经水先期,其色淡而甚多,属之湿伤气也。淡而多,水之象,先期气伤而不摄血也。(〔批〕此证肥胖之妇较多,性
多浓重。)大法以六君子汤加黑姜、茯苓、胶艾治之。(〔批〕六君子汤原有茯苓,而云加者,倍之也。后皆同。患此者多
属气。)
炙党参 甘草 半夏 阿胶珠(蛤粉炒) 制白术 茯苓 陈皮 黑姜 蕲艾叶
此方补气渗湿,兼温血海。茯苓与术草并用,功在中州,不伐肾。(〔批〕质重滞静默者湿重,当用茆赤术。茯苓不
伐肾者,定如此用法,则经产可不忌也。喻此者甚少,故附是而论之耳。)
经水先期,其色淡而甚少,或至有块者,属之血分,寒凝而气虚也。淡少者,寒象,故凝为块,然宜后期,或至瘀
闭。今反超前,以是知气虚而不摄血也,大法以归脾汤去枣仁加吴萸、姜、艾治之。
炙党参 制白术 当归 甘草 淡吴萸 艾叶 生姜 炙黄 远志筒 茯苓 木香 龙眼肉 黑姜
经水一月再行,初谓偶然先期也,既则屡屡若是,此乃崩中之渐也,及早治之,则易为力。其人体不甚瘠,脉浮大,
口不渴,倦惫无力,大便时秘时且 溏,此乃气虚而血不归经也。(〔批〕循至此种使人预为之防也。前六句自为一小段。
总论以下分出气虚、血热两种治法。)法宜大补其气,及其任脉,佐以引血归经之味。
吉林人参(另炖) 炙黄 炒当归 黑姜炭 炒淮山药 于白术(土炒) 细抚芎 黑芥穗 贯众炭 炒芡实子
(〔批〕力不足者用真潞党参一二两代之,下元不固者加山萸肉。)
Menstruation arrives early, with pale color and excessive volume, indicating that dampness has injured Qi. Pale color and excessive volume are manifestations of water-dampness, suggesting that injured Qi fails to control the blood. (Comment: This syndrome is more common in obese women, whose constitutions tend to be heavy and dense.) The general principle of treatment is to use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Hei Jiang (Charred Ginger), Fu Ling (Poria), E Jiao (Donkey-hide Gelatin), and Ai Ye (Mugwort Leaf). (Comment: Liu Jun Zi Tang originally contains Fu Ling; the term "add" here implies doubling the dosage. This applies to subsequent prescriptions as well. Patients suffering from this condition mostly have Qi deficiency.)
Zhi Dang Shen (Processed Codonopsis Root), Gan Cao (Licorice Root), Ban Xia (Pinellia Tuber), E Jiao Zhu (E Jiao beads fried with clam powder), Zhi Bai Zhu (Processed Atractylodes Macrocephala Rhizome), Fu Ling (Poria), Chen Pi (Tangerine Peel), Hei Jiang (Charred Ginger), Qi Ai Ye (Qicheng Mugwort Leaf).
This formula tonifies Qi and leaches out dampness, while simultaneously warming the Blood Sea (Uterus). The combination of Fu Ling, Bai Zhu, and Gan Cao acts on the Middle Jiao (Spleen and Stomach) without damaging the Kidney. (Comment: Individuals with a heavy body frame and sluggish movements have severe dampness and should use Mao Chi Zhu (Cang Zhu). Fu Ling does not damage the Kidney because, with this specific usage, it can be used safely during menstruation and postpartum periods without contraindication. Few clarify this point, so I append this discussion.)
Menstruation arrives early, with pale color and scanty volume, or accompanied by clots, belonging to the Blood aspect, caused by Cold coagulation and Qi deficiency. Scanty and pale flow indicates Cold, leading to clot formation; logically, menstruation should be delayed or even obstructed. Since it arrives early instead, we know it is due to Qi deficiency failing to control the blood. The general principle of treatment is to use Gui Pi Tang (Restore the Spleen Decoction) minus Zao Ren (Sour Jujube Seed), added with Wu Yu (Evodia Fruit), Sheng Jiang (Fresh Ginger), and Ai Ye (Mugwort Leaf).
Zhi Dang Shen (Processed Codonopsis Root), Zhi Bai Zhu (Processed Atractylodes Macrocephala Rhizome), Dang Gui (Angelica Sinensis Root), Gan Cao (Licorice Root), Dan Wu Yu (Light Evodia Fruit), Ai Ye (Mugwort Leaf), Sheng Jiang (Fresh Ginger), Zhi Huang Qi (Honey-fried Astragalus Root), Yuan Zhi Tong (Polygala Root tubes), Fu Ling (Poria), Mu Xiang (Aucklandia Root), Long Yan Rou (Longan Aril), Hei Jiang (Charred Ginger).
Menstruation occurs twice a month. Initially thought to be an occasional early arrival, but when it happens repeatedly, it is a precursor to Beng Lou (Metrorrhagia and Metrostaxis). Early treatment makes it easier to manage. The patient's body is not emaciated, pulse is floating and large, mouth is not thirsty, fatigue and weakness are present, and bowel movements alternate between constipation and loose stools. This indicates Qi deficiency causing blood to fail to return to its vessels. (Comment: One must take preventive measures for such cases. The first six sentences form a short paragraph. Below, the general discussion divides into two treatment methods: Qi deficiency and Blood heat.) The method should involve greatly tonifying Qi and supplementing the Ren Mai (Conception Vessel), assisted by herbs that guide blood back to the vessels.
Jilin Ren Shen (Ginseng from Jilin, stewed separately), Zhi Huang Qi (Honey-fried Astragalus Root), Chao Dang Gui (Stir-fried Angelica Sinensis Root), Hei Jiang Tan (Charred Ginger Carbon), Chao Huai Shan Yao (Stir-fried Chinese Yam Rhizome), Tu Bai Zhu (Earth-fried Atractylodes Macrocephala Rhizome), Xi Fu Xiong (Fine Ligusticum Chuanxiong Rhizome), Hei Jie Sui (Charred Shepherd's Purse Herb), Guan Zhong Tan (Charred Cibotium Barometz Rhizome), Chao Qian Shi (Stir-fried Euryale Seed).
(Comment: For those with insufficient strength, use genuine Lu Dang Shen (Codonopsis Pilosula) one to two taels as a substitute. For those with insecure Lower Yuan, add Shan Yu Rou (Cornus Officinalis Fruit).)