洛阳孙伯英，因诬狱，妻子被系，逃于故人。是夜，觉胃胁痛，托故人求药。故人曰∶有名医张戴人在焉，
当与公同往。时戴人酒未醒，强呼之，故人曰∶吾有一亲人病，欲求诊。戴人隔窗望见伯英曰∶此公伏大惊恐。
故人曰∶何以知之？戴人曰∶面青脱色，胆受怖也。后会赦乃出，方告戴人。（《儒门事亲》。）
华佗传盐渎严昕与数人共候佗，适至，佗谓昕曰∶君身中佳否？昕曰∶自如常。佗曰∶君有急病，见于面，
莫多饮酒。坐毕归，行数里，昕卒头眩堕车，人扶将还载归家中，一宿死。（《三国志》。）
有士人病颜面青而光，其气哽哽，钱乙曰∶肝乘肺，此逆候也。若秋得之可治，今春不可治。其家祈哀，
强之与药。明日，曰∶吾药再泻肝而不少却，三补肺而益虚，又加唇白，法当三日死。然安谷者过期，不安
谷者不及期，今倘能粥，五日而绝。（《宋史》。亦仿仓公传。）
汪石山曰∶伏经脉最难求，如积热之久，脉反沉细，而外症又寒，苟非兼望闻问切，何可得也？世俗讳言
试医，医复讳情妄臆，而豪贵妇女，往往不得望闻，岂不大错？
徐灵胎曰∶妇人之疾，与男子无异。惟经期胎产之疾不同，且多 瘕之疾。其所以多 瘕之故，亦以经带
胎产之血易于凝滞，故较之男子为多。故古人名妇科谓之带下医，以其病总属于带下也。凡治妇人，先明冲任
之脉。冲脉起于气街，（在毛际两旁。）并少阴之经，挟脐上行，至胸中而散。任脉起于中极之下，（脐下四
寸。）以上毛际，循腹里上关元。又云∶冲任皆起于胞中，上循背里，为经脉之海。此皆血之所从生，而胎之
所由系也。明于冲任之故，则本原洞悉，而后其所生之病，千条万绪，可以知其所从起。更参合古人所用之方，
而神明变化之，则每症必有传受，不概治以男子泛用之药，自能所治辄效矣。至如世俗相传之说，如产前宜凉，
产后宜温等论。夫胎前宜凉，理或有之。若产后宜温，则脱血之后，阴气大伤，孤阳独炽，又瘀血未净，结为蕴
热，乃反用姜、桂等药，我见时医以此杀人无数。观仲景于产后之疾，以石膏、白薇、竹茹等药治之，无不神
效。或云产后瘀血，得寒则凝，得热则行，此大谬也。凡瘀血结凝，因热而凝者，得寒降而解；因寒而凝者，
得热降而解。如桃仁承气汤，非寒散而何？未闻此汤能凝血也。盖产后瘀血，热结为多，热瘀成块，更益以热，
则炼成干血，永无解散之日。其重者阴涸而即死，轻者或坚痞褥劳等疾。惟实见真属寒气所结之瘀，则宜用温散。
故凡治病之法，不本于古圣，而反宗后人之邪说，皆足以害人。诸科皆然，不独妇科也。
裴兆期治一妇，头眩耳鸣，肉 筋惕，恍惚不得寐，乍作乍止半载矣。后乃阻经四月，小腹如怀孕状，医
疑其妊而安之。忽一日，下紫黑血少许，始知为经闭。改用通经药数剂，腹不减，反增恶心呕哕，粥饮下咽，
旋即越出，咽喉焦痛，舌黑无津，医不知何故。裴诊之，六脉弦细而滑，两关尤甚。曰∶顽痰闭滞，血海壅瘀，
月事乃阻耳。其脉细而滑者，痰脉也；头眩耳鸣恍惚者，痰证也；呕吐不食者，痰客中焦也；舌黑无津，咽喉
焦痛者，痰生热也。经谓治病必求其本，今病本于痰，必以治痰为首务。遂投滚痰丸八十粒，不动。再投七十
粒，小腹微痛。次日又服如数，小腹痛不可忍，将夜半下如猪肝者四五块，每块几盈尺，更下如破絮脂膜者无
数，又累累若石榴子，红白攒缀，联系而下者，不啻二三斗，小腹顿平，痛亦如失。最异者吐痰碗许，俱如绿
草汁色，口角流涎不断，如琴弦之坚。丹溪谓怪病是痰，十居八九，良然。时胸次未平，饮食少进，用橘红、
茯苓各一钱，枳实、黄连、半夏曲各八分，水煎入姜汁二匙，竹沥半酒杯。二剂后，以六君子汤加减，更服加
味润下丸，调理百余日而愈，逾年生一子。
沈尧封曰∶《素问》云二阳之病发心脾，有不得隐曲，女子不月。其传为息贲者，死不治。二阳指阳明经
言，不指脏腑言。二阳之病发心脾者，阳明为多血之经，血乃水谷之精气，藉心火 炼而成。忧愁思虑伤心，
困及其子，不嗜饮食，血无以资生，阳明病矣。经云，前阴总宗筋之所会，会于气冲，而阳明为之长。故阳明
病则阳事衰，而不得隐曲也。太冲为血海，并阳明之经而行，故阳明病则冲脉衰，而女子不月也。又寇宗 曰∶
童年情窦早开，积想在心，月水先闭。盖忧愁思虑则伤心，心伤则血耗竭，故经水闭也。火既受病，不能荣养
其子，故不嗜食。脾既虚，则金气亏，故发嗽。嗽既作，则水气竭，故四肢干。木气不充，故多怒，发鬓焦，
筋痿。五脏以次传遍，故不卒死，然终死也，比于诸证最为难治。按∶此条亦从《金匮》虚字内分出，但所愿
不遂，相火必炽，非补水无以制之。六味地黄丸汤补阴泻阳，固是妙法。然脾虚食减，尚嫌地黄腻膈，炒枯可
也。不然，以女贞子易之。
