《经》曰∶悲哀太过则心系急，肺布叶举，而上焦不通，热气在中，故血走而崩也。又曰∶阴虚阳搏谓之崩。然有
得之悲哀者，七情伤心之崩也；有得之劳力者，内伤劳倦之崩也。崩者，经血卒然大至，或清或浊，或纯下瘀血，如山
之崩，势不可遏之谓也。有崩甚腹痛，人多疑恶血未尽，又见血色瘀黑，愈信恶血，不敢止截。殊不知血因经络之气而
流行，故能色鲜而不滞，若一出经络既失阳和，复无气运，犹天寒风静，水即为冰，停在腹中，便为瘀血。以瘀为恶，
又焉知瘀之不为虚冷乎。瘀而腹痛，血行则痛止，崩而腹痛，血住则痛止。芎归汤加姜、附止其血而痛自止去。以色黑
为瘀血，而尽去之，则经络中之乘虚而走者，何时而生耶。必气脱人亡而后已。甚有涎郁胸中，清气不升，故经脉壅
遏而降下，非开涎则不足以行气，非气升则血不能以归隧道。治宜二陈之类，先服后吐之，既开胸膈之痰涎，复散郁滞
之浊气，则气升浊降，血归隧道而不崩矣。
冲任为经脉之海，凡血气调适，则外循经络，内荣脏腑，经下根据时。若劳伤过极，冲任气虚不能约制经血，乃为崩
中暴下。治当大补气血，升举脾胃之气，微加镇坠心火，补阴泻阳而崩自止。若过凉剂投服，则加遏阳气于气海，经血
愈难宁静。古人多用烧干姜灰，或烧桂心灰，方书用治寒崩，非治寒也，取其散结从治法耳。然更当分阴阳而治。夫气
血，人身之阴阳也，阳主升，阴主降，阳根阴，阴根阳，一升一降循经而行，无崩漏也。若阳有余则升者胜，血出上窍；
阳不定则降者胜，血出下窍，故血随阳气而升降。阳气者，风也，风能上升，然必须东方之温风，始能升生长养也。
妇人血崩，来如潮涌，明是热势妄行，然岂可用寒治。寒则血凝泣，而热郁于中宫益深矣，治宜清补兼为升提，血
自循经，经自摄血，故宜不可骤止也，宜地黄、阿胶、芍药、麦冬、桑耳灰、木耳灰之类。久则亦多虚寒，而宜温补脾
肾者，当以脉侯之。然血症多兼用黑药者，以血者火之色也，黑者水之象也，血挟火势，令水化制之，故黑能胜红也。
《经》云∶阴虚阳搏谓之崩。盖尺脉既虚，阴血已损，寸脉搏击，虚火愈炽，火迫妄行而为之。崩皆从胞络中出也，
血久下行，已为熟经，则本宫血乏，十二经之血皆从此渗漏矣。然胞络下系于肾，上通于心，故此症实关心肾二经，宜
有阴虚阳搏之脉也。东垣用十二经引经之药，使血归十二经，然后用黑药止之。若不先服引血归经，则止血藏于何所，
势必益增泛滥无拘矣。尤宜清心绝欲，则心得拱默之德，肾得闭藏之司，肝无妄泄之害矣。
崩者，倏忽暴下也；漏者，淋沥不断也。总由劳役过度而伤中，喜怒不节而伤肝，脾虚不能统血，肝伤不能藏血，
而为崩中漏下。或悲思忧恐太甚，阳气内动，真阴愈虚，不能镇守胞络，相火迫血而崩，故宜养血安神为主，若因脾胃
气虚下陷，肾与相火相合，湿热下迫而致者，宜调理养血为主；或大小新产，遽触房事；或经水未绝，欲炽而伤血海，
皆致崩漏，并宜调气养血，于肝心脾肾则脏求之。
女子漏下恶血，或暴崩不止，多下水浆之物，皆由饮食不节，或劳倦伤脾，或心气不足。夫脾为至阴，滋荣周身者
也；心主血脉，实肾贯脾者也。二者受病，病皆在脉。脉者，血之府也；心者，脉之神也；心不主令，包络代之。心系
者，胞络命门之脉也，主月事生孕。因脾胃虚而心包乘之，故漏下血水不止，当除湿去热，用升阳除湿汤，即提阳气之
下陷，复假风药以胜其湿热之势也。若病愈，经血恶物已尽，必须以黄 、人参、甘草、当归之类补之；若经血恶物下
之不绝，因虚不能收摄者，当益脾胃，补气血，兼升兼止；因于热者，兼以清心凉血之药。
人之七情过极，则动五志之火，五志之火一甚，则经血暴下如风动水摇，火燃水沸也。治崩次第，初用止血以塞其
流，中用清热凉血以澄其源，末用补血以还其旧。若止塞其流而不澄其源，则滔天之势不能遏；若止澄其源而不复其旧，
则孤立之阳无以立。故急则治标，缓则治本，本末勿遗，前后罔紊，方可以言治。
立斋曰∶有妇人患崩，过服寒药，脾胃久虚，中病未已，寒病复起，烦渴引饮，粒米不进，昏愦时作，脉洪大而按
之微弱。此无根之火，内虚寒而外假热也，十全大补加附子而崩减，日服八味丸而愈。又有久患崩者，服四物凉血剂，
或作或止。有主降火为治，则更加腹痛、手足俱冷。此脾胃虚寒所致，先用附子理中汤，次用济生归脾、补中益气二汤
而崩愈。崩且水泻，是前后二阴之气下脱也，参苓 术佐升柴，大升大补为佳。如病患自觉寒冷如水，时欲喜暖所，下
污水色如屋漏，或多白带，脉虽洪紧而无力，或沉伏者，此属浊气郁滞冲任所致，宜以升散开结平肝为要，必兼辛散，
平以辛凉，其纯热纯寒之药俱不可用。炒黄柏、苍术、香附、抚芎、半夏、青陈皮、白芷、柴胡、肉桂、炮姜之类最宜。
凡受热而色赤者，谓之阳崩；受冷而色白者，谓之阴崩。五脏皆虚，五色随崩俱下。一脏虚，随脏见色者∶下色白
如涕，肺脏之虚冷也；色青如蓝，肝脏之虚冷也；色黄如烂瓜，脾脏之虚冷也；色赤如绛，心脏之虚冷也；色黑如肝血，
肾脏之虚冷也。五脏俱虚，五色相杂，谓之五崩。
立斋曰∶血崩兼心痛者，心主血，去血过多，心无所养以致作痛也，宜十全汤倍参术多服；如瘀血不行者，失笑散；
阴血耗散者，乌贼丸敛之。然崩为急症，漏为缓症；崩必大怒伤肝，冲动血海，或火盛之极，血热沸腾也；漏则房劳过
度，伤损冲任二脉，气虚不能约制经血，或其人平素多火，血不能安，故不时漏泄；崩宜理气降火升提，漏宜滋阴补气
养血；或兼制火也。
崩漏不止之症，先因心火亢甚，于是血脉泛溢，以致肝实而不能纳血，出纳之用遂废。《经》曰∶子能令母实。是以
