经病百端血滞枯，
妇人以血为主，天真气隆，壬癸水合，肾气全盛，血脉流行，常以三旬一见，以象月盈则亏，故曰月经。经
行与产后一般，若其时余血一点未净，或外被风寒及湿冷暑热邪气，或内伤生冷，七情郁结，为痰为瘀，凝
积于中，曰血滞。或经止后，用力太过，入房太甚，及服食燥热，以致火动，邪气盛而津血衰，曰血枯。《良方
》云∶经后被惊，则血气错乱妄行，逆于上，则从口鼻而出；逆于身，则水血相搏变为水肿。恚怒则气血逆于腰
腿、心腹、背胁、手足之间重痛，经行则发，过期则止。怒极伤肝，则有眩晕、呕血、瘰 、血风、疮疡等病；
加之经血渗漏于其间，遂成窍穴生疮，淋沥不断。湿热相搏，遂为崩带；血结于内，变为 瘕，凡此变证百出，
不过血滞与枯而已。但血滞亦有虚热，血枯亦有虚热，故重则经闭不通，以滞、枯分言；轻则经水不调，止言虚
与热而已。
滞宜破血枯补虚；
血滞经闭宜破者，原因饮食热毒，或暴怒凝瘀积痰，直须大黄、干漆之类，推陈致新，俾旧血消而新血生
也。若气旺血枯，起于劳役忧思，却宜温和滋补；或兼有痰火湿热，尤宜清之凉之。每以肉桂为佐者，热则血行
也，但不可纯服峻药，以亏阴道。至于耗气益血之说，虽女科要法，但血为气配，气热则热，气寒则寒，气升
则升，气降则降，气行则行，气滞则滞。如果郁火气盛于血者，方可单香附丸、散，抑气散，常加木香、槟榔、
枳壳以开郁行气。若气乱则调，气冷则温，气虚则补，男女一般。阳生则阴自长；气衰则血亦涸，岂可专耗其
气耶！论者多泥叔和血旺气衰，不知叔和论肝肺二脉，则宜肝旺于肺，其实气血平和有孕，故继曰两脏通和。
但妇人见偏性鄙，婢外家志不得伸，郁怒无时不起，故香附为女人仙药。经曰∶邪气盛则实，正气夺则虚。可不
悟诸！
滞因外感伤冷郁，
经行登厕，风寒入内，以致凝涩者，小温经汤。经行适来，或得寒热，就闭不通，或寒或暑，俱谓之热入
血室，小柴胡汤加生地，或黄芩芍药汤加生地。经行过食生冷，或外被冷湿，以致瘀血凝结者，五积散去麻黄，
加牡丹皮、红花。七情心气郁结不行者，分心气饮去羌活、半夏、桑皮、青皮，加川芎、当归、香附、莪术、
玄胡索；有火者，更加黄芩，或小调经散、单香附丸。
也有盛实欠宣疏；
气血盛实，经络遏闭，或时挟痰者，单大黄膏，或马鞭草取汁熬膏为丸，或烧存性，红花、当归煎汤下。
枯伤劳食或作泄，
内伤饮食劳倦，损伤脾胃，气弱体倦，发热，腹痛，肠鸣，饮食减少而不生血者，补中益气汤，加川芎、
生地、天花粉。有肠鸣，月水不来者，病在胃，胃虚不生血气，宜单浓朴五钱，空心水煎，或单苍术膏。水泄
少食者，升阳益
胃汤；无泄少食者，二陈汤加白术、黄 、便制香附、当归、芍药、牡丹皮、麦门冬、山楂、麦芽。因饮食积
者，更加莪术、枳壳。
湿痰胃热分胖 ；
湿痰粘住血海地位经闭者，导痰汤加川芎、黄连，不可服地黄，泥膈故也。如用须姜汁炒过。胃热消渴，
善食渐瘦，津液为热燥渴者，宜泻胃热，四物汤合调胃承气汤，名玉烛散，再合凉膈散，名三和散。轻者，小
柴胡汤合四物汤去人参、半夏，加天花粉。素虚形瘦，口燥，善食浓味，郁为痰火，有潮者，逍遥散加黄芩；
无潮者，四物汤加桃仁、红花，或加味养荣丸。大概肥人多气弱有湿痰，瘦人多血怯有火。
脱血入房胞气竭，
少年大脱血，或醉后入房，气竭肝肠，月事衰少者，乌贼丸。
或多产育过劳劬。
堕胎及多产育伤血，或误用汗下克伐之药，以致血衰气乏不行者，十全大补汤。
不通大概只如此，
虚、热、痰、气四证而已，不调亦大相同。随证调治，饮食调和，自然血气流通。更有凝滞，然后可用
红花当归散、紫葳散、通经丸、导经丸之类。虚者只用当归散以通之，通后又须养血益阴，使津液流通。苟不
务气血充和，而惟以毒药攻逼，是求千金于乞丐，必死而后已。以上言经水不通，以下言经水不调。
不调前后色何如？
以期言之，对期者，性和血足，易来，或只差一二日者，亦不为害；以色言之，心主血，阴从阳，故以色
红为正，虽不对期，而色正者易调。
后期来少血不足，
后期三五日者为血虚，四物汤加参、 、白术、陈皮、升麻。瘦人只是血少，四物汤倍归、地，少加桃仁、
红花；肥人多痰，二陈汤加南星、苍术、滑石、芎、归、香附。来少色和者，四物汤；点滴欲闭，潮烦，脉数
者，四物汤去芎、地，加泽兰叶三倍、甘草少许，十味香附丸；内寒血涩来少，或日少五六日以上者，四物汤
加桃仁、红花、牡丹皮、葵花。
先期来多血有余；
先期三五日者为血热，四物汤加芩、连，肥人加痰药。先十数日者，血气俱热也，四物汤加黄芩、柴胡、
香附；肥人，清海苍莎丸加黄连、白术。来多或日多五六日以上者，内热血散也，四物汤加芩、术。瘦人有火
者，固经丸；肥人多痰者，清海苍莎丸。
或前或后气血乱，
或前或后，或多或少，或逾月不至，或一月再至，当归散、调经散、单丹参散。
淋沥不断邪未疏。
时行时止，淋沥不断，腹中作痛，乃寒热邪气客于胞中，留滞血海外疼也。如有积，下利不定，有所去则
愈。脐下逆气上攻胸膈欲呕者，桃仁散，或用当归四钱，干漆三钱，蜜丸服。如腰脐腹痛者，牛膝散；或行或
止、心痛者，失笑散。经水适来适断，往来寒热者，先服小柴胡汤加地黄，后以四物汤和之。有月事频数者，
四物汤倍芍药，加黄 ；有经行不止者，四物汤加地榆、阿胶、荆芥，热者倍黄芩，或吞固经丸。
风热色紫甚则黑，淡因痰滞湿模糊；
色紫者，风也；黑者，热甚也；淡白者，虚也，或挟痰停水以混之也；如烟尘水、如屋漏水、如豆汁、或
带黄混浊模糊者，湿痰也；成块作片、色不变者，气滞也，或风冷乘之也；色变紫黑者，血热也。大概紫者，
