一妇人经候黑血凝结成块，左厢有血瘕，水泻不止，谷食有时一化，有时不化。至今
岁四月，血块暴下，并水注俱作，是前后二阴有形之血，脱竭于下，既久，经候尤不调，
水泻日见三两行，食罢心烦不快，饮食减少，甚至瘦弱。东垣先生曰∶夫圣人治病，必本
四时升降浮沉之理，权变之宜。若不本四时，以顺为逆，非其治也。且治之大法，必先岁
气，无伐天和。无盛盛，无虚虚，遗人夭殃。无致邪，无失正，绝人长命。故圣人云∶阳
盛阴虚，下之则愈，汗之则死。阴盛阳虚，汗之则愈，下之则死。大抵圣人立法，各自有
义。且如升阳或发散之剂，是助春夏之阳气，令其上升，乃泻秋冬收藏殒杀寒凉之气，此
病是也。当用此法治之，乃升降浮沉之至理也。夫天地之气，以升降浮沉乃从四时，如
治病逆之则杀人矣。故经云∶顺天者昌，逆天者亡。可不畏哉。夫人之身亦有天地四时
之气，不可止认在外，人体亦同天地也。今经漏不止，是前阴之气血已下脱矣。水泻又
数年不愈，是后阴之气血又下陷矣。后阴者，主有形之物也，前阴者，精气之门户，俱下
竭是病患周身之气常行秋冬之令。阴主杀，此等收藏之病是也。阳生阴长，春夏是也。在
人身之中，令气升浮者，谷气上行是也。既病则周身血气皆不生长，谷气又不升，其肌
肉消少，是两仪之气，俱将绝矣。既下元二阴俱脱，血气消竭，假令当日元是热证，令
下焦久脱，已化为寒矣。此病久沉久降，寒湿太胜，当急救之。泻寒以热，除湿以燥，大
升大举，以助生长，补养气血，不致偏枯。圣人立治之法，云湿气大胜，以所胜助之，助
甲风木上升是也。故经云∶风胜湿，是以所胜平之也。当调和胃气，次用白术之类，以
燥其湿而滋元气。如其不止，后用风药以风胜湿，此之谓也。此药便是大举大升，以助
春夏二湿之久陷下之至治也。又一本云∶此病次用四物，随湿证加减。
〔大〕独圣散 治妇人血崩不止。
用防风去芦，不以多少，为细末，酒煮白面清调下二钱，空心食前，日二服，更以
面作糊，酒投之极验。
治血崩 夏枯草为细末，每服二钱，米
饮调下，无时服。
〔千〕治崩中不止。芎 八两，清酒五升，煎至二升半，分三服。不耐者，徐徐
进之。（《衍义》云∶芎不可久服，令人暴死。）
上大举大升之剂，治崩脉沉弦而洪，或沉细而数者，皆胃气下陷也。或崩而又久泻
者，亦胃气下陷也。故举之、升之，其病愈也。
〔养血行气〕
加减四物汤 治室女二七天癸至，亦有当时未至而后至者，亦有卒然暴下，淋沥不
止至有若崩漏者，失血过多，变生诸证，悉宜服之。
川芎 熟地黄（洗焙） 川当归（去芦，酒润、切焙） 白芍药（各一两） 香附子（炒
去毛，一两半）
上 咀，每服四钱，水一盏半，生姜五片，煎至七分，去滓食前温服。如血色鲜而
不止者，去熟地黄加生地黄煎服。
〔补中去积〕
丁未年冬，郭大方来说，其妻经水暴崩不止，先曾殒身失血，自后一次经数日而来，
今次不止。其人心窄，性急多惊，以予料之，他日必因心气不足，饮食失节得之。大方曰
容。到彼诊得掌中寒，脉沉细而缓，间而沉数，九窍微不利，四肢无力，上喘气短促，口
鼻气皆不调，果有心气不足，饮食失节，脾胃虚弱之证。胃脘当心而痛，左胁下急缩有
积，当脐有动气，腹中鸣下气，大便难，诸虚证极多，不能尽录。拟先治其本，余证可
以皆去。与安心定志，镇坠其惊。调和脾胃，大益元气。补其血脉，养其心神。以大热之
剂，去其冬寒凝在皮肤内。少加生地黄，去命门相火。不令四肢痿弱。黄 当归人参汤。
黄 人参 麻黄（不去节，实表闭汗） 黄连（镇心惊，各一钱） 当归（一钱半）
草豆蔻（七分） 神曲（消食，去脾胃寒） 桂枝（必先岁气，无伐天和也）
陈皮（各五分） 杏仁（九个，研如泥） 生地黄（三分，去肾火，大去冬月相火之旺）
上为粗末，水三大盏，先煮麻黄数沸，去滓入前药，同煎至一大盏，于巳午之前，食
消尽服之。其胃脘痛乃胃上有客寒，与大热药草豆蔻丸一十五丸，其痛立止。再与肝之
积药，除其积之根源而愈。
地黄丸 治足三阴亏损，经行数日不止，或兼带下无子。
熟地黄（自制） 山茱萸肉 芜荑仁 白芍药（微炒） 代赭石（各一两） 干姜（炮）
白僵蚕（炒） 浓朴（姜制，各三钱）
上为末，蜜丸桐子大。每服五十丸，空心温酒下，日三服。
上虚挟积滞而崩。尝治一老妇人血崩不止，流流不绝，满床皆血，起床不得者三月
矣，腹满如孕。予作虚挟痰积污血治之，用四物四两，参、术各一两，甘草半两以治虚；
香附三两，半夏一两半，茯苓、陈皮、枳实、缩砂、玄胡各一两，以破痰积污血。分二十
