治妇女倒经。
干寸冬（五钱，带心） 野台参（四钱） 清半夏（三钱） 生山药（四钱，以代粳米） 生杭芍（三钱）
丹参（三钱） 甘草（二钱） 生桃仁（二钱，带皮尖捣） 大枣（三枚，捭开）
妇女倒经之证，陈修园《女科要旨》借用《金匮》麦门冬
汤，可谓特识。然其方原治“火逆上气，咽喉不利”。今用以治倒经，必略为加减，而后乃与病证吻合也。
或问，《金匮》麦门冬汤所主之病，与妇人倒经之病迥别，何以能借用之而有效验？答曰∶冲为血海，
居少腹之两旁。其脉上隶阳明，下连少阴。少阴肾虚，其气化不能闭藏以收摄冲气，则冲气易于上干。阳明胃
虚，其气化不能下行以镇安冲气，则冲气亦易于上干。冲中之气既上干，冲中之血自随之上逆，此倒经所由来
也。麦门冬汤，于大补中气以生津液药中，用半夏一味，以降胃安冲，且以山药代粳米，以补肾敛冲，于是冲
中之气安其故宅，冲中之血，自不上逆，而循其故道矣。特是经脉所以上行者，固多因冲气之上干，实亦下行
之路，有所壅塞。观其每至下行之期，而后上行可知也。故又加芍药、丹参、桃仁以开其下行之路，使至期下
行，毫无滞碍。是以其方非为治倒经而设，而略为加减，即以治倒经甚效，愈以叹经方之函盖无穷也。
用此方治倒经大抵皆效，而间有不效者，以其兼他证也。曾治一室女，倒经年余不愈，其脉象微弱。投
以此汤，服药后甚觉短气。再诊其脉，微弱益甚。自言素有短气之病，今则益加重耳。恍悟其胸中大气，必然
下陷，故不任半夏之降也。遂改用拙拟升陷汤，连服十剂。短气愈，而倒经之病亦愈。
一少妇，倒经半载不愈。诊其脉微弱而迟，两寸不起，呼吸自觉短气，知其亦胸中大气下陷。亦投以升
陷汤，连服数剂，短气即愈。身体较前强壮，即停药不服。其月经水即顺，逾十月举男矣。
或问，倒经之证，既由于冲气胃气上逆，大气下陷者，其气化升降之机正与之反对，何亦病倒经乎？答曰∶
此理甚微奥，人之大气，原能斡旋全身，为诸气之纲领。故大气常充满于胸中，自能运转胃气使之下降，镇摄
冲气使不上冲。大气一陷，纲领不
振，诸气之条贯多紊乱，此乃自然之理也。是知冲气胃气之逆，非必由于大气下陷，而大气下陷者，实可致冲
胃气逆也。致病之因既不同，用药者岂可胶柱鼓瑟哉。
治疗妇女倒经。
干寸冬（五钱，带心） 野台参（四钱） 清半夏（三钱） 生山药（四钱，用来代替粳米） 生杭芍（三钱）
丹参（三钱） 甘草（二钱） 生桃仁（二钱，带皮尖捣碎） 大枣（三枚，掰开）
关于妇女倒经这一病症，陈修园在《女科要旨》中借用《金匮要略》中的麦门冬汤，可谓独具见识。然而该方原本主治“火逆上气，咽喉不利”。如今用它来治疗倒经，必须稍作加减，才能与病情相符。
有人问：《金匮要略》中麦门冬汤所主治的病证，与妇女倒经的病证截然不同，为什么能够借用它而取得疗效？回答说：冲脉为血海，位于小腹两侧。其经脉上行隶属阳明胃经，下行连接少阴肾经。如果少阴肾虚，气化功能不能闭藏以收摄冲气，那么冲气就容易上逆侵犯上部。如果阳明胃虚，气化功能不能下行以镇安冲气，那么冲气也很容易上逆侵犯上部。既然冲脉中的气已经上逆侵犯上部，冲脉中的血自然随之上逆，这就是倒经产生的原因。麦门冬汤在大补中气以生津液的药物中，使用一味半夏，来降胃气、安冲气，并且用山药代替粳米，来补肾、收敛冲气，于是冲脉中的气安定在其原有的位置，冲脉中的血自然不再上逆，而是遵循其正常的通道运行了。特别是月经之所以向上行，固然多因冲气上逆侵犯，实际上也是由于下行的道路有所壅塞。观察她们每次到了该来月经的时候，月经才向上行，就可以知道这一点。所以又加入芍药、丹参、桃仁来开通下行的道路，使月经到了时期能顺利下行，毫无滞碍。因此，这个方子并非专门为治疗倒经而设立，只是稍作加减，就能用来治疗倒经且非常有效，这更让人感叹经方的作用无穷无尽啊。
用这个方子治疗倒经大体上都有效，但偶尔也有无效的，是因为兼有其他病证。曾治疗一位未婚女子，倒经一年多不愈，她的脉象微弱。投以此汤，服药后觉得非常短气。再次诊察她的脉象，微弱更加严重。她自己说素来有短气的病，现在则更加加重了。猛然醒悟到她的胸中大气必然下陷，所以承受不了半夏的降气作用。于是改用我拟定的升陷汤，连续服用十剂。短气痊愈，而倒经的病也好了。
还有一位少妇，倒经半年不愈。诊察她的脉象微弱而迟，两寸脉不起，呼吸自觉短气，知道她也是胸中大气下陷。也投以升陷汤，连续服用几剂，短气立即痊愈。身体比以前强壮，就停药不服了。她的月经水即顺，过了十个月生了一个男孩。
有人问：倒经的病症，既然由于冲气、胃气上逆，以及大气下陷，那么气化的升降机制正好与之相反，为什么也会得倒经呢？回答说：这个道理非常深奥微妙。人的大气，本来能斡旋全身，是诸气的纲领。所以大气常充满于胸中，自然能运转胃气使之下降，镇摄冲气使其不上冲。一旦大气下陷，纲领不振，诸气的条贯大多紊乱，这是自然的道理。由此可知，冲气、胃气的上逆，不一定都由于大气下陷；而大气下陷，确实可导致冲气、胃气上逆。致病的病因既然不同，用药的人怎么能拘泥固执不知变通呢。
To treat retrograde menstruation in women.
