一行经感冒风寒，不宜发汗，又不宜速用发散药，必俟经血行尽，方可服解表退热之剂。如
羌活、麻黄、桂枝、防风、细辛之类。
一行经之时，不亦多浴冷水，恐患四肢麻痹；又不宜多饮冷水，恐伤肺气，必患声哑咳嗽，
无药救治。
一行经不宜饮酒，恐引血妄行四肢；又不宜郁怒太甚，恐经血必停，变成闭经；又不宜骤
用补药，恐致蓄血，或四肢疼痛，或五心寒热。
调经奇方 归身钱半（酒洗） 陈皮（七分） 真川芎（八分） 白芍（一钱酒炒）
大熟地（钱半） 丹皮（七分） 延胡（七分醋炒） 吴萸（滚水泡，去黑水，去蒂梗，酒炒二分）
香附米（钱半酒炒） 白茯苓（八分）
经行先期三、五日色紫者，加条芩（酒炒一钱五分）；经行过期色淡者，加官桂五分，炮熟黑姜
五分，艾叶醋炒，五分，引用生姜一片，水一碗，煎至八分，空心温服，渣再煎，临卧服。此药俟
经行时服起，连用四剂，到次月经再行时，再服四剂，往后对月，可坐喜生男矣。
调经主方 当归（三钱） 川芎（二钱） 白芍（酒炒二钱）
酒蒸地黄（三钱） 甘草 四制香附 陈皮（各一钱） 生姜（二片）
先期而来，血热也，本方加酒炒黄芩、酒炒柴胡、丹皮各一钱；后期而至，血虚也，本方加蜜
炙黄 、土炒白术、白茯苓、杜仲、故纸各一钱；经来痛甚，气滞也，本方加桃仁、灵芝、红花、元
胡各一钱；经来痛甚有痞块，加三棱、莪术、山楂核俱用酒炒，各一钱；经行作痛，用八珍汤加
吴萸、故纸、小茴各一钱；血淡不红者，痰也，本方加半夏、南星、白术、肉桂各一钱；经来多黑
块，实热也，本方加酒炒黄连五分，红花、丹参各一钱；经来多黄水，血不足也，加白苓、黄 、
肉桂、人参、白术各一钱；经来手足酸痛，加桂枝、防风、秦艽各一钱；经来卒倒仆地，脉散，腮红，
火热肝也，不可认作中风、中痰，本方加胆草。桃红、柴胡、黄芩各一钱。
经水一月再行∶经水一月再来行，多因怒气损肝经，四物汤内加柴芩，川连增入更为灵。另
加知柏为丸服，滋阴降火治冲任。
脉与症无火，而经早不及期者，乃心脾气虚不能固摄而然。宜服八珍汤加杜仲、续断、五味子，
切不可作火治。
一月二、三至，或半月，或旬日，或二十日，此血气败乱之症，当大补气血，不得以经早同治，
宜服十全大补汤。
一血热经迟，由妇人阴火内烁，血本热而亦每过期者，此水亏血少燥涩而然。何以验之？其
经来必多紫黑，腹兼微痛，宜服滋阴八味丸合四物汤。
一血寒经迟，阳气不足，生化失期，故过月也，何以验之？其经来色多不鲜，或涩滞而少，恶
寒喜暖，脉多微沉，此无火之症。宜服理阴扶阳四物汤∶
当归（二钱） 川芎（钱半） 白芍（酒炒一钱） 熟地（二钱）
黑姜（钱半） 肉桂（一钱） 吴萸（六分） 荜茇（五分）
经闭不行三候∶一则脾胃有损伤，食少血亏非血停，急宜补脾还养血，血充气足经自行。一则忧怒损肝经。肝火郁
闭经始停，开郁二陈汤急用，四制女圣丸亦灵。一则体肥痰滞壅，故令经血不能通，加减导痰汤作主。多服方知药有功，
未嫁愆期经忽闭，急宜婚嫁自然通。
经闭饱胀腹痛∶经闭饱胀有主方，皆用通经活血汤，丹皮荆芥川牛膝，赤芍归芎生地黄，桃仁肉
桂与红花，泽兰枳壳生蒲黄，闭久忧中成痞块，更加莪术与槟榔。
崩症三候∶血崩之症分五名，赤者汁如洗绛形，黄如烂瓜流黄水，白犹鼻涕不留停，青则恰如青
靛色，黑乃紫黑血块凝。血未来时先发热，此因肝火内相浸，清肝凉血有主方，加味逍遥实可寻。血
虚气弱血来崩，归脾汤吃倍为灵。白崩之症另有方，八珍加减不须惊。绛色，肝火也；黄色，脾之湿
热也；白色，气虚也；红色，肝气盛也；黑色，肝脾实热。
一血来小腹微痛，归脾加小茴、吴萸各七七。
一妇人行经三日前，骨中发热，下血如崩，予用加味逍遥散，加知母、黄柏，每月服七、八剂，
三月全愈，原素有忧郁而致。
一妇人年逾四十，患崩症，白多红少，予用归脾汤去木香，加阿胶、续断、淡吴萸、熟地（瓦炙
干）、杜仲、故纸（盐水炒），十剂而愈。
赤白带下∶带下者，由湿痰流注于带脉，而下浊液，故曰带下，妇人多有之。赤者属热，兼虚兼
