躯脂满，经闭，导痰汤加芎、连。不可服地黄，如用，姜汁拌炒。（导痰汤即二陈加枳实、
黄连是也。）
杨村妇人年二十余，两年经闭，食少乏力。
黄连（二钱） 白术（一钱半） 陈皮 滑石（各一钱） 黄芩（半钱） 木通（三分）
桃仁（十二个） 甘草（炙，少许） 此方分两有讹。
上丹溪治痰结胸腹而经闭之法，皆用轻剂导痰降火也。
经云∶气上迫肺，则心气不得下通，故月事不来。今用连、朴之类，导痰降火，使
不上迫于肺，故心气下通而月事来也。
丹溪治一妇人久疟，食少经闭，两手无脉，每日与三花神佑丸十余粒，津咽之，月
余食进脉出。又半月脉愈，又一月经行。亦此意也。详见久疟。予尝体丹溪之意，治陈氏
妇二十余岁，形肥痞塞不食，每日卧至未牌，吃一盏薄粥，吃粥后必吐水半碗，
仍复卧，经不通三月矣。前番曾暗通黑色，脉之，辰时寸关滑，皆有力，午后关滑
寸不滑。询之，因乘怒饮食而然。遂以白术一两半，浓朴、黄连、枳实各一两，半夏、茯
苓、陈皮、山楂、人参、滑石各八钱，缩砂、香附、桃仁各半两，红花二钱，分作十帖，
每日服一帖，各入姜汁二蚬壳，间三日以神佑丸、神秘沉香丸微下。
之，至十二日吐止，食渐进，四十日平复如故。又汪氏妇三十余，形瘦，亦痞不食，吐
水，经不通，以前药方加参、术、归为君，煎熟，入竹沥半盏，姜汁服之。但不用神佑
丸下，亦平复。若咳嗽寒热而经闭者，当于咳门湿痰条求之。
〔子和〕凡妇人月事不来，用茶调散吐之，次用玉烛散、芎归汤，三和汤、桂苓白
术散之类，降心火，益肾水，开胃进食，分阴阳，利水道之药也。一妇人月事不行，寒
热往来，口干颊赤，饮食少，旦暮间咳一二声，诸医皆用虻虫、水蛭、干漆、 砂、芫
青、红娘子、没药、血竭之类。惟戴人不然，曰∶古方虽有此法，奈病患服之必脐腹发痛，
饮食不进。乃命止药，饮食少进。《内经》曰∶二阳之病发心脾。心受之则血不流，故女子
不月。既心受积热，宜抑火升水，流湿润燥，开胃诱食。乃涌出痰一二升，下泄水五六行，
湿水上下皆去，血气自然湍流，月事不为水湿所隔，自根据期而至矣。亦不用虻虫、水蛭
之类有毒之药，如用之则月经总来，小溲反闭，他证生矣。凡精血不足，宜补之以食，大
忌有毒之药，偏胜而致夭阏多矣。一妇人年三十四岁，经水不行，寒热往来，面色痿
黄，唇焦颊赤，时咳三二声。问其所服之药，黑神散、乌金丸、四物汤、烧肝散、鳖甲散、
建中汤、宁肺散，针艾千百，转剧。家人意倦，不欲求治。戴人悯之，先涌痰五六升，午
前涌毕，午后食进，余证悉除。后三日，复轻涌之，又去痰一二升，食益进，不数日又
下通经散，泻讫一二升，后数日，去死皮数重，小者如麸片，大者如苇膜，不月余经水
自行，神气大康矣。月事不来者，胞脉闭也。胞脉者，属心而络于胞中，今气上迫肺，
心气不得下通，故月事不来也。（全文见水肿。）
〔大〕室女月水不来，用雄鼠屎一两，烧存性，为细末，空心温酒调下一钱，神效。
〔海〕掌中金丸 治妇人干血气。
穿山甲（炮） 甘草 苦丁香 川椒 苦葶苈 白附子 猪牙皂角 草乌头（各三钱）
巴豆（一钱，全用研）
上为细末，以生葱绞汁，和丸弹子大，每用一丸，新绵包之，纳阴中，一日即白，二
日即赤，三日即血，神效。
〔仲〕妇人经水闭不利，脏坚癖不止，中有干血，下白物。矾石丸主之。
矾石（三钱，烧） 杏仁（一分）
上二味末之，炼蜜丸枣核大，五内中。剧者再纳之。
〔室女经闭成劳〕
寇宗 曰∶夫人之生，以气血为本。人之病，未有不先伤其气血者。若室女童男，积
想在心，思虑过度，多致劳损。男子则神色消散，女子则月水先闭。盖忧愁思虑则伤心
而血逆竭，神色先散，月水先闭。且心病则不能养脾，故不嗜食。脾虚则金亏，故发嗽。
肾水绝则木气不荣，而四肢干痿，故多怒，鬓发焦，筋骨痿。若五脏传遍则死。自能改易
心志，用药扶持，庶可保生。切不可用青蒿、虻虫等凉血、行血，宜用柏子仁丸、泽兰汤
益阴血、制虚火。
〔薛〕经云∶五谷入于胃，其糟粕、津液、宗气分为三隧。故宗气积于胸中，出于
喉咙，以贯心肺而行呼吸。荣气者，泌其津液，注之于脉，化以为血，以荣四末，内养
五脏六腑。若服苦寒之剂，复伤胃气，必致不起。一室女年十七， 久不愈，天癸未
通，发热咳嗽，饮食少思，欲用通经丸。余曰∶此盖因禀气不足，阴血未充故耳。但养
气血，益津液，其经自行。彼惑于速效，仍用之。余曰∶非其治也。此乃剽悍之剂，大
助阳火，阴血得之则妄行，脾胃得之则愈虚。后果经血妄行，饮食愈少，遂致不救。
柏子仁丸 （《大全》）治如上证，兼服泽兰汤。
柏子仁（炒，别研） 牛膝 卷柏（各半两） 泽兰叶 续断（各二两） 熟地黄（三两）
为细末，炼蜜丸如梧子大。空心米饮下三十丸。
泽兰汤
泽兰叶（三两） 当归 芍药（各一两） 甘草（半两）
为粗末，每服五钱，水二盏，煎一盏温服。
沉香鳖甲散 室女经候凝滞，或头目昏闷，停痰，五心虚烦，少食多困。
沉香 甘草（炙） 槟榔（各三分） 木香 常山 当归 柴胡 人参 半夏 桂心 生地
黄白茯苓 青皮 净陈皮（各一两） 鳖甲（一两半）
