丁香胶艾汤 治崩漏不止。盖心气不足,劳役及饮食不节所得,经隔少时,其脉两尺俱
弦紧而洪,按之无力。(东垣所论脉证必析,宜宗之)其证自觉脐下如冰,求浓衣被,以御其寒,白带白滑之物虽多,
间
下如屋漏水,下时有鲜血不多,右尺脉时微洪,屋漏水多暴下者,是急弦脉,为寒多,而洪脉
时见,乃热少,合而言之,急弦者,北方寒水多也,洪脉时出者,命门包络之火也,黑物多
,赤物少,合现房漏水之状也。
当归(一钱二分) 白芍药 熟地黄(各三分) 川芎 丁香(各四分) 阿胶(炒,六分,另后入)
生艾叶(一钱,后入)
上为细末。作一服,水二盏,煎至五沸,去滓,入胶艾,再上火煎至一大盏,空心,宿
食消尽,带热服,三服效。(服药有法有时)
芎 汤 治带下漏血不止,及风寒冷热,劳损冲任,月水不调,崩中暴下,腰重里急,
淋沥不断,及产后失血过多,虚羸腹痛;或妊娠胎动不安,下血连日,小便频数,肢体烦倦
,头晕目暗,不欲饮食。
川芎 黄 芍药 干地黄 吴茱萸 甘草(炙,各二两) 当归 干姜(各一两)
上 咀。以水一斗,煮取三升,分三服。若月经后,因有赤白不止者,除地黄、茱
萸,加杜仲、人参各二两。(好加减)
断下汤 治冲任气虚(重在气虚二字),崩中漏下,经脉不调,每遇月候将来,脐腹腰脚先痛,渐减饮食
,四肢乏力,及带下三十六疾,悉能疗之。
人参(去芦) 熟地黄 艾叶(醋炒,各一两) 乌贼骨(烧灰) 当归(酒洗,各二两) 阿胶(
蛤粉炒成珠) 川芎(各七钱) 干姜(炮,半两)
上 咀。水煎,食前服。乌贼骨,即海螵蛸。(此即胶艾四物之变局也,彼有芍药,此有人参、乌贼、干姜,
大概崩在肝气不敛者,宜芍药之酸寒以收之;气脱而不温者,宜参、姜、乌贼之类,温补而涩之;阿胶者,益金水
以成收藏之用也)
加味四物汤 治崩漏。
四物汤(一两) 人参(二钱) 吴茱萸(一钱)
上锉碎。每服半两,姜枣煎,食前服,五六服,寒热腹痛皆退。崩漏未止,续服后熟附
丸。
熟附丸
熟附子 木贼(去节) 龙骨( ) 赤石脂( 各半两) 川芎 当归(各一两)
上为细末,醋糊为丸,如桐子大。每服五六十丸,食前米饮下。(阳虚则寒,阴虚则热,故以此主之。
而腹痛一症,人皆以为瘀血者多,而此以为漏不止者,服熟附丸,正元礼所谓崩而腹痛者,崩止而痛除也)
鹿茸丸 治经候过多,其色瘀黑,甚者崩下,呼吸少气,脐腹冷极,则汗出如雨,尺脉
微小。由冲任虚衰,为风冷客乘胞中,气不能固。(此温涩之剂也,久崩漏脱者宜之)可灸关元百壮,在脐下正中三寸。
鹿茸(燎去毛,酥炙) 赤石脂(制) 禹余粮(制各一两) 当归 熟地黄 续断(各二两)
附子(炮) 艾叶(一方无) 柏叶(各半两)
上为细末,酒糊丸,如桐子大。每服三十丸,空心温酒下,炼蜜丸亦可。(丹溪以紫黑为热,而此言瘀黑者,乃下
焦气寒,血凝而黑,各有治法。然女子气海在上,血海在下,故下焦温而后气升血行。如鹿茸者,以血成形,由气而长
,血随气上而成角,故入血分以生焉;又以附子、艾叶,佐而温之,以石脂、余粮镇而固之;柏叶清之;归、地、续断,
补而续之,诚下元虚寒之全方也。不加人参,岂无意焉,而灸关元之意,盖可想矣)
Dingxiang Jiao'ai Decoction: Treats metrorrhagia and leukorrhea (non-menstrual heavy bleeding or prolonged spotting) that does not stop. This condition arises from insufficient Heart Qi, compounded by overwork and irregular diet. After a period of time, the pulse presents as wiry, tight, and surging at both Chi positions (Kidney pulse), yet feels weak upon deep pressure. (Dong Yuan's analysis of these pulse and symptom patterns is detailed and should be followed.) The patient complains of a sensation of ice-cold coldness below the umbilicus, desiring thick clothing and quilts to ward off the cold. Although there is abundant white leukorrhea and slippery white discharge, occasionally fluid resembling "leaking roof water" is discharged, sometimes accompanied by a small amount of bright red blood. The Right Chi pulse often shows a slight surging quality. If the "roof-leaking" discharge suddenly flows out in large quantities, this indicates an urgent wiry pulse, signifying excess Cold; the intermittent appearance of the surging pulse indicates minor Heat. Synthesizing these, the urgent wiry pulse represents an abundance of Northern Cold Water energy, while the emergence of the surging pulse reflects the fire of the Mingmen (Gate of Life) and Pericardium. An abundance of blackish discharge with less red discharge combines to present the state of "leaking roof water."
