes depleted. This disease is named "Blood Deficiency Amenorrhea." One should drain the dryness and heat of the Stomach and tonify Qi and Blood, and menses will flow naturally. In such cases, conception may occur during menstruation, leading to unstable pregnancy or fetal disease. (This is due to Heat accumulation in the Middle Jiao/Stomach.)
If the Pericardium pulse is surging and rapid, with irritability, constipation, clear but difficult urination, and amenorrhea, this is dryness of the Sea of Blood. One should regulate the Blood vessels, eliminate Fire pathogenic factors in the Pericardium, and menses will flow naturally. (This is due to Heat accumulation in the Lower Jiao/Uterine vessels.)
Or, due to mental overwork, Heart Fire flares upward, causing amenorrhea because the Uterine vessels are blocked. The Uterine vessels belong to the Heart and connect to the uterus. Now, Qi presses upward against the Lung, preventing Heart Qi from descending, thus causing amenorrhea. One should calm the mind, tonify Blood, and drain Fire, and menses will flow naturally. (This is due to Heat accumulation in the Upper Jiao/Heart, Liver, and Lung.)
The wife of Pei Zezhi suffered from alternating chills and fever, with amenorrhea for several years, compounded by wheezing and coughing. Physicians prescribed Gejie (Gecko), Guizhi (Cinnamon Twig), and Fuzi (Aconiti Lateralis Radix Praeparata). I said: Incorrect. The patient suffers from Yin deficiency attacked by Yang pathogens. Excessive warm tonics are harmful; cool agents should be used. Cool-Blood and harmonize-Blood medicines will work. It proved correct.
[Zhang Jiegu] For women with amenorrhea, first drain Heart Fire, and Blood will descend. The Neijing states: Diseases of the Two Yang (Stomach and Large Intestine) originate in the Heart and Spleen. Due to hidden grievances, women do not menstruate, transforming into Feng Xiao (Wind Wasting). Wang Bing notes: Heat in the intestines and stomach affects the Heart and Spleen. The Heart governs Blood; Heart disease causes Blood stagnation. The Spleen governs taste; Spleen disease causes failure to transform flavors. Failure to transform flavors leads to insufficient Essence, hence the inability to resolve hidden grievances. With Spleen Earth depleted, Wind pathogens prevail, further consuming Qi. Also, the classics state: Amenorrhea is due to blocked Uterine vessels. These vessels belong to the Heart and connect to the uterus. Qi pressing on the Lung prevents Heart Qi from descending, causing amenorrhea. First administer formulas to drain Heart Fire, then Wu Bu Wan (Five Tonics Pill) from the Ju Fang, followed by Weisheng Tang (Health Preservation Decoction) to treat the Spleen and nourish Blood.
[Taihui Heji Ju Fang] Wu Bu Wan (Five Tonics Pill) tonifies various deficiencies, calms the Five Zang organs, strengthens bones and marrow, and nourishes Spirit.
Shu Dihuang (Prepared Rehmanniae Radix), Ren Shen (Ginseng Radix), Niuxi (Achyranthis Bidentatae Radix - soaked in wine, remove radicle, dry), Bai Fuling (Poria), Digupi (Lycii Cortex). Equal parts.
Grind into fine powder, mix with refined honey to make pills the size of paulownia seeds. Take 30-50 pills per dose with warm wine on an empty stomach.
Weisheng Tang
Danggui (Angelicae Sinensis Radix), Baishaoyao (White Paeoniae Radix) (each two liang), Huangqi (Astragali Radix) (three liang), Gancao (Glycyrrhizae Radix et Rhizoma) (one liang).
Grind into coarse powder. Take half a liang per dose, add two cups of water, decoct to one cup, take warm on an empty stomach. For deficiency, add Ren Shen (Ginseng Radix) one liang.