上为细末，每二钱，姜二片，水煎七分，空心温服。
劫劳散 疗心肾俱虚，水火不交，初则微嗽，遇夜发热即冷，有盗汗，倦怠瘦弱，减
食恍惚。或微嗽，唾中有红线，名曰肺痿，为不治。
白芍药（六两） 黄 甘草 人参 当归 半夏 白茯苓 北五味子 阿胶（炒） 熟地
黄（洗，各二两）
上 咀，每三大钱，水盏半，姜十二片，枣三枚，煎温服。百药不效，一料除根。
麦煎散 治少男、室女骨蒸，妇人血风攻疰四肢，心胸烦壅，口臭，肌热盗汗。
鳖甲 大黄（煨） 常山 赤茯苓 柴胡 白术 当归 干漆（炒烟尽） 生地黄 石膏（各
一两） 甘草（半两）
上为细末，每服二钱，水一盏，小麦五十粒，食后临卧温服。有虚汗，加麻黄根一两。
牡丹散 （《和剂》）治血气虚损，内则月水不行，外发潮热，肢体羸困，渐成骨蒸。
干漆（炒，二两） 苏木 蓬莪术 鬼箭（各一分） 甘草 当归 桂心 牡丹皮 芍药 延
胡索（炒） 净陈皮 红花 乌药 没药（别研，各一两）
上 咀，每服三钱，水一盏，煎七分，温服无时。
六神汤 （《御药》）治血气不足，肌体烦热。四物汤加黄 、地骨皮，各等分， 咀，水
煎。又治冲任虚损，月水不行，肌肤发热如瘵状。四物汤各一两，柴胡半两，黄芩一分。水煎。
桃仁散 治妇人、女子血闭不通，五心烦热。
红花 当归 桃仁（炒） 牛膝（各等分）
上为末，每服三钱，酒调下，空心服。
〔脉〕师曰∶有一妇人，将一女子，年十五所，来诊言∶女子年十四时，经水自下，
今经反断，其母言恐怖。师曰∶若是夫人亲女，必夫人年十四时，亦以经水下，所以断，
此为避年，勿怪，后当自下，此真气犹怯，禀赋素弱而然也。宜固天元真气，使水升火降，
则五脏自和，而经脉通矣。
又方 鹿茸 山茱萸 当归（各四两） 麝香（一两）
为细末，入麝香拌匀，和酒糊为丸，每服百丸，或五十丸，温酒、盐汤任下。
〔针灸〕
〔心〕经脉不通，已有寒热，此穴大效。三阴交（三分，立有效，如疼时，乃经脉要
通也。）
〔摘〕经脉不通（《心术》同。）曲池 支沟 三里 三阴交（此四穴壅塞不通，则泻之，如
虚耗不行，则补之。）
〔集〕月经断绝 中极 三阴交 肾俞 合谷
〔东〕又法 四满（在丹田傍一寸半。）
〔心〕经脉不通，变成瘕证，饮食如常，腹渐大如蛊。气海（用针通管去其泻水恶物。）阴
交（取法亦如上，去其恶物。）
〔甲〕月水不通，奔，泄气，上下引腰脊痛，气穴主之。女子不下月水，照海主
之。妇人少腹坚痛，月水不通，带脉主之。
月水不利，见血而有身，则反败及乳肿。临泣主之。
〔诊〕肾脉微涩为不月。
身体肥胖、痰湿内盛导致的经闭，用导痰汤加川芎、黄连。不可服用地黄，如果要用，需用姜汁拌炒。（导痰汤就是二陈汤加上枳实、黄连。）
杨村有一位二十多岁的妇人，两年没有来月经，食欲少且乏力。
黄连（二钱） 白术（一钱半） 陈皮 滑石（各一钱） 黄芩（半钱） 木通（三分）
桃仁（十二个） 甘草（炙，少许） 此方剂量有误。
以上是丹溪治疗因痰结于胸腹导致经闭的方法，都使用轻剂量的药物来导痰降火。
《内经》说：气上迫肺，则心气不能下行通达，所以月经不来。现在用黄连、厚朴之类的药，导痰降火，使气不上迫于肺，所以心气能下行通达而月经来潮。
丹溪治疗一位患久疟的妇人，食欲少且经闭，两手摸不到脉搏，每天给她服三花神佑丸十余粒，用津液送下，一个多月后食欲增加，脉搏出现。又过了半个月脉象更有力，再过一个月月经来潮。也是这个意思。详见“久疟”条。我曾体会丹溪的意思，治疗陈氏妇，二十多岁，形体肥胖痞塞不进食，每天睡到未时（下午1-3点），吃一盏薄粥，吃完粥后必吐半碗水，然后继续睡觉，月经不通已经三个月了。前番曾暗通黑色分泌物，诊脉，辰时（上午7-9点）寸关脉滑，都有力，午后关脉滑但寸脉不滑。询问得知，是因为生气后进食所致。于是用白术一两半，厚朴、黄连、枳实各一两，半夏、茯苓、陈皮、山楂、人参、滑石各八钱，缩砂、香附、桃仁各半两，红花二钱，分作十帖，每天服一帖，每帖加入姜汁两个蚬壳的量，每隔三天用神佑丸、神秘沉香丸轻微泻下。服药至第十二天呕吐停止，饮食逐渐增加，四十天后恢复如常。又有汪氏妇三十多岁，形体消瘦，也痞塞不进食，吐水，月经不通，用前面的药方加人参、白术、当归为君药，煎熟后，加入竹沥半盏，姜汁送服。只是不用神佑丸泻下，也恢复了健康。如果有咳嗽寒热且经闭的，应当在“咳门”的“湿痰”条中寻求治法。
