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Chen Linchuan in *Liangfang* states: "When a woman suffers from metrorrhagia (profuse uterine bleeding) accompanied by severe heart pain, it is termed 'Sha Xue Xin Tong' (Blood-Killing Heart Pain). This arises from the deficiency of blood in the Heart and Spleen. The same applies if severe heart pain occurs due to excessive blood loss following a miscarriage. One may use Sepiae Endoconcha (Cuttlefish Bone) stir-fried into powder, taken with vinegar water; Shixiao San (Formula for Stopping Pain) is also effective."

Shixiao San (see Abdominal Pain during Menstruation).

Lizhai (Xue Ji) states: "For the aforementioned condition, if Yin-blood is depleted and scattered, use Wuzei Wan (Sepia Pill) to astringe and consolidate. If stasis-blood fails to dissipate, use Shixiao San to promote circulation and disperse stasis. If Heart-blood is weak, use Xiong Gui Tang (Cnidium and Angelica Decoction) to tonify and nourish. If emotional constraint damages blood, use Guipi Tang (Restore the Spleen Decoction) to regulate and tonify."

Wuzei Wan (see *Furen Gui Ancient Formulas*), which is the formula for treating Blood Dryness (Jingxue Kuijie) from the *Huangdi Neijing*.
Ingredients: Sepiae Endoconcha (4 liang, shell removed), Rubia Cordifolia Radix et Rhizoma (1 liang, i.e., Qiancao Gen).
Grind the above into powder, mix with quail eggs to form pills the size of small beans. Take 5 or 10 pills per dose, washed down with broth made from dried cuttlefish (Baoyu), followed by rice to settle the medicine. Baoyu refers to today's dried salted fish.

Xiong Gui Tang (see *Furen Gui Ancient Formulas*), also known as Foshou San or Danggui Tang. It treats postpartum conditions involving excessive blood loss leading to restlessness, dizziness, unconsciousness, and all forms of fetal instability; it can also expel dead fetus.
Ingredients: Chuanxiong Rhizome (2 qian), Angelica Sinensis Radix (3-5 qian).
Crush the herbs, take half a liang each time, decoct in water and drink. If abdominal pain is present, add Cinnamomi Ramulus (Guizhi); if abdominal pain, spontaneous sweating, vertigo, and shortness of breath occur, add Mutton; if ineffective, switch to Bazhen Tang (Eight Treasures Decoction). To induce abortion, grind into powder and take mixed with wine.

Guipi Tang (see Irregular Menstruation).

Attached Case: A woman suffered from metrorrhagia combined with heart pain for three years. Various medicines were ineffective. Whenever the pain was severe, all signs of deficiency were evident, and her complexion was sallow. I said: "The Heart governs blood. It is likely that excessive blood loss has deprived the Heart of nourishment, causing pain. It is appropriate to use Shiquan Dabu Tang (Ten Great Tonifying Decoction), doubling the dosage of Ginseng Radix (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu)." After taking more than thirty doses, symptoms slightly improved; after over one hundred doses, she fully recovered.

I hold that Sha Xue Xin Tong, arising from excessive blood loss leading to severe heart pain, clearly belongs to the category of the Heart lacking nourishment. One should exclusively use sweet-warm substances to nourish Ying-Qi. Formulas such as Shiquan Dabu Tang, Daying Jian, Xiaoying Jian, and Wufu Yin are suitable. As for Shixiao San, it is only applicable when Qi stagnation and reversed Blood flow exist, used to move and disperse; it must not be used to treat Blood deficiency. Furthermore, Wuzei Wan is used in the *Huangdi Neijing·Fuzhong Lun* to treat Blood Dryness; it may not necessarily be effective for heart pain caused by Blood deficiency. Users should exercise caution.