汗则愈。（方见。）
〔泄泻〕
汪石山治一妇经行，必泻三日然后行，诊其脉皆濡弱，此脾虚也。脾属血，属湿。经
水将动，脾血先已流注血海，然后下流为经。脾血既亏，则虚而不能营运其湿。令作参苓
白术散，每服二钱，一日米饮调下二三次，月余经行不泻矣。 一妇年逾四十，形长色脆，
病经不调，右脉浮软而大，左脉虚软而小近驶，当时经前作泄。今年四月，感风咳嗽，用
汤洗浴汗多，因泄一月。六月，复因洗浴，发疟六七次，疟虽止而神思不爽。至八月尽而
经水过多，白带时下，泻泄，遂觉右脚疼痛。旧曾闪肭脚跟，今则假此延痛臀腿、腰胁、尻
骨，颈项右边筋皆掣痛，或咳嗽一声，则腰眼痛如腰札，日轻夜重，叫号不已，幸痛稍
止，饮食如常。今详月水过多，白带时下，日轻夜重，泻泄无时，亦属下多亡阴，宜作血
虚论治，服四物止痛之剂益甚。九月，汪复诊视，始悟此病乃合仲景所谓阳生则阴长之
法矣。夫经水多，白带下，常泄泻，皆由阳虚陷下而然，命曰阳脱是也。日轻夜重，盖
日阳旺而得健运之职，故血亦无凝滞之患，而日故轻也。夜则阴旺而阳不得其任，失其健
运之常，血亦随滞，故夜重也。遂以参、术助阳之药，煎服五七帖，痛减。此亦病证之
变，治法殊常，故记之。
〔月水不断〕
妇人月水不断，淋沥无时，或因劳损气血而伤冲任，或因经行而合阴阳，皆令气虚
不能摄血。若时止时行，腹痛脉沉细，此寒热邪气客于胞中，非因虚弱也。
〔薛〕前证若郁结伤脾，用归脾汤。恚怒伤肝，逍遥散。肝火妄动，加味四物汤。脾
气虚弱，六君子汤。元气下陷，补中益气汤。热伤元气，前汤加五味、麦门、炒黑黄柏。
儒者钱思习子室，年三十余无嗣，月经淋沥无期，夫妇异处几年矣。思习欲为娶外家，以
谋诸余。余谓此郁怒伤肝，脾虚火动，而血不归经。乃肝不能藏，脾不能摄也。当清肝
火、补脾气，遂与加味归脾、逍遥二药四剂，送至其家，仍告其姑曰∶服此病自愈，而当
受胎，外家可无娶也。果病愈，次年生子。
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。余先以四物加白术、茯苓、柴
胡、炒栀、炒龙胆，清肝养血。次用四君子加柴胡、芍药、神曲、吴茱萸、炒黄连，以
培土制肝，渐愈。惟月经不止，是血分有热，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，兼服而安。一妇人多怒，经行旬余方止，后淋沥无期，肌
体倦瘦，口干内热，盗汗如洗，日晡热甚。皆由肝脾亏损，无以生发元气，用参、 、归、
术、茯神、远志、枣仁、麦门、五味、丹皮、龙眼肉、炙草、柴胡、升麻治之，获痊。
一妇人怀抱不舒，腹胀少寐，饮食素少，痰涎上涌，月经频数。余曰∶脾统血而主涎，此
郁闷伤脾，不能摄血归源耳。用补中益气、济生归脾而愈。
胶艾汤 治劳伤血气，冲任虚损，月水过多，淋沥不断。
阿胶（炒） 川芎 甘草（炙，各二两） 当归 艾叶（炒，各三两） 熟地黄
白芍药（各四两）
上 咀，每服半两，水煎。一方有黄 。
续断丸 （《大全》）治月水不断，口干心烦，四肢羸乏，饮食减少。
川续断 当归 乌贼骨 黄 牛角 （烧） 五味子 甘草 龙骨（ 研） 赤石脂
熟地黄（各一两） 地榆（半两） 艾叶 附子 干姜 川芎（各七钱半）
上为末，炼蜜丸梧子大，每服三十丸，空心温酒下。
禹余粮丸 治久冷，月水不断，面黄肌瘦，虚烦减食。
禹余粮（二两） 鹿角胶（七钱半，粉炒） 紫石英 续断 赤石脂 熟地黄 川芎（各一两）
干姜 黄 艾叶 柏叶（炒） 当归（炒） 人参 白茯苓（各半两）
上为末，炼蜜丸梧子大，每三十丸，空心米饮下。
牡蛎丸 治血海虚损，月水不断。
牡蛎粉 赤石脂 代赭石（各一两） 阿胶 川芎 当归 鹿茸 续断 干姜（各三两）
甘草（二钱半）
上为末，炼蜜丸梧子大，每服三十丸，空心温酒下。
经验方 治经血不止。
黄芩（五分） 当归 柏叶 蒲黄（各四分） 生姜（二分） 艾叶（一分） 生地黄（二十四分）
伏龙肝（十二分）
上 咀，用水二升，煎取八合，分二服。
又经血不止，诗云∶妇人经血久淋漓，旧蕊莲蓬烧作灰，热酒一杯调八字，自然安乐
更无疑。
又方 莲蓬壳 拒霜花（二味等分）
为末，每服二钱，空心米饮调下。
伏龙肝散 （《和剂》）治血气劳伤，冲任脉虚，经血非时注下，或如豆汁，或成血片，或
五色相亲，脐腹冷痛，月经不止。
伏龙肝 麦门冬（去心） 赤石脂（各一钱） 熟地黄 艾叶（炒，各一钱半） 当归（去芦，炒）
川芎（各二钱半） 肉桂（去粗皮） 干姜（炮） 甘草（各半钱）
