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Liang Fang discusses: Women's "Beng Zhong" (sudden, heavy uterine bleeding outside the menstrual period) is caused by damage to the Zang-Fu organs and injury to the Chong and Ren meridians, resulting in deficiency of both Qi and Blood. The Chong and Ren meridians are the "Sea of the Twelve Meridians"; the movement of Qi and Blood circulates outward along the collaterals and nourishes the internal Zang-Fu organs internally. If there is no injury, Yin and Yang are harmonious, and Qi and Blood are regulated; if labor is excessive, causing all Zang-Fu organs to become deficient, and the Qi of the Chong and Ren also becomes deficient, failing to constrain and control the menstrual blood, it will suddenly flow down heavily. Alternatively, due to the struggle between Yin and Yang, being attacked by Heat pathogen, damaging the Chong and Ren, Blood flows and scatters when heated; in severe cases, it leads to fainting or dizziness. The pulse is rapid and hurried; a small pulse shape is a favorable sign, while a surging and large pulse shape is an unfavorable sign. The general principle should be primarily to regulate and tonify the Spleen and Stomach. (It is said that if Qi is deficient and cannot constrain, it is appropriate to tonify Qi; if attacked by Heat, it is appropriate to cool the Blood; one should not indiscriminately say to primarily regulate the Spleen and Stomach. Observing Li Dongyuan's methods reveals the key.)

Li Dongyuan states: "Yin deficiency with Yang pulsation is called Beng." In women, Spleen and Stomach deficiency leads to the Mingmen pulse being deep, fine, and rapid (Yin deficiency with Yang pulsation means there is fire within Yin, so the Chi pulse is used for diagnosis), or deep, wiry, surging, large, and forceful; the Cun and Guan pulses are similar. All these result from Spleen and Stomach deficiency, with Qi sinking into the Kidney, combining with Ministerial Fire, and Damp-Heat pressing downward (This refers to Spleen Qi sinking transforming into Heat, suitable for lifting and tonifying while draining fire), causing continuous dripping of menstrual blood, purple-black in color, smelling foul like rotting meat in summer. Those with white leukorrhea will have a wiry and fine pulse, indicating Cold acting in the middle (Li Dongyuan considers white leukorrhea as Cold, and the wiry-fine pulse as diagnostic, which is correct, but later generations generally consider it Damp-Heat, requiring differentiation); those with red leukorrhea will have a surging and rapid pulse, clearly indicating a Heat disease, inevitably accompanied by lower back pain or pain below the umbilicus. Approaching the menstrual period, before bleeding starts, alternating chills and fever occur first, with tightness and contraction of both hypochondria, accompanied by the appearance of Spleen and Stomach symptoms, or fatigue and heat in the four limbs, mental restlessness and oppression preventing sleep, and urgency in the epigastrium (Although Spleen and Stomach symptoms are mentioned here, mental restlessness and epigastric urgency also involve Deficient Fire). It is appropriate to greatly tonify the Spleen and Stomach and regulate the ascending and descending of Qi and Blood, achieving cure with one dose. Or, those who were once noble then became poor, or once rich then became poor, suffering from "Tuo Ying" (Depletion of Ying), have insufficient Heart Qi, with their Fire blazing fiercely within the blood vessels, further causing irregularities in Spleen and Stomach diet, with Fire invading the interior. The physical form and muscles may appear healthy, but this is a Heart disease (The Heart governs Ying, hence called Heart disease). The pathology does not manifest on the pulse, so Spleen and Stomach dietary irregularity symptoms are obvious, while menstruation comes and goes irregularly, or stops abruptly after starting, with sudden heavy bleeding. Treatment should first use words describing the terror of death to persuade them, making them fear death so the Heart remains calm, using medicines to greatly tonify Qi and Blood, nourish the Spleen and Stomach, and slightly add sedatives to subdue Heart Fire to treat the Heart. Tonifying Yin and draining Yang will naturally stop the menstruation. The *Wu Lun* (Treatise on Flaccidity Syndromes) says: Excessive grief severs the Bao Luo (uterine network); when the Bao Luo is severed, Yang Qi moves internally (Internal movement of Yang Qi means there is fire in the Bao Luo). When it erupts, there is bleeding from the heart region, and frequent urination of blood. Thus, the *Ben Bing* says: When the great vessels are empty, myositis occurs upon eruption, transmitting to Mai Wei (pulse flaccidity); this is what is meant.

