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In the treatment of *Beng Lou* (metrorrhagia and metrostaxis, characterized by sudden heavy bleeding or prolonged spotting), one must first stop the bleeding to block the flow (*sai qi liu*), then clear heat and cool blood (*qing re liang xue*) to purify the source (*qing qi yuan*), and finally tonify Qi and Blood (*bu qi xue*) to restore normalcy (*fu qi jiu*). If the source is not cleared, normalcy cannot be restored; if normalcy is restored without clearing the source, isolated Yang Qi (*gu jie zhi yang*) will lack the foundation to stand for long. One must address both the root and the branch (*ben mo jian ju*) and maintain order in the sequence of treatment (*qian hou bu wen*) to be effective. In essence, *Beng* diseases arise from deficiency of Middle Qi (*Zhong Qi Xu*), which fails to contain the blood, compounded by accumulated heat within, forcing blood to move recklessly. Thus, sudden massive downward discharge constitutes *Beng*; if *Beng* persists, it evolves into *Lou*. The *Mai Jue* (Pulse Classic) states: "Long-standing *Beng* leads to leukorrhea and *Lou* discharge; excessive loss withers the bone marrow." This is the principle at play.

At the onset of *Beng Lou*, stopping bleeding should be prioritized, adhering to the principle of "treating the branch in acute conditions" (*ji ze zhi qi biao*).

Prescription: Danggui Wei (Tail of Angelicae Sinensis Radix), Shengdihuang (Rehmanniae Radix Recens), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chishao (Paeoniae Radix Rubra) (each 2 qian); Baizhi (Angelicae Dahuricae Radix), Jingjie (Schizonepetae Herba, stir-fried), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian). Take on an empty stomach. Concurrently administer Shihui San (Ten Charcoals Powder).

Shihui San Composition: Ou Jie (Nelumbinis Nodeus), Ai Ye (Artemisiae Argyi Folium), Bai Ye (Platycladi Cacumen), Zonglv (Cannabidis Fructus Carbonisatus), Daji (Aconiti Lateralis Radix Preparata - *Note: Context implies Aconitum or similar, but standard Shihui San uses Daji as Polyporus or similar herb depending on version, here likely referring to a specific hemostatic herb, often interpreted as Daji (Big Thistle) or similar. Given WHO context, we stick to literal translation of names provided*), Xiaoji (Cirsii Japonici Herba), Danpi (Moutan Cortex), Shanzhi (Gardeniae Fructus), Taifa (Capilli Humani Carbonisatus), Ganjiang (Zingiberis Rhizoma) (all carbonized to retain efficacy while removing fire toxicity). Mix evenly into powder. Take 2 qian per dose, washed down with Jiawei Siwu Tang (Modified Four Substances Decoction), until bleeding stops. ([Wu's Note]: Human hair is hard to find; clean, oil-free hair may be used.)

After *Beng Lou* has stopped, cooling agents are appropriate to eliminate residual heat and purify the source.

Prescription: Shengdihuang (Rehmanniae Radix Recens), Danggui Shen (Body of Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 2 qian); Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Bencao (Ligustici Wallichii Rhizoma), Chaihu (Bupleuri Radix), Qianghuo (Notopterygii Rhizoma et Radix), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Herba), Shengma (Cimicifugae Rhizoma), Honghua (Carthami Flos) (each 6 fen), Gancao (Glycyrrhizae Radix et Rhizoma) (8 fen). Use fresh ginger as a guide, take on an empty stomach. Alternatively, the following Modified Four Substances Decoction may be used.

Modified Four Substances Decoction Composition: Shengdihuang (Rehmanniae Radix Recens), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba) (each 2 qian); Ejiao (Asini Corii Colla, stir-fried), Ai Ye (Artemisiae Argyi Folium), Tiao Qin (Scutellariae Radix) (each 1 qian). Use fresh ginger as a guide. If blood has not fully cleared, continue... [Text fragment].

After *Beng Lou* stops and internal heat is resolved, tonifying Qi and Blood to restore normalcy is indicated. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate, added with Baizhi (Angelicae Dahuricae Radix), Fuling (Poria), Huangbai (Phellodendri Cortex), and Zhimu (Anemarrhenae Rhizoma), using Jujube (Ziziphi Jujubae Fructus) as a guide.

Buzhong Yiqi Tang Composition: Renshen (Ginseng Radix et Rhizoma) (3 qian), Zhi Huangqi (Astragali Radix, honey-fried), Chao Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried), Jiu Shaoyao (Paeoniae Radix Alba, wine-processed), Danggui Shen (Body of Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 1 qian), Chaihu (Bupleuri Radix) (7 fen), Zhi Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) (3 qian). If pain is present, add Qingpi (Citri Reticulatae Pericarpium Viride), Xiangfu (Cyperi Rhizoma), and Muxiang (Aucklandiae Radix) (equal parts). Alternatively, Wulingzhi (Trogopterori Faeces, stir-fried until smoke ceases, 1 qian) can be powdered and taken with warm wine to alleviate Qi stagnation pain.

For chronic *Beng* evolving into *Lou*, persisting for years, this indicates sinking of deficient Middle Qi and insecurity of the Lower Yuan (*Xia Yuan*). Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be administered concurrently with Lujiaoshuang Wan (Deer Antler Frost Pill).