《内经·阴阳别论》云∶二阳之病发心脾，有不得隐曲，女子不月；其传为风消，为息
贲者，死不治。
洁古曰∶女子月事不来者，先泻心火，血自下也。《内经》曰∶二阳之病发心脾，有不
得隐曲，故女子不月，其传为风消。王启玄注曰∶大肠、胃热也，心脾受之。心主血，心
病则血不流。脾主味，脾病则味不化。味不化则精不足，故其病则不能隐曲，脾土已亏，
则风邪胜而气愈消也。又经曰∶月事不来者，胞脉闭也。胞脉属于心，络于胞中。今气上
迫肺，心气不得下通，故月事不来。先服降心火之剂，后服《局方》中五补丸，后以卫
生汤治脾养血也。
李东垣曰∶经闭不行有三，补前人之阙。妇人脾胃久虚，形体羸弱，气血俱衰，而
致经水断绝不行。或病中消胃热，善食渐瘦，津液不生。夫经者血脉津液所化，津液既绝，
为热所烁，肌肉渐瘦，时见渴燥，血海枯竭，名曰血枯经绝。宜泻胃之燥热，补益气血，经
自行矣。此病或经适行而有子，子亦不成，而为胎病者有矣。（此中焦胃热结也。）
或心包络脉洪数，躁作时见，大便秘涩，小便虽清不利，而经水闭绝不行，此乃血海干枯，
宜调血脉，除包络中火邪，而经自行矣。（此下焦胞脉热结也。）或因劳心，心火上行，
月事不来者，胞脉闭也。包脉者，属于心而络于胞中，今气上迫肺，心气不得下通，故月
事不来。宜安心、补血、泻火，经自行矣。（此上焦心肺热结也。）裴泽之夫人病寒热，月
事不至者数年，又加喘嗽，医者率以蛤蚧、桂、附投之。曰∶不然。夫人病阴为阳所搏，
温剂太过，故无益反害，投以凉剂，凉血和血药，则行矣。已而果然。
五补丸 （《局方》）补诸虚，安五脏，坚骨髓，养精神。
熟地黄 人参 牛膝（酒浸，去芦，焙干） 白茯苓 地骨皮（各等分）
上为细末，炼蜜丸如梧子大。每服三、五十丸，温酒下，空心服。
卫生汤
当归 白芍药（各二两） 黄 （三两） 甘草（一两）
上为末，每服半两，水二盏，煎至一盏，温服，空心。如虚者，加人参一两。
上东垣、洁古治血枯之法，皆主于补血，泻火也。补血者，四物之类。泻火者，东垣
分上中下，故火在中则善食消渴，治以调胃承气之类。火在下则大小秘涩，治以玉烛之
类，玉烛者四物与调胃承气等分也。火在上则得于劳心，治以芩、连及三和之类。三和
者，四物、凉膈、当归等分也。洁古先服降心火之剂者，盖亦芩、连、三和、玉烛之类，
后服五补、卫生者，亦补气之剂也。
〔素〕帝曰∶有病胸胁支满者，妨于食，病至则先闻腥臊臭，出清液，先唾血，四肢
清，目眩，时时前后血，病名为何？何以得之？岐伯曰∶病名血枯。此得之少年时有所
大脱血。若醉入房中，气竭肝伤，故月事衰少不来也。帝曰∶治之奈何？岐伯曰∶以四
乌贼骨一芦茹二味并合之，丸以雀卵，大如小豆，以五丸为后饭，饮以鲍鱼汁，利肠中
及伤肝也。（腹中论 王注云∶乌贼鱼骨主血闭，芦茹主散恶血，雀卵主血痿，鲍鱼主瘀血。
河间《宣明论方》乌贼骨、芦茹各等分，雀卵不拘数，和丸小豆大，每服五丸至十丸，
煎鲍鱼汤下，食后日三服，压以美膳。）
上岐伯、河间治血枯之法。
〔丹〕血枯经闭者，四物汤加桃仁、红花。阴虚经脉久不通，小便短涩身疼者，四
物加苍术、牛膝、陈皮、生甘草作汤。又用苍莎丸加苍耳、酒芍药为丸，就煎前药吞下。
上丹溪治血枯大法。
〔薛〕夫经水阴血也，属冲任二脉，主上为乳汁，下为月水。其为患，有因脾虚而
不能生血者，有因脾郁伤而血耗损者，有因胃火而血消烁者，有因脾胃损而血少者，有
因劳伤心而血少者，有因怒伤肝而血少者，有因肾水不能生肝而血少者，有因肺气虚不能
行血而闭者。治疗之法，若脾虚而不行者，调而补之，脾郁而不行者，解而补之。胃火而
不行者，清而补之。脾胃损而不行者，温而补之。劳伤心血而不行者，静而补之，怒伤
肝而不行者，和而补之。肺气虚而不行者，补脾胃。肾虚而不行者，补脾肺。经云∶损其
肺者，益其气，损其心者，调其荣卫。损其脾者，调其饮食，适其寒温。损其肝者，缓
其中。损其肾者，益其精。审而治之，庶无误矣。一妇人停食，饱闷发热，或用人参
养胃汤，益甚。再用木香槟榔丸，泄泻吐痰，腹中成块，饮食少思。又用二陈、黄连、浓
朴之类，前证益甚，腹胀不食，月经不至。余以为胃气亏损，用补中益气加茯苓、半夏，三
十余剂，脾胃健而诸证愈，又二十余剂而经自行。一妇人饮食后，或腹胀，或吞酸。彼
