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The woman’s menstruation arrives on time, (Comment: Since the menses arrive on time, it is known not to be retrograde menstruation. Although the methods of descending rebellious Qi and clearing heat are similar, one should simultaneously promote blood circulation to remove stasis, while the other should tonify deficiency; thus, they are vastly different.) Suddenly, she vomits blood, or even spurts out like a gushing stream, with blurred vision and mental exhaustion. This indicates Liver Qi urgency and rebellious Chong Mai (Penetrating Vessel) Qi, with blood failing to return to its vessels. It should be treated as a hemorrhagic disorder. A general therapeutic principle is proposed.
*Radix Bletillae Striatae* (Bai Wei), *Radix Glycyrrhizae* (Gan Cao), *Rhizoma Dendrobii* (Chuan Shi Hu), *Endocarpium Oryzae Sativae* (Mai Dong Rou - note: typically refers to Ophiopogonis Tuber, here likely context-specific), *Colla Corii Asini* (E Jiao), *Radix Angelicae Sinensis* (Chao Dang Gui Tou), *Radix Rehmanniae Preparata* (Da Sheng Di), *Radix Paeoniae Alba* (Bai Shao), *Radix Glehniae* (Bei Sha Shen), *Colla Cornus Cervi* (Lu Jiao Jiao), *Rhizoma Dioscoreae* (Huai Yao), *Semen Carthami Tinctorii Carbonisatum* (Jie Sui Tan).
After taking three to four doses, remove *Radix Bletillae Striatae* (Bai Wei) and *Radix Angelicae Sinensis* (Dang Gui Tou), add *Radix Codonopsis* (Dang Shen), *Rhizoma Atractylodis Macrocephalae* (Bai Zhu), and *Sclerotium Poriae Cocos* (Fu Shen), and continue taking for ten doses.

Menstruation and leukorrhea in women both descend through the vessels of the Chong Mai (Penetrating Vessel), Ren Mai (Conception Vessel), and Dai Mai (Girdle Vessel). At the initial onset of flow, if there is no blood stasis obstruction, the patient initially feels nothing unusual. However, Bai Zhuo (white turbidity) is no different from nocturnal emission in men; it exits from the Jing Qiao (essence orifice), and the patient is usually aware of it. Yet, patients wish to inform the physician but cannot bring themselves to speak of it, making differentiation difficult. In my youth, I heard of a relative who suffered from this condition. Her menstruation did not cease, and the physician treated it as leukorrhea without effect; she died within two or three months. Leukorrhea generally does not lead to death, let alone normal menstruation. However, since the patient cannot describe it herself, how can it be differentiated? The answer is: If the physician sincerely seeks to understand, even if not perfectly accurate, it will not be far off. By asking about the patient's subjective sensation when the discharge is about to occur, if there are no other diseases but frequent feelings of depression and vertigo, and the pulse is Floating and Kou (Hollow), one can definitively diagnose it as Bai Zhuo rather than leukorrhea. This belongs to deficiency-cold causing essence slipping; if there is floating fire, it is a different matter.
*Radix Codonopsis* (Dang Shen), *Radix Rehmanniae Preparata* (Shu Di), *Semen Alpiniae Oxyphyllae* (Yi Zhi Ren), *Semen Cuscutae* (Tu Si Zi), *Radix Astragali Membranacei* (Huang Qi), *Fructus Corni Officinalis* (Yu Rou), *Os Distomi* (Gu Sui Bu), *Fructus Ligustri Lucidi* (Nu Zhen Zi).