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Treats metrorrhagia (uterine bleeding) in women.

Bai Zhu (Atractylodis Rhizoma, one tael, stir-fried), Sheng Huang Qi (Astragali Radix, six qian), Long Gu (Fossilized Bones, eight qian, crushed into fine powder), Mu Li (Oyster Shell, eight qian, crushed into fine powder), Yu Rou (Corni Fructus, eight qian, pits removed completely),
Sheng Bai Shao (Paeoniae Radix Alba, four qian), Hai Piao Xiao (Cuttlefish Bone, four qian, crushed into fine powder), Qian Cao (Rubiae Cordifoliae Radix et Rhizoma, three qian), Zong Bian Tan (Livistonae Folii Carbonisatum, two qian), Wu Bei Zi (Galla Chinensis, five fen, ground into fine powder, taken with herbal decoction).
If the pulse indicates heat, add Sheng Di Huang (Rehmanniae Radix, one tael); if the pulse indicates cold, add Wu Tou (Aconiti Lateralis Radix Preparata) and Fu Zi (Aconiti Lateralis Radix Preparata), each two qian; if metrorrhagia is caused by liver qi rushing upward after severe anger, add Chai Hu (Bupleuri Radix, two qian). If not cured after two doses, remove Zong Bian Tan and add Zhen E Jiao (Asini Corii Colla, five qian), stewed separately and mixed for administration. If the patient feels hot after taking the medicine, adjust the dosage of Sheng Di Huang accordingly.

In previous prescriptions, both Long Gu and Mu Li were used raw; the rationale has been detailed under the discussion of Li Chong Wan. This prescription exclusively uses calcined forms because calcination enhances their astringent power, aiming to achieve immediate hemostatic effects.

A woman, over thirty years old, suddenly experienced vaginal bleeding that persisted for two days. When I examined her, she was unconscious and unresponsive, with a cold body and a faint, slow pulse. I determined that both qi and blood were about to collapse, and primordial yang was also collapsing. I urgently prescribed this decoction, removing Bai Shao and adding Ye Tai Shen (Codonopsis Radix, eight qian) and Wu Tou (Aconiti Lateralis Radix Preparata) and Fu Zi (Aconiti Lateralis Radix Preparata), each three qian. After one dose, the bleeding stopped, her body became warm, and her spirit recovered. Subsequently, Bai Shao was added back, and another dose was administered to consolidate the treatment.

My son, Zhang XX, once treated a woman, around forty years old. She suddenly suffered from severe vaginal bleeding. Within half a day, her breathing was weak, and she lost consciousness. Her right Cun and Guan pulses were faintly palpable, resembling floating hemp seeds on water, indistinguishable in rate, while the left pulses were imperceptible. I urgently prescribed Sheng Huang Qi (Astragali Radix, one tael), boiled vigorously for a few minutes, and administered it orally. All six pulses became palpable. However, they remained extremely thin and fine, and the bleeding continued. Observing her condition, her exhalation seemed unable to exit fully, and she frequently felt the urge to defecate. I diagnosed this as sinking of the Great Qi (Da Qi). I prescribed Gu Chong Tang, increasing the dosage of Huang Qi (Astragali Radix) to one tael. She took the medicine at 11:00 AM and was completely recovered by 3:00 PM. (Later, when Zhang XX practiced in Beijing, he treated another case of metrorrhagia. The initial Gu Chong Tang was ineffective, but adding Chai Hu (Bupleuri Radix, two qian) cured it in one dose. This demonstrates that Chai Hu's ascending and lifting properties make it an essential herb for treating metrorrhagia.)

Someone asked: Metrorrhagia is often caused by sudden anger leading to liver qi stagnation. Unable to ascend, the liver qi rushes downward, impacting the Kidney gate, causing menstrual blood to flow down. Thus, this condition is commonly called "Qi Chong" (Qi Rushing). This prescription uses many astringent and tonifying herbs. Are you not worried that it might hinder patients with liver qi stagnation? I replied: Although some cases are caused by anger-induced qi rushing, after massive blood loss, blood collapse leads to qi collapse. Consequently, the previously stagnant liver qi may naturally resolve due to this state. Moreover, in acute conditions, we treat the symptoms first. This is indeed a critical emergency. If the condition is in its early stages, not severe, and clearly caused by liver qi rushing downward, one can primarily use herbs that lift the liver and regulate qi, assisted by herbs that astringe and tonify the lower origin.

[Attached Prescription] *Fu Qingzhu Nüke* contains a prescription for metrorrhagia in elderly women, which has proven very effective. It uses Sheng Huang Qi (Astragali Radix, one tael), Dang Gui (Angelicae Sinensis Radix, one tael, washed with wine), Sang Ye (Mori Folium, fourteen leaves), and San Qi (Notoginseng Radix et Rhizoma powder, three qian, taken with herbal decoction). Boil in water and take orally. Bleeding stops after two doses and does not recur after four doses. If heat is felt, add Sheng Di Huang (Rehmanniae Radix, approximately one tael).

