东垣云∶一妇人经候黑血，凝结成块，左厢有血瘕，水泻不止，谷食有时化，有时不化
，至今岁四月，血块暴下，并水注俱作，是前后二阴有形之血脱竭于下；既久，经候尤不调
，水泻日见三两行，食罢心烦不快，饮食减少，甚至瘦弱。东垣先生曰∶夫圣人治病，必本
四时升降沉浮之理，权变之宜。若不本四时，以顺为逆，非其治也。且治之大法，必先岁气
，无伐天和，无盛盛，无虚虚，遗人夭殃；无致邪，无失正，绝人长命。故圣人云∶阳盛阴
虚，下之则愈，汗之则死；阴盛阳虚，汗之则愈，下之则死（阳盛是言阳邪盛于内，故可下；阴盛是言寒邪盛于外，
故可汗）。大抵圣人立法，各自有义。且
如升阳或发散之剂，是助春夏之阳气，令其上升，乃泻秋冬收藏殒杀寒冰之气，此病是也，
当用此法治之，乃升降浮沉之至理也。夫天地之气，以升降浮沉，乃从四时，如治病逆之，
则杀人矣。故经云∶顺天者昌，逆天者亡，可不畏哉。夫人之身，亦有天地四时之气，不可
止认在外，人体亦同天地也。今经漏不止，是前阴之气血已下脱矣；水泻数年不愈，是后阴
之气血，又下陷矣。后阴者，主有形之物也，前阴者，精气之门户，俱下竭，是病患周身之
气，常行秋冬之令。阴主杀，此等收藏之病是也。阳生阴长，春夏是也。在人身之中，令气
升浮者，谷气上行是也，既病则周身血气，皆不生长，谷气又不升，其肌肉消少，是两仪之
气，俱将绝矣。既下元二阴俱脱，血气消竭，假令当日元是热证，今下焦久脱，已化为寒矣
。此病久沉久降，寒湿大胜，当急救之，泻寒以热，降湿以燥，大升大举，以助生长，补养
气血，不致偏竭。圣人立治之法，既湿气大胜，以所胜治之，助甲（甲胆也），风木上升是也。故经云∶
风胜湿（风胜湿，正是举下陷之气，今人以为风来则干之意，非也），是以所胜平之也。当先调和胃气，次用白术之类，
以燥其湿，而滋元气，如其不止
，后用风药以胜湿，此之谓也。此便是大举大升，以助春夏二湿久陷下之至治也。又一本云
∶此病次用四物，随湿证加减。
李东垣说：有一位妇女月经来潮时排出黑色血液，凝结成块，左侧胁部有血瘕（腹部结块病证），伴有持续的水样腹泻，食物有时能消化，有时不能消化。直到今年四月，血块突然大量排出，同时水泻也加剧，这是前后二阴有形之血在下方严重耗竭；此后很久，月经更加不调，每天水泻两三次，饭后感到心烦不适，饮食减少，甚至身体消瘦虚弱。李东垣先生说：圣人治病，必须依据四季气机升降浮沉的道理，灵活变通。如果不依据四季规律，以顺应为违背，就不是正确的治疗方法。而且治疗的大法，必须先考虑当年的岁气，不要损伤天和之气，不要使实证更实，虚证更虚，从而给人带来夭折的灾祸；不要导致邪气入侵，不要失去正气，断绝人的寿命。所以圣人说：阳盛阴虚，用下法可以痊愈，用汗法会导致死亡；阴盛阳虚，用汗法可以痊愈，用下法会导致死亡（这里的“阳盛”是指阳邪盛于体内，所以可以用下法；“阴盛”是指寒邪盛于体表，所以可以用汗法）。大致说来，圣人确立法则，各自都有深意。比如升阳或发散的药剂，是助长春夏季节的阳气，使其上升，这实际上是祛除秋冬收藏、肃杀、寒冰般的气，这个病症就属于这种情况，应当用这种方法治疗，这正是升降浮沉的最高道理。天地之气，依靠升降浮沉，顺应四季，如果治病时违背它，就会杀人。所以经典说：顺应天道者昌，违背天道者亡，怎能不敬畏呢？人的身体，也有天地四季之气，不能只认为这些气存在于体外，人体也与天地相同。现在经血漏下不止，是前阴的气血已经向下脱失；水泻数年不愈，是后阴的气血又向下陷落。后阴，主管有形之物；前阴，是精气的门户，两者都向下枯竭，这意味着病患周身之气，常行秋冬肃杀之令。阴主杀伐，这类收藏的病证就是如此。阳生阴长，对应的是春夏季节。在人体内部，使气机升浮的是谷气上行，既然生病，周身气血都不能生长，谷气也不能上升，肌肉消减，这是阴阳两仪之气，都将断绝了。既然下元前后二阴都脱失，血气消竭，假如当日原本是热证，如今下焦久脱，已经转化为寒证了。这个病长久沉潜下降，寒湿大胜，应当紧急救治，用热药驱散寒邪，用燥药祛除湿气，大力升提举陷，以助生长，补养气血，不至于偏颇枯竭。圣人确立的治疗法则，既然湿气大胜，就用克制湿气的药物来治疗，助长甲胆（即少阳胆经），使风木之气上升，就是这个意思。所以经典说：风能胜湿（风能胜湿，正是提升下陷之气的意思，现代人误以为风来了就会干燥，这是不对的），这就是用所胜之气来平抑它。应当先调和胃气，其次使用白术之类的药物，来燥湿并滋养元气，如果症状仍不止，随后使用风药来胜湿，说的就是这个道理。这就是大力升举，以助春夏之气，治疗长期下陷的湿证的最高治法。另一版本记载：此病其次使用四物汤，根据湿证的情况加减用药。
Li Dongyuan stated: A woman presented with menstrual bleeding of black blood, coagulated into masses, accompanied by a blood mass (abdominal lump) in the left hypochondrium, and incessant watery diarrhea. Food digestion was intermittent; sometimes digestible, sometimes not. By April of this year, blood masses suddenly discharged profusely, concurrent with severe watery diarrhea. This indicated a depletion of tangible blood at the lower orifices (anterior and posterior). Subsequently, menstruation remained irregular, with two to three episodes of watery diarrhea daily. Postprandial restlessness and decreased appetite ensued, leading to emaciation. Mr. Li Dongyuan said: The sage treats diseases based on the principles of ascending, descending, floating, and sinking corresponding to the four seasons, exercising flexibility. Failing to follow seasonal patterns and treating compliance as violation is incorrect therapy. The fundamental principle of treatment requires first considering the annual climate (Sui Qi), avoiding damage to the Harmonious Heaven (Tian He), preventing excess from becoming excessive and deficiency from becoming deficient, thereby avoiding premature death; preventing pathogenic invasion and preserving healthy Qi to prolong life. Thus, the sages stated: In cases of Yang Excess and Yin Deficiency, purgation leads to recovery, while diaphoresis causes death; in