四物汤加防风、白芷、荆芥；黑者，四物汤加芩、连、香附；淡白者，古芎归汤加参、 、白芍、香附；有痰
者，二陈汤加芎、归；如烟尘者，二陈汤加秦艽、防风、苍术；如豆汁者，四物汤加芩、连；成块者，四物
汤加香附、玄胡索、枳壳、陈皮，随证选用。通用琥珀调经丸、百子附归丸、墨附丸。
外证潮热内腹痛，
月水循环，纤 不作而有子。若兼潮疼，重则加之咳血、汗、呕，或泻。有潮汗则血愈消耗，有咳、呕则
气往上行，泻则津偏于后，疼则积结于中。是以必先去病，而后可以滋血调经。就中潮热、疼痛，尤为妇女常
病。盖血滞积入骨髓，便为骨蒸；血滞积瘀于中，与日生新血相搏，则为疼痛。血枯不能滋养百骸，则蒸热于
外；血枯胞络火盛，或挟痰气、食积、寒冷外邪，则为疼痛。潮热有时，为内伤为虚；无时，为外感为实。虚
者，大温经汤∶热者，四物汤加柴、芩。经闭者，滋血汤；骨蒸者，大胡连丸、大乌鸡丸。五心潮者，四物汤
加黄连、胡黄连。无汗者，茯苓补心汤；有汗者，逍遥散。经前潮者，血虚有滞，逍遥散加牡丹皮、桃仁、玄
胡索；经后潮者，血虚有热，逍遥散去柴胡换地骨皮，加生地、便炒黄芩，此方能加减，退热圣药。有咳加桑
白皮、贝母、桔梗、知母、麦门冬；咳血加生地、山栀，牡丹皮；呕吐加陈皮、半夏、旋复花；嘈杂加姜炒黄
连，或芩连二陈汤。寻常潮热者，肾气丸、大造丸，或四物汤料，加便炒黄芩各一两、四制香附丸一斤，蜜丸
服。
痛滞经前虚后呼。
此言腹痛也。经事欲行，脐腹绞痛者，为血滞，四物汤料四钱，加玄胡索、苦楝、木香、槟榔各一两；痛
甚者，万痛丸。经水临行时痛者为气滞，乌药汤。气滞血瘀者，大玄胡索散，或四物汤加桃仁、红花、莪术、
玄胡索、香附、木香；发热，加柴、芩。经水将来，阵痛阵止者为血实，四物汤加玄胡索、木香、黄连、香附，
腿腹痛者，内补当归丸。经水将行，被风冷相搏，绕脐疝痛者，乃寒气客于血室，大温经汤、桂枝桃仁汤。
经水已来，时痛者，四物汤加陈皮、玄胡索、牡丹皮、甘草。经后痛者为血虚，八物汤、小乌鸡丸。历年血寒，
积结胞门，呕吐涎唾，脐胁疝痛，阴冷彻引腰脊而痛者，酒煮当归丸、大温经汤。通用交加地黄丸、滋阴百
补丸、七制香附丸。
水肿经前血肿后，
经水断而后肿，名曰血分。乃瘀血化水，闭塞胞门，比水肿更难治。但能调其经，则水自消，小调经散、
葶归丸。先浮肿而后经水不通，名曰水分。乃脾不能制血，与水并浮，肌肉为之虚肿，红矾丸。通用肾气丸，
水分君泽泻，加防己、葶苈、木通；血分君牡丹皮，加牛膝、红花。有经闭脚肿者，桑皮散。
血风身痛痹皮肤；
血风乃气血虚而袭风冷，身体历节痛者，大芎 散、麒麟竭丸、趁痛散、血风丸。经闭身痛溺涩，阴虚
湿热甚也，四物汤加苍术、陈皮、牛膝、甘草，水煎频服，间用苍莎丸加苍耳、白芍。经先期者，苍莎丸加苍
耳、白芍、龟板，金毛狗脊；经后期者，逍遥散。皮肤瘙痒者，四物汤加荆芥，或古乌荆丸；肌肉顽麻者，乌
头丸。上攻头目晕倒者，单苍耳散；关项脊痛者，柴胡调经汤。头身痛，寒热咳嗽，怔悸，一切杂证，人参荆
芥散。素虚者，女金丹、史国公浸酒方。胎前、产后皆同。
养胃通心真要法，
经曰∶二阳之病发心脾。盖冲为血海，任主胞胎，二脉起于胞内，为经络之海，与手太阳小肠、手少阴
心为表里，主上为乳汁，下为月水。月水乃经络之余，冲任气盛，则血根据时而下。忧思耗伤心血，以致火炎，
血不归肝，而出纳之用已竭，母令子虚，脾亦不磨而食少，食少则肺金失养，水绝生化之源而经闭不调。治者，
须知心为气血之主，心气郁结者，宜调心血，通心经而血自行。脾胃为气血之运，饮食劳倦损其中气，以血少
不行，或行之间断者，只宜平胃散、四君子汤之类补养脾胃，而气血自生自运，乃标本兼治，法之良者也。
室女扶阴抑寡居。
女子十四，冲任盛而月事下，必近二十，方可匹配，可见阴气之难成也。或恣食咸酸煎炒热燥，以致气血
上壅不通者，红花当归散、紫葳散，单大黄膏。如逾年未嫁，或年未及而
思男，思伤心血，火炎脾亏，肺烁肾枯，而血闭成痨者，十分难治，宜四物汤加黄芩、柴胡；或逍遥散加山栀、
芩、连，以养血凉血降火；或肾气丸加子芩、红花，养阴柏子丸亦好。因怒逆者，四制香附丸加黄芩、生地；
因惊者，抱胆丸。经绝不通者，瓦松散。寡妇郁闷百端，或慕夫不能顿忘，或门户不能支持，或望子孙昌盛，
心火无时不起，加之饮食浓味，遂成痰火。其证∶恶风、体倦、乍寒乍热、面赤、心烦，或时自汗，肝脉弦长。
当抑肝之阴气，柴胡抑肝汤、抑阴地黄丸、越鞠丸。如贫苦淡食者，四制香附丸主之。有每日上午神思昏愦，
怕见明处，恶闻人语，至午后方可，及头昏、腹痛、惊惕，稍涉劳动，与月经来时，其证尤剧，此不得遂志之
故也，宜清神养荣，四物汤加人参、茯神、陈皮、柴胡、羌活、甘草、香附。有与鬼交通者，由神不守舍，或
时独笑，或泣，脉迟伏，或如雀啄，不知度数，颜色不变者，宜茯神、羌活、蔓荆子、防风、薏苡仁、黄 、
五味子、麦门冬、石菖蒲、黄芩、甘草，水煎服。
妇女以血为本，当先天真气旺盛，壬癸水（肾水）相合，肾气全盛时，血脉运行通畅，通常每三十天来潮一次，这象征着月亮由盈转亏的规律，因此称为“月经”。经期与产后的情况相似，如果此时体内还有余血未排净，或者外感风寒、湿冷、暑热等邪气，或者内伤生冷食物，以及七情（喜、怒、忧、思、悲、恐、惊）郁结，导致形成痰浊或瘀血，凝结在体内，这就叫做“血滞”。如果在月经结束后，用力过度、房事过频，或者服用燥热食物，导致虚火内生，邪气亢盛而津液血液衰少，这就叫做“血枯”。《良方》中说：月经后受到惊吓，会导致气血错乱妄行，逆冲于上，就会从口鼻出血；逆冲于身体，就会水血相搏变成水肿。愤怒会导致气血逆乱于腰腿、心腹、背胁、手足之间，出现剧烈疼痛，经期发作，过期则停止。大怒伤肝，会出现眩晕、呕血、瘰疬、血风、疮疡等疾病；加上经血渗漏在这些部位，就会形成窍穴生疮，淋漓不断。湿热相搏，就会造成崩漏和带下；血液凝结在体内，会变成癥瘕。所有这些变证层出不穷，不过都是血滞和血枯罢了。但是，血滞也有虚热的情况，血枯也有虚热的情况，所以严重的表现为经闭不通，这是分别论述滞和枯；轻微的表现为月经不调，只论述虚和热而已。
