上述三方首方重于抗癌，二方偏于温养，补中有攻，攻补兼施。末方寓攻于补，扶正御邪而竟全功。三方之用药各有侧重，层次井然，合于普明子《医学心悟》以初、中、末三法以治癥瘕之旨，故收药到病除之效。
外科类
有孙会计者，年半百许。早岁曾患肺痨，虽然药饵常进，依旧体质渐损。所以年方知命，而头发渐渐花白，且不时脱落。1975年春夏间，忽片片脱净而成斑秃：右耳上方、头后枕骨上缘及左耳后上缘为三大块，均约2×2cm大小。其次，较小之秃斑尚有数处。某医院同时采用内服外涂措施，治疗数月依然如故。改用牛奶注射于患处皮内，实在痛极难忍，而强忍之，每周一次，又治数月，仍无进展。于是邀余用中药治疗。诊得脉弦细，舌淡红，知系本元不足，加以作务劳心，渐致气血亏损。经曰：发为血之余，肾之华在发。又曰：肾藏精，肝藏血。肝肾精血充足则美髯而华发；精血衰少，则须颓发落。故其治法宜调养肝肾，益精补血，精充血足秀发自生。选用《医宗金鉴》之“神应养真丹”化裁，并变通其方，且改丸剂为汤剂：
大熟地12g制首乌15g黑芝麻15g白芷3g白蒺藜6g菟丝子9g当归9g川芎3g桑椹子15g侧柏叶15g
自9月12日～12月5日，共服五十五帖，斑秃处华发复生。据患者自述服二十帖后，发已不脱，秃处渐有头发生长，又服三十余帖，即完好如初。
按：脱发一症，多因肝肾亏损、血虚不能上荣，风邪乘虚而入所致，此为虚证，“神应养真丹”为的对之有效良方。如因肝气郁结不畅，以致气滞血瘀、发失所养者，则须疏肝解郁、活血化瘀，《医林改错》“通窍活血汤”用之有效。余尝见脱发而口苫咽干、胆热脾虚者，投小柴胡汤而得效(见“小柴胡汤治验选”)。而余临证所见仍以肝肾亏损为多，用神应养真丹外，黑芝麻、桑椹子、侧柏叶亦为养血生发之妙品，少佐白芷以通窍道，则其效更彰也。
简易便方愈臁疮
余素习中医内科，旁及女科及针灸，通常不治外科病。然亦常有外科小恙前来索方者，盖图便利也。一日有黄姓翁前来就诊。翁患臁疮，病灶位于左足胫骨前面下三分之一处，溃疡面约1．5cm×1．5cm，稍凹陷，滋水流溢，其色黑浊腥臭。溃面周围掀红漫肿，有6cm×6cm大小。患者系两月前被摩托车撞伤胫部而病。病发后辗展医治，耗资千元有余而病足依然。余偶发遐想，不受常规之法约束，处方用药一随己意，内服外敷双管齐下。内服用四妙汤加味，以清利湿毒兼以益气活血。方为：
生黄芪30g金银花30g全当归15g生甘草6g地榆15g炒黄柏9g赤芍9g每日一剂，水煎服。
外用地榆粉撒掺溃疡面，以敷料包扎，一日一换。经治六日后红肿显著消退，疮面滋水渐干，溃面收敛近半。遂停止内服，专事外敷。不意连敷旬日，病灶虽敛而终不愈合。患者有一友人忽至病家探望，嘱以鸡蛋煮熟取黄，以文火熬取蛋黄油，以此油调地榆粉外敷患处。黄翁依法施行，不数日疮口平敛．肌肤完好，惟病灶处皮肤尚留褐色未褪，然已得临床治愈之效矣。