Above are Dongyuan and Jiegu's methods for treating Blood deficiency, both emphasizing tonifying Blood and draining Fire. Tonifying Blood uses formulas like Siwu Tang. Draining Fire is divided by Dongyuan into Upper, Middle, and Lower Jiao. Fire in the Middle Jiao causes polyphagia and thirst, treated with Tiaowei Chengqi Tang (Regulate the Stomach and Order the Great Yellow Decoction). Fire in the Lower Jiao causes constipation and urinary difficulty, treated with Yuzhu San (Jade Candle Powder), which consists of equal parts Siwu Tang and Tiaowei Chengqi Tang. Fire in the Upper Jiao results from mental overwork, treated with Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Sanhe Tang (Three Harmonies Decoction), composed of equal parts Siwu Tang, Liangge San (Cool the Chest Powder), and Danggui. Jiegu's initial use of Heart Fire-draining agents refers to Huangqin, Huanglian, Sanhe Tang, or Yuzhu San. His subsequent use of Wu Bu Wan and Weisheng Tang refers to Qi-tonifying agents.
[Suwen] The Emperor asked: There is a disease with fullness and support in the chest and hypochondrium, interfering with eating. Upon onset, the patient smells fishy and rank odors, secretes clear fluid, expectorates blood, feels cold limbs, dizziness, and frequent bleeding from the anterior and posterior orifices. What is the name of this disease? How is it contracted? Qibo answered: The disease is named Blood Deficiency (Xue Ku). It arises from massive blood loss in youth, or sexual intercourse while drunk, exhausting Qi and injuring the Liver, leading to scanty or absent menses. The Emperor asked: How to treat it? Qibo answered: Use four parts Ougu (Sepiae Endoconcha) and one part Qubai (Rubia Cordifoliae Radix), combined and formed into pills using quail eggs, the size of small beans. Take five pills as a post-meal dose, drinking cuttlefish soup to benefit the intestines and injured Liver. (Abdominal Discussions, Wang Bing note: Sepiae Endoconcha treats blood obstruction; Rubia Cordifoliae Radix disperses foul blood; quail egg treats blood atrophy; cuttlefish soup treats blood stasis. Hejian's Xuanning Lunfang uses equal parts Ougu and Qubai, quail eggs as needed, pill size of small beans, 5-10 pills per dose with decocted cuttlefish soup, three times daily after meals, accompanied by good diet.)
These are Qibo and Hejian's methods for treating Blood Deficiency.
[Maiching] Question: A woman suffers from diarrhea but her menses unexpectedly cease. Why? The Master said: Only stop the diarrhea, and menses will return naturally; do not be surprised. The reason diarrhea persists while blood ceases is the loss of Body Fluids through diarrhea, causing amenorrhea. When diarrhea stops and Body Fluids recover, menses will likely return. Question: A woman's menses cease for one or two months, yet she suddenly bleeds, and her pulse is faint and choppy. Why? The Master said: This was due to diarrhea earlier in the month, which interfered with menstruation. Once diarrhea stops, menses should return naturally; this is not a serious constitutional defect. If a woman has vaginal bleeding, dry throat but no thirst, her menses must cease. This is due to insufficient Ying (Nutritive) Blood and inherent mild Cold, so she does not crave fluids. If she is thirsty and drinks, Body Fluids circulate, Ying and Wei (Defensive) harmonize, and her menses will likely return.
[Zhang Zhongjing] Women's diseases, caused by deficiency, accumulated cold, and constrained Qi, lead to cessation of all menstrual cycles, sometimes lasting years. Cold Blood accumulates, injuring the Bao Men (uterine gate), causing meridians to congeal and harden. If located above, chronic vomiting of saliva/phlegm may lead to Lung Abscess and physical deterioration. If located in the middle, knots form around the umbilicus causing Han Shan (Cold Colic), or pain in both hypochondria connecting to internal organs, or Heat knotting in the center affecting Guan Yuan (CV4), with rapid pulse but no ulcer, skin resembling fish scales, affecting men as well as women. If located below, menses are irregular, causing pulling pain in the yin, cold sensation in the lower abdomen, radiating to the waist and spine, originating from Qichong (ST30), causing urgent pain in Qichong, painful knees and calves, sudden vertigo and blackout resembling syncope or mania, or sorrow, grief, and anger. All these are Dai Xia (Leukorrhea), not ghost possession. Long-term, the body becomes emaciated, pulse is deficient and cold. The Thirty-Six Diseases change endlessly. Examine pulses for Yin/Yang, Deficiency/Excess, Tight/String-like. Apply acupuncture and medicine to save the critical and restore peace. Though diseases may be similar, pulse origins differ; you must distinguish and record them.
