良方论曰∶妇人崩中，由脏腑伤损冲任，血气俱虚故也。冲任为经脉之海，血气之
行，外循经络，内荣脏腑，若无伤损，则阴阳和平，而气血调适；若劳动过多，致脏腑俱虚
，而冲任之气亦虚，不能约制其经血，故忽然暴下。或由阴阳相搏，为热所乘，攻伤冲任，
血得热则流散，甚者至于昏闷。其脉数疾，小为顺，洪大为逆，大法当调补脾胃为主。
（据言气虚不能约制，则宜补气，其为热所乘者，则宜凉血，不当混言调脾胃为主。观东垣法，便得其窍）
东垣曰∶阴虚阳搏谓之崩。妇人脾胃虚损，致命门脉沉细而数疾（阴虚阳搏，是阴中有火也，故以尺脉为
诊），或沉弦而洪大有力，
寸关脉亦然，皆由脾胃有亏，下陷于肾，与相火相合，湿热下迫（此言脾气下陷为热，宜用升补泻火），经漏不止，
其色紫黑，如
夏月腐肉之臭。中有白带者，脉必弦细，寒作于中（东垣以白带为寒，脉以弦细为诊，固是，而后人率以为湿热，须辩
之）；有赤带者，其脉洪数，病热明矣，必腰
痛，或脐下痛。临经欲行，而先发寒热往来，两胁急缩，兼脾胃证出见，或四肢困热，心烦
闷不得眠卧，心下急（此虽点出脾胃症，而烦心、心下急，又有虚火矣），宜大补脾胃而升降气血，可一服而愈。
或先贵而后贱，或先富而后贫
，病名脱营者，心气不足，其火大炽，旺于血脉之中，又致脾胃饮食失节，火乘其中，形质
肌肉，颜似不病者，此心病也（心主以营，故曰心病），不形于脉，故脾胃饮食不调，其证显矣，而经水不时而下，
或适来适断，暴下不止，治当先说恶死之言劝论，令惧死而心不动，以大补气血之药，补养
脾胃，微加镇坠心火之药治其心，补阴泻阳，经自止矣。《痿论》云∶悲哀太甚则胞络绝，
胞络绝，则阳气内动（阳气内动，便是胞络中有火），发则心下崩，数溲血也，故《本病》曰∶大经空虚，发则肌痹，
传为脉痿，此之谓也。
薛氏曰∶经云阴虚阳搏谓之崩。又云∶阳络伤，血外溢，阴络伤，血内溢。又云∶脾统
血。肝藏血，其为患，因脾胃虚损，不能摄血归源，或因肝经有热，血得热而下行；或因肝
经有风（何以知肝经有风），血得风而妄行；或因怒动肝火，血热而沸腾；或因脾经郁热，血伤而不归经；或因
悲哀太过，胞络伤而下崩。治疗之法，脾胃虚弱者，六君子汤加当归、川芎、柴胡；脾胃虚
陷者，补中益气汤加酒炒芍药、山栀；肝经血热者，四物汤加柴胡、山栀、苍术；肝经风热
者，加味逍遥散，或小柴胡汤加山栀、芍药、牡丹皮；若怒动肝火，亦用前药；脾经郁火者
，归脾汤加山栀、柴胡、牡丹皮；哀伤胞络者，四君子汤加柴胡、升麻、山栀。故东垣、丹
溪诸先生云∶凡下血证，须用四君子以收功，斯言厥有旨哉（薛氏所论凡七条，而脾胃三条，肝经三条，胞络一条，
皆不舍柴胡及栀、芍、丹皮者，以厥阴手足二经为多血藏血之所，血为热迫，则不能从阳亟起，故以引起肝气，
而栀、芍等收阴抑阳也，如东垣升阳举经之意，尤得其妙。所定脾胃方药，必是久病，又显出脾胃证者宜之。盖立斋
先生治久病者多，故其立言如此，且谓四君为血证收功须用，则非初治之法可知，立斋一生得力处在此）。
若大去血后，毋以脉诊，当急
此等证候，无不由脾胃先损而患，故脉洪大。察其中有胃气，受补则可救。设用寒凉之药，复
伤脾胃生气，反不能摄血归源，是速其危也。
方氏曰∶血属阴也，静则循经荣内，动则错经妄行。盖人之七情过极，则动五志之火。
五志之火亢甚，则经血暴下；失期而来，久而不止，谓之崩中，如风动木摇，火燃水沸类也
。治崩次第，初用止血以塞其流，中用清热凉血以澄其源，末用补血以还其旧（愚谓止涩之中，须寓清凉，而清凉
之中，又须破瘀解结，至于补血还旧，又须调脾。其间兼证，或有不同，又当得其所以而处治焉，似难尽一也）。
若止塞其流而不澄其源，则滔天之势不能遏；若止澄其源而不复其旧，则孤孑之阳无以立（开口便得经旨，自是不凡），
故本末勿遗
张子和云∶孟官人母五十余，血崩一载，佥用泽兰丸、黑神散、保安丸、白薇散，补之
不效。戴人见之曰∶天癸已尽，本不当下血，盖血得热而流散，非寒也。夫女子血崩，多因
大悲哭，悲甚则肺叶布，心系为之急，血不禁而下崩。《内经》曰∶阴虚阳搏谓之崩。阴脉
不足，阳脉有余，数则内崩，血乃下流，举世以虚损治之，莫有知其非者。可服大剂，大剂
者，黄连解毒汤是也（此大寒之剂，非实热症不可，非前药之误不可）。次以香附二两炒，白芍药二两焙，当归二两焙，
三味同为细末，水调
西园公治一妇人，年六十二岁，血崩不止，投黄连解毒汤四帖，后服凉膈散合四物汤六
帖即愈（即阴虚阳搏之治）。此妇因悲哀太过，则心闷急，肺布叶举，而上焦不通，热气在中，血走而崩，
故效。
薛氏曰∶一妇人年将七十，素有肝脾之证（所见证俱属肝脾，宜审之），每作则饮食（脾）不进，或胸膈（肝）
不
利，或中脘作痛（胃），或大便（脾）作泻，或小便（肝）不利，余用逍遥散加山栀、茯神、远志（以脾症而用茯神、
远
志，
何也？
岂所谓补脾不愈，而当补心欤！若然则枣仁亦不可少）、木香
而愈。后忧女孀居，不时吐紫血，其病每作，先倦怠（脾）而后发热（肝），经曰∶积忧伤肺，
积思伤脾。肺布叶举，是令子母俱病，不能摄血归经而致前证，遂以前药加炒黑黄连三分、
吴茱萸二分顿愈（此左金丸法）。复因怒，吐赤血甚多，躁渴垂死，此血脱也，法当补气。乃用人参一两，
芩、术、当归各三钱，陈皮、炮黑干姜各二钱，炙草、木香各一钱，一剂顿止。
一妇人年六十四，久郁怒，头痛寒热，春间乳内作痛，服流气饮之类益甚，不时有血如
经行，又大惊恐，饮食不进，夜寐不宁，乳肿及两胁 痛如炙，午后色赤。余以为肝脾郁火
血燥，先以逍遥散加酒炒黑龙胆一钱，山栀一钱半，二剂肿痛顿退，又二剂而全消（方证合宜，而以四剂全消，恐无