肝肾之相火，上挟心火之势，从而相扇，至令月水错经妄行，无时泛溢。若不早治，变为血枯发热痨怯矣。
《经》云∶阳络伤，血外溢；阴络伤，血内溢。又云脾统血、肝藏血。故崩漏为患，因脾胃虚损，不能统血营运。
或因肝经有火，血得热而下流。或因肝经有风，血乘风而妄动，或因怒动肝火，血热沸腾。或因脾经郁热，血不归经。
或因悲哀太过，胞络伤而渗漏。治疗之法，脾胃虚弱者，四君子加芎归。脾胃虚陷者，补中汤加白芍。肝经血热者，四
物汤加柴胡、山栀。肝经风热者，加味逍遥散。若怒动肝火，亦用前药。脾经郁火者，归脾汤加山栀、柴胡、丹皮。悲
伤胞络者，四君子加升、柴、山栀。初起多从热，久则又当从寒。然阳强阴弱者，崩愈久而阴愈虚愈热，乃阴虚之假热，
不可用寒凉正治也。朱丹溪、东垣云∶凡下血证，须四君子收功。又曰∶气虚血虚，皆以四物加参 。因劳力者，参
加升麻。若大去血后，毋以脉诊，急用独参汤救之。其发热、潮热、咳嗽、脉数，乃元气虚弱，真阳不能内藏，真阴
不能内守，假热之脉也，尤宜人参。此等症候，无不由脾胃先损，故脉洪大，察其中有胃气，受补则可救。设遇寒凉，
复伤脾胃生气，反不能摄血归源，是速其危也。盖诸血症皆以胃药收功，盖脾能统血，而脾胃又为生化之源也。至于先
贵后贱，名曰脱势；始富后贫，命曰脱营。由心气不足，其火内燔血脉之中，经候不调，形体容颜似不病者，此心病不
影于胗，至于饮食不节，则病矣。凡此宜劝解，以慰其心，再以大补气血，调益脾胃，微加镇坠心火，补阴泻阳，而经
自调矣。
《脉诀》曰∶崩漏下血，脉迟小虚滑者，生疾急；大实紧数者，死；尺寸虚者，漏血；脉浮者，死，不治。
胶艾汤
治劳伤血气，冲任虚损，月水过多，淋漓不断，及妊娠调摄失宜，治气不安，或因损动漏血伤胎。
阿胶（炒） 芎 甘草（炙，各二两） 艾叶（炒，一两） 当归（二两） 熟地黄 白芍药（各四两）
每服五钱，水一钟，酒半钟煎服。
柏子仁汤
治妇人忧思过度，劳伤心经，不能藏血，遂致崩中下血不止。
鹿茸（火去毛，酒蒸烙） 香附子（炒去毛） 柏子仁（炒。各二两） 芎 茯
神（去木） 当归 小草（各一两） 甘草（炙，五钱） 川续断（一两） 阿胶（二两，炒成珠）
每服四钱，酒一钟，姜五片煎七分，空心温服。
一方
治月水不止，用阿胶炒枯为末，好酒空心调服四钱，或白汤亦可。
乌鸡丸
治妇人羸弱，血虚有热，经水不调，崩漏带下，骨蒸等疾不能成胎。
白毛乌骨公鸡（一双，重二斤半许，闭死，去毛，肠净） 艾（四两） 青蒿（四两 碎），纳一半在鸡腹，用酒坛
一个纳鸡并余艾蒿在内，用童便和水灌，令没鸡二寸许，煮绝干，取出去骨，余俱捣烂如薄饼状，焙干，研为细末。
南香附（去毛净一斤，分作四分，米泔水浸一分，童便浸一分，醋浸一分，酒浸一分，春秋一夏一冬四日取出，晒
干） 熟地黄（四两焙干） 当归（酒浸洗炒） 白芍药（酒炒） 鳖甲（醋浸炙黄色） 人参（焙） 生地黄（怀庆
者勿犯铁器） 白术（炒） 黄 （蜜炙） 川牛膝（酒炒） 牡丹皮（酒炒） 柴胡（蜜酒炒） 知母（酒炒） 贝
母（姜汁拌炒。各二两） 地骨皮 干姜（炒黄） 玄胡索 黄连（酒浸炒。各一两） 秦艽（一两五钱，蜜酒持
炒） 川芎 白茯苓（各二两五钱）
上同香附子共为细末，和鸡末，温酒或米饮下，忌煎炒辛辣之物及苋菜。
芩心丸
治妇人四十九岁以后，天癸当住，每月却衍或过多不止。
黄芩（新枝条者二两，以米醋浸七日，炙干，又浸又炙如此七次）
为末，醋糊丸，桐子大，每服七十丸，空心温酒下，日三服。
十灰丸
治崩中下血不止。
黄绢灰 马尾灰 藕节灰 艾叶灰 赤松皮灰 蒲黄灰 莲蓬灰 油发灰 棕榈灰 绵灰（各等分）
为末，醋煮糯米糊丸桐子大，每服百丸，米饮下。
备金散
治妇人血崩不止。
香附子（四两炒） 当归（一两二钱） 五灵脂（一两）
为末，每服五钱，空心淡醋汤调下，立效。丹溪云∶崩过多者，先用五灵脂末一服，当分寒热，五灵脂能行能止。
莲蓬散
治经血不止。
莲蓬烧灰存性为末。
白汤调服二钱。
《黄帝内经》说：悲哀过度会使心脉拘急，肺叶张举，导致上焦气机不通，热气郁结于中焦，因此血液妄行而发生崩漏。又说：阴血亏虚而阳气搏动亢盛，称为崩漏。然而，有的崩漏是由于悲哀等七情内伤心脏所致；有的则是由于劳累过度、内伤劳倦所致。所谓“崩”，是指经血突然大量涌出，或清稀或浑浊，或纯为瘀血，像山崩一样，势不可挡。如果崩漏伴有剧烈腹痛，人们往往怀疑是恶血未尽，又见血色紫黑，更加确信是瘀血，不敢使用止血药。殊不知血液依靠经络之气的推动才能正常运行，所以颜色鲜红而不凝滞。一旦离开经络，失去了阳气的温煦和气的运化，就像天寒风静时水结成冰一样，停留在腹中就成了瘀血。如果把瘀血都视为有害的恶血而一味攻逐，哪里知道这种瘀血可能是因为虚寒造成的呢？如果是瘀血阻滞引起的腹痛，血液运行通畅后疼痛就会停止；如果是崩漏引起的腹痛，血液止住后疼痛也会停止。使用芎归汤加入生姜、附子来止血，疼痛自然就会消失。如果因为血色黑就认为是瘀血而将其全部祛除，那么那些乘虚而入的血液何时才能生成呢？这必然会导致气脱人亡的后果。更有甚者，痰涎郁结在胸中，导致清气不能上升，经脉壅塞阻滞而经血下泄，如果不化痰开郁就无法行气，如果气不升则血不能回归正常的脉络。治疗应当用二陈汤之类的方剂，先服用然后催吐，既开通了胸膈的痰涎，又疏散了郁滞的浊气，这样气升浊降，血液回归脉络就不会崩漏了。
