经云∶阴虚阳搏谓之崩。又云∶悲哀动中，则胞络绝。阳气内动，发为心下崩，病机已
见大端。至于治法，方书虽有暴崩宜温，久崩宜清之语，要知此温清二字，乃示人大意，未
可执论也。夫气为血之帅，暴崩气随血脱，每见晕汗诸证，故宜甘温，以益其气。盖有形之
血，不能速生，无形之气，所当急固。初非指温字为温烈之温也。阴为阳之守，久崩血耗阴伤
，每见躁热诸证，又当滋养，以培其阴。盖壮水之主，以镇阳光。盏中加油，浮焰自敛，亦
非指清字为清凉之清也。病由半产失调，始而经漏，继则崩中，黑归脾汤一方，按心脾肝三
经用药，暴崩之顷，洵属合宜，若谓反复之故，除肝脾失其藏统之外，或情怀不释，因怒动
血者有之，或冲脉空虚，不司约束者有之，或肾水下亏，不能坐镇心火者有之，或元气大
虚，不能收摄其血者有之。断无因服归
脾汤而反致崩之理。凡血离宫便成块，未可见血之有块，即认为瘀。果真内有蓄瘀，必然胀
痛拒按，何崩决数番，腹无所苦耶?血色紫黑，固多属热，然须辨其热之虚实。经言阳搏其
阴必虚，心崩由乎悲哀太甚，其旨可见。再按肾开窍于二阴，冲为血海，脉起气街，据言小
解后血随溢出，此肾真下亏。冲脉不固，益彰彰矣。
安波按∶洄溪云，崩漏宜大剂补阴，轻药不能以取效。余拟砂仁炒枯，熟地、蒲黄炒
枯、
阿胶、桑螵蛸、海螵蛸、醋 牡蛎、棕炭，以鸡黄炒茜草，以黄芩水炒血余，以童便炒
枯尽烟，人参、谷芽等分修丸。余自名为补炼丸。曾治吴观察夫人患崩三月，诸味饵遍不
效余以此丸大剂作汤饮，十裹而痊。
《黄帝内经》说：阴虚而阳气搏动，就会发生血崩。又说：悲哀等情绪扰动内脏，会导致胞络阻滞。阳气在内妄动，引发心下出血（指阴道大量出血），疾病的机理已经显露出主要方面。至于治疗方法，医书虽然有这样的说法：暴发性血崩适宜用温法，久病血崩适宜用清法，但要知道这“温”和“清”两个字，是向人展示大意原则，不可拘泥死板地讨论。气是血的统帅，暴发性血崩时气随血脱，常常出现晕厥、出汗等症状，所以适宜用甘温的药物，来补益其气。因为有形之血不能快速生成，无形之气应当紧急固摄。这里并非指“温”字是指温热燥烈的药性。阴是阳的守持者，久病血崩导致血耗伤阴，常常出现烦躁发热等症状，又应当滋养，来培补其阴。正如增强肾水之主以镇摄阳光一样，灯盏中加油，浮动的火焰自然收敛，这里也并非指“清”字是指清凉寒凉的药物。
此病由于半产（小产）后调护不当，起初是经血淋漓不尽（经漏），随后发展为崩中（大量出血）。黑归脾汤这一方剂，按照心、脾、肝三经用药，在暴发性血崩之际，确实属于合宜。如果说反复发作的原因，除了肝脾失去藏血和统血的功能之外，或许有因情怀不畅，因愤怒而动血的情况；或许有冲脉空虚，不能行使约束血液功能的情况；或许有肾水下亏，不能坐镇制约心火的情况；或许有元气大虚，不能收摄血液的情况。绝对没有服用归脾汤反而导致崩漏的道理。凡是血液离开子宫就会结成块状，不能见到血中有块，就认为是瘀血。如果体内真有蓄积的瘀血，必然会有胀痛且拒绝按压的症状，为何崩漏发作数次，腹部却没有痛苦呢？血色紫黑，固然多属于热证，但是必须辨别热的虚实。经文说阳气搏动则阴必虚，心下崩由乎悲哀太甚，其中的旨意可以由此看出。再按中医理论，肾开窍于前后二阴，冲脉为血海，脉起于气街，据患者描述小便后血液随之溢出，这说明肾真阴下亏，冲脉不固，这是显而易见的。
安波按语：洄溪曾说，崩漏适宜用大剂量补阴药物，轻药不能取得疗效。我拟定砂仁炒枯，熟地黄、蒲黄炒枯、阿胶、桑螵蛸、海螵蛸、醋煅牡蛎、棕榈炭，用鸡黄炒茜草，用黄芩水炒血余炭，用童便炒至尽烟，人参、谷芽等分制作蜜丸。我自己命名为“补炼丸”。曾治疗吴观察夫人患崩漏三个月，各种药物都试遍无效，我用此丸改为大剂量煎汤服用，十剂痊愈。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: "Yin deficiency with Yang pulsation is called Beng" (Beng refers to metrorrhagia or uterine bleeding). It also states: "Sorrow and grief disturbing the interior causes the Pericardium Collateral to be severed. Yang Qi moves internally, leading to 'Xin Xia Beng' (bleeding from below, referring to severe vaginal bleeding); the pathogenesis of the disease is already evident in its major aspects."
