王(右) 屡次滑胎,兹则经事先期,色紫不泽,临行痛楚。姑宣畅营卫。
全当归(酒炒二钱) 白蒺藜(三钱) 紫丹参(二钱) 杭白芍(酒炒一钱五分) 橘络(红花汤炒一钱)
蕲艾炭(四分) 炒川断(三钱) 菟丝子(盐水炒三钱) 炒牛膝(三钱) 制香附(二钱)
二诊 气血不固,屡屡滑胎。治法惟有调气养营,作日就月将之计。
大熟地(砂仁拌炙成炭) 泽泻(一钱五分) 细子芩(酒炒一钱五分) 橘皮(一钱) 白芍(酒炒一钱五分)
萸肉炭(一钱五分) 茯苓神(各四钱) 炒山药(三钱) 生熟谷芽(三钱) 粉丹皮(二钱) 制香附(二钱)
谢(右) 中脘作痛,腹中不舒,经事一月再至,腰酸带下。气血不固,肝胃失和。先调气和胃,再商培补。
金铃子(一钱五分) 香附(一钱五分) 砂仁(五分) 炒白芍(一钱五分) 佛手(一钱) 乌贼骨(三
钱炙) 茯苓(三钱) 当归炭(二钱) 八珍丸(绢包入煎四钱) 广皮(一钱)
陈(右) 久痛久呕,中脘板硬,月事两月不来。此必有形之滞,郁阻胃中。拟宣通气血。
延胡索(酒炒一钱五分) 瓦楞子(四钱 ) 炒赤芍(一钱) 台乌药(一钱五分) 楂肉(二钱) 土鳖虫(去
头足炙三枚) 单桃仁(去皮尖打三钱) 归须(酒炒二钱) 降香片(五分)
二诊 宣通营卫,大便解出凝而色红,脘痛势减,板硬较软,呕吐未发。再为宣通。
五灵脂(酒炒三钱) 制香附(二钱) 炒枳壳(一钱) 焦麦芽(三钱) 陈皮(一钱) 薤白头(二钱)
延胡索(酒炒一钱五分) 砂仁末(五分) 土鳖虫(去头足二枚) 广郁金(一钱五分)
三诊 宣通营滞,大解带黑,脘痛呕吐俱减。然咽中常觉哽阻,中脘仍然坚硬。脉象弦紧。效方扩充,再望应手。
上桂心(五分) 炒桃仁(三钱) 薤白头(二钱) 干漆(炒烟尽三分) 橘红(一钱) 土鳖虫(三枚)
延胡索(酒炒一钱五分) 制半夏(一钱五分) 湘军(酒炒八分)
龚(右) 每至将寐,辄觉震痉,头昏作胀,时易汗出,中脘胀满。肝风鸱张,木强土弱。拟养血熄肝,参以凉
营,盖经愈前则血愈虚也。
阿胶(三钱) 丹皮(二钱) 大生地(四钱) 黄芩(酒炒一钱五分) 女贞子(酒炒三钱) 朱茯神(三钱)
白芍(酒炒一钱五分) 香附(二钱) 金铃子(一钱五分) 橘叶(二钱) 黑豆衣(三钱) 生决明(六钱)
二诊 咽中如阻,中脘不舒,筋脉跳动,甚至欲厥,经一月再行。营血久亏,风阳震动。再育阴以涵肝木。
阿胶珠(三钱) 天冬(三钱) 豆蔻花(四分) 潼沙苑(盐水炒三钱) 丹皮(二钱) 大生地(四钱)
干橘叶(一钱五分) 炒白芍(一钱五分) 牡蛎(三钱) 生山药(三钱) 茯苓神(各二钱) 淮小麦(五钱)
三诊 每至气冲,中脘胀满,按之作痛,甚则汗出。卫气逆上,拟镇坠滋养柔和。
代赭石(四钱 ) 炙鳖甲(四钱) 生熟草(各二分) 金铃子(一钱五分) 火麻仁(三钱) 牡蛎(五钱)
淮小麦(五钱) 橘皮(一钱) 糯稻根(四钱) 白芍(酒炒一钱五分) 大南枣(四枚)
四诊 火从上升,则溱溱汗出,头面为甚,足心烙热,经不及期,左肩臂酸痛。冲阳逆上,皆由阴虚木失滋涵。
阿胶珠(三钱) 柏子霜(三钱) 炙甘草(四分) 地骨皮(二钱) 旱莲草(三钱) 牡蛎(五钱)
生白芍(一钱五分) 乌贼骨(三钱) 淮小麦(五钱) 南枣(三枚) 女贞子(酒炒三钱) 糯稻根(五钱)
五诊 经事一月再期,肝阴愈虚,肝气愈旺,肝阳愈盛,头昏作胀,寐则头汗溱溱,心中震痉,胸膺作胀,
咽中如阻,肩臂作酸。宜滋肾养肝参以凉营。
大生地(十两) 粉丹皮(二两) 生牡蛎(八两) 大天冬(三两) 黑豆衣(三两) 朱茯神(三两)
奎党参(四两) 白归身(二两) 旱莲草(三两) 炙鳖甲(十两) 炒枣仁(二两) 肥玉竹(三两)
炒木瓜(二两) 制首乌(五两) 炒萸肉(二两) 火麻仁(三两) 柏子霜(三两) 甘杞子(二两)
干橘叶(二两) 香附(醋炒二两) 杭白芍(酒炒三两) 生熟草(各三钱) 淡黄芩(一两五钱)
女贞子(酒炒三两)
加阿胶四两,龟板胶三两,鹿角胶一两,溶化收膏,每晨服一调羹。
陈(右) 结块坚硬稍软,咽中哽阻略舒。然仍气时上冲,冲则头胀。木郁土中,气阻营滞。再调气化痰。
以宣营滞。
制半夏(一钱五分) 橘皮(一钱) 薤白头(三钱) 缩砂仁(五分) 瓦楞子(四钱) 香附(二钱)
茯苓(三钱) 焦麦芽(四钱) 鳖甲煎丸(另服一钱五分)
董(右) 少腹作痛,经事不行,脉形不爽,面部丹赤成片,不时发露。营气不宣。宜为宣通。
全当归(酒炒二钱) 台乌药(一钱五分) 延胡索(酒炒一钱五分) 制香附(二钱) 杭白芍(酒炒一
钱) 茺蔚子(三钱) 炒桃仁(去皮尖打三钱) 降香片(七分) 楂炭(三钱)
二诊 经停少腹作痛。营气滞而不宣。当通和奇脉。
川桂枝(四分) 当归(酒炒二钱) 制香附(二钱) 乌药(一钱五分) 茺蔚子(三钱) 泽兰(二钱)
延胡索(酒炒一钱五分) 川芎(一钱) 炒赤芍(一钱五分) 楂炭(三钱)
三诊 宣通营滞,而理气机,腹仍作痛。血中气滞,气行则血行,故曰调经以理气为先也。
制香附(三钱) 紫丹参(二钱) 台乌药(一钱五分) 川芎(一钱) 炒枳壳(一钱) 全当归(酒炒三钱)
延胡索(酒炒一钱五分) 鸡血藤膏(一钱五分) 桂枝(四分) 白芍(一钱五分酒炒) 红花(酒炒七分)
四诊 血虚气滞,经阻不行,面发 瘰腹中 痛。宣通气滞,以望经行,再商调理。
当归(酒炒二钱) 牛膝(三钱) 卷柏(二钱) 丹参(二钱) 苏梗(三钱) 红花(酒炒一钱)
川芎(一钱) 炒川断(三钱) 泽兰(二钱) 香附(二钱) 鸡血藤膏(一钱五分) 杏仁(三钱)
王(右) 木旺脾虚,肝木克土,土不运旋,以致腹笥板硬,时为痛泄,月事不来,胸次痞闷。脉象弦硬,气血
郁滞。拟宣畅气血,必得月事通行,方为稳妥也。用严氏抑气散合逍遥法。
制香附(二钱) 花槟榔(八分) 广皮(一钱) 川断(三钱) 砂仁(五分) 卷柏(三钱)
生牛膝(三钱) 炒枳壳(一钱) 紫丹参(二钱) 逍遥散(先服三钱)
张(右) 每至经行,辄先少腹作胀,初来色淡,渐次转经。气滞不宣,则营血从而失和。宜调气和营。
制香附(二钱) 苏梗(二钱) 丹参(三钱) 乌药(一钱五分) 川芎(一钱) 楂炭(二钱)
全当归(二钱) 川断(一钱五分) 藿香正气丸(先服三钱)
沈(右) 阴虚气弱,脾不运旋,封藏不固。每至冬令,辄易感风,大便或结或溏,经事愆期,不时带下。脉濡
细,苔薄白。拟气阴并调。
党参(三钱) 茯苓(三钱) 炒山药(三钱) 白芍(酒炒一钱五分) 炒扁豆(三钱研) 潼沙苑(盐水炒
三钱) 于术(一钱) 炒木瓜皮(二钱) 菟丝子(盐水炒三钱) 杞子(三钱) 六味地黄丸(晨服一钱五分)
二诊 脾虚则大便或结或溏,肾虚则封藏不固。收藏之令,辄易感冒咳嗽,经不应期,时为带下,脉象
濡细。气阴并调,从前法扩充。
炒萸肉(一钱五分) 大熟地(砂仁炙四钱) 杭白芍(酒炒一钱五分) 橘白(一钱) 奎党参(三钱) 炒
于术(二钱) 生山药(三钱) 炙甘草(三分) 茯苓(三钱) 潼沙苑(盐水炒三钱)
三诊 脾虚则不运,肾虚则不藏,脾不运则大便时溏,肾不藏则封固不密。每至冬令,易召外感,而为
喘咳,经事遂不应期,带脉从而不固。宜从脾肾并调。
炙绵 (三两) 炒萸肉(一两) 炒山药(二两) 奎党参(四两) 远志肉(五钱) 炒扁豆(二两)
川断肉(二两) 炒于术(二两) 白茯苓(三两) 炙黑草(五钱) 制首乌(四两) 菟丝子(二两)
破故纸(二两) 巴戟肉(二两) 甘杞子(二两) 制香附(一两五钱) 潼沙苑(盐水炒三两) 广皮(一两)
大熟地(砂仁炙四两) 制半夏(一两五钱) 粉归身(酒炒一两五钱) 杜仲(三两) 杭白芍(酒炒一两五钱)
紫丹参(一两五钱) 泽泻(一两) 大生地(姜汁炙四两) 炒枣仁(一两研)
清阿胶三两,鹿角胶二两,龟板胶二两,以上三胶溶化收膏,晨服七八钱。
胡(右) 十二经之血,注于冲脉,从冲脉而下者,谓之月经。冲为肝之隶脉,情怀抑郁,木土失和,中脘作
痛。冲脉之气,因而阻滞,经事数月方行,面色浮黄。唇白舌淡无华,脉象细涩。气血皆滞,当为宣通。
川桂枝(五分) 制香附(二钱) 炒枳壳(一钱) 紫丹参(二钱) 单桃仁(二钱) 白芍(酒炒一钱五分)
全当归(酒炒二钱) 砂仁末(五分) 茺蔚子(三钱) 香橼皮(一钱)
二诊 宣通营滞,脉细稍起,经事未来,脘腹作痛。久病营血必滞。仍为宣通。
川桂枝(五分) 单桃仁(二钱) 制香附(二钱) 紫丹参(二钱) 川断肉(三钱) 延胡索(酒炒一钱五分)
台乌药(一钱五分) 炒赤芍(一钱五分) 茺蔚子(三钱) 归身(二钱) 川芎(一钱)
陈(右) 火从上升,升则头晕且痛,目涩肌热。经事一月数至。皆由木郁生火。姑清以泄之。
龟甲心 粉丹皮 黑豆衣 女贞子 石决明 白归身
杭白芍 乌贼骨 左牡蛎(盐水炒) 炒白薇
席(右) 经事一月数至,至则如涌。营热之甚,恐致血崩。
大生地 当归炭 制香附 丹皮炭 细子芩 乌贼骨 老苏梗 元参 鲜藕(煎汤代水)
二诊 经不及期,色鲜甚多,头胀作痛。风热袭入营分也。
细子芩 炒防风 当归炭 丹皮炭 茯神 制香附 生地炭 旱莲草 炙乌贼骨
姚(右) 肝肾素亏,风阳上升,时为头痛。经事迟行,将至之前,足酸腹胀,既至之后,淋沥不止。此皆营气
不主宣畅,所谓气滞则血亦滞也。故调血以理气为先。
粉全归 砂仁 制香附 川断肉 老苏梗 降香 丹参 川芎 广皮
某(右) 经来淋沥,少腹作痛,腿股牵引不舒。冲瘀未清,则冲脉转难固摄,恐壅极而致崩败。
淡吴萸(三分) 炒当归 苏梗 延胡索 降香 生熟蒲黄(各四分)
南楂炭 香附 炒赤芍
张(右) 经来淋沥,脘痛少腹滞坠,辄成块作片而下。气乱则血亦乱,不能循行经络。
制香附 生熟蒲黄 白芷 川朴 大腹皮 茜草炭 藿香 乌贼骨 茯苓 广皮 苏梗 半夏曲
朱(右) 经来淋沥,少腹作痛。脉弦尺涩。冲气不调,则冲脉不固矣。
制香附 生熟蒲黄(各四分) 砂仁 当归炭 茯神 乌贼骨 茜草炭 磨苏梗 广皮 台乌药
二诊 调气和营,未尝止血而止痛也,然淋沥已定,腹痛亦止。可见血为气之配,气和则妄行者循经
而不乱矣。前法再参养营。
磨苏梗 杭白芍 首乌 当归 广皮 香附 炒枣仁 砂仁 茯神
姚(右) 气为血之帅,经前胀满,经至淋沥,皆气滞不宣。调经以理气为先,旨哉斯言也。
全归 白芍 制半夏 上广皮 川断 香附
紫丹参 老苏梗 藿香正气丸
谈(右) 每至经行,辄块攻痛胀,甚则呕吐。气瘀交阻。姑为宣通。
当归 川芎 延胡 蓬术 乌药 橘络(红花汤炒) 楂炭 桂枝 香附 青皮 猩绛 炒赤芍
陈(右) 经事临期,腹痛难忍。血之下也,未来则胀,将来则痛,既来则痛渐定。血虚气滞。宜补血之不足,
疏气之有余。
炙熟地 炒杞子 香附 全归 乌药 砂仁 川断肉 白芍 楂炭
陈(右) 气上迫肺,心气不能下通,月事不来,所以起居如常,腹无痛胀之苦。用武叔卿加味导痰之法。
中朴(一两) 云苓(三两) 制半夏(二两) 枳实(一两) 川芎(一两二钱) 雅连(三钱) 广皮(一
两二钱)
研细末,以姜汤泛丸如绿豆大,每晨服三钱。
某(右) 经停十五月之久,而起居如常,脉缓苔薄白,此名为歇,不治自愈,但须徐以待之耳。
全当归 橘白 土炒白芍 白蒺藜 制香附 半夏曲 茯苓 生熟谷芽 甜杏仁(炒香)
林(右) 诸经之血会于冲脉,从冲脉而下者,谓之月经。冲气不调,经来血聚,冲气不通,所以胀势每甚。
仿金匮温经法。
人参须(一钱) 泽泻(一钱五分) 炙黑草(三分) 粉丹皮(二钱) 炒麦冬(三钱) 粉归身(二钱)
炮姜(四分) 真阿胶(一钱五分) 上徭桂(二分研末饭丸烘干先服)
右 每至经行,辄腰腹作痛。迩来中脘不舒,食入泛漾,头痛眩晕,凛热无时。此气滞血虚,肝胃失协。
先从肝胃两和。
王(右侧脉象):多次发生滑胎,此次月经提前,颜色紫暗且无光泽,行经时伴有疼痛。暂用宣畅营卫的方法治疗。
全当归(酒炒二钱) 白蒺藜(三钱) 紫丹参(二钱) 杭白芍(酒炒一钱五分) 橘络(红花汤炒一钱)
蕲艾炭(四分) 炒川断(三钱) 菟丝子(盐水炒三钱) 炒牛膝(三钱) 制香附(二钱)
二诊:气血不固,屡次导致滑胎。治疗方法唯有调气养营,做好循序渐进、日积月累的治疗打算。
大熟地(砂仁拌炙成炭) 泽泻(一钱五分) 细子芩(酒炒一钱五分) 橘皮(一钱) 白芍(酒炒一钱五分)
萸肉炭(一钱五分) 茯苓神(各四钱) 炒山药(三钱) 生熟谷芽(三钱) 粉丹皮(二钱) 制香附(二钱)
谢(右侧脉象):中脘部位疼痛,腹部不适,月经一月来两次,腰酸且有带下。气血不固,肝胃失和。先调理气机、和胃,再商议培补之法。
金铃子(一钱五分) 香附(一钱五分) 砂仁(五分) 炒白芍(一钱五分) 佛手(一钱) 乌贼骨(三钱炙) 茯苓(三钱) 当归炭(二钱) 八珍丸(绢包入煎四钱) 广皮(一钱)
陈(右侧脉象):长期疼痛呕吐,中脘部板硬,月经两个月未来。这必定是有形的积滞,郁阻在胃中。拟用宣通气血的方法。
延胡索(酒炒一钱五分) 瓦楞子(四钱) 炒赤芍(一钱) 台乌药(一钱五分) 楂肉(二钱) 土鳖虫(去头足炙三枚) 单桃仁(去皮尖打三钱) 归须(酒炒二钱) 降香片(五分)
二诊:宣通营卫后,大便排出凝块且色红,胃痛减轻,板硬感变软,呕吐未发作。继续采用宣通法。
五灵脂(酒炒三钱) 制香附(二钱) 炒枳壳(一钱) 焦麦芽(三钱) 陈皮(一钱) 薤白头(二钱)
延胡索(酒炒一钱五分) 砂仁末(五分) 土鳖虫(去头足二枚) 广郁金(一钱五分)
三诊:宣通营分滞涩后,大便带黑色,胃痛呕吐均减轻。然而咽喉常觉哽阻,中脘仍然坚硬。脉象弦紧。效方需扩充,再望见效。
上桂心(五分) 炒桃仁(三钱) 薤白头(二钱) 干漆(炒烟尽三分) 橘红(一钱) 土鳖虫(三枚)
延胡索(酒炒一钱五分) 制半夏(一钱五分) 湘军(酒炒八分)
龚(右侧脉象):每次临近入睡,就感觉身体震颤痉挛,头晕发胀,时常出汗,中脘胀满。肝风鸱张,木强土弱。拟养血熄肝,参以凉营,因为月经刚过则血更虚。
阿胶(三钱) 丹皮(二钱) 大生地(四钱) 黄芩(酒炒一钱五分) 女贞子(酒炒三钱) 朱茯神(三钱)
白芍(酒炒一钱五分) 香附(二钱) 金铃子(一钱五分) 橘叶(二钱) 黑豆衣(三钱) 生决明(六钱)
二诊:咽喉如有物梗阻,中脘不适,筋脉跳动,甚至欲晕厥,月经一月来两次。营血久亏,风阳震动。再育阴以涵敛肝木。
阿胶珠(三钱) 天冬(三钱) 豆蔻花(四分) 潼沙苑(盐水炒三钱) 丹皮(二钱) 大生地(四钱)
干橘叶(一钱五分) 炒白芍(一钱五分) 牡蛎(三钱) 生山药(三钱) 茯苓神(各二钱) 淮小麦(五钱)
三诊:每当气机上冲,中脘胀满,按压作痛,甚则出汗。卫气逆上,拟用镇坠滋养柔和之法。
代赭石(四钱) 炙鳖甲(四钱) 生熟草(各二分) 金铃子(一钱五分) 火麻仁(三钱) 牡蛎(五钱)
淮小麦(五钱) 橘皮(一钱) 糯稻根(四钱) 白芍(酒炒一钱五分) 大南枣(四枚)
四诊:火从上升,则汗出淋漓,头面部尤为严重,脚心烙热,月经提前,左肩臂酸痛。冲阳逆上,皆因阴虚木失滋涵。
阿胶珠(三钱) 柏子霜(三钱) 炙甘草(四分) 地骨皮(二钱) 旱莲草(三钱) 牡蛎(五钱)
生白芍(一钱五分) 乌贼骨(三钱) 淮小麦(五钱) 南枣(三枚) 女贞子(酒炒三钱) 糯稻根(五钱)
五诊:月经一月两至,肝阴愈虚,肝气愈旺,肝阳愈盛,头晕发胀,睡眠时头部汗出淋漓,心中震颤痉挛,胸膺胀满,咽喉如阻,肩臂酸痛。宜滋肾养肝,参以凉营。
大生地(十两) 粉丹皮(二两) 生牡蛎(八两) 大天冬(三两) 黑豆衣(三两) 朱茯神(三两)
奎党参(四两) 白归身(二两) 旱莲草(三两) 炙鳖甲(十两) 炒枣仁(二两) 肥玉竹(三两)
炒木瓜(二两) 制首乌(五两) 炒萸肉(二两) 火麻仁(三两) 柏子霜(三两) 甘杞子(二两)
干橘叶(二两) 香附(醋炒二两) 杭白芍(酒炒三两) 生熟草(各三钱) 淡黄芩(一两五钱)
女贞子(酒炒三两)
加阿胶四两,龟板胶三两,鹿角胶一两,溶化收膏,每晨服一调羹。
陈(右侧脉象):结块坚硬稍软,咽喉哽阻略舒。然而仍有气机上冲,冲则头胀。木郁土中,气阻营滞。再调气化痰,以宣通营滞。
制半夏(一钱五分) 橘皮(一钱) 薤白头(三钱) 缩砂仁(五分) 瓦楞子(四钱) 香附(二钱)
茯苓(三钱) 焦麦芽(四钱) 鳖甲煎丸(另服一钱五分)
董(右侧脉象):少腹疼痛,月经不行,脉形不爽,面部皮肤发红成片,不时显露。营气不宣。宜为宣通。
全当归(酒炒二钱) 台乌药(一钱五分) 延胡索(酒炒一钱五分) 制香附(二钱) 杭白芍(酒炒一钱) 茺蔚子(三钱) 炒桃仁(去皮尖打三钱) 降香片(七分) 楂炭(三钱)
二诊:经停少腹作痛。营气滞而不宣。当通和奇脉。
川桂枝(四分) 当归(酒炒二钱) 制香附(二钱) 乌药(一钱五分) 茺蔚子(三钱) 泽兰(二钱)
延胡索(酒炒一钱五分) 川芎(一钱) 炒赤芍(一钱五分) 楂炭(三钱)
三诊:宣通营滞,而理气机,腹部仍作痛。血中气滞,气行则血行,所以说调经以理气为先。
制香附(三钱) 紫丹参(二钱) 台乌药(一钱五分) 川芎(一钱) 炒枳壳(一钱) 全当归(酒炒三钱)
延胡索(酒炒一钱五分) 鸡血藤膏(一钱五分) 桂枝(四分) 白芍(一钱五分酒炒) 红花(酒炒七分)
四诊:血虚气滞,经阻不行,面部发瘰疬,腹中疼痛。宣通气滞,以望经行,再商调理。
当归(酒炒二钱) 牛膝(三钱) 卷柏(二钱) 丹参(二钱) 苏梗(三钱) 红花(酒炒一钱)
川芎(一钱) 炒川断(三钱) 泽兰(二钱) 香附(二钱) 鸡血藤膏(一钱五分) 杏仁(三钱)
王(右侧脉象):木旺脾虚,肝木克土,土不运旋,以致腹部板硬,时而痛泄,月经不来,胸次痞闷。脉象弦硬,气血郁滞。拟宣畅气血,必须得月经通行,方为稳妥也。用严氏抑气散合逍遥法。
制香附(二钱) 花槟榔(八分) 广皮(一钱) 川断(三钱) 砂仁(五分) 卷柏(三钱)
生牛膝(三钱) 炒枳壳(一钱) 紫丹参(二钱) 逍遥散(先服三钱)
张(右侧脉象):每次月经来潮前,先少腹作胀,初来时颜色淡,渐次转经。气滞不宣,则营血从而失和。宜调气和营。
制香附(二钱) 苏梗(二钱) 丹参(三钱) 乌药(一钱五分) 川芎(一钱) 楂炭(二钱)
全当归(二钱) 川断(一钱五分) 藿香正气丸(先服三钱)
沈(右侧脉象):阴虚气弱,脾不运旋,封藏不固。每到冬季,容易感受风邪,大便或结或溏,月经延期,不时带下。脉濡细,苔薄白。拟气阴并调。
党参(三钱) 茯苓(三钱) 炒山药(三钱) 白芍(酒炒一钱五分) 炒扁豆(三钱研) 潼沙苑(盐水炒三钱) 于术(一钱) 炒木瓜皮(二钱) 菟丝子(盐水炒三钱) 杞子(三钱) 六味地黄丸(晨服一钱五分)
二诊:脾虚则大便或结或溏,肾虚则封藏不固。收藏之令,辄易感冒咳嗽,月经不应期,时为带下,脉象濡细。气阴并调,从前法扩充。
炒萸肉(一钱五分) 大熟地(砂仁炙四钱) 杭白芍(酒炒一钱五分) 橘白(一钱) 奎党参(三钱) 炒于术(二钱) 生山药(三钱) 炙甘草(三分) 茯苓(三钱) 潼沙苑(盐水炒三钱)
三诊:脾虚则不运,肾虚则不藏,脾不运则大便时溏,肾不藏则封固不密。每到冬季,易召外感,而为喘咳,月经遂不应期,带脉从而不固。宜从脾肾并调。
炙绵 (三两) 炒萸肉(一两) 炒山药(二两) 奎党参(四两) 远志肉(五钱) 炒扁豆(二两)
川断肉(二两) 炒于术(二两) 白茯苓(三两) 炙黑草(五钱) 制首乌(四两) 菟丝子(二两)
破故纸(二两) 巴戟肉(二两) 甘杞子(二两) 制香附(一两五钱) 潼沙苑(盐水炒三两) 广皮(一两)
大熟地(砂仁炙四两) 制半夏(一两五钱) 粉归身(酒炒一两五钱) 杜仲(三两) 杭白芍(酒炒一两五钱)
紫丹参(一两五钱) 泽泻(一两) 大生地(姜汁炙四两) 炒枣仁(一两研)
清阿胶三两,鹿角胶二两,龟板胶二两,以上三胶溶化收膏,晨服七八钱。
胡(右侧脉象):十二经之血,注于冲脉,从冲脉而下者,谓之月经。冲为肝之隶脉,情怀抑郁,木土失和,中脘作痛。冲脉之气,因而阻滞,经事数月方行,面色浮黄。唇白舌淡无华,脉象细涩。气血皆滞,当为宣通。
川桂枝(五分) 制香附(二钱) 炒枳壳(一钱) 紫丹参(二钱) 单桃仁(二钱) 白芍(酒炒一钱五分)
全当归(酒炒二钱) 砂仁末(五分) 茺蔚子(三钱) 香橼皮(一钱)
二诊:宣通营滞,脉细稍起,月经未来,脘腹作痛。久病营血必滞。仍为宣通。
川桂枝(五分) 单桃仁(二钱) 制香附(二钱) 紫丹参(二钱) 川断肉(三钱) 延胡索(酒炒一钱五分)
台乌药(一钱五分) 炒赤芍(一钱五分) 茺蔚子(三钱) 归身(二钱) 川芎(一钱)
陈(右侧脉象):火从上升,升则头晕且痛,目涩肌热。月经一月数至。皆由木郁生火。姑清以泄之。
龟甲心 粉丹皮 黑豆衣 女贞子 石决明 白归身
杭白芍 乌贼骨 左牡蛎(盐水炒) 炒白薇
席(右侧脉象):月经一月数至,至则如涌。营热之甚,恐致血崩。
大生地 当归炭 制香附 丹皮炭 细子芩 乌贼骨 老苏梗 元参 鲜藕(煎汤代水)
二诊:月经不及期,色鲜甚多,头胀作痛。风热袭入营分也。
细子芩 炒防风 当归炭 丹皮炭 茯神 制香附 生地炭 旱莲草 炙乌贼骨
姚(右侧脉象):肝肾素亏,风阳上升,时为头痛。月经迟行,将至之前,足酸腹胀,既至之后,淋沥不止。此皆营气不主宣畅,所谓气滞则血亦滞也。故调血以理气为先。
粉全归 砂仁 制香附 川断肉 老苏梗 降香 丹参 川芎 广皮
某(右侧脉象):经来淋沥,少腹作痛,腿股牵引不舒。冲瘀未清,则冲脉转难固摄,恐壅极而致崩败。
淡吴萸(三分) 炒当归 苏梗 延胡索 降香 生熟蒲黄(各四分)
南楂炭 香附 炒赤芍
张(右侧脉象):经来淋沥,脘痛少腹滞坠,辄成块作片而下。气乱则血亦乱,不能循行经络。
制香附 生熟蒲黄 白芷 川朴 大腹皮 茜草炭 藿香 乌贼骨 茯苓 广皮 苏梗 半夏曲
朱(右侧脉象):经来淋沥,少腹作痛。脉弦尺涩。冲气不调,则冲脉不固矣。
制香附 生熟蒲黄(各四分) 砂仁 当归炭 茯神 乌贼骨 茜草炭 磨苏梗 广皮 台乌药
二诊:调气和营,未尝止血而止痛也,然淋沥已定,腹痛亦止。可见血为气之配,气和则妄行者循经而不乱矣。前法再参养营。
磨苏梗 杭白芍 首乌 当归 广皮 香附 炒枣仁 砂仁 茯神
姚(右侧脉象):气为血之帅,经前胀满,经至淋沥,皆气滞不宣。调经以理气为先,旨哉斯言也。
全归 白芍 制半夏 上广皮 川断 香附
紫丹参 老苏梗 藿香正气丸
谈(右侧脉象):每次月经来潮,辄块攻痛胀,甚则呕吐。气瘀交阻。姑为宣通。
当归 川芎 延胡 蓬术 乌药 橘络(红花汤炒) 楂炭 桂枝 香附 青皮 猩绛 炒赤芍
陈(右侧脉象):月经临期,腹痛难忍。血之下也,未来则胀,将来则痛,既来则痛渐定。血虚气滞。宜补血之不足,疏气之有余。
炙熟地 炒杞子 香附 全归 乌药 砂仁 川断肉 白芍 楂炭
陈(右侧脉象):气上迫肺,心气不能下通,月经不来,所以起居如常,腹无痛胀之苦。用武叔卿加味导痰之法。
中朴(一两) 云苓(三两) 制半夏(二两) 枳实(一两) 川芎(一两二钱) 雅连(三钱) 广皮(一两二钱)
研细末,以姜汤泛丸如绿豆大,每晨服三钱。
某(右侧脉象):月经停止十五月之久,而起居如常,脉缓苔薄白,此名为歇,不治自愈,但须徐以待之耳。
全当归 橘白 土炒白芍 白蒺藜 制香附 半夏曲 茯苓 生熟谷芽 甜杏仁(炒香)
林(右侧脉象):诸经之血会于冲脉,从冲脉而下者,谓之月经。冲气不调,经来血聚,冲气不通,所以胀势每甚。仿金匮温经法。
人参须(一钱) 泽泻(一钱五分) 炙黑草(三分) 粉丹皮(二钱) 炒麦冬(三钱) 粉归身(二钱)
炮姜(四分) 真阿胶(一钱五分) 上徭桂(二分研末饭丸烘干先服)
右(右侧脉象):每次月经来潮,辄腰腹作痛。近来中脘不舒,食入泛漾,头痛眩晕,凛热无时。此气滞血虚,肝胃失协。先从肝胃两和。
Wang (Right): Having experienced recurrent spontaneous abortion (habitual miscarriage) multiple times, menstruation now occurs prematurely. The blood is dark purple and lacks luster, accompanied by pain during flow. Temporarily employ a method to promote the free flow of Ying (Nutritive Qi) and Wei (Defensive Qi).
Quan Dang Gui (Angelicae Sinensis Radix, stir-fried with wine, 2 qian), Bai Ji Li (Tribuli Fructus, 3 qian), Zi Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 2 qian), Hang Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian), Ju Luo (Citri Reticulatae Pericarpium Viride Retinervum, stir-fried with Hong Hua decoction, 1 qian).
Qi Ai Tan (Artemisiae Argyi Folium Carbonisatum, 0.4 qian), Chao Chuan Duan (Dipsaci Radix, stir-fried, 3 qian), Tu Si Zi (Cuscutae Semen, stir-fried in salt water, 3 qian), Chao Niu Xi (Achyranthis Bidentatae Radix, stir-fried, 3 qian), Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian).
Second visit: Qi and Blood are insecure, leading to recurrent spontaneous abortions. The treatment method must focus on regulating Qi and nourishing Ying, adopting a strategy of gradual progress and steady accumulation.
Da Shu Di (Rehmanniae Radix Preparata, mixed with Sha Ren and stir-fried to charcoal), Ze Xie (Alismatis Rhizoma, 1.5 qian), Xi Zi Qin (Scutellariae Radix, stir-fried with wine, 1.5 qian), Ju Pi (Citri Reticulatae Pericarpium, 1 qian), Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian).
Yu Rou Tan (Corni Fructus Carbonisatum, 1.5 qian), Fu Ling Shen (Poria with Hostwood, 4 qian each), Chao Shan Yao (Dioscoreae Rhizoma, stir-fried, 3 qian), Sheng Shu Gu Ya (Oryzae Fructus Germinatus, raw and prepared, 3 qian), Fen Dan Pi (Moutan Cortex, 2 qian), Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian).
Xie (Right): Pain in the Zhong Wan (Epigastrium), abdominal discomfort, menstruation occurring twice a month, lower back soreness, and leukorrhea. Qi and Blood are insecure; Liver and Stomach are disharmonious. First regulate Qi and harmonize the Stomach, then discuss tonification.
Jin Ling Zi (Meliae Semen, 1.5 qian), Xiang Fu (Cyperi Rhizoma, 1.5 qian), Sha Ren (Amomi Fructus Rotundus, 0.5 qian), Chao Bai Shao (Paeoniae Radix Alba, stir-fried, 1.5 qian), Fo Shou (Citri Sarcodactylis Fructus, 1 qian), Ou Hai Gu (Sepiae Endoconcha, stir-fried, 3 qian), Fu Ling (Poria, 3 qian), Dang Gui Tan (Angelicae Sinensis Radix Carbonisatum, 2 qian), Ba Zhen Wan (Eight Treasures Pill, wrapped in silk for decoction, 4 qian), Guang Pi (Citri Reticulatae Pericarpium, 1 qian).
Chen (Right): Long-standing pain and vomiting, hardness in the Zhong Wan (Epigastrium), menstruation absent for two months. This must be due to有形 (tangible) stagnation obstructing the Stomach. Propose promoting the free flow of Qi and Blood.
Yan Hu Suo (Corydalis Rhizoma, stir-fried with wine, 1.5 qian), Wa Leng Zi (Arcae Shell, 4 qian), Chao Chi Shao (Paeoniae Radix Rubra, stir-fried, 1 qian), Tai Wu Yao (Linderae Radix, 1.5 qian), Zha Rou (Crataegi Fructus, 2 qian), Tu Bie Chong (Eupolyphaga Seu Steleophaga, deheaded and defooted, roasted, 3 pieces), Dan Tao Ren (Persicae Semen, peeled and pitted, crushed, 3 qian), Gui Xu (Angelicae Sinensis Radix Caulescens, stir-fried with wine, 2 qian), Jiang Xiang Pian (Dalbergiae Odoriferae Lignum, 0.5 qian).
Second visit: After promoting the free flow of Ying and Wei, stool was passed with clots and red color, epigastric pain decreased, hardness softened, vomiting did not recur. Continue promoting free flow.
Wu Ling Zhi (Trogopteri Excrementum, stir-fried with wine, 3 qian), Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian), Chao Zhi Ke (Aurantii Fructus Immaturus, stir-fried, 1 qian), Jiao Mai Ya (Hordei Fructus Germinatus, scorched, 3 qian), Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Xie Bai (Allii Macrostemonis Bulbus, 2 qian).
Yan Hu Suo (Corydalis Rhizoma, stir-fried with wine, 1.5 qian), Sha Ren Mo (Amomi Fructus Rotundus powder, 0.5 qian), Tu Bie Chong (Eupolyphaga Seu Steleophaga, deheaded and defooted, 2 pieces), Guang Yu Jin (Curcumae Radix, 1.5 qian).
Third visit: After promoting the free flow of Ying stagnation, stool was black, epigastric pain and vomiting both reduced. However, a sensation of obstruction in the throat persists, and the Zhong Wan (Epigastrium) remains hard. Pulse is wiry and tight. Expand the effective formula, hoping for a response.
Shang Gui Xin (Cinnamomi Ramulus Cortex, 0.5 qian), Chao Tao Ren (Persicae Semen, stir-fried, 3 qian), Xie Bai (Allii Macrostemonis Bulbus, 2 qian), Gan Qi (Drynariae Rhizoma or related resinous substance, stir-fried until smoke ceases, 0.3 qian), Ju Hong (Citri Reticulatae Pericarpium Rubrum, 1 qian), Tu Bie Chong (Eupolyphaga Seu Steleophaga, 3 pieces).
Yan Hu Suo (Corydalis Rhizoma, stir-fried with wine, 1.5 qian), Zhi Ban Xia (Pinelliae Rhizoma Preparatum, 1.5 qian), Jun Jun (Ephedrae Herba, stir-fried with wine, 0.8 qian).
Gong (Right): Just before falling asleep, tremors and spasms occur, accompanied by dizziness and distension, frequent sweating, and fullness in the Zhong Wan (Epigastrium). Liver Wind is rampant, Wood overacts on Earth. Propose nourishing Blood to extinguish Liver Wind, combined with cooling Ying, as earlier menstruation leads to greater Blood deficiency.
E Jiao (Asini Corii Colla, 3 qian), Dan Pi (Moutan Cortex, 2 qian), Da Sheng Di (Rehmanniae Radix, 4 qian), Huang Qin (Scutellariae Radix, stir-fried with wine, 1.5 qian), Nu Zhen Zi (Ligustri Lucidi Fructus, stir-fried with wine, 3 qian), Zhu Fu Shen (Poria with Hostwood coated with Cinnabar, 3 qian).
Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian), Xiang Fu (Cyperi Rhizoma, 2 qian), Jin Ling Zi (Meliae Semen, 1.5 qian), Ju Ye (Citri Reticulatae Folium, 2 qian), Hei Dou Yi (Sojae Semen Nigrum Testa, 3 qian), Sheng Jue Ming (Cassiae Semen, 6 qian).
Second visit: Sensation of obstruction in the throat, discomfort in the Zhong Wan (Epigastrium), twitching of sinews and vessels, even near fainting, menstruation occurring twice a month. Ying Blood has been deficient for a long time, stirring up Wind-Yang. Further nourish Yin to submerge Liver Wood.
E Jiao Zhu (Asini Corii Colla beads, 3 qian), Tian Dong (Asparagi Radix, 3 qian), Dou Kou Hua (Cardamomi Fructus Flos, 0.4 qian), Tong Sha Yuan (Tussilaginis Semen, stir-fried in salt water, 3 qian), Dan Pi (Moutan Cortex, 2 qian), Da Sheng Di (Rehmanniae Radix, 4 qian).
Gan Ju Ye (Citri Reticulatae Folium, dried, 1.5 qian), Chao Bai Shao (Paeoniae Radix Alba, stir-fried, 1.5 qian), Mu Li (Ostreae Concha, 3 qian), Sheng Shan Yao (Dioscoreae Rhizoma, 3 qian), Fu Ling Shen (Poria with Hostwood, 2 qian each), Huai Xiao Mai (Tritici Fructus, 5 qian).
Third visit: Whenever Qi surges upward, the Zhong Wan (Epigastrium) becomes full and painful upon pressure, sometimes with sweating. Wei (Defensive) Qi rebels upward. Propose sedating, nourishing, and softening.
Dai Zhe Shi (Haematitum, 4 qian), Zhi Bie Jia (Trionycis Carapax, steamed, 4 qian), Sheng Shu Cao (Glycyrrhizae Radix et Rhizoma, raw and prepared, 0.2 qian each), Jin Ling Zi (Meliae Semen, 1.5 qian), Huo Ma Ren (Cannabis Semen, 3 qian), Mu Li (Ostreae Concha, 5 qian).
Huai Xiao Mai (Tritici Fructus, 5 qian), Ju Pi (Citri Reticulatae Pericarpium, 1 qian), Nuo Dao Gen (Oryzae Sativa Radix, 4 qian), Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian), Da Nan Zao (Jujubae Fructus, 4 pieces).
Fourth visit: Fire rises, causing profuse sweating, especially on the head and face, burning heat in the soles of the feet, premature menstruation, and soreness/aching in the left shoulder and arm. Chong (Penetrating) Yang rebels upward, all due to Yin deficiency failing to nourish Wood.
E Jiao Zhu (Asini Corii Colla beads, 3 qian), Bai Zi Shuang (Platycladi Semen endosperm, 3 qian), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.4 qian), Di Gu Pi (Lycii Cortex, 2 qian), Han Lian Cao (Ecliptae Herba, 3 qian), Mu Li (Ostreae Concha, 5 qian).
Sheng Bai Shao (Paeoniae Radix Alba, raw, 1.5 qian), Ou Hai Gu (Sepiae Endoconcha, 3 qian), Huai Xiao Mai (Tritici Fructus, 5 qian), Nan Zao (Jujubae Fructus, 3 pieces), Nu Zhen Zi (Ligustri Lucidi Fructus, stir-fried with wine, 3 qian), Nuo Dao Gen (Oryzae Sativa Radix, 5 qian).
Fifth visit: Menstruation occurs twice a month. Liver Yin is increasingly deficient, Liver Qi increasingly hyperactive, Liver Yang increasingly flourishing. Symptoms include dizziness, distension, profuse sweating on the head during sleep, palpitations/spasms in the heart, chest fullness, sensation of obstruction in the throat, and soreness in shoulders and arms. Should nourish Kidney and Liver, combined with cooling Ying.
Da Sheng Di (Rehmanniae Radix, 10 liang), Fen Dan Pi (Moutan Cortex, 2 liang), Sheng Mu Li (Ostreae Concha, raw, 8 liang), Da Tian Dong (Asparagi Radix, 3 liang), Hei Dou Yi (Sojae Semen Nigrum Testa, 3 liang), Zhu Fu Shen (Poria with Hostwood coated with Cinnabar, 3 liang).
Kui Dang Shen (Codonopsis Radix, 4 liang), Bai Gui Shen (Angelicae Sinensis Radix, 2 liang), Han Lian Cao (Ecliptae Herba, 3 liang), Zhi Bie Jia (Trionycis Carapax, steamed, 10 liang), Chao Zao Ren (Ziziphi Spinosae Semen, stir-fried, 2 liang), Fei Yu Zhu (Polygonati Odorati Rhizoma, 3 liang).
Chao Mu Gua (Chaenomelis Fructus, stir-fried, 2 liang), Zhi Shou Wu (Polygoni Multiflori Radix Preparata, 5 liang), Chao Yu Rou (Corni Fructus, stir-fried, 2 liang), Huo Ma Ren (Cannabis Semen, 3 liang), Bai Zi Shuang (Platycladi Semen endosperm, 3 liang), Gan Qi Zi (Lycii Fructus, 2 liang).
Gan Ju Ye (Citri Reticulatae Folium, dried, 2 liang), Xiang Fu (Cyperi Rhizoma, vinegar-fried, 2 liang), Hang Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 3 liang), Sheng Shu Cao (Glycyrrhizae Radix et Rhizoma, raw and prepared, 3 qian each), Dan Huang Qin (Scutellariae Radix, light, 1.5 liang).
Nu Zhen Zi (Ligustri Lucidi Fructus, stir-fried with wine, 3 liang).
Add E Jiao (Asini Corii Colla, 4 liang), Gui Ban Jiao (Testudinis Carapax et Plastrum Colla, 3 liang), Lu Jiao Jiao (Cervi Cornus Colla, 1 liang). Dissolve and make into paste. Take one spoonful every morning.
Chen (Right): The mass is slightly softer, and the sensation of obstruction in the throat is relieved. However, Qi still surges upward, causing head distension. Wood stagnates in Earth, Qi obstructs Ying stagnation. Further regulate Qi and transform Phlegm to promote the free flow of Ying stagnation.
Zhi Ban Xia (Pinelliae Rhizoma Preparatum, 1.5 qian), Ju Pi (Citri Reticulatae Pericarpium, 1 qian), Xie Bai (Allii Macrostemonis Bulbus, 3 qian), Suo Sha Ren (Amomi Fructus Rotundus, 0.5 qian), Wa Leng Zi (Arcae Shell, 4 qian), Xiang Fu (Cyperi Rhizoma, 2 qian).
Fu Ling (Poria, 3 qian), Jiao Mai Ya (Hordei Fructus Germinatus, scorched, 4 qian), Bie Jia Jian Wan (Biejiajian Pill, taken separately, 1.5 qian).
Dong (Right): Lower abdomen pain, amenorrhea, irregular pulse, facial erythema in patches appearing intermittently. Ying Qi is not promoted. Should promote free flow.
Quan Dang Gui (Angelicae Sinensis Radix, stir-fried with wine, 2 qian), Tai Wu Yao (Linderae Radix, 1.5 qian), Yan Hu Suo (Corydalis Rhizoma, stir-fried with wine, 1.5 qian), Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian), Hang Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1 qian), Chong Wei Zi (Leonuri Fructus, 3 qian).
Chao Tao Ren (Persicae Semen, peeled, pitted, crushed, 3 qian), Jiang Xiang Pian (Dalbergiae Odoriferae Lignum, 0.7 qian), Zha Tan (Crataegi Fructus Carbonisatum, 3 qian).
Second visit: Amenorrhea with lower abdominal pain. Ying Qi is stagnant and not promoted. Should unblock and harmonize the奇脉 (Extraordinary Vessels).
Chuan Gui Zhi (Cinnamomi Ramulus, 0.4 qian), Dang Gui (Angelicae Sinensis Radix, stir-fried with wine, 2 qian), Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian), Wu Yao (Linderae Radix, 1.5 qian), Chong Wei Zi (Leonuri Fructus, 3 qian), Ze Lan (Lycopersici Herba, 2 qian).
Yan Hu Suo (Corydalis Rhizoma, stir-fried with wine, 1.5 qian), Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 qian), Chao Chi Shao (Paeoniae Radix Rubra, stir-fried, 1.5 qian), Zha Tan (Crataegi Fructus Carbonisatum, 3 qian).
Third visit: Promoted free flow of Ying stagnation and regulated Qi mechanism, but abdominal pain persists. Qi stagnation in Blood; when Qi moves, Blood moves. Thus, regulating menstruation prioritizes regulating Qi.
Zhi Xiang Fu (Cyperi Rhizoma, processed, 3 qian), Zi Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 2 qian), Tai Wu Yao (Linderae Radix, 1.5 qian), Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 qian), Chao Zhi Ke (Aurantii Fructus Immaturus, stir-fried, 1 qian), Quan Dang Gui (Angelicae Sinensis Radix, stir-fried with wine, 3 qian).
Yan Hu Suo (Corydalis Rhizoma, stir-fried with wine, 1.5 qian), Ji Xue Teng Gao (Spatholobi Caulis Paste, 1.5 qian), Gui Zhi (Cinnamomi Ramulus, 0.4 qian), Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian), Hong Hua (Carthami Flos, stir-fried with wine, 0.7 qian).
Fourth visit: Blood deficiency with Qi stagnation, menstrual obstruction, facial phymatous nodules, abdominal pain. Promote free flow of Qi stagnation to hope for menstruation, then discuss regulation.
Dang Gui (Angelicae Sinensis Radix, stir-fried with wine, 2 qian), Niu Xi (Achyranthis Bidentatae Radix, 3 qian), Juan Bai (Serissae Herba, 2 qian), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 2 qian), Su Geng (Perillae Caulis, 3 qian), Hong Hua (Carthami Flos, stir-fried with wine, 1 qian).
Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 qian), Chao Chuan Duan (Dipsaci Radix, stir-fried, 3 qian), Ze Lan (Lycopersici Herba, 2 qian), Xiang Fu (Cyperi Rhizoma, 2 qian), Ji Xue Teng Gao (Spatholobi Caulis Paste, 1.5 qian), Xing Ren (Armeniacae Semen Amarum, 3 qian).
Wang (Right): Wood excess with Spleen deficiency, Liver Wood overacts on Earth, Earth fails to transport and rotate, resulting in abdominal hardness, intermittent painful diarrhea, amenorrhea, and chest stuffiness. Pulse is wiry and hard, Qi and Blood are depressed and stagnant. Propose promoting free flow of Qi and Blood. Only when menstruation flows freely can it be considered stable. Use Yan Shi Yi Qi San combined with Xiao Yao San.
Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian), Hua Bing Lang (Arecae Semen, 0.8 fen), Guang Pi (Citri Reticulatae Pericarpium, 1 qian), Chuan Duan (Dipsaci Radix, 3 qian), Sha Ren (Amomi Fructus Rotundus, 0.5 qian), Juan Bai (Serissae Herba, 3 qian).
Sheng Niu Xi (Achyranthis Bidentatae Radix, raw, 3 qian), Chao Zhi Ke (Aurantii Fructus Immaturus, stir-fried, 1 qian), Zi Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 2 qian), Xiao Yao San (Free and Easy Wanderer Powder, take first 3 qian).
Zhang (Right): Every time menstruation occurs, lower abdominal distension precedes it. Initially pale, gradually turning normal. Qi stagnation not promoted causes Ying Blood to become disharmonious. Should regulate Qi and nourish Ying.
Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian), Su Geng (Perillae Caulis, 2 qian), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 3 qian), Wu Yao (Linderae Radix, 1.5 qian), Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 qian), Zha Tan (Crataegi Fructus Carbonisatum, 2 qian).
Quan Dang Gui (Angelicae Sinensis Radix, 2 qian), Chuan Duan (Dipsaci Radix, 1.5 qian), Huo Xiang Zheng Qi Wan (Agaricus Pill, take first 3 qian).
Shen (Right): Yin deficiency with Qi weakness, Spleen fails to transport and rotate, storage and consolidation are insecure. Every winter, prone to wind invasion, stool alternates between constipation and loose, menstruation delayed, intermittent leukorrhea. Pulse is soggy and fine, coating thin white. Propose simultaneous regulation of Qi and Yin.
Dang Shen (Codonopsis Radix, 3 qian), Fu Ling (Poria, 3 qian), Chao Shan Yao (Dioscoreae Rhizoma, stir-fried, 3 qian), Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian), Chao Bian Dou (Lablab Semen Album, stir-fried, ground, 3 qian), Tong Sha Yuan (Tussilaginis Semen, stir-fried in salt water, 3 qian).
Yu Zhu (Atractylodis Rhizoma, 1 qian), Chao Mu Gua Pi (Chaenomelis Fructus Cortex, stir-fried, 2 qian), Tu Si Zi (Cuscutae Semen, stir-fried in salt water, 3 qian), Qi Zi (Lycii Fructus, 3 qian), Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia, take 1.5 qian in morning).
Second visit: Spleen deficiency causes alternating constipation and loose stool; Kidney deficiency leads to insecure storage and consolidation. During storage seasons, prone to colds and coughs, menstruation irregular, intermittent leukorrhea, pulse soggy and fine. Regulate Qi and Yin simultaneously, expanding from previous method.
Chao Yu Rou (Corni Fructus, stir-fried, 1.5 qian), Da Shu Di (Rehmanniae Radix Preparata, fried with Sha Ren, 4 qian), Hang Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian), Ju Bai (Citri Reticulatae Pericarpium Albugo, 1 qian), Kui Dang Shen (Codonopsis Radix, 3 qian), Chao Yu Zhu (Atractylodis Rhizoma, stir-fried, 2 qian).
Sheng Shan Yao (Dioscoreae Rhizoma, raw, 3 qian), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried, 0.3 qian), Fu Ling (Poria, 3 qian), Tong Sha Yuan (Tussilaginis Semen, stir-fried in salt water, 3 qian).
Third visit: Spleen deficiency fails to transport, Kidney deficiency fails to store. Spleen failure causes loose stool; Kidney failure causes insecure consolidation. Winter invites external pathogens leading to wheezing and coughing, menstruation becomes irregular, Dai (Belt) Vessel becomes insecure. Should regulate Spleen and Kidney simultaneously.
Zhi Mian (Astragali Radix, honey-fried, 3 liang), Chao Yu Rou (Corni Fructus, stir-fried, 1 liang), Chao Shan Yao (Dioscoreae Rhizoma, stir-fried, 2 liang), Kui Dang Shen (Codonopsis Radix, 4 liang), Yuan Zhi Rou (Polygalae Radix endocarp, 5 qian), Chao Bian Dou (Lablab Semen Album, stir-fried, 2 liang).
Chuan Duan Rou (Dipsaci Radix, 2 liang), Chao Yu Zhu (Atractylodis Rhizoma, stir-fried, 2 liang), Bai Fu Ling (Poria, 3 liang), Zhi Hei Cao (Glycyrrhizae Radix et Rhizoma, charred, 5 qian), Zhi Shou Wu (Polygoni Multiflori Radix Preparata, 4 liang), Tu Si Zi (Cuscutae Semen, 2 liang).
Po Gu Zhi (Psoraleae Fructus, 2 liang), Ba Ji Rou (Morindae Officinalis Radix, 2 liang), Gan Qi Zi (Lycii Fructus, 2 liang), Zhi Xiang Fu (Cyperi Rhizoma, processed, 1.5 liang), Tong Sha Yuan (Tussilaginis Semen, stir-fried in salt water, 3 liang), Guang Pi (Citri Reticulatae Pericarpium, 1 liang).
Da Shu Di (Rehmanniae Radix Preparata, fried with Sha Ren, 4 liang), Zhi Ban Xia (Pinelliae Rhizoma Preparatum, 1.5 liang), Fen Gui Shen (Angelicae Sinensis Radix, stir-fried with wine, 1.5 liang), Du Zhong (Eucommiae Cortex, 3 liang), Hang Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 liang).
Zi Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 1.5 liang), Ze Xie (Alismatis Rhizoma, 1 liang), Da Sheng Di (Rehmanniae Radix, ginger juice-fried, 4 liang), Chao Zao Ren (Ziziphi Spinosae Semen, stir-fried, ground, 1 liang).
Qing E Jiao (Asini Corii Colla, clear, 3 liang), Lu Jiao Jiao (Cervi Cornus Colla, 2 liang), Gui Ban Jiao (Testudinis Carapax et Plastrum Colla, 2 liang). Dissolve these three collas and make into paste. Take 7-8 qian in the morning.
Hu (Right): Blood from the twelve meridians pours into the Chong (Penetrating) Vessel; what flows down from the Chong Vessel is called menstruation. The Chong Vessel is an attendant vessel of the Liver. Emotional depression causes Wood and Earth disharmony, leading to Zhong Wan (Epigastrium) pain. Qi of the Chong Vessel becomes obstructed, menstruation occurs only after months, complexion is sallow and floating. Lips are white, tongue pale without luster, pulse is fine and choppy. Both Qi and Blood are stagnant, should promote free flow.
Chuan Gui Zhi (Cinnamomi Ramulus, 0.5 qian), Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian), Chao Zhi Ke (Aurantii Fructus Immaturus, stir-fried, 1 qian), Zi Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 2 qian), Dan Tao Ren (Persicae Semen, single, 2 qian), Bai Shao (Paeoniae Radix Alba, stir-fried with wine, 1.5 qian).
Quan Dang Gui (Angelicae Sinensis Radix, stir-fried with wine, 2 qian), Sha Ren Mo (Amomi Fructus Rotundus powder, 0.5 qian), Chong Wei Zi (Leonuri Fructus, 3 qian), Xiang Yuan Pi (Eupteleae Fructus Cortex, 1 qian).
Second visit: Promoted free flow of Ying stagnation, pulse slightly rose from fine, menstruation has not yet come, epigastric and abdominal pain persist. Chronic illness inevitably leads to Ying Blood stagnation. Continue promoting free flow.
Chuan Gui Zhi (Cinnamomi Ramulus, 0.5 qian), Dan Tao Ren (Persicae Semen, single, 2 qian), Zhi Xiang Fu (Cyperi Rhizoma, processed, 2 qian), Zi Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma, 2 qian), Chuan Duan Rou (Dipsaci Radix, 3 qian), Yan Hu Suo (Corydalis Rhizoma, stir-fried with wine, 1.5 qian).
Tai Wu Yao (Linderae Radix, 1.5 qian), Chao Chi Shao (Paeoniae Radix Rubra, stir-fried, 1.5 qian), Chong Wei Zi (Leonuri Fructus, 3 qian), Gui Shen (Angelicae Sinensis Radix, 2 qian), Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1 qian).
Chen (Right): Fire rises, causing dizziness and headache, dry eyes, and skin heat. Menstruation occurs several times a month. All due to Wood stagnation generating Fire. Temporarily clear and drain.
Gui Jia Xin (Testudinis Carapax et Plastrum Heart), Fen Dan Pi (Moutan Cortex, 2 qian), Hei Dou Yi (Sojae Semen Nigrum Testa), Nu Zhen Zi (Ligustri Lucidi Fructus), Shi Jue Ming (Haliotidis Concha), Bai Gui Shen (Angelicae Sinensis Radix).
Hang Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Ou Hai Gu (Sepiae Endoconcha), Zuo Mu Li (Ostreae Concha, stir-fried in salt water), Chao Bai Wei (Cynanchi Atrati Radix).
Xi (Right): Menstruation occurs several times a month, flowing like a surge. Ying Heat is severe, fearing blood explosion (metrorrhagia).
Da Sheng Di (Rehmanniae Radix), Dang Gui Tan (Angelicae Sinensis Radix Carbonisatum), Zhi Xiang Fu (Cyperi Rhizoma, processed), Dan Pi Tan (Moutan Cortex Carbonisatum), Xi Zi Qin (Scutellariae Radix), Ou Hai Gu (Sepiae Endoconcha), Lao Su Geng (Perillae Caulis, old), Yuan Shen (Scrophulariae Radix), Xian Ou (Nymphaeae Nelumbinis Rhizoma, decocted to replace water).
Second visit: Menstruation comes early, bright red and abundant, head distension and pain. Wind-Heat invades the Ying level.
Xi Zi Qin (Scutellariae Radix), Chao Fang Feng (Saposhnikoviae Radix, stir-fried), Dang Gui Tan (Angelicae Sinensis Radix Carbonisatum), Dan Pi Tan (Moutan Cortex Carbonisatum), Fu Shen (Poria with Hostwood), Zhi Xiang Fu (Cyperi Rhizoma, processed), Sheng Di Tan (Rehmanniae Radix Carbonisatum), Han Lian Cao (Ecliptae Herba), Zhi Ou Hai Gu (Sepiae Endoconcha, processed).
Yao (Right): Liver and Kidney have been deficient since youth, Wind-Yang rises, causing occasional headaches. Menstruation is delayed. Before onset, legs ache and abdomen distends; after onset, dripping continues endlessly. This is due to Ying Qi failing to promote free flow, meaning Qi stagnation leads to Blood stagnation. Thus, regulating Blood prioritizes regulating Qi.
Fen Quan Gui (Angelicae Sinensis Radix, powdered), Sha Ren (Amomi Fructus Rotundus), Zhi Xiang Fu (Cyperi Rhizoma, processed), Chuan Duan Rou (Dipsaci Radix), Lao Su Geng (Perillae Caulis, old), Jiang Xiang (Dalbergiae Odoriferae Lignum), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Chuan Xiong (Ligusticum Chuanxiong Rhizoma), Guang Pi (Citri Reticulatae Pericarpium).
Certain Patient (Right): Menstruation drips, lower abdominal pain, thighs pulled uncomfortably. Chong stasis not cleared makes Chong Vessel difficult to consolidate, fearing excessive congestion leading to collapse.
Dan Wu Zhu Yu (Evodiae Fructus, light, 0.3 qian), Chao Dang Gui (Angelicae Sinensis Radix, stir-fried), Su Geng (Perillae Caulis), Yan Hu Suo (Corydalis Rhizoma), Jiang Xiang (Dalbergiae Odoriferae Lignum), Sheng Shu Pu Huang (Typhae Pollen, raw and prepared, 0.4 qian each).
Nan Zha Tan (Crataegi Fructus Carbonisatum, southern type), Xiang Fu (Cyperi Rhizoma), Chao Chi Shao (Paeoniae Radix Rubra, stir-fried).
Zhang (Right): Menstruation drips, epigastric pain, lower abdominal dragging sensation, passing clumps and sheets. Chaotic Qi leads to chaotic Blood, unable to follow meridians.
Zhi Xiang Fu (Cyperi Rhizoma, processed), Sheng Shu Pu Huang (Typhae Pollen, raw and prepared), Bai Zhi (Angelicae Dahuricae Radix), Chuan Po (Magnoliae Officinalis Cortex), Da Fu Pi (Arecae Pericarpium), Qian Cao Tan (Rubiae Radix et Rhizoma Carbonisatum), Huo Xiang (Agastaches Herba), Ou Hai Gu (Sepiae Endoconcha), Fu Ling (Poria), Guang Pi (Citri Reticulatae Pericarpium), Su Geng (Perillae Caulis), Ban Xia Qu (Pinelliae Rhizoma fermented).
Zhu (Right): Menstruation drips, lower abdominal pain. Pulse wiry, Chi position choppy. Chong Qi unregulated means Chong Vessel insecure.
Zhi Xiang Fu (Cyperi Rhizoma, processed), Sheng Shu Pu Huang (Typhae Pollen, raw and prepared, 0.4 qian each), Sha Ren (Amomi Fructus Rotundus), Dang Gui Tan (Angelicae Sinensis Radix Carbonisatum), Fu Shen (Poria with Hostwood), Ou Hai Gu (Sepiae Endoconcha), Qian Cao Tan (Rubiae Radix et Rhizoma Carbonisatum), Mo Su Geng (Perillae Caulis, rubbed), Guang Pi (Citri Reticulatae Pericarpium), Tai Wu Yao (Linderae Radix).
Second visit: Regulating Qi and nourishing Ying does not stop bleeding but stops pain. However, dripping stabilizes and abdominal pain stops. This shows Blood is paired with Qi; when Qi is harmonious, erratic flow follows meridians without chaos. Previous method combined with nourishing Ying.
Mo Su Geng (Perillae Caulis, rubbed), Hang Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Shou Wu (Polygoni Multiflori Radix Preparata), Dang Gui (Angelicae Sinensis Radix), Guang Pi (Citri Reticulatae Pericarpium), Xiang Fu (Cyperi Rhizoma), Chao Zao Ren (Ziziphi Spinosae Semen, stir-fried), Sha Ren (Amomi Fructus Rotundus), Fu Shen (Poria with Hostwood).
Yao (Right): Qi is the commander of Blood. Pre-menstrual fullness and dripping during menstruation are all due to Qi stagnation not promoted. Regulating menstruation prioritizes regulating Qi; this statement is profound.
Quan Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Zhi Ban Xia (Pinelliae Rhizoma Preparatum), Shang Guang Pi (Citri Reticulatae Pericarpium, superior), Chuan Duan (Dipsaci Radix), Xiang Fu (Cyperi Rhizoma).
Zi Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Lao Su Geng (Perillae Caulis, old), Huo Xiang Zheng Qi Wan (Agaricus Pill).
Tan (Right): Every time menstruation occurs, masses attack causing pain and distension, sometimes vomiting. Qi and Blood stasis intersect. Temporarily promote free flow.
Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligusticum Chuanxiong Rhizoma), Yan Hu (Corydalis Rhizoma), Peng Zhu (Curcumae Zedoariae Rhizoma), Wu Yao (Linderae Radix), Ju Luo (Citri Reticulatae Pericarpium Viride Retinervum, stir-fried with Hong Hua decoction), Zha Tan (Crataegi Fructus Carbonisatum), Gui Zhi (Cinnamomi Ramulus), Xiang Fu (Cyperi Rhizoma), Qing Pi (Citri Reticulatae Pericarpium Immaturum, green peel), Xing Jiang (Calami Rhizoma? Or specific variant), Chao Chi Shao (Paeoniae Radix Rubra, stir-fried).
Chen (Right): Menstruation approaches, unbearable abdominal pain. Blood descends. Before coming, distension; about to come, pain; after coming, pain gradually settles. Blood deficiency with Qi stagnation. Should supplement insufficient Blood and disperse excess Qi.
Zhi Shu Di (Rehmanniae Radix Preparata, honey-fried), Chao Qi Zi (Lycii Fructus, stir-fried), Xiang Fu (Cyperi Rhizoma), Quan Gui (Angelicae Sinensis Radix), Wu Yao (Linderae Radix), Sha Ren (Amomi Fructus Rotundus), Chuan Duan Rou (Dipsaci Radix), Bai Shao (Paeoniae Radix Alba), Zha Tan (Crataegi Fructus Carbonisatum).
Chen (Right): Qi presses upward on Lung, Heart Qi cannot descend downward, menstruation does not come. Therefore daily activities are normal, no abdominal pain or distension. Use Wu Shuqing’s Modified Dao Tan (Guide Out Phlegm) method.
Zhong Po (Magnoliae Officinalis Cortex, central part, 1 liang), Yun Ling (Poria, cloud type, 3 liang), Zhi Ban Xia (Pinelliae Rhizoma Preparatum, 2 liang), Zhi Shi (Aurantii Fructus Immaturus, 1 liang), Chuan Xiong (Ligusticum Chuanxiong Rhizoma, 1.2 liang), Ya Lian (Coptidis Rhizoma, elegant, 3 qian), Guang Pi (Citri Reticulatae Pericarpium, 1.2 liang).
Grind into fine powder, form pills with Ginger Juice similar to mung bean size. Take 3 qian every morning.
Certain Patient (Right): Menstruation stopped for fifteen months, yet daily activities are normal, pulse slow, coating thin white. This is named "Xie" (Rest), self-healing without treatment, but requires waiting patiently.
Quan Dang Gui (Angelicae Sinensis Radix), Ju Bai (Citri Reticulatae Pericarpium Albugo), Tu Chao Bai Shao (Paeoniae Radix Alba, earth-stir-fried), Bai Ji Li (Tribuli Fructus), Zhi Xiang Fu (Cyperi Rhizoma, processed), Ban Xia Qu (Pinelliae Rhizoma fermented), Fu Ling (Poria), Sheng Shu Gu Ya (Oryzae Fructus Germinatus, raw and prepared), Tian Xing Ren (Pruni Armeniacae Semen, sweet, stir-fried fragrant).
Lin (Right): Blood from all meridians converges in the Chong (Penetrating) Vessel; what flows down from the Chong Vessel is called menstruation. Chong Qi unregulated, blood gathers during menstruation, Chong Qi blocked, hence distension is often severe. Imitate Jin Gui Wen Jing (Warm the Meridians) method.
Ren Shen Xu (Ginseng Radix et Rhizoma tendril, 1 qian), Ze Xie (Alismatis Rhizoma, 1.5 qian), Zhi Hei Cao (Glycyrrhizae Radix et Rhizoma, charred, 0.3 qian), Fen Dan Pi (Moutan Cortex, 2 qian), Chao Mai Dong (Ophiopogonis Radix, stir-fried, 3 qian), Fen Gui Shen (Angelicae Sinensis Radix, 2 qian).
Pao Jiang (Zingiberis Rhizoma Preparatum, 0.4 qian), Zhen E Jiao (Asini Corii Colla, authentic, 1.5 qian), Shang Yao Gui (Cinnamomi Ramulus, superior, 0.2 qian, ground to powder, rice pill, dried, take first).
You (Right): Every time menstruation occurs, waist and abdomen hurt. Recently, Zhong Wan (Epigastrium) uncomfortable, food regurgitation, headache and vertigo, chills and fever at times. This is Qi stagnation and Blood deficiency, Liver and Stomach disharmony. First harmonize Liver and Stomach.