薛立斋治一妇人，性急，每怒非太阳耳项喉齿胸乳作痛，则胸满吞酸，吐泻少食，经行不止，此皆肝火之
症。肝自病则外症见，土受克则内症作。先以四物加白术、茯苓、柴胡、栀子炒、龙胆清肺养血，次用四君加
柴胡、白芍、神曲、吴茱萸、炒黄连以培土制肝，渐愈。惟月经不止，是血分有热，脾气尚虚，以逍遥散倍用
白术、茯苓、陈皮，又以补中益气汤加酒芍，兼服而愈。
一妇人怀抱不舒，腹胀少寐，饮食素少，痰涎上涌，月经频数。薛曰∶脾统血而主涎，此郁闷伤脾，不能
摄血归源耳。用补中益气、济生归脾而愈。
一妇人血崩兼心痛，三年矣，诸药不应。每痛甚，虚症悉具，面色萎黄。薛曰∶心主血，盖由去血过多，
心无所养，以致作痛。宜用十全大补汤，参、术倍之，三十余剂稍愈，百余剂乃全愈。
大尹王天成之内，久患崩，自服四物凉血之剂，或作或辍。因怒发热，其血不止，服前药不应。乃主降火，
更加胁腹大痛，手足俱冷。薛曰∶此脾胃虚寒所致。先用附子理中汤，体热痛止。又用《济生》归脾、补中益
气二汤，崩血渐愈。若泥痛无补法，则误矣。
锦衣杨永兴之内，患血崩，过服寒凉之剂，其症益甚，更加肚腹闷痞，饮食不入，发热烦躁，脉洪大而虚。
薛曰∶此脾经气血虚而发躁也。当急用八珍汤加炮姜以温补之，缓则不救。不信，仍服止血降火之剂，虚症蜂
起，始信其言，缓不及治矣。
一妇人因怒崩血，久不已，面青黄而或赤，此肝木制脾土而血虚。用小柴胡合四物，清肝火生肝血，又用
归脾、补中二汤，益脾气，生肝血而瘥。此症若因肝气风热而血不宁者，防风为丸，以兼症之药煎送。或肝经
火动，而血不宁者，炒条芩为丸，以兼症之药送下。若瘀血为患，用五灵脂为末，烧铁器 酒调服，无不效者。
周晖内人病血大崩，诸医皆危之。刘春斋用当归一两，荆芥一两，酒一钟，水一钟，煎服立止如神。（《续
金陵琐事》。）
易思兰治一妇患崩，昼夜十余次，每次去血升许。用止血药愈甚。卧床月余，羸瘦食少，面青爪黑，气促
痰喘。诊之，心脉平和，肝脉弦大，时一结，肺脉沉而大且有力，脾胃脉沉涩，两尺沉而无力，曰∶此气郁病
也。询之，果因午餐小婢忤意，发怒构疾。随以四神散与之，苏梗五分，甘草三分，抚芎三分，白芷五分，加
当归二分，白术三分，神曲三分，香附一钱，乌药一钱，服药半盂，未及一时，顿觉神爽。易曰∶未也，明曰
子时分，指甲变桃红色，方可救。至期，甲色过红。复诊之，左三部如前，肺脉微起，脾胃虽沉缓而不涩，二
尺仍旧，谓其家曰∶午时血当大崩，毋得惊惶，以骇病者。至期，果然下紫黑血块数枚，自此遂止。后用壮真
五和丸，醋炒香附二两，乌药一两，汉防己五钱，归身二两，酒炒白芍二两，熟地四两，续断四两，甘草五钱，
秦艽一两，藿香一两，白茯苓一两，山药二两，砂仁五钱，蜜丸，调理月余全愈，次年生子。或问曰∶崩血症
也，诸医用血药不效，公用气药而愈，何也？易曰∶崩虽在血，其源在气。气有一息不运，则血有一息不行。
欲治其血，先调其气。或曰∶是固然矣。然尝见有调气而血不愈者，有不调气而治血亦愈者，何也？易曰∶此
所因不同也。有因血而病气者，有因气而病血者，能以脉症辨之，而气血之先后定矣。如人有禀来血弱者，有
偶伤力失血者。假使血虚气必盛，阴虚火必炽。其症咳血，咯血，便血，作渴，日晡潮热，五心烦热，甚则咽
喉肿痛，此因血而气病者也。治宜养阴降火，而以气药兼之。此症右肺主气，时值正秋肺气当令，脉宜浮短，
今反沉大，失其令矣。大者火也，沉者气也。沉而且大，是血郁而不运也。肝木至秋当微弱，今反弦大而结。
肝木结者，血积于内也。此病原因怒气伤肝，肝火郁结，血不归经而妄行，乃因气而病血也。惟其所因气，而
所以治气为先也。夫血活则红，血凝则黑。爪甲黑者，血凝而不散也。今用药以行其气，至子时一阳初动，气
行则血行，肝血一行，其血即活，斯黑变红矣。至午时一阴复生，肝乃乙木，乙木生于午，肝气得令，邪不能
容，故积血于此时尽出，积出则气运血行，而病已矣。药不在多，贵得其宜。四神散虽数味常药，然以香附行
气为之君，乌药助香附行气为之臣，苏梗通十二经之关窍，白芷化腐血生新血为佐，加当归引气入心而生新血，
抚芎引气入肝，舒肝之郁而去旧纳新，神曲引气入脾，畅脾结而统新血，白术健脾胃而和中气为使。以行气为
主，活血辅之，此活血先调气之法也。
吴孚先治俞氏妇，血淋念载，已成痼疾。因幼孙出痘危险，忽下血两昼夜不止，汗泻交作，晕数次，（思
虑恐惧，三阴并伤也。）脉向弦大而革者，忽变而数疾欲脱，奄奄一息。用人参、黄 各一两，制附、炮姜、
枣仁各三钱，五味、龙骨各一钱。或疑附子太热，且谓何不用血药？曰∶血脱补气，古人精义。谓有形之血，
不能速生，几微之气，所当急固。又脾胃气血，俱喜温而恶寒，姜、附宜服也。二剂脉渐转，前方加归、芍等药，
血症已除。然脉气不和，非三年调摄，未易复也。自后参、 不辍，计服补剂六百余帖，膏丸数料而起，并宿疾亦瘳。
一妇半月前小产，继以血崩舌硬，心摇，汗出发润，日夜俱热，耳闭不闻，目视不见，身浮浮如在舟车，
六脉细数欲脱。用人参二两，黄 二两，白术一两，熟地二两，当归五钱，炮姜、制附、枣仁各三钱，龙骨一
钱五分，一剂顿减，二剂精神爽慧。
陆养愚治玉笠云母，年四十九，经事已止半年，一日忽暴崩不止，昏晕厥逆。脉之，两手沉微如丝，急以
八珍汤加附子、姜炭灌之，半时方醒。连进二大剂，乃止十之七八。至十剂后，方能止。后数月复崩，亦昏晕，
或以犀角地黄汤加藕节、阿胶之属，不止。脉仍沉弱，以附子、干姜、鹿茸，俱烧存性，同釜底墨酒调服之即
止。后以六味加四物料服之，约二斤，一年不作。次年八月间又暴至，昏晕更久，脉之如旧，仍以八物汤加附
子，连进二剂，昏晕自晡至晚未苏，咸谓必死。诊之，决其必苏。盖气血暴脱，一时补力未能与胃气相迎耳。
或投以牛黄丸，至半夜人事稍省，而血尚未止。明早陆诊后，仍锉八味汤，少加姜、附二剂。或适至，云昨夜
