Library

There is another condition known as "Pi Mass" (abdominal masses that are fixed and immovable), which, although formed by the combination of phlegm, blood stasis, and food stagnation, is mostly caused by blood stasis. When masses are formed due to phlegm and food stagnation, even if they form, they do not obstruct menstruation. When caused by blood stasis, there may also be cases where menstruation occurs on time but flows intermittently; this necessarily indicates that upon the onset of menstruation, there is still old blood remaining in the body. If one occasionally contracts cold pathogenic factors or is provoked by anger, causing qi and blood to stagnate between the hypochondrium and the lower abdomen, a blood-related Pi Mass forms.

In cases where menstruation has been absent for months and there are painful masses in the abdomen and hypochondrium, this is "Jia Mass" (abdominal masses that gather and disperse irregularly) formed by menstrual blood. The treatment method should focus on regulating menstruation and relieving pain, using herbs such as Tao Ren (Peach Kernel), Hou Po (Magnolia Bark), Dang Gui (Angelica Sinensis), Hong Hua (Safflower), Xiang Fu (Cyperus Rhizome), Yuan Hu (Corydalis Rhizome), Rou Gui (Cinnamon Bark), Mu Dan Pi (Moutan Cortex), Ru Xiang (Frankincense), Mu Xiang (Aucklandiae Radix), Niu Xi (Achyranthes Root), Xiao Hui Xiang (Fennel Fruit), and Sha Ren (Amomum Fruit).

In cases where abdominal pain occurs during menstruation accompanied by limb numbness, headache, aversion to cold, and fever, this is due to catching a cold during the menstrual period. It is appropriate to use Jiajian Wuji San (Modified Five Accumulations Powder). If throughout the body there is pain during menstruation, with numbness in hands and feet, aversion to cold, fever, and dizziness, remove Gan Jiang (Dried Ginger) from the previous prescription and add Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Bai Zhi (Angelicae Dahuricae Radix), Dang Gui (Angelicae Sinensis Radix), Guan Gui (Cassiae Ramulus), Ma Huang (Ephedrae Herba), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Chen Pi (Citri Reticulatae Pericarpium), and Cang Zhu (Atractylodis Rhizoma).

In cases of irregular menstruation with occasional lower abdominal pain and mixed leukorrhea (white and red discharge), this is due to deficiency-cold of the uterus. The treatment should employ Aifu Nuangong Wan (Mugwort and Cyperus Warming Uterus Pill).

In cases where qi and blood are weak during menstruation, the Sea of Blood is cold, leading to irregular menstruation, heart and abdominal pain, leukorrhea resembling fish brains or rice water, mixed and indistinguishable, continuous dripping beyond the expected period, sallow complexion, emaciation, weakness in the four limbs, dizziness, and blurred vision, Bu Jing Tang (Menstruation-Nourishing Decoction) is appropriate.

**Aifu Nuangong Wan (Mugwort and Cyperus Warming Uterus Pill)**
Ai Ye (Artemisiae Argyi Folium), Xiang Fu (Cyperi Rhizoma - processed by four methods), Yuan Hu (Corydalidis Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Grind all into fine powder, make pills with vinegar paste, size of paulownia seeds. Take 80 pills per dose, washed down with rice soup.

**Bu Jing Tang (Menstruation-Nourishing Decoction)**
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Xiang Fu (Cyperi Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata), Yuan Hu (Corydalidis Rhizoma), Rou Gui (Cinnamomi Cortex), Wu Zhu Yu (Evodiae Fructus), Sha Ren (Amomi Fructus), Fu Shen (Poria Cum Radice), Chen Xiang (Aquilariae Lignum Resinatum), E Jiao (Colla Corii Asini), Huang Qi (Astragali Radix), Xiao Hui Xiang (Foeniculi Fructus), Chen Pi (Citri Reticulatae Pericarpium), Bai Shao (Paeoniae Radix Alba).
Decoct in water and take orally.