〔张子和〕凡是妇人月经不来，用茶调散催吐，其次用玉烛散、芎归汤、三和汤、桂苓白术散之类的药，这些是降心火、益肾水、开胃进食、分阴阳、利水道的药。一位妇人月经不行，寒热往来，口干脸颊红，饮食少，早晚咳一二声，众医都用虻虫、水蛭、干漆、硇砂、芫青、红娘子、没药、血竭之类的药。只有戴人不同意，说：古方虽有此法，但患者服用后必定脐腹发痛，饮食不进。于是命令停药，饮食稍进。《内经》说：二阳之病发于心脾。心受病则血不流，所以女子不来月经。既然心受积热，应当抑火升水，流湿润燥，开胃诱食。于是涌吐出一二升痰，泄下水五六行，湿水上下皆去，血气自然湍流，月经不被水湿阻隔，自然按期而至。也不用虻虫、水蛭之类有毒的药，如果用，则月经总来，小便反而闭塞，其他病症就产生了。凡精血不足，宜用食物补养，大忌有毒之药，偏胜而导致夭折的很多。一位三十四岁的妇人，经水不行，寒热往来，面色萎黄，唇焦颊赤，时常咳两三声。问其所服之药，有黑神散、乌金丸、四物汤、烧肝散、鳖甲散、建中汤、宁肺散，针灸千百次，病情反而加重。家人意兴阑珊，不想求治。戴人怜悯她，先涌吐痰五六升，午前涌吐完毕，午后饮食增加，其余病症悉除。三天后，再次轻涌，又去痰一二升，饮食更加增加，不几天又服下通经散，泻下一二升，后来数日，脱去死皮数层，小的如麸片，大的如苇膜，不过一个多月月经自行来潮，精神气色大康。月经不来，是胞脉闭阻。胞脉，属于心而络于胞中，现在气上迫肺，心气不得下行通达，所以月经不来。（全文见“水肿”条。）
〔李东垣〕室女月经不来，用雄鼠屎一两，烧存性，研为细末，空腹温酒调服一钱，神效。
〔朱丹溪〕掌中金丸 治疗妇人干血气。
穿山甲（炮） 甘草 苦丁香 川椒 苦葶苈 白附子 猪牙皂角 草乌头（各三钱）
巴豆（一钱，全用研）
以上研为细末，用生葱绞汁，和丸如弹子大，每次用一丸，新绵包裹，纳入阴道中，一日即白带，二日即红带，三日即出血，神效。
〔张仲景〕妇人经水闭不利，脏坚癖不止，中有干血，下白物。矾石丸主之。
矾石（三钱，烧） 杏仁（一分）
以上两味研末，炼蜜丸如枣核大，纳入阴道中。重者再纳。
〔室女经闭成劳〕
寇宗奭说：人的生存，以气血为本。人的疾病，没有不先伤其气血的。若室女童男，积想在心，思虑过度，多致劳损。男子则神色消散，女子则月经先闭。盖忧愁思虑则伤心而血逆竭，神色先散，月经先闭。且心病则不能养脾，故不嗜食。脾虚则金亏，故发嗽。肾水绝则木气不荣，而四肢干痿，故多怒，鬓发焦，筋骨痿。若五脏传遍则死。若能改易心志，用药扶持，庶可保生。切不可用青蒿、虻虫等凉血、行血药，宜用柏子仁丸、泽兰汤益阴血、制虚火。
〔薛己〕《内经》说：五谷入于胃，其糟粕、津液、宗气分为三隧。所以宗气积于胸中，出于喉咙，以贯心肺而行呼吸。营气者，泌其津液，注之于脉，化以为血，以荣四末，内养五脏六腑。若服苦寒之剂，复伤胃气，必致不起。一位十七岁室女，久病不愈，天癸未通，发热咳嗽，饮食少思，想用通经丸。我说：这大概是因为禀气不足，阴血未充的缘故。只要养气血，益津液，其经自行。她惑于速效，仍用之。我说：这不是正确的治法。这是剽悍之剂，大助阳火，阴血得之则妄行，脾胃得之则愈虚。后果经血妄行，饮食愈少，遂致不治。
柏子仁丸 （《大全》）治疗如上证，兼服泽兰汤。
柏子仁（炒，别研） 牛膝 卷柏（各半两） 泽兰叶 续断（各二两） 熟地黄（三两）
研为细末，炼蜜丸如梧桐子大。空腹米饮下三十丸。
泽兰汤
泽兰叶（三两） 当归 芍药（各一两） 甘草（半两）
研为粗末，每次服五钱，水二盏，煎至一盏温服。
沉香鳖甲散 室女经候凝滞，或头目昏闷，停痰，五心虚烦，少食多困。
沉香 甘草（炙） 槟榔（各三分） 木香 常山 当归 柴胡 人参 半夏 桂心 生地黄 白茯苓 青皮 净陈皮（各一两） 鳖甲（一两半）
以上研为细末，每次二钱，姜二片，水煎七分，空腹温服。
劫劳散 治疗心肾俱虚，水火不交，初则微嗽，遇夜发热即冷，有盗汗，倦怠瘦弱，减食恍惚。或微嗽，唾中有红线，名曰肺痿，为不治。
白芍药（六两） 黄芪 甘草 人参 当归 半夏 白茯苓 北五味子 阿胶（炒） 熟地黄（洗，各二两）
以上切碎，每次三大钱，水一盏半，姜十二片，枣三枚，煎温服。百药不效，一料除根。
麦煎散 治疗少男、室女骨蒸，妇人血风攻疰四肢，心胸烦壅，口臭，肌热盗汗。
鳖甲 大黄（煨） 常山 赤茯苓 柴胡 白术 当归 干漆（炒烟尽） 生地黄 石膏（各一两） 甘草（半两）
以上研为细末，每次服二钱，水一盏，小麦五十粒，食后临卧温服。有虚汗，加麻黄根一两。
牡丹散 （《和剂局方》）治疗血气虚损，内则月水不行，外发潮热，肢体羸困，渐成骨蒸。
干漆（炒，二两） 苏木 蓬莪术 鬼箭羽（各一分） 甘草 当归 桂心 牡丹皮 芍药 延胡索（炒） 净陈皮 红花 乌药 没药（别研，各一两）
以上切碎，每次服三钱，水一盏，煎七分，随时温服。
六神汤 （《御药院方》）治疗血气不足，肌体烦热。四物汤加黄芪、地骨皮，各等分，切碎，水煎。又治冲任虚损，月水不行，肌肤发热如痨状。四物汤各一两，柴胡半两，黄芩一分。水煎。
桃仁散 治疗妇人、女子血闭不通，五心烦热。
红花 当归 桃仁（炒） 牛膝（各等分）
以上研末，每次服三钱，酒调下，空腹服。
〔脉诊〕老师说：有一位妇人带着一个女儿，十五岁左右，来诊治说：女儿十四岁时，月经自下，现在月经反而中断，母亲很惊恐。老师说：如果是夫人的亲生女儿，必定夫人十四岁时，也以经水下，所以中断，这叫避年，不要奇怪，后来当自下，这是因为真气犹怯，禀赋素弱所致。宜固天元真气，使水升火降，则五脏自和，而经脉通矣。