火治之；白者属湿，兼虚兼痰治之；年久不止，补脾肾兼升提。大抵瘦人多火，肥人多痰，最要分辨。
白带、白浊、白淫三种，三者相似，而迥然各别。白带者，时常流出清冷稠粘，此下元虚损也；白浊者，浊随小便而来，
混浊如泔，此胃中浊气渗入膀胱也；白淫者，常在小便之后，而来亦不多，此男精不摄，滑而自出也。
崩漏带下危症∶
一崩带日久，纯下臭黄水，或带紫黑筋块，腥秽不堪者，不治。
一崩带腹满，不能饮食，不受参、术补益者，不治。
一崩带服大补剂后，反加寒热口燥，面目足胫浮肿者，不治。
一崩带已止，少腹不疼，后变阴户肿胀，痛如刀割者，死期迫矣。
治妇人赤白带下，此丸神良（此症须当壮脾胃，升阳气为主）∶
马毛(二两椒和，伏火一宿。白马毛治白带，赤马毛治赤带） 龟甲四两（醋炙） 鳖甲(二两醋炙） 牡蛎（二两
火炙）
为末，醋水跌，丸如梧桐子大，每服三钱，温酒送下，日三服。为散尤妙。
气陷于下焦则白带，血陷于下焦则赤带。以涩药止之，则未尽之带留而不出，以利药下之，则
既损之中，又伤其下，皆非治也。马得干之刚，毛得血之余，血余可以固血，干刚可以利气，固
血则赤止，利气则自愈，此用马毛之意也。龟鳖、牡蛎外刚而内柔，离之象也，去其柔而用其刚，
故可以化症，可以固气，化症则赤白之成带者，无复中留，固气则荣卫之行不复下陷，营不陷则无
赤，卫不陷则无白矣。
【行经三忌】
一、月经期间若感冒风寒，不宜使用发汗法，也不宜急于使用发散药物，必须等到经血排尽后，方可服用解表退热的方剂。例如羌活、麻黄、桂枝、防风、细辛之类的药物。
二、月经期间，不宜多洗冷水澡，恐怕导致四肢麻痹；也不宜多喝冷水，恐怕损伤肺气，必定会导致声音嘶哑和咳嗽，且无药可救。
三、月经期间不宜饮酒，恐怕引动血液妄行于四肢；也不宜过度郁结愤怒，恐怕导致经血停止，变成闭经；也不宜突然大量使用补药，恐怕导致瘀血蓄积，或者出现四肢疼痛，或者出现五心烦热或畏寒的症状。
调经奇方：当归身（钱半，酒洗）、陈皮（七分）、真川芎（八分）、白芍（一钱，酒炒）、大熟地（钱半）、丹皮（七分）、延胡索（七分，醋炒）、吴茱萸（滚水泡，去黑水，去蒂梗，酒炒二分）、香附米（钱半，酒炒）、白茯苓（八分）。
若月经先期来潮三、五天且颜色紫暗者，加条芩（酒炒一钱五分）；若月经过期来潮且颜色淡者，加官桂五分，炮姜五分，艾叶（醋炒五分），引用生姜一片，水一碗，煎至八分，空腹温服，药渣再煎，临睡前服用。此药从月经来时开始服用，连续用四剂，到下次月经再来时，再服四剂，往后每个月按时服用，便可喜得男胎。
调经主方：当归（三钱）、川芎（二钱）、白芍（酒炒二钱）、酒蒸地黄（三钱）、甘草、四制香附、陈皮（各一钱）、生姜（二片）。
月经先期而来，是血热所致，本方加酒炒黄芩、酒炒柴胡、丹皮各一钱；月经后期而至，是血虚所致，本方加蜜炙黄芪、土炒白术、白茯苓、杜仲、故纸（补骨脂）各一钱；月经来潮时疼痛剧烈，是气滞所致，本方加桃仁、灵芝、红花、元胡各一钱；月经来潮时疼痛剧烈且有痞块，加三棱、莪术、山楂核，均用酒炒，各一钱；月经行经作痛，用八珍汤加吴茱萸、故纸、小茴香各一钱；经血色淡不红，是痰湿所致，本方加半夏、南星、白术、肉桂各一钱；月经来潮多有黑块，是实热所致，本方加酒炒黄连五分，红花、丹参各一钱；月经来潮多有黄水，是血不足所致，加白茯苓、黄芪、肉桂、人参、白术各一钱；月经来潮手足酸痛，加桂枝、防风、秦艽各一钱；月经来潮突然昏倒仆地，脉象散乱，腮部发红，这是火热伤肝所致，不可误认为中风或中痰，本方加龙胆草、桃仁、红花、柴胡、黄芩各一钱。
月经一月两次行经：月经一月再来行，多因怒气损伤肝经，在四物汤内加柴胡、黄芩，加入川黄连更为灵验。另外加知母、黄柏制成丸药服用，以滋阴降火治疗冲任二脉。
脉象与症状显示无火，而月经提前不到期的，是心脾气虚不能固摄所致。适宜服用八珍汤加杜仲、续断、五味子，切不可当作火证治疗。
