血者水谷之精气也，在男子则化为精，在妇人则化为血，上为乳汁，下为月水。若忧愁思虑伤心，心气受
伤，脾气失养，故健运失职，饮食减少，血无以生，则经必不调。而有血枯经闭之症，亦有女子未期与男子
合，或月事适未尽而与合，此皆合之非道，亦致不调。或过淫合多则液竭，产多乳众则血枯，亦皆能损
伤阴血，致成经病也。
经者常也，月行有常度，经水有常期，其愆乎常者，皆病也。
眉批∶妇人行经，又有三月一行者，是谓季经。有一年一行者，是谓避年。有一生不行而受胎者，是谓暗
经。有受胎之后，月月行经而生子者，是谓盛胎。女子二
七天癸至，七七天癸绝，其常也。亦有女子十二三，妇人五十余而生者，其变也。皆
不可以不知也。赶前为热，退后为虚，血滞宜破，血枯宜补，要察其色，总以红为正。
其变为紫黑者，热也。黄如米泔者，湿也。淡红者，虚也。成块而紫黑色暗者，寒凝
也。将行而腹痛拒按者，气滞血凝也。既行而腹痛喜按者，气虚血少也。经前发热，为
血热。经后发热，为血虚。腹胀者，为气滞。腹痛者，为血滞。泄泻者，是脾虚。溏
泻者，是寒湿。凡逆行上溢而吐衄。错行下流而暴崩，皆属血热妄行。而亦有络脉伤损瘀积，肝旺所致。若经
水过多者，色淡为虚，色深为热。若经水适来，小便不通，腹胀欲死者，为经阻逆窍。足底痛者，血虚也。
血枯与经逆者，并用益母胜金丹加牛膝主之。
经水紫黑者，生地四物汤加丹参、丹皮、益母草。
黄如米泔者，六君子汤加苡仁、扁豆。
淡红者，八珍汤主之。
寒凝成块者，四物汤加桂心、牛膝。
热结成块者，生地四物汤加丹参、丹皮、益母草。
行经腰腹作痛者，气滞血实，人瘦有火也。桃仁四物汤加条芩、黄连。
经期或前或后者，脾胃虚弱，气血不足，四君汤加当归、白芍、丹皮、陈皮、制香附。性躁多气伤
肝，而动冲任之脉。一月经再行者，宜四物加人参、柴胡、黄芩、黄连、甘草，空心服。兼用知母、
黄柏为丸，滚汤下。
气血凝滞而作痛胀者，调经饮或四物汤加延胡，香附，木香。
气虚血少，而或痛或热者，四物汤加人参、白术。泄泻溏利者，六君子汤主之。
血热而上下妄行者，四物汤加丹皮、阿胶、黄芩、黑山栀。络
脉伤而妄行者，或大怒或过劳，八珍汤主之。
瘀血积，则血不归经，独圣丸主之。
肝火旺，不能藏血者，逍遥散主之。
经阻溺窍者，调经饮、泽兰汤。
足底痛者，血少也。用熟地、当归各六钱煎服数剂，血足痛自止矣。
调经饮
当归（三钱） 牛膝 山楂 茯苓（各二钱） 青皮（一钱五分） 制香附（二钱）
益母圣金丹
调经行血
砂仁拌熟地 酒蒸当归 酒蒸茺蔚子 土炒白术 酒炒香附（各四两） 酒炒白芍 酒蒸丹参（各三
两） 酒蒸川芎（二两五钱）
共晒燥为末，以益母草（八两） 酒水各半，熬膏加白蜜和末为
丸，每早晚开水送服。如不爱吞丸者，均熬膏冲服亦可。
独圣丸
去瘀积
五灵脂（一两去土炒烟尽）
为末醋丸，分二次酒送下。
逍遥散
治肝经血虚木郁
柴胡（一钱） 当归（二钱） 白术（一钱） 白芍（一钱） 茯苓（二钱） 丹皮（一
钱） 黑山栀（一钱） 薄荷（五分） 甘草（五分）
泽兰汤
治经闭调血脉
泽兰（二钱） 柏子仁 当归 白芍 熟地 牛膝 茺蔚子（各一钱五分）
桃仁四物汤
归尾 赤芍 川芎 生地 香附（各二钱） 丹皮 红花 延胡索（各一钱） 桃仁（十一粒，临服研入）
空心服。
Blood is the refined essence derived from food and water. In men, it transforms into sperm; in women, it transforms into blood, ascending to become breast milk and descending to become menstruation. If sorrow and overthinking damage the Heart, injuring Heart Qi, and the Spleen loses nourishment, failing in its transportation and transformation functions, dietary intake decreases, and blood fails to be generated, menstruation will inevitably be irregular. This may result in symptoms of blood depletion and amenorrhea. There are also cases where a woman has intercourse before her period is due or immediately after her period ends; these constitute improper sexual conduct and also lead to menstrual irregularities. Excessive sexual indulgence depletes body fluids, while frequent childbirth and lactation deplete blood; all these can damage Yin-blood and cause menstrual diseases.
