《内经·阴阳别论》云∶二阳之病发心脾，有不得隐曲，女子不月；其传为风消，为息
贲者，死不治。
洁古曰∶女子月事不来者，先泻心火，血自下也。《内经》曰∶二阳之病发心脾，有不
得隐曲，故女子不月，其传为风消。王启玄注曰∶大肠、胃热也，心脾受之。心主血，心
病则血不流。脾主味，脾病则味不化。味不化则精不足，故其病则不能隐曲，脾土已亏，
则风邪胜而气愈消也。又经曰∶月事不来者，胞脉闭也。胞脉属于心，络于胞中。今气上
迫肺，心气不得下通，故月事不来。先服降心火之剂，后服《局方》中五补丸，后以卫
生汤治脾养血也。
李东垣曰∶经闭不行有三，补前人之阙。妇人脾胃久虚，形体羸弱，气血俱衰，而
致经水断绝不行。或病中消胃热，善食渐瘦，津液不生。夫经者血脉津液所化，津液既绝，
为热所烁，肌肉渐瘦，时见渴燥，血海枯竭，名曰血枯经绝。宜泻胃之燥热，补益气血，经
自行矣。此病或经适行而有子，子亦不成，而为胎病者有矣。（此中焦胃热结也。）
或心包络脉洪数，躁作时见，大便秘涩，小便虽清不利，而经水闭绝不行，此乃血海干枯，
宜调血脉，除包络中火邪，而经自行矣。（此下焦胞脉热结也。）或因劳心，心火上行，
月事不来者，胞脉闭也。包脉者，属于心而络于胞中，今气上迫肺，心气不得下通，故月
事不来。宜安心、补血、泻火，经自行矣。（此上焦心肺热结也。）裴泽之夫人病寒热，月
事不至者数年，又加喘嗽，医者率以蛤蚧、桂、附投之。曰∶不然。夫人病阴为阳所搏，
温剂太过，故无益反害，投以凉剂，凉血和血药，则行矣。已而果然。
五补丸 （《局方》）补诸虚，安五脏，坚骨髓，养精神。
熟地黄 人参 牛膝（酒浸，去芦，焙干） 白茯苓 地骨皮（各等分）
上为细末，炼蜜丸如梧子大。每服三、五十丸，温酒下，空心服。
卫生汤
当归 白芍药（各二两） 黄 （三两） 甘草（一两）
上为末，每服半两，水二盏，煎至一盏，温服，空心。如虚者，加人参一两。
上东垣、洁古治血枯之法，皆主于补血，泻火也。补血者，四物之类。泻火者，东垣
分上中下，故火在中则善食消渴，治以调胃承气之类。火在下则大小秘涩，治以玉烛之
类，玉烛者四物与调胃承气等分也。火在上则得于劳心，治以芩、连及三和之类。三和
者，四物、凉膈、当归等分也。洁古先服降心火之剂者，盖亦芩、连、三和、玉烛之类，
后服五补、卫生者，亦补气之剂也。
〔素〕帝曰∶有病胸胁支满者，妨于食，病至则先闻腥臊臭，出清液，先唾血，四肢
清，目眩，时时前后血，病名为何？何以得之？岐伯曰∶病名血枯。此得之少年时有所
大脱血。若醉入房中，气竭肝伤，故月事衰少不来也。帝曰∶治之奈何？岐伯曰∶以四
乌贼骨一芦茹二味并合之，丸以雀卵，大如小豆，以五丸为后饭，饮以鲍鱼汁，利肠中
及伤肝也。（腹中论 王注云∶乌贼鱼骨主血闭，芦茹主散恶血，雀卵主血痿，鲍鱼主瘀血。
河间《宣明论方》乌贼骨、芦茹各等分，雀卵不拘数，和丸小豆大，每服五丸至十丸，
煎鲍鱼汤下，食后日三服，压以美膳。）
上岐伯、河间治血枯之法。
〔丹〕血枯经闭者，四物汤加桃仁、红花。阴虚经脉久不通，小便短涩身疼者，四
物加苍术、牛膝、陈皮、生甘草作汤。又用苍莎丸加苍耳、酒芍药为丸，就煎前药吞下。
上丹溪治血枯大法。
〔薛〕夫经水阴血也，属冲任二脉，主上为乳汁，下为月水。其为患，有因脾虚而
不能生血者，有因脾郁伤而血耗损者，有因胃火而血消烁者，有因脾胃损而血少者，有
因劳伤心而血少者，有因怒伤肝而血少者，有因肾水不能生肝而血少者，有因肺气虚不能
行血而闭者。治疗之法，若脾虚而不行者，调而补之，脾郁而不行者，解而补之。胃火而
不行者，清而补之。脾胃损而不行者，温而补之。劳伤心血而不行者，静而补之，怒伤
肝而不行者，和而补之。肺气虚而不行者，补脾胃。肾虚而不行者，补脾肺。经云∶损其
肺者，益其气，损其心者，调其荣卫。损其脾者，调其饮食，适其寒温。损其肝者，缓
其中。损其肾者，益其精。审而治之，庶无误矣。一妇人停食，饱闷发热，或用人参
养胃汤，益甚。再用木香槟榔丸，泄泻吐痰，腹中成块，饮食少思。又用二陈、黄连、浓
朴之类，前证益甚，腹胀不食，月经不至。余以为胃气亏损，用补中益气加茯苓、半夏，三
十余剂，脾胃健而诸证愈，又二十余剂而经自行。一妇人饮食后，或腹胀，或吞酸。彼
服枳术丸，吞酸益甚，饮食日少，胸膈痞满，腿内酸痛，畏见风寒。又服养胃汤一剂，腿
内作痛。又一剂，腿膝浮肿，月经不行。余谓郁结所伤，脾虚湿热下注。侵晨用四君、二
陈、芎、归，午后以前汤送越鞠丸，饮食渐进，诸证渐愈。又用归脾、八珍二汤。兼服，
两月余而经行。一妇人性沉多虑，月经不行，胸满少食，或作胀，或吞酸。余以为中
气虚寒，用补中益气加砂仁、香附、煨姜，二剂，胸膈和而饮食进。更以六君加芎、归、贝
母、桔梗、生姜、大枣数剂，脾胃健而经自调矣。一妇人素有胃火。或用清胃散而安。
后因劳役，燥渴内热，肌肉消瘦，月经不行。余谓此胃火消烁阴血，用逍遥散加丹皮、炒
栀以清胃热，用八珍汤加茯苓、远志以养脾血，而经自行矣。一妇人久患疟，形体怯
弱，内热晡热，自汗盗汗，饮食少思，月事不行。或用通经丸，虚证大具。余曰∶此因
虚而致疟，因疟以闭经也。用补中益气及六味地黄丸各百余剂，疟愈而经行。一妇人
久患疟，疟作则经不行，形虚脉大，头痛懒食，大便泄泻，小便淋沥，口干唇裂，内热
腹膨。盖由久疟，正气已虚，阴火独旺。用补中益气汤治之，寻愈。惟不时头痛，乃加
蔓荆子而痛止，又兼用六味地黄丸而经行。一妇人因劳耳鸣，头痛体倦。此元气不足，用
补中益气加麦门、五味而痊。三年后得子，因饮食劳倦，月经不行，晡热内热，自汗盗汗，
用六味地黄丸、补中益气汤，顿愈。一妇人胃气素弱，为哭母吐血咳嗽，发热盗汗，经
水三月不行。余以为悲则伤肺，思则伤脾，遂朝服补中益气加桔梗、贝母、知母，夕用归
脾汤送地黄丸而愈。一 妇少寐，经水两月余一至。误服通经丸，展转无寐，午前恶
寒，午后发热，余以为思虑亏损脾血，用归脾汤作丸，午前以六君送下，午后以逍遥散
送下，两月余得寐，半载经行如期，年余而疮愈。
上薛氏治血枯大法，以补养真元为主。盖本易水师弟之旨而广之，王道也。
〔脉〕问曰∶妇人病下利，而经水反断者，何也？师曰∶但当止利，经自当下，勿
怪。所以利不止而血断者，但下利亡津液，故经断。利止津液复，经当自下。问曰∶妇人
病经水断一二月，而反经来，今脉反微涩，何也？师曰∶此前月中若当下利，故令妨经，利
止月经当自下，此非躯也。妇人血下，咽干而不渴，其经必断。此荣不足，本自有微
寒，故不引饮。渴而引饮者，津液得通，荣卫自和，其经必复下。
〔仲〕妇人之病，因虚积冷结气为证，经水断绝，至有历年，血寒积结胞门，寒伤经
络，凝坚在上，呕吐涎沫，久成肺痈，形体损分，在中盘结，绕脐寒疝。或两胁疼痛，与
脏相连。或结热中，病在关元，脉数无疮，肌
若鱼鳞，时着男子，非止女身。在下未多，经候不匀，令阴掣痛，少腹恶寒，或引腰脊，下