服枳术丸，吞酸益甚，饮食日少，胸膈痞满，腿内酸痛，畏见风寒。又服养胃汤一剂，腿
内作痛。又一剂，腿膝浮肿，月经不行。余谓郁结所伤，脾虚湿热下注。侵晨用四君、二
陈、芎、归，午后以前汤送越鞠丸，饮食渐进，诸证渐愈。又用归脾、八珍二汤。兼服，
两月余而经行。一妇人性沉多虑，月经不行，胸满少食，或作胀，或吞酸。余以为中
气虚寒，用补中益气加砂仁、香附、煨姜，二剂，胸膈和而饮食进。更以六君加芎、归、贝
母、桔梗、生姜、大枣数剂，脾胃健而经自调矣。一妇人素有胃火。或用清胃散而安。
后因劳役，燥渴内热，肌肉消瘦，月经不行。余谓此胃火消烁阴血，用逍遥散加丹皮、炒
栀以清胃热，用八珍汤加茯苓、远志以养脾血，而经自行矣。一妇人久患疟，形体怯
弱，内热晡热，自汗盗汗，饮食少思，月事不行。或用通经丸，虚证大具。余曰∶此因
虚而致疟，因疟以闭经也。用补中益气及六味地黄丸各百余剂，疟愈而经行。一妇人
久患疟，疟作则经不行，形虚脉大，头痛懒食，大便泄泻，小便淋沥，口干唇裂，内热
腹膨。盖由久疟，正气已虚，阴火独旺。用补中益气汤治之，寻愈。惟不时头痛，乃加
蔓荆子而痛止，又兼用六味地黄丸而经行。一妇人因劳耳鸣，头痛体倦。此元气不足，用
补中益气加麦门、五味而痊。三年后得子，因饮食劳倦，月经不行，晡热内热，自汗盗汗，
用六味地黄丸、补中益气汤，顿愈。一妇人胃气素弱，为哭母吐血咳嗽，发热盗汗，经
水三月不行。余以为悲则伤肺，思则伤脾，遂朝服补中益气加桔梗、贝母、知母，夕用归
脾汤送地黄丸而愈。一 妇少寐，经水两月余一至。误服通经丸，展转无寐，午前恶
寒，午后发热，余以为思虑亏损脾血，用归脾汤作丸，午前以六君送下，午后以逍遥散
送下，两月余得寐，半载经行如期，年余而疮愈。
上薛氏治血枯大法，以补养真元为主。盖本易水师弟之旨而广之，王道也。
〔脉〕问曰∶妇人病下利，而经水反断者，何也？师曰∶但当止利，经自当下，勿
怪。所以利不止而血断者，但下利亡津液，故经断。利止津液复，经当自下。问曰∶妇人
病经水断一二月，而反经来，今脉反微涩，何也？师曰∶此前月中若当下利，故令妨经，利
止月经当自下，此非躯也。妇人血下，咽干而不渴，其经必断。此荣不足，本自有微
寒，故不引饮。渴而引饮者，津液得通，荣卫自和，其经必复下。
〔仲〕妇人之病，因虚积冷结气为证，经水断绝，至有历年，血寒积结胞门，寒伤经
络，凝坚在上，呕吐涎沫，久成肺痈，形体损分，在中盘结，绕脐寒疝。或两胁疼痛，与
脏相连。或结热中，病在关元，脉数无疮，肌
若鱼鳞，时着男子，非止女身。在下未多，经候不匀，令阴掣痛，少腹恶寒，或引腰脊，下
根气冲，气冲急痛，膝胫疼烦，奄忽眩冒，状如厥颠。或有忧惨，悲伤多嗔，此皆带下，非
有鬼神。久则羸瘦，脉虚多寒，三十六病，千变万端。审脉阴阳，虚实紧弦，行其针药，治
危得安。其虽同病，脉各异源，子当辨记，勿谓不然。
〔丹〕经候过期不行，杜牛膝捣汁大半盅，以玄胡末一钱，香附末、枳壳末各半钱，
早调服。
〔大〕万病丸 治经事不来，绕脐痛。
干漆（杵碎，炒烟尽） 牛膝（去苗，酒浸一宿，焙干，各一两）
上为末，以生地黄汁一升，入二味药末，银器内慢火熬可丸，即丸如桐子大。每服二
丸，空心米饮或温酒下。
土牛膝散 治妇人、室女血闭不通，五心烦热。
土牛膝 当归尾（各一两） 桃仁（去皮，麸炒，另研） 红花（各半两）
上为细末，每服二钱，空心温酒下。
当归干漆丸，疗月经不利，脐下憋，逆气胀满。（见调经门月水不利。）
治月经壅滞，脐腹 痛。
当归 玄胡索
上为粗末，每服三钱，姜三片，水一盅半，煎至七分，去滓，稍热服。
当归散 治血脉不通。
当归 穿山甲（灰炒） 蒲黄（炒，各半两） 辰砂（另研，一钱） 麝香（少许）
上为细末，研匀，每服二钱，食前热酒调下。
琥珀散 治心膈迷闷，腹脏撮痛，气急气闷，月信不通等疾。
天台乌药（二两） 当归 莪术（各一两）
上为细末，每服二钱，温酒调下，后以食压之。忌生冷、油腻。产后诸疾，炒姜、酒
调下。
小肠移热于大肠，为伏瘕，为沉。（王注云∶血涩不利，则月事沉滞而不行。）
〔圣〕治妇人月水涩滞不快，结成瘕块，筋胀大欲死。用马鞭草根苗五斤，锉细，水