雄按∶此证最难治。六味碍脾，归脾助火，惟薛一瓢滋荣养液膏加小麦、大枣、远志，庶几合法。一瓢
又有心脾双补丸，亦可酌用。滋荣养液膏方∶女贞子、广陈皮、干桑叶、大熟地、旱莲草、白芍药、黑
芝麻、枸杞子、甘菊花、当归身、黑 豆、玉竹、南烛叶、白茯神、沙菀蒺藜、炙甘草。以上十六味，
前十四味各四两，后二味各二两，天泉水，桑柴火熬膏，收入真阿胶三两，炼净白蜜三两，瓷瓶收贮。每
日卯时挑服五六钱、开水送下。心脾双补丸方∶人参、元参、五味子、远志肉、麦冬、茯神、酸枣仁、柏
子仁、于潜术、川贝母、生甘草、苦桔梗、丹参、生地、川黄连、制香附。上为末，用桂圆肉熬膏代蜜，
捣丸如弹子大，朱砂为衣。每晨嚼服一丸，开水送下。
沈尧封治一妇，热多寒少，谵语夜甚，经水来三日，病发而止。本家亦知热入血室，用小柴胡数帖病增，
舌色黄燥，上下齿俱是干血。沈用生地、丹皮、麦冬等药不应，药入则干呕，脉象弱而不大。因思弱脉多火，
胃液干燥，所以作呕。遂用白虎汤加生地、麦冬，二剂热退神清。惟二十余日不大便，与麻仁丸，三服得便而安。
一室女发热，经水来，医用表散药增剧，谵语夜甚。投小柴胡汤不应，夜起如狂。或疑蓄血，投凉血消瘀
药，亦不应。左关脉弦硬鼓指，询知病从怒起，因用胆草、黄芩、山栀、丹皮、羚羊角、芦荟、甘草、归身等药，
一剂知，四剂愈。
张仪表令爱发热，经水来，昏夜谵语，如见鬼状，投小柴胡汤增剧。询其病情云∶醒时下体恶寒，即愦时
亦尝牵被敛衣。因语此证，平素必患带下，且完姻未久，隐曲之事未免过当。复值经水过多，精血两亏，阴阳
并竭。其恶寒发热，由阴阳相乘所致，非外感邪热深入也。投发散清热，证同亡阳。《伤寒论》云∶亡阳则谵
语。《内经》云∶脱阳者，见鬼是也。用肾气丸，早晚各二钱，神气即清。随以苁蓉易桂、附，数剂全愈。
参香八珍膏丹，参去头尾，酒洗蒸熟，四制香附各四钱，熟地、炙黄 、白芍酒炒、蒸熟白术、白归身酒
炒、茯苓各三两，八味熬膏，每服三钱，开水调下。薛一瓢曰∶此女方调理方之首选也。气味和平，功能相称，
虚人可以久服。
青附金丹，治妇女 瘕。青皮四两，用硝石五钱化水浸；香附四两，童便浸；郁金二两，用生矾五钱化水
浸；丹参二两，姜汁浸。四味研细末，醋丸麻子大，晒干洒上阿胶水，摇令光泽。再用人参、当归、川芎各一
两，白术、茯苓、制半夏各二两，陈皮、炙草各五钱，研极细末，以米饮泛在光泽小丸上，作外廓晒干。每服
三钱，开水下。此薛一瓢方。缘虚弱人患 瘕 癖有形之病，不可任施攻下，故用此为缓消之计。其妙在以六
君、芎、归为外廓，使药入胃，将不知有攻削之味，而胃气不伤。迨其渐化，则对症之药已至病所，俾病去而
正不伤，诚女科要方也。
五香丸，治同上。五灵脂一斤，香附一斤，水浸一日，黑牵牛、白牵牛各取头末二两。上四味一半微火炒
熟，一半生用，共研细末和匀，醋糊为丸莱菔子大。每服七八分，或一钱，临卧姜汤下。次早再一服，即愈。
孕妇忌服，小儿减半。五灵脂破瘀生新，香附调气舒郁，牵牛开结行痰、逐饮、通水，合为消症散癖之方，不
为不峻。然每服钱计，用治实证，尚为善药。即痰积、食积、气滞成症，蛊膈肿胀，实痢初起，审属痞聚在腹，
有形攻痛之证皆可治之。虚人或以六君子加归、芍作煎剂送服亦可。
王氏云∶一妇人有女年十五，请诊，言女年十四时，经水自下乃忽断，其母甚恐怖。师曰∶此女为是夫人
亲女非也。若亲女者，当相为说之。妇人因答言是自女尔。师曰∶所以问者，无他。夫人年十四时，亦以经水
下，所以女至此而断，是为避年，勿怪，后当自下。（《东垣十书》。）
张子和曰∶一妇人年二十余岁，病经闭不行，寒热往来，咳嗽潮热。庸医禁切，无物可食。一日当暑出门，
忽见卖凉粉者，冰水和饮，大为一食，顿觉神清骨健，数月经水自下。（雄按∶世人但知血寒则凝，而不知血
热则结也。）
滑伯仁治龙君泽室人，暑月中，病经事沉滞，寒热自汗，咳嗽有痰，体瘦，痒，脐腹刺痛，脉弦数，六至
有余。曰∶此二阳病也。《素问》云∶二阳之病发心脾，女子得之则不月。二阳，阳明也，阳明为金，为燥化。
今其所以不月者，因其所遭也。阳明本为燥金，适遭于暑，暑火也，以火烁金，则愈燥矣。血者水类，金为化
源，宜月事沉滞不来也。他医方制归茸桂附丸以温经而未进。滑曰∶夫血得寒则止，得温则行，热则搏，搏则
燥，复加燥药，血益干，则病必甚。亟令却之，更以当归柴胡饮子，为清金泻火，流湿润燥。三五进而经事通，
余病悉除。龙君曰∶微生几为人所误也。
薛立斋诊一室女，年十七， 久不愈，天癸未通，发热咳嗽，饮食少思，欲用通经丸。薛曰∶此盖因禀气