Xue Ji states: The classic says "Yin deficiency with Yang pulsation is called Beng." It also says: Injury to Yang collaterals causes blood to overflow externally; injury to Yin collaterals causes blood to overflow internally. It also says: The Spleen controls blood; the Liver stores blood. Their pathological manifestations arise because Spleen and Stomach deficiency fails to control blood returning to its source, or because Liver channel Heat causes blood to flow downward due to heat; or because Liver channel Wind causes blood to move recklessly due to wind; or because anger stirs Liver Fire, causing blood to boil due to heat; or because Spleen channel depressed Heat injures blood, preventing it from returning to the vessels; or because excessive grief injures the Bao Luo, causing lower beng. Treatment methods: For Spleen and Stomach weakness, use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), and Chai Hu (Bupleuri Radix); for Spleen and Stomach sinking, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with wine-fried Shao Yao (Paeoniae Radix Alba) and Shan Zhi (Gardeniae Fructus); for Liver channel Blood Heat, use Si Wu Tang (Four Substances Decoction) added with Chai Hu, Shan Zhi, and Cang Zhu (Atractylodis Rhizoma); for Liver channel Wind-Heat, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) or Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Shan Zhi, Shao Yao, and Mu Dan Pi (Moutan Cortex); if anger stirs Liver Fire, use the previous formulas; for Spleen channel depressed Fire, use Gui Pi Tang (Restore the Spleen Decoction) added with Shan Zhi, Chai Hu, and Mu Dan Pi; for grief injuring the Bao Luo, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Chai Hu, Sheng Ma (Cimicifugae Rhizoma), and Shan Zhi. Therefore, Mr. Li Dongyuan and Mr. Zhu Danxi stated: For all hematochezia/hematemesis syndromes, Si Jun Zi Tang must be used to conclude treatment; this statement has profound meaning (Mr. Xue discussed seven points, three regarding Spleen/Stomach, three regarding Liver channel, and one regarding Bao Luo, none abandoning Chai Hu, Zhi, Shao, and Dan Pi, because the Jueyin hands and feet meridians are places where much blood is stored. When blood is forced by Heat, it cannot rise quickly from Yang, so Chai Hu is used to stir Liver Qi, while Zhi and Shao etc. collect Yin and suppress Yang, akin to Li Dongyuan's idea of lifting Yang and raising the vessels, which is particularly subtle. The determined Spleen/Stomach prescriptions are suitable for chronic diseases showing clear Spleen/Stomach symptoms. Since Master Lizhai treated many chronic cases, his statements reflect this, and stating Si Jun Zi Tang is necessary for concluding blood syndromes indicates it is not an initial treatment method; this is where Master Lizhai excelled throughout his life). After massive blood loss, do not rely solely on pulse diagnosis; urgently address these syndromes. All such conditions arise from prior Spleen and Stomach damage, hence the pulse is surging and large. If stomach Qi is present and can accept tonification, rescue is possible. If cold-cooling medicines are used, they will further damage the vital Qi of the Spleen and Stomach, failing to control blood returning to its source, thus accelerating danger.

Fang Shi states: Blood belongs to Yin; when quiet, it follows the channels to nourish the interior; when active, it deviates from the channels and acts recklessly. Extreme excess of the Seven Emotions stirs the Fire of the Five Wills. When the Fire of the Five Wills is hyperactive, menstrual blood flows down violently; coming out of time and lasting long is called Beng Zhong, similar to wind shaking wood or fire boiling water. The sequence for treating Beng is: initially use hemostatics to block the flow; secondly use clearing Heat and cooling Blood to clarify the source; finally use blood-tonifying medicines to restore the original state (I believe that among astringents, cooling properties must be included, and among cooling agents, blood-breaking and knot-resolving properties are needed; for restoring blood, Spleen regulation is required. Accompanying symptoms may differ, requiring specific handling, so it is difficult to apply a single rule universally). If only blocking the flow without clarifying the source, the torrential momentum cannot be stopped; if only clarifying the source without restoring the original, the isolated Yang has nothing to stand upon (Opening remarks capture the essence of the classics, proving extraordinary). Thus, neither root nor branch should be neglected.

Zhang Hezi states: The mother of Official Meng, over fifty years old, suffered from blood beng for a year. Everyone used Ze Lan Wan, Hei Shen San, Bao An Wan, and Bai Wei San, but tonification was ineffective. Dai Ren saw this and said: Tian Gui (heavenly water/menstrual fluid) has ended; she should not bleed. It is likely that blood flows and scatters due to Heat, not Cold. Female blood beng is often caused by great sorrow and crying; extreme sadness causes lung lobes to spread, the Heart Tie (connection) becomes tight, and blood uncontrollably falls down. The *Nei Jing* says: "Yin deficiency with Yang pulsation is called Beng." Yin pulse insufficiency, Yang pulse excess, rapidness indicates internal beng, and blood flows downward. The world treats it as deficiency consumption, unaware of its error. Large doses can be taken; a large dose refers to Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxins) (This is a major cold formula, not for non-excess Heat syndromes, and not unless previous medicines failed). Next, use 2 liang of fried Xiang Fu (Cyperi Rhizoma), 2 liang of baked Shao Yao, 2 liang of baked Dang Gui, ground into fine powder, mixed with water.