又方 鹿茸 山茱萸 当归（各四两） 麝香（一两）
研为细末，入麝香拌匀，和酒糊为丸，每次服百丸，或五十丸，温酒、盐汤任下。
〔针灸〕
〔《针经指南》〕经脉不通，已有寒热，此穴大效。三阴交（刺三分，立有效，如疼时，乃经脉要通也。）
〔《针灸摘英集》〕经脉不通（《心术》同。）曲池 支沟 足三里 三阴交（此四穴壅塞不通，则泻之，如虚耗不行，则补之。）
〔《针灸集成》〕月经断绝 中极 三阴交 肾俞 合谷
〔《针灸聚英》〕又法 四满（在丹田傍一寸半。）
〔《针经指南》〕经脉不通，变成瘕证，饮食如常，腹渐大如蛊。气海（用针通管去其泻水恶物。）阴交（取法亦如上，去其恶物。）
〔《甲乙经》〕月水不通，奔豚，泄气，上下引腰脊痛，气穴主之。女子不下月水，照海主之。妇人少腹坚痛，月水不通，带脉主之。
月水不利，见血而有身，则反败及乳肿。临泣主之。
Menstrual obstruction due to excessive body fat and phlegm-dampness is treated with Daotan Tang (Phlegm-Draining Decoction) added with Chuanxiong Rhizome (Chuanxiong) and Coptis Rhizome (Huanglian). Dihuang (Rehmannia Root) should not be taken; if used, it must be stir-fried with ginger juice. (Daotan Tang consists of Erchen Tang plus Zhishi (Immature Bitter Orange) and Huanglian.)
A woman from Yang Village, in her twenties, had experienced amenorrhea for two years, accompanied by poor appetite and fatigue.
Huanglian (Coptis Rhizome, 2 qian), Baizhu (Atractylodes Macrocephala Rhizome, 1.5 qian), Chenpi (Dried Tangerine Peel), Huashi (Talcum, each 1 qian), Huangqin (Scutellaria Root, 0.5 qian), Mutong (Akebia Stem, 0.3 qian), Taoren (Peach Seed, 12 pieces), Gancao (Licorice Root, roasted, a small amount). The dosages in this prescription contain errors.
The above describes Danxi's method for treating amenorrhea caused by phlegm accumulation in the chest and abdomen, using light agents to drain phlegm and descend fire.
The *Neijing* states: "When Qi forces upward upon the Lung, Heart Qi cannot descend and communicate, thus menstruation ceases." Now, using herbs like Huanglian and Houpo, we drain phlegm and descend fire, preventing Qi from forcing upward upon the Lung, thereby allowing Heart Qi to descend and communicate, resulting in the return of menstruation.
Danxi treated a woman suffering from chronic malaria, with poor appetite and amenorrhea, whose pulses were imperceptible in both hands. He administered approximately ten pills of Sanhua Shenyu Wan (Three-Flower Divine Preservation Pill) daily, swallowed with saliva. After more than a month, her appetite improved