五斗煎至一斗，去渣，别以净器盛，熬成膏，食前温酒调下半匙。（《本草》云∶马鞭草，辛凉，
破血瘕。）
〔罗〕血极膏 治妇人干血气。以川大黄为末，用酽醋熬成膏子，丸如鸡头大，每
服一丸，酒化开，临卧温服，大便利一二行后，红脉自下。是妇人之仙药也。加当归头。
〔仲〕妇人经水不利，抵当汤主之。（亦治男子膀胱满急有瘀血者。方见伤寒蓄血。）
产宝方 治月经不通，腹中痛。
牛膝（六分） 大黄 桃仁（去皮尖，炒） 细辛（各五分） 川芎 当归（各四分）
水蛭（三分，糯米炒黄）
上为细末，炼蜜丸梧子大，每服二十丸，空心温酒下。
千金桃仁煎 治血积 瘕，月水不行。
大黄（湿纸裹蒸） 朴硝 桃仁（制炒，各二两） 虻虫（一两，去足翅，炒黑。）
上为细末，醋二升半，银石器中慢火熬膏。却入大黄、桃仁、虻虫末，不住搅，度
可丸，却入朴硝，再搅良久，出之，丸如梧子大。五更初，温酒下五丸，至日午取下如
赤豆汁、鸡肝、蛤蟆衣样，候鲜红住服，仍以调气药补之。
三棱丸 治妇人经脉不通，气痛带下，兼治血瘕。
三棱（醋炒） 川芎 牛膝 玄胡索 蓬术（醋炒） 蒲黄 牡丹皮 芫花（醋炒）
白芷 当归 地龙（去土，酒浸炒） 干姜（炮，各一两） 大黄（二两，为末，以米醋熬
成膏，和药）
上为细末，以大黄膏和丸如梧子大，每服三、五十丸，空心醋汤下，或红花煎酒下。
上经一节，方七首，皆治污血有热而经闭。前一方轻剂，后六方重剂也。
〔云〕红花当归散 治妇人经候不行，
或积瘀血，腰腹疼痛，及室女月经不通。
红花 当归尾 紫葳 牛膝 甘草 苏木（细锉，各二两） 赤芍药（九两）
刘寄奴（五两） 桂心 白芷（各一两半）
上为细末，空心热酒调三钱服之，食前临卧再服。若久血不行，浓煎红花酒下，孕
妇休服。一名凌霄花散，即紫葳。
牛膝散（见调经门月水不利条。） 温经汤（见前调经门。）桂枝桃仁汤治妇人月
事不通，小腹膨胀疼痛。（见前调经门腹痛条。） 牡丹散（见前调经门月水不利条。）
通经丸 （《本事》）治妇人、室女月候不通，或成血瘕。（本草入鸡子清同丸。畏漆，入肠胃生疮
也。）
桂心 青皮（去白） 大黄（炮） 干姜（炮） 川椒（炒出汗） 川乌（炮） 蓬莪术
干漆（炒烟尽） 当归 桃仁（制炒，各等分）
上为末，先将四钱用米醋熬成膏，和余六钱末成剂，臼中杵丸如桐子大，晒干。每服二十
丸，用淡醋汤下，加至三十丸。温酒亦得，空心食前服。《济生》去川乌，加红花，等分。
滋血汤 治劳动致脏腑冲任气虚，不能约制经血，以致崩中，或下鲜血，或下五色，
连日不止，淋漓不断，形羸血劣，倦怠困乏，月水闭绝。
马鞭草 牛膝 荆芥穗（各二两） 当归 肉桂 牡丹皮 赤芍药 川芎（各一两）
上每服四钱，乌梅一个，水二盏，煎一盏，食前服。日进四五服，服至半月或一月，
经脉自通。
上方七首，皆治污血有寒而经闭。前四方轻剂，后二方重剂也。
〔大〕治月水不通，屡试有验。浓朴不以多少，姜汁炙香，细切浓煎，去渣空心服，
不过三四剂瘥。（形实气盛者宜之。）
〔丹〕积痰伤经不行，夜则妄语。
栝蒌子（一两） 黄连（半两） 吴茱萸（十两） 桃仁（五十粒） 红曲（二钱） 缩砂（三两）
山楂末（一两）
上生姜汁研，炊饼为丸。
The *Neijing·Yin Yang Bie Lun* states: Diseases of the Yangming (Large Intestine and Stomach) originate from the Heart and Spleen. If there is a hidden grievance or sexual dysfunction, women will experience amenorrhea; if the condition progresses to "Feng Xiao" (wasting syndrome due to deficiency heat causing emaciation) or "Xi Ben" (shortness of breath with chest fullness), it is a fatal and incurable condition.
