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(Attached: Blood Stabbing Pain)
In men, it is called "Xiaochang Qi" (Qi stagnation of the Small Intestine). In women, it is called "Pixue Tong" (Spleen-blood stabbing pain). It is mostly caused by cold pathogen invading after blood deficiency, leading to coagulation and stagnation of Qi and blood in the Small Intestine. The pain radiates to the waist and hypochondrium, with an underlying chronic condition, unrelated to the patency or obstruction of menstruation. Heqi Yin (Harmonizing Qi Decoction), Xuanhusuo Tang (Corydalis Rhizome Decoction), or Shixiao San (Instantly Effective Powder) are suitable. Ai Fu Wan (Mugwort and Asarum Pill) may be taken intermittently. Alternatively, take a pinch of salt, place it on an iron spoon, roast over fire until crushed, and administer Yigong San (Yi Gong Powder) mixed with wine. Recovery occurs when bowel movements become unobstructed. If it is confirmed that the pain is due to deficiency-cold of the Blood Sea (Uterus), Xiaowen Jing Tang (Minor Warming Meridian Decoction) is suitable. If there is only discomfort without pain, often resembling hunger, this indicates dryness and heat generated in the Stomach due to blood deficiency. Blood-nourishing herbs should be used for nourishment; Siwu Tang (Four Substances Decoction) can be used. If untreated for a long time, it may develop into "Xiaozhong" (Middle Consumptive Disease).
Blood stabbing pain is characterized by stabbing pain in the heart region. Use Siwu Tang (Four Substances Decoction) removing Rehmanniae Radix (Dihuang), adding Cyperi Rhizoma (Xiangfu) in equal amount.

For those with blood deficiency following illness, or with constitutional blood deficiency: symptoms include alternating chills and fever, heat in the five centers (palms, soles, and chest), weak voice, sallow complexion, dizziness, and vertigo. Various diseases may arise from this. Xionggui Tang (Peony and Angelica Decoction) with a small amount of mutton is suitable. Or take Shiquan Dabu Tang (Ten Ingredients Great Tonifying Decoction), Siwu Tang (Four Substances Decoction), or Yangrong Tang (Nourishing Vitality Decoction). For blood deficiency with flourishing Qi, Yi Qi Tang (Suppressing Qi Decoction), which is Cyperi Rhizoma powder (Xiangfu Mo), is suitable.
For blood deficiency with abdominal pain, Siwu Tang (Four Substances Decoction) is used.
For women with blood deficiency, exacerbated by anger and mental strain: symptoms resemble mania or "Xinfeng" (Wind affecting the Heart). They may laugh, sing, or speak deliriously. This syndrome often occurs during menstruation and childbirth. Use half a dose of Siwu Tang (Four Substances Decoction), remove Magnoliae Officinalis Cortex (Houpo), add Ginseng Radix (Renshen), Ophiopogonis Tuber (Maimendong), Cinnamomi Ramulus (Guizhi), Ligusticum Chuanxiong Rhizoma (Chuanxiong), and Angelicae Sinensis Radix (Danggui), each 0.5 qian. This is named Zengjian Siqi Tang (Modified Four Seven Decoction).

Bengzhong (Metrorrhagia) caused by blood-heat, or by Qi deficiency: massive bleeding is called Bengzhong. The blood may be clear or turbid, purely clotted blood, or putrid and unstoppable. Symptoms vary, and etiological factors differ. Severe cases present with dizziness, vertigo, and cold limbs. Jiao'ai Tang (Donkey-Hide Gelatin and Mugwort Decoction), Yan Zhen Ling Dan (Zhenling Pill for Throat Tremors), assisted by Sanhui San (Three Ashes Powder) are suitable. Alternatively, decoct Lizhong Tang (Regulate the Middle Decoction) with urine from an uncircumcised boy, or add Cinnamomi Cortex (Baicaoshuang/Rhizoma Imperatae Carbonized) to Chenxiang Jiangqi Tang (Aucklandia Descending Qi Decoction), administered with rice water. When metrorrhagia is severe with abdominal pain, people often suspect that evil blood (clots) remains. Seeing dark, clotted blood reinforces the belief in evil blood, making them afraid to use hemostatic agents. Generally, regarding hemorrhage, when blood is about to exit but has not yet, if it stays inside the abdomen, it becomes clotted. One cannot assume all clots are evil blood; how do we know clots are not due to deficiency-cold? If one waits to see clots before stopping the bleeding, one might stop all blood, leaving none. There is another explanation for abdominal pain: for pain caused by accumulated blood, pain stops when blood flows; for pain caused by metrorrhagia, pain stops when bleeding ceases. Xionggui Tang (Peony and Angelica Decoction) with dried ginger (Ganjiang) and prepared aconite root (Shufu) 1 qian is suitable to stop bleeding, after which pain naturally settles. Alternatively, scrape black pieces from Spina Gleditsiae (Cihuaxiu), burn to ash, powder, and mix with rice water. Another formula uses shell of hairy crab (Moxieqiao) calcined to preserve nature, taken with rice water. Some use root of hemp (Huangma Gen) burned to ash, taken with rice water.