崩漏不止，气血皆虚也。夫血气之行，外循经络，内荣脏腑，而冲任伤损，不能约经血，是以经脉错乱，
大血暴下，如山之崩也。重则为崩，轻则为漏，皆由气血大亏，脾胃先损，能受补者可治。若误用止涩寒凉之
药，复伤脾胃，生生之气，则难治矣。宜补中养胃汤，随证加减施治可也。
补中养胃汤
人参 白术（蜜炙） 当归头 侧柏叶（炒） 生地黄（各一钱） 炙甘草（五分） 茯苓 川芎 苏叶
（各八分）
水二钟，煎一钟，食前服。随证加减法∶血晕，加荆芥、泽兰叶各八分；虚汗，加黄 （蜜炙）一钱，酸
枣仁八分；崩中日久，白带不止，加龙骨、牡蛎粉各一钱；血崩日久不止，加棕榈皮（陈败者良，烧灰存性）、
新丝绵（烧灰存性）各一钱；血得热则崩不止，唇干咽燥，大小便闭结，加黄连、黄芩、山栀（俱酒炒）各五分；
血多而紫，如泥凝块，亦加芩、连、山栀（俱酒炒）各五分。
崩漏多因心气所使而然。盖以妇人幽居多郁，常无所
伸，阴性偏执，每不可解，加之贵贱异势，贫富异形，死丧疾亡，罔知义命，每多怨忧，固结于心，心气不足，
郁火大炽，焚炙于血脉之中，故经水不时而下，或适来适断，或暴下不止。治当先说恶死之言，令心不动，然
后以大补气血之药，举养脾胃，复加镇坠心火之药，补阴泻阳，而崩可止者，开郁四物汤是也。
开郁四物汤
香附米（炒） 当归身 白芍（酒炒） 熟地黄 白术（蜜炙，各一钱） 川芎 黄 （蜜炙） 蒲黄
（炒） 地榆 人参（各五分） 升麻（炒，三分）（如火浮于上者除之）
水二钟，煎七分，食前服。
Metrorrhagia and metrorrhexis that do not cease indicate deficiency of both Qi and Blood. The circulation of Qi and Blood extends externally along the meridians and collaterals (jingluo) and internally nourishes the Zang-Fu organs. When the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) are damaged and fail to constrain the menstrual blood, the menstrual cycle becomes disordered, leading to a sudden, massive hemorrhage, resembling a landslide. Severe cases are termed "Beng" (sudden heavy bleeding), while mild cases are termed "Lou" (continuous dripping bleeding). Both result from severe depletion of Qi and Blood and prior damage to the Spleen and Stomach. Cases responsive to tonification are treatable. However, if astringent or cold-cooling herbs are mistakenly used, further injuring the Spleen and Stomach and depleting the vital generating Qi, the condition becomes difficult to treat. It is appropriate to use Buzhong Yangwei Tang (Supplement the Middle and Nourish the Stomach Decoction), modified according to specific symptoms.
Buzhong Yangwei Tang (Supplement the Middle and Nourish the Stomach Decoction):
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, honey-fried), Danggui Tou (Angelicae Sinensis Radix tip), Cebaiye (Platycladi Cacumen, stir-baked), Shengdihuang (Rehmanniae Radix, each 1 qian); Zhigancao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.5 qian); Fuling (Poria), Chuanxiong (Ligustici Chuanxiong Rhizoma), Ziye (Perillae Folium, each 0.8 fen).
Decoct with two zhong of water until one zhong remains. Take before meals. Modifications based on symptoms: For fainting due to blood loss, add Jingjie (Schizonepetae Spica) and Zelan Ye (Leonuri Herba, 0.8 fen each); for spontaneous sweating due to deficiency, add Huangqi (Astragali Radix, honey-fried, 1 qian) and Suanzaoren (Ziziphi Spinosomi Semen, 0.8 fen); for prolonged metrorrhagia with continuous leukorrhea, add Longgu (Fossilia Ossis Mastodi) and Muli (Concha Ostreae, powdered, 1 qian each); for prolonged intractable metrorrhagia, add Zonglupi (Livistonae Petiolus, aged material preferred, carbonized retaining its nature) and Xin Simian (New silk floss, carbonized retaining its nature, 1 qian each); for heat-induced intractable bleeding accompanied by dry lips, parched throat, and constipation of urine and feces, add Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), and Shanzhi (Gardeniae Fructus, all wine-fried, 0.5 fen each); for profuse dark purple clotted blood resembling mud, also add Huangqin, Huanglian, and Shanzhi (all wine-fried, 0.5 fen each).
Metrorrhagia and metrorrhexis often arise from the influence of Heart Qi. Women living in seclusion often harbor depression and lack outlets for expression. Their Yin-nature tends to be rigid, making it hard to resolve. Compounded by differences in social status and wealth, and experiences of death, illness, and bereavement without understanding destiny, they frequently harbor resentment and sorrow, which knot within the Heart. This leads to insufficiency of Heart Qi and blazing of Depressive Fire, which scorches the blood vessels. Consequently, menstruation occurs irregularly, stops abruptly after starting, or flows down violently without cessation. Treatment should first involve counseling to dispel fear and anxiety, stabilizing the Spirit. Subsequently, use potent Qi- and Blood-tonifying herbs to raise and nourish the Spleen and Stomach, combined with herbs to settle and descend Heart Fire, tonify Yin, and drain Yang. Kaiyu Siwu Tang (Open Depression Four Substances Decoction) achieves this.
Kaiyu Siwu Tang (Open Depression Four Substances Decoction):
Xiangfu Mi (Cyperi Rhizoma, stir-baked), Danggui Shen (Angelicae Sinensis Radix root body), Baishao (Paeoniae Radix Alba, wine-fried), Shudihuang (Rehmanniae Radix Praeparata), Baizhu (Atractylodis Macrocephalae Rhizoma, honey-fried, each 1 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma), Huangqi (Astragali Radix, honey-fried), Puhuang (Typhae Pollen, stir-baked), Diyü (Sanguisorbae Radix), Renshen (Ginseng Radix, each 0.5 fen); Shengma (Cimicifugae Rhizoma, stir-baked, 0.3 fen) (omit if Fire floats upward).
Decoct with two zhong of water until seven-tenths remain. Take before meals.