王海藏曰∶妇人月事不至，是为胞闭，为血不足，宜服四物汤。妇人崩者，是为血有余，亦服四物汤何也？
曰∶妇人月事不至者，内损其原，不能生血，故胞闭不通，是血不足，宜服四物汤，是益原和血之药也。崩中
者，是血多也。暴损其原，是火逼妄行，涸竭为根，亦宜四物汤，乃润燥益原之药也。
朱丹溪曰∶崩漏有虚有热，虚则下溜，热则宣通，气虚血虚，皆以四物加参、 。因劳力者加升麻，热加
黄芩，寒加干姜。又曰∶漏下乃热而虚，四物加黄连。崩过多者，先用五灵一服。紫色成块者，血热也，四物加
柴胡、黄连，后用四物加黑姜。急则治标，用白芷汤下百草霜。
薛立斋曰∶经云，阴虚阳搏，谓之崩。又云，阳络伤，血外溢，阴络伤，血内溢。又云，脾统血，肝藏血。
其为患，因脾胃虚损，不能摄血归经。或因肝经有火，血得热而下
行。或因肝经有风，血得风而妄行。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
络伤而下崩。治疗之法，脾胃虚弱者，六君子加芎、归、柴胡。脾胃虚陷者，补中汤加白芍、山栀。肝经血热
者，四物汤加柴胡、山栀、苍术。肝经风热者，加味逍遥散，或小柴胡加山栀、白芍、丹皮。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。故丹溪、东垣云，凡
下血证，须四君子收功，斯言厥有旨也。若大去血后，毋以脉诊，急用独参汤。其发热潮热，咳嗽脉数，乃元
气虚弱，假热之脉也，尤当用人参。此等证，无不由脾胃先损，故脉洪大，察其中有胃气，受补则可救。设用
寒凉，复伤脾胃生气，反不能摄血归源，是速其危也。
王海藏说：妇女月经不来，称为胞闭，这是因为血不足，适宜服用四物汤。妇女发生崩漏的，这是血有余，为什么也服用四物汤呢？
回答说：妇女月经不来的，是内部损伤了元气，不能化生血液，所以胞脉闭塞不通，这是血不足，适宜服用四物汤，这是补益元气、调和血液的药物。崩中的，是血多。突然损伤了元气，这是火热逼迫血液妄行，以枯竭为根本原因，也适宜用四物汤，这是滋润燥热、补益元气的药物。
朱丹溪说：崩漏有虚证和热证之分，虚证则血液下泄不止，热证则气血宣通散乱。气虚和血虚，都用四物汤加入人参、白术。因劳累用力导致的，加入升麻；热证加入黄芩；寒证加入干姜。又说：漏下属于热而兼虚，用四物汤加入黄连。崩漏出血过多的，先用五灵脂一剂。血色紫暗且结成块的，是血热，用四物汤加入柴胡、黄连，之后再用四物汤加入炮姜。急症时治其标，用白芷汤送服百草霜。
薛立斋说：医经记载，阴虚而阳脉搏动有力，称为崩。又说，阳络受伤，血液向外溢出；阴络受伤，血液向内溢出。又说，脾统摄血液，肝贮藏血液。这些病症的发生，是因为脾胃虚弱受损，不能统摄血液使其回归经脉。或者因为肝经有火，血液受热而下行。或者因为肝经有风，血液受风而妄行。或者因为愤怒触动肝火，血液受热沸腾。或者因为脾经郁结化热，血液不能回归经脉。或者因为悲哀过度，胞络受伤而导致下部崩漏。治疗的方法，脾胃虚弱的，用六君子汤加入川芎、当归、柴胡。脾胃虚陷的，用补中益气汤加入白芍、山栀。肝经血热的，用四物汤加入柴胡、山栀、苍术。肝经风热的，用加味逍遥散，或小柴胡汤加入山栀、白芍、丹皮。如果是愤怒触动肝火，也用前面的药物。脾经郁火的，用归脾汤加入山栀、柴胡、丹皮。悲伤导致胞络受伤的，用四君子汤加入升麻、柴胡、山栀。所以丹溪、东垣说，凡是下血的病症，必须用四君子汤来收功，这话很有深意啊。如果在大量失血后，不要凭脉诊判断，紧急时用独参汤。那些出现发热、潮热、咳嗽、脉搏数的，是元气虚弱出现的假热脉象，尤其应当用人参。这类病症，无不是由脾胃先受损引起的，所以脉象洪大，但察其中还有胃气，能够接受补益治疗就可以救治。如果误用寒凉药物，再次损伤脾胃的生气，反而不能统摄血液回归本源，这是加速其死亡的危险做法。
Wang Haizang stated: When a woman's menstruation does not arrive, it is called "Bao Bi" (Uterine Closure), which is due to Blood deficiency; it is appropriate to take Siwu Tang (Four Substances Decoction). When a woman suffers from "Beng" (Metrorrhagia/Profuse Bleeding), this indicates an excess of Blood. Why should she also take Siwu Tang?
