妇人有经水忽来忽断，时疼时止，寒热往来者，人以为血之凝也，谁知是肝气不舒乎！夫肝属木而藏血，最恶
风寒。妇人当行经之际，腠理大开，适逢风之吹寒之袭，则肝气为之闭塞，而经水之道路亦随之而俱闭，由是腠理
经络，各皆不宣，而寒热之作，由是而起。其气行于阳分则生热，其气行于阴分则生寒，然此犹感之轻者也。倘外
感之风寒更甚，则内应之热气益深，往往有热入血室，而变为如狂之症。若但往来寒热，是风寒未甚而热未深耳。
治法宜补肝中之血，通其郁而散其风，则病随手而效，所谓治风先治血，血和风自灭，此其一也。
方用加味四物汤。
大熟地（一两，九蒸） 白芍（五钱，酒炒） 当归（五钱，酒洗） 川芎（三钱，酒洗） 白术（五钱，土炒） 粉
丹皮（三钱） 元胡（一钱，酒炒） 甘草（一钱） 柴胡（一钱）
水煎服。此方用四物以滋脾胃之阴血；用柴胡、白芍、丹皮以宣肝经之风郁；用甘草、白术、元胡以利腰脐而和
腹疼，入于表里之间，通乎经络之内，用之得宜，自奏功如响也。
眉批∶加荆芥穗（炒黑）一钱尤妙。
歌括∶经水忽来忽断焉，痛疼发作亦如然。
经行适逢风寒袭，补肝生血风自蠲。
加味四物地芍先，当归川芎和牡丹。
白术二胡并甘草，用之得当效可观。
妇女出现月经忽然来潮又忽然中断，疼痛时而发作时而停止，并伴有寒热交替症状的，人们往往认为是血液凝滞所致，却不知这其实是肝气不舒展的缘故！肝脏五行属木，负责贮藏血液，最厌恶风寒侵袭。女性在行经期间，腠理（皮肤毛孔及肌肉间隙）大开，此时若恰逢风吹、寒气袭体，就会导致肝气闭塞，进而使月经运行的通道也随之关闭。因此，腠理和经络都变得不通畅，寒热症状也就由此产生。当邪气行于阳分时则产生发热，行于阴分时则产生恶寒，但这还属于感受较轻的情况。如果外感的风寒更严重，那么体内对应的热气也会更深，常常会出现热邪进入血室，从而转变为类似发狂的症状。如果只是单纯的寒热往来，说明风寒并不严重，内热也不深。
治疗方法应当滋补肝中的血液，疏通郁结之气并驱散风邪，这样疾病就能随手而愈，正所谓“治风先治血，血和风自灭”，这是第一种情况。
方剂使用加味四物汤。
大熟地黄（一两，九次蒸制），白芍（五钱，酒炒），当归（五钱，酒洗），川芎（三钱，酒洗），白术（五钱，土炒），牡丹皮（三钱），延胡索（一钱，酒炒），甘草（一钱），柴胡（一钱）。
用水煎服。此方用四物汤来滋养脾胃的阴血；用柴胡、白芍、牡丹皮来宣散肝经的风邪郁结；用甘草、白术、延胡索来利腰脐并调和腹痛。药力作用于表里之间，通达经络之内，只要使用得当，自然能像回声一样迅速见效。
眉批：加入荆芥穗（炒黑）一钱效果尤其奇妙。
歌诀：
月经忽然来去断断续续，疼痛发作也是如此无常。
行经之时恰好遭遇风寒侵袭，补益肝血则风邪自除。
加味四物汤以熟地、白芍为先，配合当归、川芎与牡丹皮。
再加上白术、二胡（柴胡、延胡索）以及甘草，使用得当疗效可观。
Women who experience menstruation that suddenly starts and stops, with pain that comes and goes intermittently, accompanied by alternating chills and fever, are often thought to suffer from blood stasis. However, this is actually due to the stagnation of Liver Qi (Liver Qi Stagnation). The Liver belongs to Wood in the Five Elements and stores Blood; it is most averse to Wind-Cold invasion. During menstruation, the Cou Li (pores and interstitial spaces) are wide open. If exposed to wind and cold at this time, the Liver Qi becomes obstructed, causing the pathways for menstruation to close as well. Consequently, both the Cou Li and meridians become blocked, leading to the onset of chills and fever. When pathogenic factors move through the Yang aspect, heat is generated; when they move through the Yin aspect, cold is generated. This represents a mild degree of external contraction. If the external Wind-Cold is more severe, the internal heat response will be deeper, often resulting in Heat entering the Blood Chamber (Xue Shi), manifesting as symptoms resembling mania. If there are only alternating chills and fever, it indicates that the Wind-Cold is not severe and the internal heat is not deep.
The treatment method should focus on nourishing the Blood within the Liver, unblocking the stagnation, and dispersing the Wind. In this way, the disease will resolve quickly, following the principle: "To treat Wind, first treat the Blood; once the Blood is regulated, the Wind extinguishes itself." This is the first scenario.
The formula used is Jia Wei Si Wu Tang (Modified Four Substances Decoction).
Prepared Rehmannia Root (Shu Di Huang) - 1 liang, steamed nine times; White Peony Root (Bai Shao) - 5 qian, stir-fried with wine; Angelica Sinensis (Dang Gui) - 5 qian, washed with wine; Szechuan Lovage Rhizome (Chuan Xiong) - 3 qian, washed with wine; Atractylodes Macrocephala Rhizome (Bai Zhu) - 5 qian, stir-fried with soil; Moutan Cortex (Mu Dan Pi) - 3 qian; Corydalis Rhizome (Yan Hu Suo) - 1 qian, stir-fried with wine; Licorice Root (Gan Cao) - 1 qian; Bupleurum Root (Chai Hu) - 1 qian.
Decoct in water and take orally. This formula uses Si Wu Tang to nourish the Yin-Blood of the Spleen and Stomach; Chai Hu, Bai Shao, and Mu Dan Pi to disperse Wind-stagnation in the Liver Meridian; Gan Cao, Bai Zhu, and Yan Hu Suo to benefit the waist and umbilical region and harmonize abdominal pain. Acting between the exterior and interior, and penetrating within the meridians, if applied appropriately, it will yield results as swiftly as an echo.
Marginal Note: Adding 1 qian of Schizonepeta Spike (Jing Jie Sui), stir-fried until black, is particularly effective.
Verse:
Menstruation suddenly starts and stops, pain arises and subsides similarly.
During menstruation, exposure to Wind-Cold occurs; nourishing Liver Blood causes Wind to dissipate.
In Modified Four Substances, Shu Di and Bai Shao come first,
Followed by Dang Gui, Chuan Xiong, and Mu Dan Pi.
Add Bai Zhu, the two 'Hu' herbs (Chai Hu, Yan Hu Suo), and Gan Cao;
When used correctly, the efficacy is remarkable.