冲为血海，任主胞胎，女子十四岁而肾气充，天癸至，任脉通，太冲脉盛，月事以时下。三旬一至者，象月
之盈亏也。冲任之脉起于少阴，为经血之宗，脾为主化之源，心统诸经之血，胃为水谷之海，生血之大源。外无
风寒暑湿之侵，内无七情郁结之扰，则经气清和而气振血盈，乃能及时孕子。如经行受邪，则经气错乱，血液凝
泣而经闭腹痛、潮热咳嗽，鼻衄吐血，泄泻白淫，渐成劳瘵。若经后受邪，当与产后同论。
月事不来者，胞之络脉闭也。胞脉者，属心而络于胞，中气上迫肺心，气不得下通，或寒闭其经，热壅其络，痰
凝子宫，气滞胞脉而血瘀血枯皆能令女子经闭。
调经必先去病，血热者，宜清凉以利血脉；血寒者，宜温热以资化源；血瘀者，宜破宜消；血枯者，宜润宜补。
主以四物汤，血滞换赤芍加延胡索，热加山栀、丹皮，寒加炮姜、肉桂，瘀加桃仁、五灵脂，虚加阿胶、
黄明胶，风加荆芥、防风，湿加苍术、白芷，暑加香薷、藿香，气滞加木香、香附。
四物汤
治血虚经闭脉虚涩者。
熟地（五钱） 白芍（二钱，酒炒） 川芎（一钱） 当归（三钱）
水煎去渣温服。
经血虚少，冲任欠盈，不能应时而下，故月经不至，是为虚闭焉。熟地补阴滋血，白芍敛阴和血，当归养经
中之血以资冲任，川芎行血中之气以通经脉也。水煎温服，务使血荣经润，则沟满渠通而月事必应时而下，岂复
有虚闭之患乎。
玉烛散
治胃热血枯经闭、便结，脉洪涩者。
生地（五两） 当归（三两） 白芍（一两半，炒） 川芎（一两） 大黄（三两） 芒硝（一两半）
甘草（一两）
制为散，水煎四钱，去渣食前服。
血液干枯，经脉壅闭，故胃气结热而大便燥结，月事不来焉。调胃承气汤力能泻热通肠。四物汤功 养血润燥，
合之以治燥热经闭。为散水煎，使胃热顿化，则经气清和而经血自生，经脉荣润，何有血枯经闭之患哉。
三和汤
治心火上行，胞脉闭塞，月信不通，脉涩数者。
生地（五钱） 当归（二钱） 白芍（一钱半） 川芎（一钱） 连翘（一钱半） 栀子（一钱半） 黄芩
（二钱） 朴硝（一钱） 薄荷（一钱半，泡） 甘草（一钱）
水煎去渣温服。
劳心耗血，心火上行，故胞脉闭塞，月事不能下通焉。凉膈散以导热清心，四物汤以养血通闭，调胃承气
汤以下热滋干，故曰三和，以和其不和也。水煎温服，使心火下降则肾水上朝而津液得全，胞脉无闭塞之患，
月事无不通之虞矣。
二黄散
治经脉不通，脉数涩者。
大黄（三两） 生地（六两）
制为散，好酒下三钱。
血热肠枯，津液燥结，故能食肌消，经脉不能通利焉。大黄破瘀结以泻热通经，生地凉血热以滋阴化结，
为散酒调，使结化热除，则阴血得滋而经脉无不通之患矣。
二气丸
治经闭脉数涩，左右强弱不调者。
大黄（四两末） 当归（一两末） 白芍（二两末，酒炒）
先以大黄煎汁去渣熬膏入药末和丸，淡醋细嚼三钱，米饮漱口咽下。
热瘀不清，经血暗耗，故经脉闭遏月事不行焉。当归养既耗之血，白芍敛热伤之阴，大黄净汁熬膏入药丸
服，醋以引之入肝，饮以漱之和胃，使热化血荣，则冲任蓄泄有权，何患经闭不通乎。
五补丸
治胞脉虚闭，月事不来，脉虚涩者。
熟地（二两） 人参（二两） 牛膝（一两） 茯苓（一两） 地骨皮（一两）
制为末，炼蜜丸，好酒温服三钱。
气虚不能鼓运荣血而胞脉闭遏，血气暗耗，故月事不来焉。人参补心气兼生血脉，熟地补心阴能滋冲任，
茯苓清治节以化气，骨皮退肌热以资营，复需牛膝之下行，以通经气之虚闭也。炼蜜以丸之，醇酒以行之，使阳
春焕发，则沟满渠通而胞脉无虚闭之患，月事无不通之害矣。
卫生汤
治营卫两虚，经水不至，脉虚软者。
当归（三钱） 黄 （五钱，蜜炙） 白芍（一钱半，酒炒） 炙草（一钱）
水煎温服，虚甚加人参。
营卫两虚，血气不足而冲任欠盈，经脉不至，故月事不来焉。黄 壮气实卫，当归养血益营，白芍敛阴和
血，炙草缓中益胃也。水煎温服，使血气内充，则冲任蓄泄有权而经脉无不至，月事无不来矣。虚甚加人参以扶
元益气，俾气能生血而沟满渠通焉，岂有经闭之患乎。
柏子仁丸
治思虑成劳，血耗月经不通，脉濡涩者。
柏子仁（二两，炒） 熟地（三两） 牛膝（一两） 卷柏（一两） 泽兰（一两） 续断（一两）
咀为末炼蜜丸，米饮下三钱。
思虑伤心，心血虚耗，故心火独旺而月事亏损不来焉。柏子仁养心润燥，熟地黄壮水滋血，泽兰通利血脉，
卷柏活血通经，续断补经虚续络绝，牛膝以下行通利经脉也，蜜丸以润之，饮下以和之，俾心气得养，则胃气调
和而津血自布，心火自降，经脉自通，可无劳瘵之虞矣。
泽兰汤