上作一服，水二盅，红枣二枚，煎至一盅，食前服。
固经丸 治经水过多不止，乃阴虚挟热所致，法当补阴清热。
黄柏（三两） 龟板（炙，四两） 黄芩（二两） 白芍药（三两） 樗根皮（一两半） 香附子（童便制，一
两半）
上为细末，酒糊丸梧子大，每以空心食前白汤下五、七十丸。
〔月水不利〕
〔良〕妇人月水不利者，由劳伤气血，体虚而风冷客于胞内，伤于冲任之脉故也。若
寸脉弦，关脉沉，是肝病也，兼主腹痛，孔窍生疮。尺脉滑，血气实，经络不利，或尺
脉绝不至，兼主小腹引腰痛，气攻胸隔也。
〔薛〕前证属肝胆二经，盖肝胆相为表里，多因恚怒所伤。若本经风热，用补肝散。
（方见胁痛门。）血虚用四物加酸枣仁，若肾水不足用六味丸，若患诸疮疡，治见后。
牛膝散 治月水不利，脐腹作痛，或小腹引腰，气攻胸膈。
牛膝（酒制，一两） 桂心 赤芍药 桃仁（去皮尖） 玄胡索（炒） 当归（酒浸） 牡丹皮
木香（各七钱半）
上为末，每服一钱，空心温酒调下。
牡丹散 治月候不利，腹脐疼痛，不欲食。
牡丹皮 大黄（炒，各一两） 赤茯苓 桃仁 生地黄 当归 桂心 赤芍药 白术（各七钱半）
石韦（去毛） 木香（各半两）
上 咀，每服三钱，水一盏，姜三片，煎七分，空心温服。
产宝方 治女人月经不利，脐下气胀，上攻欲呕，不得睡。
当归（四钱） 干漆（三钱，炒令烟尽）
上为细末，蜜丸梧子大，空心温酒下十五丸。
养荣汤 治妇人血海虚弱，心中恍惚，时多惊悸，或发虚热，经候不调。
白芍药 川芎 熟地黄 姜黄 当归 川姜 青橘皮 五加皮 牡丹皮 海桐皮 白芷（各等分）
每服五钱，水一盏半，生姜五片，乌梅一个，煎至一盏，温服，不拘时，送紫桂丸五十粒。（紫桂丸
方见带下。）
〔过期不止〕
《产宝》云∶男子生于寅，寅属木，阳中有阴，故男子得八数。女子生于申，申属金，阴中有阳，
女子得七数。男以气为主，八八则卦数已尽，尽则阳精痿。女以血为主，七七则卦数已终，终则经水绝，
任冲脉虚衰，天癸绝，地道不通而无子矣。或劳伤过度，喜怒不时，经脉衰微之际，又为邪气攻冲，所
以当止不止而崩下也。
许学士云∶妇人经脉过期不及，腰腹疼痛，或七七数尽而月经下者，宜用当归散治
之。
当归散 治妇人天癸已过期，经脉不匀，或三四月不行，或一月再至，腰腹疼痛。
《素问》云∶七损八益。谓女子七数尽而经不根据时者，血有余也，不可止之，但令得
根据时，不腰痛为善。（方见前调经平剂条。）
〔竹〕芩心丸 治妇人四十九岁以后，天癸当住，每月却行，或过多不止。
用黄芩心枝条者二两，米泔浸七日，炙干，又浸又炙，如此七次，为末，醋丸如桐子大，
每服七十丸，空心温酒送下，日进二服。
上二方热者宜之。
茸附汤 补任冲，调血气。
干姜（四两） 肉桂（去粗皮） 附子 龙骨（生用） 防风（各一两） 牡蛎（ ） 当归（各二两）
鹿茸（三两，酒炙）
每服半两，水二盅，煎八分，温服。
补中芎 汤 治风虚冷热，劳伤冲任，月水不调，崩中暴下，产后失血过多，虚羸腹痛，或
妊娠胎动不安，下血。
当归 干姜（炮，各三两） 川芎（蜜炙） 黄 甘草（炙） 吴茱萸（炮黄）
杜仲（炒） 熟地黄 人参（各一两）
每服三钱，水一盅半，煎一盅，空心服。
上二方寒者宜之，盖亦有血海虚寒而不禁者也。
〔薛〕前证若肝肾虚热，用当归散。肝血虚热，四物加柴、栀、丹皮。肝火内动，小
柴胡加山栀、丹皮。肝火血燥，加味逍遥散。脾经郁火，加味归脾汤。肝脾郁火。归脾、逍
遥兼服。肝肾亏损，归脾、六味兼服。仍与前后月经不调治验同用。一妇人年五十，内
热晡热，经水两三月一至。此血虚有热，用逍遥散加山茱萸治之而愈。后有痰作渴，或
小便不调，或头晕白带，用六味丸而安。
〔脉〕问曰∶妇人年五十数，一朝而清血二三日不止，何以治之？师曰∶此妇人前绝生，
经水不下，今反清血，此为居经，不须治，当自止。经水下常五日止者，五日愈。
汗出则病愈。（方剂见前文。）
〔泄泻〕
汪石山治疗一位妇女，每逢月经来潮，必定腹泻三天后月经才正式行经。诊察其脉象皆呈现濡弱之象，这是脾虚所致。脾属血分，主运化水湿。月经将动之时，脾血先已流注于血海，然后下行成为经血。既然脾血亏虚，则虚弱而不能正常运化体内的湿气，导致湿气下注而成泄泻。于是开具参苓白术散，每次服用二钱，一日用米汤调服两三次，月余之后，该妇女经期不再伴随泄泻。
