妇人每行人道，必下血甚多，此血海太热也。盖冲脉丽于阳明，下通血海，血海太热，其血本当循冲脉而上，为吐
衄呕血，今以下关不固，火势乘血之顺下。（〔批〕血乃水质，其性顺下。）破虚攻瑕而外泄，所以崩也。且壮火食气，元
气衰耗而不能摄血，即使慎于房帏而血不归经，久必为吐衄血厥之病，拟备大法∶（〔批〕此证不至于气脱，故不用 、
术。五味、甘草，非以补气，酸甘化阴之意也。）
嫩白薇 大生地 地骨皮 元参 生党参 金樱子 黄柏炭 麦冬肉 醋白芍 丹参 北条参 龙骨 木耳炭
芥穗炭 北五味 甘草
服前药数剂，尺脉静，宜与补气血之品，佐以和血。盖失血家气必虚，冲任脉伤，又服凉剂，恐凝结也，然必戒客
止百日。（〔批〕前方救急，此方善后。不补气，无以生血，不补血无以养火，势必发作也，更兼和血，其义大备矣。）
生潞党 生草 全当归 炒准药 甘杞子 阿胶珠 焦冬术 茯苓 大熟地 盐杜仲 炙龟版 炒白芍 延胡索
蒲黄（冲） 麦冬肉 芥穗炭
渴甚者，去术加花粉、石斛。五心热者，去熟地，加竹心，三十剂。
（〔批〕傅青主原文稍加修节。逾曰∶此与上条证相似，然血海热甚者，胃液必耗而渴，尺脉必洪数，此证无是。但
血管有夙精，当隐隐作痛也。倘血管不痛，则非问其失无从臆断，甚至闭塞者，服行经药，血管当大痛，下秫米、绿豆
大瘀块，如上卷“血瘀”第九条所论也。亦当于此加重黄柏服之。）
妇人每交合，则血流不止，虽未若血崩之甚，而历久不愈，气血耗伤，恐致血枯之忧。此证由于犯经交合，精冲血
管，经水欲出，精逆射之，则相裹而滞于血管。交接之际，淫气感召，旧精欲出而未能，而经血反触动而出矣。方用引
精止血汤。竹泉生曰∶此傅氏原论，余稍加节而饰之，其义精绝。盖精血相裹，着于血管，即当闭塞不通，而成血瘀
为枯之证，今独幸其精少也。
傅氏引精止血汤
潞党参（五钱） 白茯苓（三钱去皮） 芥穗（三钱） 萸肉（五钱） 制白术 （一两） 大熟地（一两） 黑
姜（一钱） 黄柏（五分） 酒炒车前子（三钱）
方论，四剂愈，十剂则血管之伤痊。方用参术补气，地萸补精，精气足则血管流通，又用茯苓、车前以利窍；用黄
柏直入血管以去夙精；用芥穗以去败血；黑姜以止血管之口，调停曲折，毕尽其其妙，故能治陈 也。虽必慎欲三月，
始后无虞。此方丝丝入扣，确不可易。
When a woman engages in sexual intercourse, she invariably suffers from profuse vaginal bleeding. This is due to excessive heat in the Blood Sea (Chong Mai, the sea of blood where the Qi and Blood of the twelve meridians converge). The Chong Mai attaches to the Yangming Stomach Meridian and connects downward to the Blood Sea. When the Blood Sea is excessively hot, the blood should naturally follow the Chong Mai and move upward, manifesting as hematemesis, epistaxis, or vomiting of blood. However, because the lower gate (lower jiao) is insecure, the fire follows the natural downward flow of the blood. (Commentary: Blood is yin in nature and tends to flow downward.) The fire attacks the deficient areas and leaks outward, resulting in metrorrhagia. Moreover, vigorous fire consumes Qi; when Yuan Qi (Original Qi) is depleted, it fails to control the blood. Even if one exercises restraint in sexual activity, the blood will not return to the vessels. Over time, this inevitably leads to diseases such as hematemesis, epistaxis, or syncope due to blood loss. The general principles for treatment are prepared as follows: (Commentary: This condition has not yet reached the stage of Qi collapse, so Ren Shen and Bai Zhu are not used. Wu Wei Zi and Gan Cao are not employed to tonify Qi, but rather to utilize the principle of "sour and sweet generating Yin".)
Tender Bie Jia (Cynanchum Atratum), Large Sheng Di Huang (Rehmanniae Radix Preparata), Di Gu Pi (Lycii Cortex), Yuan Shen (Scrophulariae Radix), Sheng Dang Shen (Codonopsis Radix), Jin Ying Zi (Chrysanthemi Fructus), Huang Bo Tan (Phellodendri Cortex Carbonized), Mai Dong Rou (Ophiopogonis Medulla), Cu Bai Shao (Paeoniae Radix Alba Vinegar-processed), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Bei Tiao Shen (Codonopsis Radix), Long Gu (Fossi Mamuthi Os), Mu Er Tan (Auriculariae Auriculae Carbonized), Jie Sui Tan (Schizonepetae Spica Carbonized), Bei Wu Wei Zi (Schisandrae Chinensis Fructus), Gan Cao (Glycyrrhizae Radix et Rhizoma).
