某 便泻已除，六脉涩细，癸来涩少，脘中胀闷，皆缘肝横气滞，仍遵前法损益。（八
月初三日）
左金丸（八分） 乌药（二钱） 茯苓（四钱） 鸡血藤（钱半） 浓朴（一钱） 佩兰（三钱）
丹参（三钱） 绿萼梅（钱半） 通草（钱半） 炒谷芽（四钱） 大腹皮（三钱）
清煎四帖。
介按∶秦天一曰∶血气之化，由于水谷，水谷盛则血气亦盛，水谷衰则血气亦衰。是水
谷之
海，即是阳明胃气，又是冲脉之本。故月经之本，所重在冲脉，所重在胃气，所重在心脾生
化之源耳。今以胃被肝乘，失其生化之源，是癸来涩少。脘中胀闷，此方清肝和胃以养血，
庶几肝逆稍平，太冲脉盛，则月事以时下矣。
瓜沥王 头晕心泛已瘥，六脉细涩。癸来腰腹联痛如刺，宜和营卫为主。（五月四号甲
辰十八日。）
当归（二钱，小茴香五分拌炒） 制香附（三钱） 鸡血藤（三钱） 炒白芍（钱半） 杜仲（
三钱
）茯神（四钱） 延胡（二钱） 川芎（一钱） 小胡麻（三钱） 丹参（三钱） 玫瑰花（五朵）
清煎五帖。
介按∶血积不散，为气所冲，新血与故血相搏，引动冲任，以致经来腰腹刺痛。此方养
血理气，调和营卫之意。
西庄俞 潮热不清，右脉涩，左关沉弦，大便忽泻，经停，腹中有瘕，脐下痛较缓，气
转至咽，舌微黄。宜清热、养胃、和肝。
银柴胡（一钱） 扁豆衣（三钱） 制香附（三钱） 乌药（钱半） 地骨皮（三钱） 茯苓（四
钱） 杜仲（三钱） 绿萼梅（钱半） 青蒿梗（钱半） 丹参（三钱） 广木香（七分）
清煎五帖。
又 寒热较差，胃纳已和，右脉虚，左弦细，经停，腹中有瘕，脐下偶痛，肝木抑郁。
仍宜逍遥散加减。（十一月初四日。）
柴胡（八分） 当归（钱半） 青木香（五分） 木蝴蝶（四分） 炒白芍（钱半） 制香附（二
钱） 杜仲（三钱） 川楝子（钱半） 茯苓（四钱） 生地（三钱） 炒青皮（八分）
清煎四帖。
介按∶肝郁不畅，血气凝滞，以致脐下偶痛，而经停成瘕。然大便作泻，又是肝阳侮脾
之候
，治以理气疏肝，健脾清热，而寒热较差，胃气稍和。次以泄肝热而解肝郁，逍遥散为对症
之方。因其既和气血，又佐柴胡以微升，藉引少阳之生气。如是治疗，俾郁勃之气，由此可
以条畅。
某 冲任内损，腰疼背掣，脉涩细，头疼心悸，癸涩。宜柔肝、补心、调经。
桑寄生（三钱） 炒杜仲（三钱） 龙齿（三钱） 煨天麻（八分） 白茯神（四钱） 甘菊（
钱半） 远志肉（八分） 豆衣（钱半） 炒枣仁（三钱） 丹参（三钱） 鸡血藤胶（钱半）
清煎四帖。
介按∶肝为风木之脏，内寄相火，体阴用阳，其性主升，全赖肾水之涵，血液之养，庶
得遂
其条达之性。兹以肝肾并亏，血液已虚，因而内风时动，即觉头晕心悸，腰背酸痛，癸水涩
少，此方治法，系是缓肝熄风，滋肾退热之意。
某 脘闷气滞，癸涩，脉涩细，右弦，带下腰酸。宜养血和中。（又月初三日。）
鸡血藤（三钱） 制香附（钱半） 大腹皮（三钱） 丹皮（三钱） 冬瓜子（四钱） 小胡麻（
三钱） 丹参（三钱）
清煎五帖。
介按∶湿热蕴蓄，因而气滞血阻，以致带下腰酸，故治以理气和血，清热渗湿。
安昌包 闺女月事仍闭，脉沉涩，腹痛脘闷，肢体浮肿，顷经少安。
当归（钱半） 泽泻（钱半） 通草（钱半） 冬瓜皮（三钱） 川芎（一钱） 制香附（三钱）
车前（三钱） 鸡血藤（三钱） 延胡（三钱） 大腹皮（三钱） 杜赤豆（四钱）
清煎四帖。
介按∶此因血液被湿热逼出，旁流膈膜，以致肢体浮肿，经来之时，湿热乘虚而入，阻
碍血脉之周流，血既凝滞，自然经闭腹痛，利水活血以行气。方法面面顾到。
某 带下腰疼，脉虚细，癸涩，腹左有瘕，病在冲任。宜柔肝调经。
桑寄生（三钱） 炒杜仲（三钱） 炒白芍（钱半） 生牡蛎（四钱） 全当归（二钱） 覆盆子
（三钱） 木蝴蝶（四分） 绿萼梅（钱半） 茺蔚子（三钱） 香附（三钱） 鸡血藤（三钱）
清煎八帖。
介按∶冲任并虚，肝郁成瘕，故以柔肝固肾，理气活血为治。
安昌顾 气郁成痹，脉涩，右寸关弦，音嘶，腹痛有瘕，癸水早期。宜泄降清肝。（三
月二十七日。）
栝蒌皮（三钱） 石决明（六钱，生打） 川楝子（三钱） 茺蔚子（三钱） 薤白（一钱） 丹
皮（三钱） 木蝴蝶（四分） 绿萼梅（钱半） 霍斛（三钱） 炒延胡（钱半） 新会皮（钱半）
清煎四帖。
介按∶情怀不畅，肝郁化热，以致癸水早期，气逆上升，则胸脘阻痹，腹中瘕痛。故治
以泄肝养胃。
某 便泻未除，舌色左边浓，癸水早期，脘闷气滞，右脉虚细，左关沉弦，肝木偏横。
宜养胃、平肝、调经。（六月七号。）