是速），再用归脾加炒黑栀、贝母，诸证悉愈。
一妇人因怒，崩血久不已，面青黄而或赤，此肝木制脾土而血虚也，用小柴胡合四物汤
，以清肝火生肝血，又用归脾、补中二汤，以益脾气生肝血而瘥。此证若因肝经有风热而血
不宁者，用防风一味为丸（当云肝热生风，而下陷者宜用防风），以兼证之药煎送；或肝经火动，而血不宁者，用条芩
炒为丸（条芩是大肠经药，用柴胡则治厥阴），以
一妇人性急，每怒非太阳耳项、喉齿胸乳作痛，则胸满吞酸，吐泻少食，经行不止，此
皆肝火之证。肝自病则外证见，土受克则内证作，若自病见，用四物加白术、茯苓、柴胡、
炒栀、炒龙胆（芍、柴、栀、胆是厥阴药，白茯是平肝药）；若内证作，用四君子加柴胡、芍药、神曲、吴茱萸炒过、
黄连，诸证渐愈
惟月经不止，是血分有热（若血分有热，当加丹皮、山栀），脾气尚虚，以逍遥散倍用白术、茯苓、陈皮，又以补中益
气加酒炒芍药，兼服而调。
良方论述说：妇女崩中（指非经期阴道大量出血），是由于脏腑受损，冲任二脉受伤，导致气血俱虚的缘故。冲任二脉是十二经脉之海，气血的运行，向外循行于经络，向内滋养脏腑；如果没有损伤，则阴阳平和，气血调和；如果劳作过度，致使脏腑全部虚弱，而冲任之气也虚弱，不能约束控制经血，所以突然大量下泄。或者由于阴阳相互搏结，被热邪所乘，攻伤冲任，血液受热则流散，严重的甚至导致昏闷。其脉象数而疾速，脉形小为顺证，脉形洪大为逆证，大法应当以调补脾胃为主。（有人指出气虚不能约束，则宜补气，被热邪所乘者，则宜凉血，不应当混同地说以调补脾胃为主。观察李东垣的治法，便得其要领）
李东垣说：阴虚而阳脉搏击有力称为崩漏。妇女脾胃虚损，导致命门脉沉细而数疾（阴虚阳搏，是指阴中有火，所以以尺脉作为诊断依据），或者沉弦而洪大有力，寸部和关部的脉象也是如此，这都是因为脾胃亏损，气机下陷于肾，与相火相结合，湿热下迫（这里说的是脾气下陷化为热，适宜用升提补益兼泻火的方法），导致经血淋漓不止，颜色紫黑，像夏天腐烂的肉一样发臭。其中有白带者，脉象必定弦细，这是寒邪作祟于中焦（李东垣认为白带属寒，脉象弦细为诊断依据，固然正确，但后人多认为是湿热，需要辨别）；有赤带者，脉象洪数，病属热证是很明显的，必然伴有腰痛，或者脐下疼痛。临近经期欲行经时，先发寒热往来，两胁拘急收缩，兼见脾胃症状出现，或者四肢困倦发热，心烦闷不得安卧，心下部急迫（这里虽然点出了脾胃症状，但烦心、心下部急迫，又有虚火的成分了），应当大补脾胃并升降气血，可以一服药就痊愈。或者先尊贵后贫贱，或先富裕后贫穷，病名脱营的，心气不足，其火大炽，旺盛于血脉之中，又导致脾胃饮食失节，火邪侵犯其中，形体肌肉面色似乎没有病态，这是心病（心主营血，所以说心病），病征不显于脉象，所以脾胃饮食不调的症状明显，而月经不时而下，或者刚来即断，暴下不止，治疗应当先用说明死亡可怕的话劝诫，使其畏惧死亡而心神安定，用大补气血的药物，补养脾胃，稍加镇坠心火的药物治疗心脏，补阴泻阳，经血自然停止。《痿论》说：悲哀太甚则胞络绝阻，胞络绝阻，则阳气内动（阳气内动，就是胞络中有火），发作时心下出血，多次小便出血，所以《本病》说：大经空虚，发作时肌痹，传变为脉痿，说的就是这个道理。
薛己说：经文说阴虚阳搏称为崩漏。又说：阳络受伤，血外溢，阴络受伤，血内溢。又说：脾统血，肝藏血。它们致病的原因，是因为脾胃虚损，不能摄血归源，或者因为肝经有热，血受热而下行；或者因为肝经有风（怎么知道肝经有风），血遇风而妄行；或者因为愤怒触动肝火，血热而沸腾；或者因为脾经郁热，血受伤而不归经；或者因为悲哀太过，胞络受伤而下崩。治疗方法：脾胃虚弱者，用六君子汤加当归、川芎、柴胡；脾胃虚陷者，用补中益气汤加酒炒芍药、山栀；肝经血热者，用四物汤加柴胡、山栀、苍术；肝经风热者，用加味逍遥散，或小柴胡汤加山栀、芍药、牡丹皮；若是怒动肝火，也用前面的药；脾经郁火者，用归脾汤加山栀、柴胡、牡丹皮；哀伤胞络者，用四君子汤加柴胡、升麻、山栀。所以李东垣、朱丹溪各位先生说：凡是下血证，必须用四君子汤来收功，这话很有深意啊（薛氏所论述的凡七条，而脾胃三条，肝经三条，胞络一条，都不舍弃柴胡及栀、芍、牡丹皮，因为厥阴手足二经是多血藏血之所，血被热逼迫，就不能从阳迅速升起，所以用柴胡引起肝气，而栀、芍等药收敛阴气抑制阳气，这就像李东垣升阳举经的意思，尤其精妙。所确定的脾胃方药，一定是久病，又明显表现出脾胃症状的人适宜服用。大概立斋先生治疗久病的病人多，所以他的言论如此，并且说四君子汤是血证收功时必须用的，那么就不是初治的方法，可知立斋先生一生得力之处在此）。如果大量失血之后，不要以脉诊为准，应当紧急处理这些证候，无不是由脾胃先受损而患病，所以脉象洪大。察其中还有胃气，能受补则可以救活。假如使用寒凉的药物，再次伤害脾胃的生气，反而不能摄血归源，这是加速其危险。
方氏说：血属于阴，安静则循经荣养内部，躁动则错经妄行。人的七情过极，就会动五志之火。五志之火亢盛，则经血暴下；过期而来，久而不止，称为崩中，像风吹木摇，火烧水沸之类。治疗崩中的次第，初起用止血以塞其流，中间用清热凉血以澄其源，最后用补血以恢复旧观（我认为在止涩之中，须寓含清凉之意，而在清凉之中，又须破瘀解结，至于补血还旧，又须调理脾胃。其间兼证，或有不同，又应当得其所以然来处理，似乎难以完全一致）。如果只堵塞其流而不澄清其源，则滔天之势不能遏制；如果只澄清其源而不恢复其旧，则孤弱的阳气无以立足（开口便得经旨，自是不平凡），所以本末勿遗。
