答曰。妇人月水。有四经之所主。一者冲任二脉。二者手太阳少阴二经。然冲为血海。任为
主胞胎。二者相资。故令有子。手太阳者。小肠之经。为腑而主表。表属阳。手
少阴者。心之经。为脏而主里。里属阴。此二经。在上为乳汁。在下为月水。或劳伤气血。
致令体虚而受乎风冷。风冷客于经络。搏于血气。血得冷则壅滞。故令月水不宜利也。
养荣汤。治妇人血海虚弱。心忪恍惚。时多惊悸。或发虚热。经候不调。
白芍 川芎 当归 熟地 青皮 姜黄 川姜 丹皮 海桐皮 五加皮 白芷
上为 咀。每服五钱。水盏半。姜五片。乌梅一个。煎至一盏。去滓温服。不拘时候。将此
药送下紫桂圆七十粒。(紫桂圆方见四十九问)
答曰。经脉者。行血气。通阴阳。以营卫周身者也。血气盛。阴阳和。则形体适平。或外亏
卫气之充养。内乏营血之灌溉。血气不足。经候欲行。身体先痛也。或风冷之气。客于胞络
。损伤冲任之脉。及手太阳手太阴之经。故月水将下之际。血气与风冷相击。所以经欲行而
腰痛也。
趁痛饮子。治经脉虚寒。身体疼痛。
虎骨(五铢) 茯苓 甘草 本 防风 白芷(各二铢) 当归 白芍 续断 吴术 附子(
各三铢)
上为粗末。每服五钱。水二盏。姜五片。枣二枚。煎至一盏。去滓温服。不拘时。
温经汤。治风寒客搏经络。小腹作痛。
当归 川芎 白芍 官桂 丹皮 莪术(各半两) 人参 甘草 牛膝(各一两)
上为粗末。每服五钱。水二盏煎八分。食前服。
没药除痛散。逐寒邪。疗腹痛。
蓬莪术(炮一两) 当归(焙) 玄胡索 五灵脂 肉桂 良姜(炒) 蒲黄(炒各七钱半) 甘草
没药(各半两)
上为细末。每服三钱。温酒调下。
杨氏谓妇人每经欲行必先腹痛。令服撞气阿魏丸。酒调大圣散。下数服愈。经行不复痛矣。
撞气阿魏丸 大圣散(见宋局方妇人门)
茴香(炒香) 陈皮(去白) 青皮(去白) 川芎 丁香(皮炒) 蓬莪术(炮) 甘草 缩砂仁
肉桂(去粗皮) 白芷(炮各半两) 生姜(四两切盐半两腌一宿炒黑) 胡椒(二钱半) 阿魏(
二钱半醋浸一宿以面同为糊)
上末阿魏糊为丸。鸡豆大。每药一斤。朱砂七钱为衣。常服一粒。嚼烂醋汤茶酒任下。
滋血汤。治血风虚。经候涩滞。经脉不通。四肢麻木。肌体浑身疼痛。倦怠将成痨瘵。
马鞭草 荆芥穗(各四两) 丹皮(一两) 赤芍 枳壳 肉桂 当归 川芎(各二两)
上为粗末。每服四钱。乌梅一个。水煎食前服。
琥珀散。治月经拥滞。心腹疼痛。及治产后恶露不快。血上抢心。迷闷不省。气绝欲死。
京三棱(煮) 莪术(煮) 赤芍药(煮) 刘寄奴(煮) 牡丹皮(煮) 官桂 菊花 蒲黄 熟地
当归(各一两)
上将前五味。用乌豆半升。生姜半斤切片。米醋四升同煮。豆腐烂为度。焙干入后五味同为
末。每服二钱。温酒调下。
答：妇女的月经，由四条经脉所主管。一是冲脉和任脉；二是手太阳经和手少阴经。其中，冲脉是血海，任脉主司胞胎，这两条经脉相互资助，所以能使人受孕。手太阳经是小肠的经脉，属于腑而主表，表属阳；手少阴经是心的经脉，属于脏而主里，里属阴。这两条经脉，在上部化为乳汁，在下部化为月经。如果因劳累损伤气血，导致身体虚弱而感受风冷之邪，风冷侵袭经络，与气血相搏结，血液遇到寒冷就会壅滞不通，从而导致月经不畅利。
养荣汤，治疗妇女血海虚弱，心中悸动恍惚，时常惊悸，或者出现虚热，月经周期不调。
药材：白芍、川芎、当归、熟地黄、青皮、姜黄、川姜、丹皮、海桐皮、五加皮、白芷。
制法：将上述药材捣碎成粗末。每次服用五钱，加水一盏半，生姜五片，乌梅一个，煎煮至一盏量，去渣后温服。不拘时间。将此药送服紫桂圆七十粒。（紫桂圆的方子见第四十九问）
答：经脉，是运行气血，沟通阴阳，以营养周身组织的通道。如果气血旺盛，阴阳调和，那么形体就平和适宜。如果外则卫气充养不足，内则营血灌溉匮乏，导致气血不足，在月经将要来潮时，身体就会先出现疼痛。或者是风冷之气，客居于胞宫络脉，损伤了冲脉、任脉以及手太阳经、手太阴经。所以在月经即将下行之际，气血与风冷相互搏击，因此月经欲行时会出现腰痛。
趁痛饮子，治疗经脉虚寒，身体疼痛。
药材：虎骨（五铢）、茯苓、甘草、藁本、防风、白芷（各二铢）、当归、白芍、续断、吴术、附子（各三铢）。
制法：将上述药材捣成粗末。每次服用五钱，加水两盏，生姜五片，大枣二枚，煎煮至一盏量，去渣后温服。不拘时间。