之苏，乃牛黄丸之功，公实不知也。向日屡服参、附，致屡崩。今人事既省，断宜顺气行瘀去其病本，岂可复
蹈前辙？曰∶昨早投大补之药，即不服牛黄丸亦苏。此等脉症，急宜续投参、 ，少缓恐成不救，况可更以他
药乎？或乃怫然而去。曰∶读父书而坑赵卒，天下每多此人。陆令先服煎剂，随制存性附子等灰。午后人事更
爽，进粥，晚投末药一服，夜间血少止。明日又汤散并投，血遂止。再服煎汤十剂而瘳。
立斋治一妇人，饮食因怒，忽患血崩，四肢逆冷，抽搐口噤如发痉然，吐痰如涌。灌以二陈、柴胡、山栀、
枳壳，吐出酸味，神思稍醒，药止。次日进薄粥少许，但乳胁胀痛，此悉属肝火炽盛，致脾气不能运化。先用
六君、柴胡、山栀、钩藤，诸症顿退，惟四肢不遂，血崩如初。或又为肝火未息，欲投清肝凉血之剂。此肝脾
气血俱弱，先用补中益气汤，培其脾土，而血气归经。又用四物、参、术、柴胡养肝筋，而四肢便利。（余见《
异症名要》。）
一妇人月经淋漓无期，作郁怒伤肝，脾虚火动，而血不归经。乃肝不能藏，脾不能摄也。当清肝火，补脾
气，与归脾汤、逍遥散二药，四剂而愈。
一妇人因怒，经事淋沥，半月方竭。遇怒其经即至，甚则口噤筋挛，头痛痰喘，抽搦上视。作肝火炽盛，
以小柴胡加钩藤、黄连、熟地、山栀而愈。
王执中治皮匠妻，患血崩两月，饮食不进，与镇灵丹服，少减而未断。因检得《耆域方》如圣散，用棕榈、
乌梅、干姜各一两，令烧存性为末，每服二钱，食前乌梅汤调下，合一剂与服而疾平。患甚者，不过三服。（
《资生经》。）
有巡捕之妻，年逾五十，因伤寒而血崩，与胶艾四物汤一服渐愈。后因劳复大作，与镇灵丹十五丸而止。
或无此丹，烧鹿角存性为末，酒调服亦佳，屡验。（同上。）
陈良甫治一妇人崩漏暴下。诸医投姜、附、桂等药服之，愈甚。诊之，六脉紧数，遂用金华散兼《局方》
龙脑鸡苏丸，数服即安。《本事》单用黄芩者，亦此意也。（《良方》。）
一亲戚妇人，年四十五，经年病崩漏不止，面黄肌瘦，发黄枯槁，语言声嘶，服诸药无效。诊之，六脉微
濡。问服何药，云∶凡是当归、川芎，涩血诸品丹药，服之皆不作效。遂合《清济方》伏龙肝散兼白矾丸，服
之愈。（同上。）
缪仲淳治董清山夫人，患血崩。由于中年郁怒，百药不效，用大剂参、 ，令觅胎发百余丸，火 入药服，
久之渐愈。 发用小砂罐，盐泥炼极熟，将发入罐中，封固阴干，以炭火围之，俟黑烟将尽即起。若青烟出，
发枯不可用矣。非细心人不可任，盖火候不可过也。
王肯堂曰∶徐朝奉传其内人有血崩症，服诸药不效。用香附炒为末，每服二钱，米饮调下，服后遂痊。
（未选入。）
一亲戚黄卿内子凌夫人，忽苦血崩，百药不效。用五灵脂一味，不拘多少，炒令烟尽，研末，每服一钱，
温酒调下，旋服遂安。
蒋仲芳治毛氏妇，经来淋沥不已，已经三月，凉血止血之药，服至五六十剂，罔效，而口干唇燥愈甚，脉
来微涩。询其大便必泻，果然。即以四君子汤加熟附、炮姜、熟地、血余，二剂而止。盖寒客于中，火浮于上，
脾虚而不摄血，故淋沥不已也。
聂久吾妇，年三十九，生子月内调养未善，次年春，其经两月余不行。一日忽暴至不止，一二饭久，即昏
晕不省人事，急用十全大补汤，去桂倍加参、 ，又加熟附子、炒干姜各一钱，灌之苏省。后连服二大帖，遂
止其七八。又十余日，共服二十余剂，乃得全止。次年春，崩又大作，比前尤甚，昏晕更久，又服前方三十
余帖，尚未全安。后用鹿茸，炒烧存性研末，酒调二钱，服数次而血止。继服峻补丸药，幸年余不发。然病根
未除，次年中秋，忽又暴至，前方连服二大帖，血流如水涌，吐冷痰，至日晡昏晕，初更而气绝，惟胸次微温。
至三更，用灶心土研细，水调灌一二酒杯，冷痰少开，遂饮滚汤一盏，苏省渐安。岂初发时，服大补二剂，能
令生意不绝耶？后又服峻补之剂而血止。因思三年之内，尝服峻补丸药矣，而其病仍大作者，何也？或谓补血
太过，是以积而成崩。或谓不宜用桂、附等热药，推展其血，遂至于崩。（此说极是，惜聂君未及明。）抑知土虚
不固，然后山崩。今既血崩，则是血大虚。且血气相根据附，气虚甚则降令多，升令少，是以不能摄血，致血不归经而
妄下，不惟大补血而尤当大补气也。前丸方虽峻补，不合搀入香附、益母、砂仁、元胡等损气之品，乃令病根
不除，而屡作也。因纯用补气血药一料，而神气爽健，二料而病根除。次年遂孕，而生第八儿矣。（既云血太虚，忽
又转云气太虚，总为要用桂、附，故支离其词，可见所传之派不清。虽绝世聪明，无往而不误也。）
魏玉横曰∶刘氏媪，年七十，病血行如壮年月事，久之，淋漓不断两月余，耳鸣心跳，头晕目眩，恶食罕
眠，奄奄就毙。医者不一，有与归脾、补中者，六味、四物者、十全、八珍者，诸治未为无见。然服归脾、补
中，则上膈胀而面肿，似不宜于补气；服六味、四物，则少腹胀而足肿，似不宜于补血；服八珍、十全，则中
脘胀而气急，似气血兼补又不宜。延诊，先告以不宜用补，以症皆缘补而增也。脉之，沉小而涩，两关尤甚，
且无神，曰∶此肝脾两伤之候也。以七旬之年，两月之病，非补何以能瘳？第余之补，异乎人之补，无虑也。
与熟地二两，以一两炒炭，杞子一两，白芍炒、枣仁炒各五钱，酒连三分，四剂而淋漓止。去连四剂，而肿胀
消，诸症亦愈。
姚氏妇早寡，年三十余，因月事暴至，遂崩漏不止，势甚猛。脉之，两寸上溢，两尺甚弱。据脉不可与补
中益气，据症又不可不暂升提，以挽其下陷。先与熟地、杞子、白芍、枣仁，重剂服之，果不应。急以蓖麻仁
十数粒，去壳研，入麝一分，捏作饼子，用绿云膏贴脐上，再服前药，血去渐缓。少顷再服药，觉血不行，即
令揭去之，又服数剂全愈。
裴兆期治一富室妇，崩晕交作，已三逾日。诸医治法，不外阿胶、地黄、当归、白术、山药、人参及止崩
晕之药，益剧。裴诊之，六脉小而坚，右关细滑有力。且多呃呃欲吐之状，心下按之硬满而痛，饮食不进，大
便不通。此正与王节斋夫人崩晕证相类，受病在肠胃无疑。法当先行肠胃中积滞，使真气流行，脾得健运而统
