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This syndrome involves mixed patterns, including blood stasis (Blood Stasis), qi stagnation (Qi Stagnation), cold syndrome (Cold Syndrome), collapse syndrome (Collapse Syndrome), and qi deficiency (Qi Deficiency). In treatment, appropriate herbs for invigorating blood and resolving stasis, regulating qi, warming the interior, tonifying qi, and astringing to stop bleeding may be added according to the specific situation.

III. Mixed Cold and Heat
Manifestations include metrorrhagia and metrostaxis (irregular uterine bleeding with heavy flow or prolonged spotting), which may start suddenly with heavy flow or slowly with light flow, persisting continuously; cold pain in the lower abdomen, or chronic cold pain in the epigastrium; bitter taste and dry mouth, poor appetite, heat in the palms; thin white or thin yellow tongue coating, deep, wiry, and fine pulse. The treatment principle is to warm the meridians and stop bleeding. Use Wen Jing Tang (Warming the Meridian Decoction) modified:
Angelicae Sinensis Radix (Dang Gui) 9g, Chuanxiong Rhizome (Chuan Xiong) 9g, White Peony Root (Bai Shao) 9g, Codonopsis Radix (Dang Shen) 9g, Evodiae Fructus (Wu Zhu Yu) 3g, Cinnamon Twig (Gui Zhi) 4.5g, Donkey-hide Gelatin (E Jiao) 9g, Moutan Cortex (Dan Pi) 9g, Pinellia Tuber (Ban Xia) 9g, Ophiopogon Tuber (Mai Dong) 9g, Fresh Ginger (Sheng Jiang) 3 slices, Licorice Root (Gan Cao) 6g.
If the complexion is pale and lusterless, add Ginseng Radix (Ren Shen) 9g and remove Codonopsis Radix (Dang Shen); if bleeding volume is heavy, add Celosiae Spica (Ji Guan Hua) 30g.
If there are cold extremities, cold abdominal pain, bitter taste and dry mouth, thick yellow tongue coating, and deep, fine, wiry pulse, use Huang Tu Tang (Yellow Earth Decoction) modified:
Donkey-hide Gelatin (E Jiao) 9g, Scutellaria Root (Huang Qin) 9g, Rehmanniae Radix (Sheng Di) 12g, Atractylodes Macrocephala Rhizome (Bai Zhu) 9g, Aconite Lateralis Radix Praeparata (Fu Zi) 9g, Licorice Root (Gan Cao) 6g, Celosiae Spica (Ji Guan Hua) 30g, Long-stove Fire Clay (Fu Long Gan) 50g.
For mixed patterns of metrorrhagia and metrostaxis, the key is to distinguish the proportion of cold vs. heat, blood stasis vs. blood deficiency, and spleen deficiency vs. kidney deficiency.

IV. Qi Stagnation and Blood Stasis
Manifestations include persistent metrorrhagia and metrostaxis, sudden heavy flow or slow light flow, continuous spotting; distending and painful lower abdomen, constipation, poor appetite, bitter taste and dry mouth, yellow tongue coating, red tongue body, deep choppy or slippery rapid pulse. The treatment principle is to regulate qi and invigorate blood. Prescription:
Costus Root (Mu Xiang) 9g, Cyperi Rhizoma (Xiang Fu) 9g, Lindera Root (Wu Yao) 9g, Rehmanniae Radix (Sheng Di) 9g, White Peony Root (Bai Shao) 9g, Moutan Cortex (Dan Pi) 9g, Rheum Radix et Rhizoma (Da Huang) 3g, Tangerine Peel (Chen Pi) 9g.