Regarding treatment methods, although medical texts contain statements such as "acute Beng should be treated with warmth, and chronic Beng should be treated with clearing," it must be understood that these characters for "warmth" (Wen) and "clearing" (Qing) illustrate general principles and should not be interpreted rigidly. Qi is the commander of Blood. In acute Beng, Qi follows the loss of Blood, often presenting with symptoms such as fainting and sweating; therefore, sweet-warm herbs are appropriate to tonify Qi. This is because substantial Blood cannot be generated rapidly, whereas insubstantial Qi must be urgently secured. Here, "warmth" does not refer to hot and acrid properties. Yin is the guardian of Yang. In chronic Beng, blood loss damages Yin, often presenting with irritability and heat; thus, nourishment is required to cultivate Yin. Just as strengthening the source of Water (Kidney Yin) calms the Sun (Hyperactive Yang), adding oil to a lamp causes the floating flame to subside naturally. Similarly, "clearing" here does not refer to cold and cooling properties.
This illness originated from improper regulation after a miscarriage (Ban Chan). Initially, there was menstrual dripping (Jing Lou), which subsequently progressed to central Beng (severe uterine bleeding). The formula *Hei Gui Pi Tang* (Black Spleen-Restoring Decoction) targets the Heart, Spleen, and Liver meridians and is indeed appropriate during acute episodes of Beng. If one argues that the reason for recurrence lies beyond the Liver and Spleen failing to store and control blood, there may be cases where emotional stagnation leads to anger stirring Blood; cases where the Chong Mai (Penetrating Vessel) is empty and fails to constrain blood; cases where Kidney Water is deficient at the lower level and cannot suppress Heart Fire; or cases where Yuan Qi (Original Qi) is severely deficient and cannot grasp Blood. There is absolutely no logic suggesting that taking *Gui Pi Tang* would cause Beng. Whenever Blood leaves the uterus, it forms clots; therefore, the presence of clots in blood does not automatically indicate Blood Stasis (Yu Xue). If there were truly accumulated stasis internally, there would inevitably be distension, pain, and tenderness upon pressure. Why, then, has the patient suffered multiple episodes of Beng without any abdominal discomfort? Although purple-black blood color often indicates Heat, one must distinguish between Deficiency Heat and Excess Heat. The classic text states that Yang pulsation implies Yin deficiency. The etiology of Xin Xia Beng due to excessive sorrow illustrates this principle. Furthermore, according to TCM theory, the Kidneys open into the two yin passages (urethra and anus), and the Chong Mai serves as the Sea of Blood, originating at the Qijie region. The patient reports that blood flows out following urination, indicating a clear deficiency of Kidney True Yin and instability of the Chong Mai.
An Bo adds: Huixi stated that Beng and Lou (metrorrhagia and leukorrhea) require large doses of Yin-nourishing herbs; light doses cannot achieve efficacy. I formulated a pill using Cardamom Seed (Sha Ren) roasted until charred, Prepared Rehmannia Root (Shu Di Huang), Coptis Rhizome (Pu Huang) roasted until charred, Donkey-hide Gelatin (E Jiao), Mantis Egg Case (Sang Piao Xiao), Cuttlefish Bone (Hai Zhe Xiao), Vinegar-processed Oyster Shell (Cu Mu Li), and Palm Charcoal (Zong Tan). Additionally, I used Rubia Root (Qian Cao) stir-fried with chicken yolk, Hairy Stem Charcoal (Xue Yu Tan) stir-fried with Scutellaria Root (Huang Qin) water, and Child’s Urine (Tong Bian) stir-fried until smoke ceases, combined with Ginseng (Ren Shen) and Millet Sprout (Gu Ya) in equal proportions, processed into honey pills. I named this formula "Bu Lian Wan" (Tonifying and Refining Pill). I once treated the wife of Inspector Wu, who had suffered from Beng for three months with no effect from various medications. I prescribed this pill in large doses decocted as a soup. She recovered after ten doses.