冲脉和任脉是十二经脉的海，凡是气血调和适宜，就会外循经络，内养脏腑，月经按时来潮。如果劳损伤及极点，冲任二脉气虚不能约束经血，就会发生崩中暴下。治疗应当大补气血，升举脾胃之气，稍微加一些镇降心火的药物，通过补阴泻阳使崩漏自止。如果过用寒凉药剂，则会遏制气海的阳气，使经血更难宁静。古人多用烧成灰的干姜，或者烧成灰的桂心，方书中记载用于治疗寒性崩漏，其实并不是单纯治寒，而是取其散结和从治的方法罢了。然而更应当分辨阴阳进行治疗。气和血，就是人身体的阴阳，阳主升，阴主降，阳根源于阴，阴根源于阳，一升一降沿着经脉运行，就不会有崩漏。如果阳气有余，则升的力量占优势，血液从上窍溢出；如果阳气不安定，则降的力量占优势，血液从下窍溢出，所以血液随着阳气的升降而流动。阳气，就像风一样，风能上升，但必须是来自东方的温和之风，才能起到升发、生长、滋养的作用。
妇女血崩，来势如潮水汹涌，明显是热势妄行，但是难道可以用寒凉药治疗吗？如果用寒凉药，血液就会凝涩，而热邪会更深地郁结在中焦。治疗应当清热与补益兼施，并配合升提之法，血液自然会循经而行，经脉自然能摄血，所以不宜骤然强行止血，宜用地黄、阿胶、芍药、麦冬、桑耳灰、木耳灰等药物。时间久了，病情也多转为虚寒，适合温补脾肾的，应当根据脉象来判断。然而血症多兼用黑色药物，因为血是火的颜色，黑是水的象征，血液挟带火势，需要用水来制约它，所以黑色能胜过红色。《黄帝内经》说：阴虚阳搏谓之崩。这是因为尺脉虚弱，阴血已经受损，寸脉搏击有力，虚火更加炽盛，火热逼迫血液妄行而导致崩漏。崩漏都是从胞络中出来的，血液长期下行，已经是熟化的经血，那么本宫的血液匮乏，十二经的血液都会从这里渗漏出去。然而胞络下连于肾，上通于心，所以这个病症实际上关系到心和肾两经，应该出现阴虚阳搏的脉象。李东垣使用十二经的引经药，使血液回归十二经，然后再用黑色药物止血。如果不先服用引血归经的药物，那么止住的血藏在哪里呢？势必会增加泛滥无拘的情况。尤其应当清心绝欲，使心得以安静，肾得以闭藏，肝就没有妄泄的危害了。
崩，是指突然暴下；漏，是指淋漓不断。总都是由劳役过度损伤中气，喜怒不节损伤肝脏，脾虚不能统摄血液，肝伤不能贮藏血液，从而导致崩中和漏下。或者是悲伤思虑恐惧太过，阳气在内扰动，真阴更加虚弱，不能镇守胞络，相火逼迫血液而崩漏，所以应当以养血安神为主。如果是由于脾胃气虚下陷，肾与相火结合，湿热下迫而导致的，应当以调理养血为主；或者是大小产之后，立即进行房事；或者是月经未断，欲望强烈而损伤血海，都会导致崩漏，都应当调气养血，从肝、心、脾、肾四脏寻求治疗方法。
女子漏下恶血，或者暴崩不止，多排出水样浆液，都是由于饮食不节制，或者劳倦损伤脾气，或者心气不足。脾是至阴之脏，滋养周身；心主血脉，充实肾脏并贯通脾脏。这两者生病，病都在脉。脉是血的府库；心是脉的神明主宰；心如果不发号施令，由心包代劳。心系，就是胞络命门的脉，主管月经和生育。因为脾胃虚弱而心包乘虚侵袭，所以漏下血水不止，应当除湿去热，使用升阳除湿汤，即提升下陷的阳气，再借助风药来战胜湿热的势头。如果病愈，经血恶物已排尽，必须用黄芪、人参、甘草、当归等药物补益；如果经血恶物下个不停，是因为虚弱不能收摄，应当益脾胃，补气血，兼顾升提和止血；如果是因热引起的，兼用清心凉血的药物。
人的七情过度，就会触动五志之火，五志之火一旦旺盛，经血就会像风动水摇、火燃水沸一样暴下。治疗崩漏的步骤，起初用止血药以堵塞其流，中间用清热凉血药以澄清其源，最后用补血药以恢复其旧观。如果只堵塞其流而不澄清其源，那么滔天的洪水之势无法遏制；如果只澄清其源而不恢复其旧，那么孤立的阳气无法立足。所以急则治标，缓则治本，本末不遗漏，前后不紊乱，才可以谈论治疗。
薛立斋说：有一个妇人患崩漏，过服寒药，导致脾胃长久虚弱，原来的病没好，寒病又起，烦渴想喝水，粒米不进，时常昏愦，脉洪大但重按微弱。这是无根之火，内里虚寒而外表假热，用十全大补汤加附子使崩漏减轻，每天服用八味丸而痊愈。又有长久患崩漏的，服用四物汤等凉血剂，有时发作有时停止。有人主张降火治疗，结果更加腹痛、手足冰冷。这是脾胃虚寒所致，先用附子理中汤，再用济生归脾汤、补中益气汤两个方剂使崩漏痊愈。崩漏且伴有水泻，是前后二阴之气下脱，用人参、茯苓、白术佐以升麻、柴胡，大升大补为好。如果病患自觉寒冷如水，时时喜欢温暖的地方，排泄污水色如屋漏，或者白带多，脉虽然洪紧但无力，或者沉伏，这是属于浊气郁滞冲任所致，应当以升散开结、平肝为主要方法，必须兼用辛散药，用辛凉药平抑，纯热纯寒的药都不可用。炒黄柏、苍术、香附、抚芎、半夏、青皮陈皮、白芷、柴胡、肉桂、炮姜等最合适。
凡是受热而颜色红的，叫做阳崩；受冷而颜色白的，叫做阴崩。五脏都虚，五色随崩漏一起排出。某一脏虚，随该脏显现颜色：排出白色如涕，是肺脏虚冷；青色如蓝，是肝脏虚冷；黄色如烂瓜，是脾脏虚冷；红色如绛，是心脏虚冷；黑色如肝血，是肾脏虚冷。五脏都虚，五色混杂，叫做五崩。
薛立斋说：血崩伴随心痛的，因为心主血，失血过多，心无所养以致作痛，宜用十全大补汤倍加人参、白术多服；如果有瘀血不行的，用失笑散；阴血耗散的，用乌贼丸收敛。然而崩是急症，漏是缓症；崩一定是大怒伤肝，冲动血海，或者火盛至极，血热沸腾；漏则是房劳过度，损伤冲任二脉，气虚不能约束经血，或者其人平时多火，血不能安宁，所以不时漏泄；崩宜理气降火升提，漏宜滋阴补气养血；或者兼制火。
