瘀血留滞作 ，惟妇人有之。其证则或由经期，或由产后，凡内伤生冷，或外受风寒，或恚怒伤肝，气逆
而血留，或忧思伤脾，气虚而血滞，或积劳积弱，气弱而不行。总由血动之时，余血未净，而一有所逆，则留
滞日积而渐以成 矣。然血必由气，气行则血行。故凡欲治血，则或攻或补，皆当以调气为先。罗谦甫
曰∶养正邪自除，必先调养，使营卫充实，若不消散，方可议下。但除之不以渐，
则必有颠覆之害，若不守禁忌，纵嗜欲，其有不丧身者鲜矣。
血 作痛，或成形不散，在脐腹之下，若暂见停蓄而根盘未固者，只宜五物煎或决津煎加减主之，则血无
不去，痛无不止，足称神剂。
五物煎（见血寒论外方）
决津煎（见经期腹痛）
妇人形气、病气俱实，或腹胀，或痛甚，而新有所逆，但欲行滞止痛者，宜通瘀煎、失笑散、玄胡当归
散、加减四物汤之类，疏之、导之，气通滞去，痛必自愈。若稍久且坚，而欲消之、磨之，宜三棱丸、万病丸
之类主之。
通瘀煎（见经期腹痛）
失笑散（见经期腹痛）
玄胡当归散（见经痛论外方）
《良方》加减四物汤（见《妇人规古方》）治妇人血积。
当归 川芎 芍药 熟地 蓬术 三棱 肉桂 干漆（炒烟尽等分）
上 咀，每服五七钱，水钟半，煎七分，食远服。
三棱丸（见《古方八阵·攻阵》）治血 、血
瘕、食积、痰滞。
莪术（醋浸炒） 三棱（各三两） 青皮 麦芽（炒） 半夏（各一两）
上共享好醋一钟，煮干共为末，醋糊丸，桐子大，每服四十丸，淡醋汤下。痰积，姜汤下。
万病丸（见《妇人规古方》）治月经瘀闭，脐腹作痛，及产后 瘕等病。
干漆（炒烟出青白为度） 牛膝（酒洗焙各一两）
上为末，生地黄一升，用砂锅慢火熬膏，丸桐子大，每服二十丸，空心米饮下。
形气强壮而瘀血不行，或大便结闭，或腹胀痛甚，有非下不可者，宜《良方》桃
仁承气汤下之最捷，或用夺命丹、桃仁煎、穿山甲散、赤金豆之类皆可，然下须详慎，非有大实不得已之证，
不宜妄用。
《良方》桃仁承气汤（见《古方八阵·攻阵》）治瘀血小腹作痛，大便不利，或谵语口干，漱水
不咽，遍身黄色，小便自利或血结胸中。疼痛不可近，或寒热
昏迷，其人如狂。
桃仁（半两去皮尖） 大黄（炒一两） 甘草（二钱） 肉桂（一钱）
上姜水煎，发日五更服。
夺命丹（见鬼胎）
《良方》桃仁煎（见《古方八阵·攻阵》）治血瘕。
桃仁 大黄（炒各一两） 虻虫（半两炒黑） 朴硝（一两）
上为末，以醇醋一钟，瓷器中煮三分，下前三味，不住手搅煎至可丸，乃下朴硝，丸如桐子大，不吃晚
食，五更初温酒下五丸，日午下秽物，如未见，再服，仍以调气血药补之。立斋曰∶向
在毗陵一妇人，小便不通，脐腹胀甚，余诊之曰∶此血瘕也，用前药一服，腹痛下瘀血、血水即愈。此药猛
烈大峻，气血虚者斟酌与之。
穿山甲散（见《古方八阵·攻阵》）治 痞瘀血，心腹作痛。
穿山甲（炒焦） 鳖甲（醋炙） 赤芍药 大黄（炒） 干漆（炒烟尽） 桂心（各一两） 川芎
芫花（醋炒） 归尾（各半两） 麝香（一钱）
上为末，每服一钱，酒调下。
赤金豆（见鬼胎）
养正之法，当察阴阳上下，病之久新及邪正强弱之势。其有停瘀虽甚，而元气困弱者不可攻；病久而弱，
积难摇动者不可攻。凡此之类，皆当专固根本，以俟其渐磨渐愈，乃为良策。如郁结伤脾者，宜用归脾汤、逍
遥饮、寿脾煎。脾胃虚寒者，宜温胃饮、养中煎、六君子汤。肝肾虚寒者，宜大营煎、暖肝煎、理阴煎，或
《良方》交加散亦可。脾肾虚寒，大便泄泻或不实者，宜胃关煎、理阴煎。病久脾肾气滞而小腹痛胀者，宜八
味地黄丸。肝火不清，血热而滞者，宜加味逍遥散。以上诸证，凡虚中带滞者，不妨于前药中各加行气导滞之
品，此在用者之圆活也。
归脾汤（见经不调）
逍遥饮（见肾虚经乱）
寿脾煎（见血虚经乱）
温胃饮（见血虚经乱）
养中煎（见《新方八阵·热阵》）治中气虚寒，为呕为泄者。
人参（一至三钱） 山药（炒二钱） 白扁豆（炒二三钱） 炙甘草（一钱） 茯苓（二钱） 干姜（炒黄一二钱）
水二钟，煎七分，食远温服。如嗳腐气滞者，加陈皮一钱，或砂仁四分。如胃中空虚觉馁者，加熟地三、五钱。
六君子汤（见经期腹痛）
大营煎（见血热经早）
暖肝煎（见《新方八阵·热阵》）治肝肾阴寒，小腹疼痛疝气等证。
当归（二、三钱） 枸杞（三钱） 茯苓（二钱） 小茴香（二钱） 肉桂（一、二钱） 乌药（二钱）
沉香（一钱，或木香亦可）
水一钟半，加生姜三、五片，煎七分，食远温服。