霍斛（三钱） 鸡血藤（三钱） 通草（钱半） 紫香附（钱半） 佩兰（三钱） 谷芽（四钱）
石莲子（三钱） 生米仁（四钱） 丹皮（二钱） 木蝴蝶（四分） 丹参（三钱）
清煎四帖。
介按∶便泻未除，是挟时令之湿热，癸水早期，是属肝热而不藏血之症。肝阳横逆，则
脘闷
气滞，而左脉沉弦，胃被肝乘，未能与冲脉生化血液，则右脉虚细，治宜双方顾到，故以养
胃和血，平肝渗湿之剂。
安昌寿 血虚木旺，脉弦，右虚细，项背掣痛，癸水先后不一，脘中偶痛，夜寐少安。
宜补心平肝为主。
丹参（三钱） 当归（钱半） 生牡蛎（四钱） 小胡麻（三钱） 茯神（四钱） 炒白芍（钱半）
木蝴蝶（四分） 鸡血藤（钱半） 枣仁（三钱） 炒杜仲（三钱） 川楝子（三钱）
清煎五帖。
介按∶肝主筋而藏魂，肾主五液而恶燥，兹以肾液不能上承，则心不生血而癸水愆期，
肝不藏魂，则夜寐不安，又不养筋，则项背掣痛而联及脘中。故治以补肾养心，柔肝和血。
瓜沥王 癸涩后期，脉虚左涩，腰酸带下，胃纳不旺。姑宜养胃、调经、涩下。
钗斛（三钱） 鸡血藤（钱半） 覆盆子（三钱） 小胡麻（三钱） 省头草（三钱） 炒杜仲（
三钱） 川断（三钱） 丹参（三钱） 生牡蛎（四钱） 谷芽（四钱） 制香附（三钱）
清煎十帖。
介按∶月经之本，所重在冲脉，而冲脉隶于阳明。今以胃纳不旺而血海渐涸，是以癸涩
后期，肾虚而带脉不固，则腰酸带下。治以养胃补肾，庶几经调带止。
瓜沥王 癸涩迟滞，气冲脘闷，脉左涩，右弦滑，痰湿下注为滞。宜养血理气为主。（
四月二十三号。）
归身（二钱） 仙半夏（钱半） 鸡血藤（三钱） 制香附（三钱） 炒白芍（钱半） 新会皮（
钱半） 茺蔚子（三钱） 沉香（四分） 川芎（一钱） 生牡蛎（四钱） 杜仲（三钱）
清煎四帖。
介按∶湿痰下注于带脉，带脉不能约束而下浊液。但带脉又能于冲任，冲任并亏，则气
冲癸涩，治以补脾肾之气。又佐舒肝之品，俾血旺气和，则诸恙自愈。
安昌顾 心悸带下，癸涩过滞，腰酸，脐下痛，脉濡涩细，迩有头疼，龈起胀泡。宜胜
金丹加减。（五月二十日。）
生地（三钱） 小胡麻（三钱） 远志肉（八分） 炒杜仲（三钱） 当归（钱半） 钗斛（三钱）
茯神（四钱） 石决明（四钱） 白芍（钱半） 香附（三钱） 鸡血藤胶（钱半）
清煎五帖。
介按∶傅青主曰∶带脉横生，通于任脉，任脉直上，走于唇齿，唇齿之间，原有不断之
泉，下贯任脉以化精，使任脉无热气之绕，则口中之津液，尽化为精，以入于肾矣。惟有热邪
存下焦之间，则津液不能化精而反化湿也。今此案系是带任两脉，液虚热炽之象，故用胜金
丹加减，借以养血清热，柔肝安神。
[Background Information]
Book: Shao Lansun's Medical Cases; Author: Shao Lansun; Dynasty: Qing; Chapter: Regulating Menstruation; Category: Medical Discourse
Case 1
A certain patient: Diarrhea has been resolved. The six pulses are choppy and fine (Se-xi). Menstruation arrives with scanty flow and is choppy (Gui-lai se-shao). There is distension and stuffiness in the epigastrium. These symptoms stem from Liver Qi horizontal rebellion and Qi stagnation. Treatment still follows the previous method with modifications. (3rd day of the 8th lunar month)
Zuojin Wan (Left Metal Pill, 8 fen) Wuyao (Lindera Root, 2 qian) Fuling (Poria, 4 qian) Jixueteng (Spatholobus Stem, 1.5 qian) Houpo (Magnolia Bark, 1 qian) Peilan (Eupatorium, 3 qian) Danshen (Salvia Root, 3 qian) Lueemei (Green Calyx Plum, 1.5 qian) Tongcao (Tetrapanax Pith, 1.5 qian) Chao Guya (Stir-fried Rice Sprout, 4 qian) Dafupi (Areca Peel, 3 qian)