崩漏不止的病症，先是因为心火亢盛，于是血脉泛溢，导致肝实而不能纳血，出纳的功能于是废弛。《黄帝内经》说：子能令母实。因此肝肾的相火，上挟心火之势，从而相互煽动，致使月经错经妄行，无时泛溢。如果不早治疗，会变成血枯发热痨怯。
《黄帝内经》说：阳络受伤，血液外溢；阴络受伤，血液内溢。又说脾统血、肝藏血。所以崩漏为患，是因为脾胃虚损，不能统摄血液营运。或者因为肝经有火，血液得热而下流。或者因为肝经有风，血液乘风而妄动，或者因为愤怒触动肝火，血热沸腾。或者因为脾经郁热，血液不归经。或者因为悲哀太过，胞络受伤而渗漏。治疗方法，脾胃虚弱者，用四君子汤加川芎、当归。脾胃虚陷者，用补中益气汤加白芍。肝经血热者，用四物汤加柴胡、山栀。肝经风热者，用加味逍遥散。如果是怒动肝火，也用前面的药。脾经郁火者，用归脾汤加山栀、柴胡、丹皮。悲伤胞络者，用四君子汤加升麻、柴胡、山栀。初起多从热论治，久了则应当从寒论治。然而阳强阴弱者，崩漏越久阴越虚越热，这是阴虚的假热，不可用寒凉药正治。朱丹溪、李东垣说：凡下血证，须用四君子汤收功。又说：气虚血虚，都用四物汤加人参、黄芪。因为是劳力过度的，人参加升麻。如果大量失血后，不要凭脉诊，紧急使用独参汤抢救。如果有发热、潮热、咳嗽、脉数，这是元气虚弱，真阳不能内藏，真阴不能内守，出现的假热脉象，尤其适宜用人参。这些症候，无不首先损伤脾胃，所以脉洪大，只要察知其中有胃气，能够受补就可以救治。如果遇到寒凉药，再次损伤脾胃生气，反而不能摄血归源，这是加速其死亡。大概各种血症都以调理胃气的药收功，因为脾能统血，而脾胃又是生化之源。至于先贵后贱，名叫脱势；始富后贫，名叫脱营。由于心气不足，其火在内燔灼血脉之中，月经不调，形体容颜似乎没有病，这是心病不表现在脉诊上，直到饮食不节制，才发病。凡此情况应当劝解，以安慰其心，再用大补气血，调益脾胃，稍微加一些镇坠心火，补阴泻阳的药物，月经自然就能调好了。
《脉诀》说：崩漏下血，脉迟小虚滑的，病虽急但可生；脉大实紧数的，死；尺寸脉虚的，漏血；脉浮的，死，不治。
胶艾汤
治疗劳伤气血，冲任虚损，月经过多，淋漓不断，以及妊娠调摄失宜，胎气不安，或者因损伤动血漏血伤胎。
阿胶（炒） 川芎 甘草（炙，各二两） 艾叶（炒，一两） 当归（二两） 熟地黄 白芍药（各四两）
每次服用五钱，水一碗，酒半碗煎服。
柏子仁汤
治疗妇人忧思过度，劳伤心经，不能藏血，导致崩中下血不止。
鹿茸（火燎去毛，酒蒸烙） 香附子（炒去毛） 柏子仁（炒。各二两） 川芎 茯神（去木） 当归 小草（各一两） 甘草（炙，五钱） 川续断（一两） 阿胶（二两，炒成珠）
每次服用四钱，酒一碗，姜五片煎至七分，空腹温服。
一方
治疗月经不止，用阿胶炒枯研为末，好酒空腹调服四钱，或者白开水也可以。
乌鸡丸
治疗妇人身体羸弱，血虚有热，月经不调，崩漏带下，骨蒸等疾不能受孕。
白毛乌骨公鸡（一双，重二斤半左右，闷死，去毛，洗净肠肚） 艾叶（四两） 青蒿（四两 切碎），将一半放入鸡腹内，用一个酒坛将鸡和剩余的艾蒿放入，用童子尿加水灌入，淹没鸡约两寸，煮至完全干燥，取出去掉骨头，其余都捣烂如薄饼状，焙干，研为细末。
南香附（去毛净一斤，分作四分，米泔水浸一分，童便浸一分，醋浸一分，酒浸一分，春秋季一天夏季一天冬季四天取出，晒干） 熟地黄（四两焙干） 当归（酒浸洗炒） 白芍药（酒炒） 鳖甲（醋浸炙黄色） 人参（焙） 生地黄（怀庆产的勿犯铁器） 白术（炒） 黄芪（蜜炙） 川牛膝（酒炒） 牡丹皮（酒炒） 柴胡（蜜酒炒） 知母（酒炒） 贝母（姜汁拌炒。各二两） 地骨皮 干姜（炒黄） 玄胡索 黄连（酒浸炒。各一两） 秦艽（一两五钱，蜜酒持炒） 川芎 白茯苓（各二两五钱）
以上同香附子共研为细末，和鸡末混合，温酒或米饮送下，忌食煎炒辛辣之物及苋菜。
芩心丸
治疗妇人四十九岁以后，天癸应当停止，每月却延期或过多不止。
黄芩（新枝条者二两，以米醋浸七日，炙干，又浸又炙如此七次）
研为末，醋糊丸，梧桐子大，每次服用七十丸，空腹温酒送下，每日三次。
十灰丸
治疗崩中下血不止。
黄绢灰 马尾灰 藕节灰 艾叶灰 赤松皮灰 蒲黄灰 莲蓬灰 油发灰 棕榈灰 绵灰（各等分）
研为末，醋煮糯米糊丸梧桐子大，每次服用一百丸，米饮送下。
备金散
治疗妇人血崩不止。
香附子（四两炒） 当归（一两二钱） 五灵脂（一两）
研为末，每次服用五钱，空腹淡醋汤调下，立刻见效。丹溪说：崩漏过多的，先用五灵脂末一服，应当分辨寒热，五灵脂既能行血又能止血。
莲蓬散
治疗经血不止。
莲蓬烧灰存性研为末。
白开水调服二钱。