cases of Yin Excess and Yang Deficiency, diaphoresis leads to recovery, while purgation causes death. (Here, "Yang Excess" refers to internal Yang pathogens, suitable for purgation; "Yin Excess" refers to external Cold pathogens, suitable for diaphoresis.) Generally, the laws established by sages have specific meanings. For instance, formulas that raise Yang or induce diaphoresis assist the Yang Qi of Spring and Summer, promoting its ascent, thereby dispelling the collecting, killing, and icy Qi of Autumn and Winter. This disease falls into this category and should be treated accordingly, embodying the ultimate principle of ascending, descending, floating, and sinking. The Qi of Heaven and Earth operates through these dynamics, aligning with the seasons; opposing them in treatment can be fatal. Hence, the Classics state: Those who follow Heaven prosper; those who oppose Heaven perish. Should one not revere this? The human body also possesses the Qi of Heaven, Earth, and the four seasons; it is erroneous to consider these forces solely external, as the human body mirrors the cosmos. Currently, persistent metrorrhagia indicates downward collapse of Qi and Blood at the anterior orifice; chronic watery diarrhea indicates downward sinking of Qi and Blood at the posterior orifice. The posterior orifice governs tangible substances, while the anterior orifice is the gateway of Essence and Qi. Their simultaneous downward depletion signifies that the patient's systemic Qi follows the autumnal and winteral directives of contraction and killing. Yin governs killing, characterizing such collecting-pathologies. Yang generates and Yin grows, corresponding to Spring and Summer. Within the body, the ascent of Grain Qi (Gu Qi) promotes floating and ascending dynamics. Disease disrupts this, causing systemic Qi and Blood stagnation, failure of Grain Qi to ascend, muscle wasting, and impending exhaustion of the Two Poles (Yin and Yang). With the lower origin and both orifices depleted, and Qi and Blood exhausted, even if the initial presentation was Heat, prolonged lower Jiao collapse transforms it into Cold. This chronic condition involves deep sinking and descent, with overwhelming Cold-Dampness. Urgent rescue is required: using Hot herbs to dispel Cold, Drying herbs to resolve Dampness, and strong lifting and raising techniques to support growth, nourish Qi and Blood, and prevent extreme depletion. The sage’s therapeutic law dictates that when Dampness is excessive, one uses the controlling element to treat it, assisting the Gallbladder of Jueyin (Jia Dan) and promoting the ascent of Wind-Wood Qi. Thus, the Classics state: Wind overcomes Dampness. (This precisely means lifting sunken Qi; the modern misconception that wind merely dries is incorrect.) This employs the controlling element to pacify the pathology. First, harmonize Stomach Qi; second, use herbs like Baizhu (Atractylodis Macrocephalae Rhizoma) to dry Dampness and tonify Yuan Qi. If symptoms persist, subsequently use Wind herbs to overcome Dampness. This constitutes the supreme treatment involving strong lifting and raising to assist Spring-Summer Qi for long-standing sinking Dampness. Another version notes: Subsequently, use Siwu Tang (Four Substances Decoction), modified according to Dampness manifestations.