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Beng (sudden, heavy uterine bleeding) presents as blood flowing down violently in clots, resembling a landslide. Lou (prolonged, scanty uterine bleeding) presents as menstruation lingering without cessation, like an unstoppered funnel. The *Suwen* states: "Yin deficiency with vigorous Yang pulse is called Beng." It also says: "When Yin collaterals are injured, blood overflows internally." This is because blood circulates within the collaterals and converges at the Chong Mai (Penetrating Vessel), which is known as the Sea of Blood. Unless excessive Yang attacks Yin, causing damage to the internal collaterals, blood would not gush forth uncontrollably. Furthermore, the Heart governs blood, the Spleen controls blood, and the Liver stores blood. Any worry, thought, anger, or fatigue that stirs the fire of the Five Emotions can damage the collaterals, causing the Chong and Ren Mai (Conception Vessel), which govern pregnancy, to lose their hold. This leads to sudden, profuse menstrual bleeding that persists, termed Beng Zhong (Central Beng). The *Liangfang* also states that women's Beng Zhong results from deficiency of the Zang-Fu organs and deficiency of the Chong and Ren Mai, which cannot constrain the menstrual blood. Alternatively, Yang heat attacks Yin, damaging the Chong and Ren Mai with heat; blood flows freely when heated, potentially leading to fainting and collapse. A rapid and small pulse indicates a favorable prognosis, while a surging and large pulse indicates unfavorable. The general principle of treatment should be to regulate and tonify the Spleen and Stomach. The *Jiyin Gangmu* states: "Beng and Lou belong to Qi deficiency, unable to constrain; thus, tonifying Qi is appropriate. If caused by heat invasion, cooling the blood is appropriate." One should not vaguely speak only of regulating and tonifying the Spleen and Stomach, but analyze specifically: there are cases of Yang deficiency of the Zang-Fu and Chong/Ren Mai, Yin deficiency of the Zang-Fu and Chong/Ren Mai, Yin deficiency with concurrent Yang hyperactivity, and cases where initial injury to the Zang-Fu leads to prolonged Beng/Lou, repeatedly damaging the Chong/Ren Mai until the collaterals are deficient and unable to grasp the blood. Simply discussing Spleen and Stomach regulation has not hit the crucial point.

In the past, Li Dongyuan treated Beng by greatly tonifying the Spleen and Stomach, ascending and descending Qi and Blood, because Qi and Blood are generated by the Spleen and Stomach, and the Chong Mai belongs to the Yangming Stomach channel. Since the classics explicitly state that collateral injury causes blood overflow, is it not necessary to build dikes for restraint and mend the gaps? Such as Ejiao (Donkey-hide Gelatin), Jixueteng Gao (Caulis Spatholobi Paste), Chishizhi (Halloysitum Rubrum), Ziyingshi (Fluorite), etc. Only when there is stagnant Qi in the blood, with dull pain in the umbilical and abdominal regions, is it inappropriate to abruptly use astringents, which might cause distension and swelling. One must refer to the classic principles and employ "treat obstruction with unblocking" methods. Use Yimucao (Herba Leonuri), Xiangfu (Rhizoma Cyperi), Zelan (Herba Lycopi), Baishao (Radix Paeoniae Alba), Yanhusuo (Rhizoma Corydalis), Haipiaoxiao (Endoconcha Sepiae), Guiwei (Radix Angelicae Sinensis tail), etc. Harmonize the Qi, and the blood will naturally regulate. According to the *Chanbao*, Beng is divided into Yin Beng and Yang Beng. Those affected by heat with red blood are called Yang Beng; those affected by cold with white blood are called Yin Beng. Red indicates Blood Heat; white indicates Qi deficiency. However, if Beng persists for a long time, it may transform into leukorrhea (Dai Xia); in such cases, direct tonification and consolidation are required. Use Duzhong (Cortex Eucommiae), Xuduan (Radix Dipsaci), Qianshi (Semen Nelumbinis), Muli (Concha Ostreae), Shayuanzi (Semen Astragali Complanati), Tusizi (Semen Cuscutae), etc. Do not allow the condition to progress to exhaustion of marrow and essence. It is suitable to use Renshen (Radix Ginseng), Shudihuang (Radix Rehmanniae Preparata), Gouqizi (Fructus Lycii), Fushen (Poria with Hostwood), Lu'jiao Jiao (Corpus Cornus Cervi Gelatin), Wuweizi (Fructus Schisandrae), Congrong (Cibotium Barometz), Danggui (Radix Angelicae Sinensis), etc. The dosage of herbs should be large to fill the Lower Yuan.

Li Dongyuan discussed Qi sinking and Blood depletion, stating the method should be to lift and raise.

