血热者，经期常早，此营血流利及未甚亏者多有之。其有阴火内烁，血本热而亦每过期者。此水亏血
少，燥涩而然。治宜清火滋阴，以加味四物汤、加减一阴煎、滋阴八味丸之类主之。
加味四物汤（见《经不调》）
加减一阴煎（见《新方八阵·补阵》）此治水亏火胜之剂。凡肾水真阴虚损而脉证多阳，虚火发热及阴
虚动血等证；或疟疾伤寒，屡散之后，取汗既多，脉虚气弱而烦渴不止，潮热不退者，此以汗多伤阴，水亏而
然也。皆宜用此汤加减主之。
生地 芍药 麦冬（各二钱） 熟地（三、五钱） 炙甘草（五、七分） 知母 地骨皮（各一钱）
水二钟煎服。如烦躁热甚便结者，加石膏二三钱；如小水热涩者加栀子一二钱；如火浮于上者，加泽泻一
二钱，或黄芩一钱；如血燥血少者，加当归一二钱。
滋阴八味丸（见《新方八阵·寒阵》）治阴虚火盛，下焦湿热等证。此方变丸为汤即名滋阴八味煎。
山药（四两） 丹皮（三两） 白茯苓（三两） 山茱萸（肉四两） 泽
泻（三两） 黄柏（盐水炒三两） 熟地黄（八两蒸捣） 知母（盐水炒三两）
上加炼蜜捣丸梧桐子大，或空心或午前用滚白汤或淡盐汤送下百余丸。
凡血寒者，经必后期而至。然血何以寒？亦惟阳气不足，则寒从内生，而生化失期，是即所谓寒也。至若
阴寒由外而入，生冷由内而伤，或至血逆，或为疼痛，是又寒滞之证，非血寒经迟之谓也。当详辨也。
凡阳气不足，血寒经迟者，色多不鲜，或色见沉黑，或涩滞而少。其脉或微、或细、或沉、迟、弦、
涩。其脏色形气必恶寒喜暖。凡此者，皆无火之证。治宜温养血气，以大营煎、理阴煎之类加减主之。
大约寒则多滞，宜加姜、桂、吴茱萸、荜茇之类，甚者须加附子。
大营煎（见血热经早）
理阴煎（见《新方八阵·热阵》）此理中汤之变方也。凡脾肾中虚等证，宜刚燥者，当用理中、六君之
类；宜温润者，当用理阴、大营之类。欲知调补，当先察此。此方通治真阴虚弱，胀满呕哕，痰饮恶心，吐泻
腹痛，妇人经迟血滞等证。又凡真阴不足，或素多劳倦之辈，因而忽感寒邪，不能疏解，或发热，或头身疼
痛，或面赤舌焦，或虽渴而不喜冷冻饮料，或背、心、肢体畏寒，但脉见无力者，悉是假热之证。若用寒凉攻之，
必死。宜速用此汤，照后加减以温补阴分，托散表邪，连进数服，使阴气渐充，则汗从阴达，而寒邪不攻自
散，此最切于时用者也。神效，不可尽述。
熟地（三、五、七钱或一、二两） 当归（二、三钱或五、七钱） 炙甘草（一、二钱） 干姜（炒黄色、一、
二、三钱） 或加桂肉（一、二钱）
水二钟，煎七八分，热服。此方加附子，即名附子
理阴煎；再加人参，即名六味回阳饮，治命门火衰，阴中无阳等证。若风寒外感，邪未入深，但见发热身痛，
脉数不洪，凡内无火证，素禀不足者，但用此汤加柴胡一钱半或二钱，连进一二服，其效如神。若寒凝阴盛，
而邪有难解者，必加麻黄一、二钱，放心用之。或不用柴胡亦可，恐其清利也。此寒邪初感，温散第一方。惟
仲景独知此义，但仲景之温散，首用麻黄、桂枝二汤。余之温散，即以理阴煎及大温中饮为增减。此虽一从阳
分，一从阴分，其迹若异，然一逐于外，一托于内，而用温则一也。学人当因所宜，酌而用之。若阴胜之时，
外感寒邪，脉细恶寒或背恶寒者，乃太阳少阴证也，加细辛一、二钱，甚者再加附子一、二钱，真神剂也。或
并加柴胡以助之亦可。若阴虚火盛，其有内热，不宜用温，而气血俱虚，邪不能解者，宜去姜、桂，单以三味
加减与之，或只加人参亦可。若脾、肾两虚，水泛为痰，或呕或胀者，于前方加茯苓一钱半，或加白芥子五
分以行之。若泄泻不止及肾泄者，少用当归，或并去之，加山药、扁豆、吴茱萸、破故纸、肉豆蔻、附子之
属。若腰腹有痛，加杜仲、枸杞。若腹有胀滞疼痛，加陈皮、木香、砂仁之属。
Those with blood heat (Blood Heat) typically have their menstrual periods arrive early. This is common in individuals whose Ying blood (Nutritive Blood) flows freely and has not yet suffered severe depletion. However, some who suffer from internal Yin fire (Yin Fire) scorching the body, where the blood is inherently hot but menstruation is also frequently delayed, do so because of kidney water deficiency and scanty blood, leading to dryness and astringency. Treatment should focus on clearing fire and nourishing yin, primarily using modified formulas such as Jiawei Siwu Tang (Modified Four Substances Decoction), Jiajian Yiyin Jian (Modified One-Yin Decoction), or Ziyin Bawei Wan (Nourishing Yin Eight-Ingredient Pill).