一个月来两三次，或者半个月，或者十天，或者二十天就来一次，这是气血败乱的病症，应当大补气血，不得将其作为月经提前同治，适宜服用十全大补汤。
血热导致的月经推迟，是由于妇人阴火内灼，血液本热也每每过期才来，这是肾水亏虚、血少燥涩所致。如何验证呢？其经血来潮时必定多为紫黑色，腹部兼有微痛，适宜服用滋阴八味丸合四物汤。
血寒导致的月经推迟，是阳气不足，生化失期，所以过月才来。如何验证呢？其经血来潮颜色多不鲜艳，或者涩滞量少，恶寒喜暖，脉象多微沉，这是无火的病症。适宜服用理阴扶阳四物汤：当归（二钱）、川芎（钱半）、白芍（酒炒一钱）、熟地（二钱）、黑姜（钱半）、肉桂（一钱）、吴茱萸（六分）、荜茇（五分）。
【经闭不行三候】
一则脾胃有损伤，食少血亏并非血停，急宜补脾养血，血充气足经血自然通行。一则忧怒损伤肝经，肝火郁闭导致经血停止，急用开郁二陈汤，四制女圣丸也有效。一则身体肥胖痰湿壅滞，导致经血不能通畅，以加减导痰汤为主方。多服方能知晓药效，未嫁女子经期忽闭，急宜婚嫁自然通经。
【经闭饱胀腹痛】
经闭伴有饱胀腹痛有主方，皆用通经活血汤：丹皮、荆芥、川牛膝、赤芍、当归、川芎、生地黄、桃仁、肉桂、红花、泽兰、枳壳、生蒲黄。闭经日久因忧郁而成痞块者，再加莪术与槟榔。
【崩症三候】
血崩之症分为五种名称：赤色如洗绛之色，黄色如烂瓜流黄水，白色犹鼻涕不留停，青色恰如青靛色，黑色乃紫黑血块凝结。血未来时先发热，这是因为肝火内侵，清肝凉血有主方，加味逍遥散确实可寻。血虚气弱导致血来崩漏，归脾汤加倍服用更为灵验。白崩之症另有方剂，八珍汤加减不必惊慌。绛色属肝火；黄色属脾之湿热；白色属气虚；红色属肝气盛；黑色属肝脾实热。
其二，一妇人行经前三日，骨中发热，下血如崩，我用加味逍遥散，加知母、黄柏，每月服用七八剂，三个月全愈，原本素有忧郁所致。
其三，一妇人年逾四十，患崩症，白带多红血少，我用归脾汤去木香，加阿胶、续断、淡吴茱萸、熟地（瓦上炙干）、杜仲、故纸（盐水炒），十剂而愈。
【赤白带下】
带下病，是由湿痰流注于带脉，而下泄浊液，故曰带下，妇人多有此病。赤色属热，兼虚兼火治之；白色属湿，兼虚兼痰治之；年久不止，补脾肾兼升提。大抵瘦人多火，肥人多痰，最要分辨清楚。
白带、白浊、白淫三种，三者相似，而迥然各别。白带者，时常流出清冷稠粘，这是下元虚损；白浊者，浊液随小便而来，混浊如米泔水，这是胃中浊气渗入膀胱；白淫者，常在小便之后而来，量也不多，这是男精不摄，滑而自出（此处指女性相火妄动，精关不固之类似症状，古籍中常以此类比或指代女性阴道分泌物异常滑泄）。
其一，崩漏带下日久，纯下臭黄水，或带紫黑筋块，腥秽不堪者，不治。
其三，崩漏带下服用大补剂后，反加寒热口燥，面目足胫浮肿者，不治。
其四，崩漏带下已止，少腹不疼，后变阴户肿胀，痛如刀割者，死期迫矣。
【治妇人赤白带下，此丸神良】（此症须当壮脾胃，升阳气为主）：
马毛（二两，与椒同炒，伏火一宿。白马毛治白带，赤马毛治赤带）、龟甲四两（醋炙）、鳖甲（二两，醋炙）、牡蛎（二两，火炙）。
研为末，醋和水泛丸，如梧桐子大，每服三钱，温酒送下，日服三次。做成散剂尤其妙。
气陷于下焦则白带，血陷于下焦则赤带。以涩药止之，则未尽之带留而不出；以利药下之，则既损之中，又伤其下，皆非治疗方法。马得干之刚劲，毛得血之余，血余可以固血，干刚可以利气，固血则赤带止，利气则自愈，这就是用马毛的意思。龟甲、鳖甲、牡蛎外刚而内柔，离卦之象也，去其柔而用其刚，故可以化癥瘕，可以固气，化癥瘕则赤白之成带者，无复中留；固气则营卫之行不复下陷，营不陷则无赤，卫不陷则无白矣。
[Three Taboos During Menstruation]