帖，每帖煎干，加荷叶、侧柏叶汤再煎服之，服尽良愈，今再不发，神效。
〔凉剂〕
〔素〕阴虚阳搏，谓之崩。
〔垣〕凉血地黄汤 治妇人血崩不止，肾水阴虚，不能镇守包络相火，故血走而崩也。
生地黄 当归尾（各半钱） 黄连 黄柏 知母 本 川芎 升麻（各二分）
红花（少许） 柴胡 防风 川羌话 黄芩 细辛 荆芥穗 蔓荆子 甘草（炙，各一分）
咀作一服，水三盏，煎至一盏，去滓空心稍热服。
足太阴脾之经中血海二穴，在膝膑上内廉白肉际二寸中，治女子漏中恶血，月事不
调，逆气腹胀，其脉缓者是也，灸三壮。足少阴肾之经中阴谷二穴，在膝内辅骨后大筋
下小筋上，按之应手，屈膝取之，治膝如锥不得屈伸，舌纵涎流，烦逆溺难，少腹急引
阴痛，股内痛，妇人漏下不止，腹胀满不得息，小便黄，如蛊，女子如妊身，可灸三壮。
〔大〕小蓟汤 治崩漏不止，色明如水，
得温则烦闷者，此阳伤于阴，令人下血。当补其阴。脉数疾小者顺，大者逆。
小蓟茎叶（研取汁） 生地黄（研取汁，各一盏） 白术（半两，锉）
上三件，入水一盏，煎减一半，去滓温服。
芎 酒 治崩中昼夜不止，医不能治。
芎 （一两） 生地黄汁（一盏）
上用酒五盏，煮芎 一盏，去滓，下地黄汁再煎二三沸，分为三服。
治崩中去血不止。
大小蓟根（五两） 白茅根（三两）
上二味细切，用酒五升，煮取四升，去渣分四服。
〔丹〕漏下乃热兼虚，四物加黄连。
奇效四物汤 治有热，久患血崩。
当归（头尾俱用） 白芍药 大川芎 熟地黄（洗焙） 大艾叶 阿胶（蛤粉炒如珠子）
黄芩（去黑者，各半两）
上锉碎，每服四钱，水一盏半，生姜五片，煎七分，空心温服。
有一医疗血崩，往 咀药铺市药，其方则四物汤加阿胶、大艾也。就铺分作八服，又
为铺索黄芩半两，加入药内。铺家亦医者，曰∶此药何为加黄芩？医曰∶非汝所知，吾与此
药，正以黄芩为主。夫心主血，血得热则行，得寒则止。病者一服而愈，服至八服，至
今无恙。又见数妇血崩者，亦用此。医以黄连解毒汤加大艾治，无不效者，又当量其虚
实用之。
〔云〕金华散 治血室有热，崩下不止，服温药不效者。
延胡索 瞿麦穗 当归 干姜 牡丹皮（各一两） 石膏（二两） 桂心（别研） 威灵仙（各七钱半）
蒲黄（半两）
上为细末，每服三钱，水一盏半，空心温服，日二。
治崩中下血方 崩中药多是用止血药及补血药，惟此方治阳乘阴，所谓天暑地热，经
水沸溢者。
黄芩（不以多少）
上为细末，每服一钱，霹雳酒调下。一方∶荆芥煎汤下。近朝有王御医直夜，有
一宫女血如山崩，其时暑月，药笥中只有大顺散两帖，以冷水调服，旋即奏效。以此知
医者要在权变也。
治漏下五色，亦治呕血，令人黄瘦虚弱。
上用地榆三两，锉碎，以醋一升，煮十余沸，去滓，食前稍热服一合。《本草》注
云∶地榆主带下十二病。一曰多赤，二曰多白，三曰月水不通，四曰阴蚀，五曰子脏坚，
六曰子门 ，七曰合阴阳患痛，八曰小腹寒痛，九曰子门闭，十曰子宫冷，十一曰梦与
鬼交，十二曰五脏不定。一方∶竹叶水煎服代茶，甚解热。
〔丹〕经水多去不能住，以三补丸加莎根、龟板、金毛狗脊。（三补丸者，芩、连、柏也。）
〔子和〕孟官人母，年五十余，血崩一载，佥用泽兰丸、黑神散、保安丸、白薇散
补之，不效。戴人见之曰∶天癸已尽，本不当下血，盖血得热而流散，非寒也。夫女子
血崩，多因大悲哭，悲甚则肺叶布，心系为之急，血不禁而下崩。《内经》曰∶阴虚阳搏
谓之崩。阴脉不足，阳脉有余，数则内崩，血乃下流。举世以虚损治之，莫有知其非者，可
服大剂，大剂者，黄连解毒汤是也。次以香附二两炒，白芍药二两焙，当归二两焙，三
味同为细末，水调下。又服摈榔丸，不旬日而安。西园公治一妇人年六十二岁，血崩
不止，投黄连解毒汤四帖后，服凉膈散合四物，六帖即愈。此妇因悲哀太过，则心闷急，
肺布叶举而上焦不通，热气在中，血走而崩，故效。
〔薛〕一妇人年将七十，素有肝脾之证，每作则饮食不进，或胸膈不利，或中脘作痛，
或大便作泻，或小便不利。余用逍遥散加山栀、茯神、远志、木香而愈。后忧女孀居，不时吐紫血，
其病每作，先倦怠而后发热。经曰∶积忧伤肺，积思伤脾。肺布叶举，是令子母俱病，不能摄血归经而致
前证。遂以前药加炒黑黄连三分，吴茱萸二分，顿愈。复因怒吐赤血甚多，躁渴垂死，此血脱也，法
当补气。乃用人参一两，苓、术、当归各三钱，陈皮、炮黑干姜各二钱，炙草、木香各一钱，一
剂顿止。一妇人年六十四，久郁怒，头痛寒热，春间乳内时痛，服流气饮之类益甚，不时有血如经行。