如寒甚者，加吴茱萸、干姜，再甚者，加附子。
理阴煎（见血寒经迟）
《良方》交加散（见经痛论外方）
胃关煎（见产后腹痛）
八味地黄汤（即八味丸。见经不调）
加味逍遥散（见经不调）
妇人久 宿痞，脾肾必亏，邪正相搏，牢固不动，气联子脏则不孕；气联冲任则月水不通。内治之法宜如
前，外以阿魏膏贴之，仍用熨痞方，或用琥珀膏亦可，然必须切慎七情及六淫、饮食、起居，而不时随证
调理，庶乎可愈。
阿魏膏（见《外科钤古方》）治一切痞块，更服胡连丸。
羌活 独活 玄参 官桂 赤芍药 穿山甲 生地黄 两头尖 大黄 白芷 天麻 红花（各半两） 木
鳖（十枚去壳） 乱发（一团） 槐、柳、桃枝（各半两）
上用麻油二斤四两，煎药黑去渣，入发再煎，发化，仍去渣，入上好真正黄丹，煎收软硬得中，入后细
药，即成膏矣。
阿魏 芒硝 苏合油 乳香 没药（各五钱） 麝香（三钱）
上，凡贴膏药，须先用朴硝随患处铺半指浓，以纸盖，用热熨斗熨良久，如硝耗，再加熨之，二时许方贴
膏药。若是肝积，加芦荟末同熨之。
熨痞方（见《古方八阵·攻阵》）
一层用麝香二、三分掺肉上，二层阿魏一、二钱，三层芒硝一、二两铺盖于上。
上，先用荞麦面和成条，量痞大小围住铺药于内，以青布盖之，随烧砖四五块，轮流布上熨之，觉腹中气
行宽快，即是痞消之兆。以手烘热摩之亦妙。内须服调养气血之药。
Accumulation and mass (Ji Ju) caused by stagnant blood occurs only in women. The manifestations may arise during menstruation or postpartum. Internal injury from cold and raw food, external contraction of wind-cold, anger injuring the liver leading to qi rebellion and blood stagnation, worry and overthinking injuring the spleen leading to qi deficiency and blood stasis, or chronic fatigue and weakness leading to qi deficiency failing to move blood, all result in this condition. Generally, when blood is moving, if residual blood is not cleared and any of the above factors intervene, it accumulates day by day and gradually forms an accumulation/mass. However, blood relies on qi; when qi moves, blood moves. Therefore, in treating blood disorders, whether using purgative or tonifying methods, regulating qi must be prioritized. Luo Qianfu said: "Nourishing righteousness causes evil to eliminate itself; one must first regulate and nourish to ensure Ying and Wei are sufficient. If the accumulation does not dissipate, only then can purgation be considered." But if removal is not gradual, there will inevitably be harmful consequences; if taboos are not observed and desires indulged, few will survive without losing their lives.
