妇人经水适行，小腹作痛者，气血涩滞也。用四乌汤。经行而腹痛者，或属虚寒，然气亦能
作痛，恐有血瘀气滞，不必骤补，先用四物加陈皮、香附，次用八物汤加香附。如泻者，先
止其泻，而痛自止矣。有每遇经行，辄头痛心忡，饮食减少，肌肤不润泽者，宜加减吴茱萸
汤。亦有冲任虚衰，小腹有寒，月水过期，不能受孕者，大温经汤主之。有经水过而作痛者
，血虚有寒也，法当温经养血，宜四物加桃仁、香附、肉桂。有经行着气，心腹腰胁疼痛者
，血瘀气滞也，当顺气消瘀，青皮、归、芍、桃仁、红花、川芎、乌药，水煎服。有经水过
期而来作痛者，血虚有热也，宜生血清热，四物加桃仁、香附、丹皮、甘草、元胡。有经水
行后而作痛者，气血虚而空痛也，法当调养气血，宜八珍汤加姜枣。有经水过多，久不止而
腹痛者，乃脾经血虚也，治宜补血健脾，四物加白术、茯苓、木香、浓朴、香附、陈皮、干
姜、甘草，水煎。
血风者，经水逆行，上攻于脑，头目旋闷，不省人事，甚至满头满面，皆发赤斑者，此因经
水适临，感冒风邪所致。盖风善行而数变，其势易上而难下，经水为风邪所激，以故倒流而
上行也。血风乃血证中之最急者，宜以四物为主，加山栀、桃仁、红花、荆芥、防风、天麻
、薄荷、白术之类。其所以用白术者，以其能去面上游风，及利腰脐间血故也。
四乌汤
乌药 当归 三棱 文术 赤芍 红花 桃仁 官桂 益母 香附
吴茱萸汤
吴萸 人参 大枣 老姜
八珍汤
熟地 白芍 川芎 当归 人参 白术 茯苓 甘草
八物汤（见经水过期）
大温经汤（见调经）
四物汤
熟地 白芍 当归 川芎
妇女月经来潮时，小腹出现疼痛的，是气血运行涩滞所致。使用四乌汤。月经期间腹痛的，有的属于虚寒证，但气机不畅也能引起疼痛，恐怕存在血瘀气滞的情况，不要急于进补，先用四物汤加入陈皮、香附，随后使用八物汤加入香附。如果伴有腹泻的，先止住腹泻，腹痛自然就会停止。有的人每次遇到月经来潮，就出现头痛、心悸（心慌）、饮食减少、肌肤不润泽的症状，适宜使用加减吴茱萸汤。也有冲任二脉虚衰，小腹有寒气，月经过期不来，不能受孕的，以大温经汤主治。有的人月经结束后才出现疼痛的，是血虚兼有寒气，治法应当温经养血，适宜用四物汤加入桃仁、香附、肉桂。有的人经期情绪激动（着气），导致心腹腰胁疼痛的，是血瘀气滞，应当顺气消瘀，用青皮、当归、白芍、桃仁、红花、川芎、乌药，水煎服用。有的人月经过期后才来潮并出现疼痛的，是血虚兼有热邪，适宜生血清热，用四物汤加入桃仁、香附、丹皮、甘草、元胡。有的人月经行经后出现疼痛的，是气血虚弱导致的空痛，治法应当调养气血，适宜用八珍汤加入生姜、大枣。有的人月经量过多，长久不止且伴有腹痛的，是脾经血虚，治疗应当补血健脾，用四物汤加入白术、茯苓、木香、厚朴、香附、陈皮、干姜、甘草，水煎。
所谓“血风”，是指月经逆行，向上攻冲头部，导致头晕目眩、昏厥不省人事，甚至满头满脸都发出赤斑的症状，这是因为月经刚至，感受风邪所致。因为风邪善于游走且变化迅速，其病势容易上行而难以下降，月经被风邪激荡，所以倒流而上行。血风是血证中最紧急的一种，适宜以四物汤为主方，加入山栀、桃仁、红花、荆芥、防风、天麻、薄荷、白术等药物。之所以使用白术，是因为它能去除面部的游风，以及疏通腰脐间的血液。
四乌汤
乌药 当归 三棱 莪术 赤芍 红花 桃仁 官桂 益母草 香附
八物汤（参见经水过期条）
大温经汤（参见调经条）
When a woman's menstruation is just beginning and she experiences pain in the lower abdomen, it is due to the stagnation of Qi and Blood. Siwu Tang (Four Substances Decoction) should be used. If abdominal pain occurs during menstruation, it may belong to deficiency-cold; however, Qi stagnation can also cause pain. One must suspect blood stasis and Qi stagnation, and not rush to tonify. First, use Siwu Tang (Four Substances Decoction) added with Chenpi (Tangerine Peel) and Xiangfu (Cyperus Rhizome), followed by Bayu Tang (Eight-Ingredient Decoction) added with Xiangfu (Cyperus Rhizome). If diarrhea is present, stop the diarrhea first, and the pain will cease naturally. Some women experience headache, palpitations (Xin Chong), reduced appetite, and unmoistened skin every time menstruation arrives; Jiajian Wuzhuyu Tang (Modified Evodia Decoction) is suitable. In cases where the Chong and Ren vessels are deficient and weak, with cold in the lower abdomen, causing delayed menstruation and inability to conceive, Dawenjing Tang (Great Warming the Menses Decoction) is the primary treatment. For those who experience pain after menstruation has ended, it is due to blood deficiency with cold; the method should be to warm the meridians and nourish blood, using Siwu Tang (Four Substances Decoction) added with Taoren (Peach Kernel), Xiangfu (Cyperus Rhizome), and Rougui (Cinnamon Bark). For those whose menstrual emotions become agitated ("Zhe Qi"), leading to pain in the heart, abdomen, waist, and hypochondrium, it is due to blood stasis and Qi stagnation; one should soothe Qi and resolve stasis, using Qingpi (Green Tangerine Peel), Danggui (Angelica Sinensis), Shaoyao (White Peony