另一位妇女年过四十，身形修长但体质娇脆，患有月经不调，右脉浮软而大，左脉虚软而小且近于疾数，当时正值经前作泄泻。今年四月，因感受风邪而咳嗽，使用汤药洗浴后出汗过多，因此导致泄泻持续一个月。六月，再次因洗浴，发作疟疾六七次，虽然疟疾停止，但神志思维不清爽。到了八月末，月经量过多，白带时下，伴有泄泻，随即感觉右脚疼痛。旧伤曾闪挫脚跟，如今借此延痛至臀部、腿部、腰胁及尻骨，颈项右侧筋脉均出现掣痛，有时咳嗽一声，则腰部酸痛如被针刺，症状日轻夜重，叫喊不停。幸好疼痛稍止，饮食如常。现在详细分析：月经量多，白带时下，日轻夜重，泄泻无定时，这也属于下部失血导致的亡阴，应当作为血虚论治，服用四物汤止痛的药剂反而加重病情。九月，汪石山再次诊视，才明白此病符合张仲景所说的“阳生则阴长”的方法。月经多、白带下、常泄泻，皆由阳虚陷下所致，命名为阳脱。日轻夜重，是因为白天阳气旺盛，能够行使健运的功能，所以血液也没有凝滞的隐患，故白天症状轻；夜晚则阴气旺盛而阳气不能胜任，失去了健运的常态，血液随之凝滞，故夜晚症状重。于是用人参、白术等助阳的药物，煎服五七帖，疼痛减轻。这也是病证的变化，治疗方法不同于常规，所以记录下来。
〔月水不断〕
妇女月经淋漓不断，无时休止，或因劳损气血而损伤冲任二脉，或因经期行房事，都会导致气虚不能摄血。如果时止时行，腹痛且脉象沉细，这是寒热邪气客居于胞宫，并非因为虚弱所致。
〔薛〕前述证候若因郁结伤脾，使用归脾汤。因愤怒伤肝，使用逍遥散。肝火妄动，使用加味四物汤。脾气虚弱，使用六君子汤。元气下陷，使用补中益气汤。热邪损伤元气，在前述方剂基础上加五味子、麦门冬、炒黑黄柏。
儒者钱思习的妻子，三十多岁无子嗣，月经淋漓无期，夫妇分居几年了。思习想为妻子娶妾，以此征求我的意见。我说这是郁怒伤肝，脾虚火动，导致血不归经。乃是肝不能藏血，脾不能摄血。应当清肝火、补脾气，于是给予加味归脾汤和逍遥散两种药各四剂，送到他家，并告诉他的婆婆说：“服用这些药病会自愈，并且会受孕，可以不用娶妾了。”果然病愈，次年生子。
一位妇女性格急躁，每次发怒不是太阳经、耳部、颈部、咽喉、牙齿、胸部乳房作痛，就是胸满吞酸，呕吐泄泻少食，月经不止。这都是肝火的证候，肝自病则外证显现，脾土受克则内证发作。我先用四物汤加白术、茯苓、柴胡、炒栀子、炒龙胆草，以清肝养血。接着用四君子汤加柴胡、芍药、神曲、吴茱萸、炒黄连，以培土制肝，逐渐痊愈。只有月经不止，是血分有热，脾气尚虚，用逍遥散倍用白术、茯苓、陈皮，又用补中益气汤加酒炒芍药，兼服而安。
一位妇女多怒，月经行十余天方止，后来淋漓无期，身体疲倦消瘦，口干内热，盗汗如洗，傍晚发热甚剧。皆由肝脾亏损，无以生发元气，用人参、黄芪、当归、白术、茯神、远志、枣仁、麦门冬、五味子、丹皮、龙眼肉、炙甘草、柴胡、升麻治疗，获得痊愈。
一位妇人怀抱不舒，腹胀少寐，饮食素少，痰涎上涌，月经频数。我说：“脾统血而主涎，这是郁闷伤脾，不能摄血归源罢了。”用补中益气汤、济生归脾汤而愈。
胶艾汤 治疗劳伤血气，冲任虚损，月经量多，淋漓不断。
阿胶（炒） 川芎 甘草（炙，各二两） 当归 艾叶（炒，各三两） 熟地黄 白芍药（各四两）
以上药材切碎，每次服用半两，用水煎煮。另一版本方中有黄芪。
续断丸 （出自《大全》）治疗月经淋漓不断，口干心烦，四肢瘦乏，饮食减少。
川续断 当归 乌贼骨 黄芪 牛角腮（烧） 五味子 甘草 龙骨（研碎） 赤石脂 熟地黄（各一两） 地榆（半两） 艾叶 附子 干姜 川芎（各七钱半）
以上药材研为末，炼蜜制成梧桐子大小的丸药，每次服用三十丸，空腹时用温酒送下。
禹余粮丸 治疗久冷，月经淋漓不断，面色黄肌瘦，虚烦减食。
禹余粮（二两） 鹿角胶（七钱半，粉炒） 紫石英 续断 赤石脂 熟地黄 川芎（各一两） 干姜 黄芪 艾叶 侧柏叶（炒） 当归（炒） 人参 白茯苓（各半两）
以上药材研为末，炼蜜制成梧桐子大小的丸药，每次三十丸，空腹时用米饮送下。
牡蛎丸 治疗血海虚损，月经淋漓不断。
牡蛎粉 赤石脂 代赭石（各一两） 阿胶 川芎 当归 鹿茸 续断 干姜（各三两） 甘草（二钱半）
以上药材研为末，炼蜜制成梧桐子大小的丸药，每次服用三十丸，空腹时用温酒送下。
经验方 治疗经血不止。
黄芩（五分） 当归 柏叶 蒲黄（各四分） 生姜（二分） 艾叶（一分） 生地黄（二十四分） 伏龙肝（十二分）
以上药材切碎，用水二升，煎取八合，分两次服用。
又有经血不止的诗云：“妇人经血久淋漓，旧蕊莲蓬烧作灰，热酒一杯调八字，自然安乐更无疑。”
又一方：莲蓬壳 拒霜花（两味等分）
研为末，每次服用二钱，空腹时用米饮调下。
