（杀血心痛附）
〔大法〕
〔丹〕紫色成块者血热，四物加黄连、柴胡之类。气虚血虚者，皆于四物内加参、 。
急则治其标，白芷汤调百草霜，甚者棕榈灰，后用四物加炒干姜调理。因劳者，用人参带
升补药。因热者，用黄芩。因寒者，用炒干
姜。
〔戴〕血大至曰崩中，或清或浊，或纯下瘀血，或腐，势不可止，证状非一，所感
亦异，甚则头目昏晕，四肢厥冷，并宜胶艾汤咽震灵丹，佐以三灰散。或以童子小便煎
理中汤，或以沉香降气汤加入百草霜，米饮调下。血崩甚而腹痛，人多疑恶血未尽，又
见血色瘀黑，愈信恶血之说，不敢止截。大凡血之为患，欲出未出之际，停在腹中，即
成瘀色，难尽以瘀为恶，又焉知瘀之不为虚冷乎？若必待见瘀血之后截之，恐并与人无
之矣。此腹痛更有说瘀而腹痛，血通而痛止，崩而腹痛，血住则痛止，宜芎归汤加干姜、熟
附一钱，止其血而痛自止，仍以刺花绣拭黑片烧灰研末，米饮调下。一方，以毛蟹壳烧
存性，米饮下。亦有以早黄麻根烧灰为末，米饮下。
〔薛〕经云∶阴虚阳搏，谓之崩。又云∶阳络伤则血外溢，阴络伤则血内溢。又云∶脾
统血，肝藏血。其为患因脾胃虚损，不能摄血归源。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，血热而沸腾。或因脾经郁结，血伤而不归经。
或因悲哀太过，胞络伤而下崩。治疗之法∶脾胃虚弱者，六君子汤加当归、川芎、柴胡。脾
胃虚陷者，补中益气汤加酒炒芍药、山栀。肝经血热者，四物汤加柴胡、山栀、苓、术。肝
经风热者，加味逍遥散，或小柴胡汤加山栀、芍药、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。哀伤胞络者，四君子汤加柴胡、升麻、山栀。故
东垣、丹溪诸先生云∶凡下血证须用四君子以收功，斯言厥有旨哉。若大去血后，毋以
脉诊，当急用独参汤救之。其发热、潮热、咳嗽、脉数，乃是元气虚弱，假热之脉也，尤
当用人参之类。此等证候，无不由脾胃先损，故脉洪大。察其有胃气受补则可救，设用寒
凉之药，复伤脾胃生气，反不能摄血归源，是速其危也。
《经验》、《简要》治崩中等证。冷者，脉紧细，手足寒，红去、淡黑或五色，当归
建中加白龙骨、血竭、附子，下紫石英丸、震灵丹。灸火。热者，脉洪，四肢温，心烦
口苦燥，血沸而成，用黄芩汤、荆芥散，或清心莲子饮加竹沥、生地黄汁，甚者，生地
黄汁磨京墨、百草霜冷服。虚者，胶艾汤加麦门冬、鹿茸、龙骨、酸枣仁，或养荣汤
加龙骨、血竭，送震灵丹。实者，腹中痛，煮附丸、四物汤加香附子。心虚者，恍忽
多梦，健忘，舌强，小便多，面红盗汗，柏子仁汤、酸枣仁汤加龙骨、京墨、百草霜，吞
灵砂丹。又灵砂、当归、莲肉、龙骨、枣肉丸，参汤送下。崩中作麝香、当归，香者，心
气已散，急服灵砂、龙骨等。
有田妇崩中，断下者，用大芜根酒煎，清早服。生麦中，如蓬蒿花。或云∶即蓟根也。
《产宝》分阴崩、阳崩。受热而赤，谓之阳崩。受冷而白，谓之阴崩。
胶艾汤 治阳崩不止，小腹疼痛。（见前月水不断条。）
固经丸 治阴崩不止。
艾叶（醋炒） 鹿角霜 伏龙肝 干姜（各等分为末）
上熔鹿角胶和药乘热丸，食后淡醋汤下五十丸。
丹溪云∶涎郁胸中，清气不升，故经脉壅遏而降下，非开涎不足以行气，非气升则
血不能归隧道。此论血泄之义甚明，盖开胸膈浊涎则清气升，清气升则血归隧道不崩矣。
故其证或腹满如孕，或脐腹 痛，或血结成片，或血出则快，止则闷，或脐上动。其治
法宜开结痰，行滞气，消污血。
〔开痰〕
江氏妇三十岁，坠胎后血不止，食少中满，倦怠不起，躁烦，六脉沉伏而数，重取
微弦。予作怒气伤肝，感动胃气。二陈加川芎、白术、缩砂，二十帖而安。
〔仲〕旋复花汤 治半产漏下，脉弦而
大。
旋复花（三两） 葱（十四茎） 新绛（少许）
上三味，以水三升，煮取一升，顿服之。（《本草》云∶旋复主留饮结气。）
半夏丸 （《直指》）治下血、吐血、崩中、带下，痰喘急满，虚肿。亦消宿瘀百病。
圆白半夏，刮净捶扁，姜汁调飞白面作饼，包，炙黄色，去面取半夏作末。
米糊为丸，绿豆大，每服十丸，温熟水下。芎归汤、沉香降气汤各半煎送下。止血
之要药。
〔千〕治妇人崩中下血不止。以衣中白鱼、僵蚕等分为末，以井花水服之，日三服，
瘥。
上三方开痰。
〔行气〕
〔罗〕备金散 治妇人血崩不止。
香附子（四两，炒） 当归尾（一两二钱） 五灵脂（一两，炒）
上为细末，每服五钱，醋汤调，空心服立效。
〔本〕治下血不止，或成五色崩漏。用香附子舂去皮毛，中断之，略炒为末，每服
二钱，清米饮调下。此方徐朝奉传。其内人有是疾，遍服药不效，后服此遂愈。久服为
佳。亦治产后腹痛，大是妇人仙药，常服益血调气。
〔大〕煮附丸（见前调经平剂。一方∶用香附子、白芷为丸。）
缩砂散 治血崩。用缩砂仁不以多少，于新瓦上炒香为细末，米饮调下三钱。
上四方行滞气。
〔消污血〕
〔世〕治血崩。用干荷叶浓煎汤一碗，空心服之立愈。或调醋炒香附末，尤妙。
五灵脂散 治妇人血崩，及治男子脾积气。
五灵脂（不以多少，炒令烟尽，研末）
上为末，每服一钱，温酒调下。此药兼能解毒及蛇蝎蜈松咬，涂伤处立愈。一方∶
每服三钱，水酒、童便各半盏，煎至八分，通口服，名抽刀散。治产后有病，服三服，散
恶血或心腹、胁肋、脚痛不可忍者。或止用童子小便尤佳。或中风，即入草乌头半钱同
煎。亦治肠风下血，如不饮酒者，煎乌梅柏叶汤调下。如心烦口干渴者，加蒲黄炒减半。
一方∶烧存性，霹雳酒下。然此药气恶难吃，烧之存性极妙。一方∶治妇人经血不
止，加当归两片，酒一盅，与药末同煎服。昔亲戚黄守正卿为和剂局日，内子凌夫人忽苦
此疾危殆，百药不效，偶得此方，旋服遂愈。
〔云〕治血崩不止。
五灵脂二钱，炒热，加当归酒同煎，或水酒、童便各半盏同煎服。一方∶五灵脂
半生半熟为末，酒调服。一方∶水煎五灵脂半干，去渣澄清，再煎成膏，入神曲末为
丸，如桐子大，空心温酒下二、三十丸，便止。
又方∶鹿茸（醋炙） 当归（各二钱） 蒲黄（半两，炒）
上为末，温酒调下五钱匕，日三服。
〔仲〕桂枝茯苓丸 治妇人有 在脐上动，下血不止。（方见胎动下血。）
上四方消污血。
〔补养〕
〔垣〕当归芍药汤 治妇人经脉漏下不止，其色鲜红。时值七月处暑之间，先因劳
役，脾胃虚弱，气短逆，自汗不止，身热闷乱，恶见饮食，亦不思食，沉困懒倦，四肢
无力，大便时泻。后复因心气不足，其经脉再下不止，惟觉气下脱，其元气逆上全无，惟
觉心腹中气不行，气短少不能言，是无力以言，非懒语也。此药主之。
黄 （一两半） 白术 苍术（泔浸，去皮） 当归身 白芍药（各五钱） 甘草（炙）
生地黄（各三分） 柴胡（二分） 熟地黄 陈皮（去白，各五分）
上十味为粗末，作二服，水煎去滓，热服，空心。一服之后，渐减。次日诸证悉去，
顿喜饮食。所以者何？盖气通而闻饮食之香，得平康故也。
〔薛〕一妇人面黄或赤，觉腰间或脐下作痛，四肢困倦，烦热不安，经行先发寒热，
两肋如束，血涌如崩。此脾胃亏损，元气下陷，与相火湿热所致。用补中益气加防风、芍
药、炒黑黄柏，间以归脾汤调补，而血始归经。
汪石山治一妇年逾四十，形色苍紫，忽病血崩，医者或用凉血，或用止涩，俱罔效。
诊之六脉皆沉濡而缓，按之无力，乃气病，非血病也。当用甘温之剂，健脾理胃，使胃气
上腾，血循经络，则元复崩矣。遂用补中益气汤多加参、 ，兼服参苓白术散，崩果愈。