Ingredients: Danggui (Radix Angelicae Sinensis) (1 qian 2 fen), Baishao (Radix Paeoniae Alba), Shudihuang (Rehmanniae Radix Praeparata) (each 3 fen), Chuanxiong (Rhizoma Chuanxiong), Dingxiang (Flos Caryophylli) (each 4 fen), Ejiao (Colla Corii Asini) (stir-fried, 6 fen, added later separately), Sheng Aiye (Folium Artemisiae Argyi) (1 qian, added later).
Preparation and Administration: Grind the above herbs into fine powder. Take one dose, add two zhan of water, boil until five boils occur, strain the dregs, add Ejiao and Aiye, and boil again on fire until reduced to one da zhan. Take warm on an empty stomach after residual food has digested. Three doses will yield efficacy. (There are specific methods and timings for taking medicine.)
Xiong Tang: Treats leukorrhea, persistent metrorrhagia, and damage to the Chong and Ren meridians due to wind-cold or alternating cold-heat. It addresses irregular menstruation, sudden heavy bleeding (bengzhong), heaviness in the waist and tension in the abdomen, continuous dripping, excessive blood loss postpartum leading to emaciation and abdominal pain; or restless fetus during pregnancy with continuous bleeding for days, frequent urination, limb fatigue and irritability, dizziness and blurred vision, and loss of appetite.
Ingredients: Chuanxiong (Rhizoma Chuanxiong), Huangqi (Astragali Radix), Shaoyao (Radix Paeoniae Alba), Gadihuang (Rehmanniae Radix), Wuzhuyu (Fructus Evodiae), Gancao (Radix Glycyrrhizae Preparata) (roasted, each 2 liang), Danggui (Radix Angelicae Sinensis), Jiangjiang (Zingiberis Rhizoma) (each 1 liang).
Preparation and Administration: Cut the herbs. Boil in one dou of water to obtain three sheng of decoction, divided into three doses. If red and white discharge persists after menstruation, remove Dihuang and Zhuyu, and add Duzhong (Eucommiae Cortex) and Renshen (Ginseng Radix) each 2 liang. (This is a good modification method.)
Duansha Tang: Treats deficiency of Qi in the Chong and Ren meridians (emphasizing the term "Qi deficiency"), causing metrorrhagia and spotting, irregular menstruation. Before each menstrual period, pain precedes in the umbilical/abdominal region and lower back/legs, appetite gradually decreases, limbs feel weak, and it treats thirty-six types of leukorrhea diseases.
Ingredients: Renshen (Ginseng Radix) (remove rhizome), Shudihuang (Rehmanniae Radix Praeparata), Aiye (Folium Artemisiae Argyi) (stir-fried with vinegar, each 1 liang), Wweigu (Sepiae Endoconcha) (burned to ash), Danggui (Radix Angelicae Sinensis) (washed with wine, each 2 liang), Ejiao (Colla Corii Asini) (fried with clam powder into beads), Chuanxiong (Rhizoma Chuanxiong) (each 7 qian), Jiangjiang (Zingiberis Rhizoma) (processed, half liang).