血，则崩自止，晕自宁矣。遂屏去诸药，先用导滞丸，一服不动，再一服大便始通，神少清而崩亦可止。改服
Xue Lizhai treated a woman with an irritable temperament. Whenever she became angry, she would either experience pain in the ears, neck, throat, teeth, chest, and breasts along the Taiyang (Foot-Taiyang Bladder Meridian) pathway, or suffer from chest fullness, acid regurgitation, vomiting, diarrhea, and poor appetite. These are all symptoms of Liver Fire. When the Liver itself is diseased, external symptoms appear; when the Earth (Spleen/Stomach) is controlled by Wood (Liver), internal symptoms arise. Initially, he used Siwu Tang (Four Substances Decoction) added with Baizhu (Atractylodis Rhizoma), Fuling (Poria), Chaihu (Bupleuri Radix), fried Zhizi (Gardeniae Fructus), and Longdancao (Gentianae Radix) to clear Lung heat and nourish Blood. Subsequently, he used Sijunzi Tang (Four Gentlemen Decoction) added with Chaihu, Baishao (Paeoniae Radix Alba), Shenqu (Massa Medicata Fermentata), Wuzhuyu (Evodiae Fructus), and fried Huanglian (Coptidis Rhizoma) to fortify the Earth and restrain the Liver, leading to gradual improvement. Only the persistent menstruation remained, indicating Heat in the Blood level and deficiency of the Spleen Qi. He then used Xiaoyao San (Free and Easy Wanderer Powder) with doubled amounts of Baizhu and Fuling, plus Chenpi (Citri Reticulatae Pericarpium), while concurrently administering Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Jiushaoyao (Wine-processed Paeoniae Radix Alba). The combination cured her.
Another woman suffered from emotional depression, abdominal distension, insomnia, habitual poor appetite, surging phlegm-saliva, and frequent menstruation. Xue said: "The Spleen controls Blood and governs saliva. This is due to depression injuring the Spleen, failing to control Blood and return it to its source." She was cured using Buzhong Yiqi Tang and Jisheng Guipi Tang (Guipi Decoction from *Jisheng Fang*).
Another woman suffered from metrorrhagia accompanied by heart pain for three years, with no response to various medicines. When the pain was severe, all deficiency symptoms manifested, and her complexion was sallow. Xue said: "The Heart governs Blood. It is likely that excessive blood loss left the Heart un-nourished, causing pain. One should use Shiquan Dabu Tang (Ten Great Tonics Decoction), doubling the dosage of Renshen (Ginseng Radix et Rhizoma) and Baizhu. After more than thirty doses, there was slight improvement; after over one hundred doses, complete recovery occurred."