伏龙肝散 （出自《和剂局方》）治疗血气劳伤，冲任脉虚，经血非时注下，或如豆汁，或成血片，或五色混杂，脐腹冷痛，月经不止。
伏龙肝 麦门冬（去心） 赤石脂（各一钱） 熟地黄 艾叶（炒，各一钱半） 当归（去芦，炒） 川芎（各二钱半） 肉桂（去粗皮） 干姜（炮） 甘草（各半钱）
以上为一服量，用水二盅，红枣二枚，煎至一盅，饭前服用。
固经丸 治疗经水过多不止，乃阴虚挟热所致，法当补阴清热。
黄柏（三两） 龟板（炙，四两） 黄芩（二两） 白芍药（三两） 樗根皮（一两半） 香附子（童便制，一两半）
以上研为细末，酒糊制成梧桐子大小的丸药，每次空腹食前用白开水送服五、七十丸。
〔月水不利〕
〔良〕妇女月经不畅，是由于劳伤气血，身体虚弱而风冷客居于胞内，损伤冲任二脉所致。如果寸脉弦，关脉沉，是肝病，兼主腹痛，孔窍生疮。尺脉滑，血气实，经络不利，或者尺脉绝不至，兼主小腹牵引腰痛，气攻胸膈。
〔薛〕前述证候属于肝胆二经，盖因肝胆相为表里，多因恚怒所伤。若本经风热，使用补肝散。（方剂见胁痛门。）血虚用四物汤加酸枣仁，若肾水不足用六味丸，若患诸疮疡，治法见后文。
牛膝散 治疗月经不畅，脐腹作痛，或小腹牵引腰部，气攻胸膈。
牛膝（酒制，一两） 桂心 赤芍药 桃仁（去皮尖） 玄胡索（炒） 当归（酒浸） 牡丹皮 木香（各七钱半）
以上研为末，每次服用一钱，空腹时用温酒调下。
牡丹散 治疗月经不利，腹脐疼痛，不欲食。
牡丹皮 大黄（炒，各一两） 赤茯苓 桃仁 生地黄 当归 桂心 赤芍药 白术（各七钱半） 石韦（去毛） 木香（各半两）
以上切碎，每次服用三钱，用水一盏，姜三片，煎至七分，空腹温服。
产宝方 治疗女人月经不利，脐下气胀，上攻欲呕，不得睡。
当归（四钱） 干漆（三钱，炒令烟尽）
以上研为细末，蜜丸梧桐子大小，空腹温酒送下十五丸。
养荣汤 治疗妇人血海虚弱，心中恍惚，时常惊悸，或发虚热，月经不调。
白芍药 川芎 熟地黄 姜黄 当归 川姜 青橘皮 五加皮 牡丹皮 海桐皮 白芷（各等分）
每次服用五钱，用水一盏半，生姜五片，乌梅一个，煎至一盏，温服，不拘时候，送服紫桂丸五十粒。（紫桂丸方见带下篇。）
〔过期不止〕
《产宝》说：“男子生于寅，寅属木，阳中有阴，所以男子得八数。女子生于申，申属金，阴中有阳，所以女子得七数。男以气为主，八八则卦数已尽，尽则阳精痿。女以血为主，七七则卦数已终，终则经水绝，任冲脉虚衰，天癸绝，地道不通而无子矣。”或者劳伤过度，喜怒不时，在经脉衰微之际，又为邪气攻冲，所以当止不止而崩漏下血。
许学士说：“妇人经脉过期不及，腰腹疼痛，或者七七数尽而月经仍下的，宜用当归散治疗。”
当归散 治疗妇人天癸已过期，经脉不匀，或三四月不行，或一月再至，腰腹疼痛。
《素问》说：“七损八益。”指女子七数尽而经不按时的，是血有余也，不可止之，只要令其按时来潮，不腰痛就好。（方剂见前调经平剂条。）
〔竹〕芩心丸 治疗妇人四十九岁以后，天癸应当停止，每月却行经，或过多不止。
用黄芩心枝条者二两，米泔水浸泡七日，炙干，又浸又炙，如此七次，研为末，醋丸如桐子大小，每次服用七十丸，空腹温酒送下，每日进二服。
以上两个方剂适用于热证。
茸附汤 补任冲，调血气。
干姜（四两） 肉桂（去粗皮） 附子 龙骨（生用） 防风（各一两） 牡蛎（煅） 当归（各二两） 鹿茸（三两，酒炙）
每次服用半两，用水二盅，煎八分，温服。
补中芎 汤 治疗风虚冷热，劳伤冲任，月经不调，崩中暴下，产后失血过多，虚羸腹痛，或者妊娠胎动不安，下血。
当归 干姜（炮，各三两） 川芎（蜜炙） 黄芪 甘草（炙） 吴茱萸（炮黄） 杜仲（炒） 熟地黄 人参（各一两）
每次服用三钱，用水一盅半，煎一盅，空腹服。
以上两个方剂适用于寒证，大概也有血海虚寒而不禁的情况。
〔薛〕前述证候若肝肾虚热，使用当归散。肝血虚热，四物汤加柴胡、栀子、丹皮。肝火内动，小柴胡汤加山栀、丹皮。肝火血燥，加味逍遥散。脾经郁火，加味归脾汤。肝脾郁火，归脾汤、逍遥散兼服。肝肾亏损，归脾汤、六味丸兼服。仍与前后月经不调治验同用。一位妇女年五十，内热晡热，经水两三月一至。这是血虚有热，用逍遥散加山茱萸治疗而愈。后有痰作渴，或者小便不调，或者头晕白带，用六味丸而安。
〔脉〕问曰：“妇人年五十数，一朝而清血二三日不止，何以治之？”师曰：“此妇人前绝生，经水不下，今反清血，此为居经，不须治，当自止。经水下常五日止者，五日愈。”
Sweating leads to recovery. (Formula see above.)
