治妇女血崩。
白术（一两，炒） 生黄 （六钱） 龙骨（八钱， 捣细） 牡蛎（八钱， 捣细） 萸肉（八钱，去净核）
生杭芍（四钱） 海螵蛸（四钱，捣细） 茜草（三钱） 棕边炭（二钱） 五倍子（五分，轧细药汁送服）
脉象热者加大生地一两；凉者加乌附子二钱；大怒之后，因肝气冲激血崩者，加柴胡二钱。若服两剂不
愈，去棕边炭，加真阿胶五钱，另炖同服。服药觉热者宜酌加生地。
从前之方，龙骨、牡蛎皆生用，其理已详于理冲丸下。此方独用 者，因 之，则收涩之力较大，欲借
之以收一时之功也。
一妇人，年三十余。陡然下血，两日不止。及愚诊视，已昏愦不语，周身皆凉，其脉微弱而迟。知其气
血将脱，而元阳亦脱也。遂急用此汤，去白芍，加野台参八钱、乌附子三钱。一剂血止，周身皆热，精神亦复。
仍将白芍加入，再服一剂，以善其后。
子××曾治一妇人，年四十许。骤得下血证甚剧，半日之间，即气息奄奄，不省人事。其脉右寸关微见，
如水上浮麻，不分至数，左部脉皆不见。急用生黄 一两，大火煎数沸灌之，六部脉皆出。然微细异常，血仍
不止。观其形状，呼气不能外出，又时有欲大便之意，知其为大气下陷也。遂为开固冲汤方，将方中黄 改用
一两。早十一点钟，将药服下，至晚三点钟，即愈如平时（后子××在京，又治一血崩证，先用固冲汤不效，加
柴胡二钱，一剂即愈，足见柴胡升提之力，可为治崩要药）。
或问∶血崩之证，多有因其人暴怒，肝气郁结，不能上达，而转下冲肾关，致经血随之下注者，故其病俗
亦名之曰气冲。兹方中多用涩补之品，独不虑于肝气郁者，有妨碍乎？答曰∶此证虽有因暴怒气冲而得者，然
当其血大下之后，血脱而气亦随之下脱，则肝气之郁者，转可因之而开。且病急则治其标，此证诚至危急之病
也。若其证初得，且不甚剧，又实系肝气下冲者，亦可用升肝理气之药为主，而以收补下元之药辅之也。
【附方】《傅青主女科》，有治老妇血崩方，试之甚效。其方用生黄 一两，当归一两（酒洗），桑叶
十四片，三七末三钱（药汁送下）水煎服，二剂血止，四剂不再发。若觉热者，用此方宜加
生地两许。
又∶诸城友人王××，传一治血崩秘方。用青莱菔生捣取汁，加白糖数匙，微火炖温，陆续饮至三大盅，必愈。
又∶西药中有麦角，原霉麦上所生之小角，其性最善收摄血管，能治一切失血之证，而对于下血者用之
尤效。角之最大者，长近寸许，以一枚和乳糖（无乳糖可代以白蔗糖）研细，可作两次服。愚常用之与止血之
药并服，恒有捷效。
附∶治女子血崩有两种草药
一种为宿根之草，一根恒生数茎，高不盈尺，叶似地肤，微宽，浓则加倍，其色绿而微带苍色，孟夏开
小白花，结实如杜梨，色如其叶，老而微黄，多生于宅畔路旁板硬之地，俗呼为HT 牛蛋，又名臭科子，然实未
有臭味。初不知其可入药也。戊辰孟夏，愚有事回籍。有南关王氏妇，患血崩，服药不效。有人教用此草连根
实锉碎，煮汤饮之，其病顿愈。后愚回津言及此方，门生李××谓∶“此方余素知之，若加黑豆一小握，用水、
酒各半煎汤，则更效矣。”
一种为当年种生之草，棵高尺余，叶圆而有尖，色深绿，季夏开小白花，五出，黄蕊，结实大如五味，状
若小茄，嫩则绿，熟则红，老则紫黑，中含甜浆可食，俗名野茄子，有山之处呼为山茄子。奉省医者多采此草
阴干备用，若遇血崩时，将其梗叶实共切碎煎汤服之立愈。在津曾与友人张××言及此草，张××谓，此即《本
草纲目》之龙葵，一名天茄子，一名老鸦睛草者是也。而愚查《本草纲目》龙葵，言治吐血不止，未尝言治血
崩。然治吐血之药，恒兼能治下血，若三七、茜草诸药是明征也。以遍地皆有之草，而能治如此重病，洵堪珍哉。
附录∶
直隶青县张××来函∶
族姊适徐姓，年三十余。有妊流产，已旬日矣。忽然下血甚多，头晕腹胀，脉小无力。知为冲脉滑脱之征
证，予以固冲汤，加柴胡钱半，归身二钱。服药三剂即止。俾继服坤顺至宝丹以善其后。