治血亏经闭，脉涩者。
当归（二钱） 白芍（一钱半，酒炒） 炙草（一钱） 泽兰（三钱）
水煎去渣温服。
思虑劳心，干血内结，新血不生，故血失滋荣而经闭不通焉。当归养血荣心，白芍敛阴和血，炙草益胃气以
生新血，泽兰利结血以通经脉也。水煎温服，使结化血行，则思郁自解，而新血日渐滋生，何有血涸经闭之患哉。
通经丸
治经闭不月，腹中结块，脉涩实者。
大黄（一两，制） 归尾（二两） 干漆（一两，烧烟尽） 桃仁（一两，去皮尖） 三
棱（一两，醋炒） 蓬术（一两，醋炒） 丹皮（一两） 肉桂（一两，去皮） 牛膝（一两） 麝香（一钱）
制为末，皂角一两、芫花一两煎浓汁捣糊丸，米饮下二钱。
血瘀结块，挟蓄水而冲任气闭血脉不流，故月事不行焉。归尾破血以通经脉，桃仁破血以润燥坚，干漆化坚结
之血积，肉桂通冲任之经闭，蓬术破坚凝，三棱削结块，牛膝下行通利，丹皮凉血通经，麝香通闭遏之窍，大黄
通血结之幽，皂角通关利窍，芫花泻水泄闭也。煎汁糊丸，米饮调下，无不使瘀化气行，则坚积自散而经气鼓运，
营血输化，何经闭不月，结块坚凝之不退哉。
Chong (Penetrating) vessel is the Sea of Blood, and Ren (Conception) vessel governs the uterus. When a girl reaches fourteen years of age, her Kidney Qi becomes abundant, Tian Gui (substances promoting reproductive maturation) arrives, the Ren vessel becomes unobstructed, and the Tai Chong vessel becomes vigorous, causing menstruation to occur on time. The monthly cycle corresponds to the waxing and waning of the moon. The Chong and Ren vessels originate from the Shaoyin channel and are the source of menstrual blood; the Spleen is the source of Qi and Blood transformation; the Heart commands the blood of all vessels; the Stomach is the Sea of Grain and Water, the great source of Blood generation. If there is no invasion of external Wind, Cold, Summer-heat, or Dampness, and no disturbance from internal emotional stagnation, then the Menstrual Qi will be clear and harmonious, with sufficient Qi and abundant Blood, enabling timely conception and childbirth. If pathogenic factors are contracted during menstruation, the Menstrual Qi will become disordered, and Blood will coagulate and stagnate, leading to amenorrhea, abdominal pain, tidal fever, cough, epistaxis, hematemesis, diarrhea, leukorrhea, gradually evolving into consumptive disease (Lao Zhai). If pathogenic factors are contracted after menstruation, it should be discussed similarly to postpartum conditions.