张子和说：孟官人的母亲五十多岁，血崩一年，大家都用泽兰丸、黑神散、保安丸、白薇散，补益无效。戴人见了说：天癸已尽，本来不应再下血，大概是血受热而流散，并非寒证。女子血崩，多因大悲哭，悲伤太甚则肺叶布展，心系为之紧急，血不禁而下崩。《内经》说：阴虚阳搏称为崩漏。阴脉不足，阳脉有余，数则内崩，血乃下流，举世都以虚损治疗，没有人知道其错误。可服大剂量的药，大剂量指的是黄连解毒汤（这是大寒之剂，非实热症不可用，若非前药之误不可用）。其次用香附二两炒，白芍药二两焙，当归二两焙，三味同为细末，水调服。
西园公治疗一个妇人，六十二岁，血崩不止，投予黄连解毒汤四帖，后来服凉膈散合四物汤六帖即愈（这就是阴虚阳搏的治疗方法）。此妇因为悲哀太过，则心闷急，肺叶布展举起，而上焦不通，热气在中，血走而崩，所以有效。
薛己说：一个妇人将近七十岁，素有肝脾之证（所见证候都属于肝脾，应当审察），每次发作则饮食不进，或者胸膈不利，或者中脘作痛，或者大便作泻，或者小便不利，我用逍遥散加山栀、茯神、远志、木香而痊愈。后来因担忧女儿守寡，不时吐出紫血，其病每次发作，先倦怠而后发热，经文说：积忧伤肺，积思伤脾。肺叶布展举起，是令子母俱病，不能摄血归经而导致前述证候，于是用前面的药加炒黑黄连三分、吴茱萸二分顿愈（这是左金丸的法度）。又因愤怒，吐出赤血很多，躁渴垂死，这是血脱，法当补气。于是用人参一两，黄芩、白术、当归各三钱，陈皮、炮黑干姜各二钱，炙甘草、木香各一钱，一剂顿止。
一个妇人六十四岁，长期郁怒，头痛寒热，春季乳内作痛，服用流气饮之类更加严重，不时有血如月经行，又大惊恐，饮食不进，夜寐不宁，乳肿及两胁痛如炙烤，午后色赤。我认为这是肝脾郁火血燥，先用逍遥散加酒炒黑龙胆一钱，山栀一钱半，二剂肿痛顿退，又二剂而全消（方证合宜，而以四剂全消，恐怕没有这么快），再用归脾汤加炒黑栀、贝母，诸证悉愈。
一个妇人因为愤怒，崩血久不已，面青黄而或赤，这是肝木克制脾土而血虚，用小柴胡汤合四物汤，以清肝火生肝血，又用归脾汤、补中益气汤，以益脾气生肝血而痊愈。此证若因肝经有风热而血不宁者，用防风一味为丸（应当说是肝热生风，而下陷者适宜用防风），以兼证的药煎汤送服；或者肝经火动，而血不宁者，用条芩炒为丸（条芩是大肠经药，用柴胡则治厥阴），以……
一个妇人性格急躁，每次发怒如果不是太阳经耳项、喉齿胸乳作痛，就是胸满吞酸，吐泻少食，经行不止，这些都是肝火之证。肝自病则外证见，土受克则内证作，若自病见，用四物汤加白术、茯苓、柴胡、炒栀、炒龙胆（芍药、柴胡、栀、龙胆是厥阴药，白术茯苓是平肝药）；若内证作，用四君子汤加柴胡、芍药、神曲、吴茱萸炒过、黄连，诸证渐愈。
惟月经不止，是血分有热（若血分有热，应当加牡丹皮、山栀），脾气尚虚，用逍遥散倍用白术、茯苓、陈皮，又以补中益气汤加酒炒芍药，兼服而调。
Liang Fang discusses: Women's "Beng Zhong" (sudden, heavy uterine bleeding outside the menstrual period) is caused by damage to the Zang-Fu organs and injury to the Chong and Ren meridians, resulting in deficiency of both Qi and Blood. The Chong and Ren meridians are the "Sea of the Twelve Meridians"; the movement of Qi and Blood circulates outward along the collaterals and nourishes the internal Zang-Fu organs internally. If there is no injury, Yin and Yang are harmonious, and Qi and Blood are regulated; if labor is excessive, causing all Zang-Fu organs to become deficient, and the Qi of the Chong and Ren also becomes deficient, failing to constrain and control the menstrual blood, it will suddenly flow down heavily. Alternatively, due to the struggle between Yin and Yang, being attacked by Heat pathogen, damaging the Chong and Ren, Blood flows and scatters when heated; in severe cases, it leads to fainting or dizziness. The pulse is rapid and hurried; a small pulse shape is a favorable sign, while a surging and large pulse shape is an unfavorable sign. The general principle should be primarily to regulate and tonify the Spleen and Stomach. (It is said that if Qi is deficient and cannot constrain, it is appropriate to tonify Qi; if attacked by Heat, it is appropriate to cool the Blood; one should not indiscriminately say to primarily regulate the Spleen and Stomach. Observing Li Dongyuan's methods reveals the key.)
Li Dongyuan states: "Yin deficiency with Yang pulsation is called Beng." In women, Spleen and Stomach deficiency leads to the Mingmen pulse being deep, fine, and rapid (Yin deficiency with Yang pulsation means there is fire within Yin, so the Chi pulse is used for diagnosis), or deep, wiry, surging, large, and forceful; the Cun and Guan pulses are similar. All these result from Spleen and Stomach deficiency, with Qi sinking into the Kidney, combining with Ministerial Fire, and Damp-Heat pressing downward (This refers to Spleen Qi sinking transforming into Heat, suitable for lifting and tonifying while draining fire), causing continuous dripping of menstrual blood, purple-black in color, smelling foul like rotting meat in summer. Those with white leukorrhea will have a wiry and fine pulse, indicating Cold acting in the middle (Li Dongyuan considers white leukorrhea as Cold, and the wiry-fine pulse as diagnostic, which is correct, but later generations generally consider it Damp-Heat, requiring differentiation); those with red leukorrhea will have a surging and rapid pulse, clearly indicating a Heat disease, inevitably accompanied by lower back pain or pain below the umbilicus. Approaching the menstrual period, before bleeding starts, alternating chills and fever occur first, with tightness and contraction of both hypochondria, accompanied by the appearance of Spleen and Stomach symptoms, or fatigue and heat in the four limbs, mental restlessness and oppression preventing sleep, and urgency in the epigastrium (Although Spleen and Stomach symptoms are mentioned here, mental restlessness and epigastric urgency also involve Deficient Fire). It is appropriate to greatly tonify the Spleen and Stomach and regulate the ascending and descending of Qi and Blood, achieving cure with one dose. Or, those who were once noble then became poor, or once rich then became poor, suffering from "Tuo Ying" (Depletion of Ying), have insufficient Heart Qi, with their Fire blazing fiercely within the blood vessels, further causing irregularities in Spleen and Stomach diet, with Fire invading the interior. The physical form and muscles may appear healthy, but this is a Heart disease (The Heart governs Ying, hence called Heart disease). The pathology does not manifest on the pulse, so Spleen and Stomach dietary irregularity symptoms are obvious, while menstruation comes and goes irregularly, or stops abruptly after starting, with sudden heavy bleeding. Treatment should first use words describing the terror of death to persuade them, making them fear death so the Heart remains calm, using medicines to greatly tonify Qi and Blood, nourish the Spleen and Stomach, and slightly add sedatives to subdue Heart Fire to treat the Heart. Tonifying Yin and draining Yang will naturally stop the menstruation. The *Wu Lun* (Treatise on Flaccidity Syndromes) says: Excessive grief severs the Bao Luo (uterine network); when the Bao Luo is severed, Yang Qi moves internally (Internal movement of Yang Qi means there is fire in the Bao Luo). When it erupts, there is bleeding from the heart region, and frequent urination of blood. Thus, the *Ben Bing* says: When the great vessels are empty, myositis occurs upon eruption, transmitting to Mai Wei (pulse flaccidity); this is what is meant.
Xue Ji states: The classic says "Yin deficiency with Yang pulsation is called Beng." It also says: Injury to Yang collaterals causes blood to overflow externally; injury to Yin collaterals causes blood to overflow internally. It also says: The Spleen controls blood; the Liver stores blood. Their pathological manifestations arise because Spleen and Stomach deficiency fails to control blood returning to its source, or because Liver channel Heat causes blood to flow downward due to heat; or because Liver channel Wind causes blood to move recklessly due to wind; or because anger stirs Liver Fire, causing blood to boil due to heat; or because Spleen channel depressed Heat injures blood, preventing it from returning to the vessels; or because excessive grief injures the Bao Luo, causing lower beng. Treatment methods: For Spleen and Stomach weakness, use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Chuanxiong Rhizoma), and Chai Hu (Bupleuri Radix); for Spleen and Stomach sinking, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with wine-fried Shao Yao (Paeoniae Radix Alba) and Shan Zhi (Gardeniae Fructus); for Liver channel Blood Heat, use Si Wu Tang (Four Substances Decoction) added with Chai Hu, Shan Zhi, and Cang Zhu (Atractylodis Rhizoma); for Liver channel Wind-Heat, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) or Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Shan Zhi, Shao Yao, and Mu Dan Pi (Moutan Cortex); if anger stirs Liver Fire, use the previous formulas; for Spleen channel depressed Fire, use Gui Pi Tang (Restore the Spleen Decoction) added with Shan Zhi, Chai Hu, and Mu Dan Pi; for grief injuring the Bao Luo, use Si Jun Zi Tang (Four Gentlemen Decoction) added with Chai Hu, Sheng Ma (Cimicifugae Rhizoma), and Shan Zhi. Therefore, Mr. Li Dongyuan and Mr. Zhu Danxi stated: For all hematochezia/hematemesis syndromes, Si Jun Zi Tang must be used to conclude treatment; this statement has profound meaning (Mr. Xue discussed seven points, three regarding Spleen/Stomach, three regarding Liver channel, and one regarding Bao Luo, none abandoning Chai Hu, Zhi, Shao, and Dan Pi, because the Jueyin hands and feet meridians are places where much blood is stored. When blood is forced by Heat, it cannot rise quickly from Yang, so Chai Hu is used to stir Liver Qi, while Zhi and Shao etc. collect Yin and suppress Yang, akin to Li Dongyuan's idea of lifting Yang and raising the vessels, which is particularly subtle. The determined Spleen/Stomach prescriptions are suitable for chronic diseases showing clear Spleen/Stomach symptoms. Since Master Lizhai treated many chronic cases, his statements reflect this, and stating Si Jun Zi Tang is necessary for concluding blood syndromes indicates it is not an initial treatment method; this is where Master Lizhai excelled throughout his life). After massive blood loss, do not rely solely on pulse diagnosis; urgently address these syndromes. All such conditions arise from prior Spleen and Stomach damage, hence the pulse is surging and large. If stomach Qi is present and can accept tonification, rescue is possible. If cold-cooling medicines are used, they will further damage the vital Qi of the Spleen and Stomach, failing to control blood returning to its source, thus accelerating danger.
Fang Shi states: Blood belongs to Yin; when quiet, it follows the channels to nourish the interior; when active, it deviates from the channels and acts recklessly. Extreme excess of the Seven Emotions stirs the Fire of the Five Wills. When the Fire of the Five Wills is hyperactive, menstrual blood flows down violently; coming out of time and lasting long is called Beng Zhong, similar to wind shaking wood or fire boiling water. The sequence for treating Beng is: initially use hemostatics to block the flow; secondly use clearing Heat and cooling Blood to clarify the source; finally use blood-tonifying medicines to restore the original state (I believe that among astringents, cooling properties must be included, and among cooling agents, blood-breaking and knot-resolving properties are needed; for restoring blood, Spleen regulation is required. Accompanying symptoms may differ, requiring specific handling, so it is difficult to apply a single rule universally). If only blocking the flow without clarifying the source, the torrential momentum cannot be stopped; if only clarifying the source without restoring the original, the isolated Yang has nothing to stand upon (Opening remarks capture the essence of the classics, proving extraordinary). Thus, neither root nor branch should be neglected.
Zhang Hezi states: The mother of Official Meng, over fifty years old, suffered from blood beng for a year. Everyone used Ze Lan Wan, Hei Shen San, Bao An Wan, and Bai Wei San, but tonification was ineffective. Dai Ren saw this and said: Tian Gui (heavenly water/menstrual fluid) has ended; she should not bleed. It is likely that blood flows and scatters due to Heat, not Cold. Female blood beng is often caused by great sorrow and crying; extreme sadness causes lung lobes to spread, the Heart Tie (connection) becomes tight, and blood uncontrollably falls down. The *Nei Jing* says: "Yin deficiency with Yang pulsation is called Beng." Yin pulse insufficiency, Yang pulse excess, rapidness indicates internal beng, and blood flows downward. The world treats it as deficiency consumption, unaware of its error. Large doses can be taken; a large dose refers to Huang Lian Jie Du Tang (Coptis Decoction for Resolving Toxins) (This is a major cold formula, not for non-excess Heat syndromes, and not unless previous medicines failed). Next, use 2 liang of fried Xiang Fu (Cyperi Rhizoma), 2 liang of baked Shao Yao, 2 liang of baked Dang Gui, ground into fine powder, mixed with water.
Master Xiyuan Gong treated a sixty-two-year-old woman with continuous blood beng. She took four doses of Huang Lian Jie Du Tang, followed by six doses of Liang Ge San (Cool the Chest Powder) combined with Si Wu Tang, and was cured (This is the treatment for Yin deficiency with Yang pulsation). This woman suffered excessive grief, causing mental oppression and urgency, lung lobes spreading and rising, upper Jiao obstruction, heat in the middle, blood rushing causing beng, hence the efficacy.
Xue Ji states: A woman nearing seventy years old had chronic Liver and Spleen syndromes (All observed symptoms belong to Liver and Spleen, requiring careful examination). Each attack resulted in poor appetite (Spleen), chest/diaphragm discomfort (Liver), epigastric pain (Stomach), diarrhea (Spleen), or dysuria (Liver). I used Xiao Yao San added with Shan Zhi, Fu Shen (Poria Cum Radix Pini), Yuan Zhi (Polygalae Radix), and Mu Xiang (Aucklandiae Radix), resulting in cure. Later, worried about her widowed daughter, she occasionally vomited purple blood. Each episode began with fatigue (Spleen) followed by fever (Liver). The Classic says: Accumulated grief injures the Lung; accumulated worry injures the Spleen. Lung lobes spreading and rising causes mother and child organs to suffer together, failing to control blood returning to vessels, leading to the aforementioned symptoms. I used the previous prescription added with 3 fen of charred Huang Lian (Coptidis Rhizoma) and 2 fen of Wu Zhu Yu (Evodiae Fructus), achieving immediate cure (This is the method of Zuo Jin Wan). Anger again caused vomiting of bright red blood in large amounts, restlessness, thirst, approaching death; this is Blood depletion, requiring Qi tonification. I used 1 liang of Ren Shen (Ginseng Radix), 3 qian each of Qin (Scutellariae Radix), Zhu (Atractylodis Macrocephalae Rhizoma), and Dang Gui, 2 qian each of Chen Pi (Citri Reticulatae Pericarpium) and Pao Hei Gan Jiang (Prepared Blackened Ginger Rhizome), 1 qian each of Zhi Cao (Prepared Licorice Root) and Mu Xiang, stopping it immediately with one dose.
A sixty-four-year-old woman, with long-term depression and anger, suffered headache and alternating chills/fever. In spring, breast pain occurred; taking Liu Qi Yin (Flowing Qi Decoction) worsened it. She intermittently had bleeding like menstruation, then experienced great fright, poor appetite, restless sleep, breast swelling, and burning pain in both hypochondria, with reddish complexion in the afternoon. I considered this Liver-Spleen depressed Fire and Blood dryness. First, I used Xiao Yao San added with 1 qian of wine-fried black Long Dan (Gentianae Radix) and 1.5 qian of Shan Zhi. After two doses, swelling and pain subsided; after two more doses, it completely resolved (Formula and syndrome matched, but complete resolution in four doses seems too fast). Then, Gui Pi Tang added with charred Shan Zhi and Bei Mu (Fritillariae Thunbergii Bulbus) cured all symptoms.
A woman, due to anger, had prolonged blood beng, with a face turning green-yellow or red. This is Liver Wood controlling Spleen Earth, leading to Blood deficiency. I used Xiao Chai Hu Tang combined with Si Wu Tang to clear Liver Fire and generate Liver Blood, then used Gui Pi Tang and Bu Zhong Yi Qi Tang to benefit Spleen Qi and generate Liver Blood, resulting in recovery. If this syndrome is due to Liver channel Wind-Heat causing Blood instability, use Fang Feng (Saposhnikoviae Radix) alone made into pills (Should say Liver Heat generates Wind, and sinking cases suit Fang Feng), taken with decoctions for accompanying symptoms; or if Liver channel Fire moves causing Blood instability, use Tiao Qin (Scutellariae Radix) fried into pills (Tiao Qin is a Large Intestine channel medicine; using Chai Hu treats Jueyin)...
A woman with an impatient temper, whenever angry, would suffer either Taiyang channel ear/nape/throat/tooth/chest/breast pain, or chest fullness, acid regurgitation, vomiting/diarrhea, reduced food intake, and continuous menstruation. These are all Liver Fire syndromes. If the Liver itself is diseased, external symptoms appear; if Earth is controlled, internal symptoms arise. If self-disease appears, use Si Wu Tang added with Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Ling (Poria), Chai Hu, charred Shan Zhi, and charred Long Dan (Shao Yao, Chai Hu, Shan Zhi, Long Dan are Jueyin medicines; Bai Zhu and Fu Ling are Liver-calming medicines); if internal symptoms arise, use Si Jun Zi Tang added with Chai Hu, Shao Yao, Shen Qu (Massa Medicata Fermentata), fried Wu Zhu Yu, and Huang Lian, with symptoms gradually improving.
Only continuous menstruation indicates Heat in the Blood division (If Blood division has Heat, add Mu Dan Pi and Shan Zhi), while Spleen Qi remains deficient. Use Xiao Yao San doubling Bai Zhu, Fu Ling, and Chen Pi, combined with Bu Zhong Yi Qi Tang added with wine-fried Shao Yao, taken concurrently for regulation.