Pain caused by blood stasis, or formed masses that do not disperse, located below the umbilicus and abdomen: if the stagnation is recent and the root is not yet solid, it is appropriate to use Wuwu Decoction (Five-Ingredient Decoction) or Juejin Decoction with modifications. This ensures that blood stasis is removed and pain stops, worthy of being called a miraculous formula.
Wuwu Decoction (See External Formulas for Blood Cold Discussion)
Juejin Decoction (See Menstrual Period Abdominal Pain)
For women with strong constitution and excess pathogenic factors, presenting with abdominal distension or severe pain, and where the disturbance is recent, aiming to promote circulation and relieve pain, Tongyu Decoction, Shixiao San (Laughing Off Powder), Xuanhu Danggui San (Corydalis and Angelica Powder), or Modified Siwu Tang (Four-Substance Decoction) should be used to dredge and guide. Once qi flows freely and stagnation is removed, pain will heal itself. If the condition has persisted longer and become hard, aiming to dissolve and grind the mass, Sanleng Wan (Curcuma Pill) or Wanbing Wan (Ten-Thousand-Disease Pill) should be used.
Tongyu Decoction (See Menstrual Period Abdominal Pain)
Shixiao San (See Menstrual Period Abdominal Pain)
Xuanhu Danggui San (See External Formulas for Menstrual Pain Discussion)
Modified Siwu Tang from *Liangfang* (See *Furen Gui Ancient Formulas*) treats blood accumulation in women.
Danggui (Angelicae Sinensis Radix), Chuanxiong (Chuanxiong Rhizoma), Shaoyao (Paeoniae Radix), Shudi (Rehmanniae Radix Praeparata), Ezhu (Zedoariae Rhizoma), Sanleng (Sparganii Rhizoma), Rougui (Cinnamomi Cortex), Ganqi (Dryopteridis Rhizoma - fried until smoke ceases), equal parts.
Crush these ingredients. Take 5–7 qian per dose, decoct in half zhong of water until 0.7 zhong remains, take after meals.
Sanleng Wan (See *Gufu Bazhen · Gongzhen*) treats blood accumulation, blood masses, food stagnation, and phlegm stasis.
Ezhu (soaked in vinegar and fried), Sanleng (each 3 liang), Qingpi (Citri Reticulatae Pericarpium Viride), Maiya (Hordei Fructus Germinatus - fried), Banxia (Pinelliae Rhizoma Praeparatum, each 1 liang).
Boil these in one zhong of good vinegar until dry, grind into powder, make pills with vinegar paste, size of paulownia seeds. Take 40 pills per dose with light vinegar soup. For phlegm accumulation, take with ginger soup.
Wanbing Wan (See *Furen Gui Ancient Formulas*) treats menstrual obstruction due to blood stasis, pain in the umbilical and abdominal region, and postpartum masses.
Ganqi (fried until blue-white smoke appears), Niuxi (Achyranthis Bidentatae Radix - washed in wine and dried, each 1 liang).
Grind into powder. Use one sheng of Shengdi Huang (Rehmanniae Radix), slowly simmer in a clay pot to make a paste, form pills size of paulownia seeds. Take 20 pills per dose on an empty stomach with rice drink.
For those with strong constitution and unyielding blood stasis, or constipation, or severe abdominal distension and pain, requiring purgation: Taoren Chengqi Tang (Peach Kernel Decoction to Order the Qi) from *Liangfang* is the most effective, or Duoming Dan (Life-Snatching Pill), Taoren Jian (Peach Kernel Decoction), Chuanshanjia San (Pangolin Scale Powder), or Chijin Dou (Golden Bean) can also be used. However, purgation must be applied with caution; unless there is a severe excess condition necessitating it, it should not be used recklessly.
Taoren Chengqi Tang from *Liangfang* (See *Gufu Bazhen · Gongzhen*) treats lower abdominal pain due to blood stasis, difficulty in defecation, delirium, dry mouth, rinsing water but not swallowing, generalized yellowing of the body, free urination, or blood binding in the chest. Pain so severe it cannot be touched, alternating chills and fever, coma, or mania-like behavior.
Taoren (Peach Kernel - peeled and slit, half liang), Dahuang (Rhei Radix et Rhizoma - fried, 1 liang), Gancao (Licorice Root, 2 qian), Rougui (Cinnamon Bark, 1 qian).
Decoct with ginger water, take at dawn on the day symptoms appear.
Duoming Dan (See Ghost Fetus)
Taoren Jian from *Liangfang* (See *Gufu Bazhen · Gongzhen*) treats blood masses.