又大惊恐，饮食不进，夜寐不宁，乳肿及两胁， 痛如炙，午后色赤。余以为肝脾郁火血燥，先以逍遥散
加酒炒黑龙胆一钱，山栀一钱半，二剂，肿痛顿退，又二剂而全消。再用归脾加炒栀、贝母，诸证
悉愈。一妇人因怒，崩血久不已，面青黄而或赤，此肝木制脾土而血虚也。用小柴胡合四物，以清肝火，生
肝血。又用归脾、补中二汤，以益脾气，生肝血而瘥。此证若因肝经有风热而血不宁者，用防风一味
为丸，以兼证之药煎送。或肝经火动而血不宁者，用条芩炒为丸，以兼证之药煎送，无有不效。一妇
人性急，每怒非太阳、耳、项、喉，齿、胸乳作痛，则胸满吞酸，吐泻少食，经行不止。此皆肝火之证，
肝自病则外证见，土受克则内证作。若自病见，用四物加白术、茯苓、柴胡、炒栀、炒龙胆。若内证作，用
四君子加柴胡、芍药、神曲、吴茱萸、炒过黄连，诸证渐愈。惟月经不止，是血分有热，脾气尚虚，以
逍遥散倍用白术、茯苓、陈皮，又以补中益气加酒炒芍药，兼服而调。
〔温剂〕
〔垣〕丁香胶艾汤 治崩漏不止。盖心气不足，劳役及饮食不节所得，经隔少时，其脉两尺俱弦紧而
洪，按之无力。其证自觉脐下如冰，求浓衣被以御其寒，白带白滑之物虽多，间下如屋漏水，下时有
鲜血不多，右尺脉时微洪。屋漏水多，暴下者是，急弦脉，为寒多。而洪脉时见，乃热少。合而言之，急
弦者，北方寒水多也。洪脉时出者，命门包络之火也。黑物多，赤物少，合现房漏水之状也。
川芎 丁香（各四分） 熟地黄（以泻大洪脉） 白芍药（各三分） 阿胶（炒，六分，另后入）
当归身（一钱二分） 生艾叶（一钱，后入）
为细末，作一服，水二盏，煎至五沸，去滓，入胶、艾再上火煎至一大盏，空心，宿食消尽带热
服，三服效。
〔大〕治血崩
熟艾（如鸡子大） 阿胶（半两） 干姜（一钱）
上粗末，用水五盏，先煎艾叶、姜至二盏半，入胶消，温分二服，空心服。
芎 汤 （一名芎 温中汤。）治带下漏血不止，及风虚冷热，劳损冲任，月水不调，崩
中暴下，腰重里急，淋沥不断；及产后失血过多，虚羸腹痛；或妊娠胎动不安，下血，连日小便
频数，肢体烦倦，头运目暗，不欲饮食。
芎 黄 芍药 干地黄 吴茱萸 甘草（各二两） 当归 干姜（各一两）
上 咀，以水一斗，煮取三升，分三服。若月经后因有赤白不止者，除地黄、茱萸，加
杜仲、人参各二两。
断下汤 治冲任气虚，崩中漏下，经脉不调，每遇月候将来，脐腹腰脚先痛，渐减
饮食，四肢乏力及带下，三十六疾，悉能疗之。
人参（去芦） 熟地黄（洗焙） 艾叶（醋炒，各一两） 乌贼骨（烧灰） 当归（酒洗，各二两）
川芎（七钱） 干姜（炮，半两） 阿胶（蛤粉炒成珠，七钱半）
上 咀，每服五钱，水一盏半，煎至七分，去滓食前温服。
治崩漏方
四物汤（一两） 人参（二钱） 吴茱萸（一钱）
A woman presented with menstrual blood that was black and coagulated into clots, accompanied by a blood mass (abdominal mass) in the left hypochondrium, incessant watery diarrhea, and food digestion that was intermittent—sometimes digesting, sometimes not. By April of this year, large amounts of black blood clots suddenly discharged, along with profuse watery diarrhea. Both anterior and posterior orifices had lost substantial tangible blood over a long period, leading to severe depletion. Consequently, menstruation became even more irregular, with two to three episodes of watery diarrhea daily, mental restlessness and discomfort after meals, reduced appetite, and eventually emaciation and weakness.