[Diarrhea]
Wang Shishan treated a woman who, upon the onset of menstruation, would inevitably suffer from diarrhea for three days before her menses fully proceeded. Her pulse was diagnosed as all soft and weak (Ru Ruo), indicating Spleen deficiency (Pi Xu). The Spleen governs Blood and is associated with Dampness. When menstrual blood is about to move, Spleen Blood first flows into the Sea of Blood (Xue Hai) and then descends to become menstruation. Since Spleen Blood is deficient, it becomes too weak to properly transport and transform internal Dampness, causing it to descend and result in diarrhea. He prescribed Shen Ling Bai Zhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder), two qian per dose, taken twice or thrice daily mixed with rice water. After more than a month, her menstruation ceased to be accompanied by diarrhea.
Another woman, over forty years old, tall but frail, suffered from irregular menstruation. Her right pulse was floating, soft, and large; her left pulse was empty, soft, small, and rapid. At that time, she experienced pre-menstrual diarrhea. In April this year, she contracted wind-cold coughing, and excessive sweating from herbal baths led to a month-long diarrhea. In June, another bath triggered six or seven episodes of malaria. Although the malaria stopped, her mental clarity remained impaired. By late August, she experienced menorrhagia (excessive menstrual flow), leukorrhea (white vaginal discharge), and diarrhea, followed by pain in her right foot. She had previously sprained her heel, and now the pain radiated to her buttocks, legs, waist, flanks, and sacrum. The tendons on the right side of her neck were also pulling and painful. A single cough caused sharp lower back pain like a stab wound. Symptoms were lighter during the day and heavier at night, with constant groaning. Fortunately, the pain subsided slightly, and her appetite remained normal. Upon detailed analysis: menorrhagia, leukorrhea, daytime-light/night-heavy pattern, and unregulated diarrhea all point to Yin depletion due to lower body bleeding. It should be treated as Blood deficiency. Taking Si Wu Tang (Four Substances Decoction) for pain relief worsened the condition. In September, Wang re-examined her and realized this case aligns with Zhang Zhongjing’s principle of "Yang generates Yin." Menorrhagia, leukorrhea, and chronic diarrhea are all caused by Yang deficiency sinking downward, termed Yang collapse (Yang Tuo). Daytime lightness occurs because Yang is vigorous during the day, performing its transforming functions effectively, preventing Blood stasis. Nighttime heaviness occurs because Yin dominates at night, leaving Yang unable to perform its transforming duties, leading to Blood stagnation. Thus, he used Yang-assisting herbs like Ginseng (Renshen) and Atractylodes Macrocephala (Baizhu), decocted and taken for five to seven doses, reducing the pain. This is a variation in pathology requiring unconventional treatment methods, hence recorded.
[Continuous Menstruation]
Women with continuous, dripping menstruation may suffer from Qi deficiency failing to control Blood due to labor-induced Qi and Blood damage affecting the Chong and Ren meridians, or due to intercourse during menstruation. If the flow stops and starts intermittently with abdominal pain and a deep, fine pulse, this indicates Cold-Heat pathogenic factors lodging in the Uterus (Bao Zhong), not due to deficiency.
[Xue] For the aforementioned symptoms: if caused by emotional constraint injuring the Spleen, use Gui Pi Tang (Restore the Spleen Decoction). If anger injures the Liver, use Xiao Yao San (Free and Easy Wanderer Powder). If Liver Fire moves recklessly, use Jia Wei Si Wu Tang (Modified Four Substances Decoction). If Spleen Qi is weak, use Liu Jun Zi Tang (Six Gentlemen Decoction). if Yuan Qi sinks, use Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction). If Heat damages Yuan Qi, add Schisandra (Wu Wei Zi), Ophiopogon (Mai Men Dong), and scorched Phellodendron (Huang Bo) to the previous formula.
The wife of Confucian scholar Qian Sixi, over thirty and childless, suffered from indefinite dripping menstruation, living apart from her husband for years. Sixi wished to take a concubine and sought my advice. I said this is Liver injury from frustration, Spleen deficiency with Fire movement, causing Blood to leave its vessels. The Liver fails to store Blood, and the Spleen fails to control it. One must clear Liver Fire and tonify Spleen Qi. I gave four doses each of Jia Wei Gui Pi Tang and Xiao Yao San, delivered to his home, and told his mother-in-law: "These medicines will cure the illness and enable conception; no concubine is needed." Indeed, she recovered and bore a son the following year.