Attached Cases:
Case 1: Wang, female, 55 years old. Outpatient No.: 81287.
First visit on September 14, 1965: For over 3 months, menstruation has been either continuously spotting or heavily bleeding, with pale red blood color. There is bitter taste and dry mouth with desire for cold drinks, afternoon fever, facial flushing, heat in palms and soles, yellow urine, slightly red tongue body, thin yellow coating, and slippery rapid pulse. The pattern is identified as hyperactive blood due to blood heat. Prescription:
Tortoise Plastron (Gui Ban) 30g, Scutellaria Root (Huang Qin) 7.5g, Phellodendron Bark (Huang Bo) 7.5g, Gardenia Fruit (Zhi Zi) 9g, Siegesbeckiae Herba Charred (Di Yu Tan) 6g, Moutan Cortex (Dan Pi) 9g, Salvia Root (Dan Shen) 9g, Notoginseng Root (San Qi) 9g, Cyperi Rhizoma (Xiang Fu) 6g, Cuttlefish Bone (Hai Piao Xiao) 9g.
Second visit: After 2 doses, bleeding volume decreased significantly, and bitter taste/dry mouth improved. Continue with the above prescription.
Third visit: After 6 doses, menstruation returned to normal.
Commentary: Synthesizing the pulse and symptoms, it belongs to hyperactive blood due to blood heat, caused by yin deficiency with internal heat. The treatment should clear heat and nourish yin, cool blood and stop bleeding, using Gu Jing Wan (Stabilize the Menses Pill) modified. Danshen and Sanqi were added considering the binding of blood and heat, fearing potential blood stasis changes, thus using them to invigorate blood and stop bleeding; Xiang Fu regulates qi and moves stagnation to assist blood circulation. The entire formula nourishes yin and cools blood, with a small amount of blood-invigorating herbs, reflecting Dr. Li's insight into clarifying the source and adapting to changes.

Case 2: Li, female, 35 years old. Outpatient No.: 46009.
First visit on October 7, 1961: Due to lumbar and abdominal sprain, vaginal bleeding occurred continuously with dark purple blood containing clumps, abdominal pain refusing pressure, sallow complexion, poor appetite, mental fatigue, yellow urine, dark tongue with petechiae, slightly yellow coating, and deep slippery pulse. Prescription:
Moutan Cortex (Dan Pi) 9g, Salvia Root (Dan Shen) 7.5g, Rehmanniae Radix (Sheng Di) 9g, Angelicae Sinensis Radix Tail (Gui Wei) 9g, Aucklandiae Radix (Guang Mu Xiang) 7.5g, Cyperi Rhizoma (Xiang Fu) 7.5g, White Peony Root (Bai Shao) 6g, Scutellaria Root (Huang Qin) 9g, Typha Pollen (Pu Huang) 7.5g, Trogopterorus Faeces (Ling Zhi) 7.5g.
Second visit: After 2 doses, vaginal bleeding decreased, abdominal pain relieved, blood color lightened, clumps reduced, but appetite remained poor. Add stir-fried malt and stir-fried rice sprouts (Chao Er Ya) 7.5g each to the above prescription.
Third visit: After continuing for 2 doses, bleeding basically stopped, all symptoms improved, continue usage.
Commentary: This disease resulted from traumatic sprain injuring the uterus and Chong-Ren meridians, belonging to blood stasis pattern. If old blood is not expelled, new blood cannot settle, causing continuous spotting; stasis blocking Chong-Ren causes pain due to obstruction; stasis transforming into heat causes heat signs; qi and blood stagnation failing to nourish causes sallow complexion and fatigue. This case is clearly excess pattern, treated with Zhu Yu Zhi Xue Tang (Expel Stasis Stop Bleeding Decoction) combined with Shi Xiao San (Painless Powder) modified, achieving qi regulation, blood invigoration, and heat clearing. In the second visit, Chao Er Ya, Mu Xiang, and Xiang Fu were added to resolve depression and awaken the spleen; once stasis is removed, heat clears, new blood settles, and bleeding stops. Observing this, Dr. Li seeks the root in treating diseases; when the source is clear, the flow naturally ceases.

Integrating "Stopping Flow" into "Clarifying Source," and Planning "Restoring Old" through Harmonization
Metrorrhagia and metrostaxis are common gynecological diseases. "Beng" refers to sudden heavy flow due to heat urgency, while "Lou" refers to slow light flow due to heat mildness; both are severe conditions. Fang Yuezhi proposed three methods: stopping flow (Sa Liu), clarifying source (Cheng Yuan), and restoring old (Fu Jiu), which are highly regarded by many physicians. Initially, hemostasis is used to stop the flow; finally, blood tonification is used to restore the original state. Dr. Li believes these three cannot be strictly separated; one must assess the emphasis of the disease, but both stopping flow and restoring old require treating based on etiology. Based on clarifying the source, one should not be bound by conventions. Stopping flow is not merely hemostasis; medication should follow the pattern, either tonifying qi to grasp blood, or clearing heat and cooling blood. Even if using astringents, they should be combined with opening agents to avoid trapping pathogens ("closing the door and leaving the thief"). Restoring old does not rigidly focus on liver-kidney tonification; one must re-examine the cause to harmonize Chong-Ren qi and blood, balance yin and yang, thereby regulating menstruation and curing the disease. The pathogenesis is complex; when clarifying the source and seeking the root, concurrent patterns must be considered. Known changes have signs and pulses; unknown changes are often overlooked. Thus, if treatment effect is poor, corresponding herbs for unmanifested patterns should be added, or prevention before manifestation applied, ensuring precise medication and immediate efficacy.