《金匮》胶艾汤 治劳伤血气，月水过多，淋沥漏下，连日不止，脐腹疼痛，及妊娠将
摄失宜，胎动不安，腹痛下坠，或劳伤胞络，胞阻漏血，腰痛闷乱；或因损动，胎上抢心，
奔冲短气，及因产乳冲任气虚，不能约制，延引日月，渐成羸瘦。（方见前月水不断条。）
〔薛〕一妇人久患血崩，肢体消瘦，饮食到口，但闻腥臊，口出津液，强食少许，腹
中作胀，此血枯之证，肺、肝、脾、胃亏损之患。用八珍汤、乌贼鱼骨丸兼服两月而经
行，百余剂而康宁如旧矣。
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。
柏子仁（炒） 香附子（炒、去毛） 芎 鹿茸（火燎去毛，酒蒸焙） 茯神（去皮、木）
当归（各一钱半） 阿胶 小草（各一钱） 川续断（二钱） 甘草（炙，半钱）
上作一服，水二盅，生姜五片，煎至一盅，空心服。
〔补脾升阳〕
〔垣〕经水漏不住有二，补前人之阙。
妇人脾胃虚损，致命门脉沉细而数疾，或沉弦而洪大有力，寸关脉亦然，皆由脾胃有
亏，下陷于肾，与相火相合，湿热下迫，经漏不止，其色紫黑，如夏月腐肉之臭。中有
白带者，脉必弦细，寒作于中。有赤带者，其脉洪数，病热明矣。必腰痛或脐下痛，临经
欲行而先发寒热往来，两胁急缩，兼脾胃证出见，或四肢困热，心烦闷不得眠卧，心下
急，宜大补脾胃而升降气血，可一服而愈。或先贵而后贱，或先富而后贫，病名脱营者，心
气不足，其火大炽，旺于血脉之中，又致脾胃饮食失节，火乘其中，形质肌肉颜色似不
病者，此心病也。不形于脉，故脾胃饮食不调，其证显矣，而经水不时而下，或适来适
断，暴下不止。治当先说恶死之言，劝论令惧死而心不动，以大补气血之剂，补养脾胃，
微加镇坠心火之药，治其心，补阴泻阳，经自止矣。《痿论》云∶悲哀太甚则胞络绝，胞
络绝则阳气内动，发则心下崩，数溲血也，故经曰∶大经空虚，发则肌痹，传为脉痿。此
之谓也。
益胃升阳汤 治血脱益气，古人之法也。先补胃气以助生长，故曰阳生阴长。诸甘药
为之先务，举世皆以为补气，殊不知甘能生血，此阳生阴长之理也。故先理胃气，人之
一身，纳谷为宝。
黄 （二钱） 人参（有嗽者去之） 神曲（炒，各一钱半） 升麻 柴胡（各五分）
白术（三钱） 当归身（酒浸） 甘草（炙） 陈皮（各一钱） 生黄芩（二钱，泻盛暑之伏
金肺逆，秋凉不用） 一方用生地黄。
上为粗末，每服三钱或五钱，如食添再加之，如食减，已定三钱内更减之，不可多
服。每服二钱，水煎去滓，热服。如腹痛，每服加白芍药二分，中桂少许。如渴、口干，加
干葛二分。如嗽，去人参，服不计时候。（盖先服此益胃气升阳汤不止，却服后方柴胡调
经汤，大举大升之也。）
〔升阳〕
宣德侯经历家人病崩漏，医莫能效。切脉之后，且以纸疏其证至四十余种，为制调
经升阳除湿汤疗之，明日而十减其八，前后五六日良愈。
调经升阳除湿汤 治女子漏下恶血，月
事不调，或暴崩不止，多下水浆之物。皆由饮食不节，或劳伤形体，或素有心气不足，因饮酒劳倦，致令
心火乘脾，其人必怠情嗜卧，四肢不收，困倦乏力，无气以动，气短上气，逆急上冲，其脉缓而弦急，按
之洪大，皆中指下得之，脾土受邪也。脾主滋荣周身者也，心主血，血主脉，二者受邪，病皆在脉。脉
者血之府也，脉者人之神也。心不主令，胞络代之，故曰心之脉，主属心系。心系者胞络、命门之脉
也，主月事、主孕，皆由脾胃虚而心胞乘之，故漏下血水不调也。况脾胃为血气阴阳之根蒂，当除湿
去热，益风气上伸以胜其湿。又云∶火郁则发之。
柴胡 防风 甘草（炙） 本 升麻（各一钱） 羌活 苍术 黄 （各一钱半） 独活 当归（酒
浸，各五分） 蔓荆子（七分）
上 咀，水五大盏，煎至一大盏，去滓稍热服，空心。服药毕，待少时以早膳压之，
可一服而已。如灸足太阴脾经中血海穴二七壮或三七壮，立已。此药乃从权衡之法，用风胜湿，
为胃气下陷而气迫于下，以救其血之暴崩也。若病愈，经血恶物已尽，主病虽除，后必须以黄 、甘草、
人参、当归之类数服以补之，于补气升阳汤中加和血药是也。若经血气恶物下之不绝，尤宜救其根
源，治其本经，只益脾胃，退心火之亢，乃治其根蒂也。若遇夏月白带下脱漏不止，宜用此汤，
一服立止。
柴胡调经汤 治经水不止，鲜血，项筋急，脑痛，脊骨强痛，不思饮食。
羌活 独活 本 升麻（各五分） 苍术（一钱） 柴胡根（七分） 葛根 当归身
甘草（炙，各三分） 红花（少许）
上 咀，作一服，水煎去滓，稍热空心服，微汗立止。
（杀血心痛附）
〔大法〕
〔朱丹溪〕血色紫黑且有血块，属于血热，可用四物汤加入黄连、柴胡等药物。气虚或血虚者，均在四物汤中加入人参、黄芪。
急则治其标，用白芷汤调服百草霜，病情严重者用棕榈灰，之后再用四物汤加入炒干姜进行调理。因劳累所致者，用人参配合具有升提补益作用的药物。因热邪所致者，用黄芩。因寒邪所致者，用炒干姜。
〔戴元礼〕血量极大称为崩中，经血或清稀或浑浊，或纯下瘀血，或腐败，势不可止，症状不一，致病原因也各异，严重时出现头目昏晕，四肢厥冷，均宜服用胶艾汤并吞服震灵丹，辅以三灰散。或者用童子小便煎煮理中汤，或者在沉香降气汤中加入百草霜，用米饮送服。血崩严重且伴有腹痛，人们多怀疑是恶血未尽，又见血色瘀黑，更加相信恶血的说法，不敢使用止血药。大凡血液为患，在欲出未出之际，停在腹中，就会变成瘀色，不能一概认为瘀血就是恶血，又怎知瘀血不是由于虚冷造成的呢？如果一定要等到看到瘀血之后再止血，恐怕连正常的血也没有了。这腹痛另有说法：如果是瘀血阻滞引起的腹痛，血通畅后疼痛停止；崩漏引起的腹痛，血止住后疼痛停止，宜用芎归汤加入干姜、熟附子一钱，止住血后疼痛自然停止，另外还可以取花绣布上的黑片烧成灰研末，用米饮调服。另一方法，将毛蟹壳烧至存性，用米饮送服。也有用早黄的麻根烧成灰为末，用米饮送服。
〔薛己〕《内经》说：阴虚阳搏，称为崩。又说：阳络受伤则血外溢，阴络受伤则血内溢。又说：脾统血，肝藏血。其发病原因是脾胃虚损，不能摄血归源。或者因为肝经有火，血受热而下行。或者因为肝经有风，血受风而妄行。或者因为愤怒触动肝火，血热而沸腾。或者因为脾经郁结，血受损而不归经。或者因为悲哀太过，胞络受伤而下崩。治疗方法：脾胃虚弱者，用六君子汤加当归、川芎、柴胡。脾胃虚陷者，用补中益气汤加酒炒芍药、山栀。肝经血热者，用四物汤加柴胡、山栀、茯苓、白术。肝经风热者，用加味逍遥散，或小柴胡汤加山栀、芍药、丹皮。若是怒动肝火，也用前面的药。脾经郁火者，用归脾汤加山栀、柴胡、丹皮。哀伤胞络者，用四君子汤加柴胡、升麻、山栀。所以东垣、丹溪各位先生说：凡是下血证必须用四君子汤来收功，这话很有深意啊。如果大量失血后，不要以脉诊为准，应当紧急使用独参汤抢救。那些发热、潮热、咳嗽、脉数，乃是元气虚弱，假热的脉象，尤其应当用人参之类的药物。这些证候，无不是由脾胃先受损，所以脉象洪大。观察其是否有胃气能够受补，如果可以救活，假如使用寒凉的药物，再次损伤脾胃的生气，反而不能摄血归源，这是加速其死亡。
《经验方》、《简要济众方》治疗崩中等证。属冷者，脉紧细，手足寒冷，血色红、淡黑或五色杂下，用当归建中汤加白龙骨、血竭、附子，送服紫石英丸、震灵丹。灸法。属热者，脉洪大，四肢温暖，心烦口苦燥，血沸腾而成，用黄芩汤、荆芥散，或清心莲子饮加竹沥、生地黄汁，严重者，用生地黄汁磨京墨、百草霜冷服。属虚者，用胶艾汤加麦门冬、鹿茸、龙骨、酸枣仁，或养荣汤加龙骨、血竭，送服震灵丹。属实者，腹中痛，用煮附丸、四物汤加香附子。心虚者，恍惚多梦，健忘，舌强，小便多，面红盗汗，用柏子仁汤、酸枣仁汤加龙骨、京墨、百草霜，吞服灵砂丹。又有灵砂、当归、莲肉、龙骨、枣肉丸，用参汤送下。崩中若用麝香、当归，香气明显者，说明心气已散，急服灵砂、龙骨等。