1. If one catches wind-cold during menstruation, sweating methods should not be used, nor should dispersing medicines be administered hastily. One must wait until the menstrual blood has completely ceased before administering formulas to release the exterior and reduce fever, such as those containing Notopterygii Rhizoma et Radix (Qianghuo), Ephedrae Herba (Mahuang), Cinnamomi Ramulus (Guizhi), Saposhnikoviae Radix (Fangfeng), or Asari Radix et Rhizoma (Xixin).
2. During menstruation, one should not bathe frequently in cold water, lest it cause numbness of the four limbs; nor should one drink excessive amounts of cold water, lest it damage Lung Qi, inevitably leading to hoarseness and coughing, for which there is no cure.
3. Alcohol should be avoided during menstruation, lest it provoke reckless movement of blood into the four limbs; excessive depression and anger should be avoided, lest menstrual flow stop and become amenorrhea; sudden and heavy use of tonifying medicines should be avoided, lest it lead to blood stasis accumulation, causing pain in the four limbs or symptoms of five-center heat and aversion to cold.
Miraculous Formula for Regulating Menstruation: Angelicae Sinensis Radix (Danggui) body (1.5 qian, washed with wine), Tangerine Peel (Chenpi) (0.7 qian), Chuanxiong Rhizome (Chuanxiong) (0.8 qian), Paeoniae Radix Alba (Baishao) (1 qian, stir-fried with wine), Prepared Rehmanniae Radix (Shudihuang) (1.5 qian), Moutan Cortex (Danpi) (0.7 qian), Corydalis Rhizoma (Yanhusuo) (0.7 qian, stir-fried with vinegar), Evodiae Fructus (Wuzhuyu) (steeped in boiling water, discard black water, remove stem and pedicel, stir-fried with wine 0.2 qian), Cyperi Rhizoma (Xiangfu) (1.5 qian, stir-fried with wine), Poria (Fuling) (0.8 qian).