臁疮虽非大病，常多久治不痊，耗伤气血，抑郁精神，损人真元。少数毒力强盛，尚有恶变可能，因而切莫以病小而掉以轻心，致遗祸殃。此病成因，总由湿热下注、瘀血凝聚而成。故无论内治外治，须以清热利湿、活血行瘀为大法。前用四妙汤，方中银花、甘草、地榆、黄柏解毒利湿清热；当归、赤芍活血化瘀；黄芪益气扶元、内托敛疮。全方药仅七味而方意周匝，是故能见速效。
治疗药中地榆及鸡蛋黄油为关键之品。地榆昧苦酸，性寒，入肝与大肠经。具凉血止血、泻火解毒敛疮之功。地榆炒研成粉，外敷烫火伤效验卓著即是其例。用以敷治臁疮效果亦佳。鸡子黄性味甘平，人心肾两经。功能滋阴养血、润燥熄风。因而鸡蛋黄油既可内服以治肺结核之类消耗性疾病，外敷善治烫火伤及热、湿疱疹、皮肤溃疡，因秉滋养之质，利于改善病灶局部营养条件，故用以收敛溃疡，功效独特，与地榆粉相须为用，则相得益彰。
[附]鸡蛋黄油制取法
取鲜鸡蛋数枚，以红皮者为佳。煮熟，去壳及蛋白将蛋黄置金属勺内，以文火加热，并时时翻动勺内蛋黄。约十分钟左右即可出油，此时蛋黄渐变黑褐色。及时将油倾人盛器内，继续煎熬，直至蛋黄焦枯。一枚蛋黄约可出油2ml，收储备用。
阴茎损伤性炎肿治验
朱科长年过不惑，于1977年初，小便无故出血，亦无痛感，用止血药十余日而血止。至3月初尿血复至，肉眼可视见红色，镜检则出血满视野矣。在某医院作膀胱镜检未见出血部位，亦无病灶发现。然阴茎中已被器械严重擦伤又复感染而致脓血时流。且小溲反频，每溺时，疼痛彻心。夜间被中受热则阴茎勃举，举则痛不可忍，不得已将阴茎露丁被外而睡。注射糜蛋白酶数十支，脓血仅仅稍减，疼痛则依然如故。至4月16日已经月余，始服中药。余诊其左脉浮数，按之软，左尺为甚。右弦细带滑，苔薄腻，质胖淡，中多裂纹。合参四诊，显系肝肾不足于内，阳道瘀肿于外。盖男子之外阴，由肾精涵养，肝脉绕络。治法当从肝肾入手，滋肝肾之真阴以治本，泄肝肾之相火以治标，稍兼祛瘀通络、清热解毒以消肿胀。为订一方：
生地9g杞子15g炙龟板24g炒黄柏6g知母6g金银花9g留行子6g石斛12g炒白芍9g淮牛膝15g三七粉1．5g(吞服)
上方加减服至九帖时，脓血显减，疼痛亦微，夜间已可复被而睡，又进三帖，诸症俱除。
妇科类
吴竺天临床经验方应用
业师吴竺天先生，为上海中医药大学附属曙光医院副主任医师，浙江余姚人，早岁毕业于丁甘仁先生创办之“中国医科大学”。先生擅长妇科，精研医理，娴熟临诊，因而名播遐迩，求诊者门庭若市，日无虚夕。行医数十年来治愈妇科疑难杂病及不育症不可胜数，《解放日报》曾以“孩子满天下”为题予以报道。七十年代以后，多种报刊报道先生事迹甚多，此处不遑列举。先生因诊务繁忙而无暇著述，乘此拙作梓行之机，选辑先生经验方七首以广流传．并借以了先生“为杏林耕作，为病家造福”之芳德夙愿。
一、当归补血汤
药物组成：党参12g当归9g炒白芍12g木香4．5g制香附6g生地炭12g藕节炭12g川断12g狗脊12g玫瑰花1．2g震灵丹12g(包)
加减法：出血严重者可加入阿胶烊化后冲服，腹不痛者木香、香附亦可酌减，腰不酸者川断、狗脊可去。