Mr. Li Dongyuan stated: "When sages treat diseases, they must base their approach on the principles of ascending, descending, floating, and sinking according to the four seasons, exercising flexibility. If one does not follow the seasonal patterns and treats compliance as rebellion, it is not the correct method. The general principle of treatment requires first understanding the annual climate qi, without disrupting the body's natural harmony. Do not exacerbate excess conditions or further deplete deficiency conditions, thereby avoiding premature death. Do not aid pathogenic factors or damage healthy qi, lest you cut short a person's lifespan. Thus, the sages said: In cases of Yang excess and Yin deficiency, purgation leads to recovery, while sweating leads to death; in cases of Yin excess and Yang deficiency, sweating leads to recovery, while purgation leads to death. Generally, the laws established by sages have their own rationale. For instance, agents that raise Yang or induce dispersion assist the Yang qi of Spring and Summer, causing it to ascend; this dispels the cold and storing qi of Autumn and Winter. This disease falls into this category. It should be treated with this method, which represents the ultimate principle of ascending, descending, floating, and sinking. The qi of Heaven and Earth follows the seasonal cycles of ascent, descent, float, and sink; treating illness against this pattern can be fatal. Hence, the classics state: 'Those who follow Heaven prosper; those who rebel perish.' Can one not revere this? The human body also possesses the qi of Heaven, Earth, and the four seasons; one should not assume these exist only externally, as the human body mirrors Heaven and Earth. Currently, the leakage of menstrual blood indicates that the Qi and Blood of the anterior orifice have descended and depleted. The chronic watery diarrhea for years indicates that the Qi and Blood of the posterior orifice have also sunk. The posterior orifice governs tangible substances, while the anterior orifice is the gateway of essence and Qi. Their simultaneous downward depletion causes the body's Qi to behave according to the autumnal and winterly commands of contraction and killing. Yin governs killing; this belongs to diseases of storage and contraction. Yang generates and Yin grows, corresponding to Spring and Summer. Within the body, the upward movement of Grain Qi causes Qi to ascend and float. Since the illness has occurred, the body's Qi and Blood no longer grow, and Grain Qi fails to ascend, leading to muscle wasting. This signifies that both Yin and Yang are nearing exhaustion. With the lower origin and both orifices depleted, and Qi and Blood exhausted, even if the condition was originally heat, prolonged lower Jiao depletion transforms it into cold. This disease has been deeply sunken and descending for a long time, with excessive Cold-Dampness. Urgent rescue is required. Use hot herbs to dispel Cold, drying herbs to remove Dampness, and powerful lifting methods to assist growth, nourish Qi and Blood, and prevent hemiplegia. The sage's therapeutic law states that when Dampness is excessive, use the controlling element to assist it, i.e., assist the Wind-Wood of Jia to ascend. Thus, the classics say: 'Wind overcomes Dampness,' meaning using the controlling element to balance it. One should harmonize Stomach Qi, then use herbs like Atractylodis Rhizoma (Baizhu) to dry Dampness and nourish Original Qi. If bleeding persists, wind-dispelling herbs are used later to overcome Dampness with Wind. This medicine performs a great lift and rise, assisting Spring and Summer Qi to treat long-standing sinking of Dampness, representing an excellent treatment. Another version states: For this disease, use Siwu Decoction subsequently, modified according to Dampness patterns.
[Da] Dusheng San: Treats incessant metrorrhagia in women.
Use Saposhnikoviae Radix (Fangfeng), removing the radix head, in any quantity, grind into fine powder. Mix with clarified wheat flour decoction boiled in wine, take 2 qian orally. Take on an empty stomach before meals, twice daily. Alternatively, make a paste with wheat flour, mix with wine, and administer; this is extremely effective.
For Metrorrhagia: Grind Prunellae Spica (Xiakucao) into fine powder. Take 2 qian per dose, mixed with rice water, at any time.
[Qian] For Bingzhong (profuse uterine bleeding) that does not stop: Chuanxiong Rhizome (Chuanxiong) 8 liang, clear wine 5 sheng. Decoct until 2.5 sheng remain. Divide into three doses. For those intolerant, administer slowly. (*Yanyi* states: Chuanxiong should not be taken for long periods, as it may cause sudden death.)
The aforementioned powerful lifting and rising agents are indicated for metrorrhagia with pulse characteristics of deep, wiry, and surging, or deep, fine, and rapid, all indicating Spleen-Stomach Qi sinking. Or if metrorrhagia is accompanied by chronic diarrhea, it also indicates Spleen-Stomach Qi sinking. Therefore, lifting and raising the Qi cures the disease.
[Nourishing Blood and Regulating Qi]
Modified Siwu Decoction: Treats young unmarried women around age fourteen when Tian Gui arrives. Some may have delayed onset, while others experience sudden profuse bleeding, dripping continuously, resembling metrorrhagia. Due to excessive blood loss transforming into various syndromes, this formula is suitable for all such cases.
Chuanxiong Rhizome (Chuanxiong), Prepared Rehmanniae Radix (Shudihuang, washed and dried), Angelicae Sinensis Radix (Danggui, remove radix head, moisten with wine, slice and dry), Paeoniae Radix Alba (Baishao) (each 1 liang), Cyperi Rhizoma (Xiangfu, stir-fry to remove hairs, 1.5 liang).
