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Li Dongyuan stated: There are two types of menstrual dripping (menstrual bleeding that persists beyond the normal duration) in women. One type is caused by spleen and stomach deficiency, with qi sinking to affect the kidneys; liver and ministerial fire combine, causing damp-heat to press downward, resulting in persistent menstrual dripping. The blood color is purple-black and foul-smelling, the pulse is surging, large, deep, and wiry, or deep and rapid, accompanied by pain in the lower back and umbilical region, alternating chills and fever, tight pain in both hypochondria, heat and fatigue in the four limbs, irritability, and insomnia. Treatment should focus on greatly tonifying the spleen and stomach to regulate the ascending and descending of qi and blood, leading to natural recovery (e.g., using Buzhong Yiqi Tang [Tonify the Middle and Augment the Qi Decoction] added with Fangfeng [Saposhnikovia Root], Shaoyao [Peony Root], and Chao Huangbai [Fried Phellodendron Bark]). Another type occurs in those who were once wealthy but became poor, or once noble but became humble; this disease is named "Tuo Ying" (Depletion of Vital Energy). Heart qi is insufficient, and pathogenic fire blazes within the blood vessels. Consequently, heart disease transmits to the spleen, with fire invading the earth position. The physical form, muscles, and complexion remain unchanged, yet menstruation flows irregularly. It may present as menses starting and stopping abruptly, or sudden profuse flow unceasing. Treatment involves using formulas to greatly tonify qi and blood, nourish the spleen and stomach, and slightly add herbs to suppress heart fire to treat the heart. By nourishing yin and draining yang, the redness (bleeding) will naturally stop. The *Suwen: Wei Lun* chapter states: Excessive grief severs the Bao Luo (uterine collaterals), causing internal movement of yang qi. Upon onset, it manifests as "Xin Xia Beng" (sudden bleeding from below the heart) and frequent urination of blood. It also states: When the major meridians are empty, it develops into Ji Bi (muscle bi syndrome) and transmits to Mai Wei (vessel flaccidity syndrome). This refers to such cases.

The *Liang Fang* states: The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) in women are the seas of the meridians, circulating externally along the meridians and nourishing internally the zang-fu organs. If yin and yang are harmonious, menstruation occurs on time. Only when labor and injury damage qi and blood, rendering the Chong and Ren vessels unable to constrain them, does menstrual blood suddenly flow profusely, potentially leading to fainting and dizziness. Immediate treatment should prioritize regulating and tonifying the spleen and stomach. If the cun (inch) pulse is slightly slow, it indicates cold in the upper jiao, manifesting as hematemesis (vomiting blood) or epistaxis (nosebleed). If the chi (cubit) pulse is slightly slow, it indicates cold in the lower jiao, manifesting as Beng Xue (metrorrhagia) or hematochezia (blood in stool). If the cunkou pulse is wiry and large, wiry implies tightness, and large implies Kou (hollow). Tightness indicates cold, and hollow indicates deficiency. Deficiency and cold clashing result in a Ge pulse (drum-taut pulse). In women with spontaneous abortion (half-birth) and continuous leakage, there is unceasing discharge of red and white fluids. Generally, a rapid and small pulse is favorable, while a surging and large pulse is unfavorable. A small, deficient, and slippery pulse indicates survival; a large, tight, solid, and rapid pulse indicates death. A slow pulse indicates survival; an urgent pulse indicates death. Furthermore, if a patient with leakage has a deficient and floating pulse, it is untreatable.

According to Dai Fu'an: Profuse bleeding is called "Beng Zhong" (Central Collapse). The blood may be clear or turbid, purely clotted blood, or foul-smelling and unbearable. Severe cases involve dizziness of the head and eyes, and cold extremities. Urgent treatment requires Tongbian Tiaoli Zhong Tang (Child Urine Regulating Middle Decoction) added with Baicaoshuang (Soot from Hundred Herbs) for consumption. In cases of severe metrorrhagia accompanied by abdominal pain, people often suspect that evil blood (stasis) remains. Seeing the dark, clotted blood further confirms this suspicion, leading to hesitation in stopping the bleeding. Generally, when blood pathology occurs, if blood stops in the abdomen before fully exiting, it becomes stasis that is difficult to eliminate completely. Mistaking stasis for "evil blood," one fails to realize that stasis may arise from deficiency and cold. If one insists on waiting for all stasis to pass before stopping the bleeding, it is feared that even the normal blood will be depleted. Moreover, there is another explanation for the abdominal pain here. Abdominal pain caused by stasis stagnation ceases when blood circulation resumes; abdominal pain caused by active metrorrhagia ceases when bleeding stops. It is appropriate to use Xiong Gui Tang (Angelica and Ligusticum Decoction) added with Pao Jiang (Roasted Ginger) and Shu Fuzi (Prepared Aconite) to stop the bleeding, after which the pain will naturally cease.

Xue Lizhai stated: The *Neijing* says: Yin deficiency with yang palpitation is termed Beng. It also states: Injury to yang collaterals causes external blood overflow; injury to yin collaterals causes internal blood overflow. It further states: The spleen controls blood, and the liver stores blood. Pathological conditions arise from: spleen and stomach deficiency failing to control blood and return it to its source; liver channel fire causing blood to act recklessly due to heat; liver channel wind causing blood to move recklessly due to wind; anger stirring liver fire, causing blood to boil due to heat; spleen channel depression/stagnation with spleen deficiency causing blood to leave its channels; or excessive grief severing the Bao Luo internally, leading to lower collapse. Treatment methods include: Liu Jun Zi Tang (Six Gentlemen Decoction) added with Chuanxiong, Danggui, and Chaihu for spleen and stomach weakness; Buzhong Yiqi Tang added with Baishao for spleen and stomach sinking; Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) for liver channel blood heat; and Guipi Tang (Restore the Spleen Decoction) added with Chaihu for spleen channel depression. Thus, masters like Li Dongyuan and Zhu Danxi said: For all blood disorders, Si Jun Zi Tang (Four Gentlemen Decoction) must be used to conclude treatment. This statement is profound (Xue's discussion comprises seven points: three regarding the spleen/stomach, three regarding the liver channel, and one regarding the Bao Luo. None omit Chaihu, Mudanpi, and Shaoyao, because the Jueyin meridians (hand and foot) are the reservoirs where blood is abundant and stored. When blood is forced by heat, it cannot be stored and rises rapidly from the yang aspect. Therefore, Chaihu is used to guide liver qi, while Zhi Zi and Shaoyao etc. are used to collect yin and suppress yang. This aligns with Li Dongyuan's concept of raising yang and lifting the meridian, capturing the essence. The spleen/stomach formulas established are suitable for chronic diseases presenting with spleen/stomach symptoms. Since Xue Lizhai treated many chronic cases, his statements reflect this. Also, stating that Si Jun Zi Tang is used to conclude blood disorder treatment implies it is not the method for initial treatment. It is evident that Xue Lizhai's strength lies here). However, after significant blood loss, do not rely on pulse diagnosis; instead, urgently use Du Shen Tang (Single Ginseng Decoction) for rescue. If tidal fever and cough appear with a rapid pulse, this indicates weak yuan qi and a false heat pulse; Ren Shen (Ginseng Root) should especially be used for warm tonification. Such syndromes invariably stem from prior spleen and stomach damage, hence the surging and large pulse. If the patient has stomach qi capable of accepting tonification, they can be saved. If cold-natured hemostatic drugs are used, damaging stomach qi again, they will fail to control blood and return it to its source, thereby accelerating their peril.