不足，阴血未充故耳。但养气血，益津液，其经自行。彼惑于速效，仍用之。薛曰∶非其治也。此乃 悍之剂，
大助阳火，阴血得之则妄行，脾胃得之则愈虚。后果经血妄行，饮食愈少，遂致不救。
一妇人素有胃火，或用凉胃散而安。后因劳役，燥渴内热，肌肉消瘦，月经不行。薛谓此胃火消铄阴血，
用逍遥散加丹皮、炒栀以清胃热，用八珍汤加茯苓、远志以养脾血，而经自行矣。
一 妇少寐，经水两月余一至，误服通经丸，展转无寐，午前恶寒，午后发热。薛以为思虑亏损脾血，用
归脾汤作丸，午前六君送下，午后以逍遥散送下，两月余得寐，半载经行如期，年余而疮愈。
龚子才治魏宪副妻，患逆经吐血不止，六脉微涩有力，此血虚火盛也。以四物去熟地，用生地共二两，加
酒蒸大黄一钱（钱刻本作两，疑误。）同煎，入童便服之，服后血止而经通。
徐宪副外家，患经闭，人皆疑有孕。七八月来，渐觉黄瘦，腹中左右块如鼓，发热面赤，不思饮食。诊之，
六脉微涩，此血枯气郁也。以四物汤加香附、丹皮、白术之类，（白术何以加入？）十数服；又加桃仁，红花，数服。
下血块多许乃愈。
孙文垣治吴北海内人，每月经期之前，四肢累累发块，红紫胀痛，不思饮食，胃脘亦常痛，（肝火上逆。）经水
多不及期而至。（肝火下迫。）脉之，两手皆驶。以症参观，肝脾二经郁火也。盖肝主怒，脾主思，多思多怒，隐而
不发，郁滞于中，故临经累累发红，肿于四肢也。（脾主四肢。）以青皮、香附、柴胡、川芎、乌药、白芍、丹参、
元胡索、郁金、酒炒黄连、栀子治之而愈。（青皮、乌药宜酌用。）
潘氏媳因经水不行，医投安胎之剂。越七日，经忽暴至，内有血块筋膜如手大者一二块，昏冒困惫，其脉
右关洪滑，左寸洪数，两尺皆洪大，夜分切牙乱语，（状如热入血室。）手心热，口噤，手足皆冷，心胸胀闷
不快，面色青。孙曰∶此浊痰流滞血海，以误服安胎之剂，益加其滞。由血去多，故神魂无定；痰迷心窍，故神昏
乱语。急为调气开痰，安神养血可生也。即以温胆汤加石菖蒲、酒芩、天麻、枣仁、丹皮与服。其夜子丑时，切牙乱
语皆减半，仍与前药，每帖加竹茹五钱，临睡又与黑虎丹数粒，诸症悉愈。或问病每盛于夜半何也？曰∶此心
包络与胆经有痰热故也。专治此两经，痰既消，神魂自安矣。
程好吾子妇，腹中微疼，经行不畅，喉痛，四肢麻木作胀，不知饥饿。孙诊之，右脉洪大如豌豆，以川芎、
香附、麦芽、山楂、乌梅、甘草、桔梗、酒芩、防风、荆芥、白术、茯苓，四剂而安。次月经水大行，十日不
止，以黄 、阿胶、蒲黄各一钱，白芍二钱，甘草三分，一帖而安。此后但觉浊气下坠，屁从子户中出，（即阴吹
病。）以补中益气汤，用酒炒黄连调养而平。
Sun Boying from Luoyang, due to a false accusation and imprisonment, saw his wife detained. He fled to an old friend. That night, he felt pain in his stomach and hypochondrium, and entrusted the friend to seek medicine. The friend said, "There is a famous doctor named Zhang Dairen here; I should go with you." At that time, Zhang Dairen had not yet sobered up from wine. The friend forcibly woke him, saying, "I have a relative who is ill and wish to request a diagnosis." Zhang Dairen, seeing Boyin through the window, said, "This gentleman has suffered great fright." The friend asked, "How do you know?" Zhang Dairen replied, "His face is blue and pale, indicating fear affecting the Gallbladder (Dan Shou Bu). Later, upon a general amnesty, he was released, and only then did he inform Zhang Dairen." (From *Ru Men Shi Qin*.)