If menstruation arrives three to five days early with purple color, add Scutellariae Radix (Huangqin) (1.5 qian, stir-fried with wine); if menstruation is delayed with pale color, add Cinnamomi Cortex (Rougui) 0.5 qian, Prepared Zingiberis Rhizoma (Paojiang) 0.5 qian, Artemisiae Folium (Aiye) (stir-fried with vinegar 0.5 qian), using Fresh Zingiberis Rhizome (Shengjiang) one slice as a guide, with one bowl of water, decocted to 0.8 bowl, taken warm on an empty stomach; dregs decocted again, taken before sleep. This medicine is taken starting from the onset of menstruation, used continuously for four doses; when menstruation comes next month, take another four doses; thereafter, take monthly according to the cycle, ensuring the birth of a male child.
Main Formula for Regulating Menstruation: Angelicae Sinensis Radix (Danggui) (3 qian), Chuanxiong Rhizome (Chuanxiong) (2 qian), Paeoniae Radix Alba (Baishao) (stir-fried with wine 2 qian), Wine-steamed Rehmanniae Radix (Jiuzheng Dihuang) (3 qian), Licorice Root (Gancao), Four-processed Cyperi Rhizoma (Sizhi Xiangfu), Tangerine Peel (Chenpi) (each 1 qian), Fresh Zingiberis Rhizome (Shengjiang) (two slices).
Menstruation arriving early indicates Blood Heat; add Scutellariae Radix (Huangqin) (stir-fried with wine), Bupleuri Radix (Chaihu) (stir-fried with wine), and Moutan Cortex (Danpi) each 1 qian to this formula. Menstruation arriving late indicates Blood Deficiency; add Honey-fried Astragali Radix (Huangqi), Earth-stir-fried Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Eucommiae Cortex (Duzhong), and Psoraleae Fructus (Guzhi) each 1 qian to this formula. Severe pain during menstruation indicates Qi Stagnation; add Persicae Semen (Taoren), Ganoderma (Lingzhi), Carthami Flos (Honghua), and Corydalis Rhizoma (Yanhu) each 1 qian to this formula. Severe pain with masses during menstruation adds Sparganii Rhizoma (Sanleng), Curcumae Rhizoma (Ezhu), and Crataegi Fructus Seed (Shanzha He), all stir-fried with wine, each 1 qian. Pain during menstruation uses Ba Zhen Tang (Eight Treasures Decoction) added with Evodiae Fructus (Wuzhuyu), Psoraleae Fructus (Guzhi), and Foeniculum Fructus (Xiaohui) each 1 qian. Pale and non-red blood indicates Phlegm; add Pinelliae Tuber (Banxia), Arisaematis Rhizoma (Nanxing), Atractylodis Macrocephalae Rhizoma (Baizhu), and Cinnamomi Cortex (Rougui) each 1 qian to this formula. Many black clots indicate Excess Heat; add Coptidis Rhizoma (Huanglian) (stir-fried with wine 0.5 qian), Carthami Flos (Honghua), and Salviae Miltiorrhizae Radix (Danshen) each 1 qian to this formula. Yellow discharge indicates Blood Insufficiency; add Poria (Baifuling), Astragali Radix (Huangqi), Cinnamomi Cortex (Rougui), Ginseng Radix et Rhizoma (Renshen), and Atractylodis Macrocephalae Rhizoma (Baizhu) each 1 qian. Soreness and pain in hands and feet during menstruation adds Cinnamomi Ramulus (Guizhi), Saposhnikoviae Radix (Fangfeng), and Gentianae Macrophyllae Radix (Qinjiao) each 1 qian. Sudden fainting and falling during menstruation with scattered pulse and red cheeks indicates Fire Heat injuring Liver; do not mistake it for Wind Stroke or Phlegm Obstruction; add Gentianae Radix (Longdancao), Persicae Semen (Taoren), Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin) each 1 qian to this formula.
Menstruation occurring twice a month: Often caused by anger damaging the Liver Meridian. Add Bupleuri Radix (Chaihu) and Scutellariae Radix (Huangqin) to Si Wu Tang (Four Substances Decoction); adding Coptidis Rhizoma (Chuanlian) makes it more effective. Additionally, prepare pills with Anemarrhenae Rhizoma (Zhimu) and Phellodendri Cortex (Huangbai) to nourish Yin and descend Fire, treating the Chong and Ren meridians.
