躯脂满，经闭，导痰汤加芎、连。不可服地黄，如用，姜汁拌炒。（导痰汤即二陈加枳实、
黄连是也。）
杨村妇人年二十余，两年经闭，食少乏力。
黄连（二钱） 白术（一钱半） 陈皮 滑石（各一钱） 黄芩（半钱） 木通（三分）
桃仁（十二个） 甘草（炙，少许） 此方分两有讹。
上丹溪治痰结胸腹而经闭之法，皆用轻剂导痰降火也。
经云∶气上迫肺，则心气不得下通，故月事不来。今用连、朴之类，导痰降火，使
不上迫于肺，故心气下通而月事来也。
丹溪治一妇人久疟，食少经闭，两手无脉，每日与三花神佑丸十余粒，津咽之，月
余食进脉出。又半月脉愈，又一月经行。亦此意也。详见久疟。予尝体丹溪之意，治陈氏
妇二十余岁，形肥痞塞不食，每日卧至未牌，吃一盏薄粥，吃粥后必吐水半碗，
仍复卧，经不通三月矣。前番曾暗通黑色，脉之，辰时寸关滑，皆有力，午后关滑
寸不滑。询之，因乘怒饮食而然。遂以白术一两半，浓朴、黄连、枳实各一两，半夏、茯
苓、陈皮、山楂、人参、滑石各八钱，缩砂、香附、桃仁各半两，红花二钱，分作十帖，
每日服一帖，各入姜汁二蚬壳，间三日以神佑丸、神秘沉香丸微下。
之，至十二日吐止，食渐进，四十日平复如故。又汪氏妇三十余，形瘦，亦痞不食，吐
水，经不通，以前药方加参、术、归为君，煎熟，入竹沥半盏，姜汁服之。但不用神佑
丸下，亦平复。若咳嗽寒热而经闭者，当于咳门湿痰条求之。
〔子和〕凡妇人月事不来，用茶调散吐之，次用玉烛散、芎归汤，三和汤、桂苓白
术散之类，降心火，益肾水，开胃进食，分阴阳，利水道之药也。一妇人月事不行，寒
热往来，口干颊赤，饮食少，旦暮间咳一二声，诸医皆用虻虫、水蛭、干漆、 砂、芫
青、红娘子、没药、血竭之类。惟戴人不然，曰∶古方虽有此法，奈病患服之必脐腹发痛，
饮食不进。乃命止药，饮食少进。《内经》曰∶二阳之病发心脾。心受之则血不流，故女子
不月。既心受积热，宜抑火升水，流湿润燥，开胃诱食。乃涌出痰一二升，下泄水五六行，
湿水上下皆去，血气自然湍流，月事不为水湿所隔，自根据期而至矣。亦不用虻虫、水蛭
之类有毒之药，如用之则月经总来，小溲反闭，他证生矣。凡精血不足，宜补之以食，大
忌有毒之药，偏胜而致夭阏多矣。一妇人年三十四岁，经水不行，寒热往来，面色痿
黄，唇焦颊赤，时咳三二声。问其所服之药，黑神散、乌金丸、四物汤、烧肝散、鳖甲散、
建中汤、宁肺散，针艾千百，转剧。家人意倦，不欲求治。戴人悯之，先涌痰五六升，午
前涌毕，午后食进，余证悉除。后三日，复轻涌之，又去痰一二升，食益进，不数日又
下通经散，泻讫一二升，后数日，去死皮数重，小者如麸片，大者如苇膜，不月余经水
自行，神气大康矣。月事不来者，胞脉闭也。胞脉者，属心而络于胞中，今气上迫肺，
心气不得下通，故月事不来也。（全文见水肿。）
〔大〕室女月水不来，用雄鼠屎一两，烧存性，为细末，空心温酒调下一钱，神效。
〔海〕掌中金丸 治妇人干血气。
穿山甲（炮） 甘草 苦丁香 川椒 苦葶苈 白附子 猪牙皂角 草乌头（各三钱）
巴豆（一钱，全用研）
上为细末，以生葱绞汁，和丸弹子大，每用一丸，新绵包之，纳阴中，一日即白，二
日即赤，三日即血，神效。
〔仲〕妇人经水闭不利，脏坚癖不止，中有干血，下白物。矾石丸主之。
矾石（三钱，烧） 杏仁（一分）
上二味末之，炼蜜丸枣核大，五内中。剧者再纳之。
〔室女经闭成劳〕
寇宗 曰∶夫人之生，以气血为本。人之病，未有不先伤其气血者。若室女童男，积
想在心，思虑过度，多致劳损。男子则神色消散，女子则月水先闭。盖忧愁思虑则伤心
而血逆竭，神色先散，月水先闭。且心病则不能养脾，故不嗜食。脾虚则金亏，故发嗽。
肾水绝则木气不荣，而四肢干痿，故多怒，鬓发焦，筋骨痿。若五脏传遍则死。自能改易
心志，用药扶持，庶可保生。切不可用青蒿、虻虫等凉血、行血，宜用柏子仁丸、泽兰汤
益阴血、制虚火。
〔薛〕经云∶五谷入于胃，其糟粕、津液、宗气分为三隧。故宗气积于胸中，出于
喉咙，以贯心肺而行呼吸。荣气者，泌其津液，注之于脉，化以为血，以荣四末，内养