根气冲，气冲急痛，膝胫疼烦，奄忽眩冒，状如厥颠。或有忧惨，悲伤多嗔，此皆带下，非
有鬼神。久则羸瘦，脉虚多寒，三十六病，千变万端。审脉阴阳，虚实紧弦，行其针药，治
危得安。其虽同病，脉各异源，子当辨记，勿谓不然。
〔丹〕经候过期不行，杜牛膝捣汁大半盅，以玄胡末一钱，香附末、枳壳末各半钱，
早调服。
〔大〕万病丸 治经事不来，绕脐痛。
干漆（杵碎，炒烟尽） 牛膝（去苗，酒浸一宿，焙干，各一两）
上为末，以生地黄汁一升，入二味药末，银器内慢火熬可丸，即丸如桐子大。每服二
丸，空心米饮或温酒下。
土牛膝散 治妇人、室女血闭不通，五心烦热。
土牛膝 当归尾（各一两） 桃仁（去皮，麸炒，另研） 红花（各半两）
上为细末，每服二钱，空心温酒下。
当归干漆丸，疗月经不利，脐下憋，逆气胀满。（见调经门月水不利。）
治月经壅滞，脐腹 痛。
当归 玄胡索
上为粗末，每服三钱，姜三片，水一盅半，煎至七分，去滓，稍热服。
当归散 治血脉不通。
当归 穿山甲（灰炒） 蒲黄（炒，各半两） 辰砂（另研，一钱） 麝香（少许）
上为细末，研匀，每服二钱，食前热酒调下。
琥珀散 治心膈迷闷，腹脏撮痛，气急气闷，月信不通等疾。
天台乌药（二两） 当归 莪术（各一两）
上为细末，每服二钱，温酒调下，后以食压之。忌生冷、油腻。产后诸疾，炒姜、酒
调下。
小肠移热于大肠，为伏瘕，为沉。（王注云∶血涩不利，则月事沉滞而不行。）
〔圣〕治妇人月水涩滞不快，结成瘕块，筋胀大欲死。用马鞭草根苗五斤，锉细，水
五斗煎至一斗，去渣，别以净器盛，熬成膏，食前温酒调下半匙。（《本草》云∶马鞭草，辛凉，
破血瘕。）
〔罗〕血极膏 治妇人干血气。以川大黄为末，用酽醋熬成膏子，丸如鸡头大，每
服一丸，酒化开，临卧温服，大便利一二行后，红脉自下。是妇人之仙药也。加当归头。
〔仲〕妇人经水不利，抵当汤主之。（亦治男子膀胱满急有瘀血者。方见伤寒蓄血。）
产宝方 治月经不通，腹中痛。
牛膝（六分） 大黄 桃仁（去皮尖，炒） 细辛（各五分） 川芎 当归（各四分）
水蛭（三分，糯米炒黄）
上为细末，炼蜜丸梧子大，每服二十丸，空心温酒下。
千金桃仁煎 治血积 瘕，月水不行。
大黄（湿纸裹蒸） 朴硝 桃仁（制炒，各二两） 虻虫（一两，去足翅，炒黑。）
上为细末，醋二升半，银石器中慢火熬膏。却入大黄、桃仁、虻虫末，不住搅，度
可丸，却入朴硝，再搅良久，出之，丸如梧子大。五更初，温酒下五丸，至日午取下如
赤豆汁、鸡肝、蛤蟆衣样，候鲜红住服，仍以调气药补之。
三棱丸 治妇人经脉不通，气痛带下，兼治血瘕。
三棱（醋炒） 川芎 牛膝 玄胡索 蓬术（醋炒） 蒲黄 牡丹皮 芫花（醋炒）
白芷 当归 地龙（去土，酒浸炒） 干姜（炮，各一两） 大黄（二两，为末，以米醋熬
成膏，和药）
上为细末，以大黄膏和丸如梧子大，每服三、五十丸，空心醋汤下，或红花煎酒下。
上经一节，方七首，皆治污血有热而经闭。前一方轻剂，后六方重剂也。
〔云〕红花当归散 治妇人经候不行，
或积瘀血，腰腹疼痛，及室女月经不通。
红花 当归尾 紫葳 牛膝 甘草 苏木（细锉，各二两） 赤芍药（九两）
刘寄奴（五两） 桂心 白芷（各一两半）
上为细末，空心热酒调三钱服之，食前临卧再服。若久血不行，浓煎红花酒下，孕
妇休服。一名凌霄花散，即紫葳。
牛膝散（见调经门月水不利条。） 温经汤（见前调经门。）桂枝桃仁汤治妇人月
事不通，小腹膨胀疼痛。（见前调经门腹痛条。） 牡丹散（见前调经门月水不利条。）
通经丸 （《本事》）治妇人、室女月候不通，或成血瘕。（本草入鸡子清同丸。畏漆，入肠胃生疮
也。）
桂心 青皮（去白） 大黄（炮） 干姜（炮） 川椒（炒出汗） 川乌（炮） 蓬莪术
干漆（炒烟尽） 当归 桃仁（制炒，各等分）
上为末，先将四钱用米醋熬成膏，和余六钱末成剂，臼中杵丸如桐子大，晒干。每服二十
丸，用淡醋汤下，加至三十丸。温酒亦得，空心食前服。《济生》去川乌，加红花，等分。
滋血汤 治劳动致脏腑冲任气虚，不能约制经血，以致崩中，或下鲜血，或下五色，
连日不止，淋漓不断，形羸血劣，倦怠困乏，月水闭绝。
马鞭草 牛膝 荆芥穗（各二两） 当归 肉桂 牡丹皮 赤芍药 川芎（各一两）
上每服四钱，乌梅一个，水二盏，煎一盏，食前服。日进四五服，服至半月或一月，
经脉自通。
上方七首，皆治污血有寒而经闭。前四方轻剂，后二方重剂也。
〔大〕治月水不通，屡试有验。浓朴不以多少，姜汁炙香，细切浓煎，去渣空心服，
不过三四剂瘥。（形实气盛者宜之。）
〔丹〕积痰伤经不行，夜则妄语。
栝蒌子（一两） 黄连（半两） 吴茱萸（十两） 桃仁（五十粒） 红曲（二钱） 缩砂（三两）
山楂末（一两）
上生姜汁研，炊饼为丸。
《黄帝内经·阴阳别论》说：阳明经（大肠、胃）的病变发源于心脾，如果有难以启齿的情志郁结，女子就会出现月经闭止；如果病情传变发展为风邪消烁形体（消瘦），或发展为息贲（肺积，表现为喘息气逆），则属于死证，无法治愈。
洁古（张元素）说：女子月经不来的，应当先清泻心火，血液自然下行。《黄帝内经》说：阳明经的病发于心脾，因为有难以启齿的情志郁结，所以女子月经闭止，病情传变为风邪消烁形体。王启玄（王冰）注释说：阳明指大肠和胃的热证，心脾受到这种热邪的影响。心主血脉，心病则血液运行不畅。脾主管运化水谷精微，脾病则食物不能转化为精微物质。精微物质转化不足导致精气亏虚，所以出现情志抑郁不得舒展的症状；脾土已亏损，则风邪亢盛而人体更加消瘦。又经书说：月经不来，是因为胞脉闭塞。胞脉归属于心，联络于子宫。现在气机上逆逼迫肺脏，心气不能向下通达，所以月经不来。应先服用降泄心火的药物，再服用《太平惠民和剂局方》中的五补丸，最后用卫生汤调理脾胃、滋养血液。
李东垣说：月经闭止不行有三种情况，这是对前人理论的补充。妇人脾胃长期虚弱，身体瘦弱，气血两衰，从而导致经血断绝不行。或者患有中消症（多食易饥），胃中有热，虽然食欲好但逐渐消瘦，津液无法生成。月经是由血脉和津液化生而成的，津液既然枯竭，又被热邪煎熬，肌肉逐渐消瘦，时常感到口渴烦躁，血海枯竭，这叫做“血枯经绝”。适宜清泻胃中的燥热，补益气血，月经自然就会来潮。这种病有的在月经刚来时怀孕，胎儿也不能成活，从而造成胎病。（这是中焦胃热结聚所致。）
或者心包络脉象洪大数急，烦躁发作时常有，大便秘结涩滞，小便虽然颜色清但不利，而经血闭止不行，这是血海干枯，适宜调理血脉，清除心包络中的火邪，月经自然就会来潮。（这是下焦胞脉热结所致。）或者因为劳伤心神，心火上炎，导致月经不来，这是因为胞脉闭塞。胞脉归属于心并联络于子宫，现在气机上逆逼迫肺脏，心气不能向下通达，所以月经不来。适宜安神、补血、泻火，月经自然就会来潮。（这是上焦心肺热结所致。）裴泽之的妻子患寒热往来，月经数年不来，又加上气喘咳嗽，医生们通常都用蛤蚧、桂枝、附子等温热药投喂。我说：不对。这位夫人的病是阴分被阳热邪气搏结，温补药物太过，所以不仅无益反而有害，应投以凉血和血的凉性药物，月经就能来潮。后来果然如此。