When pulse and symptoms show no Fire, but menstruation arrives early (before time), it is due to Heart and Spleen Qi Deficiency failing to secure and contain. Ba Zhen Tang (Eight Treasures Decoction) added with Eucommiae Cortex (Duzhong), Dipsaci Radix (Xuduan), and Schisandrae Fructus (Wuweizi) is suitable. Do not treat as Fire syndrome.
Menstruation coming two or three times a month, or every half month, ten days, or twenty days, is a syndrome of chaotic Qi and Blood. It requires major tonification of Qi and Blood and should not be treated as early menstruation. Shi Quan Da Bu Tang (Ten Great Tonifying Decoction) is suitable.
Blood Heat causing delayed menstruation results from internal consumption by Yin Fire in women. The blood is inherently hot and often delayed. How to verify? The menstrual blood will likely be dark purple/black, accompanied by slight abdominal pain. Zi Yin Ba Wei Wan (Nourishing Yin Eight Ingredient Pill) combined with Si Wu Tang (Four Substances Decoction) is suitable.
Blood Cold causing delayed menstruation results from insufficient Yang Qi and loss of timely transformation and generation. How to verify? The menstrual blood color is often dull, scanty, and obstructed; there is aversion to cold and preference for warmth; the pulse is often slightly deep. This is a syndrome without Fire. Li Yin Fu Yang Si Wu Tang (Regulating Yin and Supporting Yang Four Substances Decoction) is suitable: Angelicae Sinensis Radix (Danggui) (2 qian), Chuanxiong Rhizome (Chuanxiong) (1.5 qian), Paeoniae Radix Alba (Baishao) (stir-fried with wine 1 qian), Prepared Rehmanniae Radix (Shudihuang) (2 qian), Black Ginger (Heijiang) (1.5 qian), Cinnamomi Cortex (Rougui) (1 qian), Evodiae Fructus (Wuzhuyu) (0.6 qian), Piperis Longi Fructus (Bibo) (0.5 qian).
[Three Patterns of Amenorrhea]
First, Spleen and Stomach injury leads to poor appetite and Blood Deficiency, not actual blood stagnation. Urgently tonify Spleen and nourish Blood; when Blood is abundant and Qi sufficient, menstruation will naturally flow. Second, worry and anger damage the Liver Meridian. Liver Fire stagnation closes the menses. Kai Yu Er Chen Tang (Open Depression Two Chen Decoction) should be used urgently; Sizhi Nv Sheng Wan (Four-processed Female Sage Pill) is also effective. Third, obesity with Phlegm-Dampness obstruction prevents menstrual flow. Jia Jian Dao Tan Tang (Modified Guiding Phlegm Decoction) is the main formula. Taking it for a long time reveals its efficacy. For unmarried women with delayed or suddenly closed menstruation, marriage may naturally restore flow.
[Amenorrhea with Fullness, Distension, and Abdominal Pain]
The main formula for amenorrhea with fullness, distension, and abdominal pain is Tong Jing Huo Xue Tang (Unblock Menstruation and Invigorate Blood Decoction): Moutan Cortex (Danpi), Schizonepetae Spica (Jingjie), Achyranthis Bidentatae Radix (Chuan Niuxi), Paeoniae Radix Rubra (Chishao), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizome (Chuanxiong), Raw Rehmanniae Radix (Sheng Dihuang), Persicae Semen (Taoren), Cinnamomi Cortex (Rougui), Carthami Flos (Honghua), Lycopodium Herba (Zelan), Aurantii Fructus (Zhike), and Raw Lygodii Spora (Sheng Puhuang). For long-standing amenorrhea forming masses due to depression, add Curcumae Rhizoma (Ezhu) and Arecae Semen (Binglang).
[Three Patterns of Metrorrhagia]
Metrorrhagia is classified into five names based on color: Red like dyed crimson; yellow like rotting melon flowing yellow water; white like nasal mucus not staying; blue/green like indigo dye; black like dark purple/black blood clots. Fever before bleeding indicates Liver Fire invading internally. Qing Gan Liang Xue Tang (Clear Liver and Cool Blood Decoction) is the main formula; Jia Xiao Yao San (Modified Free Wanderer Powder) is sought after. Blood Deficiency and Qi Weakness causing metrorrhagia: Gui Pi Tang (Restore the Spleen Decoction) doubled is very effective. For White Leukorrhea associated with metrorrhagia, modify Ba Zhen Tang (Eight Treasures Decoction). Crimson indicates Liver Fire; yellow indicates Spleen Damp-Heat; white indicates Qi Deficiency; red indicates Exuberant Liver Qi; black indicates Liver-Spleen Excess Heat.