五脏六腑。若服苦寒之剂，复伤胃气，必致不起。一室女年十七， 久不愈，天癸未
通，发热咳嗽，饮食少思，欲用通经丸。余曰∶此盖因禀气不足，阴血未充故耳。但养
气血，益津液，其经自行。彼惑于速效，仍用之。余曰∶非其治也。此乃剽悍之剂，大
助阳火，阴血得之则妄行，脾胃得之则愈虚。后果经血妄行，饮食愈少，遂致不救。
柏子仁丸 （《大全》）治如上证，兼服泽兰汤。
柏子仁（炒，别研） 牛膝 卷柏（各半两） 泽兰叶 续断（各二两） 熟地黄（三两）
为细末，炼蜜丸如梧子大。空心米饮下三十丸。
泽兰汤
泽兰叶（三两） 当归 芍药（各一两） 甘草（半两）
为粗末，每服五钱，水二盏，煎一盏温服。
沉香鳖甲散 室女经候凝滞，或头目昏闷，停痰，五心虚烦，少食多困。
沉香 甘草（炙） 槟榔（各三分） 木香 常山 当归 柴胡 人参 半夏 桂心 生地
黄白茯苓 青皮 净陈皮（各一两） 鳖甲（一两半）
上为细末，每二钱，姜二片，水煎七分，空心温服。
劫劳散 疗心肾俱虚，水火不交，初则微嗽，遇夜发热即冷，有盗汗，倦怠瘦弱，减
食恍惚。或微嗽，唾中有红线，名曰肺痿，为不治。
白芍药（六两） 黄 甘草 人参 当归 半夏 白茯苓 北五味子 阿胶（炒） 熟地
黄（洗，各二两）
上 咀，每三大钱，水盏半，姜十二片，枣三枚，煎温服。百药不效，一料除根。
麦煎散 治少男、室女骨蒸，妇人血风攻疰四肢，心胸烦壅，口臭，肌热盗汗。
鳖甲 大黄（煨） 常山 赤茯苓 柴胡 白术 当归 干漆（炒烟尽） 生地黄 石膏（各
一两） 甘草（半两）
上为细末，每服二钱，水一盏，小麦五十粒，食后临卧温服。有虚汗，加麻黄根一两。
牡丹散 （《和剂》）治血气虚损，内则月水不行，外发潮热，肢体羸困，渐成骨蒸。
干漆（炒，二两） 苏木 蓬莪术 鬼箭（各一分） 甘草 当归 桂心 牡丹皮 芍药 延
胡索（炒） 净陈皮 红花 乌药 没药（别研，各一两）
上 咀，每服三钱，水一盏，煎七分，温服无时。
六神汤 （《御药》）治血气不足，肌体烦热。四物汤加黄 、地骨皮，各等分， 咀，水
煎。又治冲任虚损，月水不行，肌肤发热如瘵状。四物汤各一两，柴胡半两，黄芩一分。水煎。
桃仁散 治妇人、女子血闭不通，五心烦热。
红花 当归 桃仁（炒） 牛膝（各等分）
上为末，每服三钱，酒调下，空心服。
〔脉〕师曰∶有一妇人，将一女子，年十五所，来诊言∶女子年十四时，经水自下，
今经反断，其母言恐怖。师曰∶若是夫人亲女，必夫人年十四时，亦以经水下，所以断，
此为避年，勿怪，后当自下，此真气犹怯，禀赋素弱而然也。宜固天元真气，使水升火降，
则五脏自和，而经脉通矣。
又方 鹿茸 山茱萸 当归（各四两） 麝香（一两）
为细末，入麝香拌匀，和酒糊为丸，每服百丸，或五十丸，温酒、盐汤任下。
〔针灸〕
〔心〕经脉不通，已有寒热，此穴大效。三阴交（三分，立有效，如疼时，乃经脉要
通也。）
〔摘〕经脉不通（《心术》同。）曲池 支沟 三里 三阴交（此四穴壅塞不通，则泻之，如
虚耗不行，则补之。）
〔集〕月经断绝 中极 三阴交 肾俞 合谷
〔东〕又法 四满（在丹田傍一寸半。）
〔心〕经脉不通，变成瘕证，饮食如常，腹渐大如蛊。气海（用针通管去其泻水恶物。）阴
交（取法亦如上，去其恶物。）
〔甲〕月水不通，奔，泄气，上下引腰脊痛，气穴主之。女子不下月水，照海主
之。妇人少腹坚痛，月水不通，带脉主之。
月水不利，见血而有身，则反败及乳肿。临泣主之。
〔诊〕肾脉微涩为不月。
【导痰汤加减法】
如果患者形体肥胖、体内脂肪堆积导致经闭，可用导痰汤加入川芎、黄连。不可服用地黄；如果必须使用，需用姜汁拌炒后入药。（注：导痰汤即由二陈汤加入枳实、黄连组成。）
杨村有一位二十多岁的妇人，经闭两年，食欲减退且感到乏力。
处方：黄连（二钱）、白术（一钱半）、陈皮、滑石（各一钱）、黄芩（半钱）、木通（三分）、桃仁（十二个）、甘草（炙，少许）。此方剂量可能存在错误。
以上方法是丹溪治疗因痰结于胸腹而导致经闭的方法，均使用轻剂来导痰降火。