Jiegou (Zhang Yuansu) stated: For women with amenorrhea, first clear and drain Heart Fire, and the blood will flow naturally. The *Neijing* says: Diseases of Yangming originate from the Heart and Spleen; due to hidden grievances, women suffer amenorrhea, progressing to Feng Xiao. Wang Qixuan (Wang Bing) commented: "Two Yang" refers to heat in the Large Intestine and Stomach, affecting the Heart and Spleen. The Heart governs Blood; Heart disease causes blood stasis. The Spleen governs digestion and transformation; Spleen disease prevents food from transforming into essence. Insufficient essence leads to hidden grievances; as Spleen Earth is depleted, Wind pathogen prevails, further depleting Qi. Another classic states: Amenorrhea is due to the closure of the Bao Mai (Conception Vessel collateral). The Bao Mai belongs to the Heart and connects to the uterus. Now, Qi rushes upward compressing the Lung, preventing Heart Qi from descending, thus causing amenorrhea. First administer herbs to descend Heart Fire, then take Wubu Wan from the *Taiping Huimin Heji Jufang*, and finally use Weisheng Tang to regulate the Spleen and nourish Blood.
Li Dongyuan stated: There are three types of amenorrhea, supplementing previous knowledge. Women with long-term Spleen and Stomach deficiency, emaciated bodies, and deficient Qi and Blood may experience cessation of menstruation. Or they may suffer from Zhong Xiao (Stomach heat with polyphagia), eating well but gradually losing weight, with no generation of body fluids. Menstruation is formed from blood vessels and body fluids; when fluids are exhausted and scorched by heat, muscles become emaciated, thirst and dryness occur, the Sea of Blood dries up, named Xue Ku Jing Jue (Blood Dryness and Amenorrhea). One should clear Stomach dryness-heat and tonify Qi and Blood, and menstruation will return naturally. This condition sometimes occurs after conception during menstruation, where the fetus does not survive, leading to fetal disease. (This is Middle Jiao Stomach Heat accumulation.)
Or the Pericardium Collateral pulse is surging and rapid, with frequent irritability, constipation, clear but difficult urination, and complete amenorrhea; this is the drying up of the Sea of Blood. One should regulate blood vessels and eliminate Fire pathogen in the Pericardium Collateral, and menstruation will return naturally. (This is Lower Jiao Bao Mai Heat accumulation.) Or due to mental overwork, Heart Fire rises, causing amenorrhea because the Bao Mai is closed. The Bao Mai belongs to the Heart and connects to the uterus; now Qi rushes upward compressing the Lung, preventing Heart Qi from descending, thus causing amenorrhea. One should calm the Spirit, nourish Blood, and drain Fire, and menstruation will return naturally. (This is Upper Jiao Heart-Lung Heat accumulation.) Madame Pei Zezhi suffered from alternating chills and fever for years with amenorrhea, plus wheezing and coughing. Doctors usually prescribed Gecko, Cinnamon Twig, and Aconite. I said: Incorrect. Her illness is Yin being attacked by Yang; excessive warm tonics are harmful. Administer cooling blood-nourishing herbs, and menstruation will return. It proved correct.
**Wubu Wan** (*Taiping Huimin Heji Jufang*): Tonifies various deficiencies, calms the Five Zang organs, strengthens bone marrow, and nourishes the Spirit.
Prepared Rehmannia Root (Shu Dihuang), Ginseng Radix (Renshen), Achyranthes Bidentata Root (Niuxi, wine-soaked, dried), Poria (Baifuling), Lycium Bark (Digupi) (equal parts).
Grind into fine powder, mix with refined honey to make pills the size of wu zi (loquat seeds). Take 30-50 pills each time with warm wine on an empty stomach.
**Weisheng Tang**:
Angelica Sinensis Root (Danggui), White Peony Root (Baishaoyao) (each 2 liang), Astragalus Membranaceus Root (Huangqi) (3 liang), Licorice Root (Gancao) (1 liang).
Grind into powder. Take 0.5 liang each time with two cups of water, decoct to one cup, take warm on an empty stomach. Add 1 liang of Ginseng if deficient.