The Biography of Hua Tuo records: Yan Xin from Yandu and several others were waiting to see Hua Tuo together. When Hua Tuo arrived, he asked Yan Xin, "Are you well?" Yan Xin said, "As usual." Hua Tuo said, "You have an acute illness manifesting on your face; do not drink too much wine." After sitting and returning, after walking a few li, Yan Xin suddenly became dizzy and fell from the carriage. People helped him back into the carriage and home, but he died after one night. (From *Records of the Three Kingdoms*.)
A scholar had a face that was blue and lustrous, with a choking sensation in his breath. Qian Yi said, "This is Liver Qi overacting on the Lung (Gan Cheng Fei), which is an adverse prognosis. If contracted in autumn, it could be treated; now, contracted in spring, it cannot be treated." His family pleaded for mercy and forced medication upon him. The next day, (Qian Yi) said, "My medicine twice purged the Liver without reducing the condition, and three times tonified the Lung making it more deficient. Additionally, his lips are white. According to medical principles, he should die in three days. However, those who can eat may survive beyond the predicted time, while those who cannot eat will die before. Now, if he can consume congee, he will pass away in five days." (From *History of Song*, also imitating the biography of Cang Gong.)
Wang Shishan said, "Fu Mai (Hidden Pulse) is the most difficult to diagnose. For example, when accumulated heat persists for a long time, the pulse may instead be deep and fine, while external symptoms resemble cold. Unless combining Wang (Observation), Wen (Listening/Smelling), Wen (Inquiry), and Qie (Palpation), how can it be known? Secular people avoid discussing testing doctors, and doctors avoid subjective speculation. Moreover, women of noble families often do not receive Wang or Wen examinations. Is this not a great error?"
Xu Lingtai said, "Women's diseases are no different from men's. Only diseases during menstruation, pregnancy, and postpartum periods differ, and there are many cases of Jia Ju (Abdominal Masses). The reason for frequent Jia Ju is that blood from menstruation, leukorrhea, pregnancy, and childbirth is prone to stagnation, thus occurring more frequently than in men. Therefore, ancients referred to gynecology as 'Daixia Yi' (Doctor of Daixia), because their diseases generally belong to Daixia. Whenever treating women, one must first understand the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). The Chong Mai originates at Qichuan (on both sides of the pubic hair), runs alongside the Shaoyin Kidney Meridian, flanks the navel upwards, and disperses in the chest. The Ren Mai originates below Zhongji (four cun below the navel), goes up through the pubic hair region, follows the interior of the abdomen to Guanyuan. It is also said: Both Chong and Ren Mai originate in the Baozhong (Uterus), ascend along the interior of the back, and serve as the Sea of the Twelve Meridians. These are the sources from which blood is generated and where the fetus is anchored. Understanding the principles of Chong and Ren allows one to comprehend the root, so that the myriad diseases arising from them can be traced to their origin. By referencing formulas used by ancients and applying divine flexibility, each symptom will have its transmission pattern. Not using generic medicines for men will naturally ensure efficacy. As for secular theories such as 'cooling before delivery and warming after,' while cooling before delivery may have some rationale, warming after delivery is problematic. After hemorrhage, Yin Qi is greatly damaged, leaving isolated Yang blazing fiercely, with residual blood stasis forming latent heat. Using warming herbs like Ginger and Cinnamon in such cases, I have seen contemporary doctors kill countless patients. Looking at Zhang Zhongjing's treatment of postpartum diseases, using Shigao (Gypsum), Baiwei (Anemarrhenae Rhizoma), and Zhuru (Bambusae Caulis in Recens) yielded miraculous results. Some say postpartum blood stasis coagulates with cold and moves with heat; this is a major fallacy. Blood stasis coagulated due to heat resolves with cold descending; stasis coagulated due to cold resolves with heat descending. Take Tao Ren Cheng Qi Tang (Peach Kernel Decoction for Stagnation); is it not cold and dispersing? It is unheard of that this decoction coagulates blood. Generally, postpartum blood stasis involves heat accumulation. Heat-stasis forms clumps; adding heat herbs will refine them into dry blood, never to be dispersed again. Severe cases lead to immediate death from Yin exhaustion; mild cases result in hard masses, chronic fatigue, etc. Only when truly identifying stasis caused by cold should warming dispersal be used. Therefore, any treatment method not based on ancient sages but following later heresies harms people. This applies to all specialties, not just gynecology."