A woman with an irritable temper, upon anger, would experience pain in the Taiyang channel, ears, neck, throat, teeth, chest, or breasts, or chest fullness with acid regurgitation, vomiting, diarrhea, and poor appetite, along with unstoppable menstruation. These are all Liver Fire syndromes. Liver self-disease manifests externally; Spleen Earth受克 (is overcome) manifests internally. I first used Si Wu Tang plus Atractylodes (Baizhu), Poria (Fuling), Bupleurum (Chai Hu), scorched Gardenia (Zhi Zi), and scorched Gentian (Long Dan Cao) to clear Liver Fire and nourish Blood. Then I used Si Jun Zi Tang plus Bupleurum, Peony (Shaoyao), Medicated Leaven (Shen Qu), Evodia (Wu Zhu Yu), and scorched Coptis (Huang Lian) to strengthen Earth to restrain Liver. Gradually, she improved. Only the unstoppable menstruation remained, indicating Heat in the Blood level and remaining Spleen deficiency. I used Xiao Yao San with doubled Atractylodes, Poria, and Tangerine Peel (Chen Pi), combined with Bu Zhong Yi Qi Tang plus wine-fried Peony, administering both until she stabilized.
Another woman prone to anger had menstruation lasting over ten days, followed by indefinite dripping, emaciation, dry mouth, internal heat, profuse night sweats, and severe afternoon fever. All resulted from Liver and Spleen deficiency, failing to generate Yuan Qi. I treated her with Ginseng, Astragalus (Huang Qi), Angelica (Dang Gui), Atractylodes, Poria (Fushen), Polygala (Yuan Zhi), Ziziphus Seed (Suan Zao Ren), Ophiopogon, Schisandra, Moutan Bark (Dan Pi), Longan Aril (Long Yan Rou), roasted Licorice (Zhi Gan Cao), Bupleurum, and Cimicifuga (Sheng Ma), resulting in a cure.
A woman with suppressed emotions suffered from abdominal distension, insomnia, poor diet, surging phlegm-saliva, and frequent menstruation. I said: "The Spleen controls Blood and governs saliva. This is Spleen injury from depression, failing to guide Blood back to its source." She recovered using Bu Zhong Yi Qi Tang and Ji Sheng Gui Pi Tang.
Jiao Ai Tang (Donkey-hide Gelatin and Mugwort Decoction) treats Labor-injury to Qi and Blood, deficiency of Chong and Ren meridians, menorrhagia, and continuous dripping.
Donkey-hide Gelatin (Jiao E, fried) Chuanxiong (Chuan Xiong) Licorice (Gan Cao, roasted, 2 liang each) Angelica (Dang Gui) Mugwort (Ai Ye, fried, 3 liang each) Prepared Rehmannia (Shu Di Huang) White Peony Root (Bai Shao Yao, 4 liang each)
Chop the ingredients. Take half a liang per dose, decoct in water. Another version includes Astragalus (Huang Qi).
Xu Duan Wan (Teasel Root Pill) [from *Da Quan*] treats continuous menstruation, dry mouth, irritability, emaciated limbs, and reduced appetite.
Teasel Root (Chuan Xu Duan) Angelica (Dang Gui) Cuttlefish Bone (Wu Zei Gu) Astragalus (Huang Qi) Horn of Buffalo (Niu Jiao Jiao, burnt) Schisandra (Wu Wei Zi) Licorice (Gan Cao) Dragon Bone (Long Gu, ground) Red Kaolin (Chi Shi Zhi) Prepared Rehmannia (Shu Di Huang, 1 liang each) Sanguisorba (Di Yu, 0.5 liang) Mugwort (Ai Ye) Aconite (Fu Zi) Dried Ginger (Gan Jiang) Chuanxiong (Chuan Xiong, 7.5 qian each)
Grind into powder, make pills with honey the size of paulownia seeds. Take 30 pills per dose, with warm wine on an empty stomach.
Yu Yu Liang Wan (Halloysitum Pill) treats chronic cold, continuous menstruation, sallow complexion, emaciation, empty vexation, and reduced appetite.
Halloysitum (Yu Yu Liang, 2 liang) Deer Antler Gelatin (Lu Jiao Jiao, 7.5 qian, fried with powder) Purple Quartz (Zi Shi Ying) Teasel Root (Xu Duan) Red Kaolin (Chi Shi Zhi) Prepared Rehmannia (Shu Di Huang) Chuanxiong (Chuan Xiong, 1 liang each) Dried Ginger (Gan Jiang) Astragalus (Huang Qi) Mugwort (Ai Ye) Biota Leaf (Bo Ye, fried) Angelica (Dang Gui, fried) Ginseng (Ren Shen) Poria (Bai Fu Ling, 0.5 liang each)
Grind into powder, make pills with honey the size of paulownia seeds. Take 30 pills per dose, with rice water on an empty stomach.
Mu Li Wan (Oyster Shell Pill) treats deficiency of the Sea of Blood and continuous menstruation.
Oyster Shell Powder (Mu Li Fen) Red Kaolin (Chi Shi Zhi) Magnetite (Dai Zhe Shi, 1 liang each) Donkey-hide Gelatin (E Jiao) Chuanxiong (Chuan Xiong) Angelica (Dang Gui) Deer Antler (Lu Rong) Teasel Root (Xu Duan) Dried Ginger (Gan Jiang, 3 liang each) Licorice (Gan Cao, 2.5 qian)
Grind into powder, make pills with honey the size of paulownia seeds. Take 30 pills per dose, with warm wine on an empty stomach.
Empirical Formula treats unstoppable menstrual bleeding.