对于血滞应当破血，对于血枯应当补虚。
如果是血滞导致的经闭，适合用破血法，原因是饮食中的热毒，或者暴怒导致凝瘀积痰，必须使用大黄、干漆之类的药物，推陈出新，使旧血消除而新血生成。如果是气旺血枯，起因于劳累和忧思，却适宜温和滋补；如果兼有痰火湿热，尤其适宜清热凉血。每用肉桂作为辅助，是因为热能促进血行，但不可单纯服用峻猛的药物，以免亏损阴血。至于耗气益血的说法，虽然是妇科的重要法则，但血是气的配偶，气热则热，气寒则寒，气升则升，气降则降，气行则行，气滞则滞。如果是郁火之气盛于血的情况，才可以单独使用香附丸、散，或者抑气散，常加木香、槟榔、枳壳来开郁行气。如果气乱则调气，气冷则温气，气虚则补气，男女都一样。阳气生长则阴血自然增长；气衰则血液也会枯竭，怎么能专门耗损其气呢！评论的人大多拘泥于叔和所说的“血旺气衰”，不知道叔和论述的是肝肺二脉，即肝气应旺于肺气，其实气血平和才能受孕，所以他接着说两脏通和。只是妇人见识偏狭鄙陋，婢女和外家女子志向不得伸展，郁怒无时无刻不起，所以香附被称为女人的仙药。医经说：邪气盛则实证，正气夺则虚证。对此能不醒悟吗！
血滞因外感伤冷郁结：
经期如厕，风寒入内，导致凝涩的，用小温经汤。经期适逢来潮，或者感受寒热，导致闭经不通，无论寒邪还是暑邪，都称为热入血室，用小柴胡汤加生地，或者黄芩芍药汤加生地。经期过食生冷，或者外受冷湿，导致瘀血凝结的，用五积散去麻黄，加牡丹皮、红花。七情导致心气郁结不行的，用分心气饮去羌活、半夏、桑白皮、青皮，加川芎、当归、香附、莪术、玄胡索；有火的，再加黄芩，或者小调经散、单香附丸。
也有气血盛实欠宣疏的：
气血盛实，经络遏闭，或者时常挟痰的，用单大黄膏，或者马鞭草取汁熬膏为丸，或者烧存性，用红花、当归煎汤送服。
血枯因劳倦饮食损伤或导致泄泻：
内伤饮食劳倦，损伤脾胃，气弱体倦，发热，腹痛，肠鸣，饮食减少而不生血的，用补中益气汤，加川芎、生地、天花粉。有肠鸣，月经不来的，病在胃，胃虚不生血气，宜单用浓朴五钱，空腹水煎，或者单用苍术膏。水样腹泻且少食的，用升阳益胃汤；无腹泻但少食的，用二陈汤加白术、黄芪、便制香附、当归、芍药、牡丹皮、麦门冬、山楂、麦芽。因饮食积滞的，再加莪术、枳壳。
湿痰与胃热需分辨胖瘦：
湿痰粘住血海位置导致经闭的，用导痰汤加川芎、黄连，不可服用地黄，因为会碍膈故也。如果用须姜汁炒过。胃热消渴，善食渐瘦，津液被热燥渴的，宜泻胃热，四物汤合调胃承气汤，名叫玉烛散，再合凉膈散，名叫三和散。轻症的，用小柴胡汤合四物汤去人参、半夏，加天花粉。素体虚弱形体消瘦，口燥，善食浓味，郁结为痰火，有潮热的，用逍遥散加黄芩；无潮热的，用四物汤加桃仁、红花，或者加味养荣丸。大概肥人多气弱有湿痰，瘦人多血怯有火。
脱血后入房导致胞气竭：
少年大脱血，或者醉后入房，气竭肝肠，月经衰少的，用乌贼丸。
或者多产育过劳：
堕胎及多产育伤血，或者误用汗下克伐之药，导致血衰气乏不行的，用十全大补汤。
不通大概只有这些情况：
虚、热、痰、气四证而已，不调也大致相同。随证调治，饮食调和，自然血气流通。如果有更多凝滞，然后可用红花当归散、紫葳散、通经丸、导经丸之类。虚者只用当归散以通之，通后又须养血益阴，使津液流通。如果不致力于气血充和，而只用毒药攻逼，这是向乞丐求千金，必死而后已。以上言经水不通，以下言经水不调。
不调前后颜色如何？
以时间来论，按期而来的，说明性和血足，容易来潮，或者只差一二日的，也不为害；以颜色来论，心主血，阴从阳，所以以色红为正，虽然不对期，而色正的容易调理。
后期来少为血不足：
后期三五日来的为血虚，用四物汤加参、芪、白术、陈皮、升麻。瘦人只是血少，用四物汤倍用归、地，少加桃仁、红花；肥人多痰，用二陈汤加南星、苍术、滑石、芎、归、香附。来少色和的，用四物汤；点滴欲闭，潮烦，脉数的，用四物汤去芎、地，加泽兰叶三倍、甘草少许，十味香附丸；内寒血涩来少，或者日少五六日以上者的，用四物汤加桃仁、红花、牡丹皮、葵花。
先期来多为血有余：
先期三五日来的为血热，用四物汤加芩、连，肥人加痰药。先十数日来的，血气俱热也，用四物汤加黄芩、柴胡、香附；肥人，用清海苍莎丸加黄连、白术。来多或日多五六日以上者的，内热血散也，用四物汤加芩、术。瘦人有火的，用固经丸；肥人多痰的，用清海苍莎丸。
或前或后气血乱：
或前或后，或多或少，或者逾月不至，或者一月再至，用当归散、调经散、单丹参散。
淋沥不断为邪未疏：
时行时止，淋沥不断，腹中作痛，乃寒热邪气客于胞中，留滞血海外疼也。如有积，下利不定，有所去则愈。脐下逆气上攻胸膈欲呕的，用桃仁散，或者用当归四钱，干漆三钱，蜜丸服。如腰脐腹痛的，用牛膝散；或者行或止、心痛的，用失笑散。经水适来适断，往来寒热的，先服小柴胡汤加地黄，后以四物汤和之。有月事频数的，用四物汤倍芍药，加黄芪；有经行不止的，用四物汤加地榆、阿胶、荆芥，热的倍黄芩，或者吞固经丸。
风热色紫甚则黑，淡因痰滞湿模糊：
