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To treat retrograde menstruation in women.

Gastrodiae Rhizoma (5 qian, with heart) [Note: Text says Gan Cun Dong, likely Gastrodia or Ophiopogon contextually, but strictly translating name] -> *Correction*: "Gan Cun Dong" usually refers to Ophiopogonis Radix (Maidong). I will use Ophiopogonis Radix.
Ophiopogonis Radix (5 qian, with heart)
Codonopsis Radix (4 qian) [Ye Tai Shen]
Pinelliae Rhizoma Preparatum (3 qian)
Dioscoreae Rhizoma (4 qian, used to replace Coicis Semen/Jing Mi)
Paeoniae Radix Alba (3 qian)
Salviae Miltiorrhizae Radix et Rhizoma (3 qian)
Glycyrrhizae Radix et Rhizoma (2 qian)
Persicae Semen (2 qian, with skin and tip, crushed)
Ziziphi Jujubae Fructus (3 pieces, split open)

Regarding the condition of retrograde menstruation in women, Chen Xiuyuan borrowed Mai Men Dong Tang from *Jin Gui Yao Lue* in his work *Nu Ke Yao Zhi*, which can be considered a unique insight. However, this formula originally treats "fire reversal causing upward qi and difficulty in the throat." Now, using it to treat retrograde menstruation requires slight modifications to match the pathology.

One might ask: The diseases treated by Mai Men Dong Tang in *Jin Gui Yao Lue* are vastly different from retrograde menstruation in women; how can it be borrowed effectively? The answer is: The Chong vessel is the sea of blood, located on both sides of the lower abdomen. Its meridian ascends to connect with the Yangming Stomach channel and descends to connect with the Shaoyin Kidney channel. If the Shaoyin Kidney is deficient, its Qi transformation cannot close and store to control the Chong Qi, making Chong Qi prone to invading upwards. If the Yangming Stomach is deficient, its Qi transformation cannot descend to pacify the Chong Qi, making Chong Qi also prone to invading upwards. Once the Qi within the Chong vessel invades upwards, the Blood within the Chong vessel naturally follows in reverse flow; this is the origin of retrograde menstruation. Mai Men Dong Tang, among herbs that greatly tonify Middle Qi to generate fluids, uses Ban Xia to descend Stomach Qi and pacify Chong Qi, and replaces Jing Mi with Shan Yao to tonify the Kidney and consolidate Chong Qi. Thus, the Qi within the Chong vessel settles in its original residence, and the Blood within the Chong vessel no longer reverses upwards but follows its normal pathway. Specifically, the reason menstrual blood goes upwards is not only due to Chong Qi invading upwards, but also because the downward path is obstructed. Observing that menstruation occurs upwards only when it is time for it to descend confirms this. Therefore, Shao Yao, Dan Shen, and Tao Ren are added to open the downward path, allowing menstruation to descend smoothly at the proper time without obstruction. Hence, this formula was not originally designed for treating retrograde menstruation; yet, with slight modifications, it is very effective for this condition, further叹 (sighing) at the boundless utility of classical formulas.

Using this formula to treat retrograde menstruation is generally effective, but occasionally ineffective cases occur due to concurrent conditions. I once treated an unmarried woman who had suffered from retrograde menstruation for over a year without cure. Her pulse was weak and thready. After administering this decoction, she felt significant shortness of breath upon taking the medicine. On re-examination, her pulse was even weaker and thready. She stated she had always suffered from shortness of breath, which had now worsened. It suddenly dawned on me that her Upper Jiao Great Qi (Da Qi) must have sunk, so it could not tolerate the descending action of Ban Xia. I then switched to my formulated Sheng Xian Tang, administered for ten doses. The shortness of breath resolved, and the retrograde menstruation also cured.

Another young woman suffered from retrograde menstruation for half a year without cure. Her pulse was weak, thready, and slow, with neither Cun position rising. She complained of subjective shortness of breath. Knowing her condition was also due to sinking of Upper Jiao Great Qi, I administered Sheng Xian Tang. After several doses, the shortness of breath immediately resolved. Her physique became stronger than before, so she stopped taking the medicine. Her menstruation then proceeded normally, and over ten months later, she gave birth to a son.

One might ask: Since retrograde menstruation results from the rebellion of Chong Qi and Stomach Qi, as well as the sinking of Great Qi, whose mechanisms of ascending and descending are opposite to this, why does one still suffer from retrograde menstruation? The answer is: This principle is subtle and profound. Human Great Qi (Da Qi) originally rotates the whole body and serves as the leader of all Qi. Therefore, Great Qi usually fills the chest, naturally moving Stomach Qi to descend and suppressing Chong Qi to prevent it from rushing up. Once Great Qi sinks, the leadership fails, and the coordination of all Qi becomes disordered; this is a natural law. Thus, we know that the rebellion of Chong and Stomach Qi is not necessarily caused by the sinking of Great Qi, but the sinking of Great Qi can indeed lead to the rebellion of Chong and Stomach Qi. Since the causes of disease differ, how can practitioners rigidly adhere to fixed methods without flexibility?