Scutellaria (Huang Qin, 5 fen) Angelica (Dang Gui) Biota Leaf (Bo Ye) Polygonum Knotweed Spore (Pu Huang, 4 fen each) Fresh Ginger (Sheng Jiang, 2 fen) Mugwort (Ai Ye, 1 fen) Raw Rehmannia (Sheng Di Huang, 24 fen) Long-stored Hearth Mud (Fu Long Gan, 12 fen)
Chop ingredients. Use 2 sheng of water, decoct to obtain 8 he. Divide into two doses.
Another poem for unstoppable menstrual bleeding reads: "For women with long-term dripping menstrual blood, burn old lotus seed pods to ash. Mix eight characters' worth with a cup of hot wine, and naturally there will be peace and certainty."
Another Formula: Lotus Pod Shell (Lian Peng Ke) Frost-resisting Flower (Ju Shuang Hua, equal parts)
Grind into powder. Take 2 qian per dose, mixed with rice water on an empty stomach.
Fu Long Gan San (Long-stored Hearth Mud Powder) [from *He Ji Ju Fang*] treats Qi and Blood labor injury, deficiency of Chong and Ren meridians, non-timed heavy bleeding, bleeding like bean soup, blood clots, mixed colors, cold pain in umbilical/abdominal region, and unstoppable menstruation.
Long-stored Hearth Mud (Fu Long Gan) Ophiopogon (Mai Men Dong, de-heartened, 1 qian each) Red Kaolin (Chi Shi Zhi, 1 qian) Prepared Rehmannia (Shu Di Huang) Mugwort (Ai Ye, fried, 1.5 qian each) Angelica (Dang Gui, de-radicle, fried) Chuanxiong (Chuan Xiong, 2.5 qian each) Cinnamon Bark (Rou Gui, de-bark) Dried Ginger (Gan Jiang, processed) Licorice (Gan Cao, 0.5 qian each)
Take as one dose. Use 2 zhong of water and 2 red dates. Decoct to 1 zhong. Take before meals.
Gu Jing Wan (Stabilize the Menses Pill) treats excessive, unstoppable menstruation caused by Yin deficiency with Heat. The method requires tonifying Yin and clearing Heat.
Phellodendron (Huang Bo, 3 liang) Tortoise Plastron (Gui Ban, roasted, 4 liang) Scutellaria (Huang Qin, 2 liang) White Peony Root (Bai Shao Yao, 3 liang) Tree-of-heaven Root Bark (Chu Gen Pi, 1.5 liang) Cyperus (Xiang Fu Zi, processed with child's urine, 1.5 liang)
Grind into fine powder. Make pills with wine paste the size of paulownia seeds. Take 50-70 pills per dose with plain warm water on an empty stomach before meals.
[Unsmooth Menstruation]
[Liang] Unsmooth menstruation in women is caused by labor injuring Qi and Blood, bodily weakness allowing Wind-Cold to lodge in the Uterus, damaging the Chong and Ren meridians. If the Cun pulse is wiry and Guan pulse is deep, it indicates Liver disease, accompanied by abdominal pain and sores in orifices. If Chi pulse is slippery, Blood and Qi are excess, meridians are unsmooth. If Chi pulse is absent, it accompanies lower abdominal pain radiating to the lower back, and Qi attacking the chest/diaphragm.
[Xue] The aforementioned symptoms belong to the Liver and Gallbladder meridians, which are exterior-interior pairs, often injured by anger. If the meridian has Wind-Heat, use Bu Gan San (Tonify Liver Powder). (See Hypochondriac Pain section.) For Blood deficiency, use Si Wu Tang plus Ziziphus Seed (Suan Zao Ren). If Kidney Water is insufficient, use Liu Wei Wan (Six Ingredient Pill with Rehmannia). If suffering from various sores/ulcers, see treatment below.
Niu Xi San (Achyranthes Powder) treats unsmooth menstruation, umbilical/abdominal pain, lower abdominal pain radiating to the waist, or Qi attacking the chest/diaphragm.
Achyranthes (Niu Xi, wine-processed, 1 liang) Cassia Twig Heart (Gui Xin) Red Peony Root (Chi Shao Yao) Peach Kernel (Tao Ren, de-skin/husk) Corydalis (Yan Hu Suo, fried) Angelica (Dang Gui, wine-soaked) Moutan Bark (Mu Dan Pi) Costus Root (Mu Xiang, 7.5 qian each)
Grind into powder. Take 1 qian per dose with warm wine on an empty stomach.
Mu Dan San (Moutan Powder) treats unsmooth menses, abdominal/umbilical pain, and loss of appetite.
Moutan Bark (Mu Dan Pi) Rhubarb (Da Huang, fried, 1 liang each) Red Poria (Chi Fu Ling) Peach Kernel (Tao Ren) Raw Rehmannia (Sheng Di Huang) Angelica (Dang Gui) Cassia Twig Heart (Gui Xin) Red Peony Root (Chi Shao Yao) Atractylodes (Bai Zhu, 7.5 qian each) Pyrite (Shi Wei, de-hair) Costus Root (Mu Xiang, 0.5 liang each)
Chop ingredients. Take 3 qian per dose with 1 jin of water and 3 slices of ginger. Decoct to 0.7 jin. Take warm on an empty stomach.
Chan Bao Fang treats women with unsmooth menstruation, Qi distension below the navel, upward attack causing nausea, and inability to sleep.
Angelica (Dang Gui, 4 qian) Dried Lacquer (Gan Qi, 3 qian, fried until smoke ceases)
Grind into fine powder. Make honey pills the size of paulownia seeds. Take 15 pills with warm wine on an empty stomach.
Yang Rong Tang (Nourish Glory Decoction) treats women with weak Sea of Blood, vague mind, frequent palpitations, occasional deficiency fever, and irregular menstruation.