《内经》说：“气上迫肺，则心气不得下通，故月事不来。”现在使用黄连、厚朴之类药物，导痰降火，使气不上迫于肺，从而使心气得以向下通达，月经自然来潮。
丹溪曾治疗一位患长期疟疾的妇人，食欲少、经闭，两手摸不到脉搏。每天给予三花神佑丸十余粒，用津液送服，一个多月后食欲增加，脉搏出现。又过了半个月，脉象更加有力，再过一个月，月经来潮。这也是同样的道理。详见“久疟”篇。
我曾体会丹溪的意思，治疗陈氏妇，二十多岁，身体肥胖，痞塞不食，每天睡到未时（下午1-3点），喝一盏稀粥，吃完粥后必呕吐半碗水，然后继续睡觉，经闭三个月了。之前曾有过少量黑色分泌物。诊脉，辰时（上午7-9点）寸关脉滑，皆有力，午后关脉滑而寸脉不滑。询问得知，是因为生气后进食所致。于是用白术一两半，厚朴、黄连、枳实各一两，半夏、茯苓、陈皮、山楂、人参、滑石各八钱，缩砂、香附、桃仁各半两，红花二钱，分为十帖，每天服一帖，每帖加入姜汁两个蚬壳量，每隔三天用神佑丸、神秘沉香丸轻微泻下。服药至第十二日，呕吐停止，饮食逐渐增加，四十日后恢复如初。
又有一位汪氏妇人，三十多岁，身体消瘦，也痞塞不食，吐水，经闭，用前面的药方加人参、白术、当归为君药，煎熟后，加入竹沥半盏，姜汁送服。只是不用神佑丸泻下，也恢复了健康。如果是咳嗽寒热而经闭的，应当在“咳门”湿痰条中寻求治疗方法。
〔张子和〕凡是妇人月经不来，先用茶调散催吐，接着用玉烛散、芎归汤、三和汤、桂苓白术散等药物，这些是降心火、益肾水、开胃进食、分阴阳、利水道的药。
一位妇人月经不行，寒热往来，口干脸颊红，饮食少，早晚咳嗽一二声，众医都用虻虫、水蛭、干漆、硇砂、芫青、红娘子、没药、血竭之类有毒的药物。只有戴人（子和）不这样认为，他说：“古方虽有此法，但病人服用后必然脐腹疼痛，饮食不进。”于是命令停药，饮食稍进。《内经》说：“二阳之病发心脾。心受之则血不流，故女子不月。”既然心受积热，应当抑火升水，流湿润燥，开胃诱食。于是涌吐出一二升痰，泄下五六次水，湿水上下皆去，血气自然通畅，月经不被水湿阻隔，自然按期而至。也不用虻虫、水蛭之类有毒的药，如果用，则月经总来，小便反而闭塞，其他病症就会产生。凡精血不足，宜用食物补益，大忌有毒之药，偏胜而致夭折者很多。
一位三十四岁的妇人，经水不行，寒热往来，面色萎黄，唇焦颊赤，偶尔咳嗽两三声。问其所服用的药物，有黑神散、乌金丸、四物汤、烧肝散、鳖甲散、建中汤、宁肺散，针灸千百次，病情反而加重。家人厌倦，不想再求治。戴人怜悯她，先涌吐痰涎五六升，午前涌吐完毕，午后饮食增加，其余症状全部消除。三天后，再次轻微涌吐，又去痰一二升，饮食更加增加，没过几天，又服用通经散，泻下一二升，后来数日，脱落死皮数层，小的如麸片，大的如苇膜，不到一个月月经自行来潮，精神气色大大康复。
月经不来，是因为胞脉闭塞。胞脉，属于心而联络于胞宫，现在气上迫肺，心气不得下通，所以月经不来。（全文见“水肿”篇。）
〔李东垣/大抵〕室女月经不来，用雄鼠屎一两，烧存性，研为细末，空腹温酒调服一钱，神效。
〔朱丹溪/海〕掌中金丸 治疗妇人干血气。
穿山甲（炮）、甘草、苦丁香、川椒、苦葶苈、白附子、猪牙皂角、草乌头（各三钱）、巴豆（一钱，全用研）。
以上研为细末，用生葱绞汁，和丸如弹子大，每次用一丸，新棉包裹，纳入阴道中，一日白带减少，二日转赤，三日出血，神效。
〔张仲景/仲〕妇人经水闭不利，脏坚癖不止，中有干血，下白物。矾石丸主之。
矾石（三钱，烧）、杏仁（一分）。
以上两味研末，炼蜜制成如枣核大的丸药，纳入阴道内。重症者再次纳入。
〔室女经闭成劳〕
寇宗奭曰：人的生存，以气血为本。人的疾病，没有不先损伤气血的。若室女童男，积想在心，思虑过度，多导致劳损。男子则神色消散，女子则月经先闭。因为忧愁思虑伤心而血逆竭，神色先散，月经先闭。且心病则不能养脾，故不爱吃东西。脾虚则金亏，故发生咳嗽。肾水绝则木气不荣，而四肢干枯痿弱，故易怒，鬓发焦枯，筋骨痿软。若五脏传遍则死。若能改变心志，用药扶持，或许可以保全生命。切不可用青蒿、虻虫等凉血、行血的药，宜用柏子仁丸、泽兰汤益阴血、制虚火。