Pei Zhaoqi treated a woman with dizziness, tinnitus, muscle twitching, and palpitations, unable to sleep, fluctuating for half a year. Later, her menstruation stopped for four months, and her lower abdomen swelled like pregnancy. Doctors suspected pregnancy and treated her accordingly. Suddenly, she discharged a small amount of dark purple-black blood, revealing amenorrhea. Switching to menstruation-promoting herbs for several doses, her abdomen did not reduce; instead, nausea and vomiting increased. Food and drink were swallowed but immediately vomited out. Her throat was scorched and painful, tongue black and devoid of fluid. The doctor did not know the cause. Pei diagnosed: Six pulses were wiry, fine, and slippery, especially at the Guan positions. He said, "Stubborn phlegm obstruction and blood sea congestion cause menstrual blockage. Fine and slippery pulses indicate phlegm; dizziness, tinnitus, and confusion are phlegm syndromes; vomiting and anorexia indicate phlegm lodging in the Middle Jiao; black tongue, lack of fluid, and scorched throat indicate phlegm generating heat. The Classics state: Treat disease by seeking its root. Here, the root is phlegm, so treating phlegm is the priority." He administered Guntan Wan (Rolling Phlegm Pills) 80 pills initially, with no effect. Then 70 pills, causing slight lower abdominal pain. The next day, another full dose caused unbearable lower abdominal pain. Near midnight, she passed四五 pieces resembling pig liver, each nearly a chi long, followed by countless fragments resembling broken cotton fat membranes, and clusters like pomegranate seeds, red and white intermingled, connected and flowing down, totaling not less than two or three dou. Her lower abdomen instantly flattened, and pain vanished. Most strangely, she vomited about a bowl of phlegm, green like grass juice, with continuous drooling from the corners of her mouth, firm like a zither string. Danxi said strange diseases are mostly phlegm, nine or ten out of ten, which is true. At this time, her chest was unsettled, and food intake was low. He used Juhong (Tangerine Peel) and Fuling (Poria) 1 qian each, Zhishi (Immature Bitter Orange), Huanglian (Coptidis Rhizoma), and Banxia Qu (Pinelliae Fermentatum) 8 fen each, decocted in water with 2 spoons of Jiangzhi (Ginger Juice) and half a cup of Zhuli (Bamboo Sap). After two doses, he modified Liujunzi Tang (Six Gentlemen Decoction) and added Jiawei Runxia Wan (Modified Moistening Downward Pill). She recovered after over a hundred days of conditioning and gave birth to a son the following year.
Shen Yaofeng stated: The *Suwen* says, "Diseases of Er Yang (Two Yang) originate in Heart and Spleen; having unspoken grievances, women cease menstruation." If it transmits to Xifen (Lung Accumulation), it is incurable and fatal. Er Yang refers to the Yangming Meridian, not Zang-Fu organs. "Er Yang disease originating in Heart and Spleen" occurs because Yangming is a meridian abundant in blood. Blood is the essence of water and grain, refined by Heart Fire. Worry and anxiety damage the Heart, affecting its child (Spleen), leading to loss of appetite. Without nourishment, blood fails to generate, causing Yangming disease. The Classics state: The anterior yin is the convergence of Zongjin (Major Tendons), converging at Qichong, with Yangming as its leader. Thus, Yangming disease causes impotence and inability to perform sexual functions (Bu De Yinqu). Taichong is the Sea of Blood, running with the Yangming Meridian. Thus, Yangming disease weakens the Chong Mai, causing amenorrhea in women. Kou Zongshi also said: Early awakening of sexual desire in childhood, with persistent thoughts, leads to early closure of menstruation. Worry and anxiety damage the Heart; Heart damage exhausts blood, closing menstruation. Since Fire is diseased, it cannot nourish its child (Spleen), causing anorexia. Spleen deficiency leads to Metal Qi deficiency, causing cough. Once coughing starts, Water Qi exhausts, causing dry limbs. Wood Qi is insufficient, causing irritability, burnt hair, and tendon flaccidity. The Five Zang transmit sequentially, so death is not sudden, but inevitable. This case is extracted from the "Deficiency" category in *Jingui Yaolue*. Unfulfilled desires cause Ministerial Fire to blaze; only tonifying Water can control it. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) tonifies Yin and clears Yang, which is a good method. However, for Spleen deficiency and reduced appetite, Dihuang is cloying; frying it until charred helps. Alternatively, replace it with Nüzhenzi (Ligustri Lucidi Fructus).
Xiong noted: This syndrome is hardest to treat. Liuwei Dianpi affects the Spleen; Guipi Tang aids Fire. Only Xue Yupiao's Zirong Yangye Gao (Nourishing Glory and Nourishing Fluid Paste) with Xiaomai (Triticum Vulgare), Dazao (Ziziphus Jujuba), and Yuanzhi (Polygalae Radix) is appropriate. Xue Yupiao also has Xinshui Shuangbu Wan (Heart-Spleen Dual Tonification Pill), which can be considered. Zirong Yangye Gao Formula: Nüzhenzi, Guang Chenpi (Broad-leaved Tangerine Peel), Gan Sangye (Mulberry Leaf), Da Shudi (Prepared Rehmannia Root), Hanliancao (Ecliptae Herba), Baishaoyao (White Peony Root), Hei Zhima (Black Sesame Seed), Gouqizi (Goji Berry), Gan Juhua (Chrysanthemum Flower), Dangguishen (Angelica Sinensis Root Body), Heidou (Black Soybean), Yuzhu (Polygonati Odorati Rhizoma), Nanzhuye (Vaccinii Arctostaphylfolii Folium), Bai Fushen (Poria with Hostwood), Shawenyili (Astragali Complanati Semen), Zhi Gancao (Honey-fried Licorice Root). The above sixteen ingredients: the first fourteen are 4 liang each, the last two are 2 liang each. Decoct in spring water using mulberry wood fire to make paste. Add 3 liang of Zhen Ejiao (Donkey-hide Gelatin) and 3 liang of refined White Honey. Store in porcelain jars. Take 5-6 qian every morning at Mao hour (5-7 AM), washed down with boiled water. Xinshui Shuangbu Wan Formula: Renshen (Ginseng), Yuanshen (Scrophulariae Radix), Wuweizi (Schisandrae Fructus), Yuanzhi Rou (Polygalae Seed Flesh), Maidong (Ophiopogonis Tuber), Fushen (Poria with Hostwood), Suanzaoren (Ziziphi Spinosae Semen), Baiziren (Platycladi Semen), Yuqian Zhu (Atractylodis Macrocephalae Rhizoma), Chuan Beimu (Fritillariae Cirrhosae Bulbus), Sheng Gancao (Raw Licorice Root), Ku Jiegeng (Platycodonis Radix), Danshen (Salviae Miltiorrhizae Radix), Shengdi (Rehmanniae Radix), Chuan Huanglian (Coptidis Rhizoma), Zhi Xiangfu (Cyperi Rhizoma). Grind into powder. Use Longyanrou (Longan Aril) paste instead of honey. Form pills the size of a bullet. Coat with Zhusha (Cinnabar). Chew one pill every morning, washed down with boiled water.