有一位农妇患崩中断下，用大芜根酒煎，清晨服用。生长在麦田中，像蓬蒿花一样。有人说：就是蓟根。
《产宝》分阴崩、阳崩。受热而血色赤，称为阳崩。受冷而血色白，称为阴崩。
胶艾汤 治疗阳崩不止，小腹疼痛。（见前月经不断条。）
固经丸 治疗阴崩不止。
艾叶（醋炒） 鹿角霜 伏龙肝 干姜（各等分为末）
上将鹿角胶熔化调和药粉，趁热制成丸剂，饭后用淡醋汤送服五十丸。
丹溪说：痰涎郁滞胸中，清气不升，所以经脉壅遏而降下，不开除痰涎不足以行气，气不升则血不能归入隧道。这个论述血泄的道理非常明白，大概开通胸膈浊涎则清气上升，清气上升则血归隧道不再崩漏。所以他的证候有的腹部胀满如怀孕，有的脐腹疼痛，有的血结成片，有的血出则舒适，血止则闷，有的脐上跳动。其治疗方法宜开结痰，行滞气，消污血。
〔开痰〕
江氏妇人三十岁，坠胎后血不止，食少中满，倦怠不起，躁烦，六脉沉伏而数，重按微弦。我认为是怒气伤肝，感动胃气。用二陈汤加川芎、白术、缩砂，二十帖而安。
〔张仲景〕旋复花汤 治疗半产后漏下，脉弦而大。
旋复花（三两） 葱（十四茎） 新绛（少许）
上三味，用水三升，煮取一升，顿服之。（《本草》说：旋复主治留饮结气。）
半夏丸 （《直指方》）治疗下血、吐血、崩中、带下，痰喘急满，虚肿。也能消除宿瘀百病。
选圆白半夏，刮净捶扁，用姜汁调飞白面作饼，包裹，炙至黄色，去掉面取半夏作末。
用米糊为丸，绿豆大小，每服十丸，温熟水送下。也可用芎归汤、沉香降气汤各半煎送下。是止血的要药。
〔千金方〕治疗妇人崩中下血不止。用衣中白鱼、僵蚕等分为末，用井花水服之，日服三次，痊愈。
以上三方用于开痰。
〔行气〕
〔罗谦甫〕备金散 治疗妇人血崩不止。
香附子（四两，炒） 当归尾（一两二钱） 五灵脂（一两，炒）
上为细末，每服五钱，醋汤调服，空腹服立效。
〔本方〕治疗下血不止，或成五色崩漏。用香附子舂去皮毛，中断之，略炒为末，每服二钱，清米饮调下。此方徐朝奉传。其家中有此疾的人，遍服药不效，后服此遂愈。久服为佳。也治疗产后腹痛，大是妇人仙药，常服益血调气。
〔大全〕煮附丸（见前调经平剂。一方：用香附子、白芷为丸。）
缩砂散 治疗血崩。用缩砂仁不限多少，于新瓦上炒香为细末，米饮调下三钱。
以上四方用于行滞气。
〔消污血〕
〔世医得效方〕治疗血崩。用干荷叶浓煎汤一碗，空腹服之立愈。或调醋炒香附末，尤妙。
五灵脂散 治疗妇人血崩，及治疗男子脾积气。
五灵脂（不限多少，炒令烟尽，研末）
上为末，每服一钱，温酒调下。此药兼能解毒及蛇蝎蜈蚣咬伤，涂伤处立愈。一方：每服三钱，水酒、童便各半盏，煎至八分，通口服，名抽刀散。治疗产后有病，服三服，散恶血或心腹、胁肋、脚痛不可忍者。或只用童子小便尤佳。或中风，即入草乌头半钱同煎。也治疗肠风下血，如不饮酒者，煎乌梅柏叶汤调下。如心烦口干渴者，加蒲黄炒减半。一方：烧存性，霹雳酒下。然此药气味恶臭难吃，烧之存性极妙。一方：治疗妇人经血不止，加当归两片，酒一盅，与药末同煎服。昔日亲戚黄守正卿在和剂局时，内子凌夫人忽患此疾危殆，百药不效，偶得此方，旋服遂愈。
〔云岐子〕治疗血崩不止。
五灵脂二钱，炒热，加当归酒同煎，或水酒、童便各半盏同煎服。一方：五灵脂半生半熟为末，酒调服。一方：水煎五灵脂半干，去渣澄清，再煎成膏，入神曲末为丸，如桐子大，空心温酒下二、三十丸，便止。
又方：鹿茸（醋炙） 当归（各二钱） 蒲黄（半两，炒）
上为末，温酒调下五钱匕，日三服。
〔张仲景〕桂枝茯苓丸 治疗妇人有癥块在脐上动，下血不止。（方见胎动下血。）
以上四方用于消污血。
〔补养〕
〔李东垣〕当归芍药汤 治疗妇人经脉漏下不止，其色鲜红。时值七月处暑之间，先因劳役，脾胃虚弱，气短逆，自汗不止，身热闷乱，恶见饮食，亦不思食，沉困懒倦，四肢无力，大便时泻。后复因心气不足，其经脉再下不止，惟觉气下脱，其元气逆上全无，惟觉心腹中气不行，气短少不能言，是无力以言，非懒语也。此药主之。
黄芪（一两半） 白术 苍术（泔浸，去皮） 当归身 白芍药（各五钱） 甘草（炙）
生地黄（各三分） 柴胡（二分） 熟地黄 陈皮（去白，各五分）
上十味为粗末，作二服，水煎去滓，热服，空腹。一服之后，渐减。次日诸证悉去，顿喜饮食。所以者何？盖气通而闻饮食之香，得平康故也。
〔薛己〕一妇人面黄或赤，觉腰间或脐下作痛，四肢困倦，烦热不安，经行先发寒热，两肋如束，血涌如崩。此脾胃亏损，元气下陷，与相火湿热所致。用补中益气加防风、芍药、炒黑黄柏，间以归脾汤调补，而血始归经。
汪石山治疗一妇人年逾四十，形色苍紫，忽病血崩，医者或用凉血，或用止涩，俱罔效。诊之六脉皆沉濡而缓，按之无力，乃气病，非血病也。当用甘温之剂，健脾理胃，使胃气上腾，血循经络，则元复崩矣。遂用补中益气汤多加参、芪，兼服参苓白术散，崩果愈。
《金匮要略》胶艾汤 治疗劳伤血气，月水过多，淋沥漏下，连日不止，脐腹疼痛，及妊娠将摄失宜，胎动不安，腹痛下坠，或劳伤胞络，胞阻漏血，腰痛闷乱；或因损动，胎上抢心，奔冲短气，及因产乳冲任气虚，不能约制，延引日月，渐成羸瘦。（方见前月经不断条。）
〔薛己〕一妇人久患血崩，肢体消瘦，饮食到口，但闻腥臊，口出津液，强食少许，腹中作胀，此血枯之证，肺、肝、脾、胃亏损之患。用八珍汤、乌贼鱼骨丸兼服两月而经行，百余剂而康宁如旧矣。
柏子仁汤 治疗妇人忧思过度，劳伤心经，不能藏血，遂致崩中下血不止。
柏子仁（炒） 香附子（炒、去毛） 川芎 鹿茸（火燎去毛，酒蒸焙） 茯神（去皮、木）
当归（各一钱半） 阿胶 小草（各一钱） 川续断（二钱） 甘草（炙，半钱）
上作一服，水二盅，生姜五片，煎至一盅，空腹服。
〔补脾升阳〕
〔李东垣〕经水漏不住有二，补前人之阙。
妇人脾胃虚损，致命门脉沉细而数疾，或沉弦而洪大有力，寸关脉亦然，皆由脾胃有亏，下陷于肾，与相火相合，湿热下迫，经漏不止，其色紫黑，如夏月腐肉之臭。中有白带者，脉必弦细，寒作于中。有赤带者，其脉洪数，病热明矣。必腰痛或脐下痛，临经欲行而先发寒热往来，两胁急缩，兼脾胃证出见，或四肢困热，心烦闷不得眠卧，心下急，宜大补脾胃而升降气血，可一服而愈。或先贵而后贱，或先富而后贫，病名脱营者，心气不足，其火大炽，旺于血脉之中，又致脾胃饮食失节，火乘其中，形质肌肉颜色似不病者，此心病也。不形于脉，故脾胃饮食不调，其证显矣，而经水不时而下，或适来适断，暴下不止。治当先说恶死之言，劝论令惧死而心不动，以大补气血之剂，补养脾胃，微加镇坠心火之药，治其心，补阴泻阳，经自止矣。《痿论》说：悲哀太甚则胞络绝，胞络绝则阳气内动，发则心下崩，数溲血也，故经说：大经空虚，发则肌痹，传为脉痿。此之谓也。
益胃升阳汤 治疗血脱益气，古人之法也。先补胃气以助生长，故曰阳生阴长。诸甘药为之先务，举世皆以为补气，殊不知甘能生血，此阳生阴长之理也。故先理胃气，人之一身，纳谷为宝。
黄芪（二钱） 人参（有嗽者去之） 神曲（炒，各一钱半） 升麻 柴胡（各五分）
白术（三钱） 当归身（酒浸） 甘草（炙） 陈皮（各一钱） 生黄芩（二钱，泻盛暑之伏金肺逆，秋凉不用） 一方用生地黄。