Crush the herbs. Take 4 qian per dose, add 1.5 zhan of water and 5 slices of Zingiberis Rhizoma Recens (Shengjiang). Decoct to 0.7 portion. Strain and take warm before meals. If the blood color is bright red and bleeding continues, remove Prepared Rehmanniae Radix (Shudihuang) and add Rehmanniae Radix (Shengdi Huang) for decoction.
[Supplementing and Removing Accumulation]
In the winter of Dingwei year, Guo Dafang reported that his wife suffered from sudden profuse uterine bleeding. She had previously miscarried and lost blood. Subsequently, her menses arrived after several days, and this time it did not stop. His wife has a narrow mind and an irritable temperament prone to fright. I deduced she would likely suffer from Heart Qi deficiency and dietary irregularities in the future. Upon examination, her palms were cold, pulse was deep, fine, and slow, occasionally deep and rapid. Her nine orifices were slightly obstructed, limbs weak, upper body panting with shortness of breath, and breathing through mouth and nose irregular. Indeed, there were signs of Heart Qi deficiency, dietary irregularity, and Spleen-Stomach weakness. Pain at the epigastrium, tightness and accumulation in the left hypochondrium, pulsation at the umbilicus, borborygmus and flatus, difficult defecation, and numerous deficiency syndromes were present, too many to record fully. I planned to treat the root first, allowing other symptoms to resolve. I prescribed calming the mind and stabilizing the will, suppressing fright, harmonizing Spleen and Stomach, greatly benefiting Original Qi, nourishing blood vessels, and supporting Heart Spirit. Using strongly hot herbs to dispel winter cold stagnating in the skin. Adding small amounts of Rehmanniae Radix (Shengdi Huang) to clear Mingmen Ministerial Fire, preventing limb flaccidity. Formula: Huangqi Renshen Tang.
Astragali Radix (Huangqi), Ginseng Radix (Renshen), Ephedrae Herba (Mahuang, do not remove joints, to secure exterior and stop sweating), Coptidis Rhizoma (Huanglian, calm heart and fright, each 1 qian), Angelicae Sinensis Radix (Danggui, 1.5 qian), Alpiniae Katsumadai Semen (Caodoukou, 0.7 qian), Massae Fermentatae Medicinatae (Shenqu, digest food, remove Spleen-Stomach cold), Cinnamomi Ramulus (Guizhi, must follow annual climate qi, do not disrupt heavenly harmony), Citri Reticulatae Pericarpium (Chenpi, each 0.5 qian), Armeniacae Semen Amarum (Xingren, 9 grains, grind to paste), Rehmanniae Radix (Shengdi Huang, 0.3 qian, clear Kidney fire, greatly reduce winter ministerial fire).
Grind into coarse powder. Add 3 zhan of water. First boil Ephedrae Herba (Mahuang) for a few boils, discard dregs, add remaining herbs, and decoct together to 1 zhan. Take before Si/Wu hours (9 AM - 1 PM), after food digestion is complete. The epigastric pain was due to external cold in the Stomach; administer 15 pills of Caodoukou Wan (a strongly hot formula), and pain stopped immediately. Then administer herbs for Liver accumulation to remove the root cause, resulting in cure.
Dihuang Wan: Treats deficiency of the three Yin meridians of the foot, menstruation lasting several days without stopping, or accompanied by leukorrhea and infertility.
Prepared Rehmanniae Radix (Shudihuang, self-made), Corni Fructus (Shanzhuyu), Phytolaccae Radix (Wuyiren), Paeoniae Radix Alba (Baishao, lightly stir-fried), Haematitum (Daizheshi) (each 1 liang), Zingiberis Rhizoma (Ganjiang, processed), Bombyx Batryticatus (Baijiangcan, stir-fried), Magnoliae Officinalis Cortex (Houpo, ginger-processed, each 3 qian).
Grind into powder, make honey pills the size of paulownia seeds. Take 50 pills per dose, with warm wine on an empty stomach, three times daily.
The above describes metrorrhagia caused by deficiency complicated by stagnation. I once treated an elderly woman with incessant metrorrhagia, flowing continuously, filling the bed with blood, unable to get out of bed for three months, abdomen distended as if pregnant. I treated it as deficiency complicated by phlegm-stasis and dirty blood. Used Siwu Tang 4 liang, Ren Shen 1 liang, Baizhu 1 liang, Gan Cao 0.5 liang to treat deficiency; Xiang Fu 3 liang, Banxia 1.5 liang, Poria (Fuling), Chenpi, Zhi Shi, Su Sha, Yan Hu Suo each 1 liang to break phlegm-stasis and dirty blood. Divided into 20 doses. Each dose was decocted until dry, then added with He Ye (Lotus Leaf) and Ce Bai Ye (Biota Top) decoction, and taken again. After finishing the course, she recovered well and has not relapsed; miraculous effect.
[Cooling Agents]
[Ssu]: Yin deficiency with Yang bounding is called Bing (metrorrhagia).
[Yuan] Liangxue Dihuang Tang: Treats women with incessant metrorrhagia due to Kidney Water Yin deficiency, failing to control the Pericardium Ministerial Fire, causing blood to rush and bleed.
