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Ms. Hang suffered from metrorrhagia and metrostaxis for a long time, recently developing abdominal pain. The physician suspected that the emotional depression due to widowhood caused qi stagnation and disharmony, using Shixiao San (Pain-Relieving Powder) to break blood stasis and qi stagnation, adding Ejiao (Donkey-hide Gelatin), Danggui (Angelicae Sinensis Radix), and Baishao (White Peony Root) to extinguish wind and nourish the ying level. However, the abdominal pain did not cease, and the dripping bleeding increased, with blood resembling bean juice. In the late afternoon, she felt mentally exhausted with rising deficiency fire. The yin collaterals were injured, the extraordinary vessels were insecure, and deficiency yang was prone to flaring up. The left pulse was deficient and could not withstand pressure; the right pulse was floating and large but lacked strength. Treatment should focus on securing and controlling the Chong and Ren meridians, while simultaneously anchoring the deficiency yang. Hishi Shi (Red Halloysite, 2 qian), Wuwei Zi (Schisandra Fruit, 0.5 qian), Longgu (Fossilized Bones/Mammal Teeth, dosage unspecified), Danpi (Moutan Cortex, 1.2 qian each), Duzhong (Eucommia Bark, stir-fried with salt water), Shudi (Prepared Rehmannia Root, steamed with Amomum), Baishao (White Peony Root), Shanyao (Dioscorea Rhizome, all stir-fried, 2 qian each), Chai Shihu (Dendrobium Stem), Fushen (Poria with Hostwood, 3 qian each), Lianzi (Lotus Seed, 15 grains), Jixueteng Gao (Spatholobus Paste, 2 qian). After four doses, the dripping pain stopped. Hishi Shi and Longgu were removed, and Qizi (Goji Berry, roasted, 1.5 qian) and Guijia Xin (Heart of Tortoise Shell, roasted, 3 qian) were added, eliminating the deficiency fire. The Chong and Ren are part of the extraordinary vessels; prolonged metrorrhagia requires herbs that secure the extraordinary vessels. Jixueteng Gao is used to guide the medicine into the yin collaterals.

Ms. Zou, over fifty years old, suddenly experienced massive bleeding with clots, fainted, and then recovered. Her pulse was deficient and hollow (Kou pulse). This indicated deficiency wind disturbing the yin collaterals. Ejiao (3 qian) was decocted in water and taken, stopping the bleeding. Subsequently, Shudi, Fushen, Baishao, Jingjie (Schizonepeta, stir-fried with vinegar until black), Xuduan (Dipsacus Root), Qizi, Gancao (Licorice Root, roasted until black), and Wumei (Mume Fruit) were used, following the principle of sweet flavor transforming into yin to extinguish wind. She recovered soon after.

Ms. Gong had obstructed and painful urination. She took Daochi San (Guide Out Red Powder) with Danggui Wei (Angelicae Sinensis Radix Tail), Chishao (Red Peony Root), Chiling (Poria with Red Coir), and Niuxi (Achyranthes Root), which resulted in urination. However, the Chi pulse remained firm and forceful, indicating amenorrhea due to blood stasis. After ten days, she developed alternating chills and fever, abdominal pain, and sudden severe bleeding with dark purple clots, followed by bright red flow like a gush, later turning pale red like water, or mixed red and white, dripping continuously for a month. She suffered from dizziness, epigastric fullness, inability to eat or drink, mental fatigue, cold limbs, and a fine pulse nearly imperceptible. This indicated yang decline unable to control yin, with a slippery pulse suggesting impending collapse. Emergency treatment used Siwei San (Four-Dimension Powder) with Banxia (Pinellia Rhizome), Sharen (Amomum Fruit), and Fushen. The pulse and symptoms stabilized, and she was later treated with Dabu Tang (Great Tonifying Decoction) to recover.

Ms. Wu had vaginal bleeding during pregnancy or miscarriage for over a month, with continuous metrorrhagia and leukorrhea. Qi-tonifying and blood-stanching agents failed to stop the dripping, leading to palpitations, restlessness, and soreness/pain in the lower back and legs. As stated in the Mai Jue (Pulse Classic): "Metrorrhagia lasting many days leads to leukorrhea; metrostaxis lasting long depletes the marrow." Urgent securing of the extraordinary vessels was needed, imitating Xu Zhicai’s idea of "astringing to stop collapse," using Jin Suo Shen Dan (Golden Lock Key Pill). Longgu (ground), Muli (Oyster Shell, vinegar-ground), Fushen, Yuanzhi (Polygala Root, stir-fried), Hishi Shi (ground), Qizi (wine-roasted), plus Duzhong, Zaoren (Sour Jujube Seed, both stir-fried), and Wumei. One dose stopped the leakage and reduced palpitations. Further modifications brought stability.