and her pulse became palpable. Half a month later, her pulse strengthened further, and after another month, menstruation resumed. This follows the same principle. See the section on "Chronic Malaria" for details. I once applied Danxi's principle to treat a Mrs. Chen, in her twenties, who was obese, suffered from epigastric fullness and anorexia, slept until Wei hour (1-3 PM), ate only one bowl of thin porridge, vomited half a bowl of water after eating, and then returned to sleep. Her menstruation had been absent for three months. Previously, she had passed dark discharge. Pulse diagnosis at Chen hour (7-9 AM) showed slippery and forceful Cun and Guan positions, while in the afternoon, the Guan position was slippery but the Cun position was not. It was learned that this resulted from eating while angry. Thus, I prescribed Baizhu (1.5 liang), Houpo (Magnolia Bark), Huanglian, and Zhishi (each 1 liang), Banxia (Pinellia Tuber), Fuling (Poria), Chenpi, Shanzha (Hawthorn Fruit), Renshen (Ginseng), and Huashi (each 8 qian), Suisha (Amomum Fruit), Xiangfu (Cyperus Rhizome), and Taoren (each 0.5 liang), Honghua (Safflower, 2 qian). This was divided into ten doses, taken daily, with two shell-sized portions of ginger juice added to each dose. Every three days, mild purgation was induced using Shenyu Wan and Shenmi Chenxiang Wan. By the twelfth day, vomiting ceased, and food intake gradually increased. She recovered completely within forty days. Another case involved Mrs. Wang, over thirty, who was emaciated, also suffered from epigastric fullness, anorexia, vomiting of water, and amenorrhea. The previous formula was modified with Renshen, Baizhu, and Danggui (Angelica Sinensis) as chief ingredients, decocted, and mixed with half a cup of Zhuli (Bamboo Juice) and ginger juice for administration. Purgatives like Shenyu Wan were not used, yet she also recovered. For cases of amenorrhea accompanied by cough and alternating chills and fever, treatment should be sought under the "Cough" category, specifically the "Damp-Phlegm" subsection.