[Zhu Danxi] For delayed or absent menses, crush Du Niuxi (Cyathulae Radix) to extract half a cup of juice, mix with one qian of Xuanhusu (Cyperus Rotundus Rhizoma) powder, half a qian of Xiangfu (Cyperii Rhizoma) powder, and half a qian of Zhike (Aurantii Fructus) powder. Take mixed in the morning.
[Taisheng Huifang] Wanbing Wan (Ten Thousand Disease Pill) treats amenorrhea and peri-umbilical pain.
Ganqi (Drynariae Rhizoma - crushed, stir-fried until smoke ceases), Niuxi (Achyranthis Bidentatae Radix - remove sprouts, soak in wine overnight, dry, one liang).
Grind into powder. Add one sheng of fresh Shengdihuang (Rehmanniae Radix) juice. Place herbs and juice in a silver vessel. Slowly boil until pillable. Form pills the size of paulownia seeds. Take two pills on an empty stomach with rice drink or warm wine.
Treats difficult menstruation, oppression under the umbilicus, Qi distension, nausea, insomnia. (Bie means urgent.)
Danggui (Angelicae Sinensis Radix) (four qian), Ganqi (Drynariae Rhizoma) (three qian, stir-fried until smoke ceases).
Grind into powder. Mix with refined honey to make pills the size of paulownia seeds. Take fifteen pills on an empty stomach with warm wine.
Treats menstrual stagnation and peri-umbilical pain.
Danggui (Angelicae Sinensis Radix), Xuanhusu (Cyperus Rotundus Rhizoma).
Grind into coarse powder. Take three qian per dose with three slices of ginger and one and a half zhong of water. Decoct to seven tenths, strain, and take slightly warm.
Small Intestine Heat transferring to the Large Intestine causes Fu Xia (latent mass) and Chen (sinking). (Full text in Diagnosis of Disease Transmission. Wang Bing note: Sluggish Blood flow causes menstrual stagnation and absence.)
[Shengji Zonglu] Treats women with sluggish, difficult menstruation forming masses, muscle swelling nearing death. Use five jin of Ma Bian Cao (Verbena officinalis herb and stem), finely chopped. Add five dou of water, decoct to one dou. Strain. Boil the filtrate in a clean vessel until it becomes a paste. Take half a spoonful with warm wine before meals. (Bencao states: Ma Bian Cao is pungent and cool, breaks Blood masses.)
[Luo Qianfu] Xue Ji Gao (Blood Extremity Paste) treats Dry Blood Qi in women.
Grind Chuan Dahuang (Rhei Radix et Rhizoma) into powder. Boil with strong vinegar until it forms a paste. Form pills the size of a chicken head. Take one pill per dose, dissolved in hot wine, taken warm before bed. After one or two bowel movements, red menses will flow naturally. It is a miraculous drug for women; add Danggui (Angelicae Sinensis Radix) head.
[Zhang Zhongjing] For women with difficult menstruation, Didang Tang (Greatly Resolving Blood Decoction) is the primary formula. (Also treats men with bladder fullness/urgency due to Blood stasis. Formula seen in Shanghan Lun.)
The above section contains three formulas, all treating amenorrhea due to foul Blood with Heat. The first is a light agent; the latter two are heavy agents.
[Yun Qizi] Honghua Danggui San (Safflower and Angelica Powder) treats women with absent menses, accumulated Blood stasis, waist and abdominal pain, and virgin amenorrhea.
Honghua (Carthami Flos), Dangguiwei (Angelicae Sinensis Radix Tail), Ziwei (Campsis grandiflora flower), Niuxi (Achyranthis Bidentatae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Sumu (Daemonorops Spatha) (finely chopped. Each two liang), Baizhi (Angelicae Dahuricae Radix) (one and a half liang), Chi Shaoyao (Red Paeoniae Radix) (eight liang), Liu Jinu (Artemisiae Annuae Herba) (five liang), Guixin (Cinnamomi Cortex) (one and a half liang).
Grind into fine powder. Take three qian mixed with hot wine on an empty stomach. Take again before meals and before bed. For long-standing Blood stasis, decoct Honghua strongly and take with wine. Pregnant women should not take.