Rehmanniae Radix (Shengdi Huang), Angelicae Sinensis Radix Caudex (Danggui Wei, each 0.5 qian), Coptidis Rhizoma (Huanglian), Phellodendri Cortex (Huangbai), Anemarrhenae Rhizoma (Zhimu), Lepidii Semen (Ben), Chuanxiong Rhizome (Chuanxiong), Cimicifugae Rhizoma (Shengma) (each 0.2 qian), Carthami Flos (Honghua, a little), Bupleuri Radix (Chaihu), Saposhnikoviae Radix (Fangfeng), Notopterygii Rhizoma et Radix (Qianghuo), Scutellariae Radix (Huangqin), Asari Radix et Rhizoma (Xixin), Schizonepetae Spica (Jingjie Sui), Viticis Fructus (Manjingzi), Glycyrrhizae Radix et Rhizoma (Gancao, roasted, each 0.1 qian).
Crush into one dose. Add 3 zhan of water, decoct to 1 zhan. Strain and take warm on an empty stomach.
Xuehai acupoint of the Foot-Taiyin Spleen Meridian: Located 2 cun above the medial border of the patella, on the white flesh margin. Treats women with leukorrhea containing bad blood, irregular menstruation, rebellious Qi, abdominal distension, with a slow pulse. Moxibustion: 3 cones.
Yingu acupoint of the Foot-Shaoyin Kidney Meridian: Located behind the medial condyle of the tibia, under the large tendon and above the small tendon. Press to feel the pulse. Flex the knee to locate. Treats knee pain like a needle prick, inability to flex/extend, tongue protrusion with salivation, irritability, difficult urination, acute pain in lower abdomen radiating to genitals, thigh pain, women with incessant leukorrhea, abdominal fullness with dyspnea, yellow urine,蛊-like symptoms, women feeling pregnant. Moxibustion: 3 cones.
[Da] Xiaoji Tang: Treats metrorrhagia and metrostaxis that do not stop, with blood color clear as water, becoming vexatious when warmed. This indicates Yang injury by Yin, causing lower bleeding. Tonify Yin. Pulse rapid and small is favorable; large is unfavorable.
Stems and leaves of Small Thistle (Xiaoji, extract juice), Rehmanniae Radix (Shengdi Huang, extract juice, each 1 zhan), Atractylodis Macrocephalae Rhizoma (Baizhu, 0.5 liang, sliced).
Add 1 zhan of water to the three ingredients. Decoct until volume halves. Strain and take warm.
Chuanxiong Wine: Treats Bingzhong (uterine bleeding) day and night that doctors cannot cure.
Chuanxiong Rhizome (Chuanxiong, 1 liang), Juice of Rehmanniae Radix (Shengdi Huang, 1 zhan).
Add 5 zhan of wine, boil Chuanxiong until 1 zhan remains. Strain, add Shengdi Huang juice, boil 2-3 more times. Divide into three doses.
For metrorrhagia with continuous blood loss.
Roots of Large and Small Thistle (Daxiao Ji Gen, 5 liang), White Imperata Root (Baimaogen, 3 liang).
Slice finely. Add 5 sheng of wine, boil to obtain 4 sheng. Strain and divide into four doses.
[Dan] Leaking is Heat combined with Deficiency. Siwu Decoction plus Coptidis Rhizoma (Huanglian).
Qixiao Siwu Tang: Treats Heat syndrome with chronic metrorrhagia.
Angelicae Sinensis Radix (Danggui, use both head and tail), Paeoniae Radix Alba (Baishao), Large Chuanxiong Rhizome (Chuanxiong), Prepared Rehmanniae Radix (Shudihuang, washed and dried), Large Artemisiae Argyi Folium (Aiye), Asini Corii Colla (Ejiao, fried with蛤粉 until pearl-like), Scutellariae Radix (Huangqin, remove black parts, each 0.5 liang).
Crush finely. Take 4 qian per dose, add 1.5 zhan of water and 5 slices of Zingiberis Rhizoma Recens (Shengjiang). Decoct to 0.7 portion. Take warm on an empty stomach.
A physician treated metrorrhagia and went to a pharmacy to buy herbs. The prescription was Siwu Decoction plus Ejiao and Aiye. He divided it into eight doses at the shop and asked the pharmacist for 0.5 liang of Huangqin to add. The pharmacist, also a doctor, asked: "Why add Huangqin?" The physician replied: "You do not understand. My primary herb here is Huangqin. The Heart governs Blood; Blood flows with Heat and stops with Cold." The patient recovered after one dose. After eight doses, she remained healthy. I have seen several women with metrorrhagia treated with this formula. Physicians using Huanglian Jiedu Tang plus Aiye find it effective, but dosage must be adjusted based on deficiency and excess.
[Yun] Jinhua San: Treats Heat in the Blood Chamber causing incessant bleeding, ineffective with warming medicines.
Cyperi Rhizoma (Yanhusuo), Persicariae Herba (Qumai Sui), Angelicae Sinensis Radix (Danggui), Zingiberis Rhizoma (Ganjiang), Moutan Cortex (Mudanpi) (each 1 liang), Gypsum Fibrosum (Shigao, 2 liang), Cinnamomi Cortex (Guixin, separately ground), Peucedani Radix (Weilingxian) (each 0.75 liang), Polygoni Multiflori Caulis (Puhuang, 0.5 liang).
Grind into fine powder. Take 3 qian per dose, with 1.5 zhan of water, warm on an empty stomach, twice daily.
Formula for Bingzhong Lower Bleeding: Most formulas for Bingzhong use hemostatic and blood-nourishing herbs. This formula treats Yang invading Yin, described as 'hot heaven and earth, boiling overflow of menstrual water.'