Shen Yaofeng treated a woman with more heat than chills, delirium worse at night. Menstruation had lasted three days when the illness started and then stopped. The family knew it was Re Ru Xue Shi (Heat Entering the Blood Chamber) and used Xiao Chai Hu Tang (Minor Bupleurum Decoction) for several doses, worsening the condition. Tongue was yellow and dry; upper and lower teeth showed dry blood. Shen used Shengdi (Rehmanniae Radix), Danpi (Moutan Cortex), Maidong (Ophiopogonis Tuber) without effect; ingestion caused dry retching. Pulse was weak and not large. Thinking that weak pulses often indicate Fire, and dry stomach fluids cause retching, he used Baihu Tang (White Tiger Decoction) plus Shengdi and Maidong. After two doses, heat subsided and spirit cleared. Only constipation for over twenty days remained. He gave Mahuang Wan (Hemp Seed Pill); after three doses, bowel movement occurred, and she was safe.
An unmarried maiden had fever during menstruation. The doctor used exterior-releasing herbs, worsening the condition. Delirium worsened at night. Xiao Chai Hu Tang failed. At night, she rose acting like a madman. Suspecting blood retention, cool-blood and blood-breaking herbs were given, also ineffective. Left Guan pulse was wiry, hard, and striking the finger. Inquiry revealed the illness started from anger. He used Longdancao (Gentianae Radix), Huangqin (Scutellariae Radix), Shanzhi (Gardeniae Fructus), Danpi (Moutan Cortex), Lingyangjiao (Saiga Tataricae Cornu), Lvxia (Aloe), Gancao (Licorice Root), Guishen (Angelicae Sinensis Radix). One dose improved, four doses cured.
Zhang Yibiao's daughter-in-law had fever during menstruation, delirious at night seeing ghosts. Xiao Chai Hu Tang worsened it. Inquiry revealed: when awake, she feared cold in the lower body; even when confused, she pulled blankets tight. Zhang said this patient likely had leukorrhea normally, married recently, and likely had excessive intercourse. Plus, heavy menstruation led to dual deficiency of Essence and Blood, exhausting Yin and Yang. The chills and fever resulted from Yin-Yang mutual assault, not external pathogenic heat entering deeply. Exterior-releasing and heat-clearing herbs mimicked Wang Yang (Loss of Yang). *Shanghan Lun* states: Loss of Yang causes delirium. *Neijing* states: Loss of Yang sees ghosts. He used Shenqi Wan (Kidney Qi Pill), 2 qian morning and evening. Spirit cleared. Then replaced Guizhi (Cinnamon Twig) and Fuzi (Aconiti Lateralis Radix Praeparata) with Rongrong (Cynomorii Fructus). Several doses led to full recovery. Canxi Bazhen Gao Dan (Ginseng and Costus Eight-Treasure Paste): Ginseng ends removed, wine-washed and steamed; Sizhi Xiangfu (Four-Processed Cyperi Rhizoma) 4 qian each; Shudi (Prepared Rehmannia), Zhi Huangqi (Honey-fried Astragalus), Baishaoyao (White Peony, wine-fried), Zheng Baizhu (Steamed Atractylodes, steamed), Baiguishen (Angelica Root Body, wine-fried), Fuling (Poria) 3 liang each. Eight ingredients made into paste. Take 3 qian mixed with boiled water. Xue Yupiao said: This formula is the top choice for conditioning. Mild flavor and function match; deficient persons can take it long-term.