Decocted in clear water, four doses.
Commentary by Jie: Qin Tianyi said: The transformation of Blood and Qi originates from Water and Grain (dietary essence). When Water and Grain are abundant, Blood and Qi are abundant; when they are deficient, Blood and Qi are deficient. The Sea of Water and Grain is the Stomach Qi of Yangming, which is also the root of the Chong Mai (Penetrating Vessel). Therefore, the root of menstruation lies in the Chong Mai, lies in Stomach Qi, and lies in the source of transformation generated by the Heart and Spleen. Now, because the Stomach is overacted upon by Liver Wood, losing its source of transformation, menstruation is scanty and choppy. Epigastric distension and stuffiness: this formula clears the Liver and harmonizes the Stomach to nourish Blood. Hopefully, Liver rebellious Qi will be slightly pacified, the Taichong pulse will become full, and menstruation will arrive on time.
Case 2
Wang from Guali: Dizziness and nausea have improved. The six pulses are fine and choppy. During menstruation, there is piercing pain connecting the waist and abdomen. Treatment should primarily focus on harmonizing Ying and Wei (Nutritive and Defensive levels). (18th day of the 5th lunar month, Jiachen year)
Danggui (Angelica Sinensis Root, 2 qian, stir-fried with 0.5 fen Xiaohuixiang/Fennel Seed) Zhixiangfu (Prepared Cyperus Rhizome, 3 qian) Jixueteng (Spatholobus Stem, 3 qian) Chao Baishao (Stir-fried White Peony Root, 1.5 qian) Duzhong (Eucommia Bark, 3 qian) Fushen (Poria with Hostwood, 4 qian) Yanhu (Corydalis Rhizome, 2 qian) Chuanxiong (Ligusticum Rhizome, 1 qian) Xiaohuma (Sesamum Seed, 3 qian) Danshen (Salvia Root, 3 qian) Meiguihua (Rose Flower, 5 pieces)
Decocted in clear water, five doses.