〔薛己/薛〕《内经》说：“五谷入于胃，其糟粕、津液、宗气分为三隧。”所以宗气积聚于胸中，出于喉咙，以贯心肺而行呼吸。营气者，泌其津液，注入脉中，化以为血，以荣养四肢末端，内养五脏六腑。如果服用苦寒之剂，再次损伤胃气，必然导致死亡。
一位十七岁的室女，久病不愈，天癸未通，发热咳嗽，饮食少思，想用通经丸。我说：“这大概是因为禀气不足，阴血未充的缘故。只要养气血，益津液，月经自然会来。”她迷惑于速效，仍然使用。我说：“这不是正确的治疗方法。这是剽悍之剂，大助阳火，阴血得之则妄行，脾胃得之则更虚。”后果经血妄行，饮食更少，最终导致不治。
柏子仁丸 （《大全》）治疗如上证，兼服泽兰汤。
柏子仁（炒，别研）、牛膝、卷柏（各半两）、泽兰叶、续断（各二两）、熟地黄（三两）。
研为细末，炼蜜制成如梧桐子大的丸药。空腹米饮送下三十丸。
泽兰汤
泽兰叶（三两）、当归、芍药（各一两）、甘草（半两）。
研为粗末，每次服五钱，水二盏，煎至一盏，温服。
沉香鳖甲散 室女经候凝滞，或头目昏闷，停痰，五心虚烦，少食多困。
沉香、甘草（炙）、槟榔（各三分）、木香、常山、当归、柴胡、人参、半夏、桂心、生地黄、白茯苓、青皮、净陈皮（各一两）、鳖甲（一两半）。
以上研为细末，每次二钱，姜二片，水煎七分，空腹温服。
劫劳散 治疗心肾俱虚，水火不交，初则微嗽，遇夜发热即冷，有盗汗，倦怠瘦弱，减食恍惚。或微嗽，唾中有红线，名曰肺痿，为不治。
白芍药（六两）、黄芪、甘草、人参、当归、半夏、白茯苓、北五味子、阿胶（炒）、熟地黄（洗，各二两）。
以上切碎，每次三大钱，水一盏半，姜十二片，枣三枚，煎温服。百药不效，一料除根。
麦煎散 治疗少男、室女骨蒸，妇人血风攻疰四肢，心胸烦壅，口臭，肌热盗汗。
鳖甲、大黄（煨）、常山、赤茯苓、柴胡、白术、当归、干漆（炒烟尽）、生地黄、石膏（各一两）、甘草（半两）。
以上研为细末，每次服二钱，水一盏，小麦五十粒，食后临卧温服。有虚汗，加麻黄根一两。
牡丹散 （《和剂局方》）治疗血气虚损，内则月水不行，外发潮热，肢体羸困，渐成骨蒸。
干漆（炒，二两）、苏木、蓬莪术、鬼箭羽（各一分）、甘草、当归、桂心、牡丹皮、芍药、延胡索（炒）、净陈皮、红花、乌药、没药（别研，各一两）。
以上切碎，每次服三钱，水一盏，煎七分，随时温服。
六神汤 （《御药院方》）治疗血气不足，肌体烦热。四物汤加黄芪、地骨皮，各等分，切碎，水煎。又治疗冲任虚损，月水不行，肌肤发热如痨状。四物汤各一两，柴胡半两，黄芩一分。水煎。
桃仁散 治疗妇人、女子血闭不通，五心烦热。
红花、当归、桃仁（炒）、牛膝（各等分）。
以上研为末，每次服三钱，酒调下，空腹服。
〔脉诊〕老师说：有一位妇人带着一位女儿，十五岁，来就诊说：女儿十四岁时，月经自然来潮，现在月经反而中断，母亲很惊恐。老师说：“如果是这位夫人的亲生女儿，必定夫人十四岁时，也是以月经来潮，所以中断，这叫‘避年’，不要奇怪，后来会自然来潮，这是因为真气尚怯，禀赋素弱所致。”宜固护天元真气，使水升火降，则五脏自和，而经脉通矣。
又一方：鹿茸、山茱萸、当归（各四两）、麝香（一两）。
研为细末，入麝香拌匀，和酒糊为丸，每次服百丸，或五十丸，温酒、盐汤任下。
〔针灸〕
〔《心》〕经脉不通，已有寒热，此穴大效。三阴交（刺三分，立有效，如果疼时，乃经脉要通也。）
〔《摘》〕经脉不通（《心术》同。）曲池、支沟、三里、三阴交（此四穴壅塞不通，则泻之，如虚耗不行，则补之。）
〔《集》〕月经断绝 中极、三阴交、肾俞、合谷
〔《东》〕又法 四满（在丹田旁一寸半。）
〔《心》〕经脉不通，变成瘕证，饮食如常，腹渐大如蛊。气海（用针通管去其泻水恶物。）阴交（取法亦如上，去其恶物。）
〔《甲》〕月水不通，奔豚，泄气，上下引腰脊痛，气穴主之。女子不下月水，照海主之。妇人少腹坚痛，月水不通，带脉主之。
月水不利，见血而有身，则反败及乳肿。临泣主之。
〔诊法〕肾脉微涩为不月。