色紫的，是风；黑的，是热甚；淡白的，是虚，或者挟痰停水以混之；如烟尘水、如屋漏水、如豆汁、或者带黄混浊模糊的，是湿痰；成块作片、色不变的，是气滞，或者风冷乘之；色变紫黑的，是血热。大概紫的，用四物汤加防风、白芷、荆芥；黑的，用四物汤加芩、连、香附；淡白的，用古芎归汤加参、芪、白芍、香附；有痰的，用二陈汤加芎、归；如烟尘的，用二陈汤加秦艽、防风、苍术；如豆汁的，用四物汤加芩、连；成块的，用四物汤加香附、玄胡索、枳壳、陈皮，随证选用。通用琥珀调经丸、百子附归丸、墨附丸。
外证潮热内腹痛：
月水循环，纤毫不作而有子。如果兼有潮疼，重的加之咳血、汗、呕，或者泻。有潮汗则血愈消耗，有咳、呕则气往上行，泻则津偏于后，疼则积结于中。所以必须先去除病邪，然后才可以滋血调经。其中潮热、疼痛，尤为妇女常病。盖血滞积入骨髓，便为骨蒸；血滞积瘀于中，与日生新血相搏，则为疼痛。血枯不能滋养百骸，则蒸热于外；血枯胞络火盛，或者挟痰气、食积、寒冷外邪，则为疼痛。潮热有时，为内伤为虚；无时，为外感为实。虚的，用大温经汤；热的，用四物汤加柴、芩。经闭的，用滋血汤；骨蒸的，用大胡连丸、大乌鸡丸。五心潮热的，用四物汤加黄连、胡黄连。无汗的，用茯苓补心汤；有汗的，用逍遥散。经前潮热的，血虚有滞，用逍遥散加牡丹皮、桃仁、玄胡索；经后潮热的，血虚有热，用逍遥散去柴胡换地骨皮，加生地、便炒黄芩，此方能加减，退热圣药。有咳加桑白皮、贝母、桔梗、知母、麦门冬；咳血加生地、山栀，牡丹皮；呕吐加陈皮、半夏、旋复花；嘈杂加姜炒黄连，或者芩连二陈汤。寻常潮热者，用肾气丸、大造丸，或者四物汤料，加便炒黄芩各一两、四制香附丸一斤，蜜丸服。
痛滞经前虚后呼：
此言腹痛也。经事欲行，脐腹绞痛者，为血滞，用四物汤料四钱，加玄胡索、苦楝、木香、槟榔各一两；痛甚的，用万痛丸。经水临行时痛者为气滞，用乌药汤。气滞血瘀的，用大玄胡索散，或者四物汤加桃仁、红花、莪术、玄胡索、香附、木香；发热，加柴、芩。经水将来，阵痛阵止的为血实，用四物汤加玄胡索、木香、黄连、香附，腿腹痛的，用内补当归丸。经水将行，被风冷相搏，绕脐疝痛的，乃寒气客于血室，用大温经汤、桂枝桃仁汤。经水已来，时痛的，用四物汤加陈皮、玄胡索、牡丹皮、甘草。经后痛者为血虚，用八物汤、小乌鸡丸。历年血寒，积结胞门，呕吐涎唾，脐胁疝痛，阴冷彻引腰脊而痛的，用酒煮当归丸、大温经汤。通用交加地黄丸、滋阴百补丸、七制香附丸。
水肿经前血肿后：
经水断而后肿，名曰血分。乃瘀血化水，闭塞胞门，比水肿更难治。但能调其经，则水自消，用小调经散、葶归丸。先浮肿而后经水不通，名曰水分。乃脾不能制血，与水并浮，肌肉为之虚肿，用红矾丸。通用肾气丸，水分君泽泻，加防己、葶苈、木通；血分君牡丹皮，加牛膝、红花。有经闭脚肿的，用桑皮散。
血风身痛痹皮肤：
血风乃气血虚而袭风冷，身体历节痛的，用大芎 散、麒麟竭丸、趁痛散、血风丸。经闭身痛溺涩，阴虚湿热甚的，用四物汤加苍术、陈皮、牛膝、甘草，水煎频服，间用苍莎丸加苍耳、白芍。经先期的，用苍莎丸加苍耳、白芍、龟板，金毛狗脊；经后期的，用逍遥散。皮肤瘙痒的，用四物汤加荆芥，或者古乌荆丸；肌肉顽麻的，用乌头丸。上攻头目晕倒的，用单苍耳散；关项脊痛的，用柴胡调经汤。头身痛，寒热咳嗽，怔悸，一切杂证，用人参荆芥散。素虚的，用女金丹、史国公浸酒方。胎前、产后皆同。
养胃通心真要法：
医经说：二阳之病发心脾。盖冲为血海，任主胞胎，二脉起于胞内，为经络之海，与手太阳小肠、手少阴心为表里，主上为乳汁，下为月水。月水乃经络之余，冲任气盛，则血根据时而下。忧思耗伤心血，以致火炎，血不归肝，而出纳之用已竭，母令子虚，脾亦不磨而食少，食少则肺金失养，水绝生化之源而经闭不调。治者，须知心为气血之主，心气郁结的，宜调心血，通心经而血自行。脾胃为气血之运，饮食劳倦损其中气，以血少不行，或者行之间断的，只宜平胃散、四君子汤之类补养脾胃，而气血自生自运，乃标本兼治，法之良者也。
室女扶阴抑寡居：
女子十四，冲任盛而月事下，必近二十，方可匹配，可见阴气之难成也。或者恣食咸酸煎炒热燥，导致气血上壅不通的，用红花当归散、紫葳散，单大黄膏。如逾年未嫁，或者年未及而思男，思伤心血，火炎脾亏，肺烁肾枯，而血闭成痨的，十分难治，宜四物汤加黄芩、柴胡；或者逍遥散加山栀、芩、连，以养血凉血降火；或者肾气丸加子芩、红花，养阴柏子丸亦好。因怒逆的，用四制香附丸加黄芩、生地；因惊的，用抱胆丸。经绝不通的，用瓦松散。寡妇郁闷百端，或者慕夫不能顿忘，或者门户不能支持，或者望子孙昌盛，心火无时不起，加之饮食浓味，遂成痰火。其证：恶风、体倦、乍寒乍热、面赤、心烦，或者时自汗，肝脉弦长。当抑肝之阴气，用柴胡抑肝汤、抑阴地黄丸、越鞠丸。如贫苦淡食的，用四制香附丸主之。有每日上午神思昏愦，怕见明处，恶闻人语，至午后方可，以及头昏、腹痛、惊惕，稍涉劳动，与月经来时，其证尤剧，此不得遂志的缘故，宜清神养荣，用四物汤加人参、茯神、陈皮、柴胡、羌活、甘草、香附。有与鬼交通的，由神不守舍，或者时独笑，或者泣，脉迟伏，或者如雀啄，不知度数，颜色不变的，宜茯神、羌活、蔓荆子、防风、薏苡仁、黄芪、五味子、麦门冬、石菖蒲、黄芩、甘草，水煎服。
Menstrual disorders are numerous, primarily stemming from blood stasis (Xue Zhi) and blood deficiency (Xue Ku).