上为粗末，每服三钱或五钱，如食添再加之，如食减，已定三钱内更减之，不可多服。每服二钱，水煎去滓，热服。如腹痛，每服加白芍药二分，中桂少许。如渴、口干，加干葛二分。如嗽，去人参，服不计时候。（盖先服此益胃气升阳汤不止，却服后方柴胡调经汤，大举大升之也。）
〔升阳〕
宣德侯经历家人病崩漏，医莫能效。切脉之后，且以纸疏其证至四十余种，为制调经升阳除湿汤疗之，明日而十减其八，前后五六日良愈。
调经升阳除湿汤 治疗女子漏下恶血，月事不调，或暴崩不止，多下水浆之物。皆由饮食不节，或劳伤形体，或素有心气不足，因饮酒劳倦，致令心火乘脾，其人必怠情嗜卧，四肢不收，困倦乏力，无气以动，气短上气，逆急上冲，其脉缓而弦急，按之洪大，皆中指下得之，脾土受邪也。脾主滋荣周身者也，心主血，血主脉，二者受邪，病皆在脉。脉者血之府也，脉者人之神也。心不主令，胞络代之，故曰心之脉，主属心系。心系者胞络、命门之脉也，主月事、主孕，皆由脾胃虚而心胞乘之，故漏下血水不调也。况脾胃为血气阴阳之根蒂，当除湿去热，益风气上伸以胜其湿。又云：火郁则发之。
柴胡 防风 甘草（炙） 藁本 升麻（各一钱） 羌活 苍术 黄芪（各一钱半） 独活 当归（酒浸，各五分） 蔓荆子（七分）
上切碎，水五大盏，煎至一大盏，去滓稍热服，空腹。服药毕，待少时以早膳压之，可一服而已。如灸足太阴脾经中血海穴二七壮或三七壮，立已。此药乃从权衡之法，用风胜湿，为胃气下陷而气迫于下，以救其血之暴崩也。若病愈，经血恶物已尽，主病虽除，后必须以黄芪、甘草、人参、当归之类数服以补之，于补气升阳汤中加和血药是也。若经血气恶物下之不绝，尤宜救其根源，治其本经，只益脾胃，退心火之亢，乃治其根蒂也。若遇夏月白带下脱漏不止，宜用此汤，一服立止。
柴胡调经汤 治疗经水不止，鲜血，项筋急，脑痛，脊骨强痛，不思饮食。
羌活 独活 藁本 升麻（各五分） 苍术（一钱） 柴胡根（七分） 葛根 当归身
甘草（炙，各三分） 红花（少许）
上切碎，作一服，水煎去滓，稍热空心服，微汗立止。
(Attached: Heart Pain Caused by Severe Blood Loss)
[General Principles]
[Zhu Danxi] If the blood is purple-black and forms clots, it indicates Blood Heat. Use Siwu Tang (Four Substances Decoction) with added Huanglian (Coptis Rhizome) and Chaihu (Bupleurum Root). For Qi Deficiency or Blood Deficiency, add Renshen (Ginseng Radix) and Huangqi (Astragalus Membranaceus) to Siwu Tang.
In acute cases, treat the branch symptoms first. Administer Baicaoshuang (Soot from Hundred Herbs) mixed with Baizhi Tang (Angelica Dahurica Decoction); for severe cases, use Zongluyin (Date Palm Spine Ash). Afterwards, regulate with Siwu Tang (Four Substances Decoction) plus Chao Ganjiang (Fried Dried Ginger). For cases caused by overexertion, use Renshen (Ginseng Radix) combined with herbs that have lifting and tonifying properties. For cases caused by Heat, use Huangqin (Scutellaria Root). For cases caused by Cold, use Chao Ganjiang (Fried Dried Ginger).
[Dai Yuanli] Massive bleeding is called Bengzhong (Metrorrhagia). The discharge may be clear or turbid, purely clotted blood, or putrid. The flow is unstoppable, symptoms vary, and etiologies differ. In severe cases, dizziness and cold extremities occur. All such cases should be treated with Jiao'ai Tang (Donkey-hide Gelatin and Mugwort Decoction) taken with Zhenling Dan (Spirit-Shaking Pill), assisted by Sanhui San (Three Ashes Powder). Alternatively, decoct Lizhong Tang (Regulate the Middle Decoction) using Tongzi Xiaoye (Child's Urine), or add Baicaoshuang (Soot from Hundred Herbs) to Chenxiang Jiangqi Tang (Aquilaria Qi-Descending Decoction) and administer with Rice Drink. When metrorrhagia is severe with abdominal pain, people often suspect that evil blood remains. Seeing the dark, clotted blood reinforces this belief, leading to hesitation in using hemostatic agents. Generally, when blood is about to exit but lingers in the abdomen, it becomes clotted. One cannot assume all clots are "evil"; how can one know if clots are not due to Deficiency-Cold? If one waits until clots appear before stopping the bleeding, normal blood may also be lost. Regarding abdominal pain: if caused by blood stasis, pain ceases when blood flows; if caused