Niuxi San (Achyranthes Powder) treats women with difficult menstruation and peri-umbilical pain.
Niuxi (Achyranthis Bidentatae Radix) (one liang), Guixin (Cinnamomi Cortex), Chi Shaoyao (Red Paeoniae Radix), Taoren (Persicae Semen), Xuanhusu (Cyperus Rotundus Rhizoma), Danggui (Angelicae Sinensis Radix), Mudanpi (Moutan Cortex), Chuanxiong (Ligustici Chuanxiong Rhizoma), Muxiang (Aucklandiae Radix) (each seven and a half qian).
Take one fang cun bi per dose as a very fine powder, mixed with warm wine, before meals.
Wen Jing Tang (Warm the Meridians Decoction) For blocked menstruation, cold pain around the umbilicus, and deep-tight pulse, use this along with Guizhi Tao Ren Tang (Cinnamon Twig and Peach Kernel Decoction) and Wanbing Wan.
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix), Guixin (Cinnamomi Cortex), Mudanpi (Moutan Cortex), Peng Ezhu (Curcumae Phaeocaulis Rhizoma) (each half liang), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Niuxi (Achyranthis Bidentatae Radix) (each one liang).
Chop. Take five qian per dose, add one and a half cups of water, strain, and take warm.
Guizhi Tao Ren Tang Formula (See Regulation of Menses).
Mudanpi San (Moutan Powder) treats women with difficult menstruation and peri-umbilical pain.
Mudanpi (Moutan Cortex), Dahuang (Rhei Radix et Rhizoma - stir-fried. Each one liang), Chi Shaoyao (Red Paeoniae Radix), Shengdihuang (Rehmanniae Radix), Taoren (Persicae Semen), Danggui (Angelicae Sinensis Radix), Guixin (Cinnamomi Cortex), Chi Fuling (Poria with Red Wood), Baizhu (Atractylodis Macrocephalae Rhizoma) (each seven and a half qian), Shiwei (Pyri Folium - remove hairs), Muxiang (Aucklandiae Radix) (each half liang).
Chop. Take five qian per dose, add one and a half cups of water and three slices of ginger. Decoct to seven tenths, strain, and take warm on an empty stomach.
[Bencao Gangmu] Treats virgin amenorrhea, pain, or formation of Blood masses, Tongjing Wan (Unblock Menses Pill).
Guixin (Cinnamomi Cortex), Qingpi (Citri Reticulatae Pericarpium Viride - remove white pith), Dahuang (Rhei Radix et Rhizoma - processed), Ganjiang (Zingiberis Rhizoma), Chuanjiao (Sichuan Pepper), Chuanwu (Aconiti Radix), Peng Ezhu (Curcumae Phaeocaulis Rhizoma), Ganqi (Drynariae Rhizoma), Danggui (Angelicae Sinensis Radix), Taoren (Persicae Semen) (equal parts).
Grind into powder. First, boil four qian with rice vinegar until it forms a paste. Mix with the remaining six qian of powder in a mortar. Form pills the size of paulownia seeds, dry in the sun. Take twenty pills per dose with light vinegar water; increase to thirty pills. Warm wine is also acceptable. Take on an empty stomach before meals.
The above six formulas all treat amenorrhea due to Cold Blood. The first four are light agents; the last two are heavy agents.
[Taisheng Huifang] Treats amenorrhea, tested with success. Use Houpo (Magnoliae Officinalis Cortex) as needed, roast with ginger juice until fragrant, cut finely. Decoct strongly, strain, and take on an empty stomach. Not more than three doses for recovery. (Suitable for those with robust constitution and abundant Qi.)
[Zhu Danxi] Accumulated Phlegm damaging the meridians causes absent menses and delirium at night.
Gualouzi (Trichosanthis Semen), Huanglian (Coptidis Rhizoma) (half liang), Wuzhuyu (Evodiae Fructus) (ten liang), Taoren (Persicae Semen) (fifty kernels), Hongqu (Red Yeast Rice) (two qian), Suosha (Amomi Fructus Rotundus) (three liang), Shanzha (Crataegi Fructus) powder.
Grind with fresh ginger, mix with steamed dough to form pills.