Preparation and Administration: Cut the herbs. Decoct in water, take before meals. Weigu is also known as Haipiaoxiao. (This is a variation of Jiao'ai Siwu Tang; the original contains Shaoyao, this contains Renshen, Weigu, and Jiangjiang. Generally, if metrorrhagia is due to Liver Qi failing to consolidate, Sour-Cold Shaoyao is used to astringe; if due to Qi collapse without warmth, Renshen, Jiangjiang, and Weigu are used to warm, tonify, and astringe; Ejiao benefits Metal (Lung) and Water (Kidney) to facilitate storage and consolidation.)
Jiawei Siwu Tang: Treats metrorrhagia and leukorrhea.
Ingredients: Siwu Tang (Four Substances Decoction) (1 liang), Renshen (Ginseng Radix) (2 qian), Wuzhuyu (Fructus Evodiae) (1 qian).
Preparation and Administration: Chop the herbs. Take half a liang per dose, decoct with Shengjiang (Fresh Zingiberis Rhizoma) and Dazao (Jujubae Fructus), take before meals. After five or six doses, chills, fever, and abdominal pain will subside. If metrorrhagia has not stopped, continue administering Shufu Wan.
Shufu Wan:
Ingredients: Shufuzi (Prepared Aconiti Lateralis Radix), Muzei (Equiseti Herba) (remove joints), Longgu (Os Draconis), Chishizhi (Halloysit Rubra) (each half liang), Chuanxiong (Rhizoma Chuanxiong), Danggui (Radix Angelicae Sinensis) (each 1 liang).
Preparation and Administration: Grind into fine powder, make pills with vinegar paste, size of paulownia seeds. Take 50-60 pills per dose before meals with rice drink. (Yang deficiency leads to cold, Yin deficiency leads to heat; thus this formula governs. Regarding abdominal pain, people often attribute it to blood stasis, but here it is indicated for persistent leakage. Taking Shufu Wan aligns with Zheng Yuanli's statement: for metrorrhagia with abdominal pain, once the bleeding stops, the pain is eliminated.)
Lurong Wan: Treats excessive menstruation with dark,瘀black (stagnant black) color, severe cases leading to metrorrhagia, shortness of breath, extreme cold in the umbilical/abdominal region, sweating like rain, and minute/small Chi pulse. This results from deficiency and decline of the Chong and Ren meridians, where wind-cold pathogens invade the uterus, and Qi fails to secure. (This is a warming and astringent formula, suitable for those with long-term metrorrhagia and depletion.) Moxibustion can be applied to Guanyuan (CV4) for 100 moxa cones, located 3 cun directly below the umbilicus.
Ingredients: Lurong (Cornu Cervi Pantotrichum) (scalded to remove hair, fried with butter), Chishizhi (Halloysit Rubra) (processed), Yuyuliang (Halticis Fructus) (processed, each 1 liang), Danggui (Radix Angelicae Sinensis), Shudihuang (Rehmanniae Radix Praeparata), Xuduan (Dipsaci Radix) (each 2 liang), Fuzi (Aconiti Lateralis Radix Preparata), Aiye (Folium Artemisiae Argyi) (absent in another version), Baiye (Folium Ilicis Mutiensis) (each half liang).
Preparation and Administration: Grind into fine powder, make pills with wine paste, size of paulownia seeds. Take 30 pills per dose on an empty stomach with warm wine; honey pills are also acceptable. (Danxi considered purple-black as Heat, whereas here stagnant black is attributed to Cold Qi in the Lower Jiao causing blood coagulation and blackening; they have different treatments. However, the Qi Sea is upper, and the Blood Sea is lower; thus, warming the Lower Jiao allows Qi to rise and Blood to circulate. Lurong, formed from blood but growing via Qi, rises with Qi to form antlers, thus entering the Blood aspect to generate; assisted by Fuzi and Aiye for warmth, stabilized by Chishizhi and Yuyuliang for consolidation, cleared by Baiye, and supplemented/continued by Danggui, Dihuang, and Xuduan, this is indeed a comprehensive formula for Lower Yuan Deficiency-Cold. The omission of Renshen implies intent, and the meaning of moxibustion on Guanyuan can be imagined.)