Xue Lizhai discussed the causes of Beng: some due to Spleen deficiency failing to control blood, some due to Liver Fire forcing blood to run recklessly; some due to sudden anger injuring the Liver, causing Blood Heat to boil; some due to stagnant Fire in the Spleen channel, causing blood not to return to its vessels; some due to sorrow injuring the Pericardium, causing blood to fall downward. Treatment methods: For Spleen channel deficiency, use Liujunzi Tang (Six Gentlemen Decoction) plus Chuanxiong (Rhizoma Ligustici Chuanxiong), Danggui (Radix Angelicae Sinensis), Chaihu (Radix Bupleuri). For Spleen Qi deficiency and sinking, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Jiuchao Baishao (Wine-fried Radix Paeoniae Alba). For Liver channel Fire, use Siwu Tang (Four Substances Decoction) plus Chaihu (Radix Bupleuri), Shanzhi (Fructus Gardeniae), Danpi (Cortex Moutan). For anger injuring the Liver, use Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Shanzhi (Fructus Gardeniae), Danpi (Cortex Moutan), Shaoyao (Radix Paeoniae). For Liver channel Wind-Heat, use Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder). For thought and depression injuring the Spleen, use Guipi Tang (Restore the Spleen Decoction) plus Shanzhi (Fructus Gardeniae). For sorrow injuring the Pericardium, use Sijunzi Tang (Four Gentlemen Decoction) plus Chaihu (Radix Bupleuri), Shanzhi (Fructus Gardeniae), Shengma (Rhizoma Cimicifugae). Thus, ancient sages stated that for lower body bleeding, one must conclude treatment with Sijunzi Tang, following the principle of "tonifying Qi in cases of Blood depletion." After massive blood loss, immediately use Dushen Tang (Single Ginseng Decoction). If accompanied by fever, cough, and rapid pulse, this is a sign of false heat due to weak Yuan Qi; it is especially important to add Renshen (Radix Ginseng) to tonify the Spleen Yuan. Using formless Qi to generate formed Blood follows the principle of "Yin grows from Yang." If the pulse is empty and large, and stomach Qi is present, allowing supplementation can save the patient; do not mistakenly administer cold/cooling herbs, which would further injure the generating Qi. For treating anger-induced Beng with green-yellow or red complexion, indicating Liver Wood suppressing Spleen Earth, use Xiao Chaihu Tang combined with Siwu Tang. For treating Liver-Spleen stagnant Fire, Beng with breast swelling and hypochondriac pain, use Xiaoyao San plus Jiuchao Longdancao (Wine-fried Radix Gentianae) and Shanzhi (Fructus Gardeniae). Then use Guipi Tang plus Shanzhi (Fructus Gardeniae) and Beimu (Bulbus Fritillariae Thunbergii). For treating Beng with body heat, dizziness, poor appetite, and phlegm vomiting, use Bawei Wan (Eight-Ingredient Pill) for recovery. Later, due to labor relapse, with a surging pulse that is weak upon deep pressure, this is rootless Fire, internal deficiency-cold, and external false heat; use Shiquan Dabu Tang (Complete Great Tonifying Decoction) for one dose to gradually reduce symptoms. Then take Bawei Wan to cure. For prolonged Beng with Spleen-Stomach deficiency-cold, cold limbs, and abdominal pain, first use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction), then Guipi Tang and Buzhong Yiqi Tang for recovery. Overconsumption of cold herbs causing abdominal stuffiness, irritability, and a surging yet empty pulse requires immediate Bazhen Tang (Eight Treasures Decoction) plus Paojiang (Prepared Ginger). Warm and tonify; delay means no rescue.

Yuanli discussed Beng Zhong, whether clear or turbid, or purely dark clots, even with dizziness and cold limbs; all are suitable for Jiao'ai Tang (Collagen and Mume Decoction) and Yan Zhenling Dan (Swallowing Spirit Pill). Assist with Sanhui San (Three Ashes Powder), or decoct Lizhong Tang (Regulate the Middle Decoction) with Tongbian (Child's Urine). For Beng with abdominal pain, people suspect evil blood remains, and seeing dark, cloudy blood color confirms evil blood, daring not to stop it. How does one know that blood exiting collaterals turning dark is not merely stagnation, nor that stasis is not due to deficiency-cold! Moreover, stasis causing abdominal pain stops when blood flows; Beng causing abdominal pain stops when bleeding ceases. Suitable is Xiongui Tang (Cyperi and Angelica Decoction) plus Shufu (Prepared Aconite) and Ganjiang (Dried Ginger), each 0.5 fen. Stop the blood, and pain stops naturally. Wu Shuqing believed this method is not applicable unless Qi has collapsed after prolonged Beng.

The *Qianjin Fang* treats Beng, Lin, and leukorrhea using Xiao Niujiao Sai San (Small Horn Scale Powder). If accumulated cold causes Beng with continuous blood loss, backache, heavy limbs, and extreme deficiency, use Da Niujiao Sai San (Large Horn Scale Powder). The *Benjing* states: "Niujiao Sai (Horn Scale) removes stasis and closes blood." For women's leukorrhea and Beng, burn it and take with wine. Kou Zongshi's commentary states: "Burned to ash, it treats women's Beng, hematochezia, and bloody diarrhea. In deficient persons, send down with Dushen Tang or Baoyuan Tang." For continuous blood loss in Beng, use Jiaosai Lurong San (Horn Scale and Deer Antler Powder). For red and white Beng, or like bean curd juice, use Fulonggan Tang (Dragon's House Soil Decoction).