Body fat accumulation and amenorrhea: Daotan Tang (Drain Phlegm Decoction) plus Chuanxiong (Ligustici Chuanxiong Rhizoma) and Huanglian (Coptidis Rhizoma). Do not use Shudihuang (Prepared Rehmanniae Radix); if used, process with ginger juice. (Daotan Tang is Erchen Tang plus Zhishi (Aurantii Fructus) and Huanglian.)
Woman from Yang Village, over twenty years old, amenorrhea for two years, poor appetite, fatigue.
Huanglian (Coptidis Rhizoma) (two liang), Baizhu (Atractylodis Macrocephalae Rhizoma) (one and a half qian), Chenpi (Citri Reticulatae Pericarpium), Huashi (Halloysitum Rubrum) (each one qian), Huangqin (Scutellariae Radix) (half liang), Mutong (Akebiae Caulis) (three fen), Taoren (Persicae Semen) (twelve kernels), Gancao (Glycyrrhizae Radix et Rhizoma - roasted slightly).
These are Danxi's methods for treating amenorrhea due to Phlegm knotting in the chest and abdomen, using light agents to drain Phlegm and reduce Fire.
The Classics state: Qi pressing on the Lung prevents Heart Qi from descending, causing amenorrhea. Now, using Lian (Huanglian) and Po (Houpo) to drain Phlegm and reduce Fire prevents Qi from pressing on the Lung, allowing Heart Qi to descend and menses to return. Danxi treated a woman with chronic malaria, poor appetite, amenorrhea, and absent radial pulses. He gave her Shenhua Shenyao Wan (Divine Protection Pill) ten-plus pills daily to swallow with saliva. After a month, appetite improved and pulses appeared. After another half month, pulses strengthened. After another month, menses returned. This follows the same principle. See Chronic Malaria. I once applied Danxi's intent to treat Mrs. Chen, over twenty, obese with epigastric fullness and anorexia, sleeping until late afternoon, eating a bowl of thin porridge, vomiting half a bowl of water afterward, then sleeping again. Amenorrhea for three months. Previously had dark discharge. Pulse at Chen hour: Cun and Guan were slippery and forceful; at afternoon, Guan was slippery but Cun was not. Inquiry revealed this resulted from eating while angry. Prescribed Baizhu (one and a half liang), Houpo (one liang), Huanglian (one liang), Zhishi (one liang), Banxia (Pinelliae Rhizoma) (eight qian), Fuling (Poria) (eight qian), Chenpi (Citri Reticulatae Pericarpium) (eight qian), Shanzha (Crataegi Fructus) (eight qian), Renshen (Ginseng Radix) (eight qian), Huashi (Halloysitum Rubrum) (eight qian), Suosha (Amomi Fructus Rotundus) (half liang), Xiangfu (Cyperii Rhizoma) (half liang), Taoren (Persicae Semen) (half liang), Honghua (Carthami Flos) (two qian). Divide into ten doses, one per day, each with two clam shells of ginger juice. Every three days, mildly purge with Shenyao Wan and Shenmi Chenxiang Wan. By day twelve, vomiting stopped, appetite gradually improved. By day forty, fully recovered. Mrs. Wang, over fifty, emaciated, also with epigastric fullness, anorexia, vomiting water, and amenorrhea. Used the previous formula with Renshen, Baizhu, and Danggui as chief ingredients, decocted, added half a cup of Zhuli (Bambusa Textilis Sap), and ginger juice. Did not use Shenyao Wan for purging. Also recovered. For amenorrhea with cough and chills/fever, seek guidance in the Cough section under Wet Phlegm.
[Zhang Zihe] For women with amenorrhea, induce vomiting with Chatiao San (Tea-Regulating Powder). Then use Yuzhu San (Jade Candle Powder), Xiong Gui Tang (Szechuan Lovage and Angelica Decoction), Sanhe Tang (Three Harmonies Decoction), Guiling Baizhu San (Cinnamon, Poria, and Atractylodes Powder) to drain Heart Fire, tonify Kidney Water, open the Stomach, promote appetite, differentiate Yin and Yang, and benefit water pathways.