One case: Bleeding with slight lower abdominal pain. Gui Pi Tang (Restore the Spleen Decoction) added with Foeniculum Fructus (Xiaohui) and Evodiae Fructus (Wuzhuyu) each 7 qian.
One case: A woman, three days before menstruation, felt bone-deep heat and bleeding like metrorrhagia. I used Jia Xiao Yao San (Modified Free Wanderer Powder) added with Anemarrhenae Rhizoma (Zhimu) and Phellodendri Cortex (Huangbai), taking seven to eight doses monthly, cured completely in three months. Originally caused by chronic depression.
One case: A woman over forty suffered metrorrhagia, with more white discharge than red blood. I used Gui Pi Tang (Restore the Spleen Decoction) removing Amomi Fructus (Muxiang), adding Colla Corii Asini (Ejiao), Dipsaci Radix (Xuduan), mild Evodiae Fructus (Dan Wuzhuyu), Prepared Rehmanniae Radix (Shudihuang) (roasted on tile until dry), Eucommiae Cortex (Duzhong), and Psoraleae Fructus (Guzhi) (salt-water stir-fried), cured in ten doses.
[Red and White Leukorrhea]
Leukorrhea arises from Damp-Phlegm flowing into the Dai Mai (Girdle Vessel), discharging turbid fluid. It is common in women. Red indicates Heat, treated by addressing Deficiency and Fire; White indicates Dampness, treated by addressing Deficiency and Phlegm; if persistent for years, tonify Spleen and Kidney and raise Qi. Generally, thin people have more Fire, fat people have more Phlegm; distinction is crucial.
White Leukorrhea, White Turbidity, and White Seminal Emission are similar but distinct. White Leukorrhea flows constantly, clear, cold, thick, and sticky, indicating Lower Yuan Deficiency. White Turbidity mixes with urine, turbid like rice water, indicating Turbid Qi of Stompenetrating Bladder. White Seminal Emission occurs after urination, small amount, indicating failure to secure essence (analogy for female seminal leakage).
[Critical Conditions of Metrorrhagia, Metrostaxis, and Leukorrhea]
One: Long-standing metrorrhagia/leukorrhea discharging only foul yellow water, or containing dark purple/black fibrous clots, extremely fishy and offensive, is incurable.
One: Metrorrhagia/leukorrhea with abdominal fullness, inability to eat, intolerance to tonics like Ginseng Radix et Rhizoma (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu), is incurable.
One: Metrorrhagia/leukorrhea worsening with chills, fever, dry mouth, and edema of face, eyes, feet, and calves after taking major tonics, is incurable.
One: Metrorrhagia/leukorrhea stops, lower abdomen pain ceases, but later vulva swells with knife-like pain, death is imminent.
[Divine Pill for Treating Red and White Leukorrhea in Women] (This condition requires strengthening Spleen and Stomach and raising Yang Qi as the primary approach):
Horse Hair (2 liang, stir-fried with Pepper, buried in fire overnight. White horse hair treats white leukorrhea, red horse hair treats red leukorrhea), Tortoise Plastron (4 liang, stir-fried with vinegar), Softshell Turtle Carapace (2 liang, stir-fried with vinegar), Oyster Shell (2 liang, fire-roasted).
Grind into powder, make pills with vinegar and water, size of Sophora japonica seeds. Take 3 qian per dose, washed down with warm wine, three times daily. Powder form is especially excellent.
Qi sinking to the Lower Jiao causes White Leukorrhea; Blood sinking to the Lower Jiao causes Red Leukorrhea. Using astringents stops them but leaves residual discharge; using purgatives harms the already damaged lower body. Neither is correct treatment. Horse hair possesses the rigidity of Dryness; hair is the surplus of Blood. Blood surplus can secure Blood; rigidity can promote Qi flow. Securing Blood stops Red Leukorrhea; promoting Qi flow restores health. This is the rationale for using horse hair. Tortoise, turtle, and oyster shells are rigid outside and soft inside, representing the Li Trigram. Removing the soft and using the rigid allows resolving masses and securing Qi. Resolving masses prevents retention of red/white discharge; securing Qi prevents Ying and Wei Qi from sinking. If Ying does not sink, there is no Red; if Wei does not sink, there is no White.