These methods of Li Dongyuan and Jiegou for treating Blood Dryness both emphasize tonifying Blood and draining Fire. Tonifying Blood uses formulas like Siwu Tang. Draining Fire is divided by Li Dongyuan into Upper, Middle, and Lower Jiao. Fire in the Middle Jiao causes polyphagia and thirst, treated with Tiaowei Chengqi Tang. Fire in the Lower Jiao causes constipation and dysuria, treated with Yuzhu San (Siwu Tang equal parts with Tiaowei Chengqi Tang). Fire in the Upper Jiao results from mental overwork, treated with Scutellaria Baicalensis Root (Huangqin), Phellodendron Bark (Huanglian), and Sanhe San (Siwu Tang, Liange San, Angelica Sinensis equal parts). Jiegou’s initial use of Heart Fire-draining agents likely involved Huangqin, Huanglian, Sanhe San, or Yuzhu San; his subsequent use of Wubu Wan and Weisheng Tang were Qi-tonifying agents.
*[Suwen]* The Yellow Emperor asked: What is the name of a disease characterized by chest and hypochondriac fullness, difficulty eating, smelling foul odors at onset, clear nasal discharge, hemoptysis, cold limbs, vertigo, and frequent bleeding from the bowels and bladder? How does it arise? Qibo answered: This disease is named Xue Ku (Blood Dryness). It arises from severe blood loss in youth, or sexual activity while intoxicated, leading to Qi exhaustion and Liver injury, causing menstrual decline and amenorrhea. The Yellow Emperor asked: How to treat it? Qibo answered: Combine four parts Cuttlefish Bone (Wuzeiguz) and two parts Rubia Cordifolia Root (Luru). Form pills using quail eggs, size of small beans. Take five pills as a post-meal medicine, washed down with cuttlefish soup, to benefit the intestines and heal Liver damage. (Wang Bing’s note on *Fuzhong Lun*: Cuttlefish bone treats blood closure; Luru disperses evil blood; quail egg treats blood atrophy; cuttlefish soup treats blood stasis. Hejian’s *Xuanming Lunfang* uses equal parts Wuzeiguz and Luru, quail eggs as needed, pills size of small beans, 5-10 pills per dose, taken with boiled cuttlefish soup after meals, three times daily, accompanied by good diet.)
These are the methods of Qibo and Hejian for treating Blood Dryness.
*[Danxi]* For Blood Dryness amenorrhea, use Siwu Tang plus Peach Kernel (Taoren) and Safflower (Honghua). For Yin deficiency with long-term vessel blockage, scanty dark urine, and body pain, use Siwu Tang plus Atractylodes Macrocephala Rhizome (Cangzhu), Achyranthes Bidentata Root (Niuxi), Tangerine Peel (Chenpi), and Raw Licorice Root (Sheng Gancao) as a decoction. Additionally, use Cangsha Wan plus Cocklebur Fruit (Cangerzi) and Wine-processed White Peony Root (Jiu Shaoyao) as pills, swallowed with the decoction.
These are Danxi’s general principles for treating Blood Dryness.
*[Xuexi]* Menstruation is Yin Blood, governed by the Chong and Ren vessels, functioning to transform into milk upwards and menstruation downwards. Causes include: Spleen deficiency failing to generate Blood; Spleen depression injuring Blood; Stomach Fire scorching Blood; Spleen-Stomach damage reducing Blood; Mental labor injuring the Heart reducing Blood; Anger injuring the Liver reducing Blood; Kidney Water failing to nourish the Liver reducing Blood; Lung Qi deficiency failing to move Blood causing closure. Treatment: For Spleen deficiency, harmonize and tonify; for Spleen depression, resolve depression and tonify; for Stomach Fire, clear heat and tonify; for Spleen-Stomach damage, warm and tonify; for Heart Blood injury from labor, calm and tonify; for Liver injury from anger, harmonize and tonify; for Lung Qi deficiency, tonify Spleen and Stomach; for Kidney deficiency, tonify Spleen and Lung. The classics state: Damage to the Lung requires benefiting Qi; damage to the Heart requires regulating Ying and Wei; damage to the Spleen requires regulating diet and adapting to temperature; damage to the Liver requires soothing its interior; damage to the Kidney requires replenishing Essence. Careful diagnosis ensures accuracy.
Case 1: A woman with food stagnation, fullness, and fever was given Renshen Yangwei Tang, worsening symptoms. Then Muxiang Binglang Wan caused diarrhea, phlegm vomiting, abdominal masses, and poor appetite. Then Erchen Tang, Huanglian, Houpo worsened bloating and amenorrhea. I diagnosed Stomach Qi deficiency, used Buzhong Yiqi Tang plus Fuling and Banxia for 30+ doses, restoring Spleen-Stomach function and resolving symptoms; another 20 doses restored menstruation.