"Jing" (Menstruation) implies constancy. The moon's movement follows fixed patterns, and menstruation occurs at regular intervals. Any deviation from this norm indicates disease. Commentary: Some women menstruate once every three months, termed "Seasonal Menstruation"; some once a year, termed "Avoidance Year"; some never menstruate throughout their lives yet can conceive, termed "Hidden Menstruation"; some continue to menstruate monthly during pregnancy and give birth, termed "Abundant Fetal Menstruation." At age fourteen (two sevens), Tian Gui (substances promoting reproductive maturity) arrives; at age forty-nine (seven sevens), Tian Gui ceases; this is the normal state. However, some women begin menstruating at twelve or thirteen, or cease at fifty-plus; these are variations. All such conditions must be known. Menstruation arriving early indicates Heat; arriving late indicates Deficiency. Blood stasis requires breaking methods; blood depletion requires tonification. One must observe the color, with bright red being the correct hue. Purple-black color indicates Heat; yellow like rice wash water indicates Dampness; pale red indicates Deficiency. Clumps that are purple-black and dull indicate Cold coagulation. Abdominal pain that refuses pressure before menstruation indicates Qi stagnation and blood congealing; abdominal pain that welcomes pressure after menstruation indicates Qi deficiency and blood scarcity. Fever before menstruation indicates Blood Heat; fever after menstruation indicates Blood Deficiency. Abdominal distension indicates Qi stagnation; abdominal pain indicates Blood stasis. Diarrhea indicates Spleen Deficiency; loose stools indicate Cold-Dampness. Any upward regurgitation causing hematemesis or epistaxis, or downward flow causing sudden severe hemorrhage, belongs to reckless bleeding due to Blood Heat. However, some cases arise from collateral injury with blood stasis accumulation or Liver Fire hyperactivity. If menstrual flow is excessive, pale color indicates Deficiency, while dark color indicates Heat. If menstruation begins accompanied by urinary retention and severe abdominal distension and pain, it is termed "Obstructed Menstruation Blocking the Orifice." Pain in the soles of the feet indicates Blood Deficiency. For blood depletion and retrograde menstruation, Yimu Shengjin Dan (Motherwort Golden Pill) added with Niuxi (Achyranthes Root) is the primary treatment.
For purple-black menstruation, Dihuang Siwu Tang (Rehmannia Four Substance Decoction) added with Danshen (Salvia Root), Danpi (Moutan Bark), and Yimucao (Motherwort Herb) is used.
For yellow discharge like rice wash water, Liujunzi Tang (Six Gentlemen Decoction) added with Yiren (Coix Seed) and Biandou (Hyacinth Bean) is used.
For pale red menstruation, Bazhen Tang (Eight Treasures Decoction) is the primary treatment.
For clumps formed by Cold coagulation, Siwu Tang (Four Substance Decoction) added with Guixin (Cinnamon Twig) and Niuxi (Achyranthes Root) is used.
For clumps formed by Heat, Dihuang Siwu Tang (Rehmannia Four Substance Decoction) added with Danshen (Salvia Root), Danpi (Moutan Bark), and Yimucao (Motherwort Herb) is used.
For lower back and abdominal pain during menstruation, indicating Qi stagnation and Blood excess, common in thin individuals with internal Fire, Taoren Siwu Tang (Peach Kernel Four Substance Decoction) added with Tiao Qin (Scutellaria Root) and Huanglian (Coptis Rhizome) is used.
For irregular timing (early or late), indicating Spleen-Stomach weakness and Qi-Blood insufficiency, Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelica Sinensis), Baishao (White Peony Root), Danpi (Moutan Bark), Chenpi (Tangerine Peel), and Zhi Xiangfu (Prepared Cyperus Rhizome) is used. Irritable temper and anger injure the Liver, disturbing the Chong and Ren vessels. For two menstrual periods in one month, Siwu Tang (Four Substance Decoction) added with Renshen (Ginseng), Chaihu (Bupleurum Root), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Gancao (Licorice Root) is taken on an empty stomach. Additionally, Zhimu (Anemarrhena Rhizome) and Huangbai (Phellodendron Bark) are made into pills and taken with warm water.
For pain and distension due to Qi-Blood stagnation, Tiaojing Yin (Regulate Menstruation Infusion) or Siwu Tang (Four Substance Decoction) added with Yanhusuo (Corydalis Rhizome), Xiangfu (Cyperus Rhizome), and Muxiang (Aucklandia Root) is used.
