沈尧封曰∶经来声荀证。苟恒大兄长女，嫁斜塘倪姓，早寡，体气虚弱，每逢月事，声音必哑。予用
天冬、地黄、苁蓉、归身等药，病益甚，张口指画，毫无一字可辨。即于此方加细辛少许，以通少阴之络，药
才入口，其声即出。十余剂后，桂附八味丸调理，永不发。
撮要云∶经后目暗，属血虚。
汪石山曰∶经行泄泻，属脾虚多湿，宜参苓白术散。
王孟英按∶亦有肝木侮土者。
缪氏曰∶经行白带，属阳虚下陷，用参、术助阳之药。
王孟英按∶亦有郁火内盛者。
《素问》云∶二阳之病发心脾，有不得隐曲，女子不月；其传为风消，其传为息贲者，死不治。
沈尧封曰∶二阳指阳明经言，不指脏腑言。二阳之病发心脾者，阳明为多血之经，血乃水谷之精气，借
心火锻炼而成。忧愁思虑伤心，因及其子，不嗜饮食，血无以资生，阳明病矣。经云，前阴总宗筋之所会，会
于气街，而阳明为之长，故阳明病，则阳事衰而不得隐曲也；太冲为血海，并阳明之经而行，故阳明病，则
冲脉衰而女子不月也。
王孟英按∶经水固以月行为常，然阴虚者多火，经每先期。阴愈虚，行愈速，甚至旬日半月而一行。更
有血已无多，而犹每月竭蹶一行者，其涸也，可立而待也。若血虽虚而火不甚炽，汛必愆期，此含蓄有权，虽
停止一二年，或竟断绝不行，但其脉不甚数者，正合坤主吝啬之道，皆可无虑。昧者不知此理，而但凭月事
以分病之轻重，闻其不行，辄欲通之，竭泽而渔，不仁甚矣。
《金匮》云∶妇人病，因虚、积冷、结气，经水断绝。
张景岳曰∶经闭有血隔、血枯之不同。隔者病于暂，通之则愈；枯者其来也渐，补养乃充。
沈尧封曰∶《金匮》三证，积冷、结气，有血不行也，景岳谓之血隔。积冷宜用肉桂大辛热之药，导血下
行，后用养荣之药调之；结气宜宣，如逍遥散，或乌药、香附行气之品宣之。虚者，无血可行也，景岳谓之血
枯宜补，赵养葵补水、补火、补中气三法，最为扼要。
王孟英按∶补水勿泥于六味，补火勿泥于八味，补中气勿泥于归脾。
附录魏玉璜一贯煎方 治肝肾阴虚，气滞不运，胁肋攻痛，胸腹 胀，脉反细弱，或虚弦，舌无津液，喉
嗌干燥者。
沙参 麦冬 生地 归身 杞子 川楝子
口苦燥者，加酒炒川连。
附录集灵膏方（从王秉衡《重庆堂随笔》）人生五十，阴气先衰，老人阴亏者多。此方滋养真阴，柔和筋骨。
西洋参（取结实壮大者，刮去皮，饭上蒸九次，日中晒九次） 甘杞子 怀牛膝（酒蒸） 天冬 麦冬
怀生地 怀熟地 仙灵脾 八味等分，熬成膏，白汤或温酒调服。
附录滋水清肝饮方（高鼓峰） 治阴虚肝气郁窒，胃脘痛，胁痛，脉虚弦或细软，舌苔光滑鲜红者。
方即六味地黄汤加归身、白芍、柴胡、山栀、大枣。
附录薛一瓢滋营养液膏方
女贞子 旱莲草 霜桑叶 黑芝麻 黄甘菊 枸杞子 当归身 白芍药 熟地黄 黑大豆 南烛叶
白茯神 葳蕤 橘红 沙苑蒺藜 炙甘草
天泉水熬浓汁，入黑驴皮胶，白蜜炼收。
附录薛一瓢心脾双补丸方
西洋参（蒸透） 白术（蒸熟） 茯神 甘草 生地黄 丹参 枣仁 远志肉 北五味 麦门冬 玄参
柏子仁 黄连 香附（制） 川贝母 桔梗 龙眼肉
附录陆九芝坎离丸方论
九芝封翁世补斋文曰∶坎离丸者，山右阎诚斋观察取作种子第一方，最易最简，最为无弊。方乃红枣、
黑豆等分。红枣色赤入心，取其肉浓者，蒸熟去皮核；黑豆色黑入肾，即大黑豆，非马料豆，用桑椹汁浸透，
亦于饭锅内蒸之，蒸熟再浸再蒸。二味合捣令如泥，糊为丸，或印成饼。随宜服食，亦能乌须发，壮筋骨，以
此种玉，其胎自固，而子亦多寿。壬午夏，曾以此方贡于徐侍郎颂阁，入之便贱验方中。世之专事补阳而用
硫、附辈者，慎不可从。如果阳道不起，不能坚久，精薄无子，还是鹿茸，尚为血肉有情之品。然亦须同二
冬、二地及黄柏一味，大补其阴，则男妇皆可服，此亦诚斋之说也。
寇宗 曰∶童年情窦早开，积想在心，月水先闭。盖忧愁思虑则伤心，心伤则血耗竭，故经水闭也；火
既受病，不能荣养其子，故不嗜食；脾既虚则金气亏，故发嗽；嗽既作则水气竭，故四肢干；木气不充，故
多怒，发鬓焦，筋痿。五脏以次传遍，故猝不死而终死也，比于诸劳，最为难治。
沈尧封曰∶此条亦从《金匮》虚字内分出，实有是证。但此所愿不得，相火必炽，非补水无以制之。六
味地黄汤，补阴泻阳，固是妙法。然脾虚食减，倘嫌地黄腻膈，炒松可也，不然以女贞易之，顾名思义，并
泻相火。
王孟英按∶此证最难治。六味碍脾，归脾助火，惟薛一瓢滋营养液膏加小麦、大枣、远志，庶几合法。一
瓢又有心脾双补丸，亦可酌用。
楼全善曰∶经闭有污血凝滞胞门一证。罗谦甫血极膏，一味大黄为末，醋熬成膏，服之利一二行，经
血自下，是妇科仙药。
沈尧封曰∶《金匮》论经闭，有冷无热，非阙文也。盖天暑地热，则经水沸溢，岂反有凝泣不来之理？
洁古、东垣，降心火、泻三焦之说，不可尽信，即骨蒸内热，亦属阴亏，非同实火之可寒而愈。
王孟英按∶王子亨《全生指速方》地黄煎，以生地汁八两，熬耗一半，内大黄末一两同熬，候可丸，丸
如梧子大。熟水下五粒，未效加至十粒。治女子气竭伤肝，月事不来，病名血枯。盖瘀血不去，则新血枯也。
即《内经》乌 芦茹丸、仲景大黄 虫丸之义。后人但知彼血枯为血虚，而不知血得热则瘀，反用温补，岂
能愈此血枯之病？尧封亦为此论，毋乃欠考。
朱丹溪曰∶肥人痰塞胞门，宜浓朴二陈汤。
沈尧封说：月经来潮时声音嘶哑的证候。荀恒大的长女，嫁到斜塘倪家，早年守寡，体质虚弱，每次来月经时，声音必定嘶哑。我用天冬、地黄、肉苁蓉、当归身等药物治疗，病情反而加重，张嘴比划，完全无法辨认字句。就在这个方剂中加入少许细辛，以疏通少阴经的络脉，药刚入口，声音立刻恢复。服用十余剂后，用桂附八味丸进行调理，从此不再复发。
摘要指出：月经结束后视力模糊，属于血虚。
缪氏说：经期白带增多，属于阳虚下陷，应使用人参、白术等助阳药物。
《素问》说：阳明经的病发于心脾，有难以启齿的隐情，女子会出现月经不来；如果传变为风消（形容消瘦如被风吹干），或传变为息贲（呼吸急促、胸中积气），则是死症，无法治疗。
沈尧封说：“二阳”指的是阳明经，而不是指脏腑。“二阳之病发心脾”，是因为阳明经是多血之经，血液是由水谷的精微之气，借助心火的锻炼而形成的。忧愁思虑会损伤心脏，进而波及肝脏（心之子为肝，此处原文逻辑似有误，通常心火生脾土，或心主血脉，思虑伤脾，但沈氏解释为“因及其子”，结合下文“不嗜饮食”，实指思虑伤脾，脾为气血生化之源。此处依原文直译并保留中医逻辑）：导致食欲不振，血液失去化生的来源，阳明经就会生病。经文说，前阴是宗筋汇聚的地方，汇聚于气街，而阳明经统领于此，所以阳明经生病，就会导致性功能衰退和难以启齿的隐疾；太冲脉是血海，与阳明经并行，所以阳明经生病，冲脉就会衰弱，导致女子月经不来。
王孟英按语：月经固然以每月按时来潮为常态，然而阴虚的人往往多火，月经常常提前。阴越虚，行经越快，甚至十天半个月就来一次。更有甚者，血量已经很少，却还要勉强每月来潮一次，这种枯竭的状态，是可以立即预见的。如果血虽虚但火并不炽盛，月经必定延期，这是含蓄有度的表现，即使停止一两年，或者竟然断绝不行，只要脉搏不是特别快，正符合坤卦主吝啬（收敛）的道理，都可以不必担忧。愚昧的人不懂这个道理，仅仅凭月经情况来判断病情轻重，听到月经不来，就想强行通经，竭泽而渔，太不仁义了。
《金匮要略》说：妇女患病，因虚损、积冷、结气，导致经水断绝。
张景岳说：闭经有血隔和血枯的不同。血隔是暂时性的病变，通经即可痊愈；血枯是逐渐形成的，需要补养才能充盈。
沈尧封说：《金匮要略》中的三种证候，积冷和结气，会导致血液运行不畅，张景岳称之为血隔。积冷适宜使用大辛大热的肉桂，引导血液下行，之后用养荣的药物调理；结气适宜宣通，如逍遥散，或用乌药、香附等行气药物宣通。虚证，是没有血液可以运行，张景岳称之为血枯，适宜补益，赵养葵提出的补水、补火、补中气三法，最为扼要。
王孟英按语：补水不要拘泥于六味地黄丸，补火不要拘泥于八味地黄丸，补中气不要拘泥于归脾汤。
附录魏玉璜一贯煎方：治疗肝肾阴虚，气滞不运，胁肋攻痛，胸腹胀满，脉象反见细弱或虚弦，舌面无津液，咽喉干燥者。
沙参、麦冬、生地、当归身、枸杞子、川楝子。
口苦燥者，加酒炒黄连。
附录集灵膏方（选自王秉衡《重庆堂随笔》）：人到了五十岁，阴气先衰，老年人多阴亏。此方能滋养真阴，柔和筋骨。
西洋参（选取结实壮大者，刮去皮，在饭上蒸九次，在阳光下晒九次）、甘枸杞子、怀牛膝（酒蒸）、天冬、麦冬、怀生地、怀熟地、仙灵脾。以上八味等分，熬成膏，用白开水或温酒调服。
附录滋水清肝饮方（高鼓峰）：治疗阴虚肝气郁窒，胃脘痛，胁痛，脉虚弦或细软，舌苔光滑鲜红者。
方剂即六味地黄汤加入当归身、白芍、柴胡、山栀、大枣。
附录薛一瓢滋营养液膏方
女贞子、旱莲草、霜桑叶、黑芝麻、黄甘菊、枸杞子、当归身、白芍药、熟地黄、黑大豆、南烛叶、白茯神、葳蕤、橘红、沙苑蒺藜、炙甘草。
用天泉水熬制浓汁，加入黑驴皮胶，用白蜜炼收。
附录薛一瓢心脾双补丸方
西洋参（蒸透）、白术（蒸熟）、茯神、甘草、生地黄、丹参、枣仁、远志肉、北五味子、麦门冬、玄参、柏子仁、黄连、香附（制）、川贝母、桔梗、龙眼肉。
附录陆九芝坎离丸方论
九芝封翁世补斋文章说：坎离丸，是山西阎诚斋观察使取作第一种子方，最容易、最简单，也最为没有弊端。方子是红枣和黑豆等分。红枣色赤入心，选取肉质厚实的，蒸熟去皮去核；黑豆色黑入肾，即大黑豆，不是马料豆，用桑椹汁浸透，也在饭锅内蒸，蒸熟再浸再蒸。两味合捣成泥状，用糊做成丸，或印成饼。随意食用，也能使须发变黑，强壮筋骨，以此种玉，胎元自然稳固，子女也多长寿。壬午年夏天，曾将此方献给徐侍郎颂阁，收录在便贱验方中。世上专门从事补阳而使用硫磺、附子之类的人，千万不要听从。如果确实阳道不起，不能坚久，精薄无子，还是鹿茸，尚且属于血肉有情之品。但也必须同天冬、麦冬、生地、熟地及黄柏一味药一起，大补其阴，则男女皆可服用，这也是诚斋的说法。
寇宗奭说：童年时期情窦早开，积想在心中，月经先闭。大概忧愁思虑会损伤心脏，心脏受伤则血液耗竭，所以经水闭止；火既然受病，不能荣养其子（脾），所以不喜欢进食；脾既虚弱则肺气亏损，所以发生咳嗽；咳嗽既发作则肾水气竭，所以四肢干枯；肝木气不充，所以易怒，头发鬓角焦枯，筋痿。五脏依次传遍，所以突然不死但最终死亡，比起各种劳损，最为难治。
沈尧封说：这一条也是从《金匮要略》的“虚”字内分出来的，确实有这样的证候。但是这种情况所愿不得，相火必然炽盛，不补水就无法制约它。六味地黄汤，补阴泻阳，固然是妙法。然而脾虚食减，如果觉得地黄腻膈，可以炒松使用，否则用女贞子代替，顾名思义，并能泻相火。
王孟英按语：这个证候最难治疗。六味地黄丸碍脾，归脾汤助火，只有薛一瓢的滋营养液膏加上小麦、大枣、远志，才比较合乎法度。一瓢又有心脾双补丸，也可以酌情使用。
楼全善说：闭经有污血凝滞胞门这一证候。罗谦甫的血极膏，一味大黄研末，醋熬成膏，服用后利下一二行，经血自然下行，是妇科仙药。
沈尧封说：《金匮要略》论述闭经，只谈冷不谈热，并非缺文。大概天气暑热，地热上升，经水就会沸溢，难道反而会有凝涩不来的道理吗？洁古、东垣关于降心火、泻三焦的说法，不可尽信，即使是骨蒸内热，也属于阴亏，不同于实火可以用寒凉治愈。
王孟英按语：王子亨《全生指迷方》的地黄煎，用生地汁八两，熬去一半，加入大黄末一两同熬，等到可以丸药时，做成梧桐子大小。熟水送服五粒，无效加至十粒。治疗女子气竭伤肝，月事不来，病名血枯。大概瘀血不去，新血就会枯竭。这就是《内经》乌贼鱼丸、芦茹丸，以及仲景大黄䗪虫丸的含义。后人只知道那种血枯是血虚，而不知道血得热则瘀，反而使用温补，怎么能治好这种血枯的病呢？尧封也为此论，未免欠考虑。
Shen Yaofeng stated: Regarding the syndrome of hoarseness during menstruation. The eldest daughter of Xun Hengda, who married into the Ni family in Xietang and became a widow early, had a weak constitution. Every time she menstruated, her voice would become hoarse. I used herbs such as Asparagi Radix (Tian Dong), Rehmanniae Radix (Di Huang), Cistanches Herba (Rong Rong), and Angelicae Sinensis Radix (Gui Shen) for treatment, but the condition worsened; she opened her mouth and gestured, unable to articulate any words. By adding a small amount of Lignei Saposhnikoviae Radix (Xi Xin) to this prescription to unblock the collaterals of the Shaoyin channel, her voice recovered immediately after taking the medicine. After more than ten doses, she was regulated with Gui Fu Ba Wei Wan (Cinnamon Twig and Aconite Pill), and the condition never recurred.
The summary states: Blurred vision after menstruation belongs to Blood deficiency.
Wang Shishan said: Diarrhea during menstruation belongs to Spleen deficiency with dampness; Shen Ling Bai Zhu San is appropriate.
Wang Mengying noted: There are also cases where Liver Wood overacts on Earth (Spleen).
Miao Shi said: Leukorrhea during menstruation belongs to Yang deficiency with sinking; herbs that assist Yang, such as Ginseng Radix (Ren Shen) and Atractylodis Macrocephalae Rhizoma (Bai Zhu), should be used.
Wang Mengying noted: There are also cases where internal stagnant fire is abundant.
Su Wen states: Diseases of the Two Yangs originate from the Heart and Spleen. If there are hidden difficulties or emotional constraints, women will not menstruate. If it transmits to Feng Xiao (wasting syndrome resembling wind-drying), or to Xi Ben (accumulated Qi causing shortness of breath), it is a death case and untreatable.
Shen Yaofeng stated: "Two Yangs" refers to the Yangming Channel, not the Zang-Fu organs. "Diseases of the Two Yangs originating from the Heart and Spleen": The Yangming Channel is a channel abundant in Blood. Blood is formed from the essence of water and grain, refined by Heart Fire. Worry and anxiety damage the Heart, which then affects its child organ (Liver/Spleen context implies Spleen as source of blood, though text says "child", traditionally Heart generates Spleen/Earth, or Heart Fire warms Spleen; here Shen interprets it as affecting digestion/blood generation). This leads to loss of appetite, and since Blood has no source to be generated, the Yangming Channel becomes diseased. The classic text says, the anterior yin is the convergence of all sinews, converging at Qichuan, and the Yangming Channel governs it. Therefore, when the Yangming Channel is diseased, sexual function declines and hidden difficulties arise. Taichong is the Sea of Blood, running alongside the Yangming Channel. Therefore, when the Yangming Channel is diseased, the Chong Mai (Penetrating Vessel) declines, and women do not menstruate.
Wang Mengying noted: Although regular monthly menstruation is normal, those with Yin deficiency often have excessive fire, causing menstruation to occur early. The more deficient the Yin, the faster the flow, sometimes occurring every ten days or half a month. Even worse, when blood volume is already low, forcing a monthly cycle indicates imminent exhaustion. If blood is deficient but fire is not intense, menstruation will be delayed. This reflects the principle of containment (Kun trigram's attribute of frugality/concealment); even if menstruation stops for one or two years or ceases entirely, as long as the pulse is not rapid, there is no need to worry. Ignorant people do not understand this principle; they judge disease severity solely by menstrual status. Upon hearing of amenorrhea, they rush to promote flow, draining the pond to catch fish, which is extremely inhumane.
Jingui Yaolue states: Women's diseases caused by deficiency, accumulated cold, and constrained Qi lead to the cessation of menstruation.
Zhang Jingyue stated: Amenorrhea differs between Blood obstruction (Xue Ge) and Blood depletion (Xue Ku). Obstruction is temporary; promoting flow cures it. Depletion develops gradually; nourishment and tonification restore it.
Shen Yaofeng stated: In Jingui Yaolue, accumulated cold and constrained Qi cause blood stasis, which Zhang Jingyue calls Blood obstruction. Accumulated cold should be treated with large acrid-hot herbs like Cinnamomi Cortex (Rou Gui) to guide blood downward, followed by Ying Rong (Nourishing Glory) herbs for regulation. Constrained Qi should be diffused, using formulas like Xiao Yao San or Qi-moving herbs like Linderae Radix (Wu Yao) and Cyperi Rhizoma (Xiang Fu). Deficiency means there is no blood to move, which Zhang Jingyue calls Blood depletion, requiring tonification. Zhao Yangkui’s three methods—tonifying Water, tonifying Fire, and tonifying Middle Qi—are most essential.
Wang Mengying noted: When tonifying Water, do not stick rigidly to Liu Wei Di Huang Wan; when tonifying Fire, do not stick rigidly to Ba Wei Di Huang Wan; when tonifying Middle Qi, do not stick rigidly to Gui Pi Tang.
Appendix: Yi Guan Jian Formula by Wei Yuhuang. Treats Liver-Kidney Yin deficiency with Qi stagnation and failure of movement, presenting with attacking pain in the hypochondrium, chest and abdominal distension, pulse appearing fine and weak or empty and wiry, tongue lacking fluids, and dry throat.
Sha Shen, Mai Dong, Sheng Di, Dang Gui Shen, Gou Qi Zi, Chuan Lian Zi.
For bitter taste and dryness, add wine-fried Huang Lian.
Appendix: Ji Ling Gao (from Wang Bingheng's *Chongqing Tang Sui Bi*). At age fifty, Yin Qi declines first; many elderly people suffer from Yin deficiency. This formula nourishes True Yin and softens sinews and bones.
Xi Yang Shen (select robust rhizomes, peel, steam nine times over rice, sun-dry nine times), Gan Gou Qi Zi, Huai Niu Xi (wine-steamed), Tian Dong, Mai Dong, Huai Sheng Di, Huai Shu Di, Xian Ling Pi. Equal parts of these eight ingredients, decocted into a paste, taken with warm water or warm wine.
Appendix: Zi Shui Qing Gan Yin Formula (Gao Gufeng). Treats Yin deficiency with Liver Qi depression and obstruction, epigastric pain, hypochondriac pain, pulse empty-wiry or fine-soft, tongue coating smooth and bright red.
This formula is Liu Wei Di Huang Tang plus Dang Gui Shen, Bai Shao, Chai Hu, Shan Zhi, and Da Zao.
Appendix: Zi Yang Ying Ye Gao by Xue Yipiao.
Nu Zhen Zi, Han Lian Cao, Shuang Sang Ye, Hei Zhi Ma, Huang Gan Ju, Gou Qi Zi, Dang Gui Shen, Bai Shao Yao, Shu Di Huang, Hei Da Dou, Nan Zhu Ye, Bai Fu Shen, Wei Rui, Ju Hong, Sha Yuan Ji Li, Zhi Gan Cao.
Decoct with spring water to make a thick juice, add Black Donkey-Hide Gelatin (E Jiao), and refine with white honey.
Appendix: Xin Pi Shuang Bu Wan by Xue Yipiao.
Xi Yang Shen (steamed through), Bai Zhu (steamed cooked), Fu Shen, Gan Cao, Sheng Di Huang, Dan Shen, Zao Ren, Yuan Zhi Rou, Bei Wu Wei Zi, Mai Men Dong, Xuan Shen, Bai Zi Ren, Huang Lian, Xiang Fu (processed), Chuan Bei Mu, Jie Geng, Long Yan Rou.
Appendix: Kan Li Wan Theory by Lu Jiuzhi.
Lu Jiuzhi's ancestor, Shibu Zhai, wrote: Kan Li Wan is the premier fertility formula taken by Observer Yan Chengzhai from Shanxi. It is easiest, simplest, and safest. The formula consists of Red Dates and Black Beans in equal proportions. Red dates are red and enter the Heart; select thick-fleshed ones, steam until cooked, remove skin and pits. Black beans are black and enter the Kidneys; use large black beans, not horse feed beans. Soak them in Mulberry Juice until saturated, then steam in a rice steamer. Steam, soak, and steam again. Mash the two ingredients into a paste, bind with starch to form pills or cakes. Take as desired; it can darken hair and strengthen sinews and bones. Using this to "plant jade," the fetus will naturally stabilize, and children will live long. In the summer of Renwu year, this formula was presented to Vice Minister Xu Songge and included in his collection of effective prescriptions. Those who specialize in tonifying Yang using Sulfur and Aconite should beware. If there is indeed erectile dysfunction, inability to maintain hardness, thin semen, and infertility, Deer Antler (Lu Rong) is still a product of flesh and blood with vital energy. However, it must be combined with Tian Dong, Mai Dong, Sheng Di, Shu Di, and Huang Bo to greatly tonify Yin, making it suitable for both men and women. This is also Chengzhai's view.
Kou Zongshi said: Early awakening of sexual desire in childhood, with persistent thoughts in the mind, causes early closure of menstruation. Worry and anxiety damage the Heart; Heart damage leads to blood exhaustion, thus closing the menses. Since Fire is diseased, it cannot nourish its child (Spleen), leading to poor appetite. Spleen deficiency leads to Lung Qi deficiency, causing cough. Once coughing occurs, Kidney Water Qi is exhausted, leading to dry limbs. Liver Wood Qi is insufficient, leading to irritability, scorched hair/temples, and flaccid sinews. The Five Zang organs transmit sequentially; thus, sudden death does not occur, but eventual death follows. Compared to other consumptive diseases, this is the most difficult to treat.
Shen Yaofeng stated: This section is derived from the "deficiency" aspect of Jingui Yaolue, and such syndromes do exist. However, in cases of unfulfilled desires, Ministerial Fire (Xiang Huo) becomes intense; without tonifying Water, it cannot be controlled. Liu Wei Di Huang Tang, which tonifies Yin and drains Yang, is indeed a wonderful method. However, for Spleen deficiency with reduced appetite, if Rehmannia is considered too cloying, it can be stir-fried until loose; otherwise, replace it with Nu Zhen Zi, which, by name and nature, also drains Ministerial Fire.
Wang Mengying noted: This syndrome is the most difficult to treat. Liu Wei Di Huang Wan hinders the Spleen; Gui Pi Tang aids Fire. Only Xue Yipiao’s Zi Yang Ying Ye Gao added with Xiao Mai, Da Zao, and Yuan Zhi is likely to conform to the correct principles. Yipiao also has Xin Pi Shuang Bu Wan, which can be considered.
Lou Quanshan stated: Amenorrhea includes a syndrome of turbid blood stagnating in the uterine gate. Luo Qianfu’s Xue Ji Gao consists of a single herb, Da Huang powder, boiled with vinegar into a paste. Taking it promotes one or two bowel movements, allowing menstrual blood to flow naturally; it is a fairy medicine for gynecology.
Shen Yaofeng stated: Jingui Yaolue discusses amenorrhea focusing only on Cold, not Heat, not due to missing text. Generally, when heaven is hot and earth is warm, menstrual water boils and overflows; how could it instead stagnate and fail to come? The theories of Jiegu and Dongyuan regarding descending Heart Fire and draining the Triple Burner cannot be fully trusted. Even bone-steaming internal heat belongs to Yin deficiency, not excess Heat that can be cured with cold herbs.
Wang Mengying noted: Wang Ziheng’s *Quansheng Zhimi Fang* contains Di Huang Jian. Use eight taels of fresh Rehmannia juice, boil down by half, add one tael of Rhubarb powder, and boil together until pillable. Form pills the size of mulberry seeds. Take five pills with cooked water; increase to ten if ineffective. It treats women with Qi exhaustion and Liver injury, amenorrhea, named Blood Depletion. Essentially, if stasis is not removed, new blood dries up. This aligns with the meaning of Wutou Luru Wan in Neijing and Dahuang Zhechong Wan in Shanghan Lun. Later generations only know that this type of Blood Depletion is Blood deficiency, not realizing that Heat causes stasis. Instead, they use warm tonics, which cannot cure this Blood Depletion. Yaofeng also held this view, which may lack thorough examination.
Zhu Danxi said: In obese individuals, Phlegm obstructs the uterine gate; Nong Po Er Chen Tang is appropriate.