Jiawei Siwu Tang (See "Irregular Menstruation" chapter)
Jiajian Yiyin Jian (See "New Formulas Eight Arrays · Tonifying Array"), which is a formula treating kidney water deficiency and hyperactive fire. It is suitable for conditions where the true yin of the kidney is damaged, presenting with pulse and symptoms predominantly yang, such as deficiency-fire fever and bleeding due to yin deficiency; or after malaria or shaoyang disease treated repeatedly with sweating methods, resulting in excessive perspiration, weak pulse, qi deficiency, unceasing thirst and irritability, and persistent tidal fever. These are caused by sweat-induced yin injury and water deficiency. Such cases are all suitable for treatment with this decoction, modified as needed.
Ingredients: Shengdi Huang (Rehmanniae Radix, 2 qian), Shaoyao (Paeoniae Radix, 2 qian), Maidong (Ophiopogonis Radix, 2 qian); Shudi Huang (Prepared Rehmanniae Radix, 3–5 qian); Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma, 5–7 fen); Zhimu (Anemarrhenae Rhizoma, 1 qian); Digupi (Lycii Cortex, 1 qian). Decoct with two zhong of water and take orally. If there is irritability, severe heat, and constipation, add Shigao (Gypsum Fibrosum, 2–3 qian); if urination is hot and difficult, add Zhizi (Gardeniae Fructus, 1–2 qian); if fire floats upward, add Zexie (Alismatis Rhizoma, 1–2 qian) or Huangqin (Scutellariae Radix, 1 qian); if blood is dry and scanty, add Danggui (Angelicae Sinensis Radix, 1–2 qian).
Ziyin Bawei Wan (See "New Formulas Eight Arrays · Cold Array"), treating yin deficiency with hyperactive fire and damp-heat in the lower jiao. Changing this pill to a decoction yields the name Ziyin Bawei Jian.
Ingredients: Shanyao (Dioscoreae Rhizoma, 4 liang), Danpi (Moutan Cortex, 3 liang), Baifuling (Poria, 3 liang), Shanzhuyu Rou (Corni Fructus, 4 liang), Zexie (Alismatis Rhizoma, 3 liang), Huangbai (Phellodendri Cortex, salt-fried, 3 liang), Shudihuang (Prepared Rehmanniae Radix, steamed and pounded, 8 liang), Zhimu (Anemarrhenae Rhizoma, salt-fried, 3 liang). Mix with refined honey and pound into pills the size of tung tree seeds. Take over one hundred pills on an empty stomach or before noon, washed down with warm white water or light salt water.
For those with blood cold (Blood Cold), menstruation must be delayed. But why does blood become cold? It is solely due to insufficient yang qi, causing cold to arise internally, disrupting the timing of blood and qi generation; this is what is meant by cold. As for yin-cold entering from outside, or raw/cold food injuring from within, leading to blood rebellion or pain, these are patterns of cold stagnation, not the pattern of blood cold causing delayed menstruation. These must be carefully distinguished.
In cases of insufficient yang qi and blood cold causing delayed menstruation, the blood color is often dull, appearing dark black, or scanty and sluggish. The pulse may be faint, fine, deep, slow, wiry, or choppy. The organ manifestations, complexion, form, and qi will definitely show aversion to cold and preference for warmth. All these are signs of absence of fire. Treatment should warm and nourish blood and qi, primarily using Daying Jian (Great Camp Decoction) or Liyin Jian (Regulating Yin Decoction), modified as needed.
Generally, cold leads to stagnation; it is appropriate to add Jiang (Zingiberis Rhizoma), Gui (Cinnamomi Ramulus), Wuzhuyu (Evodiae Fructus), and Bibai (Long Pepper Fruit). In severe cases, Fuzi (Aconiti Lateralis Radix Praeparata) must be added.