温经汤，治疗风寒客居搏击经络，小腹作痛。
药材：当归、川芎、白芍、官桂、丹皮、莪术（各半两）、人参、甘草、牛膝（各一两）。
制法：将上述药材捣成粗末。每次服用五钱，加水两盏，煎至八分满，饭前服用。
没药除痛散，驱逐寒邪，治疗腹痛。
药材：蓬莪术（炮制一两）、当归（焙干）、玄胡索、五灵脂、肉桂、良姜（炒）、蒲黄（炒，各七钱半）、甘草、没药（各半两）。
制法：将上述药材研为细末。每次服用三钱，用温酒调服。
杨氏认为妇女每次月经将要来潮时必定先出现腹痛，建议服用撞气阿魏丸，并用酒调服大圣散，服用几剂后即可痊愈，经期不再疼痛。
撞气阿魏丸、大圣散（见宋代官方局方妇人门）。
药材：茴香（炒香）、陈皮（去白）、青皮（去白）、川芎、丁香（皮炒）、蓬莀术（炮制）、甘草、缩砂仁、肉桂（去粗皮）、白芷（炮制，各半两）、生姜（四两切片，用盐半两腌制一夜后炒黑）、胡椒（二钱半）、阿魏（二钱半，醋浸一夜后用面粉同煮成糊状）。
制法：用阿魏糊作为粘合剂制成丸药，大小如鸡豆。每斤药粉配朱砂七钱作为衣层。常服一粒，嚼烂后随意用醋汤、茶或酒送下。
滋血汤，治疗血虚受风，月经涩滞，经脉不通，四肢麻木，全身肌肉疼痛，倦怠乏力，即将形成劳瘵（慢性消耗性疾病）。
药材：马鞭草、荆芥穗（各四两）、丹皮（一两）、赤芍、枳壳、肉桂、当归、川芎（各二两）。
制法：将上述药材捣成粗末。每次服用四钱，加乌梅一个，用水煎煮，饭前服用。
琥珀散，治疗月经拥滞，心腹疼痛，以及治疗产后恶露排出不畅，瘀血上冲于心，导致昏迷不省人事，气息微弱欲死。
药材：京三棱（煮）、莪术（煮）、赤芍药（煮）、刘寄奴（煮）、牡丹皮（煮）、官桂、菊花、蒲黄、熟地黄、当归（各一两）。
制法：先将前五味药材，用乌豆半升、生姜半斤切片、米醋四升一同煮，直到煮烂如豆腐状，然后焙干，再与其他五味药材一起研为细末。每次服用二钱，用温酒调服。
Answer: A woman's menstruation is governed by four meridians. The first are the Chong (Penetrating) and Ren (Conception) vessels. The second are the Hand Taiyang (Small Intestine) and Hand Shaoyin (Heart) meridians. Among these, the Chong vessel serves as the Sea of Blood, while the Ren vessel governs the uterus; their mutual support enables conception. The Hand Taiyang meridian belongs to the Small Intestine, a Fu organ that governs the exterior, which is associated with Yang. The Hand Shaoyin meridian belongs to the Heart, a Zang organ that governs the interior, which is associated with Yin. These two meridians transform into breast milk in the upper body and into menstruation in the lower body. If labor and fatigue damage Qi and Blood, leading to bodily weakness and susceptibility to Wind-Cold pathogens, the Wind-Cold may lodge in the meridians and contend with Qi and Blood. When blood encounters cold, it becomes stagnant and obstructed, resulting in unsmooth menstruation.