Scutellariae Radix (Huangqin, any quantity).
Grind into fine powder. Take 1 qian per dose, mixed with Pili Jiu (Thunderbolt Wine). Another method: Mixed with Jingjie decoction. Recently, Imperial Physician Wang, on night duty, encountered a palace maid with mountain-like uterine bleeding during summer. Only Dashun San packets were available in his medical kit. He mixed them with cold water, and the effect was immediate. This shows physicians must exercise flexibility.
Treats leukorrhea of five colors, also treats hematemesis, leading to jaundice, thinness, and weakness.
Use Diyu (Sanguisorbae Radix) 3 liang, slice finely. Boil with 1 sheng of vinegar for ten boils. Strain. Take 1 he of the decoction, warm, before meals. *Bencao* notes: Diyu treats twelve types of leukorrhea. 1. Excessive red discharge; 2. Excessive white discharge; 3. Amenorrhea; 4. Genital erosion; 5. Hard uterus; 6. Closed cervical os; 7. Pain during intercourse; 8. Lower abdominal cold pain; 9. Cervical closure; 10. Cold uterus; 11. Dreams of ghosts; 12. Unstable Five Viscera. Another method: Decoct Zhuye (Bamboo Leaf) in water and drink as tea; very effective for clearing Heat.
[Dan] Menstrual flow excessive and uncontrolled: Sanbu Wan plus Shagen (Sedge Root), Guiban (Tortoise Shell), Jinmao Gouji (Cibotium Rhizome). (Sanbu Wan consists of Huangqin, Huanglian, Huangbai).
[Zihe]: Mother of Official Meng, over fifty years old, suffered from metrorrhagia for one year. All physicians used Zelany Wan, Heishen San, Bao'an Wan, Baiwei San to tonify, without effect. Dairen examined her and said: "Tian Gui has ended; bleeding should not occur. Blood flows and scatters due to Heat, not Cold. Female metrorrhagia is often caused by extreme grief/sobbing. Extreme grief causes Lung lobes to expand, the Heart Tie (connection) becomes tense, and blood cannot be controlled, leading to collapse. *Neijing* states: 'Yin deficiency with Yang bounding is called Bing.' Yin pulse insufficient, Yang pulse excessive, rapid pulse indicates internal collapse, blood flows down. The world treats this as deficiency consumption, none knowing it is wrong. Administer a large dose; the large dose is Huanglian Jiedu Tang. Next, stir-fry 2 liang of Xiangfu, bake 2 liang of Baishao, bake 2 liang of Danggui. Grind three herbs into fine powder, mix with water and take. Also administer Binglang Wan. Within ten days, she stabilized. Mr. Xiyuan treated a sixty-two-year-old woman with incessant metrorrhagia. After four doses of Huanglian Jiedu Tang, she took Liangge San combined with Siwu Tang for six doses and recovered. This woman suffered excessive grief, causing Heart oppression and urgency, Lung expansion blocking Upper Jiao, Heat trapped inside, causing blood to rush and bleed. Hence the efficacy."
[Xue]: A woman nearly seventy years old, with chronic Liver-Spleen disorders. Attacks caused anorexia, chest/diaphragm obstruction, epigastric pain, diarrhea, or difficulty urinating. I used Xiaoyao San plus Zhizi, Fushen, Yuanzhi, Muxiang, and she recovered. Later, due to widowhood and worry, she intermittently vomited purple blood. Each attack began with fatigue followed by fever. Classics state: "Accumulated sorrow injures Lung, accumulated thought injures Spleen." Lung expansion causes mother-daughter organs to both suffer, failing to control blood return to vessels, causing previous symptoms. I added 0.3 qian of charcoal-processed Huanglian and 0.2 qian of Wuzhuyu to the previous formula, achieving instant cure. Later, due to anger, she vomited large amounts of red blood, became restless/thirsty near death. This is Blood loss; method requires tonifying Qi. I used 1 liang of Renshen, 3 qian each of Lingzhi, Baizhu, Danggui, 2 qian each of Chenpi, charred Ganjiang, 1 qian each of Zhi Gancao, Muxiang. One dose stopped the bleeding. A sixty-four-year-old woman, with chronic anger/stagnation, headache/chills-fever, breast pain in spring, worsened by Liqi Yin. Intermittent bleeding like menstruation. After great fright, anorexia, insomnia, breast/lateral hypochondrium swelling, burning pain, red complexion in afternoon. I diagnosed Liver-Spleen stagnant Fire and Blood dryness. First used Xiaoyao San plus 1 qian wine-charred Longdan, 1.5 qian Zhizi. Two doses reduced swelling/pain; two more doses eliminated it completely. Then used Guipi Tang plus charred Zhizi, Beimu; all symptoms resolved. A woman, due to anger, had prolonged metrorrhagia, face green-yellow or red. This is Liver Wood overacting on Spleen Earth causing Blood deficiency. Used Xiao Chai Hu Tang combined with Siwu Tang to clear Liver Fire and generate Liver Blood. Then used Guipi Tang and Buzhong Yiqi Tang to benefit Spleen Qi, generate Liver Blood, and recover. If this syndrome is due to Wind-Heat in Liver channel causing Blood unrest, use Fangfeng alone made into pills, taken with decoction for accompanying symptoms. If Liver Fire moves causing Blood unrest, use Tiao Qin (Scutellaria) charred into pills, taken with accompanying symptom decoction; always effective. A woman with quick temper, upon anger, experienced pain in Taiyang region, ears, neck, throat, teeth, chest/breasts, OR chest fullness with acid regurgitation, vomiting/diarrhea, reduced food intake, incessant menstruation. These are all Liver Fire syndromes. Liver self-disease manifests externally; Earth受克 (affected by Wood) manifests internally. If self-disease appears, use Siwu Tang plus Baizhu, Fuling, Chaihu, charred Zhizi, charred Longdan. If internal symptoms appear, use Sijunzi Tang plus Chaihu, Shaoyao, Shenqu, Wuzhuyu, charred Huanglian; symptoms gradually improve. Only incessant menstruation indicates Heat in Blood level and still-deficient Spleen Qi. Use Xiaoyao San doubling Baizhu, Fuling, Chenpi, combined with Buzhong Yiqi Tang plus wine-charred Shaoyao, taken concurrently to regulate.