Ms. Wang, around forty-nine (seven times seven), had menstruation cease for half a year, then suddenly resumed with continuous metrorrhagia. Although the Blood Sea was deficient, it was sufficient to use Xuduan and Duzhong to secure blood, combined with Aiye (Mugwort Leaf) and Fuzi (Aconite Root) to regulate qi. Instead, the physician used Zonghui (Palma Ash) and Hei Puhuang (Blackened Lygodium Spore) to forcibly astringe, causing lower abdominal distension, hardness, pain, and tenderness, headache, epigastric fullness, fever, thirst, irritability, scanty and painful urination, with a wiry left and rapid right pulse. This indicated collateral obstruction and bi-syndrome pain. The primary treatment should be resolving stasis, assisted by unblocking collaterals, which is the method for extraordinary vessels, not comparable to Shixiao San or Juejin Jian. Wulingzhi (Trogopterus Dung), Yujin Zhi (Curcuma Juice, 0.8 fen each), Niuxi, Gualou (Trichosanthes Fruit), Juluo (Tangerine Medullary Fiber, 1.5 qian each), Yanhu (Corydalis Rhizome), Taoren (Peach Kernel), Chishao, Mutong (Akebia Stem, 1 qian each), Danggui Xu (Angelica Suture), Jiangxiang Mo (Dalbergia Odorifera Dust, 2 qian each). After three doses, stasis moved and the abdomen softened. However, dry mouth and slight thirst persisted, and the head felt unclear, indicating fluid deficiency and internal wind. Ajiao, Ganju (Chrysanthemum, stir-fried), Maidong (Ophiopogon Tuber), Shihu, Jingjie (vinegar-fried), Zaoren, Fushen, Baishao, Lianzi, Longyanrou (Longan Aril) were used. Bleeding stopped, and symptoms receded. Later, leukorrhea appeared due to qi deficiency sinking. Dangshen (Codonopsis), Yuzhu (Polygonatum Odoratum Rhizome), Fuling (Poria), Xuduan, Duzhong (salt-water fried), Shengdi Tan (Charred Rehmannia), Qianshi (Euryale Seed), Qizi (all roasted) were used. Three doses resulted in complete recovery.

Ms. Xu, in middle age, suffered blood loss leading to turbid leukorrhea, indicating deficiency of the Chong and Ren meridians. The Chong is the Sea of Blood, and the Ren governs bearing and carrying. The Chong meridian belongs to the Yangming Stomach channel. Premature decline of Yangming led to poor appetite, causing the Blood Sea to be insecure and the Ren meridian to lose its function, which is the root cause of dripping leakage. Recently, postprandial epigastric discomfort, belching with putrid odor, and night-time blooming occurred, indicating Spleen and Kidney yang deficiency. The treatment principle is to secure yin by first benefiting yang, to promote vital energy and appetite. With slow and weak pulses on both sides, warming and unblocking was appropriate. Zhifu Zi (Processed Aconite, 3 fen), Yizhiren (Alpinia Oxyphylla Fruit, roasted 8 fen), Shayuanzi (Astragalus Complanatus Seed), Baishao, Guishen (Angelica Body), Zhibanxia (Processed Pinellia, 2 qian each), Pogouzhi (Psoralea Fruit), Qizi (both roasted), Wugu (Black-bone Chicken, vinegar-roasted), Xuduan (Jiu-chao, 1.5 qian each), Hutao Rou (Walnut Meat, 2 pieces), Weijiang (Roasted Ginger, 3 qian). Three doses stopped leakage and improved appetite. Zhifu Zi, Pogouzhi, and Banxia were removed, and Qianshi, Duzhong, Tusizi (Dodder Seed, all stir-fried) were added. Several more doses secured the condition.