Amenorrhea occurs due to the obstruction of the collateral vessels of the uterus. The Bao Mai (Uterine Vessels) belong to the Heart and connect to the uterus. If Middle Jiao Qi presses upward upon the Lung and Heart, preventing Qi from descending smoothly, or if Cold obstructs the vessels, Heat congests the collaterals, Phlegm condenses in the uterus, Qi stagnates in the Bao Mai, or if there is Blood stasis or Blood exhaustion, all can cause amenorrhea in women.
A faint and choppy Kidney pulse indicates amenorrhea; a tight and choppy Liver pulse indicates amenorrhea; a slippery and rapid pulse indicates Heat congestion; a fine and choppy pulse indicates Cold pathology.
To regulate menstruation, one must first eliminate the disease. For Blood Heat, cooling herbs should be used to benefit the blood vessels; for Blood Cold, warming herbs should be used to support the source of transformation; for Blood Stasis, methods to break stasis and resolve masses should be employed; for Blood Exhaustion, moistening and tonifying methods should be used.
The primary formula is Si Wu Tang (Four Substances Decoction). For Blood stagnation, replace Bai Shao with Chi Shao and add Yan Hu Suo; for Heat, add Shan Zhi and Dan Pi; for Cold, add Pao Jiang and Rou Gui; for Stasis, add Tao Ren and Wu Ling Zhi; for Deficiency, add E Jiao and Huang Ming Jiao; for Wind, add Jing Jie and Fang Feng; for Dampness, add Cang Zhu and Bai Zhi; for Summer-heat, add Xiang Ru and Huo Xiang; for Qi stagnation, add Mu Xiang and Xiang Fu.
Si Wu Tang (Four Substances Decoction)
Treats amenorrhea due to Blood deficiency with a deficient and choppy pulse.
Shu Di Huang (Rehmanniae Radix Praeparata, 5 qian), Bai Shao (Paeoniae Radix Alba, 2 qian, stir-fried with wine), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 qian), Dang Gui (Angelicae Sinensis Radix, 3 qian).
Decoct in water, remove dregs, and take warm.
When menstrual Blood is deficient and the Chong and Ren vessels are insufficiently filled, they cannot descend on time, resulting in amenorrhea, termed "Deficient Amenorrhea." Shu Di Huang nourishes Yin and benefits Blood; Bai Shao astringes Yin and harmonizes Blood; Dang Gui nourishes the Blood within the vessels to support the Chong and Ren vessels; Chuan Xiong moves Qi within the Blood vessels to unblock the meridians. Decoct in water and take warm, ensuring that Blood becomes lush and vessels moistened, so that the channels fill and flow freely, and menstruation will surely arrive on time, eliminating the risk of deficient amenorrhea.
Yu Zhu San (Jade Candle Powder)
Treats amenorrhea, constipation, and a flooding-choppy pulse due to Stomach Heat and Blood exhaustion.
Sheng Di Huang (Rehmanniae Radix, 5 liang), Dang Gui (Angelicae Sinensis Radix, 3 liang), Bai Shao (Paeoniae Radix Alba, 1.5 liang, stir-fried), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 liang), Da Huang (Rhei Radix et Rhizoma, 3 liang), Mang Xiao (Natrii Sulfas, 1.5 liang), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 liang).
Process into powder. Decoct 4 qian in water, remove dregs, and take before meals.
Blood is dry and exhausted, and meridians are congested and blocked, causing Stomach Qi to accumulate Heat and feces to become dry and hard, resulting in amenorrhea. Tiao Wei Cheng Qi Tang has the power to purge Heat and unblock the intestines. Si Wu Tang nourishes Blood and moistens dryness. Combined, they treat amenorrhea due to Dryness-Heat. Processed as powder and decocted in water, this clears Stomach Heat instantly, making Menstrual Qi clear and harmonious, allowing Blood to generate naturally and meridians to become lush, eliminating the risk of Blood-exhaustion amenorrhea.
San He Tang (Three Harmonies Decoction)
Treats amenorrhea with a choppy-rapid pulse due to Heart Fire ascending and obstruction of the Bao Mai.
Sheng Di Huang (Rehmanniae Radix, 5 qian), Dang Gui (Angelicae Sinensis Radix, 2 qian), Bai Shao (Paeoniae Radix Alba, 1.5 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 qian), Lian Qiao (Forsythiae Fructus, 1.5 qian), Zhi Zi (Gardeniae Fructus, 1.5 qian), Huang Qin (Scutellariae Radix, 2 qian), Po Xiao (Natrii Sulfas, 1 qian), Bo He (Menthae Haplocalycis Herba, 1.5 qian, soaked), Gan Cao (Glycyrrhizae Radix et Rhizoma, 1 qian).