by metrorrhagia, pain ceases when bleeding stops. Use Xionggui Tang (Ligusticum and Angelica Decoction) with Ganjiang (Dried Ginger) and Shu Fuzi (Prepared Aconite Carapax et Radix Preparata, 1 qian). Once bleeding stops, pain will cease. Alternatively, burn black flakes from embroidered cloth to ash, powder it, and take with Rice Drink. Another method: burn crab shell until preserved nature, take with Rice Drink. Some use dried hemp root burned to ash, taken with Rice Drink.
[Xue Ji] The Classic says: Yin Deficiency with Yang pounding is called Beng. It also says: Injury to Yang collaterals causes external bleeding; injury to Yin collaterals causes internal bleeding. Furthermore: Spleen governs blood; Liver stores blood. Pathogenesis involves Spleen-Stomach deficiency failing to control blood return to its source. Or Liver channel Fire causing blood to descend due to heat. Or Liver channel Wind causing blood to move recklessly. Or anger stirring Liver Fire causing blood to boil. Or Spleen channel stagnation injuring blood so it does not return to vessels. Or excessive grief injuring the Bao Luo (Uterine Collaterals) causing lower bleeding. Treatment methods: For Spleen-Stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction) with Danggui (Angelica Sinensis), Chuanxiong (Sichuan Lovage Rhizome), and Chaihu (Bupleurum Root). For Spleen-Stomach sinking, use Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) with Jiushao Yao (Wine-fried White Peony Root) and Shanzhi (Gardenia Fruit). For Liver channel Blood Heat, use Siwu Tang (Four Substances Decoction) with Chaihu (Bupleurum Root), Shanzhi (Gardenia Fruit), Fuling (Poria), and Baizhu (Atractylodes Macrocephala Rhizome). For Liver channel Wind-Heat, use Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder) or Xiao Chaihu Tang (Minor Bupleurum Decoction) with Shanzhi (Gardenia Fruit), Shaoyao (Peony Root), and Mudanpi (Tree Peony Bark). If caused by anger stirring Liver Fire, use the aforementioned formulas. For Spleen channel Stagnant Fire, use Guipi Tang (Restore the Spleen Decoction) with Shanzhi (Gardenia Fruit), Chaihu (Bupleurum Root), and Mudanpi (Tree Peony Bark). For grief injuring Bao Luo, use Sijunzi Tang (Four Gentlemen Decoction) with Chaihu (Bupleurum Root), Shengma (Cimicifuga Rhizome), and Shanzhi (Gardenia Fruit). Thus, Dongyuan and Danxi stated: For all lower bleeding syndromes, conclude treatment with Sijunzi Tang (Four Gentlemen Decoction). This statement is profound. After massive blood loss, do not rely solely on pulse diagnosis; urgently use Dushen Tang (Single Ginseng Decoction) to rescue. Fever, tidal fever, cough, and rapid pulse indicate Yuan Qi (Original Qi) deficiency and false Heat; Ren Shen (Ginseng Radix) is especially indicated. These syndromes stem from prior Spleen-Stomach damage, hence the flooding pulse. If stomach Qi can accept tonification, rescue is possible. Using cold-cooling herbs would further damage Spleen-Stomach generating Qi, preventing blood from returning to vessels, thus accelerating death.