五补丸（出自《太平惠民和剂局方》）：补益各种虚损，安定五脏，坚固骨髓，滋养精神。
熟地黄、人参、牛膝（酒浸，去芦头，焙干）、白茯苓、地骨皮（各等分）。
以上药物研为细末，用炼蜜制成梧桐子大小的丸剂。每次服用三五十丸，用温酒送服，空腹服用。
卫生汤：
当归、白芍药（各二两）、黄芪（三两）、甘草（一两）。
以上药物研为粗末，每次服用半两，加水两盏，煎煮至一盏，温服，空腹服用。如果是虚证严重的，加人参一两。
以上是李东垣、张元素治疗血枯的方法，都主张以补血、泻火为主。补血方面，多用四物汤之类的方剂。泻火方面，李东垣分为上、中、下三焦，所以火在中焦则表现为善食消渴，治疗用调胃承气汤之类；火在下焦则表现为大小便秘涩，治疗用玉烛散之类，玉烛散就是四物汤与调胃承气汤等量合用；火在上焦则因劳心所致，治疗用黄芩、黄连及三和散之类。三和散就是四物汤、凉膈散、当归等量合用。张元素先服用降心火的药剂，大概也是黄芩、黄连、三和散、玉烛散之类，后服用五补丸、卫生汤，也是补气养血之剂。
〔《素问·腹中论〕黄帝问：有病胸胁胀满的，妨碍饮食，发病时先闻到腥臊臭味，流出清稀液体，先唾血，四肢清冷，头晕目眩，时常大小便出血，这是什么病？怎么得的？岐伯说：病名叫血枯。这是由于年轻时曾有大失血，或者醉酒后行房事，导致气竭肝伤，所以月经衰少甚至不来。黄帝问：怎么治疗？岐伯说：用四份乌贼骨、两份芦茹（茜草），将这两味药混合，用雀卵做丸，如小豆大小，每次五丸，饭后服用，用鲍鱼汁送服，以通利肠道及修复肝脏损伤。（王冰注：乌贼骨主治血闭，芦茹主治消散恶血，雀卵主治血痿，鲍鱼主治瘀血。河间《宣明论方》用乌贼骨、芦茹各等分，雀卵不拘数量，和丸如小豆大，每次五至十丸，煎鲍鱼汤送下，饭后每日三次，并用美味膳食辅助。）
〔朱丹溪〕血枯经闭者，用四物汤加桃仁、红花。阴虚经脉久不通，小便短涩身疼者，用四物汤加苍术、牛膝、陈皮、生甘草作汤剂。另外用苍莎丸加苍耳子、酒炒芍药做成丸剂，就着煎好的前药吞服。
以上是丹溪治疗血枯的大法。
〔薛己〕月经属于阴血，由冲任二脉所主，上行化为乳汁，下行成为月经。其致病原因，有因脾虚而不能生血的，有因脾郁受伤而血耗损的，有因胃火而血被消烁的，有因脾胃受损而血少的，有因劳伤心而血少的，有因怒伤肝而血少的，有因肾水不能生肝而血少的，有因肺气虚不能行血而闭经的。治疗方法，若脾虚而不行者，调和而补益之；脾郁而不行者，解郁而补益之。胃火而不行者，清热而补益之。脾胃受损而不行者，温补而补益之。劳伤心血而不行者，静养而补益之，怒伤肝而不行者，调和而补益之。肺气虚而不行者，补益脾胃。肾虚而不行者，补益脾肺。经书说：损伤肺的，要益其气；损伤心的，要调和营卫；损伤脾的，要调节饮食，适应寒温；损伤肝的，要舒缓其中气；损伤肾的，要填补精髓。仔细审察而治疗，才不至于出错。
有一个妇人停食，饱闷发热，有人用人参养胃汤，病情加重。再用木香槟榔丸，导致泄泻吐痰，腹中成块，饮食减少。又用二陈汤、黄连、厚朴之类，前面的症状更加严重，腹胀不食，月经不至。我认为这是胃气亏损，用补中益气汤加茯苓、半夏，三十多剂后，脾胃健运而诸证痊愈，又二十多剂而月经自行来潮。
有一个妇人饮食后，有时腹胀，有时吞酸。她服用枳术丸，吞酸更甚，饮食日渐减少，胸膈痞满，腿内侧酸痛，怕见风寒。又服养胃汤一剂，腿内侧作痛。又一剂，腿膝浮肿，月经不行。我认为是郁结所伤，脾虚湿热下注。清晨用四君子汤、二陈汤、川芎、当归，午后以前汤送服越鞠丸，饮食渐进，诸证渐愈。又用归脾汤、八珍汤两方兼服，两个多月而月经来潮。
有一个妇人性情沉静多虑，月经不行，胸满少食，有时作胀，有时吞酸。我认为是中气虚寒，用补中益气汤加砂仁、香附、煨姜，两剂后，胸膈舒畅而饮食增进。再以六君子汤加川芎、当归、贝母、桔梗、生姜、大枣数剂，脾胃健运而月经自然调畅。
有一个妇人素有胃火。曾用清胃散而安。后因劳累，燥渴内热，肌肉消瘦，月经不行。我认为是胃火消烁阴血，用逍遥散加丹皮、炒栀子以清胃热，用八珍汤加茯苓、远志以养脾血，而月经自行来潮。
有一个妇人久患疟疾，形体怯弱，内热晡热（下午发热），自汗盗汗，饮食少思，月事不行。有人用通经丸，虚证大增。我说：这是因虚而致疟，因疟疾而闭经。用补中益气汤及六味地黄丸各百余剂，疟疾痊愈而月经来潮。
有一个妇人久患疟疾，疟疾发作则月经不行，形体虚脉大，头痛懒食，大便泄泻，小便淋沥，口干唇裂，内热腹膨。这是由于久疟，正气已虚，阴火独旺。用补中益气汤治疗，不久痊愈。只是不时头痛，于是加蔓荆子而痛止，又兼用六味地黄丸而月经来潮。
有一个妇人因劳累耳鸣，头痛体倦。这是元气不足，用补中益气汤加麦门冬、五味子而痊愈。三年后得子，因饮食劳倦，月经不行，晡热内热，自汗盗汗，用六味地黄丸、补中益气汤，顿然痊愈。
有一个妇人胃气素弱，因哭母吐血咳嗽，发热盗汗，经水三月不行。我认为是悲则伤肺，思则伤脾，于是早晨服用补中益气汤加桔梗、贝母、知母，晚上用归脾汤送服地黄丸而痊愈。
有一个妇人睡眠少，经水两个多月来一次。误服通经丸，辗转难眠，午前恶寒，午后发热，我认为是思虑亏损脾血，用归脾汤作丸剂，午前用六君子汤送下，午后用逍遥散送下，两个多月得以安睡，半年后月经如期来潮，一年多后疮疡痊愈。
以上是薛氏治疗血枯的大法，以补养真元为主。大概是秉承易水学派（张元素、李东垣）的宗旨而加以推广，属于王道疗法。
〔脉案〕问：妇人病下利，而经水反而断绝，为什么？师曰：只要止住下利，经水自然会来，不要奇怪。之所以下利不止而血断，只是因为下利亡失津液，所以经断。利止津液恢复，经当自行来潮。问：妇人病经水断一两个月，反而经来，现在脉象反而微涩，为什么？师曰：这是前半月如果当下利，所以妨碍了月经，利止月经应当自行来下，这不是躯壳之病。妇人血下，咽干而不渴，其经必断。这是营血不足，本自有微寒，所以不引饮。渴而引饮者，津液得通，营卫自和，其经必复下。
〔张仲景〕妇人的病，因虚、积冷、结气而成证，经水断绝，甚至有历年不愈的。血寒积结于胞门，寒邪损伤经络，凝坚在上部，呕吐涎沫，久则成肺痈，形体受损；在中部盘结，绕脐寒疝。或两胁疼痛，与脏腑相连。或结热于中，病在关元，脉数而无疮，肌肤如鱼鳞状，时常牵连男子，不只是女人患病。在下部未多，经候不匀，令阴部掣痛，少腹恶寒，或牵引腰脊，下根气冲穴，气冲急痛，膝胫疼烦，突然眩晕冒昧，状如厥逆癫狂。或有忧惨，悲伤多怒，这都是带下病，并非鬼神作祟。久则羸瘦，脉虚多寒，三十六病，千变万端。审察脉象的阴阳、虚实、紧弦，施行针药，治危得安。虽然同病，脉象各异源，你应当辨别记忆，不要说不然。
〔丹溪〕经候过期不行，用杜牛膝捣汁大半盅，以玄胡索末一钱，香附末、枳壳末各半钱，早晨调服。