孟城按：先生使用此方时，极少不用木香、香附、川断、狗脊，盖因妇女多见腰脊酸软一症，故常用川断、狗脊。至于木香、香附，先生曾曰：“人身血贵流通，调经当以行气为主，古人云‘气为血帅，气行则血行，’即是固经止漏之剂，亦不能一味收敛止血，必兼行气方是正法，始不至有经止瘀留之弊。”师治崩漏用以止血者常为生地炭，藕节炭而不用他炭。生地补而性凉，藕节涩而兼通，此二味常与震灵丹同用。妇人经行将净，经血淋漓不断者，用震灵丹(12g)布包入煎，止血净经颇具卓效，然经行伊始者无效，是谓“避其锐气，击其堕归”者也。
先生于妇科方中恒用玫瑰花，余举以问焉，师曰：“玫瑰花不仅疏气，而且行血，妇科病以凋气血为先，故常用此品也。如病妇素来大便不通者，则易以月季花，因月季花破血通经，兼能通便，常用量为4．5g。”
二、加减桃红汤
主治：月经不调，经前腰酸腹痛，经行不畅，或瘀滞内阻之经水淋漓不止。
药物组成：川断12g狗脊12g当归9g川芎9g桃仁12g红花6g木香4．5g制香附6g丹参12g鸡血藤12g玫瑰花1．2g
加减法：月经闭阻者，三棱、莪术(各用15～30g)、留行子、茺蔚子、赤芍等可加入。胞宫不温者仙灵脾、阳起石、紫石英等又可选用。若下元虚寒较甚者，肉桂、干姜更宜益人。腹中胀满者，须兼乌药、娑噜子。
孟城按：方中川芎一味乃先生极为善用之品，曾谓余曰：“此物少用则升散行血，能治头目疼痛，常用量为2．4～4．5g。用其一般剂量(9g)则善能调经，行气活血两兼其功。重用(15g)则反能收缩子宫，减少出血量。”又先生常重用川芎以治孕妇胎位不正，加入安胎方中，每收良效：
三、加昧舒肝汤
主治：经前乳胀、腹胀，输卵管阻塞或积水，附件炎，卵巢囊肿等。
药物组成：柴胡9g川楝子9g木香4．5g制香附6g红藤30g麦芽15g败酱草30g炙鳖甲12g炙山甲12g桃仁12g苡仁12g玫瑰花1．2g
加减法：宫寒加仙灵脾、阳起石、紫石英、仙茅等，大便不通加生大黄4．5～9g(后下)，腰酸酌加川断、狗脊、仙茅、仙灵脾、补骨脂、杜仲等，腹中有块加三棱、莪术。
孟城按：先生以此方加减治愈卵巢囊肿者甚多，余曾以本方随证化裁治愈一例子宫肌瘤。患者姓夏干部，年近四十，B超示2cm×3cm，4cmx4cm子宫肌瘤各一枚，平素月经不调，经行胸乳胀痛。以上方加减服用二月余，复查肌瘤消失，经行正常而愈。
先生曾为余论述卵巢囊肿之成因、发病机制及治疗法则：“此病之得，多在经期行房或房事后不慎受凉，下焦阳气被郁而不运，遂至气滞、瘀凝，结成瘕块。本病以祛瘀消炎为治则大要，佐以舒肝和气、发育子宫。阳起石、仙灵脾、紫石英等俱为发育子宫之品。如方中加入当归、怀牛膝温补肝肾而流畅血分，其效更速。至于山甲、牡蛎等软坚通络之品，可根据病情选用。方中败酱草如若缺货，可以紫花地丁代用，但地丁之功效不如败酱为优。治本病须注意大便通畅否，便秘不通者以通便为要着，便畅则肠中积垢俱去，经络易于畅达而癥块易除也。故方中每用蒌仁、生大黄，如饯以枳壳则更好。治此病时不能强行攻破，只可因势利导。每当月经临行之时，须重用行气破血之品，经血以多行为佳，血通则瘀去，瘀去则病消。”
