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Menstrual blood coagulates and qi stagnates, failing to circulate freely. When amenorrhea is about to resolve, the menstrual blood color transitions from purple to pale red. Excessive sweating after illness damages blood, or it may be caused by damp-heat combined with cold and wind. If qi depression results in a deep and faint pulse, qi-promoting methods should be employed.

Use Binglang (Areca Seed), Fuzi (Prepared Aconite Root), E Zhu (Turmeric Tuber). Combine with Taoren (Peach Kernel), Niuxi (Achyranthes Root), Guizhi (Cinnamon Twig), and Mengchong (Blister Beetle). If the pulse is wiry and soggy indicating qi deficiency, use Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome), Huangqin (Scutellaria Root), Gancao (Licorice Root), Mudanpi (Moutan Bark), and Xiong (Ligusticum Rhizome).

If stomach fire causes dryness and depletion, administering Dajiang (Rhubarb) with wine yields great efficacy.

All these conditions arise from labor and fatigue damaging qi and blood, injuring the Ren Mai (Conception Vessel) and Chong Mai (Penetrating Vessel). With both qi and blood deficient, they cannot restrain menstrual blood, causing leakage. It may gradually become dripping and continuous. This often occurs because women are young, or their status declines from wealth to poverty, leading to flaming up of heart fire. Treatment should involve persuasion and counseling, along with herbs that suppress heart fire.

Beng Lou (Metrorrhagia and Metrostaxis) all result from injury to qi and blood. The pulse comes wiry, fine, large, and long. Li Dongyuan attributes this to sinking without mentioning heat; students must carefully consider this. Danxi emphasizes discussing deficiency, dampness, and heat. If the pulse is rapid, clearing heat is indicated. Taking Jingjie (Schizonepeta Spike) and Huangqin (Scutellaria Root) as powder is beneficial. Bai Cao Shuang (Soot from Chimney) ground and mixed with Siwu Tang (Four Substances Decoction); for severe pain, add Chao Hei Yuanhu (Stir-fried Black Corydalis Rhizome) and Ganjiang (Dried Ginger).

If the pulse is soggy and qi is weak, use Renshen (Ginseng Root) and Baizhu (Atractylodes Rhizome). Xuduan (Dipsacus Root) and Fangfeng (Saposhnikovia Root) have strong effects. For prolonged beng lou causing sinking, lifting methods are appropriate. Nourish blood, regulate spleen, and drain the two yangs.

Red discharge belongs to blood; white discharge belongs to qi. Damp-heat disease causing leukorrhea involves phlegm accumulation in the stomach flowing downward, seeping into the bladder; thick and sticky texture indicates this type. Another type presents like rice water first. The method should involve lifting qi; in severe cases, emesis is used to raise qi. One should avoid rich and heavy flavors.

The root cause of white leukorrhea is mostly damp-heat; red leukorrhea arises from disharmony of Ying (Nutrient) and Wei (Defensive) levels. Onset brings soreness and pain in bones and knees. If leakage persists for a long time, true yin is worn down. A wiry and slow pulse indicates wind-fire injury; Gansan (Liver Powder) is often effective. How effective is Chugen (Phellodendri Cortex or Broussonetiae Cortex depending on context, here likely Phellodendri or related bark for heat) when the pulse is rapid?

Fulonggan (Dragon's House Soil), Aiye (Mugwort Leaf), Chuanxiong (Ligusticum Rhizome) (1.5 qian each), Chishizhi (Red Halloysite), Maidong (Ophiopogon Root) (0.4 qian each), Ganjiang (Dried Ginger) (0.5 qian), Danggui (Angelica Sinensis Root) (3 qian), Rougui (Cinnamon Bark) (2 qian each), Zaoju (Jujube Fruit) (2 pieces). Decoct and take orally. Alternatively, grind into powder and take with rice water or wine.

Fetal qi should be clear and not hot; quiet and not active. There are cases where fetal pathology causes maternal unrest, and cases where maternal pathology causes fetal unrest. These must be examined in detail.