White Peony Root (Bai Shao Yao) Chuanxiong (Chuan Xiong) Prepared Rehmannia (Shu Di Huang) Turmeric (Jiang Huang) Angelica (Dang Gui) Zingiber (Chuan Jiang) Green Tangerine Peel (Qing Ju Pi) Five-finger Pittosporum (Wu Jia Pi) Moutan Bark (Mu Dan Pi) Tongole Pittosporum (Hai Tong Pi) Angelica Dahurica (Bai Zhi, equal parts)
Take 5 qian per dose with 1.5 jin of water, 5 slices of ginger, and 1 smoked plum. Decoct to 1 jin. Take warm, anytime. Follow with 50 grains of Zi Gui Wan. (Zi Gui Wan formula see Leukorrhea section.)
[Delayed but Continuous Bleeding]
*Chan Bao* states: "Men are born in Yin (Tiger), Yin belongs to Wood, containing Yang within, so men receive the number Eight. Women are born in Shen (Monkey), Shen belongs to Metal, containing Yin within, so women receive the number Seven. Men prioritize Qi; after 8x8 cycles, hexagram numbers end, and Yang essence withers. Women prioritize Blood; after 7x7 cycles, hexagram numbers end, menstruation ceases, Chong and Ren meridians weaken, Tian Gui ends, the earthly pathway closes, and they cannot bear children." Or, due to excessive labor, irregular emotions, when meridians are weak, pathogenic factors attack, causing bleeding that should have stopped to become metrorrhagia.
Scholar Xu says: "For women with delayed or insufficient menstruation, lower back/abdominal pain, or menstruation continuing after the 7x7 cycle ends, use Dang Gui San."
Dang Gui San treats women whose Tian Gui has passed the expected age, irregular periods, amenorrhea for 3-4 months, or double menstruation in one month, with lower back/abdominal pain.
*Suzhou Wen* states: "Seven losses, Eight gains." This refers to women whose seven-cycle ends with irregular menstruation, indicating Blood excess. Do not stop it; simply regulate timing and prevent lower back pain. (Formula see Regulation of Menses section.)
[Zhu] Qin Xin Wan treats women after age 49, when Tian Gui should cease, yet menstruates monthly, or excessively without stopping.
Use 2 liang of Scutellaria heart branches. Soak in rice wash water for 7 days, roast dry, soak again, roast again. Repeat 7 times. Grind into powder. Make vinegar pills the size of paulownia seeds. Take 70 pills per dose with warm wine on an empty stomach, twice daily.
The above two formulas are suitable for Heat patterns.
Rong Fu Tang (Deer Antler and Aconite Decoction) tonifies Chong and Ren, regulates Qi and Blood.
Dried Ginger (Gan Jiang, 4 liang) Cinnamon Bark (Rou Gui, de-bark) Aconite (Fu Zi) Dragon Bone (Long Gu, raw) Saposhnikovia (Fang Feng, 1 liang each) Oyster Shell (Mu Li, calcined) Angelica (Dang Gui, 2 liang each) Deer Antler (Lu Rong, 3 liang, wine-roasted)
Take 0.5 liang per dose. Use 2 zhong of water, decoct to 0.8 jin. Take warm.
Bu Zhong Xiong Tang (Supplement Middle and Cyperus Decoction) treats Wind-deficiency Cold-Heat, labor injury to Chong/Ren, irregular menstruation, sudden metrorrhagia, postpartum excessive blood loss, deficiency wasting abdominal pain, or pregnancy restless fetus with bleeding.
Angelica (Dang Gui) Dried Ginger (Gan Jiang, processed, 3 liang each) Chuanxiong (Chuan Xiong, honey-roasted) Astragalus (Huang Qi) Licorice (Gan Cao, roasted) Evodia (Wu Zhu Yu, processed yellow) Eucommia (Du Zhong, fried) Prepared Rehmannia (Shu Di Huang) Ginseng (Ren Shen, 1 liang each)
Take 3 qian per dose. Use 1.5 zhong of water, decoct to 1 zhong. Take on an empty stomach.
The above two formulas are suitable for Cold patterns, addressing cases of Cold deficiency in the Sea of Blood failing to contain blood.
[Xue] For the aforementioned symptoms: if Liver/Kidney deficiency Heat, use Dang Gui San. Liver Blood deficiency Heat, Si Wu Tang plus Bupleurum (Chai Hu), Gardenia (Zhi Zi), Moutan (Dan Pi). Internal moving Liver Fire, Xiao Chai Hu Tang plus Gardenia (Zhi Zi), Moutan (Dan Pi). Liver Fire with Blood dryness, Jia Wei Xiao Yao San (Modified Free and Easy Wanderer). Spleen Meridian constrained Fire, Jia Wei Gui Pi Tang. Liver/Spleen constrained Fire, Gui Pi Tang and Xiao Yao San combined. Liver/Kidney deficiency, Gui Pi Tang and Liu Wei Wan combined. Use consistently with previous successful treatments for irregular menstruation. A 50-year-old woman with internal heat and afternoon fever, menstruating every 2-3 months, had Blood deficiency with Heat. She recovered using Xiao Yao San plus Cornus (Shan Zhu Yu). Later, with phlegm-thirst, irregular urination, or dizziness/leukorrhea, she stabilized using Liu Wei Wan.
[Pulse] Question: "A woman in her fifties suddenly bleeds clear blood for 2-3 days continuously. How to treat?" Master answers: "This woman previously stopped bearing children and menstruation did not flow. Now she bleeds clear blood; this is Ju Jing (Residing Menses). No treatment is needed; it will stop spontaneously. If menstruation normally lasts 5 days, it will heal in 5 days."