Women take blood as their foundation. When the innate qi (Tian Zhen Qi) is robust, the Ren and Du meridians (associated with Kidney water) harmonize, and Kidney qi is fully abundant, blood vessels flow smoothly. Menstruation typically occurs every thirty days, mirroring the waxing and waning of the moon; hence it is called "menstruation" (Jing Yue). The condition during menstruation is similar to that after childbirth. If residual blood remains unexpelled at this time, or if external pathogenic factors such as wind-cold, damp-cold, summer-heat, or heat invade, or if internal injury results from consuming raw/cold foods, or if emotional stagnation (Seven Emotions: joy, anger, worry, thought, sadness, fear, fright) leads to the formation of phlegm or blood stasis condensing within, this is termed "blood stasis" (Xue Zhi). If, after menstruation ends, one exerts excessive physical effort, engages in frequent sexual intercourse, or consumes drying and heating foods, causing deficient fire to arise, where pathogenic factors are hyperactive while body fluids and blood decline, this is termed "blood deficiency" (Xue Ku). *Liang Fang* states: If startled after menstruation, qi and blood become chaotic and flow recklessly. Reversing upward, bleeding may occur from the mouth and nose; reversing through the body, water and blood contend, transforming into edema. Anger causes qi and blood to reverse in the waist, legs, heart, abdomen, back, flanks, hands, and feet, causing severe pain that erupts during menstruation and ceases when overdue. Extreme anger injures the Liver, leading to vertigo, hematemesis, scrofula (Luo Li), blood wind (Xue Feng), sores, and ulcers. Combined with menstrual blood leaking into these areas, sores may form in orifices, dripping continuously. Damp-heat contending leads to metrorrhagia (Beng) and leukorrhea (Dai); blood coagulating internally transforms into masses (Zheng Jia). All these varied manifestations stem merely from blood stasis and blood deficiency. However, blood stasis can also involve deficient heat, and blood deficiency can also involve deficient heat. Thus, severe cases present as amenorrhea, discussed separately regarding stasis and deficiency; mild cases present as irregular menstruation, discussed only regarding deficiency and heat.
For blood stasis, blood-breaking methods are indicated; for blood deficiency, tonifying deficiency is indicated.
If amenorrhea is due to blood stasis suitable for blood-breaking, the cause is dietary heat-toxin or violent anger causing coagulated stasis and accumulated phlegm. One must use drugs like Da Huang (Rhei Radix et Rhizoma) and Gan Qi (Drynariae Rhizoma) to push out the old and bring forth the new, eliminating old blood so new blood can generate. If qi is abundant but blood is deficient, arising from labor and worry/thought, gentle warming and tonification are appropriate. If complicated by phlegm-fire or damp-heat, clearing and cooling are especially suitable. Using Rou Gui (Cinnamomi Cortex) as an assistant is because heat promotes blood circulation, but one must not solely administer harsh drugs to deplete yin-blood. Regarding the theory of depleting qi to benefit blood, although a key method in gynecology, blood is paired with qi: if qi is hot, it is hot; if cold, cold; ascending, descending, moving, or stagnant, it follows suit. Only if constrained fire and qi are hyperactive relative to blood should one use Xiang Fu Wan (Cyperi Rhizoma Pill) or San alone, or Yi Qi San (Suppress Qi Powder), often adding Mu Xiang (Aucklandiae Radix), Bing Lang (Arecae Semen), and Zhi Ke (Aurantii Fructus Immaturus) to open constraints and move qi. If qi is chaotic, regulate it; if cold, warm it; if deficient, tonify it—this applies to both men and women. When yang generates, yin naturally grows; when qi declines, blood dries up. How can one specifically deplete qi! Critics often cling to Shu He's statement that "blood is abundant and qi is deficient," unaware that Shu He was discussing the Liver and Lung pulses, implying Liver qi should be vigorous relative to Lung qi. In reality, balanced qi and blood allow conception, hence he continued saying the two organs must harmonize. However, women often have narrow perspectives; maids and daughters-in-law whose ambitions are unfulfilled experience constant郁怒 (depression and anger), making Xiang Fu (Cyperi Rhizoma) the "immortal herb" for women. The Classic says: "When pathogenic factors are abundant, it is excess; when healthy qi is depleted, it is deficiency." Should one not realize this?
Blood stasis due to external contraction, cold, and constraint:
If menstruation occurs while using the toilet, allowing wind-cold to enter and cause coagulation and涩 (stagnation), use Xiao Wen Jing Tang (Minor Warming the Menses Decoction). If menstruation coincides with onset, or exposure to cold/heat leads to closure and obstruction, whether from cold or summer-heat, it is called "Heat Entering the Blood Chamber" (Re Ru Xue Shi). Use Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Sheng Di Huang (Rehmanniae Radix), or Huang Qin Shao Yao Tang (Scutellaria and Peony Decoction) plus Sheng Di Huang. If excessive consumption of raw/cold foods during menstruation, or external exposure to cold-dampness, causes blood stasis to coagulate, use Wu Ji San (Five Accumulations Powder) minus Ma Huang (Ephedrae Herba), plus Mu Dan Pi (Moutan Cortex) and Hong Hua (Carthami Flos). If Seven Emotions cause Heart qi stagnation and failure to circulate, use Fen Xin Qi Yin (Dividing Heart Qi Drink) minus Qiang Huo (Notopterygii Rhizoma), Ban Xia (Pinelliae Tuber), Sang Bai Pi (Mori Cortex), and Qing Pi (Citri Reticulatae Pericarpium Viride), plus Chuan Xiong (Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Xiang Fu (Cyperi Rhizoma), E Zhu (Curcumae Rhizoma), and Yan Hu Suo (Corydalis Rhizoma); if there is fire, add Huang Qin (Scutellariae Radix), or use Xiao Tiao Jing San (Minor Regulating Menses Powder) or Dan Xiang Fu Wan (Single Cyperi Rhizoma Pill).