Decoct in water, remove dregs, and take warm.
Mental exertion consumes Blood, causing Heart Fire to ascend, thus blocking the Bao Mai and preventing menstruation from flowing downward. Liang Ge San guides Heat out and clears the Heart; Si Wu Tang nourishes Blood and unblocks obstruction; Tiao Wei Cheng Qi Tang purges Heat and nourishes dryness. Hence it is called "Three Harmonies," to harmonize disharmony. Decoct in water and take warm, causing Heart Fire to descend and Kidney Water to rise, preserving fluids, so the Bao Mai is not obstructed and menstruation flows without hindrance.
Er Huang San (Two Yellows Powder)
Treats unblocked meridians with a rapid-choppy pulse.
Da Huang (Rhei Radix et Rhizoma, 3 liang), Sheng Di Huang (Rehmanniae Radix, 6 liang).
Process into powder, take 3 qian with good wine.
Blood Heat and intestinal dryness cause fluid depletion and hard stool, leading to increased appetite but muscle wasting, and inability of meridians to flow smoothly. Da Huang breaks stasis to purge Heat and unblock menstruation; Sheng Di Huang cools Blood Heat to nourish Yin and resolve stagnation. Taken as powder mixed with wine, this resolves stagnation and eliminates Heat, nourishing Yin-Blood and ensuring smooth meridian flow.
Er Qi Wan (Two Qi Pill)
Treats amenorrhea with a rapid-choppy pulse and unequal strength between left and right pulses.
Da Huang (Rhei Radix et Rhizoma, 4 liang, powdered), Dang Gui (Angelicae Sinensis Radix, 1 liang, powdered), Bai Shao (Paeoniae Radix Alba, 2 liang, powdered, stir-fried with wine).
First, decoct Da Huang in water, remove dregs, and boil down to a paste. Mix with the powdered herbs to form pills. Chew 3 qian slowly with light vinegar, rinse mouth with rice drink, and swallow.
Unclear Heat-Stasis secretly consumes menstrual Blood, obstructing meridians and stopping menstruation. Dang Gui nourishes consumed Blood; Bai Shao astringes Yin damaged by Heat. Da Huang paste mixed into pills, guided by vinegar into the Liver, and harmonized with rice drink in the Stomach, transforms Heat and nurtures Blood, regulating the storage and discharge of Chong and Ren vessels, curing amenorrhea.
Wu Bu Wan (Five Tonics Pill)
Treats deficient obstruction of Bao Mai, amenorrhea, and a deficient-choppy pulse.
Shu Di Huang (Rehmanniae Radix Praeparata, 2 liang), Ren Shen (Ginseng Radix, 2 liang), Niu Xi (Achyranthis Bidentatae Radix, 1 liang), Fu Ling (Poria, 1 liang), Di Gu Pi (Lycii Cortex, 1 liang).
Process into powder, make pills with refined honey, take 3 qian warm with good wine.
Qi deficiency fails to propel and transform Nutritive Blood, obstructing Bao Mai and secretly consuming Qi and Blood, causing amenorrhea. Ren Shen tonifies Heart Qi and generates Blood vessels; Shu Di Huang tonifies Heart Yin and nourishes Chong and Ren vessels; Fu Ling clears and regulates the diaphragm to transform Qi; Di Gu Pi reduces muscular heat to support Ying Blood. Niu Xi aids downward movement to unblock deficient Qi in the vessels. Honey makes the pills moist; wine promotes circulation. This awakens Yang Qi, fills the channels, prevents deficient obstruction of Bao Mai, and ensures regular menstruation.
Wei Sheng Tang (Health Preservation Decoction)
Treats amenorrhea with a soft-deficient pulse due to dual deficiency of Ying and Wei.
Dang Gui (Angelicae Sinensis Radix, 3 qian), Huang Qi (Astragali Radix, 5 qian, honey-fried), Bai Shao (Paeoniae Radix Alba, 1.5 qian, stir-fried with wine), Zhi Gan Cao (Prepared Licorice Root, 1 qian).
Decoct in water and take warm. Add Ren Shen if deficiency is severe.
Dual deficiency of Ying and Wei leads to insufficient Qi and Blood, failing to fill the Chong and Ren vessels, causing amenorrhea. Huang Qi strengthens Qi and secures the Exterior; Dang Gui nourishes Blood and benefits Ying; Bai Shao astringes Yin and harmonizes Blood; Zhi Gan Cao moderates the middle and benefits the Stomach. Decoct in water and take warm, filling Qi and Blood internally, regulating Chong and Ren storage/discharge, ensuring all vessels are filled and menstruation arrives. Adding Ren Shen supports Yuan Qi and generates Blood, filling the channels and curing amenorrhea.