For pain or fever due to Qi deficiency and blood scarcity, Siwu Tang (Four Substance Decoction) added with Renshen (Ginseng) and Baizhu (Atractylodes Rhizome) is used. For diarrhea and loose stools, Liujunzi Tang (Six Gentlemen Decoction) is the primary treatment.
For reckless bleeding up and down due to Blood Heat, Siwu Tang (Four Substance Decoction) added with Danpi (Moutan Bark), Ejiao (Donkey-Hide Gelatin), Huangqin (Scutellaria Root), and Hei Shanzhi (Charred Gardenia Fruit) is used. For reckless bleeding due to collateral injury, caused by great anger or overexertion, Bazhen Tang (Eight Treasures Decoction) is the primary treatment.
For blood stasis accumulation preventing blood from returning to its vessels, Dusheng Wan (Single Sage Pill) is the primary treatment.
For Liver Fire hyperactivity failing to store blood, Xiaoyao San (Free and Easy Wanderer Powder) is the primary treatment.
For obstructed menstruation blocking the urinary orifice, Tiaojing Yin (Regulate Menstruation Infusion) and Zelan Tang (Lycopus Decoction) are used.
For foot sole pain due to blood scarcity, Shudi (Prepared Rehmannia Root) and Danggui (Angelica Sinensis), each 6 qian, are decocted and taken for several doses; once blood is replenished, the pain stops naturally.
Tiaojing Yin (Regulate Menstruation Infusion)
Danggui (Angelica Sinensis) (3 qian) Niuxi (Achyranthes Root) Shanzha (Hawthorn Fruit) Fuling (Poria) (each 2 qian) Qingpi (Green Tangerine Peel) (1.5 qian) Zhi Xiangfu (Prepared Cyperus Rhizome) (2 qian)
Yimu Shengjin Dan (Motherwort Golden Pill)
Function: Regulate menstruation and promote blood circulation
Sharen (Amomum Fruit) mixed with Shudi (Prepared Rehmannia Root) Jiu Zheng Danggui (Wine-steamed Angelica Sinensis) Jiu Zheng Chongweizi (Wine-steamed Motherwort Fruit) Tu Chao Baizhu (Earth-fried Atractylodes Rhizome) Jiu Chao Xiangfu (Wine-fried Cyperus Rhizome) (each 4 liang) Jiu Chao Baishao (Wine-fried White Peony Root) Jiu Zheng Danshen (Wine-steamed Salvia Root) (each 3 liang) Jiu Zheng Chuanxiong (Wine-steamed Ligusticum Rhizome) (2.5 liang)
Dry together, grind into powder. Use Yimucao (Motherwort Herb) (8 liang) with half wine and half water, decoct into paste, mix with white honey and the powder to form pills. Take with boiled water morning and evening. Those who dislike swallowing pills may take the paste directly.
Dusheng Wan (Single Sage Pill)
Function: Remove blood stasis accumulation
Wulingzhi (Trogopterus Dung) (1 liang, remove earth and stir-fry until smoke ceases)
Grind into powder, make pills with vinegar. Divide into two doses, take with wine.
Xiaoyao San (Free and Easy Wanderer Powder)
Function: Treat Liver channel blood deficiency and wood depression
Chaihu (Bupleurum Root) (1 qian) Danggui (Angelica Sinensis) (2 qian) Baizhu (Atractylodes Rhizome) (1 qian) Baishao (White Peony Root) (1 qian) Fuling (Poria) (2 qian) Danpi (Moutan Bark) (1 qian) Hei Shanzhi (Charred Gardenia Fruit) (1 qian) Bohe (Mentha Herb) (0.5 qian) Gancao (Licorice Root) (0.5 qian)
Zelan Tang (Lycopus Decoction)
Function: Treat amenorrhea and regulate blood vessels
Zelan (Lycopus Herb) (2 qian) Baiziren (Biota Seed) Danggui (Angelica Sinensis) Baishao (White Peony Root) Shudi (Prepared Rehmannia Root) Niuxi (Achyranthes Root) Chongweizi (Motherwort Fruit) (each 1.5 qian)
Taoren Siwu Tang (Peach Kernel Four Substance Decoction)
Guiwei (Angelica Sinensis Tail) Chishao (Red Peony Root) Chuanxiong (Ligusticum Rhizome) Shengdi (Raw Rehmannia Root) Xiangfu (Cyperus Rhizome) (each 2 qian) Danpi (Moutan Bark) Honghua (Safflower) Yanhusuo (Corydalis Rhizome) (each 1 qian) Taoren (Peach Kernel) (11 grains, crushed just before taking)
Take on an empty stomach.