〔大方〕万病丸：治经事不来，绕脐痛。
干漆（杵碎，炒烟尽）、牛膝（去苗，酒浸一宿，焙干，各一两）。
以上研为末，用生地黄汁一升，入二味药末，在银器内慢火熬至可丸，即丸如桐子大。每次服二丸，空腹米饮或温酒送下。
土牛膝散：治妇人、室女血闭不通，五心烦热。
土牛膝、当归尾（各一两）、桃仁（去皮，麸炒，另研）、红花（各半两）。
以上研为细末，每次服二钱，空腹温酒送下。
当归干漆丸：疗月经不利，脐下憋闷，逆气胀满。（见调经门月水不利条。）
治月经壅滞，脐腹痛。
当归、玄胡索。
以上为粗末，每次服三钱，姜三片，水一盅半，煎至七分，去滓，稍热服。
当归散：治血脉不通。
当归、穿山甲（灰炒）、蒲黄（炒，各半两）、辰砂（另研，一钱）、麝香（少许）。
以上研为细末，研匀，每次服二钱，食前热酒调下。
琥珀散：治心膈迷闷，腹脏撮痛，气急气闷，月信不通等疾。
天台乌药（二两）、当归、莪术（各一两）。
以上研为细末，每次服二钱，温酒调下，后用食物压之。忌生冷、油腻。产后诸疾，炒姜、酒调下。
小肠移热于大肠，为伏瘕，为沉。（王冰注：血涩不利，则月事沉滞而不行。）
〔圣济总录〕治妇人月水涩滞不快，结成瘕块，筋胀大欲死。用马鞭草根苗五斤，锉细，水五斗煎至一斗，去渣，别以净器盛，熬成膏，食前温酒调下半匙。（《本草》云：马鞭草，辛凉，破血瘕。）
〔罗谦甫〕血极膏：治妇人干血气。以川大黄为末，用浓醋熬成膏子，丸如鸡头大，每服一丸，酒化开，临卧温服，大便利一二行后，红脉自下。是妇人之仙药也。加当归头。
〔张仲景〕妇人经水不利，抵当汤主之。（亦治男子膀胱满急有瘀血者。方见伤寒蓄血篇。）
产宝方：治月经不通，腹中痛。
牛膝（六分）、大黄、桃仁（去皮尖，炒）、细辛（各五分）、川芎、当归（各四分）、水蛭（三分，糯米炒黄）。
以上研为细末，炼蜜丸梧子大，每次服二十丸，空腹温酒送下。
千金桃仁煎：治血积瘕，月水不行。
大黄（湿纸裹蒸）、朴硝、桃仁（制炒，各二两）、虻虫（一两，去足翅，炒黑）。
以上研为末，醋二升半，银石器中慢火熬膏。却入大黄、桃仁、虻虫末，不住搅，度可丸，却入朴硝，再搅良久，出之，丸如梧子大。五更初，温酒下五丸，至日午取下如赤豆汁、鸡肝、蛤蟆衣样，候鲜红住服，仍以调气药补之。
三棱丸：治妇人经脉不通，气痛带下，兼治血瘕。
三棱（醋炒）、川芎、牛膝、玄胡索、蓬术（醋炒）、蒲黄、牡丹皮、芫花（醋炒）、白芷、当归、地龙（去土，酒浸炒）、干姜（炮，各一两）、大黄（二两，为末，以米醋熬成膏，和药）。
以上研为细末，以大黄膏和丸如梧子大，每次服三、五十丸，空腹醋汤下，或红花煎酒下。
以上经一节，方七首，皆治污血有热而经闭。前一方轻剂，后六方重剂也。
〔云〕红花当归散：治妇人经候不行，或积瘀血，腰腹疼痛，及室女月经不通。
红花、当归尾、紫葳、牛膝、甘草、苏木（细锉，各二两）、赤芍药（九两）、刘寄奴（五两）、桂心、白芷（各一两半）。
以上研为细末，空心热酒调三钱服之，食前临卧再服。若久血不行，浓煎红花酒下，孕妇休服。一名凌霄花散，即紫葳。
牛膝散（见调经门月水不利条）。温经汤（见前调经门）。桂枝桃仁汤治妇人月事不通，小腹膨胀疼痛。（见前调经门腹痛条）。牡丹散（见前调经门月水不利条）。
通经丸（《本事方》）：治妇人、室女月候不通，或成血瘕。（本草入鸡子清同丸。畏漆，入肠胃生疮也。）
桂心、青皮（去白）、大黄（炮）、干姜（炮）、川椒（炒出汗）、川乌（炮）、蓬莪术、干漆（炒烟尽）、当归、桃仁（制炒，各等分）。
以上为末，先将四钱用米醋熬成膏，和余六钱末成剂，臼中杵丸如桐子大，晒干。每次服二十丸，用淡醋汤下，加至三十丸。温酒亦得，空腹食前服。《济生方》去川乌，加红花，等分。
滋血汤：治劳动致脏腑冲任气虚，不能约制经血，以致崩中，或下鲜血，或下五色，连日不止，淋漓不断，形羸血劣，倦怠困乏，月水闭绝。
马鞭草、牛膝、荆芥穗（各二两）、当归、肉桂、牡丹皮、赤芍药、川芎（各一两）。
以上每服四钱，乌梅一个，水二盏，煎一盏，食前服。日进四五服，服至半月或一月，经脉自通。
〔大方〕治月水不通，屡试有验。浓朴不以多少，姜汁炙香，细切浓煎，去渣空心服，不过三四剂瘥。（形实气盛者宜之。）
〔丹溪〕积痰伤经不行，夜则妄语。
栝蒌子（一两）、黄连（半两）、吴茱萸（十两）、桃仁（五十粒）、红曲（二钱）、缩砂（三两）、山楂末（一两）。
以上生姜汁研，炊饼为丸。
The *Neijing · Yin-Yang Bie Lun* states: Diseases of the Yangming (Large Intestine and Stomach) originate from the Heart and Spleen. If there is emotional constraint that is difficult to express, women will experience amenorrhea; if the condition progresses to "Feng Xiao" (wasting due to deficiency-heat leading to emaciation) or "Xi Ben" (shortness of breath with chest accumulation), it is a fatal and incurable condition.
Jiegou (Zhang Yuansu) stated: For women with amenorrhea, one should first clear and drain Heart Fire, and the blood will flow naturally. The *Neijing* says: Diseases of the Yangming originate from the Heart and Spleen; due to emotional constraint, women suffer from amenorrhea, which progresses to Feng Xiao. Wang Qixuan (Wang Bing) annotated: Yangming refers to heat in the Large Intestine and Stomach, affecting the Heart and Spleen. The Heart governs Blood; Heart disease leads to stagnant blood circulation. The Spleen governs digestion and transformation; Spleen disease leads to failure to transform food essence. Insufficient essence leads to emotional constraint; when Spleen Earth is depleted, Wind pathogen prevails, further depleting Qi. Another classic states: Amenorrhea is caused by the closure of the Bao Mai (Uterine Vessels). The Bao Mai belongs to the Heart and connects to the Bao Gong (Uterus). Now, Qi rises and presses against the Lung, preventing Heart Qi from descending, thus causing amenorrhea. One should first take herbs to descend Heart Fire, then take Wubu Wan from the *Taiping Huimin Heji Jufang*, and finally use Weisheng Tang to regulate the Spleen and nourish Blood.
Li Dongyuan stated: There are three types of amenorrhea, supplementing previous theories. Women with long-term Spleen-Stomach deficiency, emaciated physique, and depleted Qi and Blood may experience cessation of menstruation. Or, they may suffer from Zhong Xiao (excessive hunger and thirst), stomach heat, increased appetite but gradual thinning, and lack of Jin-Ye (body fluids). Menstruation is formed from blood vessels and body fluids; if fluids are exhausted and scorched by heat, muscles waste away, accompanied by frequent thirst and dryness, leading to depletion of the Blood Sea, named Xue Ku Jing Jue (Blood Dryness and Amenorrhea). One should clear dryness-heat in the Stomach and tonify Qi and Blood, and menstruation will resume naturally. In some cases, conception occurs during menstruation, but the fetus does not develop, resulting in fetal disease. (This is accumulation of Heat in the Middle Jiao.)
Alternatively, the Pericardium Collateral pulse is surging and rapid, with irritability appearing intermittently, constipation, and clear but difficult urination, while menstruation is completely absent. This is dryness of the Blood Sea; one should regulate blood vessels and eliminate Fire pathogen in the Pericardium Collateral, and menstruation will resume naturally. (This is Heat accumulation in the Lower Jiao Bao Mai.) Or, due to mental overwork, Heart Fire flares upward, causing amenorrhea because the Bao Mai is closed. The Pericardium Collateral belongs to the Heart and connects to the Uterus; now Qi presses against the Lung, preventing Heart Qi from descending, thus causing amenorrhea. One should calm the Spirit, nourish Blood, and drain Fire, and menstruation will resume naturally. (This is Heat accumulation in the Upper Jiao Heart and Lung.) Mrs. Peizezhi suffered from alternating chills and fever for years with amenorrhea, plus wheezing and coughing. Physicians administered Gejie (Gecko), Guizhi (Cinnamon Twig), and Fuzi (Aconite Root). I said: Incorrect. Her illness is Yin being constrained by Yang pathogen; excessive warm tonics are harmful. Administer cooling agents, blood-cooling and blood-moistening herbs, and menstruation will resume. It proved correct.
