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Wang Haizang stated: When a woman's menstruation does not arrive, it is called "Bao Bi" (Uterine Closure), which is due to Blood deficiency; it is appropriate to take Siwu Tang (Four Substances Decoction). When a woman suffers from "Beng" (Metrorrhagia/Profuse Bleeding), this indicates an excess of Blood. Why should she also take Siwu Tang?

The answer is: In cases where menstruation does not arrive, the internal source (Yuan Qi) is damaged, failing to generate Blood, thus causing the uterine vessels to be blocked and unpatent. This represents Blood deficiency, so taking Siwu Tang is appropriate, as it is a formula that tonifies the source and harmonizes Blood. In cases of Beng, there is an abundance of Blood. A sudden damage to the source causes Fire to force Blood to move recklessly, with exhaustion/depletion as the root cause. Siwu Tang is also appropriate here, as it is a formula that moistens dryness and tonifies the source.

Zhu Danxi stated: Metrorrhagia and metrostaxis (Beng Lou) can be due to Deficiency or Heat. Deficiency leads to downward leakage; Heat leads to dispersion and uncontrolled flow. For both Qi deficiency and Blood deficiency, Siwu Tang is used with the addition of Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome). For cases caused by labor and exertion, add Shengma (Cimicifugae Rhizome); for Heat, add Huangqin (Scutellariae Radix); for Cold, add Ganjiang (Zingiberis Rhizoma). He further stated: Metrostaxis (Lou Xia) is due to Heat combined with Deficiency; use Siwu Tang with the addition of Huanglian (Coptidis Rhizome). For profuse bleeding from Beng, first administer Wuling (Trogopteri Dung) in one dose. If the blood is purple and forms clots, this indicates Blood Heat; use Siwu Tang with Chaihu (Bupleuri Radix) and Huanglian, followed by Siwu Tang with Paojiang (Prepared Zingiberis Rhizoma). In acute situations, treat the branch/symptom using Baizhi Tang (Angelica Dahurica Decoction) to deliver Baicaoshuang (Carbonized Herba Artemisiae Annuae).

Xue Lizhai stated: The medical classics record: "Yin Deficiency with vigorous Yang pulse is called Beng." It also states: "Injury to Yang collaterals causes blood to overflow outward; injury to Yin collaterals causes blood to overflow inward." Furthermore, it states: "The Spleen controls the blood; the Liver stores the blood." These disorders arise because Spleen-Stomach weakness and damage fail to control the blood, keeping it within the vessels. Or, because there is Fire in the Liver channel, the blood flows downward due to heat. Or, because there is Wind in the Liver channel, the blood moves recklessly due to wind. Or, anger stirs up Liver Fire, causing the blood to boil due to heat. Or, depression-heat in the Spleen channel prevents the blood from returning to the vessels. Or, excessive sorrow injures the Bao Luo (Uterine Collaterals), leading to lower bleeding. The treatment methods are as follows: For Spleen-Stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction) with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelica Sinensis Radix), plus Chaihu. For Spleen-Stomach sinking/prolapse, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Shaoyao (Paeoniae Radix Alba) and Zhizi (Gardeniae Fructus). For Liver channel Blood Heat, use Siwu Tang with Chaihu, Zhizi, and Cangzhu (Atractylodis Rhizoma). For Liver channel Wind-Heat, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) or Xiao Chaihu Tang (Minor Bupleurum Decoction) with Zhizi, Shaoyao, and Mudanpi (Moutan Cortex). If anger stirs Liver Fire, the aforementioned formulas are also used. For Spleen channel depression-fire, use Guipi Tang (Restore the Spleen Decoction) with Zhizi, Chaihu, and Mudanpi. For sorrow injuring the Bao Luo, use Sijunzi Tang (Four Gentlemen Decoction) with Shengma, Chaihu, and Zhizi. Therefore, Danxi and Dongyuan stated that for all hemorrhagic syndromes, one must conclude treatment with Sijunzi Tang; these words hold profound significance. After massive blood loss, do not rely on pulse diagnosis; urgently use Dushen Tang (Single Ginseng Decoction). Fever, tidal fever, cough, and rapid pulse indicate Yuan Qi deficiency presenting as false heat; Ren Shen (Ginseng Radix) is especially indicated. Such syndromes invariably stem from prior Spleen-Stomach damage; thus, although the pulse may be洪大 (Huge and Large), if the Stomach Qi is present and the patient can tolerate tonification, rescue is possible. If cold-cooling herbs are mistakenly used, they will further damage the vital Qi of the Spleen-Stomach, preventing the blood from returning to its source, thereby accelerating death.