三和汤
石瘕带表吴茱萸,攻里琥珀散最宜。胞闭三和汤四物,硝黄连薄草芩栀。
【注】寒气客于胞中,血留不行而成石瘕。兼表证多者,宜吴茱萸汤温散之;里证多者,
宜琥珀散攻之。胞脉闭,上迫于肺,心气不得下通,故月事不来,宜三和汤清之,即四
物汤合凉膈散,乃朴硝、大黄,连翘、薄荷、甘草、栀子、黄芩也。如大便不实者,去硝
黄。
吴茱萸汤 琥珀散 四物汤(方俱见前调经门)
六味地黄汤
胃热烁血玉烛散。失血血枯养荣汤。地黄汤治房劳损,萸药苓丹泽地良。乳众血枯经若闭,须用
十全大补方。
【注】经曰∶二阳之病发心脾,女子不月。二阳,胃也。胃热甚,则烁其血,血海干枯,
故月事不下。宜以玉烛散泄其胃热,则经血自行。若原素有吐衄之证,或生育过多,则
血海干枯,及房劳过伤阴血,乳众伤其血液,皆足以致经闭。失血多,宜养荣汤主之;房
劳过者,以六味地黄汤滋之,即山萸、山药、白茯苓、丹皮、泽泻、熟地黄也;乳众者,以
十全大补汤培补之。
玉烛散 养荣汤 十全大补汤(俱见前调经门)
劫劳散
月水不行蒸潮汗,食减咳嗽血风劳。劫劳散用参苓芍,归地甘 半味胶。
【注】经闭久嗽,又见骨蒸潮热,盗汗自汗,饮食减少之证,则为之血风劳。宜用劫
劳散,即人参、茯苓、白芍、当归、生地、甘草、黄 、半夏、五味子、阿胶也。
三和汤
石瘕兼有表证用吴茱萸汤,攻逐里实琥珀散最为适宜。胞脉闭阻用三和汤,由四物汤加上硝石、黄连、薄荷、甘草、黄芩、栀子组成。
【注】寒气侵入胞宫,血液停滞不行而形成石瘕。如果兼有表证且症状较多者,宜用吴茱萸汤温经散寒;如果里实证较多者,宜用琥珀散攻逐瘀血。胞脉闭阻,向上压迫肺脏,心气不能向下通达,所以月经不来潮,宜用三和汤清热,即四物汤合凉膈散,其中包含朴硝、大黄、连翘、薄荷、甘草、栀子、黄芩。如果大便不成形者,去掉朴硝和大黄。
吴茱萸汤、琥珀散、四物汤(方剂均见前文调经门)
六味地黄汤
胃热灼伤阴血用玉烛散。失血导致血枯用养荣汤。六味地黄汤治疗房劳损伤,山茱萸、山药、茯苓、丹皮、泽泻、熟地黄疗效良好。乳汁过多导致血枯经闭,须用十全大补方。
【注】医经说:阳明胃与太阴脾的病变发于心脾,女子月经停止。二阳指的是胃。胃热严重,就会灼伤血液,血海干枯,所以月经不下行。宜用玉烛散清泄胃热,则经血自然通行。如果原本就有吐血、衄血的病症,或者生育过多,导致血海干枯,以及房事过度损伤阴血,乳汁分泌过多耗伤血液,都足以导致经闭。失血多者,宜以养荣汤为主治;房劳过度者,用六味地黄汤滋养,即山茱萸、山药、白茯苓、丹皮、泽泻、熟地黄;乳汁过多者,用十全大补汤培补元气。
玉烛散、养荣汤、十全大补汤(均见前文调经门)
劫劳散
月经不行伴有蒸蒸发热、潮热盗汗,食欲减退、咳嗽,属血风劳证。劫劳散用人参、茯苓、白芍、当归、地黄、甘草、黄柏、半夏、五味子、阿胶十味药组成。
【注】经闭日久咳嗽,又出现骨蒸潮热、盗汗自汗、饮食减少的症状,这就称为血风劳。宜用劫劳散治疗,即人参、茯苓、白芍、当归、生地、甘草、黄柏、半夏、五味子、阿胶。
Sanhe Decoction (Three-Harmony Decoction)
For Shijia (Stone Leiomyoma) with exterior syndrome, Wuzhuyu Tang (Evodia Decoction) is indicated; for interior excess, Hupo San (Amber Powder) is most appropriate. For Baobi (Uterine Obstruction), use Sanhe Decoction, which consists of Siwu Tang (Four-Substance Decoction) combined with Xiaoshi (Natrii Sulfas), Huanglian (Coptidis Rhizoma), Bohe (Menthae Haplocalycis Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqin (Scutellariae Radix), and Zhizi (Gardeniae Fructus).