Attached Case:
Bai, female, 23 years old. Outpatient No.: 74927.
First visit on March 21, 1964: Constitutionally weak, excessive postpartum bleeding, pale and lusterless complexion, mental fatigue, dizziness, palpitations upon exertion, sweating, cold hands and feet, thin white tongue coating, deep fine and forceless pulse. Prescription:
Astragali Radix (Huang Qi) 15g, Codonopsis Radix (Dang Shen) 9g, Angelicae Sinensis Radix (Dang Gui) 15g, White Peony Root (Bai Shao) 7.5g, Atractylodes Macrocephala Rhizome (Bai Zhu) 9g, Poria (Fu Shen) 9g, Dried Ginger (Gan Jiang) 3g, Prepared Rehmanniae Radix (Shu Di) 15g, Aucklandiae Radix (Mu Xiang) 4.5g, Honey-fried Licorice Root (Zhi Cao) 4.5g.
Second visit: After 2 doses, bleeding volume decreased, palpitations and shortness of breath alleviated. Continue with the above prescription for 2 more doses.
Third visit: Patient felt symptom relief, vaginal bleeding stopped. After several more days, switched to Yang Xue Gui Pi Wan (Nourish Blood Restore Spleen Pill).
Commentary: This disease is postpartum hemorrhage. Although no hemostatic herbs were used, qi tonification was employed to grasp blood, integrating "stopping flow" into "clarifying source." When bleeding subsided, Yang Xue Gui Pi Wan was used to regulate menstruation and conclude treatment, representing "restoring old" based on "clarifying source."

Irregular Menstruation
Women's Early Menstruation: Patterns Divided into Deficient Heat and Stasis
Early menstruation is mostly deficient or hot. Deficiency leads to loss of control and insecurity of Chong-Ren; heat forces blood to move recklessly, disturbing the Sea of Blood. Dr. Li believes that stasis involves blood stasis obstructing the uterus, making meridians unfavorable and excretion abnormal, leading to early menstruation. Thus, this disease is summarized into three types: deficiency, heat, and stasis. Differentiation focuses on concurrent patterns and menstrual volume, color, and quality. For heat, there is always preference for cold and aversion to heat. Excess heat presents with purple, thick, heavy flow, accompanied by irritability, chest tightness, red tongue, thin yellow coating, and slippery rapid pulse. Deficient heat presents with light flow, red color, thick/sticky quality, malar flush, palm/sole heat, and deficient rapid pulse. Deficiency presents with mental fatigue, shortness of breath, heavy flow, pale color, thin quality, and slow weak or deficient large pulse. Stasis presents with lower abdominal distension and pain, worse on pressure, black stool, or tongue petechiae, purple-dark bloody clumps, light flow with difficult passage, tongue petechiae, and fine choppy pulse.
Women utilize blood; the Liver stores blood, having a yin substance and yang function. Sufficient liver blood ensures gentle liver qi; normal liver storage function ensures regular menstruation. Si Wu Tang (Four Substances Decoction) is a universal formula for all blood disorders related to menstruation and childbirth. Therefore, Dr. Li treats this disease by modifying Si Wu Tang: for excess heat, Zhi Bai Si Wu Tang or Qin Shu Si Wu Tang; for deficient heat, Di Gu Pi Yin (Si Wu plus Lycii Cortex and Moutan Cortex) or Xian Qi Yin (Jiao Ai Si Wu plus Anemarrhena, Cyperi Rhizoma, Coptis, Scutellaria, Phellodendron); for deficiency, Sheng Yu Tang; for stasis, Tao Hong Si Wu Tang; for heat excess with stagnant blood, Jiang Qin Si Wu Tang (Si Wu plus Turmeric, Scutellaria, Moutan Cortex, Cyperi Rhizoma, Corydalis).