[Modification of Daotan Tang]
If the patient is obese with excessive body fat leading to amenorrhea, Daotan Tang (Phlegm-Draining Decoction) can be used with added Chuanxiong Rhizome (Chuanxiong) and Coptis Rhizome (Huanglian). Dihuang should not be taken; if it must be used, it should be stir-fried with ginger juice. (Note: Daotan Tang consists of Erchen Tang plus Zhishi and Huanglian.)
A woman from Yangcun, in her twenties, had been amenorrheic for two years, with poor appetite and fatigue.
Prescription: Huanglian (2 qian), Baizhu (1.5 qian), Chenpi, Huashi (each 1 qian), Huangqin (0.5 qian), Mutong (3 fen), Taoren (12 pieces), Gancao (stir-baked, a small amount). There may be an error in the dosages of this formula.
The above method describes Danxi’s treatment for amenorrhea caused by phlegm accumulation in the chest and abdomen, using mild agents to drain phlegm and descend fire.
*Neijing* states: "When Qi presses upward on the Lung, Heart Qi cannot flow downward, thus menstruation does not occur." Now, using herbs like Huanglian and Houpo to drain phlegm and descend fire prevents Qi from pressing upward on the Lung, allowing Heart Qi to flow downward, so menstruation naturally resumes.
Danxi once treated a woman suffering from chronic malaria, with poor appetite and amenorrhea, whose pulses were imperceptible in both hands. He administered ten to fifteen pills of Sanhua Shenyu Wan daily, swallowed with saliva. After more than a month, her appetite increased and pulses became palpable. Half a month later, her pulse strengthened further, and after another month, menstruation resumed. This follows the same principle. See the section on Chronic Malaria.