方中用桃、米仁之意，先生曾释曰：“卵巢囊肿必有瘀血留体，用桃仁意在通瘀消肿。而卵巢既有囊肿，必至阻塞不通，体内分泌物(多为粘液)必积滞其间，故用米仁以消之。”
四、舒肝调经汤
药物组成：柴胡9g川楝子9g木香4．5g制香附6g麦芽15g当归9g丹参12g淮牛膝12g炙鳖甲9g炙山甲9g赤芍9g玫瑰花1．2g
加减法：输卵管积水或有囊肿者加红藤、败酱草；大便不畅加生军，能一日便下二、二次更佳。其余加减悉同加味舒肝汤方。
孟城按：本方与加减桃红汤为姐妹方，同为治疗月经不调之主方。本方侧重疏肝解郁，而加减桃红汤则侧重活血祛瘀。此两方及当归补血汤为先生临证时使用频率最高之方剂。先生曾谓其临证时所诊最多之证为经前乳房胀痛而有块，少腹两侧作痛不舒，经净则诸症如失。患者多婚后八、九年仍不育，治以逍遥散合调经之品加减(即本方)，肝舒经调则自能受孕。
临床亦可见到血热瘀滞型月经不调，证见经行先期，经前或经后腹痛，按之痛甚，经行量多色赤或紫，唇红口干，心烦失眠，尿黄便秘，脉象弦数，舌红苔黄。治当凉血活血以调经，先生常以生地、赤芍、丹皮、元胡、当归、川芎、红花、制香附、炙甘草等出入为剂，但先生未拟定处方，因而附志于此。
五、止带方
主治：白带
加减法：黄带加椿根皮9g、粉萆薢12g；赤带加银花炭12g、生地炭12g或加茜草炭、贯众炭。腰酸加川断、狗脊。纳差加焦六曲。预防子宫癌加土茯苓30g、鬼臼12g、龙牡各30g。
孟城按：本方为先生临证治疗带下之方，不论证之寒热虚实，随证加减，皆可应用。据先生经验，患者如见带净则经至，经净则带下现象，宜认真检查，须防宫颈癌。先生平素并不单独为病人治疗带下，而常于治疗其他妇科病之对症处方中，合入本方，病愈带净，一举两得。
侍诊时余曾就方中使用扁豆花，举以请益。师谓扁豆花不仅善清湿热，且有收敛作用，故白带频下者用之多效。
六、安胎方
主治：妊娠胎动不安。
药物组成：川断12g狗脊12g菟丝子12g钩藤15g(后入)
加减法：习惯性流产孕妇，可用本方合补中益气汤同用。羊水过多者加黄芩、白术、焦六曲、茯苓、冬瓜皮、赤小豆、藿苏梗等品。先兆流产可以本方加党参12g，当归6g，白芍12g，生地炭12g，藕节炭12g，玫瑰花1．2g，以益气养血、安胎、止红，红止则胎自保。
上述三个方剂中，第一个方剂侧重于抗癌，第二个方剂偏向于温补滋养，在补益中兼有攻邪，攻补兼施。最后一个方剂寓攻于补，通过扶助正气以抵御病邪从而完成治疗。这三个方剂的用药各有侧重，层次分明，符合普明子在《医学心悟》中提出的以初、中、末三法治疗癥瘕（腹内结块）的宗旨，因此收到了药到病除的效果。
外科类
有一位姓孙的会计，年龄大约五十岁。早年曾患肺结核，虽然经常服药，但体质依然逐渐受损。所以刚到知天命之年，头发便渐渐花白，且不时脱落。1975年春夏之间，突然成片脱落直至完全光洁，形成斑秃：右耳上方、头后枕骨上缘及左耳后上缘为三大块，每块约2×2厘米大小。其次，还有几处较小的秃斑。某医院同时采用内服和外涂的措施，治疗数月依然如故。改用牛奶注射于患处皮内，实在痛得难以忍受，患者强忍着，每周一次，又治疗数月，仍无进展。于是邀请我用中药治疗。诊得脉象弦细，舌质淡红，知道这是本元不足，加上劳作用心，逐渐导致气血亏损。《内经》说：发为血之余，肾之华在发。又说：肾藏精，肝藏血。肝肾精血充足则胡须美而头发黑亮；精血衰少，则胡须颓败头发脱落。所以治疗方法宜调养肝肾，益精补血，精充血足秀发自然生长。选用《医宗金鉴》中的“神应养真丹”进行化裁，并变通其方，且将丸剂改为汤剂：
大熟地黄12克 制何首乌15克 黑芝麻15克 白芷3克 白蒺藜6克 菟丝子9克 当归9克 川芎3克 桑椹子15克 侧柏叶15克
从9月12日至12月5日，共服用五十五帖，斑秃处长出了黑发。据患者自述，服用二十帖后，头发不再脱落，秃处渐有头发生长，又服用三十余帖，即完好如初。
按语：脱发一症，多因肝肾亏损、血虚不能上荣，风邪乘虚而入所致，此为虚证，“神应养真丹”是对证的良方。如因肝气郁结不畅，以致气滞血瘀、发失所养者，则须疏肝解郁、活血化瘀，《医林改错》中的“通窍活血汤”用之有效。我曾见脱发而口苦咽干、胆热脾虚者，投用小柴胡汤而得效（见“小柴胡汤治验选”）。而我临证所见仍以肝肾亏损为多，使用神应养真丹外，黑芝麻、桑椹子、侧柏叶亦为养血生发的妙品，稍佐白芷以通窍道，则疗效更显著。
简易便方治愈臁疮
我素来研习中医内科，旁及女科及针灸，通常不治疗外科病。然而常有外科小恙前来索方者，大概是图便利吧。一日有位黄姓老人前来就诊。老人患有臁疮（小腿慢性溃疡），病灶位于左足胫骨前面下三分之一处，溃疡面约1.5cm×1.5cm，稍凹陷，滋水流溢，颜色黑浊腥臭。溃面周围掀红漫肿，有6cm×6cm大小。患者是两个月前被摩托车撞伤胫部而发病。病发后辗转医治，耗资千元有余而病足依然。我偶发遐想，不受常规之法约束，处方用药一随己意，内服外敷双管齐下。内服用四妙汤加味，以清利湿毒兼以益气活血。方为：
生黄芪30克 金银花30克 全当归15克 生甘草6克 地榆15克 炒黄柏9克 赤芍9克 每日一剂，水煎服。
外用地榆粉撒掺溃疡面，以敷料包扎，一日一换。经治六日后红肿显著消退，疮面滋水渐干，溃面收敛近半。遂停止内服，专事外敷。不料连续敷贴十天，病灶虽收敛但最终未愈合。患者有一友人忽至病家探望，嘱咐将鸡蛋煮熟取黄，以文火熬取蛋黄油，以此油调地榆粉外敷患处。黄翁依法施行，不数日疮口平敛，肌肤完好，惟病灶处皮肤尚留褐色未褪，然已得临床治愈之效矣。
臁疮虽非大病，常多久治不痊，耗伤气血，抑郁精神，损人真元。少数毒力强盛，尚有恶变可能，因而切莫以病小而掉以轻心，致遗祸殃。此病成因，总由湿热下注、瘀血凝聚而成。故无论内治外治，须以清热利湿、活血行瘀为大法。前用四妙汤，方中银花、甘草、地榆、黄柏解毒利湿清热；当归、赤芍活血化瘀；黄芪益气扶元、内托敛疮。全方药仅七味而方意周匝，是故能见速效。
