答曰。夫月水不通。因风冷客于胞络。或醉后入房。或为血枯血瘕血 。或因堕坠惊恐。皆
令月水不通也。病源云。血性得温宣流。得寒则涩闭。既为冷所结搏。则月水不得通行。若
肠中鸣者。则月事不来。不来因冷干于胃腑。或醉入房者。则内气耗损。劳伤于肝经或吐血
唾血下血。谓之脱血。使血枯于中。为积块血瘕血 。名曰血聚。使荣结于内。心主行血。
堕坠惊恐。神无所倚而血散。亦令月水不通也。
顺荣汤。治妇人血积血块 症。腹大内有块形。筑筑作痛。久无寒热。
大黄(一两酒浸蒸熟锉) 当归(一两) 荜茇(半两) 鬼腰带(各一两腰带一本作箭) 枳壳(
一两去穣麸炒) 赤芍药(半两) 猪牙皂角(半两火上炙者)
上为 咀。每服一两。纯酒二盏。煎至一盏。去滓食前温服。
滋血汤。治劳过度。致伤腑脏。冲任气虚。不能约制其经。血忽暴下。谓之崩中。或下鲜血。或
下瘀血。或下血片。或下五色。连日不止。淋沥不断。形气羸劣。倦怠困乏。或月水闭绝。
气不升降。
马鞭草 牛膝 荆芥穗(各四两) 丹皮 赤芍 枳壳 肉桂 当归 川芎(各二两)
每服四钱。乌梅一个。水煎空心服。至半月或一月。经脉自通。
桃仁煎丸。治血瘕血积。经候不通。
桃仁(去皮尖面炒黄) 大黄(湿纸裹蒸) 川朴硝(各一两) 虻虫(半两炒黄)
上为末。以醇醋二升半。银石器中慢火煎取一升半。下大黄桃仁虻虫等。不住手搅。欲团圆
。下朴硝。更不住手搅。良久出之。丸如桐子大。前一日不用吃晚食。五更初。用温酒吞下五粒
。日午取下如赤豆汁鸡肝虾麻衣。未下再服。血鲜红即止。续以调气血药补之。此千金方出。
万病丸(见六问中)
Answer: Menstrual obstruction and cessation are caused by wind-cold pathogens invading the uterine collaterals (Baoluo). It may also result from sexual intercourse after intoxication, blood deficiency (Xueku), blood masses (Xuexia), or blood accumulation (Xueji). Additionally, trauma from falls or fright can lead to menstrual cessation. The *Zhubing Yuanhou Lun* states that blood flows freely when warm but becomes stagnant and obstructed when cold. When congealed by cold, menstruation cannot flow smoothly. If there is borborygmus in the intestines, menstruation ceases; this is due to cold disturbing the stomach fu organs. Sexual intercourse after intoxication depletes internal qi and injures the Liver meridian. Conditions such as hematemesis, spitting blood, or lower bleeding are termed "blood loss" (Tuoxue), leading to internal blood exhaustion. Formation of accumulations, blood masses, and blood accumulation is named "blood gathering" (Xueju), causing Ying Qi to knot internally. Since the Heart governs blood circulation, trauma or fright causes the Shen (Spirit) to lose its anchor and blood to scatter, also resulting in menstrual cessation.
Shunrong Decoction: Treats women with blood accumulation and mass formation presenting as abdominal distension with palpable masses, paroxysmal abdominal pain, and absence of chills or fever for a long duration.
Ingredients: Dahuang (Rhei Radix et Rhizoma, 1 liang, soaked in wine, steamed, and sliced), Danggui (Angelicae Sinensis Radix, 1 liang), Biba (Piperis Kadsurae Fructus, 0.5 liang), Guiyao dai (Gastrodiae Rhizoma, 1 liang; some editions read "Jian"), Zhike (Aurantii Fructus, 1 liang, pith removed, stir-fried with bran), Chishao (Paeoniae Radix Rubra, 0.5 liang), Zhuya zaojiao (Gleditsiae Sinensis Spina, 0.5 liang, roasted over fire).
Preparation and Administration: Crush the herbs into coarse powder. Take 1 liang per dose, decoct with two cups of pure wine until reduced to one cup. Strain and take warm before meals.
Zixue Decoction: Treats excessive labor damaging the zang-fu organs, leading to deficiency of Qi in the Chong and Ren meridians, which fail to constrain the menses, resulting in sudden profuse bleeding termed "Bengzhong" (Metrorrhagia). Symptoms include fresh blood, clots, blood fragments, or five-colored discharge, continuous for days without stopping, accompanied by emaciation, fatigue, lethargy, menstrual cessation, and dysfunction of Qi ascending and descending.
Ingredients: Mabiancao (Verbena Herba), Niuxi (Achyranthis Bidentatae Radix), Jingjie sui (Schizonepetae Spica) (each 4 liang), Danpi (Moutan Cortex), Chishao (Paeoniae Radix Rubra), Zhike (Aurantii Fructus), Rougui (Cinnamomi Cortex), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 2 liang).
Preparation and Administration: Take 4 qian per dose, add one Wumei (Mume Fructus), decoct with water, and take on an empty stomach. Continue for half a month to one month until menstruation resumes naturally.
Taoren Jian Wan: Treats blood masses and blood accumulation causing menstrual obstruction.
Ingredients: Taoren (Persicae Semen, peeled and tip removed, stir-fried with flour until yellow), Dahuang (Rhei Radix et Rhizoma, steamed wrapped in wet paper), Chuanponxiao (Natrii Sulfas, each 1 liang), Mengchong (Blaberidae, stir-fried until yellow, 0.5 liang).
Preparation and Administration: Grind into fine powder. Boil 2.5 sheng of strong vinegar in a silver or ceramic vessel over low heat until reduced to 1.5 sheng. Add Dahuang, Taoren, Mengchong, etc., stirring continuously. To form pills, add Poxiao, continuing to stir. Remove after a while and shape into pills the size of paulownia seeds. Do not eat dinner the night before. At dawn (Wugeng time), swallow five pills with warm wine. By noon, expel substances resembling red bean juice, chicken liver, shrimp, or hemp cloth. If not expelled, take again. Stop if bright red blood appears, then administer formulas to regulate Qi and nourish Blood. This formula originates from the *Qianjin Fang*.
Wanbing Wan (See Question 6)