Daying Jian (See "Blood Heat Early Menstruation" chapter)
Liyin Jian (See "New Formulas Eight Arrays · Warm Array"), a modification of Lizhong Tang. For spleen and kidney middle-jiao deficiency, if rigid-drying herbs are indicated, use Lizhong Tang or Liu Jun Zi Tang; if moist-warming herbs are indicated, use Liyin Jian or Daying Jian. To know how to regulate and tonify, one must first examine this. This formula treats true yin deficiency, distension and fullness, vomiting and hiccups, phlegm-fluids and nausea, vomiting and diarrhea with abdominal pain, and women's delayed menstruation with blood stagnation. Furthermore, for those with true yin insufficiency or chronic fatigue who suddenly contract cold pathogens that cannot be resolved, presenting with fever, headache and body pain, red face and scorched tongue, thirst without desire for cold drinks, or aversion to cold in the back, chest, and limbs, provided the pulse is powerless—all these are false heat patterns. Using cold-cooling purgatives will lead to death. One must quickly use this decoction, modifying according to the following to warm and tonify the yin aspect, expel and scatter exterior pathogens, and administer continuously for several doses until yin qi gradually replenishes. Then sweat will emerge from the yin, and cold pathogens will dissipate without forceful attack. This is most pertinent to current clinical needs. Its miraculous efficacy cannot be fully described.
Ingredients: Shudihuang (Prepared Rehmanniae Radix, 3, 5, 7 qian or 1, 2 liang), Danggui (Angelicae Sinensis Radix, 2, 3 qian or 5, 7 qian), Zhigancao (Honey-fried Glycyrrhizae Radix et Rhizoma, 1, 2 qian), Ganjiang (Dried Zingiberis Rhizoma, stir-fried yellow, 1, 2, 3 qian), or add Rongui (Cinnamomi Cortex, 1, 2 qian).
Decoct with two zhong of water to about 70–80%, and take hot. Adding Fuzi (Aconiti Lateralis Radix Praeparata) to this formula creates Fuzi Liyin Jian; adding Ren Shen (Ginseng Radix) creates Liuwei Huiyang Yin (Six-Ingredient Return-to-Yang Drink), treating Mingmen fire decline and yang absence within yin. If wind-cold affects the exterior with shallow pathogen depth, presenting only with fever and body pain, rapid but not surging pulse, and no internal fire signs in constitutionally deficient individuals, simply use this decoction with Chaihu (Bupleuri Radix, 1.5–2 qian), administered continuously for one or two doses, yielding miraculous effects. If cold coagulation and yin excess make pathogen resolution difficult, add Mahuang (Ephedrae Herba, 1–2 qian) with confidence. Chaihu may be omitted to avoid its cooling-draining nature. This is the primary warming-dispersal formula for initial cold pathogen contraction. Only Zhang Zhongjing understood this principle; his warming-dispersal methods prioritize Mahuang Tang and Guizhi Tang. My warming-dispersal methods modify Liyin Jian and Dawenzhong Yin. Although one acts from the yang aspect and the other from the yin aspect, appearing different, one expels externally while one supports internally, yet both utilize warmth. Students should choose based on appropriateness. During times of yin excess with external cold contraction, presenting with fine pulse, aversion to cold, or specifically back aversion to cold, this is a Taiyang-Shaoyin syndrome; add Xixin (Asari Radix, 1–2 qian), and in severe cases, add Fuzi (1–2 qian), truly a divine formula. Adding Chaihu to assist is also acceptable. If yin deficiency with hyperactive fire exists, with internal heat making warming inappropriate, yet qi and blood are both deficient preventing pathogen resolution, remove Jiang and Gui, and use only the three main ingredients modified, or add only Ren Shen. If spleen and kidney are both deficient, with water flooding to create phlegm, or vomiting/distension, add Fuling (Poria, 1.5 qian) or Baijiezi (Brassicae Semen, 0.5 qian) to move qi. For unremitting diarrhea or kidney diarrhea, reduce Danggui or omit it entirely, adding Shanyao (Dioscoreae Rhizoma), Bian Dou (Phaseoli Semen), Wuzhuyu (Evodiae Fructus), Pogu Zhi (Psoraleae Fructus), Roudoukou (Myristicae Semen), and Fuzi (Aconiti Lateralis Radix Praeparata). For waist and abdominal pain, add Duzhong (Eucommiae Cortex) and Gouqi (Lycii Fructus). For abdominal distension, stagnation, and pain, add Chenpi (Citri Reticulatae Pericarpium), Muxiang (Aucklandiae Radix), and Sharen (Amomi Fructus Rotundus).