直隶盐山李××来函∶
天津赵××妻，年四十余岁，行经过期不止，诸治不效，延弟诊视。见两部之脉皆微细无力，为开固冲汤原
方予之，服数剂即全收功。因思如此年岁，血分又如此受伤，谅从此断生育矣。不意年余又产一子，安然无恙。
盖因固冲汤止血兼有补血之功也。
又∶天津张××妻，年二十四岁，因小产后血不止者绵延月余，屡经医治无效。诊其脉象，微细而数，为开
固冲汤方，因其脉数，加生地一两。服药后，病虽见轻，而不见大功。反复思索，莫得其故。细询其药价过贱，
忽忆人言此地药局所鬻黄 ，有真有假，今此方无显著之功效，或其黄 过劣也。改用口黄 ，连服两剂全愈。
由斯知药物必须地道真正方效也。
治疗妇女血崩（阴道大量出血）。
白术（一两，炒制） 生黄芪（六钱） 龙骨（八钱，捣碎成细粉） 牡蛎（八钱，捣碎成细粉） 山茱萸（八钱，去净果核）
生白芍（四钱） 海螵蛸（四钱，捣碎成细粉） 茜草（三钱） 棕榈炭（二钱） 五倍子（五分，轧成细粉，用药汁送服）
脉象表现为热者，加生地黄一两；脉象表现为凉者，加乌头、附子各二钱；因大怒之后，肝气冲激导致血崩者，加柴胡二钱。如果服用两剂后未愈，去掉棕榈炭，加入真阿胶五钱，单独炖煮后混合服用。服药后感觉发热者，应酌情增加生地黄的用量。
以前的方剂中，龙骨和牡蛎都是生用，其原理已在理冲丸的论述中详细说明。此方唯独使用煅制品，是因为煅制后，收敛固涩的力量较大，想要借助它来取得一时的功效。
有一位妇人，三十多岁。突然下血，两天不止。等我诊视时，她已经昏迷不醒，全身发凉，脉象微弱而迟缓。我知道这是气血即将脱失，而且元阳也即将脱失。于是急忙使用此汤，去掉白芍，加入野党参八钱、乌头、附子三钱。一剂药后血止，全身变暖，精神恢复。随后仍将白芍加入，再服一剂，以巩固疗效。
我的儿子张××曾治疗一位妇人，四十岁左右。突然患上严重的下血症，半天之间，气息奄奄，不省人事。她的右寸关脉微弱可见，像水上浮麻一样，分不清至数，左部脉都摸不到。急忙使用生黄芪一两，大火煎煮几沸后灌服，六部脉象全部出现。然而脉象微细异常，血仍不止。观察她的形态，呼气不能外出，又时常有想大便的感觉，知道这是大气下陷。于是为她开具固冲汤方，将方中的黄芪改为一两。早上十一点服药，到晚上三点钟，病愈如常人。（后来张××在北京，又治疗一例血崩证，先用固冲汤无效，加入柴胡二钱，一剂即愈，足见柴胡升提之力，可作为治疗崩漏的要药）。
有人问：血崩之证，多因为病人暴怒，肝气郁结，不能上达，转而向下冲击肾关，导致经血随之而下注，所以这种病俗名也叫“气冲”。这个方子中多用涩补之品，难道不怕对肝气郁结者有所妨碍吗？回答说：此证虽然有因暴怒气冲而得的，但在大量出血之后，血脱而气也随之脱失，那么肝气的郁结，反而可能因此得以开通。况且病急则治其标，此证确实是极其危急的病。如果病情初起，且不严重，又确实属于肝气下冲者，也可以用升肝理气的药物为主，而以收补下元的药物为辅。
【附方】《傅青主女科》中有治疗老年妇女血崩的方子，试用非常有效。其方用生黄芪一两，当归一两（酒洗），桑叶十四片，三七末三钱（用药汁送下），水煎服，两剂血止，四剂不再复发。如果感觉热者，用此方宜加生地黄约一两。
另外：诸城友人王××，传授一个治疗血崩的秘方。用青萝卜生捣取汁，加白糖数匙，小火炖温，陆续饮至三大盅，必定痊愈。
另外：西药中有麦角，是生长在发霉麦子上的小角，其性质最善于收敛血管，能治疗一切失血之证，而对于下血者使用尤其有效。麦角最大的一枚，长近一寸左右，取一枚与乳糖（无乳糖可用白蔗糖代替）研细，可分两次服用。我常用它与止血药一起服用，常有迅速见效的效果。
附：治疗女子血崩有两种草药