The *Classic of Medicine* (*Huangdi Neijing*) states: Excessive sorrow causes the heart vessels to contract, the lungs to expand and rise, leading to obstruction in the upper jiao (upper burner), with heat qi stagnating in the middle. Consequently, blood flows recklessly causing metrorrhagia (sudden heavy uterine bleeding). It also states: Yin deficiency with Yang pulsation is termed metrorrhagia. However, some cases of metrorrhagia arise from sorrow and other emotional injuries to the Heart; others result from overexertion and internal injury due to fatigue. "Metrorrhagia" refers to the sudden, massive flow of menstrual blood, which may be clear or turbid, or purely clotted blood, resembling a landslide that cannot be stopped. If metrorrhagia is accompanied by severe abdominal pain, people often suspect that evil blood (stasis) remains, and seeing dark purple blood reinforces this belief, making them afraid to use hemostatic agents. They fail to realize that blood circulates relying on the Qi of the meridians, thus maintaining a fresh color without stagnation. Once leaving the meridians, it loses the warming influence of Yang Qi and the transport function of Qi. Like water freezing when the wind is cold and the air still, if it stays in the abdomen, it becomes stasis. If one considers all stasis as harmful evil blood and attempts to expel it completely, how can one know that this stasis might not be due to deficiency-cold? If abdominal pain is caused by stasis, pain ceases when blood circulation resumes; if abdominal pain is caused by metrorrhagia, pain ceases when bleeding stops. Using Xiong Gui Tang (Cnidium and Angelica Decoction) added with Sheng Jiang (Fresh Ginger) and Fu Zi (Prepared Aconite Root) to stop bleeding will naturally relieve pain. If one assumes black blood is stasis and expels it entirely, when will the blood that entered due to deficiency regenerate? This would inevitably lead to Qi collapse and death. Furthermore, phlegm-dampness may stagnate in the chest, preventing Clear Qi from ascending, causing meridian obstruction and downward flow of blood. Without resolving phlegm, Qi cannot move; without ascending Qi, blood cannot return to the proper channels. Treatment should employ formulas like Er Chen Tang (Two-Cured Decoction); administer first, then induce vomiting. This opens the chest diaphragm's phlegm-dampness and disperses stagnant turbid Qi. With Qi ascending and turbidity descending, blood returns to the channels, and metrorrhagia ceases.
Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) are the seas of the twelve meridians. When Qi and Blood are harmonious, they circulate externally along the meridians and nourish internally the Zang-Fu organs, allowing menstruation to occur on time. If overexertion damages these vessels excessively, Qi deficiency in Chong and Ren fails to constrain menstrual blood, resulting in sudden heavy bleeding (Beng Zhong). Treatment requires greatly tonifying Qi and Blood, raising Spleen and Stomach Qi, and slightly suppressing Heart Fire. By tonifying Yin and draining Yang, metrorrhagia will cease. Overuse of cold/cooling herbs will suppress Yang Qi in the Qi Sea, making menstrual blood even harder to stabilize. Ancients often used charred Gan Jiang (Dried Ginger Rhizome) or Gui Xin (Cinnamon Twig Heart) ash. Although formularies record these for treating cold-type metrorrhagia, the intent is not merely to treat cold, but to utilize the method of scattering nodules and contrary treatment. One must differentiate Yin and Yang. Qi and Blood represent the Yin and Yang of the body; Yang governs ascent, Yin governs descent. Yang roots in Yin, Yin roots in Yang. Ascending and descending along the meridians prevents metrorrhagia. If Yang is excessive, ascent prevails, and blood exits through upper orifices; if Yang is unstable, descent prevails, and blood exits through lower orifices. Thus, blood follows the movement of Yang Qi. Yang Qi is like Wind; Wind rises, but only the warm East Wind can promote growth and nourishment.
Women's metrorrhagia comes like a tidal surge, clearly indicating reckless Heat. Yet, can it be treated with Cold? Cold causes blood to coagulate and stagnate, deepening Heat in the Middle Jiao. Treatment should combine clearing Heat with tonification, plus lifting methods. Blood will follow the meridians, and meridians will constrain blood, so abrupt cessation is inappropriate. Use Di Huang (Rehmannia Root), E Jiao (Donkey-Hide Gelatin), Shao Yao (Peony Root), Mai Dong (Ophiopogon Tuber), Sang Er Hui (Mulberry Pustule Ash), and Mu Er Hui (Wood Ear Fungus Ash). Long-standing cases often become deficiency-cold, suitable for warming and tonifying Spleen and Kidney, determined by pulse diagnosis. Hemorrhagic conditions often use black-colored herbs because Blood is the color of Fire, and Black is the image of Water. Blood carries Fire's nature, requiring Water to control it; thus, Black overcomes Red. The *Classic* says: Yin deficiency with Yang pulsation is metrorrhagia. The Chi (Kidney) pulse is deficient, indicating damaged Yin Blood; the Cun (Lung) pulse beats forcefully, indicating blazing Deficiency Fire. Fire forces blood to flow recklessly. Metrorrhagia originates from the Bao Luo (Uterine Network). Long-term downward flow exhausts the Uterus, causing leakage from the Twelve Meridians. The Bao Luo connects down to the Kidney and up to the Heart; thus, this condition involves both Heart and Kidney, presenting with Yin deficiency/Yang pulsation pulses. Li Dongyuan used guiding herbs for the Twelve Meridians to return blood to the channels before using black herbs to stop bleeding. Without guiding blood back, where would the stopped blood reside? It would inevitably flood uncontrollably. One must also clear the Heart and abandon desires, allowing the Heart to remain quiet and the Kidney to store essence, preventing the Liver from reckless leakage.
"Beng" (Metrorrhagia) is sudden, violent discharge; "Lou" (Metrorrhagia with dripping) is continuous, dripping leakage. Both stem from overwork damaging the Middle Jiao, unregulated emotions injuring the Liver, Spleen deficiency failing to control blood, and Liver injury failing to store blood. Excessive grief, worry, or fear moves Yang Qi internally, further depleting True Yin, which fails to guard the Bao Luo. Ministerial Fire forces blood out, causing metrorrhagia. Treatment focuses on nourishing Blood and calming the Spirit. If caused by Spleen/Stomach Qi sinking combined with Kidney/Ministerial Fire and Damp-Heat pressing downward, focus on regulating and nourishing Blood. Postpartum intercourse or sexual desire during menstruation damages the Blood Sea, causing both conditions. Treatment involves regulating Qi and nourishing Blood, addressing the Liver, Heart, Spleen, and Kidney.
Women with dripping evil blood or sudden heavy bleeding, often discharging watery fluids, suffer from irregular diet, fatigue damaging the Spleen, or insufficient Heart Qi. The Spleen is the ultimate Yin organ, nourishing the body; the Heart governs blood vessels and enriches the Kidney/Spleen connection. Disease affects the vessels. Vessels are the residence of Blood; the Heart is the spirit of the vessels. If the Heart does not command, the Pericardium acts. The Heart connection is the vessel of the Bao Luo and Ming Men, governing menstruation and pregnancy. Spleen/Stomach deficiency allows the Pericardium to invade, causing persistent bloody/watery discharge. Treat by removing Dampness and Heat using Sheng Yang Chu Shi Tang (Raise Yang and Remove Dampness Decoction) to raise sinking Yang and use Wind herbs to overcome Damp-Heat. After recovery, when evil matter is cleared, tonify with Huang Qi (Astragalus Root), Ren Shen (Ginseng Root), Gan Cao (Licorice Root), and Dang Gui (Angelica Sinensis). If discharge persists due to deficiency failing to contain, tonify Spleen/Stomach and Qi/Blood, combining lifting and stopping. If heat-related, add Heart-clearing and Blood-cooling herbs.
