过期饮
21.过期血滞物桃红, 附莪桂草木香通, 血虚期过无胀热, 双和圣愈
及养荣.
【注】经水过期不至, 因血气凝滞胀痛者, 用过期饮, 其方即四物汤
加桃仁, 红花, 香附, 莪术, 肉桂, 甘草, 木香, 木通也. 若过期不
至,并不胀痛者, 乃无血可行, 是血虚也, 宜用双和饮, 圣愈汤, 人
参养荣汤.
加味地骨皮饮 六神汤
22.经来身热有表发, 内热地骨加胡连, 经后六神加耆骨, 逍遥理脾
而清肝.
【注】经来发热有表邪证者, 用前桂枝四物等汤发之. 若内热者, 用
地骨皮饮加胡连清之, 名加味地骨皮饮. 经后发热, 乃血虚内热, 用
四物汤加黄耆, 地骨皮补而凉之, 名六神汤. 若脾虚肝热, 用逍遥散
理脾而清肝.
逍遥散方见前.
羌桂四物汤 黄耆建中汤
23.经来身痛有表发, 无表四物羌桂枝, 经后血多黄耆建, 耆桂芍草
枣姜饴.
【注】经来时身体痛疼, 若有表证者, 酌用前麻黄四物, 桂枝四物等
汤以发之. 若无表证者, 乃血脉壅阻也, 宜用四物汤加羌活, 桂枝以
疏通经络, 名羌桂四物汤. 若经行后或血去过多者, 乃血虚不荣也,
宜用黄耆建中汤以补之, 其方即小建中汤──桂枝, 白芍, 甘草, 姜
,枣, 饴糖加黄耆也.
过期饮
21. 治疗经期推迟且因血滞引起的病症，方用桃红四物汤加味（即四物汤加入桃仁、红花），并配合附子、莪术、肉桂、甘草、木香、通草以疏通气血。若经期推迟但无胀痛和发热感，属于血虚证，应选用双和饮、圣愈汤或人参养荣汤。
【注释】月经延期不来，如果是因为气血凝滞导致腹部胀痛，使用过期饮。该方剂是由四物汤加入桃仁、红花、香附、莪术、肉桂、甘草、木香、木通组成。如果月经延期不来，且没有胀痛感，说明体内无血可下，这是血虚的表现，适宜使用双和饮、圣愈汤、人参养荣汤。
加味地骨皮饮、六神汤
22. 经期身体发热且有表证者，在地骨皮饮中加入胡黄连；经后发热者，在六神汤中加入黄耆和地骨皮；逍遥散则用于调理脾胃并清泻肝热。
【注释】经期发热且伴有表邪症状的，使用前文提到的桂枝四物汤等方剂发汗解表。如果是内热，使用地骨皮饮加入胡黄连进行清热，称为加味地骨皮饮。经后发热，是由于血虚导致的内热，使用四物汤加入黄耆、地骨皮进行补益和凉血，称为六神汤。如果是脾虚兼有肝热，使用逍遥散来调理脾胃并清肝。
逍遥散的方剂见前文。
羌桂四物汤、黄耆建中汤
23. 经期身体疼痛且有表证者，宜发汗解表；若无表证，则用四物汤加羌活、桂枝；经后若失血过多，用黄耆建中汤补益，其方由黄耆、桂枝、白芍、甘草、大枣、生姜、饴糖组成。
【注释】经期时身体疼痛，如果有表证，酌情使用前文提到的麻黄四物汤、桂枝四物汤等方剂发汗解表。如果没有表证，则是血脉壅阻所致，适宜使用四物汤加入羌活、桂枝以疏通经络，称为羌桂四物汤。如果经期过后或失血过多，则是血虚不能濡养身体，适宜使用黄耆建中汤进行补益，该方即小建中汤——由桂枝、白芍、甘草、生姜、大枣、饴糖组成，再加入黄耆。
Guoqi Yin (Decoction for Delayed Menstruation)
21. For menstrual delay caused by blood stasis, use Tao Hong Si Wu Tang (Four Substance Decoction with Peach Kernel and Safflower) combined with Fuzi (Aconite Lateral Root), Ezhu (Curcuma Zedoaria Rhizome), Rougui (Cinnamon Bark), Gancao (Licorice Root), Muxiang (Aucklandiae Radix), and Mutong (Akebiae Caulis) to unblock Qi and Blood. If the period is delayed without distension or heat, it indicates Blood Deficiency; Shuanghe Yin (Double Harmony Decoction), Shengyu Tang (Sage One Decoction), or Renshen Yangrong Tang (Ginseng Nourishing the Nutritive Qi Decoction) should be used.