There are also cases of abundant/excess qi and blood lacking dissemination:
When qi and blood are abundant and excess, meridians are obstructed, or occasionally complicated by phlegm, use Dan Da Huang Gao (Single Rheum Paste), or extract juice from Ma Bian Cao (Verbena Herba), boil into paste for pills, or calcine until charred, taken with decoction of Hong Hua and Dang Gui.
Blood deficiency due to labor/dietary injury or diarrhea:
Internal injury from diet and fatigue damages the Spleen and Stomach, causing weak qi, body fatigue, fever, abdominal pain, borborygmus, reduced appetite, and failure to generate blood. Use Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction) plus Chuan Xiong, Sheng Di Huang, and Tian Hua Fen (Trichosanthis Radix). If there are borborygmus and absent menstruation, the disease is in the Stomach; Stomach deficiency fails to generate qi and blood. Use Niu Po (Magnoliae Officinalis Cortex) alone, five qian, decocted in water on an empty stomach, or Cang Zhu Gao (Atractylodis Macrocephalae Rhizoma Paste) alone. For watery diarrhea with poor appetite, use Sheng Yang Yi Wei Tang (Augment Yang and Benefit the Stomach Decoction); for no diarrhea but poor appetite, use Er Chen Tang (Two-Cured Decoction) plus Bai Zhu (Atractodis Macrocephalae Rhizoma), Huang Qi (Astragali Radix), Bian Zhi Xiang Fu (Prepared Cyperi Rhizoma), Dang Gui, Shao Yao (Paeoniae Radix), Mu Dan Pi, Mai Men Dong (Ophiopogonis Tuber), Shan Zha (Crataegi Fructus), and Mai Ya (Hordei Fructus Germinatus). If due to food accumulation, add E Zhu and Zhi Ke.
Differentiate damp-phlegm and Stomach heat by obesity/emaciation:
If damp-phlegm adheres to the Sea of Blood location causing amenorrhea, use Dao Tan Tang (Guiding Out Phlegm Decoction) plus Chuan Xiong and Huang Lian (Coptidis Rhizoma). Do not use Sheng Di Huang as it clogs the chest; if used, stir-fry with ginger juice. For Stomach heat with wasting-thirst, good appetite but gradual emaciation, and thirst due to fluid dryness from heat, clear Stomach heat using Si Wu Tang (Four Substances Decoction) combined with Tiao Wei Cheng Qi Tang (Regulate the Intestines and Direct Downward Decoction), named Yu Zhu San (Jade Candle Powder), further combined with Liang Ge San (Cool the Diaphragm Powder), named San He San (Three Harmonies Powder). For mild cases, combine Xiao Chai Hu Tang with Si Wu Tang, removing Ren Shen (Ginseng Radix) and Ban Xia, adding Tian Hua Fen. For those constitutionally deficient and thin, with dry mouth, preference for rich flavors, depression transforming into phlegm-fire, and tidal fever, use Xiao Yao San (Free and Easy Wanderer Powder) plus Huang Qin; without tidal fever, use Si Wu Tang plus Tao Ren (Persicae Semen) and Hong Hua, or Jia Wei Yang Rong Wan (Modified Nourishing Nutrient Pill). Generally, obese people have weak qi and damp-phlegm; thin people have fearful blood and fire.
Blood loss followed by intercourse leading to exhaustion of the Uterus qi:
In youth, after massive blood loss, or intercourse after drunkenness, exhausting qi and injuring Liver/intestines, with scant menstruation, use Ou Mei Wan (Cuttlebone Pill).
Or excessive labor from multiple births:
Abortion and multiple births injure blood, or misuse of sweating/purgative attacking drugs lead to blood deficiency and qi insufficiency failing to circulate. Use Shi Quan Da Bu Tang (Great Tonifying Ten Agents Decoction).
Obstruction generally presents thus:
Deficiency, Heat, Phlegm, and Qi stagnation constitute four syndromes; irregularity is largely similar. Treat according to syndrome, harmonize diet, and qi/blood will naturally circulate. If more stasis exists, then use Hong Hua Dang Gui San (Carthamus and Angelica Powder), Zi Wei San (Bignonia Powder), Tong Jing Wan (Unblocking Menses Pill), or Dao Jing Wan (Guiding Menses Pill). For deficiency, use Dang Gui San (Angelica Powder) to unblock, then nourish blood and benefit yin to ensure fluid circulation. If one does not strive for qi/blood abundance and harmony, but uses toxic drugs to attack, it is like seeking a thousand gold from a beggar; death will ensue. The above discusses amenorrhea; below discusses irregular menstruation.
What about the color before and after irregularity?
Regarding timing: arriving on schedule indicates balanced nature and sufficient blood, coming easily; being off by one or two days is also harmless. Regarding color: the Heart governs blood, yin follows yang, so red is the correct color. Even if not on schedule, if the color is correct, it is easy to regulate.
Late arrival with scant flow indicates blood insufficiency:
Arriving three to five days late indicates blood deficiency; use Si Wu Tang plus Ren Shen, Huang Qi, Bai Zhu, Chen Pi, and Sheng Ma. Thin people simply have little blood; use Si Wu Tang doubling Dang Gui and Sheng Di Huang, adding small amounts of Tao Ren and Hong Hua. Obese people have much phlegm; use Er Chen Tang plus Nan Xing (Arisaematis Cum Bile), Cang Zhu, Hua Shi (Talcum), Xiong (Chuan Xiong), Gui (Dang Gui), and Xiang Fu. Scant flow with harmonious color: Si Wu Tang. Droplets nearly closed, tidal irritability, rapid pulse: Si Wu Tang remove Chuan Xiong and Sheng Di Huang, add Ze Lan Ye (Leonuri Herba) triple amount and small amount of Gan Cao (Licorice Root), plus Shi Wei Xiang Fu Wan (Ten-Ingredient Cyperi Rhizoma Pill). Internal cold with sluggish blood, scant flow, or delayed by five to six days: Si Wu Tang plus Tao Ren, Hong Hua, Mu Dan Pi, and Kui Hua (Hibisci Rosa-Sinensis Flos).
Early arrival with heavy flow indicates blood excess:
Arriving three to five days early indicates blood heat; use Si Wu Tang plus Huang Qin and Huang Lian, adding phlegm-resolving drugs for obese people. Arriving ten-plus days early indicates both qi and blood are hot; use Si Wu Tang plus Huang Qin, Chai Hu (Bupleuri Radix), and Xiang Fu. For obese people, use Qing Hai Cang Sha Wan (Clear Sea Cinnamon and Cyperi Pill) plus Huang Lian and Bai Zhu. Heavy flow or lasting five to six extra days indicates internal heat scattering blood; use Si Wu Tang plus Huang Qin and Bai Zhu. Thin people with fire: Gu Jing Wan (Stabilize Menses Pill). Obese people with phlegm: Qing Hai Cang Sha Wan.
Irregular timing indicates chaotic qi and blood:
Early or late, heavy or light, absent for over a month, or occurring twice a month: use Dang Gui San, Tiao Jing San, or Dan Dan Shen San (Single Salvia Miltiorrhiza Powder).