Additionally: A friend from Zhucheng, Wang XX, passed down a secret prescription for metrorrhagia. Use fresh green radish, crush and extract the juice, add several spoons of white sugar, warm gently over low fire, and drink continuously until three large cups are consumed. It will surely cure the condition.

Additionally: In Western medicine, Ergot (Claviceps purpurea), small horns growing on moldy wheat, has strong vascular astringent properties and can treat all types of hemorrhage, especially effective for lower bleeding. The largest ergot grains are nearly one cun long. Take one grain, grind it finely with lactose (or white sucrose if lactose is unavailable), and divide into two doses. I often administer it together with hemostatic herbs, achieving rapid results.

Attachment: Two herbal remedies for female metrorrhagia
One is a perennial herb. One root produces several stems, less than one chi high. Leaves resemble Chenopodium leaves, slightly wider, denser foliage doubles the volume. Color is green with a bluish tint. Small white flowers bloom in early summer. Fruits resemble wild pears, same color as leaves, turning slightly yellow when mature. Grows mostly on hard soil near houses or roadsides. Commonly called "HT Niu Dan," also known as Chou Ke Zi, though it actually has no odor. I initially did not know it could be used medicinally. In early summer of the Wuchen year, I returned to my hometown due to family matters. Mrs. Wang from South Gate suffered from metrorrhagia, unresponsive to medication. Someone advised using this herb, including roots and fruits, chopped and boiled into a decoction. The illness was instantly cured. Later, when I mentioned this formula in Tianjin, my student Li XX said, "I have always known this formula. Adding a handful of Hei Dou (Soybean) and boiling with equal parts water and wine makes it even more effective."

The other is an annual herb. Stems are over one chi high. Leaves are round with pointed tips, deep green. Small white flowers with five petals and yellow stamens bloom in late summer. Fruits are as large as Schisandra berries, shaped like small eggplants. Green when tender, red when ripe, purple-black when old. Contains sweet pulp edible. Commonly named Ye Qie Zi (Wild Eggplant), or Shan Qie Zi in mountainous areas. Doctors in Fengtian Province often collect and shade-dry this herb for reserve. In cases of metrorrhagia, chopping stems, leaves, and fruits together and boiling into a decoction brings immediate cure. In Tianjin, I discussed this herb with friend Zhang XX, who identified it as Long Kui (Solanum nigrum) from *Bencao Gangmu*, also known as Tian Qie Zi or Lao Ya Jing Cao. However, checking *Bencao Gangmu*, Long Kui is recorded for treating persistent hematemesis, not metrorrhagia. Nevertheless, herbs treating hematemesis often also treat lower bleeding, as seen with San Qi (Notoginseng Radix et Rhizoma) and Qian Cao (Rubiae Cordifoliae Radix et Rhizoma). That a common weed can treat such a severe disease is truly precious.

Appendix:
Letter from Zhang XX of Qing County, Zhili:
My clan sister, married to surnamed Xu, over thirty years old. Suffered miscarriage ten days ago. Suddenly experienced heavy vaginal bleeding, dizziness, abdominal distension, and a small, weak pulse. Diagnosed as slipping of the Chong Mai (Penetrating Vessel). Prescribed Gu Chong Tang, adding Chai Hu (Bupleuri Radix, half qian) and Dang Gui Shen (Angelicae Sinensis Radix, two qian). Bleeding stopped after three doses. Advised continuing with Kun Shun Zhi Bao Dan for recovery.

Letter from Li XX of Yanshan, Zhili:
Wife of Zhao XX from Tianjin, over forty years old. Menstruation overdue and continuous, unresponsive to various treatments. Consulted my younger brother. Both radial pulses were faint, thin, and weak. Prescribed the original Gu Chong Tang. Complete recovery after several doses. Given her age and blood deficiency, I assumed fertility would cease. Unexpectedly, she gave birth to a healthy child over a year later. This confirms Gu Chong Tang's ability to stop bleeding and tonify blood.

Additionally: Wife of Zhang XX from Tianjin, twenty-four years old. Continuous bleeding after spontaneous abortion for over a month, unresponsive to multiple treatments. Pulse was faint, thin, and rapid. Prescribed Gu Chong Tang, adding Sheng Di Huang (Rehmanniae Radix, one tael) due to the rapid pulse. Symptoms improved but did not resolve significantly. After reflection, I inquired about the cost of medicines and found them unusually cheap. Recalling rumors of fake Huang Qi (Astragali Radix) sold in local pharmacies, I suspected the inferior quality of the herb used. Switched to authentic Kou Huang Qi (Astragali Radix). Cured after two doses.
This proves that only genuine, geographically appropriate herbs are effective.