Jingyan Fang (Experience Formulas) and Jianyao Fang (Essential Formulas) treat Bengzhong (Metrorrhagia). For Cold patterns: tight/thin pulse, cold limbs, red/dark/black or multi-colored discharge. Use Danggui Jianzhong Tang (Angelica Build the Middle Decoction) with Bailonggu (Fossilized Bones), Xuexue (Dragon's Blood), and Fuzi (Aconite Carapax et Radix Preparata). Follow with Zi Shiying Wan (Purple Quartz Pill) and Zhenling Dan (Spirit-Shaking Pill). Moxibustion. For Heat patterns: flooding pulse, warm limbs, irritability, bitter/dry mouth, boiling blood. Use Huangqin Tang (Scutellaria Decoction), Jingjie San (Schizonepeta Powder), or Qingxin Lianzi Yin (Clear Heart Lotus Seed Drink) with Zhuli (Bamboo Juice) and Shengdihuang汁 (Fresh Rehmannia Juice). For severe cases, mix Shengdihuang汁 (Fresh Rehmannia Juice) with Jingmo (Beijing Ink) and Baicaoshuang (Soot from Hundred Herbs), take cold. For Deficiency patterns: Jiao'ai Tang (Donkey-hide Gelatin and Mugwort Decoction) with Maidong (Ophiopogon Tuber), Lurong (Deer Antler), Longgu (Fossilized Bones), and Suanzaoren (Ziziphus Seed). Or Yangrong Tang (Nourish Vigor Decoction) with Longgu (Fossilized Bones) and Xuexue (Dragon's Blood), followed by Zhenling Dan (Spirit-Shaking Pill). For Excess patterns: abdominal pain. Use Zhu Fu Wan (Boiled Aconite Pill) or Siwu Tang (Four Substances Decoction) with Xiangfu (Cyperus Rhizome). For Heart Deficiency: vagueness, dreams, forgetfulness, stiff tongue, frequent urination, facial flushing, night sweats. Use Baizi Ren Tang (Biota Seed Decoction) or Suanzaoren Tang (Ziziphus Seed Decoction) with Longgu (Fossilized Bones), Jingmo (Beijing Ink), and Baicaoshuang (Soot from Hundred Herbs). Swallow Lingsha Dan (Cinnabar-Sulfur Pill). Also, pills of Lingsha (Cinnabar-Sulfur), Danggui (Angelica Sinensis), Lianrou (Lotus Seed Plumule), Longgu (Fossilized Bones), and Jujube flesh, taken with Renshen Tang (Ginseng Decoction). If Bengzhong shows musk and Danggui (Angelica Sinensis) aroma, Heart Qi has scattered; urgently take Lingsha (Cinnabar-Sulfur) and Longgu (Fossilized Bones).
A peasant woman suffered metrorrhagia and leukorrhea. She took Da Wugen (Great Arisaema Root) decocted in wine, taken early morning. It grows in wheat fields, resembling Artemisia flowers. Some say it is Jigen (Thistle Root).
Chanbao (Treasures of Childbirth) distinguishes Yin Beng and Yang Beng. Heat-induced red discharge is Yang Beng. Cold-induced white discharge is Yin Beng.
Jiao'ai Tang (Donkey-hide Gelatin and Mugwort Decoction) treats Yang Beng unceasing with lower abdominal pain. (See previous section on continuous menstruation.)
Gu Jing Wan (Stabilize the Menses Pill) treats Yin Beng unceasing.
Ai Ye (Mugwort Leaf, stir-fried with vinegar), Lujiaoshuang (Deer Horn Glue Frost), Fulonggan (Dragons' Blood Soil), Ganjiang (Dried Ginger) (equal parts, powdered).
Melt Lujiaojiao (Donkey-hide Gelatin) and mix with powder. Form pills while hot. Take 50 pills after meals with light vinegar water.
Danxi said: Phlegm-fluid retention in the chest prevents Clear Qi from ascending, obstructing meridians and causing downward flow. Without resolving phlegm, Qi cannot move; without ascending Qi, Blood cannot return to its vessels. This clearly explains blood leakage. Resolving chest phlegm allows Clear Qi to ascend; ascending Clear Qi stops bleeding. Symptoms include abdominal fullness like pregnancy, umbilical/abdominal pain, blood clots, comfort upon bleeding but oppression upon cessation, or pulsation above the navel. Treatment: resolve phlegm, move stagnant Qi, eliminate dirty blood.
[Resolving Phlegm]
Madam Jiang, 30 years old, had post-abortion bleeding, poor appetite, abdominal fullness, fatigue, restlessness. Six pulses were deep, hidden, rapid, and slightly wiry upon heavy pressure. I diagnosed Liver Qi stagnation affecting Stomach Qi. Used Erchen Tang (Two Aged Substances Decoction) with Chuanxiong (Sichuan Lovage Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), and Suosha (Amomum Fruit). 20 doses brought relief.
[Zhang Zhongjing] Xuanfuhua Tang (Inula Flower Decoction) treats miscarriage leakage with wiry/large pulses.
Xuanfuhua (Inula Flower, 3 liang), Cong (Green Onion Stem, 14 stalks), Xinjiang (New Crimson Silk, a little).
Decoct three ingredients in 3 sheng water to 1 sheng. Take at once. (Bencao states: Xuanfuhua treats retained fluid and Qi stagnation.)
Banxia Wan (Pinellia Pill) [Zhizhi Fang] treats lower bleeding, hematemesis, metrorrhagia, leukorrhea, phlegm-wheezing/fullness, edema. Also eliminates old stasis.
Use round white Banxia (Pinellia Tuber), scrape clean, flatten. Mix with Jiangzhi (Ginger Juice) and refined flour to make cakes. Wrap and roast until yellow. Remove flour, powder Banxia.
Form pills with rice paste, size of mung beans. Take 10 pills with warm cooked water. Can also be taken with half-decoctions of Xionggui Tang (Ligusticum and Angelica Decoction) or Chenxiang Jiangqi Tang (Aquilaria Qi-Descending Decoction). Essential hemostatic herb.
[Qianjin Fang] Treats female metrorrhagia. Equal parts Yizhong Baiyu (Silverfish) and Jiangcan (Silkworm). Powder, take well water, 3 times daily. Cure.
The above three formulas resolve phlegm.
[Moving Qi]
[Luo Qianfu] Beijin San (Precious Metal Powder) treats female metrorrhagia.
Xiangfu (Cyperus Rhizome, 4 liang, fried), Dangguiwei (Angelica Sinensis Tail, 1.2 qian), Wulingzhi (Trogopterus Dung, 1 liang, fried).