For women whose menstruation is regular but who fail to conceive, there are three main causes: obstruction of the uterus by phlegm-dampness, qi stagnation combined with consumption of raw/cold foods, or male yang deficiency leading to premature ejaculation.

If the cause is phlegm-dampness obstructing the uterus, the woman will likely be obese with fair skin, and experience no abdominal pain during menstruation. Dao Tan Tang (Phlegm-Resolving Decoction) or Renshen Banxia Wan (Ginseng and Pinellia Pill) are appropriate, or a combination of Er Chen Tang (Two-Aged Decoction) and Si Wu Tang (Four Substances Decoction).

If caused by qi stagnation and consumption of raw/cold foods, abdominal pain is common. Warmth is required, so Qianjin Jixiang Wan (Thousand Gold Auspicious Pill) may be used. However, if cough is present, this formula is contraindicated; instead, use Si Wu Tang (Four Substances Decoction) added with Chen Pi (Citri Reticulatae Pericarpium), Xiang Fu (Cyperi Rhizoma), and Shan Zha (Crataegi Fructus).

If qi stagnation causes diarrhea, use Zhi Shi Wan (Immature Bitter Orange Pill).

If the man suffers from cold sperm and premature ejaculation, preventing conception, this is unrelated to the woman; only the man needs medication.

Some argue that regular menstruation with a cold uterus makes conception impossible. This is logically flawed. If the uterus were cold, menstruation would inevitably be delayed. Others claim uterine coldness results from cold exposure of the vaginal opening during childbirth. However, if the vaginal opening were cold postpartum, the mother would immediately lose her voice; since she can speak, it cannot be attributed to cold exposure.

Xue Gumeng stated: Women with irregular menstruation often fail to conceive, but some conceive before their expected date due to blood heat. Gynecological texts state: Early menstruation indicates blood heat, while late menstruation indicates blood and qi deficiency. However, early and late patterns may coexist. Why? Generally, women have stubborn temperaments and are prone to anger, which disrupts qi flow. Since qi is the mother of blood, chaotic qi leads to chaotic menstruation. Therefore, regulating menstruation prioritizes regulating qi. Guifu Wan (Angelica and Cyperus Pill) or Si Wu Wan (Four Substances Pill) are appropriate.

For damage to the Chong and Ren meridians due to cold, resulting in failure to conceive or frequent miscarriages, Shenshen Wan (Shenshen Pill) is the primary treatment.

**Shenshen Wan (Shenshen Pill)**
Gan Jiang (Zingiberis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Mu Dan Pi (Moutan Cortex), Yuan Hu (Corydalidis Rhizoma), Rou Gui (Cinnamomi Cortex), Ze Lan (Lycopus Herba), Shu Di Huang (Rehmanniae Radix Praeparata), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Shi Hu (Dendrobii Caulis).
Grind into powder, make pills with vinegar paste, take with boiled wine.

**Yi Tan Tang (Strange Phlegm Decoction)**
Ban Xia (Pinelliae Tuber), Nan Xing (Arisaematis Rhizoma), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Zhi Shi (Aurantii Fructus Immaturus), Fu Ling (Poria), Ren Shen (Ginseng Radix), Chang Pu (Acori Tatarinowii Rhizoma), Zhu Ru (Bambusae Caulis in Taenia), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Decoct with ginger slices.

**Qianjin Jixiang Wan (Thousand Gold Auspicious Pill)**
Tian Ma (Gastrodiae Rhizoma - roasted, 1 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Rou Gui (Cinnamomi Cortex), Mu Dan Pi (Moutan Cortex), Shu Di Huang (Rehmanniae Radix Praeparata), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Liu Xu (Poplar Catkin), Wu Wei Zi (Schisandrae Chinensis Fructus), Fu Ling (Poria), Tu Si Zi (Cuscutae Semen), Fu Pen Zi (Rubi Fructus), Zhi Shi (Aurantii Fructus Immaturus), Tao Hua Pian (Peach Blossom Slices) (each 1 liang).
Grind into powder, make honey pills, size of beans. Take 5 pills per dose on an empty stomach, washed down with boiled wine.