室女妇人经事先期而来，其故有二∶有热甚者，有气血多而伤血海者。血热者腹多不痛，乃
火也，身必热，其色必紫，其脉必洪，宜凉血地黄汤。虚热者逍遥散，或补中益气加黄柏、
知母，或四物加陈皮、香附、黄柏、知母，醋糊丸服。如腹中冷痛，禁用寒凉，而用五积散
。若泻者，先理脾胃，咳嗽者，逍遥散加川贝。若气血多而伤血海者，其腹必痛，以补血行
气为主，亦慎用凉药，宜归附丸及霍香正气散。若妇人四十外，月经或二三日一至者，日久
必成淋症。王肯堂曰∶月事先期而来，血热必带紫色，或先或后，血色淡而稠粘者，痰也，
将来而先腰腹痛者，血海空虚而气不收摄也。或止或来无定期者，因气不调，故血亦随之为
行止也。或一月两至，或数日一至，乃气虚而血热也。或经年之后，累数日而不能止者，乃
血海脱滑，兼有火以动之也。既止之后，隔两三日而复见微血者，以旧血未尽，为新生之血
所催，故不能容而复出也。明理者观之，即可以施治矣。
凡妇人女子，月事过期而来，其说有三∶有血虚者，有血寒者，有湿滞者。血虚腹不痛，身
微热，然亦有腹痛者，乃空痛也。宜服生气补血之药，八物汤加香附。血寒者，归附丸。以
脉辨之，若浮大而无力，微濡芤细，皆虚也，沉迟弦紧，皆寒也。王肯堂云∶经水过期而至
，血虚也，其色必淡，治宜补血为主，以四物加香附、艾叶、五味、麦冬之类，倍加当归、
熟地。血淡而稠粘者，以化痰为主，二陈汤加香附、生姜、砂仁。如经水将来而腰腹痛者
，以行气
为主，宜君以木香，佐以枳壳、香附，同四物煎服。如经水止而复腰腹痛者，以补血为主
，君以熟地，佐以归、芍、参、术、芎、苓、香附、陈皮、甘草之类。或一月两至，数日一
至者，以补血凉血为主，宜八物汤加黄连、山栀、龟板、炒蒲黄之类。或止或来无定期者，
以调气为主，君以香附，佐以陈皮、乌药、砂仁、艾叶之类，与四物同煎服。经数日不止者
，以凉血为主，君以炒黑山栀，佐以炒蒲黄、地榆炭、牡蛎、侧柏、香附之类。经正后，过
二三四日复见微血者，以四物汤为主，加香附、陈皮、甘草之类煎服。然此不足为病，即不
服药，亦无害也。
八物汤
熟地 白芍 川芎 当归 白术 人参 广皮 半夏
五积散
白芷 陈皮 浓朴 当归 苍术 麻黄 川芎 白芍 官桂 桔梗 甘草
水煎服。
二陈汤
半夏 茯苓 陈皮 甘草
水煎服。
醋煎散
赤芍 乌梅 甘草 香附 三棱 莪术 官桂
加醋半杯，水煎。血多加当归、红花、青皮。
艾煎丸
白芍 熟地 艾叶 川芎 当归 人参 石菖蒲
各等分为末，醋糊丸。
归附丸
当归 附子
逍遥散（见调经）
In virgins or married women, menstrual periods arriving early have two main causes: one is excessive heat, and the other is an excess of Qi and Blood injuring the Xuehai (Sea of Blood, referring to the Chong Mai). In cases of Blood Heat, there is usually no abdominal pain; this is due to Fire pathogenic factors. The body will be hot, the blood color will necessarily be purple, and the pulse will necessarily be surging (Hong). Liangxue Dihuang Tang (Cooling Blood Rehmannia Decoction) is indicated. For Deficient Heat, Xiaoyao San (Free and Easy Wanderer Powder) may be used, or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma), or Siwu Tang (Four Substances Decoction) added with Chenpi (Citri Reticulatae Pericarpium), Xiangfu (Cyperī Rhizoma), Huangbai, and Zhimu, made into pills with vinegar paste. If there is cold pain in the abdomen, cold-natured drugs are strictly prohibited; instead, Wuji San (Five Accumulations Powder) should be used. If there is diarrhea, regulate the Spleen and Stomach first; if there is cough, add Chuanbei (Fritillariae Thunbergii Bulbus) to Xiaoyao San. If the cause is an excess of Qi and Blood injuring the Xuehai, there will necessarily be abdominal pain. Treatment focuses on tonifying Blood and promoting Qi circulation, while also using cold-natured drugs cautiously. Guifu Wan (Angelica and Aconite Pill) and Huoxiang Zhengqi San (Agarwood and Patchouli Regulating Qi Powder) are indicated. If a woman over forty years old has her period every two or three days, it will eventually develop into Lin Syndrome (strangury). Wang Kentang stated: When menstruation arrives early, Blood Heat manifests as purple color. If it comes irregularly, early or late, with pale and viscous blood, it is Phlegm. If lower back and abdominal pain occur before menstruation, it is due to emptiness of the Xuehai and failure of Qi to consolidate. If bleeding stops or starts irregularly, it is because Qi mechanism is disordered, causing Blood to flow irregularly. If menstruation occurs twice a month or once every few days, it is due to Qi deficiency and Blood Heat. If after menopause, bleeding continues for several days without stopping, it is due to slipping and sliding of the Xuehai combined with Fire stirring. After bleeding stops, if slight bleeding reappears after two or three days, it is because residual old blood is urged by newly generated Blood, unable to be contained, and thus re-emerges. Those who understand principles can treat based on these observations.