Gastrodiae Rhizoma (5 qian, with heart) [Note: Text says Gan Cun Dong, likely Gastrodia or Ophiopogon contextually, but strictly translating name] -> *Correction*: "Gan Cun Dong" usually refers to Ophiopogonis Radix (Maidong). I will use Ophiopogonis Radix.
Ophiopogonis Radix (5 qian, with heart)
Codonopsis Radix (4 qian) [Ye Tai Shen]
Pinelliae Rhizoma Preparatum (3 qian)
Dioscoreae Rhizoma (4 qian, used to replace Coicis Semen/Jing Mi)
Paeoniae Radix Alba (3 qian)
Salviae Miltiorrhizae Radix et Rhizoma (3 qian)
Glycyrrhizae Radix et Rhizoma (2 qian)
Persicae Semen (2 qian, with skin and tip, crushed)
Ziziphi Jujubae Fructus (3 pieces, split open)
Regarding the condition of retrograde menstruation in women, Chen Xiuyuan borrowed Mai Men Dong Tang from *Jin Gui Yao Lue* in his work *Nu Ke Yao Zhi*, which can be considered a unique insight. However, this formula originally treats "fire reversal causing upward qi and difficulty in the throat." Now, using it to treat retrograde menstruation requires slight modifications to match the pathology.
One might ask: The diseases treated by Mai Men Dong Tang in *Jin Gui Yao Lue* are vastly different from retrograde menstruation in women; how can it be borrowed effectively? The answer is: The Chong vessel is the sea of blood, located on both sides of the lower abdomen. Its meridian ascends to connect with the Yangming Stomach channel and descends to connect with the Shaoyin Kidney channel. If the Shaoyin Kidney is deficient, its Qi transformation cannot close and store to control the Chong Qi, making Chong Qi prone to invading upwards. If the Yangming Stomach is deficient, its Qi transformation cannot descend to pacify the Chong Qi, making Chong Qi also prone to invading upwards. Once the Qi within the Chong vessel invades upwards, the Blood within the Chong vessel naturally follows in reverse flow; this is the origin of retrograde menstruation. Mai Men Dong Tang, among herbs that greatly tonify Middle Qi to generate fluids, uses Ban Xia to descend Stomach Qi and pacify Chong Qi, and replaces Jing Mi with Shan Yao to tonify the Kidney and consolidate Chong Qi. Thus, the Qi within the Chong vessel settles in its original residence, and the Blood within the Chong vessel no longer reverses upwards but follows its normal pathway. Specifically, the reason menstrual blood goes upwards is not only due to Chong Qi invading upwards, but also because the downward path is obstructed. Observing that menstruation occurs upwards only when it is time for it to descend confirms this. Therefore, Shao Yao, Dan Shen, and Tao Ren are added to open the downward path, allowing menstruation to descend smoothly at the proper time without obstruction. Hence, this formula was not originally designed for treating retrograde menstruation; yet, with slight modifications, it is very effective for this condition, further叹 (sighing) at the boundless utility of classical formulas.
Using this formula to treat retrograde menstruation is generally effective, but occasionally ineffective cases occur due to concurrent conditions. I once treated an unmarried woman who had suffered from retrograde menstruation for over a year without cure. Her pulse was weak and thready. After administering this decoction, she felt significant shortness of breath upon taking the medicine. On re-examination, her pulse was even weaker and thready. She stated she had always suffered from shortness of breath, which had now worsened. It suddenly dawned on me that her Upper Jiao Great Qi (Da Qi) must have sunk, so it could not tolerate the descending action of Ban Xia. I then switched to my formulated Sheng Xian Tang, administered for ten doses. The shortness of breath resolved, and the retrograde menstruation also cured.
Another young woman suffered from retrograde menstruation for half a year without cure. Her pulse was weak, thready, and slow, with neither Cun position rising. She complained of subjective shortness of breath. Knowing her condition was also due to sinking of Upper Jiao Great Qi, I administered Sheng Xian Tang. After several doses, the shortness of breath immediately resolved. Her physique became stronger than before, so she stopped taking the medicine. Her menstruation then proceeded normally, and over ten months later, she gave birth to a son.
One might ask: Since retrograde menstruation results from the rebellion of Chong Qi and Stomach Qi, as well as the sinking of Great Qi, whose mechanisms of ascending and descending are opposite to this, why does one still suffer from retrograde menstruation? The answer is: This principle is subtle and profound. Human Great Qi (Da Qi) originally rotates the whole body and serves as the leader of all Qi. Therefore, Great Qi usually fills the chest, naturally moving Stomach Qi to descend and suppressing Chong Qi to prevent it from rushing up. Once Great Qi sinks, the leadership fails, and the coordination of all Qi becomes disordered; this is a natural law. Thus, we know that the rebellion of Chong and Stomach Qi is not necessarily caused by the sinking of Great Qi, but the sinking of Great Qi can indeed lead to the rebellion of Chong and Stomach Qi. Since the causes of disease differ, how can practitioners rigidly adhere to fixed methods without flexibility?