Yangrong Tang (Nourishing Prosperity Decoction) treats deficiency of the Blood Sea in women, characterized by palpitations, mental restlessness, frequent fright and palpitation, or deficiency heat, along with irregular menstrual cycles.
Ingredients: Baishao (Radix Paeoniae Alba), Chuanxiong (Rhizoma Chuanxiong), Danggui (Radix Angelicae Sinensis), Shudi (Radix Rehmanniae Preparata), Qingpi (Pericarpium Citri Reticulatae Viride), Jianghuang (Rhizoma Curcumae Longae), Chuanjiang (Rhizoma Zingiberis), Danpi (Cortex Moutan), Haitongpi (Cortex Erythrinae), Wujia pi (Cortex Acanthopanacis), Baizhi (Radix Angelicae Dahuricae).
Preparation: Grind the above herbs into coarse powder. Take 5 qian per dose, add 1.5 cups of water, 5 slices of fresh ginger, and one smoked plum. Decoct until 1 cup remains, strain, and take warm. Administer at any time. Swallow this medicine with 70 pills of Zi Guiyuan (see Question 49 for the formula).
Answer: Meridians circulate Qi and Blood, connect Yin and Yang, and nourish the entire body. When Qi and Blood are abundant and Yin and Yang are harmonious, the physical form remains balanced. However, if there is an external lack of Wei Qi (Defensive Qi) nourishment and an internal deficiency of Ying Qi (Nutritive Blood) irrigation, resulting in insufficient Qi and Blood, body pain may precede the onset of menstruation. Alternatively, Wind-Cold pathogens may lodge in the uterine collaterals, damaging the Chong and Ren vessels, as well as the Hand Taiyang and Hand Taiyin meridians. Thus, when menstruation is about to descend, Qi and Blood contend with Wind-Cold, causing lower back pain during the pre-menstrual phase.
Chentong Yinzi (Pain-Relieving Drink Powder) treats deficiency-cold of the meridians accompanied by body pain.
Ingredients: Hugu (Os Tigris, Tiger Bone, 5 zhu), Fuling (Poria), Gancao (Radix Glycyrrhizae), Bencao (Radix Ligustici Chuanxiong), Fangfeng (Radix Saposhnikoviae), Baizhi (Radix Angelicae Dahuricae, each 2 zhu), Danggui (Radix Angelicae Sinensis), Baishao (Radix Paeoniae Alba), Xuduan (Radix Dipsaci), Wuzhu (Atractylodes Macrocephala Rhizoma), Fuzi (Radix Aconiti Lateralis Preparata, each 3 zhu).
Preparation: Grind into coarse powder. Take 5 qian per dose, add 2 cups of water, 5 slices of fresh ginger, and 2 dates. Decoct until 1 cup remains, strain, and take warm. Administer at any time.
Wenjing Tang (Warm the Meridians Decoction) treats Wind-Cold lodging and contending in the meridians, causing abdominal pain.
Ingredients: Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong), Baishao (Radix Paeoniae Alba), Guigui (Cinnamomi Ramulus), Danpi (Cortex Moutan), Ezhu (Rhizoma Curcumae Zedoariae, each half liang), Renshen (Radix Ginseng), Gancao (Radix Glycyrrhizae), Niuxi (Radix Achyranthis Bidentatae, each 1 liang).
Preparation: Grind into coarse powder. Take 5 qian per dose, add 2 cups of water, decoct to 8/10 strength, and take before meals.
Moyao Chutong San (Myrrh Pain-Relieving Powder) expels Cold pathogens and treats abdominal pain.