For women whose menstruation is delayed, there are three explanations: Blood Deficiency, Blood Cold, and Dampness Stagnation. In Blood Deficiency, there is no abdominal pain, and the body is slightly hot, though some may have abdominal pain, which is empty pain. Drugs that generate Qi and tonify Blood are suitable, such as Bayu Tang (Eight Substance Decoction) added with Xiangfu. For Blood Cold, Guifu Wan is used. Differentiation by pulse: floating and large but forceless, or fine and hollow like a reed or thin thread, all indicate Deficiency; deep, slow, wiry, and tight pulses all indicate Cold. Wang Kentang said: Menstruation arriving late indicates Blood Deficiency; the color must be pale. Treatment should focus on tonifying Blood, using Siwu Tang added with Xiangfu, Aiye (Artemisiae Argyi Folium), Wuweizi (Schisandrae Chinensis Fructus), Maidong (Ophiopogonis Radix), etc., doubling the dosage of Danggui (Angelicae Sinensis Radix) and Shudi (Rehmanniae Radix Praeparata). If the blood is pale and viscous, treatment focuses on resolving Phlegm, using Erchen Tang (Two Aged Substances Decoction) added with Xiangfu, Shengjiang (Zingiberis Rhizoma Recens), and Sharen (Amomi Fructus). If lower back and abdominal pain occur before menstruation, treatment focuses on promoting Qi circulation, using Muxiang (Aucklandiae Radix) as the sovereign herb, Zhike (Aurantii Fructus Immaturus) and Xiangfu as minister herbs, decocted with Siwu Tang. If lower back and abdominal pain occurs after menstruation stops, treatment focuses on tonifying Blood, using Shudi as the sovereign herb, and Danggui, Shaoyao (Paeoniae Radix Alba), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chuanxiong (Chuanxiong Rhizoma), Fuling (Poria), Xiangfu, Chenpi, and Gancao (Glycyrrhizae Radix et Rhizoma) as minister herbs. If menstruation occurs twice a month or every few days, treatment focuses on tonifying and cooling Blood, using Bayu Tang added with Huanglian (Coptidis Rhizoma), Shanzhi (Gardeniae Fructus), Guiban (Testudinis Carapax et Plastrum), and Chao Puhuang (Tortois Shell and Pollen Typhae, stir-fried), etc. If bleeding is irregular, treatment focuses on regulating Qi, using Xiangfu as the sovereign herb, and Chenpi, Wuyao (Linderae Radix), Sharen, Aiye as minister herbs, decocted with Siwu Tang. If menstruation lasts for several days without stopping, treatment focuses on cooling Blood, using Chao Hei Shanzhi (Stir-fried Black Gardeniae Fructus) as the sovereign herb, and Chao Puhuang, Diyu Tan (Sanguisorbae Radix Charred), Muli (Concha Ostreae), Ce Bai Ye (Platycladi Cacumen), and Xiangfu as minister herbs. After normal menstruation ends, if slight bleeding appears after two or three days, use Siwu Tang as the base, adding Xiangfu, Chenpi, and Gancao for decoction. However, this is not considered a disease; even without medication, it causes no harm.
Bayu Tang (Eight Substance Decoction)
Shudi (Prepared Rehmannia Root) Baishao (White Peony Root) Chuanxiong (Sichuan Lovage Rhizome) Danggui (Dong Quai Root) Baizhu (Largehead Atractylodes Rhizome) Renshen (Ginseng Root) Guangpi (Broad-leaved Citrus Peel) Banxia (Pinellia Tuber)
Wuji San (Five Accumulations Powder)
Baizhi (Angelicae Dahuricae Radix) Chenpi (Citri Reticulatae Pericarpium) Houpo (Magnoliae Officinalis Cortex) Danggui (Angelicae Sinensis Radix) Cangzhu (Atractylodis Rhizoma) Mahuang (Ephedrae Herba) Chuanxiong (Chuanxiong Rhizoma) Baishao (Paeoniae Radix Alba) Guanzi Gui (Cinnamomi Ramulus) Jiegeng (Platycodonis Radix) Gancao (Licorice Root)
Decoct in water and take.
Erchen Tang (Two Aged Substances Decoction)
Banxia (Pinellia Tuber) Fuling (Poria) Chenpi (Citri Reticulatae Pericarpium) Gancao (Licorice Root)
Decoct in water and take.
Cu Jian San (Vinegar-Boiled Powder)
Chishao (Red Peony Root) Wumei (Mume Fruit) Gancao (Licorice Root) Xiangfu (Cyperus Rhizome) Sanleng (Sparganii Rhizoma) Ezhu (Curcumae Rhizoma) Guanzi Gui (Cinnamomi Ramulus)
Add half cup of vinegar, decoct in water. Add Danggui, Honghua (Carthami Flos), and Qingpi (Tangerine Green Peel) if bleeding is heavy.
Ai Jian Wan (Mugwort-Boiled Pill)
Baishao (White Peony Root) Shudi (Prepared Rehmannia Root) Aiye (Mugwort Leaf) Chuanxiong (Chuanxiong Rhizome) Danggui (Angelicae Sinensis Radix) Renshen (Ginseng Root) Shichangpu (Acori Tatarinowii Rhizoma)
Grind equal parts into powder, make pills with vinegar paste.
Guifu Wan (Angelica and Aconite Pill)
Danggui (Angelicae Sinensis Radix) Fuzi (Aconiti Lateralis Radix Praeparata)
Xiaoyao San (See Menstrual Regulation section)