Taoren (Peach Kernel), Dahuang (Rhei Radix et Rhizoma - fried, each 1 liang), Mengchong (Blatta Orientalis - fried until black, half liang), Poxiao (Natrii Sulfas, 1 liang).
Grind into powder. Boil one zhong of pure vinegar in a porcelain vessel until reduced by one-third, add the first three ingredients, stir constantly until suitable for pill-making, then add Poxiao. Make pills size of paulownia seeds. Skip dinner, take five pills with warm wine at dawn. By noon, foul matter should pass. If no effect, take again, then follow with formulas to regulate and tonify qi and blood. Lizhai said: "Previously in Piling, I treated a woman with urinary retention and severe abdominal distension/pain. Diagnosing it as a blood mass, I prescribed the above formula. One dose resulted in the expulsion of painful blood and bloody fluid, and she recovered. This formula is fierce and drastic; use with caution in those with qi and blood deficiency."
Chuanshanjia San (See *Gufu Bazhen · Gongzhen*) treats痞 (Pi) masses and blood stasis causing heart and abdominal pain.
Chuanshanjia (Manis Squama - fried until scorched), Biejia (Testudinis Carapax et Plastrum - vinegar-fried), ChiShaoyao (Paeoniae Radix Rubra), Dahuang (Rhei Radix et Rhizoma - fried), Ganqi (Dryopteridis Rhizoma - fried until smoke ceases), Guixin (Cinnamomi Ramulus, each 1 liang), Chuanxiong (Chuanxiong Rhizoma), Yuanhua (Genkwa Flos - vinegar-fried), Guiwei (Angelicae Sinensis Radix), Shexiang (Moschus, 1 qian).
Grind into powder. Take 1 qian per dose, mixed with wine.
Chijin Dou (See Ghost Fetus)
The method of nourishing righteousness involves observing yin and yang, upper and lower aspects, the duration of the disease, and the strength of pathogenic versus healthy factors. Even if blood stasis is severe, if original qi is weak, purgation is contraindicated. If the disease is chronic and the patient is weak, making the accumulation difficult to move, purgation is contraindicated. In such cases, one must focus on consolidating the root and wait for gradual resolution through slow grinding/dissolving; this is the best strategy. For spleen injury due to constraint, Gui Pi Tang (Restore the Spleen Decoction), Xiaoyao Yin (Free and Easy Wanderer Drink), or Shou Pi Jian (Longevity Spleen Decoction) are suitable. For spleen and stomach deficiency-cold, Wen Wei Yin (Warm Stomach Drink), Yang Zhong Jian (Nourish Middle Decoction), or Liujunzi Tang (Six-Gentlemen Decoction) are suitable. For liver and kidney deficiency-cold, Daying Jian (Great Camp Decoction), Nuangan Jian (Warm Liver Decoction), or Liyin Jian (Nourish Yin Decoction) are suitable, or Jiaojia San from *Liangfang* may also be used. For spleen and kidney deficiency-cold with loose stools or incomplete evacuation, Weiguan Jian (Stomach Gate Decoction) or Liyin Jian are suitable. For chronic disease with spleen/kidney qi stagnation causing lower abdominal pain and distension, Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) is suitable. For unextinguished liver fire, blood heat, and stagnation, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is suitable. For all the above conditions, if deficiency coexists with stagnation, adding qi-regulating and stagnation-resolving herbs to the aforementioned formulas is acceptable; this depends on the practitioner's flexibility.
Gui Pi Tang (See Irregular Menstruation)
Xiaoyao Yin (See Kidney Deficiency Menstrual Disorder)
Shou Pi Jian (See Blood Deficiency Menstrual Disorder)
Wen Wei Yin (See Blood Deficiency Menstrual Disorder)
Yang Zhong Jian (See *Xinfu Bazhen · Rezhen*) treats middle qi deficiency-cold manifesting as vomiting and diarrhea.
Renshen (Ginseng Radix et Rhizoma, 1–3 qian), Shanyao (Dioscoreae Rhizoma, fried 2 qian), Baibian Dou (Phaseoli Semen, fried 2–3 qian), Zhigancao (Prepared Licorice Root, 1 qian), Fuling (Poria, 2 qian), Ganjiang (Zingiberis Rhizoma, fried yellow 1–2 qian).
Decoct two zhong of water until 0.7 zhong remains, take warm after meals. If belching and qi stagnation occur, add Chenpi (Citri Reticulatae Pericarpium, 1 qian) or Sharen (Amomi Fructus, 4 fen). If the stomach feels empty and hungry, add Shudi (Prepared Rehmannia Root, 3–5 qian).
Liujunzi Tang (See Menstrual Period Abdominal Pain)
Daying Jian (See Blood Heat Early Menstruation)
Nuanguan Jian (See *Xinfu Bazhen · Rezhen*) treats liver-kidney yin-cold, lower abdominal pain, hernia, etc.
Danggui (Angelicae Sinensis Radix, 2–3 qian), Gouqi (Lycii Fructus, 3 qian), Fuling (Poria, 2 qian), Xiaohuixiang (Foeniculi Fructus, 2 qian), Rougui (Cinnamomi Cortex, 1–2 qian), Wuyao (Linderae Radix, 2 qian), Chenxiang (Aquilariae Lignum Resinatum, 1 qian, or Muxiang/Aucklandiae Radix is acceptable).
Decoct one and a half zhong of water with 3–5 slices of fresh ginger until 0.7 zhong remains, take warm after meals.
If cold is severe, add Wuzhuyu (Evodiae Fructus) and Ganjiang (Zingiberis Rhizoma); if even more severe, add Fuzi (Aconiti Lateralis Radix Praeparata).
Liyin Jian (See Blood Cold Delayed Menstruation)
Jiaojia San from *Liangfang* (See External Formulas for Menstrual Pain Discussion)
Weiguan Jian (See Postpartum Abdominal Pain)
Bawei Dihuang Tang (i.e., Bawei Wan. See Irregular Menstruation)
Jiawei Xiaoyao San (See Irregular Menstruation)
Women with chronic Pi masses necessarily have spleen and kidney deficiency. Pathogenic and healthy factors struggle, becoming fixed and immovable. If qi affects the Zi Zang (uterus), infertility results; if qi affects Chong and Ren vessels, amenorrhea results. Internal treatment follows the methods described above. Externally, Awei Gao (Asafoetida Plaster) can be applied, along with Yi Pi Fang (Plaster-Warming Formula for Masses) or Hupo Gao (Amber Plaster). However, one must strictly avoid emotional disturbances, six climatic pathogens, improper diet, and lifestyle, while adjusting treatment according to symptoms. Only then can recovery be expected.
Awei Gao (See *Waike Qian Ancient Formulas*) treats all types of masses; additionally take Hulian Wan.
Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Xuanshen (Scrophulariae Radix), Guanzi (Cinnamomi Cortex), Chi Shaoyao (Paeoniae Radix Rubra), Chuanshanjia (Manis Squama), Sheng Di Huang (Rehmanniae Radix), Liang Tou Jian (Adenophorae Radix), Dahuang (Rhei Radix et Rhizoma), Baizhi (Angelicae Dahuricae Radix), Tianma (Gastrodiae Rhizoma), Honghua (Carthami Flos, each half liang), Mugua (Sicyi Semen - ten pieces, shell removed), Luannian (Human Hair - one bundle), Huaizi, Liu Zhi, Tao Zhi (Hoveniae Ramulus, Salix Ramulus, Pruni Persicae Ramulus, each half liang).
Use two jin four liang of Sesame Oil. Fry herbs until black, strain. Add hair, fry until dissolved, strain again. Add high-quality Huangdan (Litharge), fry until consistency is moderate. Add the following fine powders to complete the plaster.
Awei (Asafetida), Mangxiao (Natrii Sulfas), Suhe You (Styrax Oil), Ruxiang (Olibanum), Moyao (Myrrha), each 5 qian; Shexiang (Moschus, 3 qian).
When applying plaster, first spread Poxiao (Natrii Sulfas) half-finger thick over the affected area, cover with paper, and apply hot ironing tool for a long time. If the salt diminishes, continue ironing. After about two hours, apply the plaster. For liver accumulation, add Lvhuo powder and iron together.
Yi Pi Fang (See *Gufu Bazhen · Gongzhen*)
Layer 1: Sprinkle 2–3 fen of Shexiang (Moschus) on the skin.
Layer 2: Apply 1–2 qian of Awei (Asafetida).
Layer 3: Cover with 1–2 liang of Mangxiao (Natrii Sulfas).
Make strips of buckwheat flour dough, place around the mass to contain the herbs, cover with green cloth. Heat 4–5 bricks, rotate them on top to warm/iron the area. When abdominal qi movement brings relief, it indicates the mass is dissolving. Rubbing with warm hands is also beneficial. Internally, take formulas to tonify qi and blood.