**Wubu Wan** (*Taiping Huimin Heji Jufang*): Tonifies various deficiencies, calms the Five Zang organs, strengthens bone marrow, and nourishes the Spirit.
Shudihuang (Prepared Rehmannia Root), Renshen (Ginseng Root), Niuxi (Achyranthes Root - soaked in wine, remove rhizome, dry), Baifuling (Poria), Digupi (Lycium Bark - equal parts).
Grind into fine powder, mix with refined honey to make pills the size of wu zi (Chinese quince seeds). Take 30-50 pills per dose, with warm wine, on an empty stomach.
**Weisheng Tang**
Danggui (Angelica Sinensis Root), Baishaoyao (White Peony Root - each 2 liang), Huangqi (Astragalus Root - 3 liang), Gancao (Licorice Root - 1 liang).
Grind into powder. Take 0.5 liang per dose, add two cups of water, decoct to one cup, take warm on an empty stomach. For severe deficiency, add Renshen (Ginseng Root) 1 liang.
Li Dongyuan and Jiegou's methods for treating Blood Dryness both emphasize tonifying Blood and draining Fire. Blood-tonifying formulas include Siwu Tang. For draining Fire, Li Dongyuan categorized by Jiao: Fire in the Middle Jiao causes polyphagia and thirst, treated with Tiaowei Chengqi Tang. Fire in the Lower Jiao causes constipation and dysuria, treated with Yuzhu San (Siwu Tang combined equally with Tiaowei Chengqi Tang). Fire in the Upper Jiao results from mental overwork, treated with Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Sanhe San (Siwu Tang, Liangge San, and Danggui in equal parts). Jiegou's initial use of Heart Fire-draining herbs likely involved Huangqin, Huanglian, Sanhe San, or Yuzhu San; subsequent use of Wubu Wan and Weisheng Tang were for Qi tonification.
*[Suwen]* The Yellow Emperor asked: A patient has fullness and distension in the chest and hypochondrium, interfering with eating. Before the attack, they smell fishy and foul odors, discharge clear fluid, expectorate blood, have cold limbs, dizziness, and frequent bleeding from the anterior and posterior orifices. What is this disease? How did it arise? Qibo replied: This disease is called Xue Ku (Blood Dryness). It arises from massive blood loss in youth, or sexual activity after drunkenness, exhausting Qi and injuring the Liver, leading to scanty or absent menstruation. The Emperor asked: How to treat it? Qibo replied: Combine four parts Oumeigu (Cuttlefish Bone) and two parts Luru (Rubia Cordifolia Root), form pills using sparrow eggs, size of small beans. Take five pills as a post-meal dose, drink with Abaoyou (Dried Cuttlefish) juice to benefit the intestines and heal liver injury. (Wang Bing's annotation on *Fuzhong Lun*: Cuttlefish Bone treats blood obstruction; Rubia disperses evil blood; Sparrow egg treats blood atrophy; Dried Cuttlefish treats blood stasis. Hejian's *Xuanming Lunfang* uses equal parts Cuttlefish Bone and Rubia, sparrow eggs as needed, pills size of beans, 5-10 pills per dose, taken with decocted Abaoyou soup, three times daily after meals, supplemented with nutritious food.)
These are the methods of Qibo and Hejian for treating Blood Dryness.
*[Danxi]* For amenorrhea due to Blood Dryness, use Siwu Tang plus Taoren (Peach Kernel) and Honghua (Safflower). For Yin deficiency with long-term meridian blockage, short dark urine, and body pain, use Siwu Tang plus Cangzhu (Atractylodes Rhizome), Niuxi (Achyranthes Root), Chenpi (Tangerine Peel), and Sheng Gancao (Raw Licorice Root) as a decoction. Also use Cangsha Wan plus Can'erzi (Xanthium Fruit) and Jiushaoyao (Wine-fried White Peony Root) as pills, taken with the decoction.
These are Danxi's general principles for treating Blood Dryness.
*[Xuexi]* Menstrual blood is Yin blood, governed by the Chong and Ren meridians, transforming upwards into milk and downwards into menses. Causes include: Spleen deficiency failing to generate blood; Spleen depression damaging blood consumption; Stomach Fire scorching blood; Spleen-Stomach damage reducing blood; Mental labor injuring the Heart reducing blood; Anger injuring the Liver reducing blood; Kidney Water failing to nourish Liver reducing blood; Lung Qi deficiency failing to move blood causing closure. Treatment: For Spleen deficiency, regulate and tonify; for Spleen depression, resolve depression and tonify; for Stomach Fire, clear heat and tonify; for Spleen-Stomach damage, warm and tonify; for Heart blood injury from labor, calm and tonify; for Liver injury from anger, harmonize and tonify; for Lung Qi deficiency, tonify Spleen-Stomach; for Kidney deficiency, tonify Spleen-Lung. Classics state: Damage to Lung benefits Qi; damage to Heart regulates Ying and Wei; damage to Spleen regulates diet and temperature adaptation; damage to Liver soothes the interior; damage to Kidney replenishes Essence. Careful diagnosis ensures no error.
Case 1: A woman with food stagnation, fullness, and fever was given Renshen Yangwei Tang, worsening symptoms. Then Muxiang Binglang Wan caused diarrhea, phlegm vomiting, abdominal masses, and poor appetite. Then Erchen Tang, Huanglian, Houpo worsened bloating, anorexia, and amenorrhea. I diagnosed Stomach Qi deficiency, used Buzhong Yiqi Tang plus Fuling (Poria) and Banxia (Pinellia Tuber) for 30+ doses; Spleen-Stomach function recovered, symptoms resolved, and menstruation resumed after another 20 doses.
Case 2: A woman had postprandial bloating and acid regurgitation. She took Zhizhu Wan, worsening acid regurgitation, decreasing appetite, chest oppression, inner thigh soreness, and aversion to wind/cold. One dose of Yangwei Tang caused leg pain; another dose caused knee swelling and amenorrhea. I diagnosed depression injury with Spleen deficiency and damp-heat pouring downward. Morning: Sijunzi Tang, Erchen Tang, Chuanxiong (Sichuan Lovage Rhizome), Danggui (Angelica Sinensis Root). Afternoon: Previous decoction sending Yueju Wan. Diet improved, symptoms resolved. Then combined Guipi Tang and Bazhen Tang for over two months until menstruation resumed.
Case 3: A melancholic, overthinking woman had amenorrhea, chest fullness, poor appetite, occasional bloating and acid regurgitation. I diagnosed Middle Qi deficiency-cold, used Buzhong Yiqi Tang plus Sharen (Amomum Fruit), Xiangfu (Cyperus Rhizome), and Wei Jiang (Baked Ginger) for 2 doses; chest comfort and appetite returned. Then Liu Jun Zi Tang plus Chuanxiong, Danggui, Beimu (Fritillaria Bulb), Jiegeng (Platycodon Root), Shengjiang (Fresh Ginger), Dazao (Jujube) for several doses; Spleen-Stomach strengthened, menstruation regulated.
Case 4: A woman with chronic Stomach Fire was treated with Qingwei San. Later, due to labor, she had dryness-thirst, internal heat, emaciation, and amenorrhea. I diagnosed Stomach Fire scorching Yin blood, used Xiaoyao San plus Danpi (Moutan Bark) and Chao Zhizi (Fried Gardenia) to clear Stomach heat, and Bazhen Tang plus Fuling, Yuanzhi (Polygala Root) to nourish Spleen blood, resuming menstruation.
Case 5: A woman with chronic malaria had weak physique, internal heat, evening fever, spontaneous/diaphoresis, poor appetite, and amenorrhea. Tongjing Wan exacerbated deficiency. I diagnosed malaria due to deficiency causing amenorrhea. Used Buzhong Yiqi Tang and Liuwei Dihuang Wan for 100+ doses each; malaria cured, menstruation resumed.
Case 6: A woman with chronic malaria had amenorrhea during attacks, weak form, large pulse, headache, anorexia, diarrhea, dysuria, dry mouth/lips, internal heat, and abdominal distension. Chronic malaria depleted Zheng Qi, leaving Yin Fire hyperactive. Treated with Buzhong Yiqi Tang, soon recovered. Occasional headache treated with Manjingzi (Vernonia Seed); menstruation resumed with Liuwei Dihuang Wan.
Case 7: A woman with tinnitus, headache, and fatigue due to labor had insufficient Yuan Qi. Treated with Buzhong Yiqi Tang plus Maidong (Ophiopogon Tuber) and Wuweizi (Schisandra Berry); recovered. Conceived three years later. Postpartum dietary/labor strain caused amenorrhea, evening/internal heat, sweating. Treated with Liuwei Dihuang Wan and Buzhong Yiqi Tang; instantly recovered.
Case 8: A woman with weak Stomach Qi vomited blood and coughed after mourning her mother, with fever, night sweats, and amenorrhea for three months. I diagnosed Grief injuring Lung, Worry injuring Spleen. Morning: Buzhong Yiqi Tang plus Jiegeng, Beimu, Zhimu (Anemarrhena Rhizome). Evening: Guipi Tang sending Dihuang Wan; recovered.
Case 9: A woman with insomnia had menstruation every two months. Mistakenly taking Tongjing Wan caused insomnia, morning chills, afternoon fever. I diagnosed mental worry depleting Spleen blood. Guipi Wan taken morning with Sijunzi Tang, afternoon with Xiaoyao San. Slept well after two months; menstruation regular after half a year; sores healed after one year.
These are Xuexi's general principles for Blood Dryness, focusing on tonifying True Yuan, expanding on the Yishui school's teachings, representing the "Kingly Way" of treatment.
*[Maijue]* Question: Why does a woman with diarrhea have amenorrhea? Master said: Stop the diarrhea, and menstruation will return naturally. Diarrhea depletes Jin-Ye, causing amenorrhea; when diarrhea stops and fluids recover, menstruation resumes. Question: A woman with amenorrhea for 1-2 months suddenly bleeds, with a faint and choppy pulse. Why? Master said: If she had diarrhea mid-cycle, it interfered with menstruation; once stopped, menstruation should resume naturally; this is not a structural defect. If a woman loses blood, has dry throat but no thirst, menstruation stops due to Ying blood deficiency and inherent mild cold, hence no desire to drink. If thirsty and drinking, Jin-Ye flows, Ying-Wei harmonizes, and menstruation resumes.
*[Shanghan Lun]* Women's diseases caused by deficiency, accumulated cold, and constrained Qi lead to amenorrhea, sometimes lasting years. Cold blood accumulates in the Bao Gate, injuring collaterals. Congealed cold above causes vomiting of saliva/foam, eventually lung abscess, wasting the body. Congealed cold in the middle causes umbical cold hernia. Pain in hypochondrium connects to Zang organs. Heat accumulation in the center affects Guan Yuan point; rapid pulse without sores, skin like fish scales. Affects men too, not just women. Below, irregular menstruation causes genital pulling pain, lower abdominal aversion to cold, radiating to waist/spine, originating from Qichong point, causing urgent pain in Qichong, knee/shin pain, sudden vertigo resembling epilepsy. Emotional distress, sadness, irritability are all Dai diseases, not ghost possession. Long-term emaciation, deficient pulse with cold, thirty-six diseases, myriad changes. Examine pulse Yin/Yang, deficiency/excess, tight/wiry; apply acupuncture/herbs to save danger and restore peace. Same disease, different pulse origins; distinguish carefully.
*[Danxi]* For delayed amenorrhea, crush Tu Niuxi (Irregular-leaved Achyranthes Root) for half a cup of juice, mix with 1 qian Xuanhusuo (Corydalis Rhizome) powder, 0.5 qian Xiangfu (Cyperus Rhizome) powder, and 0.5 qian Zhike (Aurantium Fruit) powder, taken early morning.
*[Dajian]* Wanbing Wan treats amenorrhea and periumbilical pain.
Ganqi (Drynaria Rhizome - crushed, fried until smoke ceases), Niuxi (Achyranthes Root - remove sprouts, soak in wine overnight, dry, each 1 liang).
Grind to powder, add 1 sheng fresh Shudihuang (Prepared Rehmannia Root) juice, slow-fire boil in silver vessel until pillable, form pills size of tung seeds. Take 2 pills, empty stomach with rice drink or warm wine.
Tu Niuxi San treats female amenorrhea with five-palm heat.
Tu Niuxi (Irregular-leaved Achyranthes Root), Dangguwei (Angelica Sinensis Tail - each 1 liang), Taoren (Peach Kernel - peeled, bran-fried, ground separately), Honghua (Safflower - each 0.5 liang).
Grind to fine powder. Take 2 qian, empty stomach with warm wine.
Danggui Ganqi Wan treats irregular menstruation, lower abdominal distension, rebellious Qi. (See Tiaojing section).
Treats menstrual stasis and umbilical/abdominal pain.
Danggui (Angelica Sinensis Root), Xuanhusuo (Corydalis Rhizome).
Coarse powder. Take 3 qian, 3 slices ginger, 1.5 cups water, decoct to 0.7 cup, strain, take slightly warm.
Danggui San treats blood vessel blockage.
Danggui (Angelica Sinensis Root), Chuanshanjia (Pangolin Scale - ash-fried), Puhuang (Lygodium Spore - fried, each 0.5 liang), Chensha (Cinnabar - ground separately, 1 qian), Shexiang (Musk - small amount).
Fine powder. Take 2 qian before meals with hot wine.
Hupo San treats chest confusion, abdominal cramping pain, shortness of breath, amenorrhea.
