当归建中汤 加味乌药散 琥珀散
24.经后腹痛当归建, 经前胀痛气为殃, 加味乌药汤乌缩, 延草木香
香附榔. 血凝碍气疼过胀, 本事琥珀散最良, 棱莪丹桂延乌药, 寄奴
当归芍地黄.
【注】经后腹痛或去血过多, 乃血虚也, 宜用当归建中汤补之, 其方
即小建中汤加当归也. 经前腹胀痛, 乃血气凝滞. 若胀过于痛, 是气
滞其血也, 宜用加味乌药汤开之, 其方即乌药, 缩砂, 延胡索, 甘草
,木香, 香附, 槟榔也. 若痛过于胀, 是血凝碍气也, 宜用琥珀散破
之,其方即三棱, 莪术, 丹皮, 官桂, 延胡索, 乌药, 刘寄奴, 当归
,赤芍, 生地黄也.
大温经汤 吴茱萸汤
25.胞虚寒病大温经, 来多期过小腹疼, 归芎芍草人参桂, 吴丹胶半
麦门冬. 不虚胞受风寒病, 吴茱萸汤更加风,?? 细干姜茯苓木, 减去
阿胶参芍芎.
【注】凡胞中虚寒, 一切经病, 皆因经水来多, 胞虚受寒所致. 或因
受寒过期不行, 小腹冷痛者, 宜用大温经汤, 即当归, 川芎, 白芍,
炙草, 人参, 肉桂, 吴茱萸, 丹皮, 阿胶, 半夏, 麦门冬也. 若胞中
不虚, 惟受风寒为病, 宜吴茱萸汤, 根据大温病经汤方更加防风,?? 本
,细本, 干姜, 茯苓, 木香, 减去阿胶, 人参, 白芍药, 川芎, 即是
吴茱萸汤也.
Danggui Jianzhong Decoction, Jiawei Wuyao Powder, Hupo Powder
24. For abdominal pain occurring after menstruation, Danggui Jianzhong Decoction is indicated; for distension and pain before menstruation, the cause is Qi dysfunction. Jiawei Wuyao Tang (Additive Costus Root Decoction) consists of Wuyao (Linderae Radix), Suosha (Amomi Fructus Rotundus), Yanhusuo (Corydalis Rhizoma), Muxiang (Aucklandiae Radix), Xiangfu (Cyperi Rhizoma), and Binglang (Arecae Semen). If blood stasis obstructs Qi flow causing pain to exceed distension, Hupo San from *Beishi Fang* is most effective; this formula contains Lenghe (Curcumae Zedoariae Rhizoma), Ezhu (Curcumae Longae Rhizoma), Danpi (Moutan Cortex), Guanzi Gui (Cinnamomi Ramulus), Yanhusuo, Wuyao, Liujinu (Artemisiae Annuae Herba), Danggui (Angelicae Sinensis Radix), Chishao (Paeoniae Radix Rubra), and Sheng Dihuang (Rehmanniae Radix Recens).
[Note] Abdominal pain after menstruation, or resulting from excessive blood loss, indicates Blood Deficiency. It should be treated with Danggui Jianzhong Decoction for tonification. This formula is Xiao Jianzhong Decoction with the addition of Danggui. Distension and pain in the abdomen before menstruation result from Qi and Blood stagnation. If distension exceeds pain, it signifies Qi stagnation leading to impaired Blood circulation; Jiawei Wuyao Tang should be used to regulate Qi and open stagnation. This formula consists of Wuyao, Suosha, Yanhusuo, Gancao (Glycyrrhizae Radix et Rhizoma), Muxiang, Xiangfu, and Binglang. If pain exceeds distension, it signifies Blood coagulation obstructing Qi flow; Hupo San should be used to break up Blood stasis. This formula consists of Lenghe, Ezhu, Danpi, Guanzi Gui, Yanhusuo, Wuyao, Liujinu, Danggui, Chishao, and Sheng Dihuang.
Da Wenjing Decoction, Wuzhuyu Decoction
25. For diseases of the uterus due to deficiency-cold, Da Wenjing Decoction is indicated, characterized by heavy menstrual flow, short duration, and lower abdominal pain. The formula includes Danggui, Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Renshen (Ginseng Radix et Rhizoma), Rougui (Cinnamomi Cortex), Wuzhuyu (Evodiae Fructus), Danpi, Ejiao (Asini Corii Colla), Banxia (Pinelliae Rhizoma Praeparatum), and Maidong (Ophiopogonis Radix). If the uterus is not deficient but affected by Wind-Cold pathogenic factors, Wuzhuyu Decoction should be used with added wind-dispelling herbs such as Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Herba), Xixin (Asari Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma), Fuling (Poria), and Muxiang, while removing Ejiao, Renshen, Baishao, and Chuanxiong.
[Note] All menstrual disorders caused by deficiency-cold in the uterus result from excessive menstrual flow leading to uterine emptiness and susceptibility to cold. Alternatively, if cold invasion causes delayed menstruation accompanied by cold pain in the lower abdomen, Da Wenjing Decoction should be used. Its composition is: Danggui, Chuanxiong, Baishao, Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma), Renshen, Rougui, Wuzhuyu, Danpi, Ejiao, Banxia, and Maidong. If the uterus is not deficient but merely afflicted by Wind-Cold pathogens, Wuzhuyu Decoction is appropriate. Based on the Da Wenjing Decoction formula, add Fangfeng, Jingjie, Xixin, Ganjiang, Fuling, and Muxiang, and remove Ejiao, Renshen, Baishao, and Chuanxiong. This constitutes Wuzhuyu Decoction.