Root), Taoren (Peach Kernel), Honghua (Safflower), Chuanxiong (Ligusticum Rhizome), and Wuyao (Lindera Root), decocted in water. For those whose menstruation is delayed and then arrives with pain, it is due to blood deficiency with heat; the method should be to generate blood and clear heat, using Siwu Tang (Four Substances Decoction) added with Taoren (Peach Kernel), Xiangfu (Cyperus Rhizome), Danpi (Moutan Cortex), Gancao (Licorice Root), and Yuanhu (Corydalis Rhizome). For those who experience pain after menstruation has ceased, it is empty pain caused by Qi and Blood deficiency; the method should be to regulate and nourish Qi and Blood, using Bazhen Tang (Eight-Treasure Decoction) added with Shengjiang (Fresh Ginger) and Dazao (Jujube). For those with excessive menstruation that persists for a long time accompanied by abdominal pain, it is due to blood deficiency in the Spleen Meridian; treatment should focus on nourishing blood and strengthening the Spleen, using Siwu Tang (Four Substances Decoction) added with Baizhu (Atractylodes Macrocephala Rhizome), Fuling (Poria), Muxiang (Vladimiria Root), Houpo (Magnolia Bark), Xiangfu (Cyperus Rhizome), Chenpi (Tangerine Peel), Ganjiang (Dried Ginger), and Gancao (Licorice Root), decocted in water.
"Blood Wind" refers to menstruation flowing retrograde, attacking upwards to the brain, causing dizziness, fainting, and even red spots all over the head and face. This is caused by contracting wind-pathogen when menstruation is just starting. Since wind is agile and changes frequently, its pathogenic force tends to ascend and is difficult to descend. Stimulated by the wind-pathogen, menstruation flows backward and upward. Blood Wind is the most urgent among blood disorders. It should be treated primarily with Siwu Tang (Four Substances Decoction), added with Zhizi (Gardenia Fruit), Taoren (Peach Kernel), Honghua (Safflower), Jingjie (Schizonepeta Spike), Fangfeng (Saposhnikovia Root), Tianma (Gastrodia Rhizome), Bohe (Mint), and Baizhu (Atractylodes Macrocephala Rhizome). The reason for using Baizhu (Atractylodes Macrocephala Rhizome) is that it can dispel wandering wind from the face and promote blood circulation in the waist and umbilical region.
Siwu Tang (Four Substances Decoction)
Wuyao (Lindera Root), Danggui (Angelica Sinensis), Sanleng (Sparganium Rhizome), Ezhu (Curcuma Zedoaria Rhizome), Chishao (Red Peony Root), Honghua (Safflower), Taoren (Peach Kernel), Guangui (Official Cinnamon Bark), Yimucao (Motherwort Herba), Xiangfu (Cyperus Rhizome)
Wuzhuyu Tang (Evodia Decoction)
Wuyu (Evodia Fruit), Renshen (Ginseng Radix), Dazao (Jujubae Fructus), Laojiang (Old Ginger)
Bazhen Tang (Eight-Treasure Decoction)
Shudi (Rehmanniae Radix Preparata), Baishao (Paeoniae Radix Alba), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma)
Bayu Tang (Eight-Ingredient Decoction) (See "Delayed Menstruation")
Dawenjing Tang (Great Warming the Menses Decoction) (See "Regulating Menstruation")
Siwu Tang (Four Substances Decoction)
Shudi (Rehmanniae Radix Preparata), Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma)