瘀血留滞作症，惟妇人有之。其证则或由经期，或由产后，凡内伤生冷，或外受风
寒，或恚怒伤肝，气逆而血留，或忧思伤脾，气虚而血滞，或积劳积弱，气弱而不行，总由
血动之时，余血未净，而一有所逆，则留滞日积而渐以成症矣。然血必由气，气行则血
行。故凡欲治血，则或攻或补，皆当以调气为先。罗谦甫曰∶养正邪自除。必先调养，使营
卫充实。若不消散，方可议下。但除之不以渐，则必有颠覆之害。若不守禁忌，纵嗜欲，其
有不丧身者鲜矣。
一、血瘀作痛，或成形不散，在脐腹之下。若暂见停蓄而根盘未固者，只宜五物煎，或
决津煎加减主之，则血无不去，痛无不止，足称神剂。
一、妇人形气病气俱实，或腹胀，或痛甚，而新有所逆，但欲行滞止痛者，宜通瘀煎、
失笑散、玄胡当归散、加减四物汤之类，疏之导之，气通滞去，痛必自愈。若稍久且坚而欲
消之磨之，宜三棱煎、万病丸之类主之。
一、形气强壮而瘀血不行，或大病结闭，或腹胀痛甚，有非下不可者，宜《良方》桃仁
承气汤下之最捷，或用夺命丹、桃仁煎、穿山甲散、赤金豆之类皆可。然下须详慎，非有大
实不得已之证，不宜妄用。
一、养正之法，当察阴阳上下，病之久新，及邪正强弱之势。其有停瘀虽甚而元气困弱
者，不可攻。病久而弱，积难摇动者，不可攻。凡此之类，皆当专固根本，以俟其渐磨渐愈
，乃为良策。如郁结伤脾者，宜用归脾汤、逍遥饮、寿脾煎。脾胃虚寒者，宜温胃饮、养中
煎、六君子汤。肝肾虚寒者，宜大营煎、暖肝煎、理阴煎，或《良方》交加散亦可。脾肾虚
寒，大便泄泻或不实者，宜胃关煎、理阴煎。病久脾肾气滞而小腹痛胀者，宜八味地黄丸。
肝火不清，血热而滞者，宜加味逍遥散。以上诸证，凡虚中带滞者，不妨于前药中各加行气
导滞之品，此在用者之圆活也。
一、妇人久 宿痞，脾肾必亏，邪正相搏，牢固不动，气联子脏则不孕，气联冲任
则月水不通。内治之法宜如前，外以阿魏膏贴之，仍用熨痞方，或用琥珀膏亦可。然必须切
慎七情及六淫、饮食起居，而不时随证调理，庶乎可愈。
瘀血停留阻滞而形成的症积，只有妇女才会得。这种病症，有的是因为月经期间，有的是因为产后，凡是内伤生冷食物，或者外感风寒邪气，或者愤怒导致肝气受伤，气机逆乱而血液留滞，或者忧思过度损伤脾气，气虚而导致血液停滞，或者长期劳累、体质虚弱，气弱而不能推动血液运行，总归是在血液变动的时候，残留的血液没有排净，一旦遇到气机逆乱的情况，就会日积月累地停留阻滞，逐渐形成症积。然而，血液的运行必须依赖气的推动，气行则血行。所以凡是想要治疗血病，无论是攻伐还是补益，都应当以调理气机为先。罗谦甫说：“养护正气，邪气自然消除。”必须先进行调养，使营气和卫气充实。如果症状不能消散，才可以考虑使用攻下法。但是如果不循序渐进地去除，就必然会有危及生命的危害。如果不遵守禁忌，放纵嗜欲，能够不丧失性命的就太少了。
一、血瘀引起疼痛，或者形成有形之物不散，位于脐腹之下。如果是暂时出现停蓄且根基未稳固的，只适宜用五物煎，或者决津煎加减来主治，这样血就能去除，痛就能停止，足以称为神奇的方剂。
一、妇人形体和元气以及病气都实盛的，或者腹胀，或者疼痛剧烈，并且是新近受到气机逆乱的，只要是想疏通滞气、止痛的，适宜用通瘀煎、失笑散、玄胡当归散、加减四物汤这类方剂，疏利导引，气机通畅、滞气去除，疼痛必定自愈。如果病程稍久且质地坚硬，想要消磨消散的，适宜用三棱煎、万病丸之类的主治。
一、形体元气强壮但瘀血不行，或者大病结闭，或者腹胀疼痛剧烈，有非用攻下法不可的情况，适宜用《良方》中的桃仁承气汤攻下最为快捷，或者使用夺命丹、桃仁煎、穿山甲散、赤金豆之类都可以。但是攻下必须详细审慎，如果不是有大实证不得已的情况，不宜妄加使用。
一、养护正气的治法，应当观察阴阳上下、疾病的久暂新久，以及邪气与正气的强弱态势。其中有停瘀虽然严重但元气困弱的人，不可攻伐。病程长且体弱，积滞难以动摇的，不可攻伐。像这一类情况，都应当专门巩固根本，等待其逐渐磨消逐渐痊愈，这才是好策略。如郁结损伤脾气的，适宜用归脾汤、逍遥饮、寿脾煎。脾胃虚寒的，适宜用温胃饮、养中煎、六君子汤。肝肾虚寒的，适宜用大营煎、暖肝煎、理阴煎，或者《良方》中的交加散也可以。脾肾虚寒，大便泄泻或不成形的，适宜用胃关煎、理阴煎。病程长导致脾肾气滞且小腹痛胀的，适宜用八味地黄丸。肝火不清，血热而滞涩的，适宜用加味逍遥散。以上各种证候，凡是虚证中夹杂滞涩的，不妨在前面的药物中各加入行气导滞的药物，这在于使用者的灵活变通。
一、妇人长久患有宿痞（腹部积块），脾肾必然亏损，邪气与正气相互搏结，牢固不动，气机牵连子宫就会导致不孕，气机牵连冲脉任脉就会导致月经不通。内治的方法应该像前面所说的那样，外用阿魏膏贴敷，仍然使用熨痞方，或者使用琥珀膏也可以。然而必须谨慎对待七情（喜、怒、忧、思、悲、恐、惊）以及六淫（风、寒、暑、湿、燥、火）、饮食起居，并且不时根据证候进行调理，这样才能痊愈。
Symptoms of mass formation caused by the retention and stagnation of blood stasis occur only in women. These conditions may arise during menstruation or postpartum. They result from internal injury due to cold and raw food, external contraction of wind-cold pathogenic factors, anger injuring the Liver causing Qi rebellion and subsequent blood stagnation, excessive worry damaging the Spleen leading to Qi deficiency and blood stasis, or chronic fatigue and weakness resulting in Qi deficiency failing to move blood. In all cases, when blood is in motion, if residual blood remains uncleaned and encounters any disruption in Qi flow, it will accumulate day by day, gradually forming masses. However, blood relies on Qi for movement; where Qi moves, blood moves. Therefore, in treating blood disorders, whether employing purgative or tonifying methods, regulating Qi must be prioritized. Luo Qianfu stated: "Nourishing the upright Qi causes the pathogenic factors to eliminate themselves." One must first regulate and nourish to ensure the sufficiency of Ying (Nutritive) and Wei (Defensive) Qi. Only if the mass does not dissipate should one consider using purgative methods. However, removing it without gradual progression inevitably leads to catastrophic harm. If one fails to observe dietary and lifestyle taboos and indulges in desires, few will escape losing their lives.
1. Pain caused by blood stasis, or the presence of formed masses that do not disperse, located below the umbilicus and abdomen. If the accumulation is recent and the root is not yet solidified, Wuwu Decoction (Five-Ingredient Decoction) or Juejin Decoction (Decoction for Crossing the Ford), with modifications, are appropriate. This ensures the removal of blood stasis and cessation of pain, truly deserving the title of a miraculous formula.
2. For women presenting with excess in both constitution and pathology, accompanied by abdominal distension or severe pain, and recent onset of Qi disruption, aiming to move stagnation and relieve pain, Tongyu Decoction (Decoction for Promoting Blood Circulation), Shixiao San (Pain-Stopping Powder), Xuanhu Danggui San (Corydalis and Angelica Powder), or Jiawei Siwu Tang (Modified Four-Substance Decoction) are suitable to soothe and guide the flow. Once Qi flows freely and stagnation is removed, pain will resolve spontaneously. If the condition has persisted longer and the mass is hard, requiring gradual dissolution, Sanleng Decoction (Decoction with Burreed Rhizome) or Wanbing Wan (Ten-Thousand-Disease Pill) may be used.
3. For individuals with strong constitution but stagnant blood, or those suffering from severe obstruction due to major illness, or intense abdominal distension and pain requiring purgation, Taoren Chengqi Tang (Peach Kernel and Rheum Decoction) from *Liangfang* (Excellent Prescriptions) is the most rapid option. Alternatively, Duoming Dan (Life-Snatching Pill), Taoren Jian (Peach Kernel Decoction), Chuanshanjia San (Pangolin Scale Powder), or Chijin Dou (Red Gold Bean) may be employed. However, purgation requires extreme caution and should not be used recklessly unless there is a clear excess syndrome necessitating it.
4. The method of nourishing upright Qi requires observing Yin and Yang, upper and lower regions, the duration and novelty of the disease, and the relative strength of pathogenic versus upright Qi. Even if blood stasis is severe, if Yuan Qi (Original Qi) is weak, purgation is contraindicated. If the disease is chronic and the patient is weak, with accumulations difficult to dislodge, purgation is contraindicated. In such cases, one should focus on consolidating the root and wait for gradual improvement through mild treatment. For cases where emotional constraint damages the Spleen, Guipi Tang (Restore the Spleen Decoction), Xiaoyao Yin (Free and Easy Wanderer Drink), or Shoupi Jian (Spleen-Nourishing Decoction) are indicated. For Spleen and Stomach deficiency-cold, Wenwei Yin (Stomach-Warming Drink), Yangzhong Jian (Middle-Nourishing Decoction), or Liujunzi Tang (Six-Gentlemen Decoction) are appropriate. For Liver and Kidney deficiency-cold, Daying Jian (Great Camp Nourishing Decoction), Nuangan Jian (Liver-Warming Decoction), or Liyin Jian (Yin-Nourishing Decoction) are suitable, or Jiajia San (Additive Powder) from *Liangfang*. For Spleen and Kidney deficiency-cold with loose stools or incomplete evacuation, Weiguan Jian (Stomach Gate Decoction) or Liyin Jian are indicated. For chronic disease leading to Spleen and Kidney Qi stagnation with lower abdominal pain and distension, Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) is used. For unextinguished Liver Fire causing blood heat and stagnation, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is appropriate. In all the above syndromes involving deficiency with concurrent stagnation, Qi-moving and stagnation-resolving herbs may be added to the aforementioned formulas, demonstrating the practitioner's flexibility.
5. Women with long-standing fixed masses (Pi) inevitably suffer from Spleen and Kidney deficiency. Pathogenic factors and upright Qi struggle against each other, making the mass firm and immobile. If Qi affects the Zi Zang (Uterus), infertility results; if it affects the Chong and Ren Mai (Penetrating and Conception Vessels), amenorrhea occurs. Internal treatment follows the principles mentioned above. Externally, Awei Gao (Asafoetida Plaster) can be applied, along with Yupi Fang (Plaster for Masses) or Hupo Gao (Amber Plaster). However, one must strictly avoid emotional disturbances (Seven Emotions), Six Exogenous Pathogens (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), and maintain proper diet and daily routine, while adjusting treatment according to symptoms as they change, for recovery to be achieved.