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Li Dongyuan stated: In the winter of the Dingwei year, Guo Dafang came to report that his wife suffered from sudden and severe menorrhagia (abnormal uterine bleeding). Previously, she had lost blood due to physical injury. Since then, her menstruation occurred every few days, but this time it did not stop. His wife was narrow-minded, impatient, and prone to fright. Based on my estimation, this must be caused by insufficient Heart Qi and irregular diet. Guo Dafang said: "When I went there for diagnosis, I found her palms cold, with a deep, fine, and slow pulse, occasionally showing a deep and rapid quality. Her nine orifices were slightly obstructed, her limbs were weak, she experienced upper body asthma and shortness of breath, and both mouth and nose breathing were irregular. Indeed, there were signs of insufficient Heart Qi, irregular diet (the syndrome differentiation was meticulous, truly the work of an experienced practitioner), and Spleen-Stomach weakness. There was pain in the epigastrium at the heart's location, tightness and contraction in the hypochondrium with accumulation (previously deficiency, now excess), pulsation around the umbilicus, borborygmus in the abdomen, excessive flatulence, difficulty in defecation, and numerous other deficiency syndromes which could not all be recorded. I planned to treat the root first, so that the remaining symptoms would resolve. The treatment aimed to calm the mind and stabilize the will, suppress fright, harmonize the Spleen and Stomach, greatly benefit Yuan Qi, tonify blood vessels, and nourish the Heart Spirit (this section is particularly brilliant and difficult). Using large doses of hot-natured herbs to dispel winter cold congealed in the skin, with a small addition of Sheng Di Huang (Rehmanniae Radix) to control Mingmen Fire and prevent limb flaccidity, I formulated Huangqi Danggui Renshen Tang."

Zhu Danxi stated: Phlegm-fluids stagnating in the chest prevent Clear Qi from ascending, causing the meridians to become congested and blood to descend. Without opening the phlegm, Qi cannot circulate (this offers another perspective; people often say Master Zhu Danxi was skilled in treating phlegm, which is true). If Qi does not ascend, blood cannot return to the normal vessels. This discussion clearly explains the mechanism of blood leakage. Generally, by clearing turbid phlegm from the chest and diaphragm, Clear Qi ascends; once Clear Qi ascends, blood returns to the vessels and hemostasis occurs. Therefore, symptoms may include abdominal fullness resembling pregnancy, colicky pain in the umbilical and abdominal regions, blood clots forming, relief during bleeding but oppression when stopped, or pulsation above the umbilicus. The treatment method should involve resolving accumulated phlegm, moving stagnant Qi, and eliminating foul blood.

Liang Fang stated: When women suffer from metrorrhagia accompanied by severe cardiac pain, it is called "Killing Blood Cardiac Pain," caused by deficiency of blood in the Heart and Spleen. Similarly, if excessive blood loss after miscarriage leads to severe cardiac pain, the condition is the same. Use cuttlefish bone (Hai Piao Xiao) stir-fried into powder, taken with vinegar water. Shixiao San is also effective. (Since it is stated as Heart-Spleen blood deficiency, one should naturally tonify both roots; why use only Hai Piao Xiao and Shixiao San to treat the branch?)

Xue Ji stated: For the aforementioned conditions, if Yin blood is depleted and scattered, use Wuzei Wan to consolidate; if stasis blood does not disperse, use Shixiao San to move and dissipate it; if Heart blood is deficient and weak, use Xiong Gui Tang to tonify and nourish; if depression damages blood, use Guipi Tang to regulate and tonify. (The explanation is appropriate, but stating that for Heart blood deficiency one uses only Chuanxiong and Danggui seems incomplete; understanding the following case reveals the essential principle.)

A woman suffered from metrorrhagia combined with cardiac pain for three years. Various medicines failed to respond. Whenever the pain was severe, all deficiency signs were present, and her complexion was sallow. I said: The Heart governs blood. It is likely that due to excessive blood loss, the Heart lacked nourishment, leading to pain. One should use Shiquan Dabu Tang, doubling the dosage of Renshen and Baizhu. After more than thirty doses, she improved slightly; after more than one hundred doses, she recovered completely.