The wife of Dayin Wang Tiancheng had suffered from prolonged metrorrhagia for a long time. She self-administered cooling-blood agents like Siwu Tang, with intermittent efficacy. Due to anger and fever, bleeding continued, and previous medications failed. The treatment shifted to clearing fire, but this exacerbated hypochondriac and abdominal pain, accompanied by cold extremities. Xue said: "This is caused by deficiency-cold of the Spleen and Stomach." He first used Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction), which resolved the fever and pain. Then, he used Guipi Tang from *Jisheng Fang* and Buzhong Yiqi Tang, leading to gradual cessation of bleeding. Adhering rigidly to the principle that "pain has no tonification method" would have been a mistake.
The wife of Jin Yi Yang Yongxing suffered from metrorrhagia. Overuse of cold-cooling agents worsened her condition, adding abdominal stuffiness, inability to eat, fever, irritability, and a flooding yet empty pulse. Xue said: "This is irritability arising from Qi and Blood deficiency in the Spleen Meridian. Urgently use Bazhen Tang (Eight Treasures Decoction) added with Paojiang (Prepared Ginger) to warm and tonify. Delay will be fatal." The family did not believe him and continued using hemostatic and fire-clearing agents. Deficiency symptoms surged, and by the time they accepted his advice, it was too late to save her.
A woman suffered from metrorrhagia due to anger, lasting a long time, with a complexion alternating between green-yellow and red. This indicated Liver Wood controlling Spleen Earth and Blood deficiency. Xiao Chaihu Tang (Minor Arcanum Decoction) combined with Siwu Tang was used to clear Liver Fire and generate Liver Blood. Subsequently, Guipi Tang and Buzhong Yiqi Tang were used to tonify Spleen Qi and generate Liver Blood, resulting in recovery. If the symptom was due to Wind-Heat in the Liver Qi disturbing the Blood, Fangfeng (Saposhnikoviae Radix) pills taken with decoctions for concurrent symptoms would work. If due to Liver Meridian Fire disturbing the Blood, fried Huangqin (Scutellariae Radix) pills taken with decoctions for concurrent symptoms would work. If caused by Blood stasis, Wulingzhi (Trogopterori Faeces) powder mixed with wine using a red-hot iron tool would be effective without exception.