Attached Case:
Li, female, 23 years old. Outpatient No.: 69072.
First visit on July 5, 1963: Menstruation advanced by 10 days for about a year, with epistaxis 1-2 days before menstruation, bright red blood, heavy volume, irritable temperament, preference for cold drinks, thin yellow tongue coating. Pulse is strong. Prescription:
Rehmanniae Radix (Sheng Di) 9g, Angelicae Sinensis Radix (Dang Gui) 9g, Raw White Peony Root (Sheng Bai Shao) 9g, Chuanxiong Rhizome (Chuan Xiong) 4.5g, Anemarrhena Rhizome (Zhi Mu) 7.5g, Phellodendron Bark (Huang Bo) 7.5g.
Second visit: After 12 doses, menstruation arrived on time, epistaxis did not occur.
Commentary: This disease combines early menstruation with reverse menstruation (epistaxis coinciding with menses), belonging to heat pattern. Due to the patient's irritable temperament, indicating hyperactive liver yang, blood reverses upward, driven by heat. Heat is a yang pathogen, controlled by yin, hence preference for cold drinks. Synthesizing pulse and symptoms, it is excess heat, characterized by heavy flow and severe heat. Dr. Li used Zhi Bai Si Wu Tang here to clear heat, cool blood, and regulate menstruation. Si Wu nourishes blood and softens the liver; Zhi Mu and Huang Bo nourish yin and descend fire, guiding fire back to its source, causing blood to flow downward. Their yin-nourishing nature also prevents heat from severely damaging yin, hence the effective treatment.

Late Menstruation: Not Only Deficient Cold
Treatment Has Methods, But May Not Just Regulate Menstruation
Most physicians believe late menstruation is mostly deficient and cold. Dr. Li follows Zhang Jingyue's "Complete Works" stating: "Those with blood heat often have early periods... those with vigorous Ying blood flow and not severely depleted often have this; furthermore, internal blazing of yang fire, where blood is originally hot, may also delay periods; this is due to water deficiency and blood scarcity, causing dryness and stiffness." He argues that initially, heat forces blood movement, causing missed timing; as heat progresses, blood binds with heat, slowing qi and blood circulation. If the Sea of Blood fills early, menstruation comes late. Thus, heat is also a mechanism for this disease. Additionally, internal and external dampness condensing into phlegm, phlegm-damp stagnating in Chong-Ren, blocking meridians, causing unfavorable qi-blood circulation and delayed periods; blood deficiency and qi weakness, insufficient transformation, powerless qi-blood circulation leading to delayed periods; qi stagnation, unfavorable blood flow, cold evil attacking Chong-Ren, qi-blood coagulation, or yang deficiency generating internal cold, leading to late menstruation. Thus, this disease is treated from five types: blood heat, blood cold, qi-blood dual deficiency, qi stagnation-blood stasis, and phlegm-damp. Fu Qingzhu stated: "The quantity in late periods varies greatly; late with little flow indicates blood cold and insufficiency; late with much flow indicates blood cold and excess." Thus, blood cold has excess cold and deficient cold differences. Dr. Li believes deficient cold is not necessarily yang deficiency generating internal cold; actually, it differs by qi deficiency, blood deficiency, yang deficiency, yin deficiency with cold, and location in zang or fu organs. Clinically, there are pure excess/pure deficiency, mixed excess-deficiency/cold-heat, and differences in qi/blood/yin/yang/zang-fu. Treatment must prioritize based on severity, quantity, and urgency of symptoms, starting from the whole body, either treating other diseases to regulate menstruation or regulating menstruation to cure other diseases. One must not confuse primary/secondary or heavy/light, otherwise missing the main contradiction inside things leads to poor efficacy.
Blood cold manifests as delayed menstruation, preference for heat and aversion to cold, dislike for cold food/drinks, cold lower abdomen, heavy or light flow, pale or dark color, pale tongue with thin white coating, deep slow pulse. Among these, for deficient cold, use Shuang He Yin or Jin Gui Wen Jing Tang; Shuang He Yin consists of Si Wu plus Astragali Radix, Cinnamon Bark, and Licorice Root. For liver/spleen/kidney deficient cold, use Wen Jing She Xue Tang, containing Prepared Rehmanniae Radix, White Peony Root, Chuanxiong Rhizome, Atractylodes Macrocephala Rhizome, Schisandra Berry, Bupleurum Root, Cinnamon Bark, and Dipsacus Root. For excess cold, use Wu Zhu Yu Tang or Gui Zhi Tang.
Blood heat manifests as preference for cold and aversion to heat, preference for cold food/drinks, late menstruation, purple-black bloody clumps, lower abdominal pain, red tongue with yellow coating, deficient rapid pulse. Use Jia Jian Yi Yang Jian, containing Rehmanniae Radix, Peony Root, Ophiopogon Tuber, Prepared Rehmanniae Radix, Anemarrhena Rhizome, Lycii Cortex, and Honey-fried Licorice Root.
Qi stagnation and blood stasis manifest as late menstruation, lower abdominal distension/pain, purple-black bloody clumps, or chest/hypochondriac discomfort, deep choppy or wiry pulse. Use Guo Qi Yin, consisting of Si Wu plus Peach Kernel, Safflower, Cyperi Rhizoma, Costus Root, Akebia Stem, and Curcuma Zedoaria Rhizome.
Qi-blood dual deficiency manifests as delayed, pale menstruation, no lower abdominal distension/pain, preference for pressure, dizziness, mental fatigue, pale or sallow complexion, fine weak pulse. Treatment should tonify qi and blood, using Ren Shen Yang Rong Tang.
Phlegm-damp obstruction manifests as delayed menstruation, pale light flow, thick/sticky quality, chest/epigastric fullness/stuffiness, nausea/vomiting phlegm, white tongue with greasy coating, slippery pulse. Use Qi Zhi Xiang Fu Wan.

