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Zhu Quansheng stated: The above discussions on blood stasis and blood depletion, whether deficiency or excess syndromes, and whether tonification or purgation is indicated, are all mutually contrasting. Although this volume lists only four types, they all belong to hemorrhagic conditions; treatment should employ astringent and tonifying methods, slightly combined with promoting circulation. Only the condition of sprain and fall injury appears like metrorrhagia but is not true metrorrhagia, thus it is suitable for clearing blood stasis; this is the secondary content (guest) in this volume. The five types of leukorrhea, although forming another volume, its principles are actually attached to regulating menstruation. The category of regulating blood is mutually explanatory with the principles of regulating menstruation, so its meaning directly relates to regulating menstruation. And the blood syndromes discussed in the lower volume are attachments to this volume. As for the single entry on turbid discharge at the end of this volume, the previous explanations have already covered it.

[Commentary: The first item of metrorrhagia originates from menstrual flow, showing that although menstrual blood and metrorrhagic blood are not identical, they have a relationship as close as lips and teeth.]

Excessive menstrual flow, or occurring twice within one month, indicates that blood does not return to its vessels and overflows along with Tian Gui (heavenly water/reproductive essence). The patient must suffer from vertigo and dizziness (Yu Mao), dry throat, lower back pain, fatigue, and difficult defecation. The pulse is scattered, large, floating, and rapid. Refer to the two treatment methods for recurrent menstruation in the "Regulating Menstruation" section mentioned earlier.

Metrorrhagia caused purely by Qi deficiency presents with bright red blood, possibly with clumps of blood expelled subsequently. The pulse is hollow (Kou), respiration is hurried, the body is not emaciated, and the complexion is pale [Commentary: Patients who lose blood often have a sallow complexion due to sudden depletion of body fluids; since the complexion here is white, it indicates Yang Qi collapse and Qi deficiency]. They usually suffer from constipation, sometimes alternating with diarrhea, or even undigested food in stool. The four extremities are often cold. Treatment focuses specifically on Spleen Yang, tonifying Mingmen Fire, and guiding blood back to the vessels. Ren Shen (Ginseng Radix et Rhizoma), Zhi Bai Zhu (Prepared Atractylodis Macrocephalae Rhizoma), Chao Dang Gui (Stir-fried Angelicae Sinensis Radix), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Jie Sui Tan (Carbonized Schizonepetae Spica), Guan Zhong Tan (Carbonized Cibotii Rhizoma), Zhi Yi Zhi Ren (Honey-fried Alpinia Oxyphylla Fruit), Long Gu (Fossilized Bones), Fu Pian (Prepared Aconiti Lateralis Radix), Shan Yu Rou (Corni Fructus), Jiang Tan (Carbonized Ginger).

For metrorrhagia where the eyes go dark, fainting occurs leading to falling to the ground, and loss of consciousness: Use Du Shen Tang (Single Ginseng Decoction) mixed with Guan Zhong Tan powder and administered via gavage. Once the patient regains slight stability, if Qi does not rebel and the tongue is not deep purple, this indicates Yin deficiency. Although there may be floating fire, do not drain it. Da Shu Di (Prepared Rehmanniae Radix), Zhi Bai Zhu (Prepared Atractylodis Macrocephalae Rhizoma), Ren Shen (Ginseng Radix et Rhizoma), Dang Gui (Angelicae Sinensis Radix), Mai Dong Rou (Ophiopogonis Tuber), Jiang Tan (Carbonized Ginger), Da Sheng Di (Raw Rehmanniae Radix), Sheng Huang Qi (Raw Astragali Membranacei Radix), Gan Cao (Licorice Root), Yuan Shen (Scrophulariae Radix), Guan Zhong Tan (Carbonized Cibotii Rhizoma), Yu Rou (Corni Fructus).