Extreme emotions stir the Fire of the Five Wills. When this Fire is intense, menstrual blood rushes like wind-driven water or boiling fire-water. Treatment steps for metrorrhagia: First, stop bleeding to block the flow; second, clear Heat and cool Blood to clarify the source; third, tonify Blood to restore the original state. Blocking flow without clarifying the source cannot stop the flood; clarifying the source without restoring the body leaves isolated Yang unsupported. Therefore, treat the branch in emergencies and the root in chronic cases. Do not neglect either.
Xue Lizhai said: A woman with metrorrhagia took too many cold herbs, causing long-term Spleen/Stomach deficiency. The original disease persisted, and cold symptoms returned: irritability, thirst, inability to eat, occasional coma, and a洪大 (Surging) pulse that was weak upon pressure. This is Rootless Fire: internal deficiency-cold with external false-heat. Ten Complete Decoction added with Fu Zi reduced bleeding; daily Ba Wei Wan (Eight-Ingredient Pill) cured her. Another chronic case taking Si Wu Tang (Four Substances Decoction) had intermittent bleeding. Treating with Fire-descending herbs worsened abdominal pain and cold limbs, indicating Spleen/Stomach deficiency-cold. Use Fu Zi Li Zhong Tang (Aconite Regulate the Middle Decoction) first, then Ji Sheng Gui Pi Tang and Bu Zhong Yi Qi Tang to cure. Metrorrhagia with watery diarrhea indicates Qi sinking from both openings. Use Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) assisted by Sheng Ma (Cimicifuga Rhizome) and Chai Hu (Bupleurum Root) for great lifting and tonification. If the patient feels cold like water, prefers warmth, passes dirty water like roof leaks, or has leukorrhea, with a洪紧 (Surging-Tight) but forceless or deep-hidden pulse, this is turbid Qi stagnating in Chong/Ren. Treat by lifting, dispersing, resolving knots, and soothing the Liver, using acrid-dispersing and acrid-cooling methods. Pure hot/cold herbs are unsuitable. Chao Huang Bo (Processed Phellodendron Bark), Cang Zhu (Atractylodes Rhizome), Xiang Fu (Cyperus Rhizome), Fu Xiong (Sichuan Lovage Rhizome), Ban Xia (Pinellia Tuber), Qing/Chen Pi (Green/Tangerine Peel), Bai Zhi (Angelica Dahurica Root), Chai Hu, Rou Gui (Cinnamon Bark), Pao Jiang (Prepared Ginger) are suitable.
Red color from Heat is Yang Beng; White color from Cold is Yin Beng. If all five Zang are deficient, five colors discharge together. Specific colors indicate specific Zang deficiency: White like mucus (Lung deficiency-cold); Blue/Green like indigo (Liver deficiency-cold); Yellow like rotten melon (Spleen deficiency-cold); Crimson (Heart deficiency-cold); Black like liver blood (Kidney deficiency-cold). Mixed five colors is called Wu Beng (Five Metrorrhagias).
Xue Lizhai said: Metrorrhagia with heart pain occurs because the Heart governs Blood; excessive loss leaves the Heart un-nourished. Use Ten Complete Decoction with doubled Ren Shen and Bai Zhu. For stasis, use Shi Xiao San (Laughing While Expecting Powder). For Yin/Blood depletion, use Ou Mei Wan (Cuttlebone Pill) to astringe. Metrorrhagia is acute, Lou is chronic. Metrorrhagia stems from anger injuring the Liver, stirring the Blood Sea, or extreme Heat boiling Blood. Lou stems from sexual excess damaging Chong/Ren, Qi deficiency failing to constrain blood, or inherent Fire disturbing Blood. Treat metrorrhagia by regulating Qi, descending Fire, and lifting; treat Lou by nourishing Yin, tonifying Qi, and nourishing Blood.
Persistent metrorrhagia begins with Hyperactive Heart Fire, causing vessel overflow and Liver excess failing to accept blood. As stated in the *Classic*: "The child makes the mother full." Kidney/Liver Ministerial Fire joins Heart Fire, causing erratic menstruation. Untreated, it becomes Blood Dryness with Fever and Consumption. The *Classic* says: Injury to Yang vessels causes external bleeding; injury to Yin vessels causes internal bleeding. Spleen controls Blood; Liver stores Blood. Metrorrhagia results from Spleen/Stomach deficiency failing to control Blood, Liver Fire forcing Blood downward, Liver Wind moving Blood recklessly, Anger stirring Liver Fire, Spleen Stagnant Heat preventing Blood from returning to channels, or excessive Grief injuring Bao Luo. Treatments: Spleen/Stomach deficiency uses Si Jun Zi Tang (Four Gentlemen Decoction) + Xiong Gui; Sinking uses Bu Zhong Yi Qi Tang + Bai Shao; Liver Blood Heat uses Si Wu Tang + Chai Hu/Zhi Zi; Liver Wind-Heat uses Jia Wei Xiao Yao San; Liver Fire uses previous formulas; Spleen Stagnant Fire uses Gui Pi Tang + Zhi Zi/Chai Hu/Mu Dan Pi; Grief injuring Bao Luo uses Si Jun Zi Tang + Sheng Ma/Chai Hu/Zhi Zi. Early stages are Heat; late stages are Cold. In Yang-excess/Yin-deficiency, prolonged metrorrhagia increases Yin deficiency and Heat (false-heat); do not use pure Cold. Zhu Danxi and Li Dongyuan stated: All hemorrhagic conditions conclude with Si Jun Zi Tang. Qi/Blood deficiency uses Si Wu Tang + Ren Shen/Huang Qi. Fatigue adds Sheng Ma. After massive blood loss, ignore pulse diagnosis and urgently use Du Shen Tang (Single Ginseng Decoction). Fever, tidal fever, cough, rapid pulse indicate weak Yuan Qi, unconcealed True Yang, and unguarded True Yin (false-heat pulse); Ren Shen is crucial. These conditions always damage Spleen/Stomach first. If the Surging pulse contains Stomach Qi and accepts tonification, it is curable. Cold herbs damage Spleen/Stomach Sheng Qi, preventing Blood return, accelerating death. All hemorrhagic conditions conclude with Stomach-tonifying herbs because the Spleen controls Blood, and Spleen/Stomach are the source of transformation. "Tuo Shi" (Loss of Status) and "Tuo Ying" (Loss of Nourishment) from social decline cause Heart Qi deficiency, internal Fire burning vessels, irregular menstruation, and seemingly healthy appearance (Heart disease not showing in pulse). Irregular diet triggers illness. Advise comfort, then tonify Qi/Blood, regulate Spleen/Stomach, slightly suppress Heart Fire, tonify Yin, drain Yang to regulate menstruation.