Case 2: A woman had post-prandial bloating and acid regurgitation. Zhizhu Wan worsened acid regurgitation and appetite, causing chest stuffiness, leg soreness, and aversion to wind/cold. Yangwei Tang caused leg pain and swelling, stopping menstruation. I diagnosed Depression injury with Spleen deficiency and Damp-Heat pouring downward. Morning: Sijunzi Tang, Erchen Tang, Chuanxiong, Danggui. Afternoon: Yueju Wan sent down with the morning decoction. Diet improved, symptoms resolved. Then Guipi Tang and Bazhen Tang combined for 2 months, restoring menstruation.
Case 3: A quiet, overthinking woman had amenorrhea, chest fullness, poor appetite, bloating, and acid regurgitation. I diagnosed Middle Qi deficiency-cold, used Buzhong Yiqi Tang plus Sharen, Xiangfu, and Roasted Ginger for 2 doses, relieving chest discomfort and improving appetite. Then Liujunzi Tang plus Chuanxiong, Danggui, Beimu, Jiegeng, Shengjiang, Dazao for several doses, restoring Spleen-Stomach function and regulating menstruation.
Case 4: A woman with chronic Stomach Fire was treated with Qingwei San. Later, due to labor, she had dryness-thirst, internal heat, emaciation, and amenorrhea. I diagnosed Stomach Fire scorching Yin Blood, used Xiaoyao San plus Mudanpi and Fried Gardenia to clear Stomach heat, and Bazhen Tang plus Fuling and Yuanzhi to nourish Spleen Blood, restoring menstruation.
Case 5: A woman with chronic malaria was weak, with afternoon fever, spontaneous/diaphoresis, poor appetite, and amenorrhea. Tongjing Wan exacerbated deficiency. I diagnosed malaria due to deficiency causing amenorrhea. Used Buzhong Yiqi Tang and Liuwei Dihuang Wan for 100+ doses each, curing malaria and restoring menstruation.
Case 6: A woman with chronic malaria had amenorrhea during attacks, weak form, large pulse, headache, anorexia, diarrhea, dysuria, dry mouth/lips, internal heat, and abdominal distension. Long-term malaria depleted Zheng Qi, leaving Yin Fire hyperactive. Treated with Buzhong Yiqi Tang, soon recovered. Occasional headache resolved with Manjingzi; menstruation returned with Liuwei Dihuang Wan.
Case 7: A woman had tinnitus, headache, and fatigue due to labor. Diagnosed Yuan Qi deficiency, treated with Buzhong Yiqi Tang plus Maidong and Wuweizi, recovering. Conceived 3 years later. Later, due to diet/labor, had amenorrhea, afternoon/internal heat, sweating. Treated with Liuwei Dihuang Wan and Buzhong Yiqi Tang, instantly recovered.
Case 8: A woman with weak Stomach Qi had hematemesis, cough, fever, and night sweats after mourning her mother, with amenorrhea for 3 months. I diagnosed Grief injuring Lung, Worry injuring Spleen. Morning: Buzhong Yiqi Tang plus Jiegeng, Beimu, Zhimu. Evening: Guipi Tang sending down Dihuang Wan, cured.
Case 9: A woman had insomnia and irregular menstruation (once every 2 months). Mistakenly taking Tongjing Wan caused insomnia, morning chills, afternoon fever. I diagnosed Worry injuring Spleen Blood. Guipi Wan taken morning with Liujunzi Tang, evening with Xiaoyao San. Recovered sleep in 2 months, regular menstruation in half a year, sores healed in over a year.
These are Xuexi’s general principles for treating Blood Dryness, focusing on tonifying True Yuan, expanding on the Yishui school’s philosophy, representing the "Kingly Way" of treatment.
*[Maijue]* Question: Why does a woman with diarrhea have amenorrhea? Teacher: Stop the diarrhea, and menstruation will return naturally. Diarrhea loses body fluids, causing amenorrhea. When diarrhea stops and fluids recover, menstruation returns. Question: A woman has amenorrhea for 1-2 months, then bleeding occurs, with a faint and choppy pulse. Why? Teacher: Earlier diarrhea interfered with menstruation. Once stopped, menstruation should return naturally. This is not a structural defect. If a woman bleeds, has dry throat but no thirst, menstruation stops due to insufficient Ying Blood and inherent mild cold, so she doesn't drink. If thirsty and drinking, fluids circulate, Ying and Wei harmonize, and menstruation resumes.
*[Shanghan Lun]* Women’s diseases due to deficiency, accumulated cold, and constrained Qi cause amenorrhea, lasting years. Cold blood accumulates in the Bao Gate, damaging collaterals. Congealed cold above causes vomiting of saliva/foam, eventually lung abscess, wasting the body. Congealed cold in the middle causes umbilical cold hernia. Pain in hypochondrium connects to organs. Heat constriction in the center affects Guan Yuan point. Rapid pulse without sores, fish-scale skin, affects men too, not just women. Below, irregular menstruation causes genital pulling pain, cold lower abdomen, radiating to waist/spine, affecting Qichong point, causing acute pain in legs/knees, sudden vertigo resembling epilepsy. Emotional distress, sadness, anger are all Dai diseases, not ghosts. Long-term emaciation, deficient pulse with cold, thirty-six diseases vary endlessly. Diagnose Yin/Yang pulses, deficiency/excess, tight/string-like, apply acupuncture/herbs to save lives. Same disease, different pulse origins, must distinguish carefully.
