芩连四物汤 地骨皮饮 胶艾四物汤 芩术四物汤 桃红四物汤 当
归补血汤 圣愈汤 姜芩四物汤 佛手散 芎归汤
20.先期实热物芩连, 虚热地骨皮饮丹, 血多胶艾热芩术, 逐瘀桃红
紫块粘, 血少浅淡虚不摄, 当归补血归耆先. 虚甚参耆圣愈补, 血滞
姜芩丹附延, 逐瘀芎归佛手散, 又名芎归效若仙.
【注】经水先期而至, 属热而实者, 用四物汤加黄芩, 黄连清之, 名
芩连四物汤. 属热而虚者, 用四物汤加地骨皮, 丹皮凉之, 名地骨皮
饮.血多无热者, 用四物汤加阿胶, 艾叶止之, 名胶艾四物汤. 血多
因热者, 用四物汤加黄芩, 白术和之, 名芩术四物汤. 若血多有块,
色紫稠粘, 乃内有瘀血, 用四物汤加桃仁, 红花破之, 名桃红四物汤
.先期血少浅淡, 乃气虚不能摄血也, 用当归补血汤补之, 其方即当
归,黄耆也. 若虚甚者, 则当用四物汤加人参, 黄耆补之, 名圣愈汤
.若血涩少, 其色赤者, 乃热盛滞血, 用四物汤加姜黄, 黄芩, 丹皮
,香附, 延胡通之, 名姜芩四物汤. 逐瘀须用佛手散, 即四物汤去生
地,白芍, 又名芎归汤, 逐瘀血其效如神也.
芩连四物汤、地骨皮饮、胶艾四物汤、芩术四物汤、桃红四物汤、当归补血汤、圣愈汤、姜芩四物汤、佛手散、芎归汤。
20. 月经先期而至，若属实热证，用芩连四物汤；若属虚热证，用地骨皮饮（含丹皮）。若经量多且无热象，用胶艾四物汤；若经量多因热所致，用芩术四物汤。若经血多有血块，颜色紫暗且稠粘，说明体内有瘀血，用桃红四物汤（含桃仁、红花）以破瘀。若经血量少、色浅淡，乃气虚不能统摄血液所致，用当归补血汤（由当归、黄芪组成）以补益。若虚损严重，则应用圣愈汤（四物汤加人参、黄芪）以补益。若经血涩滞量少、颜色鲜红，乃热盛导致血行不畅，用姜芩四物汤（四物汤加姜黄、黄芩、丹皮、香附、延胡索）以通利。逐瘀血需用佛手散，即四物汤去掉生地黄、白芍，又名芎归汤，其逐瘀效果如神。
Qinlian Siwu Decoction (Scutellaria and Coptis Four Substances Decoction), Digupi Yin (Lycium Bark Drink), Jiao'ai Siwu Tang (Donkey-hide Gelatin and Mugwort Four Substances Decoction), Qinshu Siwu Tang (Scutellaria and Atractylodes Four Substances Decoction), Taohong Siwu Tang (Peach Kernel and Safflower Four Substances Decoction), Danggui Buxue Tang (Angelica Sinensis Tonifying Qi Decoction), Shengyu Tang (Sage's Replenishing Decoction), Jiangqin Siwu Tang (Ginger and Scutellaria Four Substances Decoction), Foshou San (Buddha's Hand Powder), Xionggui Tang (Ligusticum and Angelica Decoction).
20. Premature menstruation due to excess-heat is treated with Qinlian Siwu Tang; premature menstruation due to deficiency-heat is treated with Digupi Yin (containing Radix Paeoniae Rubra, *Mudanpi*). Excessive menstrual flow without heat signs is treated with Jiao'ai Siwu Tang; excessive flow due to heat is treated with Qinshu Siwu Tang. If the flow is excessive with clots, dark purple color, and thick consistency, it indicates internal blood stasis (*Yu Xue*), treated with Taohong Siwu Tang (containing Semen Persicae, *Taoren*, and Carthami Flos, *Honghua*) to break up stasis. If the flow is scanty and pale, it is caused by Qi deficiency failing to control the blood, treated with Danggui Buxue Tang (composed of Radix Angelicae Sinensis, *Danggui*, and Radix Astragali Membranacei, *Huangqi*) to tonify. If the deficiency is severe, Shengyu Tang (Siwu Tang plus Ginseng Radix, *Renshen*, and Radix Astragali Membranacei, *Huangqi*) should be used for tonification. If the flow is sluggish, scanty, and bright red, it is caused by excessive heat stagnating the blood, treated with Jiangqin Siwu Tang (Siwu Tang plus Rhizoma Curcumae Longae, *Jianghuang*, Radix Scutellariae Baicalensis, *Huangqin*, Cortex Moutan, *Mudanpi*, Rhizoma Cyperi Rotundi, *Xiangfu*, and Radix Corydalis Yanhusuo, *Yanhusuo*) to promote circulation. To resolve blood stasis, Foshou San should be used, which is Siwu Tang minus Radix Rehmanniae Preparata, *Shudihuang*, and Radix Paeoniae Alba, *Baishao*, also known as Xionggui Tang; its efficacy in resolving blood stasis is miraculous.