Powder. Take 5 qian with vinegar water, fasting. Immediate effect.
[Local Formula] Treats persistent lower bleeding or five-color leukorrhea. Pound Xiangfu (Cyperus Rhizome) to remove hairs, break in middle, lightly fry, powder. Take 2 qian with clear rice drink. Passed down by Xu Chaofeng. His family member was cured after other medicines failed. Good for long-term use. Also treats postpartum abdominal pain. Excellent women's medicine, nourishes blood and regulates Qi.
[Daqan] Zhufu Wan (Boiled Aconite Pill) (See previous regular menstruation formula. Alternative: Xiangfu and Baizhi pills.)
Suosha San (Amomum Powder) treats metrorrhagia. Suosha Ren (Amomum Fruit), amount unspecified, roast on new tile until fragrant, powder. Take 3 qian with rice drink.
The above four formulas move stagnant Qi.
[Eliminating Dirty Blood]
[Shiyi De Xiao Fang] Treats metrorrhagia. Strong decoction of dry lotus leaf, one bowl, fasting. Immediate cure. Or mix with vinegar-fried Xiangfu powder. Better.
Wulingzhi San (Trogopterus Dung Powder) treats female metrorrhagia and male spleen accumulation.
Wulingzhi (Trogopterus Dung, amount unspecified, fry until smoke ceases, powder).
Powder. Take 1 qian with warm wine. Also detoxifies snake/scorpion bites. Apply topically. Alternative: Take 3 qian with half wine/half child's urine, decoct to 8 fen. Name: Choudao San. Treats postpartum conditions, disperses evil blood or unbearable heart/abdomen/flank/leg pain. Child's urine alone is better. For stroke, add Cao Wutou (Aconitum Kusnezoffii Root). Treats intestinal wind bleeding. If no wine, use Wumei BoYe Tang (Mume Leaf Decoction). If irritability/thirst, add Chao Puhuang (Roasted Pollen Typhae), reduce dose. Alternative: Burn to preserve nature, take with Pili Jiu (Thunderbolt Wine). Smells bad, but burning preserves efficacy. Alternative: For unceasing menstrual blood, add Danggui slices and wine, decoct together. Relative Huang Shouzhengqing served in Heji Bureau. His wife Lady Ling suffered critically, hundred medicines failed.偶然 obtained this formula, cured immediately.
[Yun Qizi] Treats unceasing metrorrhagia.
Wulingzhi (Trogopterus Dung, 2 qian), stir-fry hot, add Danggui and wine, decoct. Or half wine/half child's urine. Alternative: Half raw/half roasted Wulingzhi powder, wine. Alternative: Water decoct Wulingzhi until semi-dry, filter, decoct to paste, add Shenqu powder, form pills like wattle seeds. Take 20-30 pills fasting with warm wine. Stops bleeding.
Another formula: Lurong (Deer Antler, vinegar-roasted), Danggui (each 2 qian), Puhuang (Pollen Typhae, 0.5 liang, fried).
Powder. Take 5 qianbi with warm wine, 3 times daily.
[Zhang Zhongjing] Guizhi Fuling Wan (Cinnamon Twig and Poria Pill) treats uterine mass above navel with pulsation and persistent lower bleeding. (Formula see fetal movement bleeding.)
The above four formulas eliminate dirty blood.
[Nourishing]
[Li Dongyuan] Danggui Shaoyao Tang (Angelica and Peony Decoction) treats female continuous fresh-red leakage. Occurred during July/Chushu period. Initially due to labor, Spleen-Stomach weakness, shortness of breath, spontaneous sweating, body heat/restlessness, aversion to food, lethargy, weak limbs, loose stools. Later, Heart Qi deficiency caused recurrence. Feeling Qi sinking, Yuan Qi failing to rise, Qi stagnation in heart/abdomen, inability to speak due to weakness. This formula treats it.
Huangqi (Astragalus Membranaceus, 1.5 liang), Baizhu (Atractylodes Macrocephala Rhizome), Cangzhu (Atractylodes Lancea Rhizome, soaked in rice water, peeled), Dangguishen (Angelica Sinensis Root Body), Shaoyao (White Peony Root) (each 5 qian), Gancao (Licorice Root, roasted), Shengdihuang (Fresh Rehmannia Root) (each 3 fen), Chaihu (Bupleurum Root, 2 fen), Shudihuang (Prepared Rehmannia Root), Chenpi (Tangerine Peel, de-white) (each 5 fen).
Ten ingredients, coarse powder. Two doses. Decoct in water, strain, take hot fasting. Gradually reduce after one dose. Next day, symptoms gone, appetite returns. Why? Qi flows, smell of food is pleasant, health restored.
[Xue Ji] A woman with yellow/red face, waist/umbilical pain, limb fatigue, irritability, chills/fever before menses, rib binding, blood gushing like metrorrhagia. Spleen-Stomach damage, Yuan Qi sinking, Minister Fire/Damp-Heat. Use Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) with Fangfeng (Saposhnikovia Root), Shaoyao (Peony Root), and Chaohei Huangbai (Roasted Black Phellodendron Bark). Intermittently use Guipi Tang (Restore the Spleen Decoction) to regulate. Blood returned to vessels.
Wang Shishan treated a woman over 40, dark complexion, sudden metrorrhagia. Doctors used cooling or astringent herbs, ineffective. Pulses: deep, soggy, slow, weak. Qi disease, not Blood. Use sweet-warm herbs to strengthen Spleen/Stomach, raise Stomach Qi, let blood follow vessels, restore Yuan Qi. Used Buzhong Yiqi Tang (Tonify Middle and Augment Qi Decoction) with extra Renshen (Ginseng Radix) and Huangqi (Astragalus Membranaceus), plus Shenling Baizhu San (Ginseng, Poria and Atractylodes Macrocephala Powder). Cured.
[Jinkui Yaolue] Jiao'ai Tang (Donkey-hide Gelatin and Mugwort Decoction) treats labor-injury to blood/Qi, menorrhagia, dripping leakage, continuous days, umbilical pain, improper pregnancy care, fetal movement/unrest, abdominal pain/prolapse, Bao Luo injury/bleeding, back pain/restlessness, fetal distress rushing to heart, shortness of breath, postpartum Chong/Ren deficiency unable to constrain, wasting syndrome. (Formula see previous continuous menstruation section.)
[Xue Ji] A woman with chronic metrorrhagia, emaciation, aversion to fishy smells, drooling, forced eating causes bloating. Blood Dryness syndrome. Lung/Liver/Spleen/Stomach damage. Use Bazhen Tang (Eight Treasures Decoction) and Wzeiyugu Wan (Cuttlefish Bone Pill) for two months. Menstruation resumed, cured after 100+ doses.
Baizi Ren Tang (Biota Seed Decoction) treats excessive worry damaging Heart channel, failing to store blood, causing metrorrhagia.
Baizi Ren (Biota Seed, fried), Xiangfu (Cyperus Rhizome, fried/de-haired), Chuanxiong (Sichuan Lovage Rhizome), Lurong (Deer Antler, fire-scraped, wine-steamed/baked), Fushen (Poria with Hostwood, peeled/de-woody), Danggui (Angelica Sinensis) (each 1.5 qian), Ejiao (Donkey-hide Gelatin), Xiaocao (Herba Patriniae) (each 1 qian), Chuanxuduan (Teasel Root, 2 qian), Gancao (Licorice Root, roasted, 0.5 qian).
