〔集〕血崩并漏下。中极（补） 子宫（二寸半。） 败血不止。三阴交 百劳 风门 中
极肾俞 膏肓 曲池 绝骨。
〔甲〕妇人不字，阴暴出，经水漏。然谷主之。妇人漏血，腹胀满不得息，小便黄。
阴谷主之。（《千金》云∶漏血，少腹满如阻，体寒热，腹偏肿。）女子血不通。会阴主之。女子
漏血。太冲主之。
〔脉〕问曰∶五崩何等类？师曰∶白崩者形如涕，赤崩者形如绛，黄崩者形如烂瓜，
青崩者形如蓝色，黑崩者形如 血也。寸口脉弦而大，弦则为减，大则为芤，减则为寒，
芤则为虚，寒虚相搏，此名曰革，妇人则半产漏下。（又见诸见血。）
〔仲〕寸口脉微而缓，微者卫气疏，疏则其肤空，缓者胃弱不实，则谷消而水化也。
谷入于胃，脉道乃行，水入于经，其血乃成，荣盛则其肤必疏，三焦绝经，名曰血崩。
〔脉〕诊妇人漏下赤白，日下血数升，脉急疾者死，迟者生。诊妇人漏下赤白不
止，脉小虚滑者生，大紧实数者死。
尺寸脉虚者漏血，脉浮者俱不治。（峻实其下，亦有得全者。）
〔良〕妇人冲任二脉，为经脉之海，外循经络，内荣脏腑。若阴阳和平，经下根据时。
若劳伤不能约制，则忽然暴下，甚则昏闷。若寸脉微迟，为寒在上焦，则吐血、衄血。尺
脉微迟，为寒在下焦，则崩血、便血。大抵数小为顺，洪大为逆。大法当调补脾胃为主。
〔杀血心痛〕
〔良〕妇人血崩而心痛甚，名曰杀血心痛，由心脾血虚也。若小产去血过多而心痛
甚者亦然。用乌贼鱼骨炒为末，醋汤调下。失笑散亦效。
〔薛〕前证若阴血耗散，用乌贼丸收敛之。若瘀血不散，用失笑散行散之。若心血
虚弱，用芎归汤补养之。若郁结伤血，用归脾汤调补之。一妇人血崩兼心痛三年矣，诸
药不应，每痛甚虚证悉具，面色痿黄。余曰∶心主血，盖由去血过多，心无所养，以致作
痛，宜用十全大补汤，参、术倍之。三十余剂稍愈，百余剂全愈。
[Collection] For treating metrorrhagia (sudden heavy uterine bleeding) accompanied by leukorrhea with blood spotting (continuous slight bleeding outside the menstrual period): Zhongji (CV3) acupoint (tonification method), Zigong (EX-CA1) acupoint (depth 2.5 cun). If bloody stasis does not cease, select Sanyinjiao (SP6), Bailao (EX-B1), Fengmen (BL12), Zhongji (CV3), Shenshu (BL23), Gahuang (BL43), Quchi (LI11), and Juegu (GB39) acupoints.
[Jia] For women with infertility, sudden profuse discharge from the vagina, and dripping menstruation, RanGu (KI7) is indicated. For women with bloody spotting, abdominal distension causing difficulty in breathing, and yellow urine, YinGu (KI10) is indicated. (*Qianjin Fang* records: Bloody spotting, fullness in the lower abdomen as if obstructed, alternating chills and fever, unilateral abdominal swelling.) For women with obstruction of menstrual blood flow, Huiyin (CV1) is indicated. For women with bloody spotting, Taichong (LR3) is indicated.
[Mai] Question: What are the categories of the Five Metrorrhaeias? The Master said: White metrorrhagia resembles mucus; red metrorrhagia resembles crimson fluid; yellow metrorrhagia resembles rotting melon; blue metrorrhagia resembles blue color; black metrorrhagia resembles coagulated blood. The pulse at Cun Kou is wiry and large. Wiry indicates reduction (deficiency); large indicates hollow (Kou pulse). Reduction indicates cold; hollow indicates deficiency. Cold and deficiency clashing together is named Ge pulse. In women, this leads to spontaneous abortion or bloody spotting. (Also seen in various hemorrhagic conditions.)
[Zhongjing] The pulse at Cun Kou is faint and moderate. Faint indicates dispersal of Wei Qi (Defensive Qi), leading to empty skin pores; moderate indicates weak Stomach Qi failing to be substantial, resulting in improper digestion of grains and transformation of water. When grains enter the Stomach, the vessel pathways operate; when water enters the meridians, blood is formed. When Ying Qi (Nutritive Qi) is abundant, the skin becomes loose. When the San Jiao (Triple Burner) meridians are severed, it is named metrorrhagia.
[Mai] Diagnosing women with bloody-white spotting, bleeding several sheng per day: a rapid and urgent pulse indicates death, while a slow pulse indicates survival. Diagnosing women with continuous bloody-white spotting: a small, deficient, and slippery pulse indicates survival; a large, tight, solid, and rapid pulse indicates death.
If pulses at Chi and Cun positions are deficient, there is bloody spotting; if the pulse is floating, it is generally untreatable. (However, if the lower body is strongly fortified, recovery is possible.)
[Sun Simiao] The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) in women are the Sea of the Twelve Meridians. They circulate externally along the meridians and nourish the internal Zang-Fu organs internally. If Yin and Yang are harmonious, menstruation occurs on time. If labor and injury fail to constrain the vessels, sudden profuse bleeding occurs, potentially leading to syncope or oppression. If the Cun pulse is faint and slow, it indicates cold in the Upper Jiao, leading to hematemesis or epistaxis. If the Chi pulse is faint and slow, it indicates cold in the Lower Jiao, leading to metrorrhagia or hematochezia. Generally, a small and fine pulse is favorable, while a洪大 (surging and large) pulse is unfavorable. The general principle is to regulate and tonify the Spleen and Stomach as the primary approach.
[Killing Blood Heart Pain]
[Sun Simiao] When a woman suffers from metrorrhagia with severe heart pain, it is called "Killing Blood Heart Pain," caused by deficiency of Heart and Spleen blood. This is also the case when severe heart pain follows excessive blood loss after spontaneous abortion. Use cuttlefish bone (Hai Piao Xiao, *Sepiae Endoconcha*) stir-fried into powder, taken with vinegar decoction. Shi Yao San (Pain-Stopping Powder) is also effective.
[Xue Ji] For the aforementioned syndrome, if Yin blood is consumed and scattered, use Wu Zei Wan (Cuttlefish Pill) to astringe and stop bleeding. If bloody stasis does not dissipate, use Shi Yao San (Pain-Stopping Powder) to invigorate blood and dissipate stasis. If Heart blood is deficient, use Xiong Gui Tang (Ligusticum and Angelica Decoction) to tonify and nourish. If depression injures blood, use Gui Pi Tang (Spleen-Restoring Decoction) to regulate and tonify. A woman suffered from metrorrhagia combined with heart pain for three years without response to various medicines. Each time the pain was severe, all deficiency symptoms were present, and her complexion was sallow and withered. I said: The Heart governs blood. It is likely that excessive blood loss left the Heart un-nourished, causing pain. It is appropriate to use Shi Quan Da Bu Tang (Comprehensive Great Tonic Decoction), doubling the dosage of Ren Shen (Ginseng Root) and Bai Zhu (Atractylodes Rhizome). After more than thirty doses, she improved slightly; after more than one hundred doses, she fully recovered.