治疗药中地榆及鸡蛋黄油为关键之品。地榆味苦酸，性寒，入肝与大肠经。具凉血止血、泻火解毒敛疮之功。地榆炒研成粉，外敷烫火伤效验卓著即是其例。用以敷治臁疮效果亦佳。鸡子黄性味甘平，入心肾两经。功能滋阴养血、润燥熄风。因而鸡蛋黄油既可内服以治肺结核之类消耗性疾病，外敷善治烫火伤及热、湿疱疹、皮肤溃疡，因秉滋养之质，利于改善病灶局部营养条件，故用以收敛溃疡，功效独特，与地榆粉相须为用，则相得益彰。
[附]鸡蛋黄油制取法
取鲜鸡蛋数枚，以红皮者为佳。煮熟，去壳及蛋白将蛋黄置金属勺内，以文火加热，并时时翻动勺内蛋黄。约十分钟左右即可出油，此时蛋黄渐变黑褐色。及时将油倾入盛器内，继续煎熬，直至蛋黄焦枯。一枚蛋黄约可出油2ml，收储备用。
阴茎损伤性炎肿治验
朱科长年过四十，于1977年初，小便无故出血，亦无痛感，用止血药十余日而血止。至3月初尿血复至，肉眼可视见红色，镜检则出血满视野矣。在某医院作膀胱镜检未见出血部位，亦无病灶发现。然阴茎中已被器械严重擦伤又复感染而致脓血时流。且小溲反频，每溺时，疼痛彻心。夜间被中受热则阴茎勃举，举则痛不可忍，不得已将阴茎露于被外而睡。注射糜蛋白酶数十支，脓血仅仅稍减，疼痛则依然如故。至4月16日已经月余，始服中药。余诊其左脉浮数，按之软，左尺为甚。右弦细带滑，苔薄腻，质胖淡，中多裂纹。合参四诊，显系肝肾不足于内，阳道瘀肿于外。盖男子之外阴，由肾精涵养，肝脉绕络。治法当从肝肾入手，滋肝肾之真阴以治本，泄肝肾之相火以治标，稍兼祛瘀通络、清热解毒以消肿胀。为订一方：
生地9克 枸杞子15克 炙龟板24克 炒黄柏6克 知母6克 金银花9克 留行子6克 石斛12克 炒白芍9克 淮牛膝15克 三七粉1.5克(吞服)
上方加减服至九帖时，脓血显减，疼痛亦微，夜间已可复被而睡，又进三帖，诸症俱除。
妇科类
吴竺天临床经验方应用
业师吴竺天先生，为上海中医药大学附属曙光医院副主任医师，浙江余姚人，早岁毕业于丁甘仁先生创办的“中国医科大学”。先生擅长妇科，精研医理，娴熟临诊，因而名播遐迩，求诊者门庭若市，日无虚夕。行医数十年来治愈妇科疑难杂病及不育症不可胜数，《解放日报》曾以“孩子满天下”为题予以报道。七十年代以后，多种报刊报道先生事迹甚多，此处不遑列举。先生因诊务繁忙而无暇著述，乘此拙作梓行之机，选辑先生经验方七首以广流传，并借以了先生“为杏林耕作，为病家造福”之芳德夙愿。
一、当归补血汤
药物组成：党参12克 当归9克 炒白芍12克 木香4.5克 制香附6克 生地炭12克 藕节炭12克 川断12克 狗脊12克 玫瑰花1.2克 震灵丹12克(包)
加减法：出血严重者可加入阿胶烊化后冲服，腹不痛者木香、香附亦可酌减，腰不酸者川断、狗脊可去。
孟城按：先生使用此方时，极少不用木香、香附、川断、狗脊，盖因妇女多见腰脊酸软一症，故常用川断、狗脊。至于木香、香附，先生曾曰：“人身血贵流通，调经当以行气为主，古人云‘气为血帅，气行则血行，’即是固经止漏之剂，亦不能一味收敛止血，必兼行气方是正法，始不至有经止瘀留之弊。”师治崩漏用以止血者常为生地炭，藕节炭而不用他炭。生地补而性凉，藕节涩而兼通，此二味常与震灵丹同用。妇人经行将净，经血淋漓不断者，用震灵丹(12g)布包入煎，止血净经颇具卓效，然经行伊始者无效，是谓“避其锐气，击其堕归”者也。