Qingfu Jin Dan (Green Skin and Costus Golden Pill) treats women's Jia Ju. Qingpi (Citri Reticulatae Pericarpium Viride) 4 liang, soaked in water dissolved with 5 qian Xiaoshi (Niter); Xiangfu (Cyperi Rhizoma) 4 liang, soaked in Tongbian (Child's Urine); Yujin (Curcumae Radix) 2 liang, soaked in water dissolved with 5 qian Shengfan (Alumen); Danshen (Salviae Miltiorrhizae Radix) 2 liang, soaked in Jiangzhi (Ginger Juice). Grind four ingredients into fine powder. Make pills the size of hemp seeds with vinegar paste. Dry and sprinkle with Ejiao glue, shaking for gloss. Then use Renshen (Ginseng), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma) 1 liang each; Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Zhi Banxia (Pinelliae Rhizoma Preparatum) 2 liang each; Chenpi (Tangerine Peel), Zhi Gancao (Licorice Root) 5 qian each. Grind extremely fine. Use rice water to coat the glossy small pills as an outer layer. Dry. Take 3 qian with boiled water. This is Xue Yupiao's formula. Because deficient persons with tangible Jia Pi diseases cannot tolerate aggressive purgatives, this serves as a slow resolution plan. Its brilliance lies in using Liujunzi (Six Gentlemen), Xiong (Chuanxiong), and Gui (Danggui) as the outer layer, so when medicine enters the stomach, the harsh taste is masked, protecting Stomach Qi. As it gradually dissolves, the targeted medicine reaches the disease site, eliminating disease without harming healthy Qi. Truly an essential gynecological formula.
Wuxiang Wan (Five Fragrances Pill) treats the same. Wulingzhi (Trogopterori Faeces) 1 jin, Xiangfu (Cyperi Rhizoma) 1 jin, soaked in water for one day. Heiqianniu (Black Morning Glory Seed) and Baiqianniu (White Morning Glory Seed) head powders 2 liang each. Half of the four ingredients lightly stir-fried, half raw. Grind fine and mix. Make pills the size of radish seeds with vinegar paste. Take 7-8 fen or 1 qian with ginger soup before bed. Take another dose early next morning; cure follows. Pregnant women forbidden; children halve dose. Wulingzhi breaks stasis and generates new blood; Xiangfu regulates Qi and relieves depression; Qianniu opens knots, moves phlegm, drains fluid, and promotes urination. Combined, it dissipates masses and癖s. Not mild. However, taken by the qian for excess syndromes, it is a good medicine. It treats phlegm accumulation, food stagnation, Qi stagnation forming masses, abdominal swelling, initial stage of dysentery, and abdominal痞聚 with tangible attacking pain. Deficient persons can take Liujunzi Tang plus Danggui and Baishao as a decoction to wash down the pills.
Wang Shi said: A woman had a fifteen-year-old daughter. Diagnosis revealed menstruation started at fourteen but suddenly stopped. The mother was terrified. The doctor asked, "Is this girl your biological daughter?" The mother confirmed. The doctor said, "I ask only because... when you were fourteen, your menstruation also started. So her stopping here is 'Bi Nian' (Avoidance Year - menstruation occurs once in a lifetime). Do not worry; it will return naturally." (From *Dongyuan Shishi*.)
Zhang Zihe said: A woman in her twenties had amenorrhea, alternating chills and fever, cough, and tidal fever. Quacks forbade all food. One day in summer heat, she saw a seller of cold jelly, drank ice water, ate a lot, and instantly felt clear-headed and strong. Months later, menstruation returned naturally. (Xiong noted: People only know blood cold causes coagulation, not that blood heat causes knotting.)
Hua Bernren treated Mrs. Long Junze. In mid-summer heat, she had stagnant menstruation, alternating chills and fever, spontaneous sweating, cough with phlegm, emaciation, itching, stabbing pain in umbilicus and abdomen. Pulse was wiry, rapid, exceeding six beats per breath. He said, "This is Er Yang disease. *Suwen* says: Er Yang disease originates in Heart and Spleen; women get amenorrhea. Er Yang is Yangming, Metal, transforming into Dryness. Her amenorrhea is due to encountering Summerheat. Yangming is originally Dry Metal; encountering Summerheat (Fire) scorches Metal, increasing dryness. Blood is Water-like; Metal is the source of transformation. Hence, stagnant menstruation. Other doctors were preparing Guirong Guifu Wan (Deer Antler and Aconite Pill) to warm meridians. Hua said: Blood stops with cold, moves with warmth. Heat causes binding, binding causes dryness. Adding drying drugs makes blood drier, worsening disease. Urgently stop that. Use Danggui Chaihu Yinzi (Angelica and Bupleurum Drink) to clear Metal, drain Fire, moisten dryness. After 3-5 doses, menstruation flowed, other diseases resolved. Long Jun said: I almost was misled."
Xue Lizhai diagnosed a seventeen-year-old maiden with chronic tuberculosis, Tian Gui (Menstruation) not yet established, fever, cough, poor appetite. Wanted to use Tongjing Wan (Menstruation-Promoting Pill). Xue said, "This is due to insufficient congenital Qi and unfull Yin Blood. Just nourish Qi and Blood, benefit fluids; menstruation will come naturally." Confused by quick effects, they still used it. Xue said, "This is incorrect treatment. This is a fierce agent, greatly aiding Yang Fire. Yin Blood will flow recklessly; Spleen and Stomach will become more deficient." Indeed, menstruation flowed recklessly, appetite decreased further, leading to death.
A woman with chronic Stomach Fire was relieved by Liangwei San (Cool Stomach Powder). Later, due to labor, internal dryness, thirst, and heat, muscles wasted, menstruation stopped. Xue believed Stomach Fire consumed Yin Blood. Used Xiaoyao San (Free and Easy Wanderer Powder) plus Danpi (Moutan Cortex) and Chao Zhi (Stir-fried Gardenia) to clear Stomach heat; Bazhen Tang (Eight Treasures Decoction) plus Fuling (Poria) and Yuanzhi (Polygalae Radix) to nourish Spleen Blood. Menstruation resumed naturally.