[He Ji] Whenever women suffer from amenorrhea, use Chatao San (Tea-Powdering Powder) to induce vomiting, followed by Yuzhu San (Jade Candle Powder), Xionggui Tang (Ligusticum and Angelica Decoction), Sanhe Tang (Three-Harmony Decoction), Guiling Baizhu San (Cinnamon, Alisma, and Atractylodes Powder), and similar formulas. These are medicines that descend Heart Fire, nourish Kidney Water, open the stomach and promote appetite, differentiate Yin and Yang, and promote urination. One woman with amenorrhea presented with alternating chills and fever, dry mouth, red cheeks, poor appetite, and occasional coughs morning and night. Most physicians prescribed toxic blood-invigorating herbs such as Mengchong (Blue Bottle Fly Larva), Shuizhi (Leech), Ganqi (Resinous Lacquer), Naosha (Natrii Nitras), Yuanqing (Blister Beetle), Hongniangzi (Red Ladybug), Moyao (Myrrh), and Xuexie (Dragon's Blood). Only Dai Ren disagreed, stating: "Although ancient formulas employ these methods, patients taking them will inevitably experience abdominal pain and loss of appetite." He ordered the cessation of medication, after which her appetite slightly improved. The *Neijing* says: "Diseases of the Two Yang originate from the Heart and Spleen. If the Heart is affected, blood does not flow, hence women do not menstruate." Since the Heart suffers from accumulated heat, one should suppress Fire and ascend Water, moisten dryness, open the stomach, and encourage eating. He induced vomiting of one or two sheng of phlegm and purged five or six stools of watery fluid. With dampness and water eliminated from above and below, blood and Qi naturally flowed freely, and menstruation returned on schedule without being obstructed by dampness-water. Toxic herbs like Mengchong and Shuizhi were avoided; had they been used, menstruation would have been irregular, urination blocked, and other symptoms arising. When Essence and Blood are deficient, they should be supplemented with food. Toxic drugs are strictly contraindicated; many premature deaths result from their excessive use. A thirty-four-year-old woman presented with amenorrhea, alternating chills and fever, sallow complexion, dry lips, red cheeks, and occasional coughs. Inquired about her medications, she reported taking Heishen San (Black Divine Powder), Wujin Wan (Black Gold Pill), Siwu Tang (Four Substances Decoction), Shaogan San (Roasted Liver Powder), Biejia San (Softshell Turtle Powder), Jianzhong Tang (Establish the Middle Decoction), Ningfei San (Calming Lung Powder), and undergoing thousands of acupuncture and moxibustion sessions, yet her condition worsened. Her family lost hope and desired no further treatment. Dai Ren pitied her, first inducing vomiting of five or six sheng of phlegm. By noon, vomiting ceased, her appetite improved, and other symptoms disappeared. Three days later, he lightly induced vomiting again, removing another one or two sheng of phlegm, further improving her appetite. Not long after, he administered Tongjing San (Unblocking Menstruation Powder), resulting in the purging of one or two sheng of stool. Over the following days, layers of dead skin peeled off, some like bran flakes, others like reed membranes. Within a month, menstruation resumed spontaneously, and her spirit and vitality greatly recovered. Amenorrhea is caused by the closure of the Bao Mai (Uterine Vessels). The Bao Mai belongs to the Heart and connects to the Bao Zhong (Uterus). Now, Qi forces upward upon the Lung, preventing Heart Qi from descending and communicating, thus menstruation ceases. (See the full text under "Edema".)
[Dah] For virgins with amenorrhea, use one liang of male rat feces, burned until carbonized but retaining its nature, ground into fine powder. Take one qian with warm wine on an empty stomach. Miraculous effect.
[Hai] Zhangshou Jin Wan (Palm-Gold Pill) treats Dry Blood Qi in women.
Shanjiapia (Pangolin Scale, prepared), Gancao (Licorice Root), Kudingxiang (Euodia Fruit), Chuanjiao (Sichuan Pepper), Ku Tingli (Descurainia Seed), Baifuzi (Typhonium Rhizome), Zhuya Zaojiao (Toothpick Soap Pod), Caowutou (Aconite Lateral Root, raw, each 3 qian), Badou (Croton Seed, 1 qian, whole, ground).
Grind all into fine powder. Mix with juice pressed from fresh green onions to form pills the size of bullet seeds. Use one pill per application, wrapped in new cotton, inserted into the vagina. On the first day, white discharge appears; on the second day, red discharge; on the third day, bleeding occurs. Miraculous effect.
[Zhong] For women with obstructed menstruation, hard masses in the viscera persisting, dry blood present internally, and leukorrhea, Fan Shi Wan (Alum Pill) is indicated.
Fanshi (Alum, 3 qian, calcined), Xingren (Apricot Seed, 1 fen).
Grind the two ingredients into powder. Mix with refined honey to form pills the size of a jujube pit. Insert into the vagina. For severe cases, re-insert.