Ingredients: Peng Ezhu (Rhizoma Curcumae Zedoariae, processed, 1 liang), Danggui (Radix Angelicae Sinensis, roasted), Yanshusu (Rhizoma Corydalis), Wulingzhi (Trogopterus Dung), Rougui (Cortex Cinnamomi), Liangjiang (Rhizoma Alpiniae Officinarum, stir-fried), Puhuang (Pollen Typhae, stir-fried, each 7.5 qian), Gancao (Radix Glycyrrhizae), Moyao (Myrrha, each half liang).
Preparation: Grind into fine powder. Take 3 qian per dose, mix with warm wine and ingest.
Master Yang stated that women invariably experience abdominal pain prior to menstruation. He recommended taking Zhuangqiawei Wan (Qi-Stabilizing Asafoetida Pills) and Daisheng San (Great Sages' Powder) taken with wine. After several doses, the condition resolves, and pain ceases during menstruation.
Zhuangqiawei Wan and Daisheng San (see Song Dynasty Bureau Formulas, Women's Section).
Ingredients: Huixiang (Foeniculum Vulgare Fruit, stir-fried until fragrant), Chenpi (Pericarpium Citri Reticulatae, white pith removed), Qingpi (Pericarpium Citri Reticulatae Viride, white pith removed), Chuanxiong (Rhizoma Chuanxiong), Dingxiang (Flos Caryophyllati, skin stir-fried), Peng Ezhu (Rhizoma Curcumae Zedoariae, processed), Gancao (Radix Glycyrrhizae), Suosaren (Fructus Amomi Rotundus), Rougui (Cortex Cinnamomi, rough bark removed), Baizhi (Radix Angelicae Dahuricae, processed, each half liang), Shengjiang (Rhizoma Zingiberis Recens, 4 liang sliced, pickled with half liang salt overnight, then stir-fried until black), Hujiao (Piperis Longi Fructus, 2.5 qian), Awei (Asafetida, 2.5 qian, soaked in vinegar overnight, cooked with flour into a paste).
Preparation: Use the Asafetida paste to bind the powder into pills the size of chicken beans. For every jin (approx. 600g) of medicinal powder, use 7 qian of Zhusha (Cinnabar) as a coating. Take one pill regularly, chew thoroughly, and swallow with vinegar water, tea, or wine as desired.
Zixue Tang (Nourishing Blood Decoction) treats deficiency of Blood with Wind invasion, resulting in scanty and sluggish menstruation, blocked meridians, numbness in the four limbs, generalized muscle pain, fatigue, and impending consumption diseases (Laozai).
Ingredients: Mabiancao (Herba Verbenaes Officinalis), Jingjiesui (Spica Schizonepetae, each 4 liang), Danpi (Cortex Moutan, 1 liang), Chishao (Radix Paeoniae Rubra), Zhiqiao (Fructus Aurantii), Rougui (Cortex Cinnamomi), Danggui (Radix Angelicae Sinensis), Chuanxiong (Rhizoma Chuanxiong, each 2 liang).
Preparation: Grind into coarse powder. Take 4 qian per dose, add one smoked plum, decoct in water, and take before meals.
Hupo San (Amber Powder) treats menstrual obstruction and epigastric/abdominal pain, as well as postpartum lochia retention. It addresses blood rushing upward to the heart, causing coma, unconsciousness, weak respiration, and near-death states.
Ingredients: Jingsanleng (Rhizoma Sparganii, boiled), Ezhu (Rhizoma Curcumae Zedoariae, boiled), Chishaoyao (Radix Paeoniae Rubra, boiled), Liuji nu (Herba Siegesbeckiae, boiled), Mudanpi (Cortex Moutan, boiled), Guigui (Cinnamomi Ramulus), Juhua (Flos Chrysanthemi), Puhuang (Pollen Typhae), Shudi (Radix Rehmanniae Preparata), Danggui (Radix Angelicae Sinensis, each 1 liang).
Preparation: First, boil the first five ingredients with half a sheng of black soybeans, half a jin of sliced fresh ginger, and four sheng of rice vinegar until soft like tofu. Dry them, then grind together with the remaining five ingredients into powder. Take 2 qian per dose, mix with warm wine and ingest.