Zhou Hui's concubine suffered from severe metrorrhagia, with physicians considering it critical. Liu Chunzhai used Danggui (Angelicae Sinensis Radix) 1 liang, Jingjie (Schizonepetae Spica) 1 liang, Wine 1 zhong, and Water 1 zhong, decocted and administered. Bleeding stopped miraculously immediately. (*Xu Jinling Suoshi*)
Yi Silan treated a woman with metrorrhagia, occurring more than ten times day and night, losing approximately one sheng of blood each time. Hemostatic drugs worsened the condition. She had been bedridden for over a month, emaciated, eating little, with a greenish complexion and black fingernails, shortness of breath, and wheezing phlegm. Pulse diagnosis revealed a peaceful Heart pulse, a wiry and large Liver pulse with occasional intermission, a deep, large, and forceful Lung pulse, a deep and choppy Spleen-Stomach pulse, and deep, weak Kidney pulses at both Chi positions. Yi said: "This is a Qi stagnation disease." Inquiry confirmed it started from anger due to a maid displeasing her at lunch. He immediately prescribed Six Spirits Powder (Sishen San): Sugeng (Perillae Caulis) 5 fen, Gancao (Liquiritiae Radix et Rhizoma) 3 fen, Fukxiong (Ligusticum Chuanxiong Rhizoma) 3 fen, Baizhi (Angelicae Dahuricae Radix) 5 fen, added with Danggui 2 fen, Baizhu 3 fen, Shenqu 3 fen, Xiangfu (Cyperi Rhizoma) 1 qian, and Wuyao (Linderae Radix) 1 qian. After half a cup, within less than one shichen (two hours), she felt refreshed. Yi said: "Not yet. Tomorrow at Zi hour (11 PM - 1 AM), if her fingernails turn peach-red, she can be saved." At that time, her nails were overly red. Re-pulse diagnosis showed the left three positions unchanged, Lung pulse slightly rising, Spleen-Stomach pulse deep and slow but not choppy, Chi positions still unchanged. He told the family: "At Wu hour (11 AM - 1 PM), there will be heavy bleeding. Do not panic, lest you frighten the patient." Indeed, several purple-black blood clots were expelled, and bleeding stopped thereafter. Later, Zhuangzhen Wuhe Wan (True Vitality Five Harmonizing Pills) was used for conditioning: Vinegar-processed Xiangfu 2 liang, Wuyao 1 liang, Hanfangji (Stephaniae Tetrandrae Radix) 5 qian, Dangguishen (Danggui Radix) 2 liang, Wine-processed Baishao 2 liang, Shudihuang (Rehmanniae Radix Preparata) 4 liang, Xuduan (Dipsaci Radix) 4 liang, Gancao 5 qian, Qinjiao (Gentianae Macrophyllae Radix) 1 liang, Huoxiang (Agastaches Herba) 1 liang, Bai Fuling (Poria cum Ligno) 1 liang, Shanyao (Dioscoreae Rhizoma) 2 liang, Sharen (Amomi Fructus Rotundus) 5 qian, honey-pilled. Conditioning for over a month led to full recovery, and she conceived the following year. Someone asked: "Metrorrhagia is a Blood disease. Why did physicians fail with Blood herbs, but you succeeded with Qi herbs?" Yi said: "Although metrorrhagia manifests in Blood, its source is Qi. If Qi stops moving for even a moment, Blood stops flowing for that moment. To treat Blood, one must first regulate Qi." Another asked: "That makes sense. Yet I have seen cases where regulating Qi did not stop bleeding, and cases where treating Blood without regulating Qi worked. Why?" Yi said: "This depends on the cause. Some diseases start from Blood affecting Qi; others start from Qi affecting Blood. By differentiating via pulse and symptoms, the sequence of treating Qi and Blood is determined. For instance, some have congenital Blood weakness, others lose Blood due to strain. If Blood is deficient, Qi tends to be hyperactive; if Yin is deficient, Fire flares. Symptoms include coughing blood, spitting blood, bloody stool, thirst, afternoon tidal fever, five-palm heat, and even sore throat/swollen tonsils. This is Blood disease affecting Qi. Treatment should nourish Yin and descend Fire, incorporating Qi-moving herbs. In this case, the Right Lung governs Qi. In early Autumn, Lung Qi is dominant, and the pulse should be floating and short. Now it is deep and large, violating the season. Large indicates Fire; Deep indicates Qi. Deep and large suggests Blood stagnation and failure to move. Liver Wood should be weak in Autumn, but here it is wiry, large, and knotted. Knotted Liver Wood indicates Blood accumulation internally. The root cause was anger injuring the Liver, causing Liver Fire stagnation, preventing Blood from returning to its vessels and causing reckless flow. This is Qi disease affecting Blood. Since the cause is Qi, regulating Qi is prioritized. Active Blood is red; coagulated Blood is black. Black nails indicate coagulated, stagnant Blood. Now, using Qi-moving herbs, at Zi hour when Yang begins to rise, Qi moves and Blood follows. Once Liver Blood moves, it becomes active, turning from black to red. At Wu hour, Yin regenerates. The Liver belongs to Yi Wood, born at Wu hour. When Liver Qi receives the seasonal command, pathogens cannot remain, so accumulated Blood is expelled at this time. Expulsion leads to Qi movement and Blood circulation, curing the disease. Medicine quantity is not key; appropriateness is. Although Sishen San uses common herbs, Xiangfu regulates Qi as Sovereign, Wuyao assists Xiangfu as Minister, Sugeng opens pathways of the Twelve Meridians, Baizhi transforms old Blood and generates new Blood as Assistant, Danggui guides Qi into the Heart to generate new Blood, Fukxiong guides Qi into the Liver to soothe Liver stagnation and eliminate old/nourish new, Shenqu guides Qi into the Spleen to resolve Spleen stagnation and control new Blood, and Baizhu strengthens Spleen-Stomach and harmonizes Middle Qi as Envoy. Regulating Qi is primary, activating Blood is secondary. This is the method of regulating Qi before activating Blood."
Wu Fuxian treated Mrs. Yu, who suffered from bloody dysuria for twenty years, becoming a chronic ailment. Due to anxiety over her young grandson's dangerous chickenpox, she suddenly experienced continuous bleeding for two days and nights, with sweating and diarrhea alternating, and multiple faintings (Anxiety and fear injured the Three Yin meridians). Her pulse, originally wiry, large, and革 (Leather-like), suddenly became rapid, frantic, and nearly depleted, with a faint breath. He used Renshen (Ginseng Radix et Rhizoma) and Huangqi (Astragali Radix) 1 liang each, Zhi Fuzi (Prepared Aconiti Lateralis Radix Preparata), Paojiang (Prepared Ginger), Zaoren (Ziziphi Spinosomi Semen) 3 qian each, Wuweizi (Schisandrae Chinensis Fructus), and Longgu (Fossilia Ossis Mastodi) 1 qian each. Some suspected Fuzi was too hot and asked why no Blood herbs? He replied: "Tonifying Qi for Blood depletion is the profound meaning of ancients. Formative Blood cannot be generated quickly; vital Qi must be urgently secured. Moreover, Spleen-Stomach Qi and Blood prefer warmth and dislike cold; Jiang and Fu are suitable." After two doses, the pulse gradually transformed. Danggui and Shaoyao were added to the original formula, and the bleeding ceased. However, pulse and Qi were disharmonious; without three years of regulation, recovery would be difficult. Thereafter, Renshen and Huangqi were taken continuously. Totaling over six hundred doses of tonics, plus pastes and pills, she recovered, and her chronic ailments also healed.
A woman had a miscarriage half a month prior, followed by metrorrhagia, stiff tongue, restless heart, moist hair from sweating, constant day-and-night fever, deafness, blindness, a sensation of floating as if in a boat or cart, and fine, rapid pulses nearing depletion. He used Renshen 2 liang, Huangqi 2 liang, Baizhu 1 liang, Shudihuang 2 liang, Danggui 5 qian, Paojiang, Zhi Fuzi, Zaoren 3 qian each, and Longgu 1.5 qian. One dose significantly reduced symptoms; two doses restored mental clarity.
Lu Yangyu treated Yu Li Yunmu, aged 49. Menstruation had stopped for half a year. Suddenly, she suffered violent metrorrhagia, fainting, and cold limbs. Pulse was deep and minute, thread-like in both hands. Urgently, Bazhen Tang added with Fuzi (Aconiti Lateralis Radix Preparata) and Jiangtan (Charred Ginger) was forced down. She woke after half an hour. Two large doses stopped it by 70-80%. Ten doses were needed for complete cessation. Months later, metrorrhagia recurred with fainting. Someone used Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) added with Ou jie (Lotus Rhizome Node) and Ejiao (Donkey-hide Gelatin), but bleeding continued. Pulse remained deep and weak. Fuzi, Ganjiang (Zingiberis Rhizoma), and Lurong (Cervi Cornu Degelatinatum) were charred until carbonized, powdered, and taken with wine mixed with Fu di mo (Pot Bottom Ash). Bleeding stopped immediately. Later, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) combined with Sijunzi Tang ingredients were taken, totaling about two jin, preventing recurrence for a year. In August the next year, it struck violently again, with longer fainting. Pulse was unchanged. Bazhen Tang added with Fuzi was given for two consecutive doses. Fainting persisted from dusk till night without waking. Everyone deemed it fatal. Lu diagnosed and predicted recovery. Sudden depletion of Qi and Blood meant the tonic power could not immediately meet Stomach Qi. Niu Huang Wan (Calculus Bovis Pill) was given, and consciousness returned slightly by midnight, but bleeding continued. Next morning, after Lu's diagnosis, Eight-Ingredient Decoction was prepared with small additions of Jiang and Fu. Someone arrived, claiming the midnight recovery was due to Niu Huang Wan, unknown to Lu. Previously, repeated use of Renshen and Fuzi caused recurrent bleeding. Now that consciousness returned, one should guide Qi, move stasis, and remove the root cause, not repeat past errors. Lu replied: "Yesterday morning, with major tonics, she would have woken even without Niu Huang Wan. With such pulse and symptoms, continuing Renshen and Huangqi is urgent; delay risks death. How can other drugs be used?" The person left angrily. Lu said: "Reading father's books and burying Zhao soldiers—such people are common worldwide." Lu ordered decoctions first, then prepared charred Fuzi ash. By afternoon, consciousness improved further; porridge was taken. Evening dose of powder reduced bleeding. Next day, decoction and powder together stopped bleeding. Ten doses of decoction cured her.
Lizhai treated a woman whose diet was affected by anger, suddenly developing metrorrhagia, cold extremities, convulsions, locked jaw resembling tetanus, and surging phlegm. Erchen Tang, Chaihu, Zhizi, Zhike (Aurantii Fructus Immaturus) were forced down. Acid taste was vomited, and consciousness slightly returned. Medication stopped. Next day, a little thin gruel was taken, but breast and hypochondriac pain/distension appeared. All belonged to blazing Liver Fire causing Spleen transport failure. First, Liujunzi Tang, Chaihu, Zhizi, Gouteng (Uncariae Ramulus cum Uncis) were used, resolving most symptoms. Only limb paralysis and initial metrorrhagia remained. Someone suggested Liver Fire hadn't subsided and wanted to use Liver-cooling/Blood-cooling agents. Lizhai stated this was deficiency of Liver-Spleen Qi and Blood. First, Buzhong Yiqi Tang was used to fortify Spleen Earth, allowing Qi and Blood to return to their vessels. Then, Siwu Tang, Renshen, Baizhu, Chaihu were used to nourish Liver sinews, facilitating limb movement. (See *Yi Zheng Ming Yao*.)
A woman had indefinite, dripping menstruation, attributed to depression/anger injuring the Liver, Spleen deficiency with Fire agitation, causing Blood to leave its vessels. This indicated Liver's inability to store and Spleen's inability to control. Liver Fire should be cleared, Spleen Qi tonified. Guipi Tang and Xiaoyao San were given, curing her in four doses.
A woman, due to anger, had dripping menstruation lasting half a month. Anger triggered immediate menstruation; severe cases involved locked jaw, tendon contraction, headache, wheezing phlegm, convulsions, and upward gaze. Considered blazing Liver Fire, Xiao Chaihu Tang added with Gouteng, Huanglian (Coptidis Rhizoma), Shudihuang, Zhizi cured her.
Wang Zhizhong treated a tanner's wife with metrorrhagia for two months, unable to eat. Zhenling Dan was given, reducing but not stopping symptoms. Consulting *Qiyu Fang*, Rusheng San was found: Zonglv (Palmae Folium Spinum), Wumei (Mume Fructus), Ganjiang (Zingiberis Rhizoma) 1 liang each, charred to carbon, powdered. 2 qian per dose, taken before meals with Wumei decoction. One dose cured the disease. Severe cases required no more than three doses. (*Zisheng Jing*)
A patrol captain's wife, over fifty, suffered metrorrhagia due to Cold Damage. Jiao'ai Siwu Tang (Gelatin and Four Substances Decoction) one dose brought gradual improvement. Later, relapse due to labor was severe. Zhenling Dan fifteen pills stopped it. If unavailable, charred Lujiao (Cervi Cornu) powder taken with wine is also good, verified repeatedly. (Same source)
Chen Liangfu treated a woman with sudden, violent metrorrhagia. Physicians used Jiang, Fu, Gui (Cinnamomi Cortex) etc., worsening the condition. Pulse was tight and rapid. Jinhua San combined with Ju Fang Longnao Jisu Wan (Dragon Brain Chicken Mint Pill from *Formulas of the Bureau*) brought relief after a few doses. Using only Huangqin (Scutellariae Radix) in *Ben Shi Fang* implies the same intent. (*Liang Fang*)
A relative's wife, 45, suffered continuous metrorrhagia for a year, sallow, emaciated, yellowish-withered complexion, hoarse voice. Various medicines failed. Pulse was fine and soggy. Asked about previous meds: "All Danggui, Chuanxiong, astringent Blood, and alchemical pills were ineffective." Combined Qingji Fang Fulonggan San (Dragon's House Earth Powder) with Bai fan (Alumen) pills, curing her. (Same source)
Miao Zhongchun treated Mrs. Dong Qingshan with metrorrhagia. Due to middle-aged depression/anger, hundreds of medicines failed. Major doses of Renshen and Huangqi were used. Over a hundred pieces of fetal hair (Tai fa) were sought, calcined, and added to medicine. Gradual improvement occurred over time. Fetal hair preparation: Use small clay pot, seal with salt mud, dry in shade, surround with charcoal fire. Remove when black smoke ceases. Blue smoke indicates burnt, unusable hair. Requires careful attention to heat control.
Wang Kentang said: Xu Chaofeng transmitted that his wife had metrorrhagia, unresponsive to medicines. Fried Xiangfu powder, 2 qian per dose, taken with rice water, cured her. (Not selected)
Relative Huang Qing's wife, Lady Ling, suddenly suffered metrorrhagia, unresponsive to medicines. Wulingzhi alone, any amount, fried until smoke ceased, powdered. 1 qian per dose, taken with warm wine, relieved immediately.
Jiang Zhongfang treated Mrs. Mao. Dripping menstruation for three months. Cooling-blood/hemostatic medicines (50-60 doses) failed, worsening dry mouth/lips. Pulse was fine and choppy. Bowels were loose. Sijunzi Tang added with Shu Fu (Prepared Aconite), Paojiang, Shudihuang, Xueyu (Hair Charcoal) stopped it in two doses. Cold invaded the center, Fire floated above, Spleen deficiency failed to control Blood, causing dripping.