Ms. Bao had amenorrhea suspected as pregnancy, with vaginal bleeding often attributed to fetal leakage. Suddenly, severe bleeding occurred, discharging much fatty membrane. She had fever, dizziness, red face, irritability, cough, and vomiting of green foam. Upper cough caused lower leakage; frequent vomiting caused frequent dizziness; fluids could not be retained. Emergency Weijiang Zhi (Roasted Ginger Juice) was used to stop vomiting. Once cough and counterflow subsided, consciousness gradually returned. The pulse was deficient, small, and rapid; deep palpation felt empty; both Chi pulses were hollow, clearly not a pregnancy sign. This was due to irregular lifestyle and improper intake of raw/cold foods, causing qi and blood stagnation. Sudden massive loss led to yin deficiency, with yang losing its anchor, transforming into internal wind, causing vertigo, vomiting, and counterflow, like wind flying and waves overturning. It was known that yin deficiency with yang hyperactivity caused metrorrhagia. The Blood Sea was empty, deficiency yang rose counter-flowingly, due to qi failing to control blood. Since yin grows with yang, the methods of Mr. Lizhai and Mr. Jingyue should be followed: astringe yang to secure yin. Yangshen (American Ginseng, roasted), Fushen, Baishao (stir-fried, 3 qian each), Paojiang (Prepared Ginger, 1 qian), Wuwei Zi (0.5 qian), Zhibanxia, Jiaobaizhu (Scorched Atractylodes), Gancao (roasted black), Xuduan, Duzhong (salt-water fried, 2 qian each). Two doses stopped leakage and reduced fever. Slight aversion to cold indicated remaining yang deficiency; Zhichuan Fu Zi (Processed Sichuan Aconite, 5 fen) was added to the previous formula, resulting in cure.

Ms. Xie, at the age when Tian Gui (menstruation) should cease, repeatedly suffered metrorrhagia, recently accompanied by bloody leukorrhea resembling dysentery. She had head tremors, tinnitus, neck numbness, and red face. The syndrome resulted from deficiency of the Ren and Dai meridians, with fire rising and wind stirring, causing floating heart spirit, palpitations, and restlessness. Treatment focused on anchoring yang and securing yin, ensuring yang descends to interact with yin, and yin ascends to cling to yang, temporarily stopping tremors and numbness. Preserving the Blood Sea and protecting yin collaterals, revitalizing the lower origin, relies on quiet securing. Avoid mental exertion disturbing Jueyin yang, so night sweats and sleep will gradually improve. Shudi, Shanyao, Wuwei Zi (roasted), Qizi (roasted), Guiban (Tortoise Shell), Longgu, Ejiao, Muli (ground), Duzhong (salt-water fried), Longyanrou. Several doses felt very comfortable. Longgu, Muli, and Duzhong were removed. Lingyangjiao (Antelope Horn), Danpi, Baishao, Fushen, Lianzi, Qianshi, Xuduan were added to make a paste, bound with Ejiao, and taken with Xiaomai (Wheat) decoction. Gradual recovery ensued.

Ms. Wang, metrorrhagia turned into leukorrhea, until urine resembled rice water or mucus. Thigh bone pain, waist and knee soreness. Having never taken medicine, marrow fluid would inevitably be depleted, leading to incurable disease. Recently, spring warmth leaked out, causing fever, poor appetite, thirst, red cheeks, fluid exhaustion, and yang rising. Right pulse wiry, left pulse weak. Urgent yin securing and lower stabilization was needed. Shudi (stir-fried), Ejiao (melted), Shihu (2 qian each), Yangshen (3 qian), Maidong, Fushen, Hishi Shi (1.5 qian each), Baishao, Duzhong (green salt stir-fried), Gan Qizi, Xuduan (3 qian each), added Lianzi and Dazao for decoction. Symptoms decreased after several doses; Hishi Shi was removed for further doses. Then Ejiao was removed, Qianshi and Shanyao (stir-fried, 3 qian each) were added. Dozens of doses yielded results.

Ms. Wei, with obstructed menstruation and sudden severe bleeding, suspected fetal leakage. Pulse diagnosis showed no pregnancy signs; it was caused by accumulated stasis over a long time, previously managed successfully. Now, during summer-damp season, she had dizziness, nausea, evening bone-steaming fever, insomnia, and sudden severe bleeding with a deficient and rapid pulse. The syndrome belonged to internal causes, likely due to Yangming meridian deficiency, with Wood-Fire attacking Earth, penetrating the diaphragm to the vertex, shaking the Blood Sea. Empty Blood Sea generated heat in bones and joints. Treatment harmonized yang, calmed the stomach, and anchored collaterals. Nensangye (Young Mulberry Leaf), Ganju (stir-fried), Tianma (Gastrodia Rhizome), Baishao, Chaihu, Zaoren, Fushen, Muli (ground), Haipiaoxiao (Cuttlefish Bone, vinegar-roasted), Juhong (Tangerine Peel), Banxiaqu (Pinellia Fermented Curd), Xuduan. Several doses resolved all symptoms. Only the left Guan and Chi pulses were hollow and weak, indicating Liver-Kidney yin injury. Shudi, Yurou (Cornus Fruit), Shanyao, Baishao (all stir-fried), Fuling, Duzhong (salt-water fried), Haipiaoxiao, Biejia (Softshell Turtle Shell, all roasted), Ejiao (melted). Dozens of doses cured her. Follow-up with Jixueteng Gao stabilized menstruation.