（〔批〕此证难于置问，即于素无崩证，知为房劳。先崩而后产，知非胎滑也。此余心得。）
妇人素无崩中证，孕三月，忽先血崩，其胎随堕，此由气弱房劳，精泄过多所致也。法当大补精气，佐以补血，录
傅氏方如下∶
炙潞党 大熟地 杜仲炭 当归 制白术 白茯苓 山萸肉 甘草
此温补之方也。倘胎下后，尚有瘀块∶无热者，加川芎、桃仁泥；有热者，加龟版、丹皮；无瘀五心热，骨蒸者，
以生地代熟地，以金樱子代山萸，加地骨皮；肝阳上逆，两胁刺痛者，加白芍、决明、延胡索。
妇人逾七七经绝之年，贪欢浪战，血室大开，以致崩决；或孀妇肾不纳气，气冲血室，皆致崩证，其治法亦同。（〔批〕
五六十岁，经忽复行，亦崩之渐，此方主之，或加黑芥穗引血归经皆宜之。）
酒当归 山萸肉 炙党参 杭芍炭 五味子 三七末（冲） 生黄 大熟地 炒准药 贯众炭 冬桑叶 生草
血崩证，善恼怒烦恨，咽燥胁痛，干呕吞酸，或口苦，筋络掣痛，此肝气郁结而急，血不归经也。法宜平肝解郁为
主。
醋炒白芍 土炒白术 白归身 贝母 地骨皮 酒炒生地 四制香附 三七末 甘草 黑栀子 芥穗（炒黑） 石
决明（捣） 贯众炭
产后血大下，色鲜红，腹虽痛，然喜按，当以崩治，先与加参生化汤，去桃仁。
人参 当归 川芎 炙草 炮姜
继与大补气血兼佐和血之剂，即以上第四条第二方酌用之。（〔批〕党参用炙者，去龟版、蒲黄、白芍，加黄 治之。）
[Commentary: This condition is difficult to ascertain through inquiry; even if the patient has no history of metrorrhagia, it can be inferred as caused by sexual exhaustion. Bleeding preceding delivery indicates it is not due to fetal slipping. This is my personal insight.]
A woman who previously had no symptoms of metrorrhagia becomes pregnant for three months and suddenly experiences severe vaginal bleeding (metrorrhagia), resulting in the expulsion of the fetus. This is caused by Qi deficiency and excessive seminal emission due to sexual overexertion. The treatment principle should be to greatly tonify Qi and essence, assisted by blood-nourishing herbs. The formula from Master Fu is recorded as follows:
Zhi Lushen (Prepared Codonopsis Root), Da Shudi (Large Prepared Rehmannia Root), Duzhong Tan (Charred Eucommia Bark), Danggui (Angelica Sinensis Root), Zhi Baizhu (Processed Atractylodes Macrocephala Rhizome), Bai Fuling (White Poria), Shanyurou (Cornus Officinalis Fruit), Gancao (Licorice Root).
This is a warming and tonifying formula. If, after the expulsion of the fetus, blood stasis clots remain: if there is no heat, add Chuanxiong (Ligusticum Wallichii Rhizome) and Taoren Ni (Peach Seed Paste); if there is heat, add Guiban (Tartar Testudinis Carapax) and Danpi (Moutan Cortex); if there is no stasis but there is five-palm heat and bone-steaming fever, replace Shudi with Shengdi (Rehmannia Glutinosa Root) and Shanyurou with Jinyingzi (Rosa Laevigata Fruit), adding Digupi (Cortex Lycii Radicis); if Liver Yang rebels upward causing stabbing pain in both hypochondria, add Baishao (Paeoniae Radix Alba), Juemingzi (Cassiae Semen), and Yanhusuo (Corydalis Rhizome).
Women past the age of forty-nine (seven sevens), when menstruation ceases, may engage in reckless sexual activity, causing the Blood Chamber to open widely, leading to metrorrhagia; or widows whose Kidney fails to grasp Qi, allowing Qi to rush into the Blood Chamber, will also suffer from metrorrhagia. Their treatment method is the same. [Commentary: For women aged fifty or sixty whose menstruation suddenly resumes, this is also an early sign of metrorrhagia; this formula is indicated, or adding Hei Jiesui (Charred Saposhnikoviae Radix) to guide blood back to its vessels is also appropriate.]
Jiu Danggui (Wine-processed Angelica Sinensis Root), Shanyurou (Cornus Officinalis Fruit), Zhi Dangshen (Prepared Codonopsis Root), Hangshaotan (Charred Hangzhou Peony Root), Wuweizi (Schisandra Chinensis Fruit), Sanqi Mo (Notoginseng Powder, taken with decoction), Sheng Huangqi (Raw Astragalus Membranaceus Root), Da Shudi (Large Prepared Rehmannia Root), Chao Huaiyao (Stir-fried Dioscorea Polystachya Rhizome), Guanzhong Tan (Charred Cyatheae Spadix), Dong Sangye (Mulberry Leaf), Sheng Cao (Raw Licorice Root).
In cases of metrorrhagia, if the patient is prone to anger, annoyance, and resentment, with dry throat, hypochondriac pain, dry retching, acid regurgitation, bitter taste, or spasmodic pain in the sinews and collaterals, this indicates Liver Qi stagnation and urgency, causing blood to fail to return to its vessels. The treatment principle should primarily focus on soothing the Liver and resolving stagnation.
Cu Chao Baishao (Vinegar-stir-fried Paeoniae Radix Alba), Tu Chao Baizhu (Earth-stir-fried Atractylodes Macrocephala Rhizome), Bai Guishen (White Angelica Sinensis Root), Beimu (Fritillaria Cirrhosa Bulb), Digupi (Cortex Lycii Radicis), Jiu Chao Shengdi (Wine-stir-fried Raw Rehmannia Glutinosa Root), Sizhi Xiangfu (Four-process Cyperi Rhizoma), Sanqi Mo (Notoginseng Powder), Gancao (Licorice Root), Hei Zhizi (Black Gardenia Fruit), Jiesui (Charred Saposhnikoviae Radix), Shijueming (Ground Argopecten Irradians Shell), Guanzhong Tan (Charred Cyatheae Spadix).
Postpartum heavy bleeding with bright red blood, where the abdomen hurts but prefers pressure, should be treated as metrorrhagia. First administer Jiashen Shenghua Tang (Ginseng-added Decoction for Generating New Blood), removing Taoren (Peach Seed).
Renshen (Ginseng Radix et Rhizoma), Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Wallichii Rhizome), Zhi Cao (Prepared Licorice Root), Paojiang (Roasted Ginger).
Subsequently, administer a formula that greatly tonifies Qi and Blood while assisting in harmonizing the blood, referring to the second formula in Item 4 above for appropriate use. [Commentary: Use Zhi Dangshen (Prepared Codonopsis Root), remove Guiban (Tartar Testudinis Carapax), Puhuang (Pollen Typhae), and Baishao (Paeoniae Radix Alba), and add Huangqi (Astragalus Membranaceus Root) for treatment.]