一种为宿根之草，一根常年生出数茎，高不满一尺，叶子像地肤子，略宽，浓密时加倍，颜色绿而微带苍色，孟夏开小白花，果实像杜梨，颜色如其叶，老熟后微黄，多生长在宅旁路边板硬之地，俗称为“HT 牛蛋”，又名臭科子，但实际上并没有臭味。起初不知道它可以入药。戊辰年孟夏，我因事回籍。南关王氏妇，患血崩，服药无效。有人教用此草连根实锉碎，煮汤饮用，病立刻痊愈。后来我回到天津说起此方，门生李××说：“这个方子我素来知道，如果加一小把黑豆，用水、酒各半煎汤，则效果更好。”
另一种为当年种植生长的草，棵高一尺余，叶子圆而有尖，颜色深绿，季夏开小白花，五瓣，黄蕊，果实大如五味子，形状像小茄子，嫩时绿，熟时红，老时紫黑，中含有甜浆可食用，俗名野茄子，有山的地方称为山茄子。奉天省的医生多采集此草阴干备用，如果遇到血崩时，将其梗叶实共切碎煎汤服用，立刻痊愈。在天津曾与友人张××说起此草，张××说，这就是《本草纲目》中的龙葵，一名天茄子，一名老鸦睛草的就是它。而我查阅《本草纲目》关于龙葵的记载，说治疗吐血不止，未曾说治疗血崩。然而治疗吐血的药，往往兼能治疗下血，如三七、茜草等药就是明显的证据。以遍地皆有的草，却能治疗如此重病，确实值得珍视。
附录：
直隶青县张××来信：
族姐嫁给徐姓，三十多岁。怀孕流产，已经十天了。忽然下血很多，头晕腹胀，脉小无力。知道这是冲脉滑脱的征象，给予固冲汤，加柴胡钱半，当归身二钱。服药三剂即止。让她继服坤顺至宝丹以善后。
直隶盐山李××来信：
天津赵××的妻子，四十多岁，行经过期不止，各种治疗无效，请弟弟诊视。见两部脉象皆微细无力，为其开具固冲汤原方给予，服数剂即完全收功。心想如此年纪，血分又如此受伤，估计从此断绝生育了。没想到一年多后又产下一子，安然无恙。这是因为固冲汤止血兼有补血之功。
另外：天津张××的妻子，二十四岁，因小产后血不止绵延月余，屡经医治无效。诊其脉象，微细而数，为其开具固冲汤方，因其脉数，加生地黄一两。服药后，病虽见轻，而不见大功。反复思索，不得其故。仔细询问得知药价过贱，忽然想起人言此地药局所卖黄芪，有真有假，现在此方无显著功效，或许这黄芪过于低劣吧。改用口黄芪，连服两剂全愈。
由此可知药物必须地道真正才有效。
Treats metrorrhagia (uterine bleeding) in women.
Bai Zhu (Atractylodis Rhizoma, one tael, stir-fried), Sheng Huang Qi (Astragali Radix, six qian), Long Gu (Fossilized Bones, eight qian, crushed into fine powder), Mu Li (Oyster Shell, eight qian, crushed into fine powder), Yu Rou (Corni Fructus, eight qian, pits removed completely),
Sheng Bai Shao (Paeoniae Radix Alba, four qian), Hai Piao Xiao (Cuttlefish Bone, four qian, crushed into fine powder), Qian Cao (Rubiae Cordifoliae Radix et Rhizoma, three qian), Zong Bian Tan (Livistonae Folii Carbonisatum, two qian), Wu Bei Zi (Galla Chinensis, five fen, ground into fine powder, taken with herbal decoction).