The answer is: In cases where menstruation does not arrive, the internal source (Yuan Qi) is damaged, failing to generate Blood, thus causing the uterine vessels to be blocked and unpatent. This represents Blood deficiency, so taking Siwu Tang is appropriate, as it is a formula that tonifies the source and harmonizes Blood. In cases of Beng, there is an abundance of Blood. A sudden damage to the source causes Fire to force Blood to move recklessly, with exhaustion/depletion as the root cause. Siwu Tang is also appropriate here, as it is a formula that moistens dryness and tonifies the source.
Zhu Danxi stated: Metrorrhagia and metrostaxis (Beng Lou) can be due to Deficiency or Heat. Deficiency leads to downward leakage; Heat leads to dispersion and uncontrolled flow. For both Qi deficiency and Blood deficiency, Siwu Tang is used with the addition of Renshen (Ginseng) and Baizhu (Atractylodes Macrocephala Rhizome). For cases caused by labor and exertion, add Shengma (Cimicifugae Rhizome); for Heat, add Huangqin (Scutellariae Radix); for Cold, add Ganjiang (Zingiberis Rhizoma). He further stated: Metrostaxis (Lou Xia) is due to Heat combined with Deficiency; use Siwu Tang with the addition of Huanglian (Coptidis Rhizome). For profuse bleeding from Beng, first administer Wuling (Trogopteri Dung) in one dose. If the blood is purple and forms clots, this indicates Blood Heat; use Siwu Tang with Chaihu (Bupleuri Radix) and Huanglian, followed by Siwu Tang with Paojiang (Prepared Zingiberis Rhizoma). In acute situations, treat the branch/symptom using Baizhi Tang (Angelica Dahurica Decoction) to deliver Baicaoshuang (Carbonized Herba Artemisiae Annuae).
Xue Lizhai stated: The medical classics record: "Yin Deficiency with vigorous Yang pulse is called Beng." It also states: "Injury to Yang collaterals causes blood to overflow outward; injury to Yin collaterals causes blood to overflow inward." Furthermore, it states: "The Spleen controls the blood; the Liver stores the blood." These disorders arise because Spleen-Stomach weakness and damage fail to control the blood, keeping it within the vessels. Or, because there is Fire in the Liver channel, the blood flows downward due to heat. Or, because there is Wind in the Liver channel, the blood moves recklessly due to wind. Or, anger stirs up Liver Fire, causing the blood to boil due to heat. Or, depression-heat in the Spleen channel prevents the blood from returning to the vessels. Or, excessive sorrow injures the Bao Luo (Uterine Collaterals), leading to lower bleeding. The treatment methods are as follows: For Spleen-Stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction) with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelica Sinensis Radix), plus Chaihu. For Spleen-Stomach sinking/prolapse, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Shaoyao (Paeoniae Radix Alba) and Zhizi (Gardeniae Fructus). For Liver channel Blood Heat, use Siwu Tang with Chaihu, Zhizi, and Cangzhu (Atractylodis Rhizoma). For Liver channel Wind-Heat, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) or Xiao Chaihu Tang (Minor Bupleurum Decoction) with Zhizi, Shaoyao, and Mudanpi (Moutan Cortex). If anger stirs Liver Fire, the aforementioned formulas are also used. For Spleen channel depression-fire, use Guipi Tang (Restore the Spleen Decoction) with Zhizi, Chaihu, and Mudanpi. For sorrow injuring the Bao Luo, use Sijunzi Tang (Four Gentlemen Decoction) with Shengma, Chaihu, and Zhizi. Therefore, Danxi and Dongyuan stated that for all hemorrhagic syndromes, one must conclude treatment with Sijunzi Tang; these words hold profound significance. After massive blood loss, do not rely on pulse diagnosis; urgently use Dushen Tang (Single Ginseng Decoction). Fever, tidal fever, cough, and rapid pulse indicate Yuan Qi deficiency presenting as false heat; Ren Shen (Ginseng Radix) is especially indicated. Such syndromes invariably stem from prior Spleen-Stomach damage; thus, although the pulse may be洪大 (Huge and Large), if the Stomach Qi is present and the patient can tolerate tonification, rescue is possible. If cold-cooling herbs are mistakenly used, they will further damage the vital Qi of the Spleen-Stomach, preventing the blood from returning to its source, thereby accelerating death.