Tiantai Wuyao (Lindera Root - 2 liang), Danggui (Angelica Sinensis Root), Ezhu (Curcuma Rhizome - each 1 liang).
Fine powder. Take 2 qian with warm wine, follow with food. Avoid raw/cold and greasy foods. Postpartum disorders: take with fried ginger and wine.
Small Intestine heat transferring to Large Intestine causes Fu Xia (latent mass) and Chen (sinking). (Wang Bing note: Blood stasis causes menstrual stagnation.)
*[Shengji Zonglu]* Treats menstrual stasis forming masses, severe muscle distension. Use 5 jin Ma Biancao (Verbena Officinalis) seedlings, cut fine, decoct in 5 dou water to 1 dou, strain, boil in clean vessel to paste. Take half spoon with warm wine before meals. (*Bencao*: Verbena is pungent-cool, breaks blood masses.)
*[Luo Qianfu]* Xueji Gao treats female dry blood qi. Crush Chuan Dahuang (Rhubarb Root) to powder, boil with strong vinegar to paste, pills size of chicken head. Take 1 pill dissolved in wine before sleep. After 1-2 bowel movements, red blood flows. Called immortal medicine for women. Add Danggui Tou (Angelica Sinensis Head).
*[Shanghan Lun]* Irregular menstruation in women is treated with Didang Tang. (Also treats men with bladder fullness/urgency due to blood stasis. See Shanghan Shuxue.)
Chanbao Fang treats amenorrhea and abdominal pain.
Niuxi (Achyranthes Root - 6 fen), Dahuang (Rhubarb Root), Taoren (Peach Kernel - peeled, fried, each 5 fen), Xixin (Asarum Root), Chuanxiong (Sichuan Lovage Rhizome), Danggui (Angelica Sinensis Root - each 4 fen), Shuizhi (Leech - 3 fen, fried yellow with glutinous rice).
Fine powder, honey pills size of wu zi. Take 20 pills, empty stomach with warm wine.
Qianjin Taoren Jian treats blood accumulation/masses and amenorrhea.
Dahuang (Rhubarb Root - steamed in wet paper), Pomiao (Mirabilite), Taoren (Peach Kernel - processed/fried, each 2 liang), Mengchong (Bladderworm - 1 liang, remove feet/wings, fried black).
Powder. Add 2.5 sheng vinegar, slow-boil in silver/ceramic vessel to paste. Add Dahuang, Taoren, Mengchong powders, stir constantly until pillable. Add Pomiao, stir longer, form pills size of wu zi. At dawn, take 5 pills with warm wine. By noon, expel material resembling red bean juice, chicken liver, or frog skin. Stop when bright red blood stops; follow with Qi-regulating tonics.
Sanleng Wan treats female meridian blockage, Qi pain with leukorrhea, and blood masses.
Sanleng (Sparganium Rhizome - vinegar-fried), Chuanxiong, Niuxi, Xuanhusuo, Pengzhu (Curcuma Rhizome - vinegar-fried), Puhuang, Mudanpi (Tree Peony Bark), Yuanhua (Genkwa Flower - vinegar-fried), Baizhi (Angelica Dahurica Root), Danggui, Dilong (Earthworm - cleaned, wine-soaked/fried), Ganjiang (Dried Ginger - roasted, each 1 liang), Dahuang (Rhubarb Root - 2 liang, powder boiled in rice vinegar to paste, mixed with herbs).
Fine powder, mix with Dahuang paste, pills size of wu zi. Take 30-50 pills, empty stomach with vinegar soup or safflower decoction wine.
These seven formulas treat amenorrhea due to dirty blood with heat. The first is light; the next six are heavy.
*[Yunqizi]* Honghua Danggui San treats female amenorrhea, accumulated blood stasis, waist/abdominal pain, and virgin amenorrhea.
Honghua (Safflower), Dangguwei (Angelica Sinensis Tail), Ziwei (Bignonia Flower), Niuxi, Gancao (Licorice Root), Sumu (Calamus Wood - cut fine, each 2 liang), Chishaoyao (Red Peony Root - 9 liang), Liu Jimu (Knawel Herb - 5 liang), Guixin (Cinnamon Bark), Baizhi (Angelica Dahurica Root - each 1.5 liang).
Fine powder. Take 3 qian with hot wine empty stomach, repeat before meals and sleep. For long-term stasis, take with concentrated safflower wine. Pregnant women avoid. Also called Lingxiaohua San (Bignonia Flower).
Niuxi San (See Tiaojing section). Wenjing Tang (See Tiaojing section). Guizhi Taoren Tang treats female amenorrhea with lower abdominal distension/pain. (See Tiaojing Abdominal Pain section). Mudan San (See Tiaojing section).
Tongjing Wan (*Baoshi Fang*) treats female/virgin amenorrhea or blood masses. (Bencao adds egg white. Fear lacquer, causes gut sores.)
Guixin (Cinnamon Bark), Qingpi (Aurantium Peel - remove white), Dahuang (Rhubarb Root - roasted), Ganjiang (Dried Ginger - roasted), Chuanjiao (Sichuan Pepper - fried to sweat), Chuanwu (Aconite Root - roasted), Pengzhu (Curcuma Rhizome), Ganqi (Drynaria Rhizome - fried until smoke ceases), Danggui, Taoren (Peach Kernel - processed/fried, equal parts).
Powder. First 4 qian boiled in rice vinegar to paste, mix with remaining 6 qian powder, pound in mortar, pills size of tung seeds, dry. Take 20 pills with light vinegar soup, increase to 30. Warm wine acceptable, empty stomach before meals. *Jisheng Fang* removes Chuanwu, adds Honghua (Safflower) in equal parts.
Zixue Tang treats Qi deficiency of Zang-Fu, Chong, and Ren meridians due to labor, failing to control blood, causing metrorrhagia, fresh blood, or five-colored discharge, continuous dripping, emaciation, fatigue, and amenorrhea.
Ma Biancao (Verbena Officinalis), Niuxi, Jingjie Sui (Schizonepeta Spike - each 2 liang), Danggui, Rougui (Cinnamon Bark), Mudanpi, Chishaoyao, Chuanxiong (each 1 liang).
Take 4 qian per dose, 1 sour plum, 2 cups water, decoct to 1 cup, before meals. 4-5 doses daily, continue half month to one month, meridians open naturally.
These seven formulas treat amenorrhea due to dirty blood with cold. First four are light; last two are heavy.
*[Dajian]* Treats amenorrhea, proven effective. Houpo (Magnolia Bark) as needed, fried with ginger juice until fragrant, cut fine, decoct strongly, strain, take empty stomach. 3-4 doses cure. (Suitable for robust constitution.)
*[Danxi]* Phlegm accumulation injuring meridians causes amenorrhea and nighttime delirium.
Gualouzi (Trichosanthes Seed - 1 liang), Huanglian (Coptis Rhizome - 0.5 liang), Wuzhuyu (Evodia Fruit - 10 liang), Taoren (Peach Kernel - 50 grains), Hongqu (Red Yeast Rice - 2 qian), Suosha (Amomum Fruit - 3 liang), Shanzha Mo (Hawthorn Powder - 1 liang).
Grind with fresh ginger juice, form pills with steamed dough.