喻嘉言曰∶室女某，经闭年余，发热，食少，肌削，多汗，汗出如蒸笼气水，医谓属血枯，与补剂，血益涸，此经
血内闭，化汗外泄也。设无汗而血不流，则筋骨皮毛皆干萎而死矣。宜极苦之药，敛血入内，下通冲脉，则热退经行，
而汗自止也。与龙荟丸，日三服。
龙荟丸（一名当归芦荟丸）
当归（一两） 胆草（一两） 栀子（一两） 芦荟（五钱） 青黛（五钱） 麝香（五分）
黄柏（一钱） 黄芩（一两） 黄连（一两） 大黄（五钱） 木香（二钱五分）
酒丸，童便下，月余经血略至，汗热稍轻，减之日一服。又一月，经血大至，诸病皆瘳。（按∶每服不言多寡，酌用
可也。）
妇女经水断，与通经药不效，反泄泻便血，投四神、六君、八味之属，泻益甚，食少，骨瘦如柴，此血枯而不归经
也。然其血未涸，阳气不脱，易治。加减黄土汤君鹿茸以治之。
鹿茸（生用） 熟地 阿胶 赤石脂 白归身（炒） 白术（土炒） 甘草 黄芩 麦冬肉 黑芥穗
（〔批〕血枯血崩之证，气不脱者易治，脱气者危，故此下再三致意焉。）
其血未涸，气先脱，呛咳喘促者危。先服独参汤或黄 汤，少定，与加减六君子汤，君鹿茸治之。
生鹿茸 制白术 茯苓 北五味 麦冬肉 阿胶 野山参 炙甘草 陈皮 山萸肉 赤石脂 芥穗（炒）
前方偏于补血药，此方则补敛精气者居多，用意各殊也。人参如无真者，以绵黄 代之。
喻嘉言说：有一位未婚女子，月经闭止一年多，伴有发热、食欲减退、肌肉消瘦、多汗等症状，出汗时如同蒸笼冒出的水汽。医生认为这是血枯证，给予补益药剂，结果血液更加枯竭。这是因为经血在内闭塞，化为汗液向外泄出。假如没有汗出而血液不流通，那么筋骨皮毛都会干枯萎缩而导致死亡。应当使用极苦味的药物，收敛血液使其回归体内，并向下疏通冲脉，这样热退、月经来潮，汗出自然停止。给予龙荟丸，每日服用三次。
龙荟丸（又名当归芦荟丸）
当归（一两） 龙胆草（一两） 栀子（一两） 芦荟（五钱） 青黛（五钱） 麝香（五分）
黄柏（一钱） 黄芩（一两） 黄连（一两） 大黄（五钱） 木香（二钱五分）
用酒制成丸剂，以童子尿送服。一个月后月经略有来潮，汗出和发热症状稍减，改为每日服用一次。又过一个月，月经大量来潮，各种疾病都痊愈了。（按语：每次服用的剂量未明确说明，可根据情况斟酌使用。）
妇女月经断绝，使用通经药物治疗无效，反而出现腹泻、便血，投用四神丸、六君子汤、八味丸等药物后，腹泻更加严重，食欲减退，骨瘦如柴，这是血枯且血液不能归经所致。然而她的血液尚未枯竭，阳气也未脱失，属于容易治疗的病例。使用加减黄土汤，加入鹿茸作为君药来治疗。
鹿茸（生用） 熟地黄 阿胶 赤石脂 当归身（炒） 白术（土炒） 甘草 黄芩 麦冬肉 黑芥穗
（批注：血枯和血崩的病症，气未脱失的容易治疗，气脱失的则危险，因此下文再三强调这一点。）
如果血液尚未枯竭，但气先脱失，出现呛咳、气喘急促的症状，则病情危重。先服用独参汤或黄芪汤，待气息稍定，再给予加减六君子汤，加入鹿茸作为君药治疗。
生鹿茸 制白术 茯苓 北五味子 麦冬肉 阿胶 野山参 炙甘草 陈皮 山萸肉 赤石脂 芥穗（炒）
前方侧重于补血药物，此方则以补益和收敛精气为主，用意各不相同。人参如果没有真品，可以用绵黄芪代替。
Yu Jiayan stated: A certain unmarried woman had amenorrhea for over a year, accompanied by fever, poor appetite, emaciation, and excessive sweating. Her sweat was profuse like the steam from a steamer. The physician diagnosed it as Blood Depletion (Xue Ku) and administered tonifying agents, which only exacerbated the dryness of the blood. This occurred because the menstrual blood was internally obstructed and transformed into sweat that leaked outward. If there were no sweat and the blood did not flow, the sinews, bones, skin, and hair would all become dry and atrophic, leading to death. It is appropriate to use extremely bitter medicines to astringe the blood inward and unblock the Chong Mai (Penetrating Vessel) downward. In this way, the heat will subside, menstruation will resume, and sweating will cease naturally. Prescribed Long Hui Wan (Dragon Gallbladder Pill), taken three times daily.
