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(See the section on "Accumulation and Mass".) It treats women presenting with a Ge pulse (革脉,革脉: a pulse that is large, hollow, and tight, resembling a drum skin), which leads to spontaneous abortion or metrorrhagia.

Xu Dachun's commentary: Xuanfuhua Decoction (Caulis Bupleuri Inflorescence Decoction) appears twice in the *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet). One instance treats accumulation masses by unblocking Qi stagnation in the Liver; the other treats miscellaneous diseases in women by resolving the pathological transformation from Xian (弦, string-taut) and Kou (芤, scallion-stalk) pulses into a Ge pulse.

(The original formula is missing. Some say it consists of Ganjiang (Dried Ginger) and Ejiao (Donkey-hide Gelatin) decocted together. Lin Yun believes it is Jiao'ai Tang (Gelatin and Mugwort Decoction); the Jiao'ai Tang from *Qianjin Fang* can also be used.)

It is indicated for women with "Xian Jing" syndrome (陷经, sinking of the menses/uterine qi), characterized by continuous leakage of dark/black blood.

Rhyme verse:
Though the formula for Jiao Jiang Tang is lost, the symptoms remain clear;
Leaking black blood due to sinking menses requires careful discernment.
Ganjiang (Dried Ginger) is warm and lifts Qi;
Ejiao nourishes blood; hardness and softness harmonize Yin and Yang.

In the fourth year of Daoguang (1824), the third daughter-in-law of Governor Song of Fuzhou, Fujian, suffered from abdominal pain and fever at midnight, more than three months postpartum. Her menstrual blood suddenly gushed out bright red, followed by black clots, then a mixture of blood and water. The bleeding was profuse and unstoppable, amounting to approximately three or four basins. She fell into unconsciousness with clenched jaw. I was summoned to diagnose her at the fifth watch (early morning). After administering the powder, Ganjiang disperses cold and lifts sinking Qi. This aligns with the therapeutic principles of "lifting what has sunk, dispersing what is stagnant, and tonifying/nourishing what is injured."

It treats women whose lower abdomen is full and distended like a "Dun" (敦, an ancient lidded food vessel), with slightly difficult urination but no thirst. This indicates that both water and blood are bound in the Blood Chamber (血室, uterus). This decoction is indicated.

Da Huang (Rhubarb Root and Rhizome, 4 liang), Gan Sui (Kansui Root, 2 liang), E Jiao (Donkey-hide Gelatin, 2 liang).

These three ingredients are decocted in 3 sheng of water to yield 1 sheng. Take orally in one dose. The blood stasis should be discharged.

Rhyme verse:
The lower abdomen rises like a Dun vessel,
Blood stasis and water dampness both overflow (bound in the Blood Chamber).
Four liang of Da Huang, two liang each of Gan Sui and E Jiao;
One dose clears the stasis, and the disease naturally resolves.

Xu Dachun's commentary: In this formula, Da Huang attacks blood accumulation, and Gan Sui attacks water accumulation. The brilliance lies in E Jiao, which is originally derived from the pure waters of Ji River, circulating underground and converging at wells in the ancient Dong'e County. This formula utilizes the principle of "using water to move water." The *Nei Jing* states that Ji River water internally connects with the Heart. Using hide from black mules to make gelatin, where black corresponds to the Kidney, allows Water to control Fire; when Fire is extinguished, blood is generated naturally. This formula employs the principle of "tonification as a method of purgation." However, Gan Sui should perhaps be used at half dosage.