[Note] When menstruation is delayed due to Qi and Blood stagnation causing distension and pain, Guoqi Yin is indicated. This formula consists of Siwu Tang (Four Substance Decoction) added with Taoren (Peach Kernel), Honghua (Carthami Flos), Xiangfu (Cyperi Rhizoma), Ezhu (Curcumae Rhizoma), Rougui (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), Muxiang (Aucklandiae Radix), and Mutong (Akebiae Caulis). If menstruation is delayed without distension or pain, it signifies that there is no Blood available to flow, indicating Blood Deficiency. In such cases, Shuanghe Yin (Double Harmony Decoction), Shengyu Tang (Sage One Decoction), and Renshen Yangrong Tang (Ginseng Nourishing the Nutritive Qi Decoction) are appropriate.
Jiawei Digupi Yin (Modified Gardenia Root Bark Decoction), Liushen Tang (Six Deities Decoction)
22. For fever during menstruation accompanied by exterior syndrome, add Hulian (Coptidis Rhizoma) to Digupi Yin (Gardenia Root Bark Decoction); for fever after menstruation, add Huangqi (Astragali Radix) and Digupi (Gardeniae Radix) to Liushen Tang (Six Deities Decoction); Xiaoyao San (Free and Easy Wanderer Powder) regulates the Spleen and clears Liver Heat.
[Note] For fever during menstruation with exterior pathogenic factors, formulas such as Guizhi Siwu Tang (Cinnamon Twig Four Substance Decoction) mentioned previously should be used to induce sweating and release the exterior. For internal heat, Digupi Yin (Gardenia Root Bark Decoction) with added Hulian (Coptidis Rhizoma) is used to clear heat, named Jiawei Digupi Yin (Modified Gardenia Root Bark Decoction). Fever after menstruation results from Blood Deficiency causing internal heat; Siwu Tang (Four Substance Decoction) added with Huangqi (Astragali Radix) and Digupi (Gardeniae Radix) is used to tonify and cool, named Liushen Tang (Six Deities Decoction). For Spleen Deficiency with Liver Heat, Xiaoyao San (Free and Easy Wanderer Powder) is used to regulate the Spleen and clear the Liver.
The formula for Xiaoyao San (Free and Easy Wanderer Powder) is found in the previous section.
Qianggui Siwu Tang (Notopterygium and Cinnamon Twig Four Substance Decoction), Huangqi Jianzhong Tang (Astragalus Establishing the Middle Decoction)
23. For body aches during menstruation with exterior syndrome, induce sweating; without exterior syndrome, use Siwu Tang (Four Substance Decoction) added with Qianghuo (Notopterygii Rhizoma et Radix) and Guizhi (Cinnamomi Ramulus); after menstruation, if excessive blood loss occurs, use Huangqi Jianzhong Tang (Astragalus Establishing the Middle Decoction) to tonify, which consists of Huangqi (Astragali Radix), Guizhi (Cinnamomi Ramulus), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Dazao (Ziziphi Jujubae Fructus), Shengjiang (Zingiberis Rhizoma Recens), and Yitang (Maltose).
[Note] During menstruation, if body aches occur with exterior syndrome, formulas such as Mahuang Siwu Tang (Ephedra Four Substance Decoction) or Guizhi Siwu Tang (Cinnamon Twig Four Substance Decoction) mentioned previously should be used appropriately to induce sweating and release the exterior. Without exterior syndrome, the condition is due to obstruction of the blood vessels; Siwu Tang (Four Substance Decoction) added with Qianghuo (Notopterygii Rhizoma et Radix) and Guizhi (Cinnamomi Ramulus) is indicated to unblock the meridians, named Qianggui Siwu Tang (Notopterygium and Cinnamon Twig Four Substance Decoction). After menstruation, or if excessive blood has been lost, the condition is Blood Deficiency failing to nourish the body; Huangqi Jianzhong Tang (Astragalus Establishing the Middle Decoction) is indicated to tonify. This formula is Xiao Jianzhong Tang (Minor Establishing the Middle Decoction)—composed of Guizhi (Cinnamomi Ramulus), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), Dazao (Ziziphi Jujubae Fructus), and Yitang (Maltose)—with added Huangqi (Astragali Radix).