物柴胡汤。热甚。服此不平者。加干姜灰神效。经闭发热咽燥。唇干脉实者。四物凉膈散。张介宾曰。血枯血隔本不同。
盖隔者阻隔。枯者枯竭。阻隔者邪气隔滞。血有所逆也。枯竭者冲任亏败。源断其流也。凡妇女病损。至旬月半载之间。
未有不经闭者。正因阴竭所以血枯。枯之为义。无血而然。故或羸弱。或困倦。或咳嗽。或血热。或饮食减少。或亡血
失血。及一切无胀无痛无阻无隔。而经有久不至者。皆血枯经闭之候。欲其不枯。无如养荣。欲以通之。无如充之。（此
诚要义）但使血行。则经脉自至。乃医者不论有滞无滞。多兼开导之药。其有甚者。则专以桃仁、红花之类通利为事。
岂知血滞者可通。血枯者不可通乎。是宜知之矣。
经血暴下 成无己曰。妇人年及五十以上。经血暴下者。妇人经血终于七七之数。数外暴下。内经曰。火主暴
速。亦因暴喜暴怒忧结惊恐之致。切不可作冷病治。用峻热药。必死。止可用黄连解毒汤。以清于上。更用莲壳灰、棕
Chaihu Tang (Bupleurum Decoction). If the heat is severe and taking this prescription does not bring relief, adding calcined dried ginger root (Ganjiang Hui) yields miraculous effects. For amenorrhea accompanied by fever, dry throat, dry lips, and a full pulse, Siwu Liangge San (Four Substances Cool the Chest Powder) is used. Zhang Jiebin stated: Blood deficiency (Xueku) and blood obstruction (Xuege) are fundamentally different.
"Obstruction" refers to blockage; "deficiency" refers to exhaustion. Obstruction is caused by pathogenic factors stagnating, leading to rebellious flow of blood. Exhaustion results from the depletion and failure of the Chong and Ren vessels, where the source of blood flow is cut off. In cases of women's diseases involving damage, within a period of ten days to half a year, amenorrhea invariably occurs. This is precisely because yin exhaustion leads to blood deficiency. The meaning of "deficiency" arises from the absence of blood. Thus, some present with emaciation, some with fatigue, some with cough, some with blood-heat, some with reduced appetite, some with hemorrhage or loss of blood, and all those without distension, pain, stagnation, or blockage, yet whose menstruation has been absent for a long time, are signs of amenorrhea due to blood deficiency. To prevent deficiency, nothing is better than nourishing Ying (nutritive Qi); to promote flow, nothing is better than replenishing [blood]. (This is indeed a crucial principle.) As long as blood circulation is restored, the menses will naturally arrive. However, physicians often indiscriminately add herbs that open and guide [flow], regardless of whether there is stagnation or not. In severe cases, they focus exclusively on promoting flow using substances like Tao Ren (Peach Seed) and Hong Hua (Safflower). How could they know that blood stagnation can be unblocked, but blood deficiency cannot be forcibly promoted? This is something one must understand.
Sudden Profuse Menstrual Bleeding Cheng Wuji said: When women reach the age of fifty or above, sudden profuse menstrual bleeding occurs because a woman's menses should end at the number of seven sevens (49 years). Sudden bleeding beyond this number, according to the *Neijing* (Inner Canon), is attributed to Fire, which governs suddenness and speed. It may also result from sudden joy, anger, sorrowful constraint, or fright. One must absolutely not treat it as a cold syndrome using harsh hot medicines, as this will certainly lead to death. Instead, only Huanglian Jiedu Tang (Coptis Decoction to Resolve Toxicity) should be used to clear heat in the upper jiao, followed by lotus seedpod ash, palm fiber ash...