Continuous dripping indicates unresolved pathogen:
Intermittent flow, continuous dripping, abdominal pain: cold-heat pathogens lodge in the Uterus, stagnating in the Sea of Blood causing pain. If there is accumulation, irregular discharge, improvement occurs upon expulsion. Reverse qi from below navel attacking chest/diaphragm with nausea: Tao Ren San (Peach Kernel Powder), or Dang Gui four qian, Gan Qi three qian, honey pills. Waist/navel/abdominal pain: Niu Xi San (Achyranthes Powder). Intermittent movement/stopping with heart pain: Shi Xiao San (Sorrow-Dispelling Powder). Menstruation starting/stopping with alternating chills/fever: first take Xiao Chai Hu Tang plus Di Huang, then harmonize with Si Wu Tang. Frequent menstruation: Si Wu Tang double Shao Yao, add Huang Qi. Unremitting menstruation: Si Wu Tang plus Di Yu (Sanguisorbae Radix), E Jiao (Colla Corii Asini), Jing Jie (Schizonepetae Herba); if hot, double Huang Qin, or swallow Gu Jing Wan.
Wind-heat makes color purple, extreme heat makes it black; pale indicates phlegm-damp turbidity:
Purple indicates wind; black indicates extreme heat; pale white indicates deficiency, or mixing with phlegm/water retention; smoky water, leaky roof water, bean curd juice, or yellow turbid/muddy indicates damp-phlegm; clumps/sheets with unchanged color indicate qi stagnation or wind-cold invasion; turning purple-black indicates blood heat. Generally, purple: Si Wu Tang plus Fang Feng (Saposhnikoviae Radix), Bai Zhi (Angelicae Dahuricae Radix), Jing Jie. Black: Si Wu Tang plus Huang Qin, Huang Lian, Xiang Fu. Pale white: Gu Xiong Gui Tang (Ancient Chuanxiong and Angelica Decoction) plus Ren Shen, Huang Qi, Bai Shao (White Peony Root), Xiang Fu. With phlegm: Er Chen Tang plus Chuan Xiong, Dang Gui. Smoky: Er Chen Tang plus Qin Jiao (Gentianae Macrophyllae Radix), Fang Feng, Cang Zhu. Bean curd-like: Si Wu Tang plus Huang Qin, Huang Lian. Clumps: Si Wu Tang plus Xiang Fu, Yan Hu Suo, Zhi Ke, Chen Pi, select according to syndrome. General use: Hu Po Tiao Jing Wan (Amber Regulating Menses Pill), Bai Zi Fu Gui Wan (Hundred-Seed Cyperi-Angelica Pill), Mo Fu Wan (Ink Cyperi Pill).
External tidal fever and internal abdominal pain:
Normal menstrual circulation allows conception without minute pain. If accompanied by tidal pain, severe cases include hemoptysis, sweating, vomiting, or diarrhea. Tidal sweating consumes blood further; cough/vomiting sends qi upward; diarrhea shifts fluids posteriorly; pain accumulates centrally. Thus, remove pathology first, then nourish blood and regulate menses. Tidal fever and pain are common female ailments. Blood stasis accumulating in marrow becomes bone-steaming fever; stasis in center contends with daily new blood generation, causing pain. Blood deficiency failing to nourish bones causes external steaming heat; uterine collaterals with strong fire, or mixed with phlegm/qi, food accumulation, or cold external pathogen, cause pain. Tidal fever with timing indicates internal injury/deficiency; without timing indicates external contraction/excess. Deficient: Da Wen Jing Tang (Major Warming the Menses Decoction). Hot: Si Wu Tang plus Chai Hu, Huang Qin. Amenorrhea: Zi Xue Tang (Nourish Blood Decoction). Bone-steaming: Da Hu Lian Wan (Major Coptis Pill), Da Wu Ji Wan (Major Pheasant Chicken Pill). Five-center tidal fever: Si Wu Tang plus Huang Lian, Hu Huang Lian (Picrorhizae Rhizoma). No sweat: Fu Ling Bu Xin Tang (Poria Nourishing Heart Decoction). Sweating: Xiao Yao San. Pre-menstrual tidal fever: blood deficiency with stasis, Xiao Yao San plus Mu Dan Pi, Tao Ren, Yan Hu Suo. Post-menstrual tidal fever: blood deficiency with heat, Xiao Yao San remove Chai Hu, replace with Di Gu Pi (Lycii Cortex), add Sheng Di Huang, Bian Chao Huang Qin (Stir-fried Scutellaria); this formula can be modified, a holy medicine for reducing fever. Add Sang Bai Pi, Bei Mu, Jie Geng, Zhi Mu, Mai Men Dong for cough; add Sheng Di Huang, Shan Zhi (Gardeniae Fructus), Mu Dan Pi for hemoptysis; add Chen Pi, Ban Xia, Xuan Fu Hua (Inulae Flos) for vomiting; add Jiang Chao Huang Lian (Ginger-stir-fried Coptis) or Qin Lian Er Chen Tang for acid regurgitation. Common tidal fever: Shen Qi Wan (Kidney Qi Pill), Da Zao Wan (Major Creation Pill), or Si Wu Tang ingredients plus Bian Chao Huang Qin (one liang each) and Si Zhi Xiang Fu Wan (Four-Processed Cyperi Rhizoma Pill, one jin), honey pills.
Pain/stasis pre-menstrual, deficiency post-menstrual:
This refers to abdominal pain. Before menstruation, colicky umbilical/abdominal pain indicates blood stasis; use Si Wu Tang ingredients four qian, plus Yan Hu Suo, Ku Lian (Meliae Cortex), Mu Xiang, Bing Lang each one liang; severe pain: Wan Tong Wan (Myriad Pain Pill). Pain at onset indicates qi stagnation; use Wu Yao Tang (Lindera Decoction). Qi stagnation with blood stasis: Da Yan Hu Suo San (Major Corydalis Powder), or Si Wu Tang plus Tao Ren, Hong Hua, E Zhu, Yan Hu Suo, Xiang Fu, Mu Xiang; if fever, add Chai Hu, Huang Qin. Before menstruation, intermittent pain indicates blood excess; Si Wu Tang plus Yan Hu Suo, Mu Xiang, Huang Lian, Xiang Fu; leg/abdominal pain: Nei Bu Dang Gui Wan (Internal Nourishing Angelica Pill). Approaching menstruation, wind-cold collision causing periumbilical hernia-like pain: cold pathogen in Blood Chamber, Da Wen Jing Tang, Gui Zhi Tao Ren Tang (Cinnamon Twig and Peach Kernel Decoction). During menstruation, intermittent pain: Si Wu Tang plus Chen Pi, Yan Hu Suo, Mu Dan Pi, Gan Cao. Post-menstrual pain indicates blood deficiency; Ba Wu Tang (Eight Substances Decoction), Xiao Wu Ji Wan (Minor Pheasant Chicken Pill). Chronic cold-blood accumulating in Uterus gate, vomiting saliva, umbilical/flank hernia pain, cold genitals radiating to lower back/spine: Jiu Zhu Dang Gui Wan (Wine-Boiled Angelica Pill), Da Wen Jing Tang. General use: Jiao Jia Di Huang Wan (Interlaced Rehmannia Pill), Zi Yin Bai Bu Wan (Nourish Yin Hundred Tonics Pill), Qi Zhi Xiang Fu Wan (Seven-Processed Cyperi Rhizoma Pill).