The *Yitong* treats excessive Beng/Lou where tonification and purgation fail, using Niujiao Sai preserved with nature, taken with wine, 2-3 qian. For deficiency-cold with thin, pale blood color, Niujiao Sai taken with Lurong (Deer Antler) is excellent. For Beng/Lou persisting for years, use 5 Lotus Seed Pods burned to preserve nature, 2 liang Xiangfu stir-fried black, ground to fine powder. Take 2 qian on an empty stomach with aged wine. For wind entering the womb suddenly causing fresh blood flow, use Yiwei Fangfeng Wan (Single Windproof Pill) or Xuanfuhua Tang (Inula Flower Decoction). For early-stage Beng/Lou, regardless of deficiency or excess, use Jingjie Siwu Tang (Schizonepeta Four Substances Decoction). For Liver channel deficiency-heat, use Qixiao Siwu Tang (Miraculous Efficacy Four Substances Decoction). For anger stirring blood, use Yangxue Pinggan San (Nourish Blood Calm Liver Powder). For excessive mental labor, use Baiziren Tang (Biota Seed Decoction). For leakage injuring pregnancy, use Jiao'ai Siwu Tang (Collagen Mume Four Substances Decoction). For Spleen deficiency with aversion to food, use Danggui Shaoyao Tang (Angelica Peony Decoction). For blood depletion and Qi sinking, use Yiwei Shengyang Tang (Benefit Stomach Ascend Yang Decoction). For red-white Beng and leukorrhea, use Aifu Tang (Mugwort Cyperus Decoction). For deficiency-cold persistent Beng/Lou, use Dingxiang Jiao'ai Tang (Clove Collagen Mume Decoction). For Beng/Lou gradually becoming emaciated, use Lurong San (Deer Antler Powder). For various medicines failing in Beng, use Muli Wan (Oyster Shell Pill). For elderly women with Beng, the method considers it untreatable. Generally for Beng, Vinegar-fried Jingjie (Schizonepeta) and Shengma (Rhizoma Cimicifugae) are often used, as vinegar has astringent properties. Various powders like Wuhui and Shihui use stir-fried herbs; red turns black to stop bleeding. Red represents Fire image; black represents Water color. Blood diseases often combine black herbs, meaning Water can suppress Fire. Or use Lurong Wan (Deer Antler Pill).

Zhang Jingyue treats reckless blood flow due to Blood Heat with Bao Yin Jian (Preserve Yin Decoction) or Jiajian Yiyin Jian (Modified One-Yin Decoction). For excessive Fire forcing blood, use Tuxin Yin (Remove Firewood Drink) plus Xuduan (Radix Dipsaci) and Danshen (Radix Salviae Miltiorrhizae). For Spleen-Kidney deficiency-cold with vomiting, loose stools, and aversion to cold, use Liyin Jian (Regulate Yin Decoction) or Lizhong Tang (Regulate the Middle Decoction). For insecure Spleen-Kidney Yin Qi, use Guyin Jian (Secure Yin Decoction) or Miyuan Jian (Secret Origin Decoction). For Yang deficiency collapse, use Siwei San (Four Borders Powder). For blood depletion and Qi exhaustion, use Dushen Tang (Single Ginseng Decoction) or Danggui Buxue Tang (Angelica Tonify Blood Decoction). For slippery, uncontrollable blood, use Longgu San (Dragon Bone Powder) plus Renshen (Radix Ginseng). Bloody odor and slippery pulse indicate much Fire, suitable for cooling. Bloody smell, clear/cold nature, and fine pulse indicate much deficiency, requiring warming and tonification.

Zhang Jingyue also said: Blood Beng coming like a tide surge clearly indicates reckless Heat, yet one must not treat with Cold. Because Cold causes blood coagulation, trapping Heat inside. Treatment should be clearing and tonifying, combined with lifting; blood will naturally follow the channels, and channels will grasp blood, without abrupt stopping. Suitable are Dihuang (Radix Rehmanniae), Ejiao (Donkey-hide Gelatin), Baishao (Radix Paeoniae Alba), Maidong (Radix Ophiopogonis), Sang'er Hui (Ash of Auricularia), Mu'er Hui (Ash of Tremella), etc. Over time, deficiency-cold prevails, requiring warming and tonifying the Spleen and Stomach.

The *Nuke Zuanyao* states: Beng requires regulating Qi, descending Fire, and lifting. Lou requires nourishing Qi and tonifying Fire, or controlling Fire. Generally, Beng/Lou should not use many cold/cooling herbs, which injure the Spleen and Stomach, preventing grasping blood to return to its source, thereby accelerating danger.