Attached Cases:
Case 1: Bai, female, 23 years old. Outpatient No.: 58924.
First visit on September 29, 1962: Menstruation occurs every 2-3 months, with nausea, dizziness, shortness of breath, bitter taste, lower abdominal distension (relieved by heat), pregnancy excluded by examination, thin white tongue coating, weak pulse. Prescription:
Raw White Peony Root 9g, Angelicae Sinensis Radix 9g, Chuanxiong Rhizome 3g, Bupleurum Root 3g, Cyperi Rhizoma 4.5g, Tangerine Peel 7.5g, Honey-fried Licorice Root 3g.
Decoct in water and take orally.
Commentary: The Liver stores blood, having yin substance and yang function. Insufficient liver blood leads to failure of liver qi to flow freely; qi fails to disseminate, blood becomes stagnant due to qi, blocking Chong-Ren. The Sea of Blood cannot fill and overflow on time, delaying the period. Dr. Li believes this case is due to liver disease involving liver blood deficiency and liver qi stagnation. Treatment focuses on the Liver, nourishing blood and resolving stagnation; when liver disease heals, menstruation regulates. Thus, treating by nourishing liver blood and regulating qi stagnation to regulate menstruation reflects holistic treatment thinking: treating other diseases causing irregular menstruation results in regulated menstruation.

Case 2: Fang, female, 38 years old. Outpatient No.: 59003.
First visit on December 19, 1962: Menstruation occurs every 50 days, cold lower abdomen, preference for hot drinks, frequent tonsillitis, thin white tongue coating, slow pulse. Prescription:
Raw White Peony Root 9g, Angelicae Sinensis Radix 9g, Chuanxiong Rhizome 4.5g, Codonopsis Radix 4.5g, Donkey-hide Gelatin (melted) 6g, Cinnamon Twig 4.5g, Moutan Cortex 4.5g, Pinellia Tuber 4.5g, Ophiopogon Tuber 9g, Evodiae Fructus 4.5g, Honey-fried Licorice Root 3g.
Second visit: After 2 doses, cold sensation in lower abdomen alleviated, tonsillitis did not recur. Continue with the above prescription for 2 more doses.
Commentary: This syndrome belongs to deficiency with cold in Chong-Ren and Uterus. Menstrual blood cannot discharge on time, stagnates, transforms into heat, flares upward, and binds with heat to form throat disease (tonsillitis). It is generally a deficiency pattern with upper heat and lower cold. Thus, Wen Jing Tang was used to warm meridians, dispel cold, tonify deficiency, and clear heat. Once menstruation regulates, other diseases heal spontaneously, so tonsillitis did not recur.