Edema: blood swelling before, water swelling after:
Menstruation stops then swelling occurs, named Blood Division (Xue Fen). Stasis transforms to water, blocking Uterus gate, harder to treat than edema. Regulate menstruation, and water resolves; use Xiao Tiao Jing San, Ting Gui Wan (Descurainia and Angelica Pill). Swelling precedes amenorrhea, named Water Division (Shui Fen). Spleen fails to control blood, floating with water, muscles swell vacuously; use Hong Fan Wan (Red Alum Pill). General use: Shen Qi Wan. For Water Division, Jun Ze Xie (Alisma Rhizoma), add Fang Ji (Stephaniae Tetrandrae Radix), Ting Li (Lepidii Semen), Mu Tong (Akebiae Caulis); for Blood Division, Jun Mu Dan Pi, add Niu Xi (Achyranthis Bidentatae Radix), Hong Hua. Amenorrhea with foot swelling: Sang Pi San (Mulberry Bark Powder).
Blood Wind: body pain and skin numbness:
Blood Wind is qi/blood deficiency attacked by wind-cold, causing joint pain throughout body; use Da Xiong San (Major Chuanxiong Powder), Qi Lin Jie Pill (Qilin Blood Pill), Chen Tong San (Speed Pain Powder), Xue Feng Wan (Blood Wind Pill). Amenorrhea with body pain and difficult urination, severe yin-deficiency damp-heat: Si Wu Tang plus Cang Zhu, Chen Pi, Niu Xi, Gan Cao, decoct frequently; alternatively Cang Sha Wan plus Cang Er (Xanthii Fructus), Bai Shao. Early menstruation: Cang Sha Wan plus Cang Er, Bai Shao, Gui Ban (Testudinis Carapax et Plastrum), Jin Mao Gou Ji (Cibotii Rhizoma). Late menstruation: Xiao Yao San. Skin itching: Si Wu Tang plus Jing Jie, or Gu Wu Jing Wan (Ancient Polygonum and Schizonepeta Pill). Muscle numbness: Wu Tou Pill (Aconite Pill). Ascending to head/eyes causing fainting: Dan Cang Er San (Single Xanthium Powder). Neck/back pain: Chai Hu Tiao Jing Tang (Bupleurum Regulating Menses Decoction). Head/body pain, chills/fever, cough, palpitations, miscellaneous symptoms: Ren Shen Jing Jie San (Ginseng and Schizonepeta Powder). Constitutionally deficient: Nu Jin Dan (Woman Golden Pill), Shi Guo Gong Infused Wine. Same for antenatal/postnatal periods.
Essential method: Nourish Stomach, Unblock Heart:
The Classic says: Diseases of the Two Yangs originate in Heart and Spleen. Chong is the Sea of Blood, Ren governs conception; these two vessels originate in the Uterus, serving as the Sea of Meridians, exterior-interior related to Hand-Taiyang Small Intestine and Hand-Shaoyin Heart. Upper produces milk, lower produces menstruation. Menstruation is the remainder of meridians; when Chong/Ren qi is abundant, blood flows on time. Worry/thought consumes Heart blood, causing fire flare-up, blood failing to return to Liver, exhaust intake/output function, Mother failing to nourish Child, Spleen failing to digest leading to poor appetite; poor appetite causes Lung Metal to lose nourishment, Water source exhausted, leading to amenorrhea/irregularity. Practitioners must know Heart is master of qi/blood; if Heart qi is constrained, regulate Heart blood, unblock Heart meridian, and blood will self-circulate. Spleen/Stomach transport qi/blood; diet/fatigue damage middle qi, causing blood scarcity/failure to circulate or intermittent flow. Use Ping Wei San (Peace the Stomach Powder), Si Jun Zi Tang (Four Gentlemen Decoction) to tonify Spleen/Stomach, allowing qi/blood to self-generate/transport; this treats root and branch, a fine method.
Virgins: Support Yin; Widows: Suppress Fire:
Girls at fourteen, Chong/Ren abundant, menstruation begins; near twenty, ready for marriage, showing difficulty in forming yin. Indulging salty/sour/fried/hot-dry foods causes qi/blood congestion/blockage; use Hong Hua Dang Gui San, Zi Wei San, Dan Da Huang Gao. Unmarried past year, or young desiring male, thinking injures Heart blood, fire flares, Spleen亏 (deficient), Lung scorched, Kidney dried, blood closure becomes consumptive disease, very hard to treat. Use Si Wu Tang plus Huang Qin, Chai Hu; or Xiao Yao San plus Shan Zhi, Huang Qin, Huang Lian to nourish/cool blood and descend fire; or Shen Qi Wan plus Zi Huang Qin (Young Scutellaria), Hong Hua, Yang Yin Bai Zi Wan (Nourish Yin Biota Seed Pill) is also good. Due to anger/rebellion: Si Zhi Xiang Fu Wan plus Huang Qin, Sheng Di Huang. Due to fright: Bao Dan Wan (Protect Gallbladder Pill). Menopause with blockage: Wa San San (Tile Powder). Widows depressed with myriad issues, unable to forget husband, household support issues, or hoping for prosperous descendants, Heart fire rises constantly, plus rich diet leading to phlegm-fire. Symptoms: aversion to wind, fatigue, alternating chills/fever, flushed face, vexation, spontaneous sweating, Liver pulse string-long. Suppress Liver yin qi: Chai Hu Yi Gan Tang (Bupleurum Suppressing Liver Decoction), Yi Yin Di Huang Wan (Suppressing Yin Rehmannia Pill), Yue Ju Wan (Resolving Depression Pill). Poor/light diet: Si Zhi Xiang Fu Wan. Daily morning mental confusion, fear of bright places, aversion to human speech, improving after noon, plus dizziness, abdominal pain, startle, worsening with slight labor or menstruation: due to unfulfilled ambition. Clear spirit, nourish nutrient: Si Wu Tang plus Ren Shen, Fu Shen (Poria with Hostwood), Chen Pi, Chai Hu, Qiang Huo (Notopterygii Rhizoma), Gan Cao, Xiang Fu. Communicating with spirits due to unsettled mind, laughing/crying alone, slow/depressed pulse, or sparrow-pecking pulse, unknown rhythm, unchanged complexion: Fu Shen, Qiang Huo, Man Jing Zi (Vernoniae Flos), Fang Feng, Yi Yi Ren (Coicis Semen), Huang Qi, Wu Wei Zi (Schisandrae Fructus), Mai Men Dong, Shi Chang Pu (Acori Tatarinowii Rhizoma), Huang Qin, Gan Cao, decoct in water.