A woman had insomnia, menstruation once every two months. Mistakenly took Tongjing Wan, tossing without sleep, chills before noon, fever after noon. Xue attributed this to anxiety damaging Spleen Blood. Used Guipi Tang (Restore the Spleen Decoction) as pills, taken with Liujunzi Tang (Six Gentlemen Decoction) before noon, and Xiaoyao San after noon. Sleep restored in over two months; menstruation regular in half a year; sores healed in over a year.
Gong Zicai treated Wife of Vice Minister Wei, suffering from Ni Jing (Reverse Menstruation) with incessant hematemesis. Six pulses were faint, choppy, yet forceful. This was Blood deficiency with Fire excess. Removed Shudi (Prepared Rehmannia) from Siwu Tang (Four Substances Decoction), used 2 liang of Shengdi (Rehmannia Root), added 1 qian of Jiudahuang (Wine-steamed Rhubarb) [Note: Text says 'liang' in print, likely error], decocted together, taken with Tongbian (Child's Urine). Bleeding stopped, menstruation resumed.
External relative of Xu Xianfu had amenorrhea. Everyone suspected pregnancy. Over seven to eight months, she became yellow and thin, with drum-like masses left and right in abdomen, fever, red face, anorexia. Pulses were faint and choppy. This was Blood exhaustion with Qi stagnation. Used Siwu Tang plus Xiangfu (Cyperi Rhizoma), Danpi (Moutan Cortex), Baizhu (Atractylodes), etc. More than ten doses; then added Taoren (Peach Kernel) and Honghua (Carthami Flos). Passed many blood clumps, then cured.
Sun Wen yuan treated Wife of Wu Beihai. Before each menstruation, lumps appeared on limbs, red-purple, swollen and painful, anorexia, constant epigastric pain (Liver Fire counterflow). Menstruation often arrived early (Liver Fire downward pressure). Pulses were rapid in both hands. Considering symptoms, this was Depression Fire in Liver and Spleen meridians. Liver governs anger; Spleen governs thought. Much thinking and anger, hidden and unexpressed, stagnate internally. Hence, red rashes and limb swelling before menstruation (Spleen governs limbs). Treated with Qingpi (Citri Reticulatae Pericarpium Viride), Xiangfu (Cyperi Rhizoma), Chaihu (Bupleuri Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Wuyao (Linderae Radix), Baishao (White Peony Root), Danshen (Salviae Miltiorrhizae Radix), Yuanhusuo (Corydalis Rhizoma), Yujin (Curcumae Radix), Jiuhuanglian (Wine-fried Coptidis Rhizoma), Zhizi (Gardeniae Fructus). Cured. (Use Qingpi and Wuyao with caution.)
Pan Family Daughter-in-law had amenorrhea. Doctor gave Antifetal agents. Seven days later, menstruation suddenly surged with hand-sized blood clots and fascia. She fainted and was exhausted. Right Guan pulse was surging and slippery; Left Cun was surging and rapid; both Chi were surging and large. Nighttime: grinding teeth and confused speech (like Heat Entering Blood Chamber). Palms hot, jaw locked, hands and feet cold, chest distension and discomfort, blue face. Sun said: "Turbid phlegm flows and stagnates in Blood Sea. Mistaken antifetal agents increased stagnation. Massive blood loss causes unstable soul; phlegm confuses Heart Orifice, causing confusion. Urgently regulate Qi, open phlegm, calm spirit, nourish blood to survive." Used Wendan Tang (Warm Gallbladder Decoction) plus Shichangpu (Acori Tatarinowii Rhizoma), Jiuqin (Wine-fried Scutellariae Radix), Tianma (Gastrodiae Rhizoma), Zaoren (Ziziphi Spinosae Semen), Danpi (Moutan Cortex). That night at Zi-Chou hours, symptoms halved. Continued previous prescription, adding Zhuru (Bambusae Caulis in Recens) 5 qian per dose. Before sleep, gave Heihu Dan (Black Tiger Pill) several grains. All symptoms resolved. Asked why symptoms peak at midnight? Answer: Phlegm-heat in Pericardium and Gallbladder meridians. Treating these two meridians eliminates phlegm, calming the soul.
Cheng Haowu's Daughter-in-law had slight abdominal pain, irregular menstruation, sore throat, numb and swollen limbs, no hunger. Sun diagnosed: Right pulse surging large like a pea. Used Chuanxiong (Ligustici Chuanxiong Rhizoma), Xiangfu (Cyperi Rhizoma), Maiya (Hordei Fructus Germinatus), Shanzha (Crataegi Fructus), Wumei (Mume Fructus), Gancao (Licorice Root), Jiegeng (Platycodonis Radix), Jiuqin (Wine-fried Scutellariae Radix), Fangfeng (Saposhnikoviae Radix), Jingjie (Schizonepetae Spica), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria). Four doses brought peace. Next month, heavy menstruation lasting ten days. Used Huangqi (Astragali Radix), Ejiao (Colla Corii Asini), Puhuang (Typhae Pollen) 1 qian each; Baishao (White Peony Root) 2 qian; Gancao (Licorice Root) 3 fen. One dose stabilized. Afterwards, felt turbid Qi sinking, flatulence from vagina (Yinchui Disease). Used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Jiuhuanglian (Wine-fried Coptidis Rhizoma) for conditioning, bringing balance.