Nie Jiuwu's wife, 39, poorly rested postpartum. Next Spring, menstruation delayed over two months. Suddenly, violent continuous bleeding. Within two meals, she fainted unconscious. Urgently, Shiquan Dabu Tang, removing Guizhi, doubling Renshen/Huangqi, adding Shu Fu and fried Ganjiang 1 qian each, revived her. Two large doses stopped 70-80%. Over ten days, 20+ doses achieved total cessation. Next Spring, severe recurrence, worse than before, longer fainting. 30+ doses of previous formula insufficient. Later, Lurong charred/carbonized, powdered, 2 qian with wine stopped bleeding. Strong tonics prevented recurrence for over a year. Root cause remained. Mid-Autumn next year, violent recurrence. Two large doses of previous formula caused gushing blood, cold phlegm vomiting, fainting at dusk, death at first watch, only slight warmth in chest. Third watch, Zaoxintu (Kitchen Hearth Earth) finely powdered, water-mixed, 1-2 cups灌ed. Cold phlegm cleared slightly. Hot water drunk, revival gradual. Could initial two doses of major tonics sustain life? Later strong tonics stopped bleeding. Why did strong tonics over three years fail to prevent major recurrence? Some said excessive Blood tonification caused accumulation leading to rupture. Others said Gui/Fu (warm/hot drugs) pushed Blood, causing rupture. (This view is correct, pity Nie didn't clarify.) Know that Earth deficiency leads to mountain collapse. Now Blood rupture means severe Blood deficiency. Qi and Blood rely on each other. Severe Qi deficiency leads to excessive descending and insufficient ascending functions, failing to control Blood, causing reckless downward flow. Not only must Blood be heavily tonified, but Qi must be massively tonified. Previous pills, though strong tonics, incorrectly included Qi-damaging herbs like Xiangfu, Yimucao, Sharen, Yuanhu, preventing root removal and causing recurrence. Pure Qi-Blood tonics restored vitality; two doses removed the root. Conceived next year, gave birth to eighth child. (Claiming Blood too deficient then Qi too deficient, justifying Gui/Fu use, shows disjointed logic and unclear lineage. Even supreme wisdom errs.)
Wei Yuheng said: Old woman Liu, 70, had menstrual-like bleeding for a long time, dripping continuously for over two months. Tinnitus, palpitations, dizziness, aversion to food, rare sleep, near death. Various physicians tried Guipi, Buzhong, Liuwei, Siwu, Shiquan, Bazhen. None wrong, but Guipi/Buzhong caused upper chest distension and facial swelling (unsuitable for Qi tonification); Liuwei/Siwu caused lower abdomen distension and foot swelling (unsuitable for Blood tonification); Bazhen/Shiquan caused epigastric distension and shortness of breath (unsuitable for combined Qi-Blood tonification). Consulted me, warned against tonification as symptoms worsened with tonics. Pulse: deep, small, choppy, especially at Guan positions, spiritless. Said: "Liver and Spleen dual injury. At seventy, sick for two months, how else to cure except tonification? But my tonification differs from others." Used Shudihuang 2 liang (1 liang charred), Gouqi (Lycii Fructus) 1 liang, fried Baishao, fried Zaoren 5 qian each, Jiu Lian (Wine-processed Scutellariae Radix) 3 fen. Four doses stopped dripping. Removed Lian for four doses, swelling subsided, symptoms resolved.
Mrs. Yao, widowed early, 30+, sudden heavy menstruation led to continuous metrorrhagia, fierce intensity. Pulse: Cun positions overflowing upwards, Chi positions very weak. Based on pulse, Buzhong Yiqi unsuitable; based on symptoms, temporary lifting needed to rescue sinking. First, heavy dose of Shudihuang, Gouqi, Baishao, Zaoren, ineffective. Urgently, Castor seeds (Bimaren) dozen grains, peeled, ground, mixed with 1 fen Moshe (Musk), formed cake, applied to navel with Lüyun Gao (Green Cloud Ointment). Resumed previous medicine, bleeding slowed. Shortly after, feeling blood stopped, removed paste. Several doses cured completely.
Pei Zhaoqi treated a wealthy woman with alternating metrorrhagia and fainting for over three days. Physicians used Ejiao, Dihuang, Danggui, Baizhu, Shanyao, Renshen, and anti-metrorrhagia/fainting drugs, worsening condition. Pei's pulse: small and firm, Right Guan fine, slippery, and forceful. Frequent hiccups, hard/full/painful epigastrium, no food intake, constipation. Similar to Wang Jiezhai's wife's case. Disease in Intestines/Stomach certain. Method: Clear intestinal/stomach stagnation first, let True Qi circulate, Spleen transport strengthens to control Blood, metrorrhagia stops, fainting calms. Discarded other drugs. First, Daozhi Wan (Guide Stagnation Pill). One dose no effect, second dose bowel opened, mind clearer, bleeding stopped. Changed to...