Master Xiyuan Gong treated a sixty-two-year-old woman with continuous blood beng. She took four doses of Huang Lian Jie Du Tang, followed by six doses of Liang Ge San (Cool the Chest Powder) combined with Si Wu Tang, and was cured (This is the treatment for Yin deficiency with Yang pulsation). This woman suffered excessive grief, causing mental oppression and urgency, lung lobes spreading and rising, upper Jiao obstruction, heat in the middle, blood rushing causing beng, hence the efficacy.

Xue Ji states: A woman nearing seventy years old had chronic Liver and Spleen syndromes (All observed symptoms belong to Liver and Spleen, requiring careful examination). Each attack resulted in poor appetite (Spleen), chest/diaphragm discomfort (Liver), epigastric pain (Stomach), diarrhea (Spleen), or dysuria (Liver). I used Xiao Yao San added with Shan Zhi, Fu Shen (Poria Cum Radix Pini), Yuan Zhi (Polygalae Radix), and Mu Xiang (Aucklandiae Radix), resulting in cure. Later, worried about her widowed daughter, she occasionally vomited purple blood. Each episode began with fatigue (Spleen) followed by fever (Liver). The Classic says: Accumulated grief injures the Lung; accumulated worry injures the Spleen. Lung lobes spreading and rising causes mother and child organs to suffer together, failing to control blood returning to vessels, leading to the aforementioned symptoms. I used the previous prescription added with 3 fen of charred Huang Lian (Coptidis Rhizoma) and 2 fen of Wu Zhu Yu (Evodiae Fructus), achieving immediate cure (This is the method of Zuo Jin Wan). Anger again caused vomiting of bright red blood in large amounts, restlessness, thirst, approaching death; this is Blood depletion, requiring Qi tonification. I used 1 liang of Ren Shen (Ginseng Radix), 3 qian each of Qin (Scutellariae Radix), Zhu (Atractylodis Macrocephalae Rhizoma), and Dang Gui, 2 qian each of Chen Pi (Citri Reticulatae Pericarpium) and Pao Hei Gan Jiang (Prepared Blackened Ginger Rhizome), 1 qian each of Zhi Cao (Prepared Licorice Root) and Mu Xiang, stopping it immediately with one dose.

A sixty-four-year-old woman, with long-term depression and anger, suffered headache and alternating chills/fever. In spring, breast pain occurred; taking Liu Qi Yin (Flowing Qi Decoction) worsened it. She intermittently had bleeding like menstruation, then experienced great fright, poor appetite, restless sleep, breast swelling, and burning pain in both hypochondria, with reddish complexion in the afternoon. I considered this Liver-Spleen depressed Fire and Blood dryness. First, I used Xiao Yao San added with 1 qian of wine-fried black Long Dan (Gentianae Radix) and 1.5 qian of Shan Zhi. After two doses, swelling and pain subsided; after two more doses, it completely resolved (Formula and syndrome matched, but complete resolution in four doses seems too fast). Then, Gui Pi Tang added with charred Shan Zhi and Bei Mu (Fritillariae Thunbergii Bulbus) cured all symptoms.

A woman, due to anger, had prolonged blood beng, with a face turning green-yellow or red. This is Liver Wood controlling Spleen Earth, leading to Blood deficiency. I used Xiao Chai Hu Tang combined with Si Wu Tang to clear Liver Fire and generate Liver Blood, then used Gui Pi Tang and Bu Zhong Yi Qi Tang to benefit Spleen Qi and generate Liver Blood, resulting in recovery. If this syndrome is due to Liver channel Wind-Heat causing Blood instability, use Fang Feng (Saposhnikoviae Radix) alone made into pills (Should say Liver Heat generates Wind, and sinking cases suit Fang Feng), taken with decoctions for accompanying symptoms; or if Liver channel Fire moves causing Blood instability, use Tiao Qin (Scutellariae Radix) fried into pills (Tiao Qin is a Large Intestine channel medicine; using Chai Hu treats Jueyin)...

A woman with an impatient temper, whenever angry, would suffer either Taiyang channel ear/nape/throat/tooth/chest/breast pain, or chest fullness, acid regurgitation, vomiting/diarrhea, reduced food intake, and continuous menstruation. These are all Liver Fire syndromes. If the Liver itself is diseased, external symptoms appear; if Earth is controlled, internal symptoms arise. If self-disease appears, use Si Wu Tang added with Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Chai Hu, charred Shan Zhi, and charred Long Dan (Shao Yao, Chai Hu, Shan Zhi, Long Dan are Jueyin medicines; Bai Zhu and Fu Ling are Liver-calming medicines); if internal symptoms arise, use Si Jun Zi Tang added with Chai Hu, Shao Yao, Shen Qu (Massa Medicata Fermentata), fried Wu Zhu Yu, and Huang Lian, with symptoms gradually improving.

Only continuous menstruation indicates Heat in the Blood division (If Blood division has Heat, add Mu Dan Pi and Shan Zhi), while Spleen Qi remains deficient. Use Xiao Yao San doubling Bai Zhu, Fu Ling, and Chen Pi, combined with Bu Zhong Yi Qi Tang added with wine-fried Shao Yao, taken concurrently for regulation.