[Note] When cold pathogen lodges in the uterus, blood stagnates and fails to circulate, forming Shijia (Stone Leiomyoma). If exterior symptoms predominate, Wuzhuyu Tang (Evodia Decoction) should be used to warm and disperse; if interior excess symptoms predominate, Hupo San (Amber Powder) should be used to purge. When the uterine vessels are obstructed, pressure rises upward affecting the Lung, preventing Heart Qi from descending, resulting in amenorrhea. In such cases, Sanhe Decoction should be used to clear heat. This formula is a combination of Siwu Tang (Four-Substance Decoction) and Liangge San (Cooling the Chest Powder), containing Xiaoshi (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Gancao (Glycyrrhizae Radix et Rhizoma), Zhizi (Gardeniae Fructus), and Huangqin (Scutellariae Radix). If loose stools are present, remove Xiaoshi (Natrii Sulfas) and Dahuang (Rhei Radix et Rhizoma).
Wuzhuyu Tang (Evodia Decoction), Hupo San (Amber Powder), Siwu Tang (Four-Substance Decoction) (Formulas are listed in the preceding Menstrual Regulation section).
Liujun Dihuang Tang (Six-Ingredient Rehmannia Decoction)
For stomach heat scorching blood, Yuzhu San (Jade Candle Powder) is used. For blood loss leading to blood deficiency, Yangrong Tang (Nourishing the Spirit Decoction) is indicated. Liujun Dihuang Tang (Six-Ingredient Rehmannia Decoction) treats damage from sexual exhaustion; Shanzhuyu (Corni Fructus), Shanyao (Dioscoreae Rhizoma), Fuling (Poria), Mudanpi (Moutan Cortex), Zexie (Alismatis Rhizoma), and Shudihuang (Prepared Rehmanniae Radix) are effective. For amenorrhea due to blood deficiency caused by excessive lactation, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) must be used.
[Note] The Classic states: "Diseases of the Two Yangs originate from the Heart and Spleen; women suffer from amenorrhea." The Two Yangs refer to the Stomach. Severe stomach heat scorches the blood, causing the Blood Sea to dry up, thus menstruation does not flow. Yuzhu San (Jade Candle Powder) should be used to drain stomach heat, allowing menstrual blood to flow naturally. If there is a history of hematemesis or epistaxis, or excessive childbirth leading to a dry Blood Sea, or excessive sexual activity damaging Yin and blood, or excessive lactation consuming blood and fluids, all can lead to amenorrhea. For significant blood loss, Yangrong Tang (Nourishing the Spirit Decoction) is the primary treatment; for sexual exhaustion, Liujun Dihuang Tang (Six-Ingredient Rehmannia Decoction) is used to nourish, consisting of Shanzhuyu (Corni Fructus), Shanyao (Dioscoreae Rhizoma), Fuling (Poria), Mudanpi (Moutan Cortex), Zexie (Alismatis Rhizoma), and Shudihuang (Prepared Rehmanniae Radix); for excessive lactation, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) is used to tonify and supplement.
Yuzhu San (Jade Candle Powder), Yangrong Tang (Nourishing the Spirit Decoction), Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) (All listed in the preceding Menstrual Regulation section).
Jielao San (Robbing Labor Powder)
When menstruation ceases accompanied by steaming bone sensation, tidal fever, sweating, reduced appetite, and cough, it constitutes Xuefeng Lao (Blood-Wind Consumption). Jielao San uses Renshen (Ginseng Radix), Fuling (Poria), Baishao (White Peony Root), Danggui (Angelicae Sinensis Radix), Dihuang (Rehmanniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangbo (Phellodendri Cortex), Banxia (Pinelliae Rhizoma), Wuweizi (Schisandrae Fructus), and Ejiao (Asini Corii Colla).
[Note] Amenorrhea with chronic cough, along with symptoms of steaming bone, tidal fever, night sweats, spontaneous sweating, and decreased dietary intake, is termed Xuefeng Lao (Blood-Wind Consumption). Jielao San (Robbing Labor Powder) is indicated, composed of Renshen (Ginseng Radix), Fuling (Poria), Baishao (White Peony Root), Danggui (Angelicae Sinensis Radix), Shengdihuang (Raw Rehmanniae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangbo (Phellodendri Cortex), Banxia (Pinelliae Rhizoma), Wuweizi (Schisandrae Fructus), and Ejiao (Asini Corii Colla).