A woman with amenorrhea, alternating chills and fever, dry mouth, red cheeks, poor appetite, occasional cough morning and evening. Physicians used Mengchong (Blue Bottle Fly), Shuizhi (Hirudo), Ganqi (Drynariae Rhizoma), Naoshan (Sal Ammoniac), Yuanqing (Mylabris), Hongniangzi (Lytta), Moyao (Myrrha), Xuejie (Dragon's Blood). Only Dai Ren disagreed. He said: Although ancient formulas use these, patients taking them inevitably suffer abdominal pain and loss of appetite. He ordered cessation of medication, and appetite slightly improved. The Neijing states: Diseases of the Two Yang originate in the Heart and Spleen. Heart involvement causes Blood stagnation, hence female amenorrhea. Since the Heart has accumulated Heat, one should suppress Fire, raise Water, moisten dryness, open the Stomach, and encourage eating. He induced vomiting of one to two sheng of Phlegm and purged five to six stools of water. Dampness and Water were removed from above and below. Qi and Blood flowed naturally. Unobstructed by Dampness, menses arrived on schedule. He did not use toxic drugs like Mengchong or Shuizhi. Using them would cause constant bleeding, urinary retention, and other symptoms. For insufficient Essence and Blood, food tonification is appropriate. Strongly avoid toxic drugs that dominate, causing premature death.
A thirty-four-year-old woman with amenorrhea, alternating chills and fever, sallow complexion, cracked lips, red cheeks, occasional cough. She had taken Heishen San (Black Divine Powder), Wujin Wan (Black Gold Pill), Siwu Tang (Four Substances Decoction), Shaogan San (Roasted Liver Powder), Biejia San (Turtle Shell Powder), Jianzhong Tang (Establish the Middle Decoction), Ningfei San (Calming Lung Powder), and undergone thousands of acupuncture and moxibustion sessions, worsening condition. Family was weary and refused treatment. Dai Ren pitied her. First, he induced vomiting of five to six sheng of Phlegm. By noon, vomiting finished; by afternoon, appetite returned; other symptoms resolved. Three days later, he lightly induced vomiting again, removing one to two sheng of Phlegm. Appetite increased. Within days, he administered Tongjing San (Unblock Menses Powder), purging one to two sheng. Days later, several layers of dead skin peeled off, small pieces like bran, large pieces like reed membranes. Within a month, menses returned spontaneously, and vitality greatly recovered.
Amenorrhea is due to blocked Uterine vessels. The Uterine vessels belong to the Heart and connect to the uterus. Qi pressing on the Lung prevents Heart Qi from descending, causing amenorrhea. (Full text in Edema and Stomach Disease, see Diagnosis of Breathlessness.)
[Taisheng Huifang] Virgin amenorrhea. Use one liang of male rat feces, calcined to retain properties, ground into fine powder. Take one qian mixed with warm wine on an empty stomach. Miraculous effect.
[Wang Haizang] Zhangzhong Jin Wan (Palm Golden Pill) treats Dry Blood Qi in women.
Chuanshanjia (Manis Squama - processed), Gancao (Glycyrrhizae Radix et Rhizoma), Kudingxiang (Euodiae Fructus), Chuanjiao (Sichuan Pepper), Kutingli (Descurainiae Semen Lepidii Semen), Baifu Zi (Atractylodis Lanceae Rhizoma), Zhuyazaojiao (Gleditsiae Sinensis Spina), Caowutou (Aconiti Radix) (each three qian), Badou (Crotonis Fructus) (one qian, whole, ground).
Grind into fine powder. Mix with juice squeezed from fresh scallions. Form pills the size of a bullet. Take one pill per dose, wrapped in new cotton, inserted into the vagina. White discharge on day one, red on day two, blood on day three. Miraculous effect.
[Zhang Zhongjing] For women with amenorrhea, hard masses persisting, dry Blood inside, and leukorrhea, Fanshi Wan (Alum Pill) is primary.
Fanshi (Alumen - calcined) (three qian), Xingren (Pruni Armeniaci Semen) (one fen).
Grind the two ingredients into powder. Mix with refined honey to make pills the size of a jujube pit. Insert into the vagina. For severe cases, re-insert.
[Qianjin Fang] For blocked meridians with existing chills and fever, this point is highly effective. Sanyinjiao (SP6) (depth three fen, immediate effect. Pain indicates the meridian needs to be unblocked.)