One dose. Water 2 zhong, Ginger 5 slices. Decoct to 1 zhong. Take fasting.
[Spleen Tonification and Yang Ascension]
[Li Dongyuan] Two types of unceasing menstruation, supplementing predecessors.
Female Spleen-Stomach deficiency leads to Mingmen pulse deep/thin/rapid or deep/wiry/flooding/powerful. Cun/Guan pulses similar. Due to Spleen-Stomach deficiency sinking into Kidney, combining with Minister Fire, Damp-Heat pressing down, causing leakage. Color purple-black, foul like rotting meat in summer. With leukorrhea: wiry/thin pulse, internal Cold. With red leukorrhea: flooding/rapid pulse, Heat evident. Must have back/umbilical pain, chills/fever before menses, rib contraction, Spleen-Stomach symptoms, limb heat, irritability/insomnia, chest urgency. Greatly tonify Spleen-Stomach to regulate Qi/Blood, one dose cures. Or "Tuoying" (Depletion of Ying): formerly noble/poor, formerly rich/poor. Heart Qi deficiency, Fire blazing in vessels, Spleen-Stomach dietary irregularity, Fire invading middle. Appearance healthy, but Heart disease. Not visible in pulse, but Spleen-Stomach symptoms obvious. Irregular menstruation, sudden heavy bleeding. Treat by frightening patient to stop fear, then greatly tonify Qi/Blood, nourish Spleen-Stomach, slightly calm Heart Fire, tonify Yin drain Yang, menstruation stops. Fei Lun says: Excessive grief severs Bao Luo, Yang moves internally, causes heart metrorrhagia/frequent bloody urine. Large vessels empty, muscle bi transforms into Mai Wei (Vessel Flaccidity). This is it.
Yiwei Shengyang Tang (Benefit Stomach and Ascend Yang Decoction) treats blood loss by benefiting Qi, ancient method. Tonify Stomach Qi to aid growth, hence "Yang generates Yin". Sweet herbs are primary. World thinks they tonify Qi, but sweet generates Blood. Benefit Stomach Qi first, grain intake is precious.
Huangqi (Astragalus Membranaceus, 2 qian), Renshen (Ginseng Radix, omit if cough), Shenqu (Medicated Leaven, fried, each 1.5 qian), Shengma (Cimicifuga Rhizome), Chaihu (Bupleurum Root) (each 5 fen), Baizhu (Atractylodes Macrocephala Rhizome, 3 qian), Dangguishen (Angelica Sinensis Root Body, wine-soaked), Gancao (Licorice Root, roasted), Chenpi (Tangerine Peel, each 1 qian), Sheng Huangqin (Scutellaria Root, 2 qian, drains summer heat lung rebellion, omit in autumn). Alternative: Sheng Dihuang (Fresh Rehmannia Root).
Coarse powder. Take 3 or 5 qian. Increase if appetite increases, decrease if appetite decreases. Do not overdose. Take 2 qian, decoct in water, strain, take hot. If abdominal pain, add Shaoyao (Peony Root) 2 fen, Rougui (Cinnamon Bark) a little. If thirst/dry mouth, add Gegen (Kudzu Root) 2 fen. If cough, omit Renshen, take anytime. (If Yiwei Shengyang Tang fails, use next Chaihu Tiaojing Tang for strong ascending action.)
[Ascending Yang]
Family member of Xuan De Hou experienced metrorrhagia, doctors ineffective. After pulse diagnosis, listed 40+ symptoms. Prescribed Tiaojing Shengyang Chushi Tang (Regulate Menstruation, Ascend Yang, Drain Dampness Decoction). Next day, 80% improved. Cured in 5-6 days.
Tiaojing Shengyang Chushi Tang (Regulate Menstruation, Ascend Yang, Drain Dampness Decoction) treats female leakage of evil blood, irregular menstruation, sudden metrorrhagia, watery discharge. Due to irregular diet, physical labor, or inherent Heart Qi deficiency, alcohol/exhaustion causing Heart Fire attacking Spleen. Symptoms: lethargy, desire to lie down, limbs flaccid, fatigue, no energy to move, shortness of breath, Qi rushing up, slow/wiry/tight pulse, flooding upon pressure, felt at middle finger. Spleen Earth pathogen. Spleen nourishes body; Heart governs blood/vessels. Both pathogenic, disease in vessels. Vessels are blood house, spirit of man. Heart does not command, Bao Luo substitutes. Heart vessel belongs to Heart System. Heart System is Bao Luo/Mingmen vessel, governs menstruation/pregnancy. Due to Spleen-Stomach deficiency, Heart-Bao attacks, causing leakage. Spleen-Stomach is root of Qi/Blood/Yin/Yang. Drain dampness/heat, extend wind Qi to overcome dampness. "Fire depression requires dispersal."
Chaihu (Bupleurum Root), Fangfeng (Saposhnikovia Root), Gancao (Licorice Root, roasted), Gaoben (Ligusticum Wallichii Rhizome), Shengma (Cimicifuga Rhizome) (each 1 qian), Qianghuo (Notopterygium Rhizome), Cangzhu (Atractylodes Lancea Rhizome), Huangqi (Astragalus Membranaceus) (each 1.5 qian), Duhuo (Angelica Pubescens Root), Danggui (Angelica Sinensis, wine-soaked) (each 5 fen), Manjingzi (Vitex Fruit, 7 fen).
Cut. Water 5 large bowls, decoct to 1 large bowl. Strain, take slightly hot fasting. After taking, wait, eat breakfast to suppress. One dose suffices. If moxa Sanyinjiao (SP6) 14 or 21 cones, immediate stop. This uses wind to overcome dampness, for Spleen-Stomach Qi sinking pressing down, rescuing sudden metrorrhagia. If cured, evil blood gone, main disease removed, must tonify with Huangqi (Astragalus Membranaceus), Gancao (Licorice Root), Renshen (Ginseng Radix), Danggui (Angelica Sinensis). Add blood-nourishing herbs to Buqi Shengyang Tang. If leakage continues, save root, treat main channel, only benefit Spleen-Stomach, subdue Heart Fire, treat root. For summer leukorrhea/leakage, use this soup, one dose stops it.
Chaihu Tiaojing Tang (Bupleurum Regulate Menstruation Decoction) treats unceasing menstruation, fresh blood, neck tendon stiffness, headache, spine stiffness, poor appetite.
Qianghuo (Notopterygium Rhizome), Duhuo (Angelica Pubescens Root), Gaoben (Ligusticum Wallichii Rhizome), Shengma (Cimicifuga Rhizome) (each 5 fen), Cangzhu (Atractylodes Lancea Rhizome, 1 qian), Chaihugen (Bupleurum Root, 7 fen), Gegen (Kudzu Root), Dangguishen (Angelica Sinensis Root Body), Gancao (Licorice Root, roasted, each 3 fen), Honghua (Carthamus Flower, a little).
Cut. One dose. Decoct in water, strain, take slightly hot fasting. Slight sweat, immediate stop.