*[Danxi]* For delayed amenorrhea, crush Du Niuxi for half a cup of juice, mix with 1 qian Xuanhusuo powder, 0.5 qian Xiangfu powder, 0.5 qian Zhike powder, take early morning.
*[Dajian]* Wanbing Wan: Treats amenorrhea and periumbilical pain.
Drynaria Rhizome (Ganqi, crushed, fried until smoke ceases), Achyranthes Bidentata Root (Niuxi, stems removed, wine-soaked overnight, dried) (each 1 liang).
Grind to powder, add 1 sheng fresh Rehmannia Juice, slow-fire boil in silver vessel until pillable. Make pills size of tung seeds. Take 2 pills with rice water or warm wine on empty stomach.
Tuniuxi San: Treats female amenorrhea and five-palm heat.
Wild Achyranthes Root (Tuniuxi), Angelica Sinensis Root Tail (Dangguiwei) (each 1 liang), Peach Kernel (Taoren, peeled, bran-fried, separately ground), Safflower (Honghua) (each 0.5 liang).
Grind to fine powder. Take 2 qian with warm wine on empty stomach.
Danggui Ganqi Wan: Treats irregular menstruation, subumbilical oppression, rebellious Qi bloating. (See Tiaojing Men).
Treats menstrual stagnation and umbilical/abdominal pain.
Angelica Sinensis Root (Danggui), Corydalis Rhizome (Yuanhusuo).
Coarse powder. Take 3 qian with 3 slices ginger, 1.5 cups water, decoct to 0.7 cup, strain, take slightly warm.
Danggui San: Treats blood vessel obstruction.
Angelica Sinensis Root (Danggui), Pangolin Scale (Chuanshanjia, ash-fried), Coptis Rhizome (Puhuang, fried, each 0.5 liang), Cinnabar (Chensha, separately ground, 1 qian), Musk (Shexiang, small amount).
Fine powder. Take 2 qian with hot wine before meals.
Hupo San: Treats chest confusion, abdominal cramping pain, shortness of breath, amenorrhea.
Tiantai Aristolochia Fruit (Tiantai Weyao) (2 liang), Angelica Sinensis Root (Danggui), Curcuma Zedoary Rhizome (Ezhu) (each 1 liang).
Fine powder. Take 2 qian with warm wine, follow with food. Avoid raw/cold/greasy. Postpartum disorders: take with fried ginger and wine.
Small Intestine heat transferring to Large Intestine causes Fu Xia (hidden mass) and Chen (sinking). (Wang Bing note: Blood涩 implies menstrual stagnation.)
*[Shengji Zonglu]* Treats menstrual stagnation forming masses, severe muscle tension. Use 5 jin Ma Bian Cao root/leaves, chopped, decoct in 5 dou water to 1 dou, strain, boil down to paste. Take half spoon with warm wine before meals. (*Bencao*: Ma Bian Cao is pungent-cool, breaks blood masses.)
*[Luokanpu]* Xueji Gao: Treats female dry blood qi. Polygonum Multiflorum Root (Dahuang) powder, thick vinegar paste, pills size of chicken head. Take 1 pill dissolved in wine before bed. After 1-2 bowel movements, red menses will flow. Considered a fairy medicine for women. Add Angelica Sinensis Root Head.
*[Shanghan Lun]* Irregular menstruation in women: Didang Tang is indicated. (Also treats men with bladder fullness/urgency due to blood stasis. See Shanghan Shuxue.)
Chanbao Fang: Treats amenorrhea and abdominal pain.
Achyranthes Bidentata Root (Niuxi, 6 fen), Rhubarb (Dahuang), Peach Kernel (Taoren, peeled/fried), Asarum Root (Xixin) (each 5 fen), Ligusticum Chuanxiong Rhizome (Chuanxiong), Angelica Sinensis Root (Danggui) (each 4 fen), Leech (Shuizhi, 3 fen, fried with glutinous rice until yellow).
Fine powder, honey pills size of wu zi. Take 20 pills with warm wine on empty stomach.
Qianjin Taoren Jian: Treats blood accumulation/masses, amenorrhea.
Rhubarb (Dahuang, steamed in wet paper), Mirabilite (Pu Xiao), Peach Kernel (Taoren, processed/fried) (each 2 liang), Blister Beetle (Mengchong, 1 liang, feet/wings removed, fried black).
Powder. Add 2.5 sheng vinegar, slow-boil in silver/ceramic vessel to paste. Add Dahuang, Taoren, Mengchong powders, stir constantly until pillable. Add Pu Xiao, stir, remove, make pills size of wu zi. At 5 AM, take 5 pills with warm wine. By noon, pass material resembling red bean juice, chicken liver, or frog skin. Stop when bright red blood stops, then tonify Qi.
