《入门》云∶经水欲行，脐腹绞痛，属血滞。经水临行时痛为气滞。经水将来，阵痛
阵止
，为血实。经水已竣腹痛，为血虚。又有经水将行，被风相搏，绕脐抽痛者(《千金》云∶
妇人经行如厕，亦有为风所客者，可不谨欤)。有历年血寒积结胞门，呕吐涎唾，脐胁疝痛
，阴冷彻引腰脊而痛者，当分治之。
按《良方》云∶妇人经来腹痛，由风冷客于胞络冲任，或伤手太阳少阴经，用温经汤，
或桂
枝桃仁汤，或地黄通经丸。若血结而成块者，用万病丸(牛膝、干漆、地汁熬为丸)。薛立斋
云∶若前症因生冷伤脾，用六君子加炮姜。思虑伤血，四物加参、术。思虑伤气，归脾加柴
、栀。怒郁伤肝，逍遥归脾兼服。余参他症治之(然又恐感外邪伤饮食，亦能致痛，尤宜详
审，和气饮却能兼治)。戴复庵云∶经事来而腹痛，经事不来而腹亦痛，二者之病皆血之不
调也。欲调其血，先调其气，四物加茱萸、香附。痛甚者延胡索汤、通用和气饮(当归、延
胡、蒲黄、肉桂、赤芍、乳香、木香、没药、甘草、姜黄)。
《良方》云∶妇人月水不断，淋沥无时，或因劳损气血而伤冲任，或因经水将行而交合
阴阳
，皆令气虚而不能摄血。但调元气，病自愈矣。若时行时止，腹痛，脉沉细，此系寒热邪气
客于胞中，非虚弱也。
按∶前症若郁结伤脾，用归脾汤。恚怒伤肝，逍遥散。肝火妄动。加味四物汤。脾气虚
弱，六君子汤。元气下陷，补中益气汤。热作伤元气，前汤加麦冬、五味、炒黄柏。
The *Rumen* states: When menstruation is about to commence, colicky pain in the umbilical and abdominal regions indicates blood stasis (Blood Stagnation). Pain occurring when menstruation is imminent indicates qi stagnation (Qi Stagnation). Intermittent pain before menstruation begins indicates blood excess (Blood Excess). Abdominal pain persisting after menstruation has ceased indicates blood deficiency (Blood Deficiency). Additionally, there are cases where wind pathogen combats with the body as menstruation approaches, causing drawing pain around the umbilicus (The *Qianjin Fang* notes: Women defecating during menstruation may also be invaded by wind pathogen; how can one not be cautious?). There are also cases of chronic cold-blood accumulation at the uterine gate, presenting with vomiting of saliva, hernia-like pain in the umbilical and hypochondriac regions, and coldness in the genitalia radiating to the lower back and spine; these must be treated differently.
According to the *Liangfang*: Uterine pain during menstruation results from wind-cold pathogen lodging in the uterine collaterals and the Chong and Ren vessels, or damaging the Hand-Taiyang and Hand-Shaoyin meridians. One may use Wenjing Tang (Warming the Menses Decoction), Guizhi Taoren Tang (Cinnamon Twig and Peach Kernel Decoction), or Dihuang Tongjing Wan (Rehmannia Menstruation-Unblocking Pill). If blood coagulation forms masses, use Wanbing Wan (Myriad Diseases Pill) [composed of Achyranthis Radix (Niuxi), Drynariae Rhizoma (Ganqi - *Note: Text says Ganqi, likely referring to Drynaria or similar resinous herb in context, but literal translation used*), and Plantago Seed Juice boiled into pills]. Xue Lizhai stated: If the aforementioned symptoms are caused by raw/cold food damaging the Spleen, use Liujunzi Tang (Six Gentlemen Decoction) with Paojiang (Prepared Ginger). If excessive thinking damages Blood, use Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala). If excessive thinking damages Qi, use Guipi Tang (Restore the Spleen Decoction) added with Chaihu (Bupleurum) and Zhizi (Gardenia). If anger and depression damage the Liver, take Xiaoyao San (Free Wanderer Powder) and Guipi Tang concurrently. For other conditions, refer to treatments for respective syndromes (However, one must fear that external pathogens or dietary indiscretion may also cause pain; careful examination is essential. Heqi Yin (Harmonizing Qi Infusion) can treat multiple causes simultaneously). Dai Fu'an stated: Abdominal pain during menstruation, and abdominal pain even when menstruation does not occur, both indicate disharmony of Blood. To regulate Blood, one must first regulate Qi, using Siwu Tang (Four Substances Decoction) added with Zhuyu (Evodia) and Xiangfu (Cyperus). For severe pain, use Yansu Tang (Corydalis Decoction) or Tongyong Heqi Yin (Universal Harmonizing Qi Infusion) [composed of Danggui (Angelica Sinensis), Yanhusuo (Corydalis), Puhuang (Typha Pollen), Rougui (Cinnamon Bark), Chi Shao (Red Peony Root), Rushi (Frankincense), Muxiang (Aucklandia), Moyao (Myrrh), Gancao (Licorice), and Jianghuang (Curcuma Longa)].
The *Liangfang* states: Continuous, dripping menstrual flow without cessation may result from labor-induced Qi and Blood deficiency damaging the Chong and Ren vessels, or from sexual intercourse while menstruation is approaching. All such cases lead to Qi deficiency failing to control Blood. Merely regulating Yuan Qi (Original Qi) will allow the disease to heal spontaneously. If the flow is intermittent accompanied by abdominal pain and a deep, fine pulse, this indicates cold-heat pathogen lodging in the uterus, not a deficiency syndrome.
Commentary: If the aforementioned symptoms are due to emotional constraint damaging the Spleen, use Guipi Tang (Restore the Spleen Decoction). If anger damages the Liver, use Xiaoyao San (Free Wanderer Powder). If Liver Fire moves recklessly, use Jiawei Siwu Tang (Modified Four Substances Decoction). If Spleen Qi is weak, use Liujunzi Tang (Six Gentlemen Decoction). if Yuan Qi (Original Qi) sinks, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If heat pathology damages Yuan Qi (Original Qi), add Maidong (Ophiopogon), Wuweizi (Schisandra), and Chao Huangbai (Fried Phellodendron) to the aforementioned decoction.