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A widow presented with internal heat, afternoon tidal fever, abdominal distension, hypochondriac pain, soreness and numbness of the limbs, occasional expectoration of phlegm, irregular menstruation, and leukorrhea that was green or yellow. Xue Lizhai stated: This is caused by depression and anger damaging the Liver and Spleen. In the morning, administer Guipi Tang (Spleen-Restoring Decoction) to resolve Spleen Qi stagnation and generate Spleen Qi; in the evening, administer Jiawei Xiaoyao San (Modified Free and Easy Wanderer Plus Decoction) to nourish Liver Blood and clear Liver Fire. After more than a hundred doses, she recovered.

The disease of Benglou (metrorrhagia and metrostaxis) is caused by deficiency of both Qi and Blood in the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel). The classics state: The Chong Mai is the Sea of the Five Zang and Six Fu Organs, and all organs receive from it. It is also said to be the Sea of Blood for the Twelve Meridians. Because it receives the infusion from various meridians, Essence and Blood are stored here. It is further stated: The Chong Mai and Ren Mai both originate from the Bao Zhong (Uterus/Cavity). The Chong Mai runs alongside the Foot-Shaoyin Kidney Meridian, flanking the umbilicus upwards, dispersing at the chest. The Ren Mai ascends along the interior of the abdomen to the throat, face, and eyes. It is also said: When the Ren Mai is unobstructed and the Tai Chong Mai is vigorous, menstruation arrives on time. Thus, these two vessels maintain Yin-Yang harmony, circulate externally through the meridians, and nourish internally the Zang-Fu organs; how could Benglou occur? If laborious injury fails to constrain the menstrual blood, sudden profuse bleeding occurs like a mountain collapse, hence termed "Bengzhong" (Central Collapse). Long-standing Beng becomes Louxia (continuous dripping), presenting as deficiency, heat, combined deficiency-heat, or injury from sexual excess. Deficiency leads to seepage downward; Heat leads to reckless flow; Injury leads to loss of function. In acute cases, treat the branch first; stop the bleeding initially. If anger stirs Liver Fire causing blood boiling and bursting into Benglou, modify Jiawei Xiaoyao San. If Kidney Water deficiency fails to control the Minister Fire in the Bao Zhong, causing blood to run wild into Benglou, modify Baoyin Jian (Nourishing Yin Decoction) or Zuogui Yin (Left Restoring Drink). If excessive grief causes the Heart Qi to become urgent and the Bao Luo (Uterine Collaterals) to sever, [since Bao Mai belongs to the Heart and connects to the Bao Zhong, i.e., the Uterus, known as the Blood Chamber in women], severance prevents upper-lower communication, hyperactive Yang moves internally, forcing blood downward; modify Tianwang Buxin Dan (Emperor of Heaven's Heart-Nourishing Pill). If Heart Blood is insufficient, stagnation injures the Spleen, and blood lacks mastery and control, modify Jiawei Guipi Tang. According to Shen Shi: Treating Benglou requires greatly tonifying Qi and Blood, regulating the Spleen and Stomach, and slightly adding herbs to clear Heart and Liver Fire, tonifying Yin and draining Yang, so the blood stops naturally. Lizhai stated: For massive hemorrhage, urgently use Dushen Tang (Single Ginseng Decoction) to rescue. Therefore, Benglou invariably involves prior damage to the Spleen and Stomach; thus, those who can accept tonification are curable. If purely using cold-cooling hemostatic drugs, it further damages the Spleen and Stomach, making it even harder to control blood, which accelerates danger. Examining *Jinkui Yaolue*, Jiaoai Siwu Tang (Gelatin and Mugwort Four Substances Decoction) is used to treat women with sinking Jing, leaking black blood that does not resolve. Hence, Dong Yuan proposed it may belong to Cold patterns. Although this condition is mostly deficiency-heat, one must not fail to observe the infinite variations of pathology.

Guangbiji Fang (also made into pills) is very effective for treating Benglou.
Renshen (Ginseng Radix), Huangqi (Astragali Radix, [tonifies Blood to control it]), Shengdi (Rehmanniae Radix), Baishao (Paeoniae Radix Alba, [cools Blood to stop bleeding, 3 qian each)], Maidong (Ophiopogonis Radix, [Heart governs Blood; if Heart is clear, Blood does not move recklessly, 5 qian]), Zaoren (Ziziphi Spinosae Semen), Gouqi (Lycii Fructus, [3 qian each]), Duzhong (Eucommiae Cortex, [2 qian]), Xuduan (Dipsaci Radix, [Liver stores Blood; tonifying Liver ensures Blood has its return path, 2 qian]), Ejiao (Asini Corii Colla, [replenishes if much blood is lost. Genuine product is rare; substitute with Shudi or Biejia/Turtle Shell and Guijia/Tortoise Shell, 5 qian each; Turtle Shell unblocks Ren Mai, Biejia enters Liver Meridian, both tonify Yin and remove heat]), Yurou (Corni Fructus, [2 qian]), Wuweizi (Schisandrae Chinensis Fructus, [for slippery leakage, use sour astringents]), Jingjie (Schizonepetae Herba, [for seeping downward, use lifting agents, stir-fried, 8 fen each)]. If heat is severe, temporarily add Diyü (Sanguisorbae Radix) and Huaihua (Sophorae Flos).
This formula tonifies Qi and benefits Blood, nourishes Yin and clears Heat, combining sour astringency and lifting action. Its principles are comprehensive and complete, hence it is often effective. According to Jiayan: If Tiangui (Heavenly Water/Menstrual Essence) has exhausted and menstrual cycles have ceased, yet bleeding occurs like Benglou, this is Tuorong (Depletion of Glory), requiring great tonification. Urgently treat with cooling Blood and clearing Fire formulas.

Jiawei Xiaoyao San, Baoyin Jian (Niuxi is contraindicated in this formula), Zuogui Yin, Tianwang Buxin Dan, Jiawei Guipi Tang (all see under Xu Lao/Wasting-Thirst).
These five formulas can all treat Benglou; one must examine the etiology and modify/select accordingly.
The pulse should be weak and fine, not full and large.