Long Hui Wan (also known as Dang Gui Lu Hui Wan / Cinnamon Twig and Aloe Vera Pill)
Dang Gui (Angelicae Sinensis Radix, 1 liang)
Dan Cao (Gentianae Radix, 1 liang)
Zhi Zi (Gardeniae Fructus, 1 liang)
Lu Hui (Aloe, 5 qian)
Qing Dai (Indigo Naturalis, 5 qian)
She Xiang (Moschus, 5 fen)
Huang Bo (Phellodendri Cortex, 1 qian)
Huang Qin (Scutellariae Radix, 1 liang)
Huang Lian (Coptidis Rhizoma, 1 liang)
Da Huang (Rhei Radix et Rhizoma, 5 qian)
Mu Xiang (Aucklandiae Radix, 2.5 qian)
Made into pills with wine, taken with urine from an uncircumcised boy. After one month, menstruation slightly resumed, and sweating and fever slightly alleviated; dosage was reduced to once daily. After another month, menstruation flowed heavily, and all ailments were cured. (Note: The specific dosage per administration is not specified; please adjust according to circumstances.)
In cases where a woman’s menses have ceased and blood-invigorating medications are ineffective, resulting instead in diarrhea and bloody stools, administering formulas such as Si Shen Wan (Four Miracles Pill), Liu Jun Zi Tang (Six Gentlemen Decoction), or Ba Wei Wan (Eight-Ingredient Pill) exacerbates the diarrhea. With poor appetite and emaciation resembling firewood, this indicates Blood Depletion (Xue Ku) where the blood fails to return to its vessels. However, since the blood has not yet dried up and the Yang Qi has not collapsed, it is easy to treat. Use Jia Jian Huang Tu Tang (Modified Yellow Earth Decoction) with Lu Rong (Deer Antler) as the sovereign herb.
Lu Rong (Deer Antler, raw)
Shu Di (Rehmanniae Radix Preparata)
E Jiao (Colla Corii Asini)
Chi Shi Zhi (Halloysit Rubra)
Bai Gui Shen (Angelicae Sinensis Radix, stir-fried)
Bai Zhu (Atractylodis Macrocephalae Rhizoma, soil-stir-fried)
Gan Cao (Glycyrrhizae Radix et Rhizoma)
Huang Qin (Scutellariae Radix)
Mai Dong Rou (Ophiopogonis Tuber)
Hei Jie Sui (Schizonepetae Spica, charred)
(Commentary: For conditions of Blood Depletion and Metrorrhagia, cases where Qi has not collapsed are easy to treat, whereas those with Qi collapse are critical; hence, emphasis is repeatedly placed on this point below.)
If the blood has not yet dried up but Qi collapses first, presenting with choking cough and panting, the condition is critical. First administer Du Shen Tang (Single Ginseng Decoction) or Huang Qi Tang (Astragalus Decoction). Once breathing stabilizes, prescribe Jia Jian Liu Jun Zi Tang (Modified Six Gentlemen Decoction) with Lu Rong (Deer Antler) as the sovereign herb.
Sheng Lu Rong (Deer Antler, raw)
Zhi Bai Zhu (Atractylodis Macrocephalae Rhizoma, processed)
Fu Ling (Poria)
Bei Wu Wei Zi (Schisandrae Chinensis Fructus)
Mai Dong Rou (Ophiopogonis Tuber)
E Jiao (Colla Corii Asini)
Ye Shan Shen (Wild Panax Ginseng Radix)
Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried)
Chen Pi (Citri Reticulatae Pericarpium)
Shan Yu Rou (Corni Fructus)
Chi Shi Zhi (Halloysit Rubra)
Jie Sui (Schizonepetae Spica, stir-fried)
The former formula focuses on blood-tonifying herbs, while this formula primarily tonifies and astringes Essence and Qi; their intentions differ significantly. If genuine Ren Shen (Panax Ginseng Radix) is unavailable, Mian Huang Qi (Astragali Radix) may be used as a substitute.