*Mai Jue* (Pulse Classic) states: Metrorrhagia with slow, small, deficient, slippery pulse indicates life despite urgency; large, full, tight, rapid pulse indicates death; empty Chi/Cun pulses indicate leaking blood; floating pulse indicates death, untreatable.
Jiao Ai Tang (Donkey-Hide Gelatin and Moxa Decoction)
Treats labor/injury to Qi/Blood, Chong/Ren deficiency, menorrhagia, dripping, improper pregnancy care, restless fetus, or injury-induced fetal bleeding.
E Jiao (fried), Xiong, Gan Cao (roasted, 2 liang each), Ai Ye (fried, 1 liang), Dang Gui (2 liang), Shu Di Huang, Bai Shao Yao (4 liang each).
Take 5 qian, decoct with 1 zhong water and 0.5 zhong wine.
Bai Zi Ren Tang (Biota Seed Decoction)
Treats women with excessive worry injuring Heart, failing to store Blood, causing persistent metrorrhagia.
Lu Rong (fire-scraped, wine-steamed), Xiang Fu (fried, 2 liang each), Bai Zi Ren (fried), Xiong, Fu Shen (decored), Dang Gui, Xiao Cao (1 liang each), Gan Cao (roasted, 0.5 liang), Chuan Xu Duan (1 liang), E Jiao (fried to pearls, 2 liang).
Take 4 qian, decoct with 1 zhong wine and 5 slices ginger to 0.7 zhong. Take warm on an empty stomach.
Another Formula
Treats persistent menstruation. Char E Jiao to ash, take 4 qian with good wine on an empty stomach, or plain water.
Wu Ji Wan (Black Chicken Pill)
Treats emaciated women with Blood deficiency-Heat, irregular menstruation, metrorrhagia/leukorrhea, bone-steaming fever, infertility.
White-feathered black-bone rooster (1 pair, ~2.5 jin, suffocated, cleaned), Ai Ye (4 liang), Qing Hao (4 liang, crushed). Half Ai/Qing Hao in chicken belly. Place chicken and remaining herbs in a wine jar. Fill with child's urine and water to submerge chicken by 2 cun. Boil until dry. Remove bones, mash remainder into thin cakes, dry, and powder.
Nan Xiang Fu (cleaned, 1 jin, divided: 1/4 rice water, 1/4 child's urine, 1/4 vinegar, 1/4 wine soak; Spring/Autumn 1 day, Summer 1 day, Winter 4 days, then dry), Shu Di Huang (4 liang, dried), Dang Gui (wine-soaked/washed/fried), Bai Shao Yao (wine-fried), Bie Jia (vinegar-fried yellow), Ren Shen (dried), Sheng Di Huang (Huaiqing origin, no iron), Bai Zhu (fried), Huang Qi (honey-fried), Chuan Niu Xi (wine-fried), Mu Dan Pi (wine-fried), Chai Hu (honey/wine-fried), Zhi Mu (wine-fried), Bei Mu (ginger juice-fried, 2 liang each), Di Gu Pi, Gan Jiang (fried yellow), Yan Hu Suo, Huang Lian (wine-soaked/fried, 1 liang each), Qin Jiao (1.5 liang, honey/wine-fried), Chuan Xiong, Bai Fu Ling (2.5 liang each).
Powder all with Xiang Fu, mix with chicken powder. Take with warm wine or rice drink. Avoid fried/spicy foods and Amaranth.
Qin Xin Wan (Scutellaria Heart Pill)
Treats women after age 49, when Tian Gui should cease, but menstruation continues or is excessive.
Huang Qin (new twigs, 2 liang, soaked in rice vinegar 7 days, roasted, repeated 7 times).
Powder, make pills with vinegar paste, size of paulownia seeds. Take 70 pills, warm wine on empty stomach, 3 times daily.
Shi Hui Wan (Ten Ashes Pill)
Treats persistent metrorrhagia.
Huang Juan Hui, Ma Wei Hui, Ou Jie Hui, Ai Ye Hui, Chi Song Pi Hui, Pu Huang Hui, Lian Peng Hui, You Fa Hui, Zong Lu Hui, Mian Hui (equal parts).
Powder, make pills with vinegar-boiled sticky rice paste, size of paulownia seeds. Take 100 pills, rice drink.
Bei Jin San (Prepare Gold Powder)
Treats persistent metrorrhagia.
Xiang Fu (fried, 4 liang), Dang Gui (1.2 qian), Wu Ling Zhi (1 liang).
Powder. Take 5 qian, light vinegar water on empty stomach. Immediate effect. Danxi said: For excessive bleeding, take Wu Ling Zhi powder first. Differentiate cold/heat; Wu Ling Zhi moves and stops blood.
Lian Peng San (Lotus Pod Powder)
Treats persistent menstrual blood.
Char Lian Peng until carbonized, powder.
Take 2 qian with plain water.