Sanleng Wan: Treats female meridian obstruction, Qi pain with leukorrhea, blood masses.
Curcuma Aromatica Rhizome (Sanleng, vinegar-fried), Ligusticum Chuanxiong Rhizome (Chuanxiong), Achyranthes Bidentata Root (Niuxi), Corydalis Rhizome (Yuanhusuo), Curcuma Zedoary Rhizome (Pengzhu, vinegar-fried), Coptis Rhizome (Puhuang), Moutan Cortex (Mudanpi), Genkwa Flower (Yuanhua, vinegar-fried), Angelica Dahurica Root (Baizhi), Angelica Sinensis Root (Danggui), Earthworm (Dilong, soil removed, wine-soaked/fried), Ginger (Ganjiang, roasted) (each 1 liang), Rhubarb (Dahuang, 2 liang, powder boiled in rice vinegar to paste, mixed with herbs).
Fine powder, mix with Dahuang paste to make pills size of wu zi. Take 30-50 pills with vinegar water or Honghua decoction wine on empty stomach.
The above seven formulas treat heat-stasis amenorrhea. The first is light; the latter six are heavy.
*[Yunqizi]* Honghua Danggui San: Treats female amenorrhea, blood stasis, waist/abdominal pain, and maiden amenorrhea.
Safflower (Honghua), Angelica Sinensis Root Tail (Dangguiwei), Bignonia Flower (Ziwei), Achyranthes Bidentata Root (Niuxi), Licorice Root (Gancao), Calamus Wood (Sumu, finely chopped) (each 2 liang), Red Peony Root (Chishaoyao) (9 liang), Millettia Speciosa Seed (Lijinu) (5 liang), Cinnamon Twig (Guixin), Angelica Dahurica Root (Baizhi) (each 1.5 liang).
Fine powder. Take 3 qian with hot wine on empty stomach, repeat before meals/sleep. For long-term stasis, take with concentrated Honghua wine. Contraindicated in pregnancy. Also called Lingxiaohua San (Ziwei).
Niuxi San (See Tiaojing Men Wenjing Tang. Guizhi Taoren Tang treats female amenorrhea with lower abdominal distension/pain. See Tiaojing Men Abdominal Pain. Mudan San (See Tiaojing Men).
Tongjing Wan (*Benshi Fang*): Treats female/maiden amenorrhea or blood masses. (Add egg white to pills. Avoid漆/Qi due to risk of gastrointestinal ulcers.)
Cinnamon Twig (Guixin), Green Tangerine Peel (Qingpi, pith removed), Rhubarb (Dahuang, roasted), Ginger (Ganjiang, roasted), Sichuan Pepper (Chuanjiao, fried to sweat), Aconite Root (Chuanwu, roasted), Curcuma Zedoary Rhizome (Peng’e Zhu), Drynaria Rhizome (Ganqi, fried until smoke ceases), Angelica Sinensis Root (Danggui), Peach Kernel (Taoren, processed/fried) (equal parts).
Powder. Boil 4 qian in rice vinegar to paste, mix with remaining 6 qian powder, pound in mortar to make tung seed-sized pills, dry. Take 20 pills with light vinegar water, increase to 30. Warm wine acceptable. Take on empty stomach before meals. *Jisheng Fang* removes Chuanwu, adds Honghua (equal parts).
Zixue Tang: Treats organ/Chong-Ren Qi deficiency from labor, failing to control blood, causing metrorrhagia, fresh red blood, or multi-colored discharge, continuous dripping, emaciation, fatigue, amenorrhea.
Ma Bian Cao, Achyranthes Bidentata Root (Niuxi), Schizonepeta Spike (Jingjie Sui) (each 2 liang), Angelica Sinensis Root (Danggui), Cinnamon Bark (Rougui), Moutan Cortex (Mudanpi), Red Peony Root (Chishaoyao), Ligusticum Chuanxiong Rhizome (Chuanxiong) (each 1 liang).
Take 4 qian with 1 sour plum, 2 cups water, decoct to 1 cup, before meals. 4-5 doses daily. After half month to one month, menstruation opens naturally.
The above seven formulas treat cold-stasis amenorrhea. The first four are light; the latter two are heavy.
*[Dajian]* Treats amenorrhea, proven effective. Magnolia Officinalis Bark (Houpo) as needed, ginger-juice fried until fragrant, finely cut, strong decoction, strain, take on empty stomach. 3-4 doses cure. (Suitable for robust constitution.)
*[Danxi]* Phlegm accumulation injuring meridians causes amenorrhea and nighttime delirium.
Trichosanthes Seed (Gualouzi, 1 liang), Coptis Rhizome (Huanglian, 0.5 liang), Evodia Fruit (Wuzhuyu, 10 liang), Peach Kernel (Taoren, 50 grains), Red Yeast Rice (Hongqu, 2 qian), Amomum Fruit (Suosha, 3 liang), Hawthorn Powder (Shanzha Mo, 1 liang).
Grind with ginger juice, make pills with steamed bread dough.