If the pulse indicates heat, add Sheng Di Huang (Rehmanniae Radix, one tael); if the pulse indicates cold, add Wu Tou (Aconiti Lateralis Radix Preparata) and Fu Zi (Aconiti Lateralis Radix Preparata), each two qian; if metrorrhagia is caused by liver qi rushing upward after severe anger, add Chai Hu (Bupleuri Radix, two qian). If not cured after two doses, remove Zong Bian Tan and add Zhen E Jiao (Asini Corii Colla, five qian), stewed separately and mixed for administration. If the patient feels hot after taking the medicine, adjust the dosage of Sheng Di Huang accordingly.
In previous prescriptions, both Long Gu and Mu Li were used raw; the rationale has been detailed under the discussion of Li Chong Wan. This prescription exclusively uses calcined forms because calcination enhances their astringent power, aiming to achieve immediate hemostatic effects.
A woman, over thirty years old, suddenly experienced vaginal bleeding that persisted for two days. When I examined her, she was unconscious and unresponsive, with a cold body and a faint, slow pulse. I determined that both qi and blood were about to collapse, and primordial yang was also collapsing. I urgently prescribed this decoction, removing Bai Shao and adding Ye Tai Shen (Codonopsis Radix, eight qian) and Wu Tou (Aconiti Lateralis Radix Preparata) and Fu Zi (Aconiti Lateralis Radix Preparata), each three qian. After one dose, the bleeding stopped, her body became warm, and her spirit recovered. Subsequently, Bai Shao was added back, and another dose was administered to consolidate the treatment.
My son, Zhang XX, once treated a woman, around forty years old. She suddenly suffered from severe vaginal bleeding. Within half a day, her breathing was weak, and she lost consciousness. Her right Cun and Guan pulses were faintly palpable, resembling floating hemp seeds on water, indistinguishable in rate, while the left pulses were imperceptible. I urgently prescribed Sheng Huang Qi (Astragali Radix, one tael), boiled vigorously for a few minutes, and administered it orally. All six pulses became palpable. However, they remained extremely thin and fine, and the bleeding continued. Observing her condition, her exhalation seemed unable to exit fully, and she frequently felt the urge to defecate. I diagnosed this as sinking of the Great Qi (Da Qi). I prescribed Gu Chong Tang, increasing the dosage of Huang Qi (Astragali Radix) to one tael. She took the medicine at 11:00 AM and was completely recovered by 3:00 PM. (Later, when Zhang XX practiced in Beijing, he treated another case of metrorrhagia. The initial Gu Chong Tang was ineffective, but adding Chai Hu (Bupleuri Radix, two qian) cured it in one dose. This demonstrates that Chai Hu's ascending and lifting properties make it an essential herb for treating metrorrhagia.)
Someone asked: Metrorrhagia is often caused by sudden anger leading to liver qi stagnation. Unable to ascend, the liver qi rushes downward, impacting the Kidney gate, causing menstrual blood to flow down. Thus, this condition is commonly called "Qi Chong" (Qi Rushing). This prescription uses many astringent and tonifying herbs. Are you not worried that it might hinder patients with liver qi stagnation? I replied: Although some cases are caused by anger-induced qi rushing, after massive blood loss, blood collapse leads to qi collapse. Consequently, the previously stagnant liver qi may naturally resolve due to this state. Moreover, in acute conditions, we treat the symptoms first. This is indeed a critical emergency. If the condition is in its early stages, not severe, and clearly caused by liver qi rushing downward, one can primarily use herbs that lift the liver and regulate qi, assisted by herbs that astringe and tonify the lower origin.
[Attached Prescription] *Fu Qingzhu Nüke* contains a prescription for metrorrhagia in elderly women, which has proven very effective. It uses Sheng Huang Qi (Astragali Radix, one tael), Dang Gui (Angelicae Sinensis Radix, one tael, washed with wine), Sang Ye (Mori Folium, fourteen leaves), and San Qi (Notoginseng Radix et Rhizoma powder, three qian, taken with herbal decoction). Boil in water and take orally. Bleeding stops after two doses and does not recur after four doses. If heat is felt, add Sheng Di Huang (Rehmanniae Radix, approximately one tael).
Additionally: A friend from Zhucheng, Wang XX, passed down a secret prescription for metrorrhagia. Use fresh green radish, crush and extract the juice, add several spoons of white sugar, warm gently over low fire, and drink continuously until three large cups are consumed. It will surely cure the condition.