[Virgin Amenorrhea Leading to Consumption]
Kou Zongshi said: Human life is based on Qi and Blood. Diseases invariably begin with damage to Qi and Blood. Virgins and young boys, harboring obsessive thoughts and excessive mental exertion, often develop consumption. Men exhibit dissipating spirit and complexion; women experience early amenorrhea. Grief and worry injure the Heart, causing blood to reverse and exhaust, leading to dissipating spirit and early amenorrhea. Heart disease fails to nourish the Spleen, resulting in anorexia. Spleen deficiency leads to Metal deficiency, causing cough. Exhaustion of Kidney Water causes Wood Qi to wither, leading to dry and flaccid limbs, irritability, scorched hair, and weak sinews and bones. If the Five Zang organs transmit disease fully, death ensues. If one can change their mindset and use medicine to support recovery, survival may be preserved. Qinghao (Artemisia Annua) and Mengchong (Blue Bottle Fly Larva) and other cooling-blood and blood-invigorating herbs must absolutely be avoided. Instead, Baizi Ren Wan (Biota Seed Pill) and Zelang Tang (Lycopus Decoction) should be used to nourish Yin-Blood and control deficiency-fire.
[Xue] The *Neijing* states: "When five grains enter the Stomach, their dregs, fluids, and Zong Qi (Gathering Qi) are divided into three pathways." Thus, Zong Qi accumulates in the chest, emerges through the throat, penetrates the Heart and Lung to govern respiration. Ying Qi (Nutritive Qi) secretes its fluids, injects them into the vessels, transforms them into blood, nourishes the four extremities, and internally nourishes the Five Zang and Six Fu organs. If bitter-cold agents are taken, further damaging Stomach Qi, recovery will be impossible. A seventeen-year-old virgin suffered from prolonged illness, unopened Tian Gui (Menstruation), fever, cough, and poor appetite. She wished to use Tongjing Wan (Unblocking Menstruation Pill). I said: This is likely due to insufficient congenital Qi and un-filled Yin-Blood. Nourishing Qi and Blood, and benefiting fluids, will allow menstruation to resume spontaneously. Confused by the desire for rapid results, she still used it. I said: This is not the correct treatment. This is a fierce agent that greatly assists Yang-Fire; Yin-Blood becomes reckless, and the Spleen and Stomach become increasingly deficient. Indeed, her menstrual blood flowed recklessly, her appetite decreased further, leading to untreatable decline.
Baizi Ren Wan (*Quanwen*) treats conditions as described above; take concurrently with Zelang Tang.
Baizi Ren (Biota Seed, roasted, separately ground), Niuxi (Achyranthes Root), Juanbai (Selaginella), each 0.5 liang; Zelanye (Lycopus Leaf), Xuduan (Dipsacus Root), each 2 liang; Shudihuang (Prepared Rehmannia Root), 3 liang.
Grind into fine powder. Mix with refined honey to form pills the size of wetastel seeds. Take thirty pills with rice drink on an empty stomach.
Zelang Tang
Zelanye (Lycopus Leaf, 3 liang), Danggui (Angelica Sinensis), Shaoyao (Peony Root), each 1 liang; Gancao (Licorice Root), 0.5 liang.
Grind into coarse powder. Take five qian per dose, decoct with two zhan of water until one zhan remains. Take warm.
Chenxiang Biejia San (Agarwood and Softshell Turtle Powder) treats virgins with stagnant menstruation, or dizziness and heavy head, retained phlegm, emptiness-heat in the five centers, poor appetite, and frequent fatigue.
Chenxiang (Agarwood), Gancao (Licorice Root, roasted), Binglang (Areca Seed), each 0.3 fen; Muxiang (Costus Root), Changshan (Dichroa Root), Danggui, Chaihu (Bupleurum Root), Renshen, Banxia, Guixin (Cinnamon Twig), Shengdi Huang (Raw Rehmannia Root), Baifuling (White Poria), Qingpi (Green Tangerine Peel), Jing Chenpi (Cleaned Tangerine Peel), each 1 liang; Biejia (Softshell Turtle Shell), 1.5 liang.
Grind into fine powder. Take two qian per dose with two slices of ginger, decoct with water until seven fen remain. Take warm on an empty stomach.
Jielao San (Robbing Labor Powder) treats simultaneous deficiency of Heart and Kidney, failure of Water and Fire to interact, initial slight cough, night-time fever followed by cold, night sweats, fatigue, emaciation, reduced appetite, and mental confusion. Or slight cough with red threads in sputum, named Fei Wei (Lung Flaccidity), which is untreatable.
Baishao Yao (White Peony Root), 6 liang; Huangqi (Astragalus Root), Gancao, Renshen, Danggui, Banxia, Baifuling, Bei Wuweizi (Schisandra Berry), Ejiao (Donkey-Hide Gelatin, roasted), Shudihuang (washed), each 2 liang.