[Warming Agents]
[Yuan] Dingxiang Jiao'ai Tang: Treats metrorrhagia and metrostaxis that do not stop. Due to Heart Qi deficiency, labor, and dietary irregularities. After a short interval, pulse at both Chi positions is wiry, tight, and surging, but forceless on pressure. Symptoms include feeling cold below navel as if ice, seeking thick clothes/quilts to ward off cold. Although abundant white slippery leukorrhea exists, occasionally leaking like roof drip, with small amounts of fresh blood. Right Chi pulse occasionally slightly surging. Roof-drip type is profuse sudden bleeding. Rapid wiry pulse indicates much Cold. Occasional surging pulse indicates slight Heat. Combined: Rapid wiry indicates Northern Cold Water excess. Surging pulse indicates Mingmen/Pericardium Fire. Black discharge more than red matches roof-drip appearance.
Chuanxiong Rhizome (Chuanxiong), Eugeniae Flos (Dingxiang) (each 0.4 qian), Prepared Rehmanniae Radix (Shudihuang, to drain surging pulse), Paeoniae Radix Alba (Baishao) (each 0.3 qian), Asini Corii Colla (Ejiao, fried, 0.6 qian, added later), Angelicae Sinensis Radix (Danggui Shen, 1.2 qian), Fresh Artemisiae Argyi Folium (Sheng Aiye, 1 qian, added later).
Grind into fine powder, make one dose. Add 2 zhan of water, boil five times. Strain, add Ejiao and Aiye, boil again to 1 zhan. Take warm on an empty stomach after overnight food digestion. Three doses show effect.
[Da] Treating Metrorrhagia
Cooked Artemisiae Argyi Folium (Shu Aiye, size of chicken egg), Asini Corii Colla (Ejiao, 0.5 liang), Zingiberis Rhizoma (Ganjiang, 1 qian).
Coarse powder. Add 5 zhan of water. First boil Aiye and Ganjiang to 2.5 zhan. Dissolve Ejiao. Take warm, divided into two doses, on empty stomach.
Xiong Huang Tang (also named Xiong Huang Wenzhong Tang): Treats leukorrhea with continuous leaking blood, wind-deficiency cold-heat, lao sun (chronic depletion) of Chong and Ren meridians, irregular menstruation, sudden Bingzhong, heavy waist with internal tension, continuous dripping; postpartum excessive blood loss, emaciated abdominal pain; or pregnancy fetal restlessness with bleeding, consecutive days of frequent urination, limb fatigue, dizziness/blurred vision, anorexia.
Chuanxiong Rhizome (Chuanxiong), Astragali Radix (Huangqi), Paeoniae Radix (Shaoyao), Dry Rehmanniae Radix (Gan Dihuang), Evodiae Fructus (Wuzhuyu), Glycyrrhizae Radix et Rhizoma (Gancao) (each 2 liang), Angelicae Sinensis Radix (Danggui), Zingiberis Rhizoma (Ganjiang) (each 1 liang).
Crush. Add 1 dou of water, boil to obtain 3 sheng. Divide into three doses. If red/white discharge continues after menstruation, remove Dihuang and Wuzhuyu, add Duzhong and Renshen each 2 liang.
Duansha Tang: Treats Chong-Ren Qi deficiency, Bingzhong/leukorrhea, meridian irregularity. Before menstruation, pain in umbilicus/abdomen/waist/legs, reduced diet, limb weakness, leukorrhea. Treats thirty-six diseases.
Ginseng Radix (Renshen, remove head), Prepared Rehmanniae Radix (Shudihuang, wash/dry), Artemisiae Argyi Folium (Aiye, vinegar-fried, each 1 liang), Sepiae Endoconcha (Wubeigu, burnt to ash), Angelicae Sinensis Radix (Danggui, wine-washed, each 2 liang), Chuanxiong Rhizome (Chuanxiong, 0.7 qian), Zingiberis Rhizoma (Ganjiang, processed, 0.5 liang), Asini Corii Colla (Ejiao, fried with蛤粉 to pearls, 0.75 liang).
Crush. Take 5 qian per dose, add 1.5 zhan of water, decoct to 0.7 portion. Strain and take warm before meals.
Formula for Bingzhong/Metrostaxis
Siwu Tang (1 liang), Ginseng Radix (Renshen, 2 qian), Evodiae Fructus (Wuzhuyu, 1 qian).