Additionally: In Western medicine, Ergot (Claviceps purpurea), small horns growing on moldy wheat, has strong vascular astringent properties and can treat all types of hemorrhage, especially effective for lower bleeding. The largest ergot grains are nearly one cun long. Take one grain, grind it finely with lactose (or white sucrose if lactose is unavailable), and divide into two doses. I often administer it together with hemostatic herbs, achieving rapid results.
Attachment: Two herbal remedies for female metrorrhagia
One is a perennial herb. One root produces several stems, less than one chi high. Leaves resemble Chenopodium leaves, slightly wider, denser foliage doubles the volume. Color is green with a bluish tint. Small white flowers bloom in early summer. Fruits resemble wild pears, same color as leaves, turning slightly yellow when mature. Grows mostly on hard soil near houses or roadsides. Commonly called "HT Niu Dan," also known as Chou Ke Zi, though it actually has no odor. I initially did not know it could be used medicinally. In early summer of the Wuchen year, I returned to my hometown due to family matters. Mrs. Wang from South Gate suffered from metrorrhagia, unresponsive to medication. Someone advised using this herb, including roots and fruits, chopped and boiled into a decoction. The illness was instantly cured. Later, when I mentioned this formula in Tianjin, my student Li XX said, "I have always known this formula. Adding a handful of Hei Dou (Soybean) and boiling with equal parts water and wine makes it even more effective."
The other is an annual herb. Stems are over one chi high. Leaves are round with pointed tips, deep green. Small white flowers with five petals and yellow stamens bloom in late summer. Fruits are as large as Schisandra berries, shaped like small eggplants. Green when tender, red when ripe, purple-black when old. Contains sweet pulp edible. Commonly named Ye Qie Zi (Wild Eggplant), or Shan Qie Zi in mountainous areas. Doctors in Fengtian Province often collect and shade-dry this herb for reserve. In cases of metrorrhagia, chopping stems, leaves, and fruits together and boiling into a decoction brings immediate cure. In Tianjin, I discussed this herb with friend Zhang XX, who identified it as Long Kui (Solanum nigrum) from *Bencao Gangmu*, also known as Tian Qie Zi or Lao Ya Jing Cao. However, checking *Bencao Gangmu*, Long Kui is recorded for treating persistent hematemesis, not metrorrhagia. Nevertheless, herbs treating hematemesis often also treat lower bleeding, as seen with San Qi (Notoginseng Radix et Rhizoma) and Qian Cao (Rubiae Cordifoliae Radix et Rhizoma). That a common weed can treat such a severe disease is truly precious.
Appendix:
Letter from Zhang XX of Qing County, Zhili:
My clan sister, married to surnamed Xu, over thirty years old. Suffered miscarriage ten days ago. Suddenly experienced heavy vaginal bleeding, dizziness, abdominal distension, and a small, weak pulse. Diagnosed as slipping of the Chong Mai (Penetrating Vessel). Prescribed Gu Chong Tang, adding Chai Hu (Bupleuri Radix, half qian) and Dang Gui Shen (Angelicae Sinensis Radix, two qian). Bleeding stopped after three doses. Advised continuing with Kun Shun Zhi Bao Dan for recovery.
Letter from Li XX of Yanshan, Zhili:
Wife of Zhao XX from Tianjin, over forty years old. Menstruation overdue and continuous, unresponsive to various treatments. Consulted my younger brother. Both radial pulses were faint, thin, and weak. Prescribed the original Gu Chong Tang. Complete recovery after several doses. Given her age and blood deficiency, I assumed fertility would cease. Unexpectedly, she gave birth to a healthy child over a year later. This confirms Gu Chong Tang's ability to stop bleeding and tonify blood.
Additionally: Wife of Zhang XX from Tianjin, twenty-four years old. Continuous bleeding after spontaneous abortion for over a month, unresponsive to multiple treatments. Pulse was faint, thin, and rapid. Prescribed Gu Chong Tang, adding Sheng Di Huang (Rehmanniae Radix, one tael) due to the rapid pulse. Symptoms improved but did not resolve significantly. After reflection, I inquired about the cost of medicines and found them unusually cheap. Recalling rumors of fake Huang Qi (Astragali Radix) sold in local pharmacies, I suspected the inferior quality of the herb used. Switched to authentic Kou Huang Qi (Astragali Radix). Cured after two doses.
This proves that only genuine, geographically appropriate herbs are effective.