I once applied Danxi’s principle to treat Mrs. Chen, in her twenties. She was obese, suffered from epigastric fullness and anorexia, slept until Wei hour (1-3 PM), drank one bowl of thin porridge, vomited half a bowl of water after eating, then slept again. Her menstruation had ceased for three months. Previously, she had scanty dark discharge. Pulse diagnosis at Chen hour (7-9 AM) showed slippery and forceful Cun and Guan positions, while in the afternoon, only the Guan position was slippery. It was learned that this resulted from eating while angry. Thus, I prescribed Baizhu (1.5 liang), Houpo, Huanglian, Zhishi (each 1 liang), Banxia, Fuling, Chenpi, Shanzha, Renshen, Huashi (each 8 qian), Suosha, Xiangfu, Taoren (each 0.5 liang), Honghua (2 qian), divided into ten doses. One dose per day, each added with ginger juice equivalent to two clam shells. Every three days, mild purgation was induced with Shenyu Wan and Shenmi Chenxiang Wan. By the twelfth day, vomiting stopped and appetite gradually improved; by the fortieth day, she recovered completely.
Another case involved Mrs. Wang, over thirty, who was emaciated, also suffering from epigastric fullness, anorexia, vomiting of water, and amenorrhea. The previous formula was modified with Renshen, Baizhu, and Danggui as sovereign herbs. After decoction, half a cup of Zhuli (Bamboo Sap) and ginger juice were added. Purgatives like Shenyu Wan were not used, and she also recovered. For amenorrhea accompanied by cough and chills/fever, refer to the "Cough" chapter under the damp-phlegm section.
[Zhang Zihe] For women with amenorrhea, first induce vomiting with Chatiao San, then use Yuzhu San, Xiong Gui Tang, Sanhe Tang, Guiling Baizhu San, etc. These are formulas that descend Heart Fire, nourish Kidney Water, open the stomach and promote appetite, differentiate Yin and Yang, and promote urination.
A woman with amenorrhea presented with alternating chills and fever, dry mouth, red cheeks, poor appetite, and occasional coughing morning and night. Most physicians prescribed toxic substances such as Mengchong (Leech-like insect), Shuizhi (Leech), Ganqi (Dry Lacquer), Naoshan (Nao Sand), Yuanqing (Wormwood insect), Hongniangzi (Red Beetle), Moyao (Myrrh), and Xuexie (Dragon's Blood). Only Dai Ren (Zihehe) disagreed, saying: "Although ancient formulas contain these methods, patients taking them will inevitably suffer abdominal pain and loss of appetite." He ordered the cessation of medication, after which appetite slightly improved. *Neijing* states: "Diseases of the Two Yangs originate in the Heart and Spleen. If the Heart is affected, blood does not flow, hence women do not menstruate." Since the Heart suffers from accumulated heat, one should suppress fire, raise water, moisten dryness, open the stomach, and stimulate appetite. He induced vomiting of one or two sheng of phlegm and purged five or six times of watery stool. With dampness and water eliminated from above and below, blood and Qi flowed naturally, and menstruation returned on schedule without being obstructed by damp-water. Toxic drugs like Mengchong and Shuizhi were avoided; if used, menstruation might become excessive, urination might cease, and other symptoms would arise. For deficiency of essence and blood, food therapy is preferred; toxic drugs are strictly contraindicated, as imbalance often leads to premature death.
A thirty-four-year-old woman presented with amenorrhea, alternating chills and fever, sallow complexion, dry lips, red cheeks, and occasional coughing. Her previous medications included Heishen San, Wujin Wan, Siwu Tang, Shaogan San, Biejia San, Jianzhong Tang, and Ningfei San, along with hundreds of acupuncture and moxibustion sessions, yet her condition worsened. Her family lost hope. Dai Ren pitied her, first inducing vomiting of five or six sheng of phlegm. By noon, vomiting ceased, appetite improved, and other symptoms disappeared. Three days later, mild vomiting was induced again, removing another one or two sheng of phlegm; appetite further improved. A few days later, Tongjing San was administered, resulting in the purging of one or two sheng. Subsequently, several layers of dead skin shed, some like bran flakes, others like reed membranes. Within a month, menstruation resumed spontaneously, and her spirit and vitality greatly recovered.
Amenorrhea is due to the closure of the Bao Mai (Uterine Vessels). The Bao Mai belongs to the Heart and connects to the Bao Gong (Uterus). When Qi presses upward on the Lung, Heart Qi cannot flow downward, hence menstruation does not occur. (Full text see "Edema".)
[Li Dongyuan/Da Di] For maiden amenorrhea, use one liang of male rat feces, burnt until carbonized but retaining its nature, ground into fine powder. Take one qian mixed with warm wine on an empty stomach; miraculous effect.
[Zhu Danxi/Hai] Zhangjin Wan (Palm Gold Pill) treats Dry Blood Qi in women.
Shanjiapia (Pangolin Scales, fried), Gancao, Kudingxiang, Chuanjiao, Kutingli, Baifuzi, Zhuya Zaojiao, Caowutou (each 3 qian), Badou (1 qian, whole, ground).