Commentary by Jie: Accumulated Blood that does not dissipate is rushed by Qi. New Blood contends with Old Blood, stirring up the Chong and Ren (Conception) vessels, resulting in stabbing pain in the waist and abdomen during menstruation. This formula intends to nourish Blood, regulate Qi, and harmonize Ying and Wei.
Case 3
Yu from Xizhuang: Tidal fever persists. Right pulse is choppy. Left Guan position is deep and wiry. Sudden diarrhea. Menstruation stopped. Mass (Zha) in the abdomen. Pain below the umbilicus is relatively relieved. Qi reverses up to the throat. Tongue coating is slightly yellow. Treatment should clear heat, nourish Stomach, and harmonize Liver.
Yin Chaihu (Stellaria Root, 1 qian) Bian Dou Yi (Lablab Bean Integument, 3 qian) Zhixiangfu (Prepared Cyperus Rhizome, 3 qian) Wuyao (Lindera Root, 1.5 qian) Digupi (Dogwood Bark, 3 qian) Fuling (Poria, 4 qian) Duzhong (Eucommia Bark, 3 qian) Lueemei (Green Calyx Plum, 1.5 qian) Qinghao Geng (Artemisia Annua Stem, 1.5 qian) Danshen (Salvia Root, 3 qian) Guang Muxiang (Vladimiria Root, 7 fen)
Decocted in clear water, five doses.
Re-evaluation: Cold and heat symptoms have slightly decreased. Stomach appetite has harmonized. Right pulse is deficient. Left pulse is wiry and fine. Menstruation stopped. Mass (Zha) in the abdomen. Occasional pain below the umbilicus. Liver Wood is depressed.
Still appropriate to modify Xiaoyao San (Free and Easy Wanderer Powder). (4th day of the 11th lunar month)
Chaihu (Bupleurum Root, 8 fen) Danggui (Angelica Sinensis Root, 1.5 qian) Qing Muxiang (Aucklandia Root, 5 fen) Muhudie (Diopterygium Leaf, 4 fen) Chao Baishao (Stir-fried White Peony Root, 1.5 qian) Zhixiangfu (Prepared Cyperus Rhizome, 2 qian) Duzhong (Eucommia Bark, 3 qian) Chuanlianzi (Toosendan Fruit, 1.5 qian) Fuling (Poria, 4 qian) Shengdi (Rehmannia Root, 3 qian) Chao Qingpi (Stir-fried Green Tangerine Peel, 8 fen)
Decocted in clear water, four doses.
Commentary by Jie: Liver depression causes unsmoothness, leading to stagnation of Blood and Qi, causing occasional pain below the umbilicus and amenorrhea forming a mass (Zha). However, diarrhea is a sign of Liver Yang invading the Spleen. Treatment focused on regulating Qi, soothing the Liver, invigorating the Spleen, and clearing heat, so cold and heat decreased and Stomach Qi slightly harmonized. Next, to drain Liver Heat and resolve Liver Depression, Xiaoyao San is the对症 (symptom-matching) formula. Because it harmonizes Blood and Qi, and assists Chaihu to slightly ascend, borrowing to guide the Shengqi (vital energy) of Shaoyang. With such treatment, the stagnant Qi can become smooth and free.
Case 4
A certain patient: Internal damage to Chong and Ren vessels. Lower back pain with pulling sensation in the back. Pulses are choppy and fine. Headache and palpitations. Menstruation is scanty and choppy. Treatment should soften the Liver, tonify the Heart, and regulate menstruation.
Sangjisheng (Taxillus Branch, 3 qian) Chao Duzhong (Stir-fried Eucommia Bark, 3 qian) Longchi (Dragon Teeth, 3 qian) Wei Tianma (Calcined Gastrodia Rhizome, 8 fen) Bai Fushen (White Poria with Hostwood, 4 qian) Ganju (Chrysanthemum Flower, 1.5 qian) Yuanzhi Rou (Polygala Root Flesh, 8 fen) Douyi (Lablab Bean Integument, 1.5 qian) Chao Zaoren (Stir-fried Ziziphus Seed, 3 qian) Danshen (Salvia Root, 3 qian) Jixueteng Jiao (Spatholobus Gum, 1.5 qian)
Decocted in clear water, four doses.