Bai Zi Ren Wan (Biota Seed Pill)
Treats amenorrhea with a soggy-choppy pulse due to mental worry causing consumption and Blood loss.
Bai Zi Ren (Biota Semen, 2 liang, stir-fried), Shu Di Huang (Rehmanniae Radix Praeparata, 3 liang), Niu Xi (Achyranthis Bidentatae Radix, 1 liang), Juan Bai (Selaginella Tamariscina, 1 liang), Ze Lan (Lycopus Lucidus Herba, 1 liang), Xu Duan (Dipsaci Radix, 1 liang).
Cut, process into powder, make pills with refined honey, take 3 qian with rice drink.
Worry damages the Heart, exhausting Heart Blood, causing solitary Heart Fire and menstrual depletion/amenorrhea. Bai Zi Ren nourishes the Heart and moistens dryness; Shu Di Huang enriches Water and nourishes Blood; Ze Lan unblocks and benefits blood vessels; Juan Bai invigorates Blood and unblocks menstruation; Xu Duan tonifies vessel deficiency and reconnects severed collaterals; Niu Xi promotes downward flow to unblock meridians. Honey moistens; rice drink harmonizes. This nourishes Heart Qi, harmonizes Stomach Qi, distributes fluids and Blood, descends Heart Fire, unblocks meridians, and prevents consumptive disease.
Ze Lan Tang (Lycopus Decoction)
Treats amenorrhea due to Blood deficiency with a choppy pulse.
Dang Gui (Angelicae Sinensis Radix, 2 qian), Bai Shao (Paeoniae Radix Alba, 1.5 qian, stir-fried with wine), Zhi Gan Cao (Prepared Licorice Root, 1 qian), Ze Lan (Lycopus Lucidus Herba, 3 qian).
Decoct in water, remove dregs, and take warm.
Mental worry and labor cause Dry Blood to knot internally, preventing new Blood generation, leading to lack of nourishment and amenorrhea. Dang Gui nourishes Blood and benefits the Heart; Bai Shao astringes Yin and harmonizes Blood; Zhi Gan Cao benefits Stomach Qi to generate new Blood; Ze Lan resolves knotted Blood to unblock meridians. Decoct in water and take warm, resolving knots and moving Blood, relieving mental depression, generating new Blood daily, and curing Blood-depletion amenorrhea.
Tong Jing Wan (Menstruation Unblocking Pill)
Treats amenorrhea, abdominal masses, and a choppy-full pulse.
Da Huang (Rhei Radix et Rhizoma, 1 liang, processed), Gui Wei (Angelicae Sinensis Radix Tail, 2 liang), Gan Qi (Dry Lacquer, 1 liang, burned until smoke ceases), Tao Ren (Persicae Semen, 1 liang, skin and tip removed), San Leng (Sparganii Rhizoma, 1 liang, stir-fried with vinegar), Peng Ze (Curcumae Rhizoma, 1 liang, stir-fried with vinegar), Dan Pi (Moutan Cortex, 1 liang), Rou Gui (Cinnamomi Cortex, 1 liang, bark removed), Niu Xi (Achyranthis Bidentatae Radix, 1 liang), She Xiang (Moschus, 1 qian).
Process into powder. Decoct 1 liang Zao Jiao (Gleditsiae Sinensis Fructus) and 1 liang Yuan Hua (Genkwa Flos) in thick juice, mix with powder to form pills. Take 2 qian with rice drink.
Blood stasis forms masses, combined with water retention, blocking Chong and Ren Qi and stopping Blood flow, causing amenorrhea. Gui Wei breaks Blood to unblock vessels; Tao Ren breaks Blood and moistens hardness; Gan Qi dissolves hardened Blood accumulations; Rou Gui unblocks Chong and Ren vessels; Peng Ze breaks firmness; San Leng reduces masses; Niu Xi promotes downward flow; Dan Pi cools Blood and unblocks menstruation; She Xiang opens blocked orifices; Da Huang penetrates deep Blood clots; Zao Jiao opens passages; Yuan Hua drains water and relieves obstruction. Decocted juice mixed into pills, taken with rice drink, transforms stasis and moves Qi, dispersing masses, boosting Menstrual Qi, transforming Ying Blood, and curing amenorrhea and stubborn masses.