Grind into fine powder, mix with juice pressed from fresh Congbai (Green Onion Stems), form pills the size of bullet seeds. Use one pill wrapped in new cotton, insert into the vagina. White discharge stops on the first day, reddens on the second, and bleeding occurs on the third; miraculous effect.
[Zhang Zhongjing/Zhong] For women with obstructed or irregular menstruation, hard masses in the viscera persisting, dry blood within, and leukorrhea, Fanshi Wan (Alum Pill) is indicated.
Fanshi (Alum, 3 qian, calcined), Xingren (Apricot Seed, 1 fen).
Grind the two ingredients into powder, mix with refined honey to form pills the size of a date pit. Insert into the vagina. For severe cases, re-insert.
[Maiden Amenorrhea Leading to Consumption]
Kou Zongshi said: Human life is based on Qi and Blood. Disease invariably begins with damage to Qi and Blood. Maids and young boys with obsessive thoughts and excessive mental exertion often suffer from consumption. Men lose their luster and spirit; women experience amenorrhea first. Worry and anxiety damage the Heart, causing blood to reverse and exhaust, leading to loss of luster and amenorrhea. Heart disease fails to nourish the Spleen, resulting in anorexia. Spleen deficiency leads to Metal deficiency, causing cough. Exhaustion of Kidney Water causes Wood Qi to wither, leading to dry and flaccid limbs, irritability, scorched hair, and weak sinews and bones. If the Five Zang organs transmit the disease fully, death ensues. If one can change their mindset and use medicinal support, life may be preserved. Qinghao and Mengchong, which cool blood and move blood, must be avoided. Instead, Baizi Ren Wan (Biota Seed Pill) and Zelang Tang (Lycopus Decoction) should be used to nourish Yin blood and control deficient fire.
[Xue Ji/Xue] *Neijing* states: "When grains enter the Stomach, their dregs, fluids, and Zong Qi are divided into three pathways." Thus, Zong Qi accumulates in the chest, emerges from the throat, penetrates the Heart and Lungs, and governs respiration. Ying Qi secretes fluids, injects them into the vessels, transforms them into blood, nourishes the four extremities, and internally nourishes the Five Zang and Six Fu organs. If bitter-cold agents are taken, damaging the Stomach Qi again, it will inevitably lead to death.
A seventeen-year-old maiden suffered from prolonged illness, with Tian Gui (menstruation) not yet established, presenting with fever, cough, and poor appetite. She wished to use Tongjing Wan. I said: "This is likely due to insufficient congenital Qi and unfull Yin blood. Nourish Qi and Blood, benefit fluids, and menstruation will resume naturally." Confused by the desire for quick results, she persisted. I said: "This is not the correct treatment. This is a fierce agent that greatly assists Yang Fire; Yin blood will flow recklessly when exposed to it, and the Spleen and Stomach will become more deficient." Indeed, her menstruation became erratic, appetite decreased further, and she died.
Baizi Ren Wan (*Daquan*) treats the above syndrome; take concurrently with Zelang Tang.
Baizi Ren (stir-fried, separately ground), Niuxi, Juanbai (each 0.5 liang), Zelanye (Lycopus Leaf), Xuduan (each 2 liang), Shudihuang (3 liang).
Grind into fine powder, mix with refined honey to form pills the size of wutong seeds. Take thirty pills with rice drink on an empty stomach.
Zelang Tang
Zelanye (3 liang), Danggui, Shaoyao (each 1 liang), Gancao (0.5 liang).
Grind into coarse powder. Take 5 qian per dose, decoct with two zhan of water until one zhan remains, and take warm.
Chenxiang Biejia San (Agarwood and Softshell Turtle Powder) treats stagnant menstruation in maidens, dizziness and heaviness of head and eyes, retained phlegm, deficiency heat in the five centers, poor appetite, and frequent fatigue.
Chenxiang, Gancao (stir-baked), Binglang (each 3 fen), Muxiang, Changshan, Danggui, Chaihu, Renshen, Banxia, Guixin, Shengdi, Baifuling, Qingpi, Jing Chenpi (each 1 liang), Biejia (1.5 liang).
Grind into powder. Take 2 qian per dose with two slices of ginger, decoct with water until seven-tenths remain, and take warm on an empty stomach.
Jielao San treats deficiency of both Heart and Kidney, failure of Water and Fire to interact, initial slight cough, fever followed by chills at night, night sweats, fatigue, emaciation, reduced appetite, and mental confusion. Or slight cough with red threads in sputum, named Fei Wei (Lung Atrophy), which is incurable.