Commentary by Jie: The Liver is the organ of Wind-Wood, housing Ministerial Fire within. Its substance is Yin, its function is Yang, and its nature is ascending. It relies entirely on Kidney Water to nourish it and Blood to feed it, so as to achieve its smooth and free nature. Now, due to simultaneous deficiency of Liver and Kidney, Blood is already deficient, causing internal Wind to move occasionally. Thus, dizziness and palpitations are felt, along with soreness and pain in the lower back and back, and scanty, choppy menstruation. The treatment method of this formula is to soothe the Liver and extinguish Wind, nourish the Kidney and retreat heat.
Case 5
A certain patient: Epigastric stuffiness and Qi stagnation. Menstruation is scanty and choppy. Pulses are choppy and fine, right side wiry. Leukorrhea and lower back soreness. Treatment should nourish Blood and harmonize the Middle Jiao.
Jixueteng (Spatholobus Stem, 3 qian) Zhixiangfu (Prepared Cyperus Rhizome, 1.5 qian) Dafupi (Areca Peel, 3 qian) Danpi (Moutan Bark, 3 qian) Dongguazi (Winter Melon Seed, 4 qian) Xiaohuma (Sesamum Seed, 3 qian) Danshen (Salvia Root, 3 qian)
Decocted in clear water, five doses.
Commentary by Jie: Damp-Heat accumulation leads to Qi stagnation and Blood obstruction, resulting in leukorrhea and lower back soreness. Therefore, treatment focuses on regulating Qi and harmonizing Blood, clearing heat and leaching out dampness.
Case 6
Bao from Anchang: A young lady’s menstruation remains closed. Pulse is deep and choppy. Abdominal pain and epigastric stuffiness. Limbs are edematous. Recently, menstruation has slightly settled.
Danggui (Angelica Sinensis Root, 1.5 qian) Zexie (Alisma Rhizome, 1.5 qian) Tongcao (Tetrapanax Pith, 1.5 qian) Dongguapi (Winter Melon Peel, 3 qian) Chuanxiong (Ligusticum Rhizome, 1 qian) Zhixiangfu (Prepared Cyperus Rhizome, 3 qian) Cheqian (Plantago Seed, 3 qian) Jixueteng (Spatholobus Stem, 3 qian) Yanhu (Corydalis Rhizome, 3 qian) Dafupi (Areca Peel, 3 qian) Du Chidou (Red Adzuki Bean, 4 qian)
Decocted in clear water, four doses.
Commentary by Jie: This is because Blood is forced out by Damp-Heat, flowing laterally into the diaphragm, causing limb edema. During menstruation, Damp-Heat enters due to deficiency, obstructing the circulation of Blood vessels. Once Blood stagnates, naturally amenorrhea and abdominal pain occur. Using diuresis and blood-invigorating methods to move Qi. The method covers all aspects.
Case 7
A certain patient: Leukorrhea and lower back pain. Pulse is deficient and fine. Menstruation is scanty and choppy. Mass (Zha) on the left side of the abdomen. Disease is in the Chong and Ren vessels. Treatment should soften the Liver and regulate menstruation.
Sangjisheng (Taxillus Branch, 3 qian) Chao Duzhong (Stir-fried Eucommia Bark, 3 qian) Chao Baishao (Stir-fried White Peony Root, 1.5 qian) Sheng Muli (Raw Oyster Shell, 4 qian) Quan Danggui (Whole Angelica Sinensis Root, 2 qian) Fupenzi (Raspberry, 3 qian) Muhudie (Diopterygium Leaf, 4 fen) Lueemei (Green Calyx Plum, 1.5 qian) Chongweizi (Leonurus Fruit, 3 qian) Xiangfu (Cyperus Rhizome, 3 qian) Jixueteng (Spatholobus Stem, 3 qian)
Decocted in clear water, eight doses.
Commentary by Jie: Both Chong and Ren vessels are deficient. Liver depression forms a mass (Zha). Therefore, treatment uses softening the Liver and securing the Kidney, regulating Qi and activating Blood.