After taking several doses of the above prescription, if the Chi pulse (reflecting Kidney and Ming Men status) becomes calm, it is appropriate to administer formulas that tonify Qi and Blood, assisted by herbs that harmonize the blood. Patients with blood loss invariably have deficient Qi, and the Chong and Ren meridians are damaged. Since cooling agents have been taken, there is a risk of blood coagulation/stasis. Therefore, sexual abstinence must be strictly observed for one hundred days. (Commentary: The former formula is for emergency rescue, while the latter is for convalescence. Without tonifying Qi, Blood cannot be generated; without nourishing Blood, Fire cannot be contained, leading to inevitable recurrence. Adding blood-harmonizing herbs completes the therapeutic strategy.)
Sheng Lu Dang Shen (Codonopsis Radix), Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma), Quan Dang Gui (Angelicae Sinensis Radix), Chao Huai Yao (Dioscoreae Rhizoma Stir-fried), Gan Qi Zi (Lycii Fructus), E Jiao Zhu (Asini Corii Colla processed into beads), Jiao Dong Zhu (Atractylodis Macrocephalae Rhizoma Charred), Fu Ling (Poria), Da Shu Di (Rehmanniae Radix Preparata), Yan Du Zhong (Eucommiae Cortex Salt-processed), Zhi Gui Ban (Testudinis Carapax et Plastrum Honey-processed), Chao Bai Shao (Paeoniae Radix Alba Stir-fried), Yan Hu Suo (Corydalis Rhizoma), Pu Huang (Typhae Pollen, taken with decoction), Mai Dong Rou (Ophiopogonis Medulla), Jie Sui Tan (Schizonepetae Spica Carbonized).
If thirst is severe, remove Bai Zhu and add Hua Fen (Trichosanthis Radix) and Shi Hu (Dendrobii Caulis). If there is five-palm heat (heat sensation in palms, soles, and chest), remove Shu Di and add Zhu Xin (Bambusae Cacumen); take for thirty doses.
(Commentary: Modified slightly from Fu Qingzhu's original text. The next day he said: This case resembles the previous one, but in cases of extreme Heat in the Blood Sea, Stomach fluids are necessarily consumed causing thirst, and the Chi pulse would be surging and rapid. This case lacks these signs. However, there is likely retained semen in the vessels, which should cause dull pain. If there is no pain in the vessels, diagnosis cannot be made without inquiry. If there is obstruction, administering blood-invigorating drugs would cause severe vessel pain, expelling stasis clots the size of millet seeds or mung beans, as discussed in Chapter 9 "Blood Stasis" of Volume I. In such cases, Huang Bo should also be increased in dosage.)
When a woman engages in intercourse, bleeding continues incessantly. Although not as severe as metrorrhagia, if it persists for a long time, it depletes Qi and Blood, raising the fear of Blood Dryness (Xue Ku). This condition arises from intercourse during menstruation, where semen impacts the vessels. As menstrual blood attempts to exit, the retrograde ejaculation causes the two to entangle and stagnate within the vessels. During intercourse, erotic qi stimulates the body; the old semen desires to exit but cannot, thereby disturbing the menstrual blood and causing it to flow out. The formula used is Yin Jing Zhi Xue Tang (Guide Semen and Stop Bleeding Decoction). Zhu Quan Sheng stated: This is Fu's original discussion, slightly edited and refined by me. Its logic is exquisite. Generally, when essence and blood entangle and adhere to the vessels, they should become obstructed, leading to blood stasis and eventually blood dryness. Fortunately, in this case, the amount of retained essence is small.
Fu's Yin Jing Zhi Xue Tang (Guide Semen and Stop Bleeding Decoction)
Lu Dang Shen (5 qian), Bai Fu Ling (3 qian, peeled), Jie Sui (3 qian), Yu Rou (Corni Fructus, 5 qian), Zhi Bai Zhu (1 liang), Da Shu Di (1 liang), Hei Jiang (Carbonized Ginger, 1 qian), Huang Bo (0.5 qian), Jiu Chao Che Qian Zi (Plantaginis Seed Wine-stir-fried, 3 qian).
Formula Analysis: Recovery occurs after four doses, and vascular injury heals after ten doses. The formula uses Ren Shen and Bai Zhu to tonify Qi, and Di Huang and Yu Rou to tonify Essence. When Qi and Essence are sufficient, the vessels flow smoothly. Fu Ling and Che Qian Zi are used to drain dampness through the orifices. Huang Bo enters the vessels directly to eliminate retained essence. Jie Sui removes stale blood. Hei Jiang seals the openings of the vessels. The arrangement is intricate and masterful, thus capable of treating chronic conditions. Strict sexual abstinence for three months is required thereafter to ensure safety. This formula is meticulously constructed and irreplaceable.