Baishaoyao (6 liang), Huangqi, Gancao, Renshen, Danggui, Banxia, Baifuling, Beiweizi, Ejiao (stir-fried), Shudihuang (washed, each 2 liang).
Cut into pieces. Take 3 da qian per dose with one and a half zhan of water, twelve slices of ginger, and three jujubes. Decoct and take warm. If all other medicines fail, one course cures the root.
Maijian San treats bone-steaming in young men and maidens, wind-blood attacking the limbs in women, chest and heart oppression, bad breath, muscle heat, and night sweats.
Biejia, Dahuang (baked), Changshan, Chifuling, Chaihu, Baizhu, Danggui, Ganqi (stir-fried until smoke ceases), Shengdi, Shigao (each 1 liang), Gancao (0.5 liang).
Grind into powder. Take 2 qian per dose with one zhan of water and fifty wheat grains. Take warm after meals and before bed. For deficiency sweating, add Mahuanggen (Ephedra Root) 1 liang.
Mudan San (*Heji Jufang*) treats Qi and Blood deficiency, internal amenorrhea, external tidal fever, emaciated and weak limbs, gradually developing into bone-steaming.
Ganqi (stir-fried, 2 liang), Sumu, Peng'e Zhu, Guijian (each 1 fen), Gancao, Danggui, Guixin, Mudanpi, Shaoyao, Yanhusuo (stir-fried), Jing Chenpi, Honghua, Wuyao, Moyao (separately ground, each 1 liang).
Cut into pieces. Take 3 qian per dose with one zhan of water, decoct until seven-tenths remain, and take warm at any time.
Liushen Tang (*Yuyao Yuanfang*) treats Qi and Blood insufficiency and bodily restlessness/heat. Siwu Tang plus Huangqi and Digupi, equal parts, cut, and decoct in water. Also treats deficiency of Chong and Ren meridians, amenorrhea, and skin heat resembling tuberculosis. Siwu Tang each 1 liang, Chaihu 0.5 liang, Huangqin 1 fen. Decoct in water.
Taoren San treats blood obstruction and immobility in women and maidens, with heat in the five centers.
Honghua, Danggui, Taoren (stir-fried), Niuxi (equal parts).
Grind into powder. Take 3 qian per dose mixed with wine, on an empty stomach.
[Pulse Diagnosis] The Master said: A woman brought her daughter, aged fifteen, for consultation. She stated that her daughter began menstruating at fourteen, but now menstruation has suddenly stopped, causing great fear. The Master said: "If this is the woman's biological daughter, the mother likely began menstruating at fourteen as well. This cessation is called 'Bi Nian' (Avoidance Year); do not worry, it will resume naturally. This is because True Qi is still weak and constitution is inherently frail." One should consolidate Tian Yuan True Qi, ensuring Water rises and Fire descends, so the Five Zang harmonize themselves and the meridians open.
Another prescription: Lurong (Deer Antler), Shanzhuyu, Danggui (each 4 liang), Shexiang (Musk, 1 liang).
Grind into fine powder, mix Shexiang evenly, bind with wine paste to form pills. Take fifty to one hundred pills per dose with warm wine or salt water.
[Acupuncture]
[*Xin*] For blocked meridians with existing chills and fever, this acupoint is highly effective. Sanyinjiao (SP6) (Needle 3 fen, effective immediately; if pain occurs, it indicates the meridian is opening.)
[*Zhai*] Blocked meridians (Same as *Xin Shu*). Quchi (LI11), Zhigou (SJ6), Zusanli (ST36), Sanyinjiao (SP6). (For these four acupoints, if blocked, use draining method; if due to deficiency and non-flow, use tonifying method.)
[*Ji*] Amenorrhea Zhongji (CV3), Sanyinjiao (SP6), Shenshu (BL23), Hegu (LI4).
[*Dong*] Another method: Siman (CV4) (Located 1.5 cun lateral to Dantian.)
[*Xin*] Blocked meridians transforming into mass syndromes, normal diet, but abdomen gradually enlarges like gu poisoning. Qihai (CV6) (Use needle with tube to drain water and foul matter.) Yinjiao (CV7) (Method same as above, to remove foul matter.)
[*Jia*] Amenorrhea, Ben Tun (Rushing Tumor), leakage of Qi, pain radiating up and down the lumbar spine, controlled by Qixue (GB26). Women failing to menstruate, controlled by Zhaohai (KI6). Women with firm pain in the lower abdomen and amenorrhea, controlled by Daimai (GB26).
Irregular menstruation, seeing blood while pregnant, leads to deterioration and breast swelling. Linqi (GB15) controls this.
[Diagnosis] A faint and choppy Kidney pulse indicates amenorrhea.