Menstrual Delay Disease Relates to Liver, Spleen, and Kidney
Liver Qi Due to Stagnation, Spleen and Kidney Mostly Deficiency Patterns
Menstrual delay is mainly characterized by menstrual cycle disorder, occurring twice a month or not coming after a month, with normal duration and moderate volume, due to qi-blood imbalance and abnormal storage/overflow of the Sea of Blood. The Liver stores blood and governs free flow, managing the Sea of Blood, having the role of storing and regulating blood volume. Free-flowing liver qi and normal free flow ensure unhindered blood circulation; if the Sea of Blood fills and overflows on time, menstruation is regular. Over-free flow leads to early menstruation; under-free flow leads to late menstruation. Abnormal free flow, sometimes excessive or insufficient, disrupts qi mechanism, causing chaotic blood flow. The Kidney governs sealing and storing, and also governs free flow of menstrual blood. Vigorous kidney qi allows smooth Chong-Ren meridians; as menstrual blood gradually fills, it descends on time. Kidney deficiency leads to loss of sealing/storage; if it should store but doesn't, menstruation comes early; if it should release but doesn't, menstruation comes late; chaotic storage/release causes alternating early and late timing. The Spleen is the source of qi-blood production. Strong spleen qi ensures abundant qi-blood and harmony of Chong-Ren qi-blood. Spleen deficiency leads to failure in distribution, insufficient qi-blood generation, loss of control, or failure of the Sea of Blood to fill on time, resulting in irregular early/late menstruation. Thus, this disease involves the Liver, Spleen, and Kidney, with changes in qi and blood. However, following Five Elements generation/restriction, qi and blood are mutually rooted. Liver disease invading Spleen and Kidney, or Kidney disease failing to nourish Liver and warm Earth, leads to qi stagnation and blood stasis, affecting multiple organs and simultaneous qi-blood pathology. Therefore, differentiation must detail involvement of Liver, Spleen, or Kidney, assessing qi-blood deficiency/excess to avoid error. Treatment involves soothing Liver, tonifying Kidney, strengthening Spleen, regulating Chong-Ren qi-blood, ensuring smooth qi-blood and harmonious Chong-Ren, so menstruation arrives on time. Otherwise, it prolongs and becomes difficult to cure, potentially developing into amenorrhea or metrorrhagia/metrostaxis, which are thorny problems.
Liver depression pattern: menstruation comes alternately early and late, volume fluctuates, purple color, mental restlessness, chest/abdominal/breast distension/pain, thin tongue coating, wiry pulse. This pattern often sees Liver invading Spleen, with qi stagnation and blood stasis. Treatment should soothe Liver, strengthen Spleen, invigorate blood, and regulate menstruation, using Xiao Yao San combined with Shi Xiao San modified.
Kidney deficiency pattern: menstruation alternates early and late, light volume, pale color, clear quality, dizziness, sore waist, pale tongue, deep fine pulse. This type often involves simultaneous Liver-Kidney disease; treatment should address both. Use Fu Shi Ding Jing Tang, containing Cuscuta Seed, White Peony Root, Angelicae Sinensis Radix, Prepared Rehmanniae Radix, Chinese Yam, Poria, Black Bindweed Seed, and Bupleurum Root.
Spleen deficiency pattern: irregular menstrual cycle, variable volume, pale color. Body fatigue, chest/abdominal distension, muscle emaciation, undigested food, loose stools, pale tongue with white greasy coating, slow pulse. Treatment should strengthen Spleen and regulate menstruation, using Shen Ling Bai Zhu San.

Attached Case:
You, female, 27 years old. Outpatient No.: 48304.
First visit on September 8, 1962: Irregular menstruation, purple unsatisfactory flow, low spirit, lower abdominal pain radiating to hypochondrium, thin white tongue coating, wiry pulse. Prescription:
Bupleurum Root 3g, Angelicae Sinensis Radix 7.5g, Raw White Peony Root 7.5g, Poria 4.5g, Raw Atractylodes Macrocephala Rhizome 4.5g, Cyperi Rhizoma 4.5g, Green Tangerine Peel 6g, Raw Typha Pollen 4.5g, Trogopterorus Faeces 4.5g, Areca Seed 7.5g, Trichosanthes Fruit 9g, Honey-fried Licorice Root 3g.
Commentary: Liver qi stagnation and abnormal free flow, either excessive or insufficient, cause menstruation to come alternately early or late. Qi stagnation and unfavorable blood flow result in purple, unsatisfactory blood color. Distension/pain along the Liver meridian pathway and wiry pulse indicate Liver depression. Treatment uses Xiao Yao San plus Cyperi Rhizoma, Green Tangerine Peel, and Areca Seed to regulate qi and menstruation; Trichosanthes Fruit opens the chest; Shi Xiao San invigorates blood and relieves pain.

Two Methods for Regulating Menstruation
1. Regulating Menstruation First Requires Soothing Liver and Regulating Qi