Case 8
Gu from Anchang: Qi depression forms Bi syndrome (obstruction). Pulse is choppy. Right Cun and Guan positions are wiry. Hoarseness. Abdominal pain with mass (Zha). Menstruation occurs early. Treatment should drain and descend, clearing the Liver. (27th day of the 3rd lunar month)
Gualou Pi (Trichosanthes Peel, 3 qian) Shijueming (Halois Concha, 6 qian, raw and crushed) Chuanlianzi (Toosendan Fruit, 3 qian) Chongweizi (Leonurus Fruit, 3 qian) Xiebai (Allium Macrostemon Bulb, 1 qian) Danpi (Moutan Bark, 3 qian) Muhudie (Diopterygium Leaf, 4 fen) Lueemei (Green Calyx Plum, 1.5 qian) Huo Hu (Huo Shan Shi Hu / Dendrobium, 3 qian) Chao Yanhu (Stir-fried Corydalis Rhizome, 1.5 qian) Xinhui Pi (Xinhui Tangerine Peel, 1.5 qian)
Decocted in clear water, four doses.
Commentary by Jie: Unhappy emotions cause Liver depression transforming into Heat, leading to early menstruation. Qi rebels upward, causing chest and epigastric obstruction and Bi pain, and abdominal mass pain. Therefore, treatment focuses on draining the Liver and nourishing the Stomach.
Case 9
A certain patient: Diarrhea has not been resolved. Tongue color is thick on the left side. Menstruation occurs early. Epigastric stuffiness and Qi stagnation. Right pulse is deficient and fine. Left Guan position is deep and wiry. Liver Wood is excessively horizontal. Treatment should nourish Stomach, level the Liver, and regulate menstruation. (7th day of the 6th lunar month)
Huo Hu (Huo Shan Shi Hu / Dendrobium, 3 qian) Jixueteng (Spatholobus Stem, 3 qian) Tongcao (Tetrapanax Pith, 1.5 qian) Zi Xiangfu (Purple Cyperus Rhizome, 1.5 qian) Peilan (Eupatorium, 3 qian) Guya (Rice Sprout, 4 qian) Shilianzi (Nelumbo Nucifera Seed, 3 qian) Sheng Yiren (Raw Coix Seed, 4 qian) Danpi (Moutan Bark, 2 qian) Muhudie (Diopterygium Leaf, 4 fen) Danshen (Salvia Root, 3 qian)
Decocted in clear water, four doses.
Commentary by Jie: Diarrhea unresolved indicates carrying seasonal Damp-Heat. Early menstruation belongs to Liver Heat failing to store Blood. Liver Yang rebelling horizontally causes epigastric stuffiness and Qi stagnation, and left pulse deep and wiry. Stomach being overacted upon by Liver fails to generate Blood with the Chong vessel, resulting in right pulse deficient and fine. Treatment should attend to both sides, thus using agents to nourish Stomach and harmonize Blood, level Liver and leach Dampness.
Case 10
Shou from Anchang: Blood deficiency with hyperactive Wood. Pulse is wiry. Right side deficient and fine. Pulling pain in neck and back. Menstruation irregular in timing. Occasional pain in epigastrium. Night sleep slightly peaceful. Treatment should primarily tonify Heart and level Liver.
Danshen (Salvia Root, 3 qian) Danggui (Angelica Sinensis Root, 1.5 qian) Sheng Muli (Raw Oyster Shell, 4 qian) Xiaohuma (Sesamum Seed, 3 qian) Fushen (Poria with Hostwood, 4 qian) Chao Baishao (Stir-fried White Peony Root, 1.5 qian) Muhudie (Diopterygium Leaf, 4 fen) Jixueteng (Spatholobus Stem, 1.5 qian) Zaoren (Ziziphus Seed, 3 qian) Chao Duzhong (Stir-fried Eucommia Bark, 3 qian) Chuanlianzi (Toosendan Fruit, 3 qian)
Decocted in clear water, five doses.
Commentary by Jie: Liver governs sinews and stores Hun (Ethereal Soul). Kidney governs the Five Fluids and dislikes dryness. Now, because Kidney fluids cannot ascend, Heart does not generate Blood and menstruation is delayed. Liver fails to store Hun, causing restless night sleep. It fails to nourish sinews, causing pulling pain in neck and back extending to the epigastrium. Therefore, treatment focuses on tonifying Kidney and Heart, softening Liver and harmonizing Blood.
Case 11
Wang from Guali: Menstruation is scanty, late, and sluggish. Pulse is deficient, left side choppy. Lower back soreness and leukorrhea. Poor stomach appetite. Temporarily treat by nourishing Stomach, regulating menstruation, and astringing discharge.