Cut into pieces. Take three da qian per dose with one and a half zhan of water, twelve slices of ginger, and three jujubes. Decoct and take warm. If hundred medicines fail, one dose removes the root cause.
Maijian San (Wheat-Boiling Powder) treats bone-steaming in young men and virgins, blood-wind attacking the limbs of women, chest and heart oppression, bad breath, muscle heat, and night sweats.
Biejia, Dahuang (Rhubarb Root, baked), Changshan, Chi Fuling (Red Poria), Chaihu, Baizhu, Danggui, Ganqi (Resinous Lacquer, roasted until smoke ceases), Shengdi Huang, Shigao (Gypsum Fibrosum), each 1 liang; Gancao, 0.5 liang.
Grind into fine powder. Take two qian per dose with one zhan of water and fifty wheat grains. Take warm after meals and before bed. For deficiency sweating, add Mahuanggen (Ephedra Root) one liang.
Mudan San (*Heji Ju Fang*) treats Qi and Blood deficiency, internal amenorrhea, external tidal fever, emaciated and weary limbs, gradually developing into bone-steaming.
Ganqi (roasted, 2 liang), Sumu (Sappan Wood), Peng'e Zhu (Curcuma Zedoaria), Guijian (Arrowwood Branch), each 1 fen; Gancao, Danggui, Guixin, Mudan Pi (Moutan Cortex), Shaoyao, Yanhusuo (Corydalis Rhizome, roasted), Jing Chenpi, Honghua, Wuyao (Lindera Root), Moyao (Myrrh, separately ground), each 1 liang.
Cut into pieces. Take three qian per dose with one zhan of water, decoct until seven fen remain. Take warm at any time.
Liushen Tang (*Yuyao Yuan Fang*) treats Qi and Blood insufficiency and bodily restlessness. Siwu Tang added with Huangqi and Digupi (Dogwood Bark), equal parts, cut into pieces, decocted in water. Also treats deficiency of Chong and Ren meridians, amenorrhea, and skin heat resembling tuberculosis. Siwu Tang each 1 liang, Chaihu 0.5 liang, Huangqin 0.1 fen. Decoct in water.
Taoren San treats blood obstruction and non-flow in women and girls, with emptiness-heat in the five centers.
Honghua, Danggui, Taoren (roasted), Niuxi, equal parts.
Grind into powder. Take three qian per dose, mixed with wine. Take on an empty stomach.
[Pulse Diagnosis] The Master said: A woman brought her daughter, aged fifteen, for consultation. She stated: "Her menstruation began at fourteen, but has now suddenly stopped." The mother was terrified. The Master said: "If this is your biological daughter, you likely also experienced menstruation at fourteen, which is why it stopped. This is called 'Bi Nian' (Avoidance Year). Do not be alarmed; it will resume spontaneously. This is because her True Qi is still weak and her constitution is inherently frail." One should consolidate the Tianyuan True Qi, causing Water to ascend and Fire to descend, so that the Five Zang harmonize themselves and the meridians open.
Another Prescription: Lurong (Deer Antler), Shanzhuyu (Cornus Fruit), Danggui (each 4 liang); Shexiang (Musk, 1 liang).
Grind into fine powder. Mix Shexiang evenly. Form pills with wine paste. Take fifty to one hundred pills per dose, with warm wine or salted broth as desired.
[Acupuncture]
[Heart Meridian] For unobstructed meridians with existing chills and fever, this acupoint is highly effective. Sanyinjiao (SP6) (Insert 0.3 cun; effective immediately. Pain indicates the meridian needs thorough unblocking.)
[Excerpts] Unobstructed meridians (Same as *Xinshu*). Quchi (LI11), Zhigou (SJ6), Zusanli (ST36), Sanyinjiao (SP6). (If these four acupoints are obstructed, reduce them; if deficiency prevents flow, tonify them.)
[Collection] Amenorrhea: Zhongji (CV3), Sanyinjiao (SP6), Shenshu (BL23), Hegu (LI4).
[Dong] Another Method: Siman (CV4 side, 1.5 cun lateral to Dantian).
[Heart Meridian] Unobstructed meridians transforming into Jia masses, normal diet, abdomen gradually enlarging like Gu poisoning. Qihai (CV6) (Use needle with tube to drain water and evil substances.) Yinjiao (CV7) (Method as above, to remove evil substances.)
[Jia Yi Jing] Amenorrhea, Benpeng (Rushing Pig), leakage of Qi, lower back and spine pain radiating up and down, Qixue (GB26) governs. Women failing to menstruate, Zhaohai (KI6) governs. Women with firm pain in the lower abdomen and amenorrhea, Daimai (GB26) governs.
Menstrual difficulty, seeing blood while pregnant, then miscarriage and breast swelling. Linqi (GB15) governs.
[Diagnosis] A faint and choppy Kidney pulse indicates amenorrhea.