Chai Hu (Chai Hu Shi Hu / Dendrobium, 3 qian) Jixueteng (Spatholobus Stem, 1.5 qian) Fupenzi (Raspberry, 3 qian) Xiaohuma (Sesamum Seed, 3 qian) Shentou Cao (Peilan/Eupatorium, 3 qian) Chao Duzhong (Stir-fried Eucommia Bark, 3 qian) Chuanduan (Dipsacus Root, 3 qian) Danshen (Salvia Root, 3 qian) Sheng Muli (Raw Oyster Shell, 4 qian) Guya (Rice Sprout, 4 qian) Zhixiangfu (Prepared Cyperus Rhizome, 3 qian)
Decocted in clear water, ten doses.
Commentary by Jie: The root of menstruation lies in the Chong Mai, which is subordinate to Yangming (Stomach). Now, due to poor stomach appetite, the Sea of Blood gradually dries up, hence menstruation is scanty, late, and sluggish. Kidney deficiency and insecure Dai Mai (Girdle Vessel) cause lower back soreness and leukorrhea. Treatment focuses on nourishing Stomach and tonifying Kidney, hoping for regulated menstruation and stopped leukorrhea.
Case 12
Wang from Guali: Menstruation is scanty, delayed, and sluggish. Qi rushes causing epigastric stuffiness. Left pulse choppy, right side wiry and slippery. Phlegm-Dampness sinking downward causes obstruction. Treatment should primarily nourish Blood and regulate Qi. (23rd day of the 4th lunar month)
Guishen (Angelica Sinensis Root Tip, 2 qian) Xian Banxia (Pinellia Ternata, 1.5 qian) Jixueteng (Spatholobus Stem, 3 qian) Zhixiangfu (Prepared Cyperus Rhizome, 3 qian) Chao Baishao (Stir-fried White Peony Root, 1.5 qian) Xinhui Pi (Xinhui Tangerine Peel, 1.5 qian) Chongweizi (Leonurus Fruit, 3 qian) Chenxiang (Agarwood, 4 fen) Chuanxiong (Ligusticum Rhizome, 1 qian) Sheng Muli (Raw Oyster Shell, 4 qian) Duzhong (Eucommia Bark, 3 qian)
Decocted in clear water, four doses.
Commentary by Jie: Wet-Phlegm sinks downward to the Dai Mai (Girdle Vessel), which cannot constrain and stops the flow of turbid fluid. But the Dai Mai connects to Chong and Ren. If Chong and Ren are both deficient, Qi rushes and menstruation is scanty and sluggish. Treatment focuses on tonifying Qi of Spleen and Kidney. Assisted by Liver-soothing herbs, making Blood abundant and Qi harmonious, so all ailments heal themselves.
Case 13
Gu from Anchang: Palpitations and leukorrhea. Menstruation is scanty, overly delayed. Lower back soreness. Pain below umbilicus. Pulse is soggy, choppy, and fine. Recently headache. Gums have swollen blisters. Treatment should modify Shengjin Dan. (20th day of the 5th lunar month)
Shengdi (Rehmannia Root, 3 qian) Xiaohuma (Sesamum Seed, 3 qian) Yuanzhi Rou (Polygala Root Flesh, 8 fen) Chao Duzhong (Stir-fried Eucommia Bark, 3 qian) Danggui (Angelica Sinensis Root, 1.5 qian) Chai Hu (Chai Hu Shi Hu / Dendrobium, 3 qian) Fushen (Poria with Hostwood, 4 qian) Shijueming (Halois Concha, 4 qian) Baishao (White Peony Root, 1.5 qian) Xiangfu (Cyperus Rhizome, 3 qian) Jixueteng Jiao (Spatholobus Gum, 1.5 qian)
Decocted in clear water, five doses.
Commentary by Jie: Fu Qingzhu said: The Dai Mai (Girdle Vessel) grows horizontally, connecting to the Ren Mai (Conception Vessel). The Ren Mai goes straight up, traveling to the lips and teeth. Between the lips and teeth, there is originally an uninterrupted spring of fluid. Descending through the Ren Mai to transform into Essence, if the Ren Mai has no hot Qi surrounding it, then the saliva in the mouth is fully transformed into Essence, entering the Kidney. Only if pathogenic Heat stays between the Lower Jiao, then Body Fluids cannot transform into Essence but instead transform into Dampness. This case shows deficiency of fluids and blazing heat in both Dai and Ren vessels. Therefore, Shengjin Dan is modified to nourish Blood, clear Heat, soften Liver, and calm Spirit.