先生于妇科方中恒用玫瑰花，余举以问焉，师曰：“玫瑰花不仅疏气，而且行血，妇科病以调气血为先，故常用此品也。如病妇素来大便不通者，则易以月季花，因月季花破血通经，兼能通便，常用量为4.5g。”
二、加减桃红汤
主治：月经不调，经前腰酸腹痛，经行不畅，或瘀滞内阻之经水淋漓不止。
药物组成：川断12克 狗脊12克 当归9克 川芎9克 桃仁12克 红花6克 木香4.5克 制香附6克 丹参12克 鸡血藤12克 玫瑰花1.2克
加减法：月经闭阻者，三棱、莪术(各用15～30g)、留行子、茺蔚子、赤芍等可加入。胞宫不温者仙灵脾、阳起石、紫石英等又可选用。若下元虚寒较甚者，肉桂、干姜更宜益人。腹中胀满者，须兼乌药、娑噜子。
孟城按：方中川芎一味乃先生极为善用之品，曾谓余曰：“此物少用则升散行血，能治头目疼痛，常用量为2.4～4.5g。用其一般剂量(9g)则善能调经，行气活血两兼其功。重用(15g)则反能收缩子宫，减少出血量。”又先生常重用川芎以治孕妇胎位不正，加入安胎方中，每收良效：
三、加味舒肝汤
主治：经前乳胀、腹胀，输卵管阻塞或积水，附件炎，卵巢囊肿等。
药物组成：柴胡9克 川楝子9克 木香4.5克 制香附6克 红藤30克 麦芽15克 败酱草30克 炙鳖甲12克 炙山甲12克 桃仁12克 苡仁12克 玫瑰花1.2克
加减法：宫寒加仙灵脾、阳起石、紫石英、仙茅等，大便不通加生大黄4.5～9g(后下)，腰酸酌加川断、狗脊、仙茅、仙灵脾、补骨脂、杜仲等，腹中有块加三棱、莪术。
孟城按：先生以此方加减治愈卵巢囊肿者甚多，余曾以本方随证化裁治愈一例子宫肌瘤。患者姓夏干部，年近四十，B超示2cm×3cm，4cmx4cm子宫肌瘤各一枚，平素月经不调，经行胸乳胀痛。以上方加减服用二月余，复查肌瘤消失，经行正常而愈。
先生曾为余论述卵巢囊肿之成因、发病机制及治疗法则：“此病之得，多在经期行房或房事后不慎受凉，下焦阳气被郁而不运，遂至气滞、瘀凝，结成瘕块。本病以祛瘀消炎为治则大要，佐以舒肝和气、发育子宫。阳起石、仙灵脾、紫石英等俱为发育子宫之品。如方中加入当归、怀牛膝温补肝肾而流畅血分，其效更速。至于山甲、牡蛎等软坚通络之品，可根据病情选用。方中败酱草如若缺货，可以紫花地丁代用，但地丁之功效不如败酱为优。治本病须注意大便通畅否，便秘不通者以通便为要着，便畅则肠中积垢俱去，经络易于畅达而癥块易除也。故方中每用蒌仁、生大黄，如饯以枳壳则更好。治此病时不能强行攻破，只可因势利导。每当月经临行之时，须重用行气破血之品，经血以多行为佳，血通则瘀去，瘀去则病消。”
方中用桃、米仁之意，先生曾释曰：“卵巢囊肿必有瘀血留体，用桃仁意在通瘀消肿。而卵巢既有囊肿，必至阻塞不通，体内分泌物(多为粘液)必积滞其间，故用米仁以消之。”
四、舒肝调经汤
药物组成：柴胡9克 川楝子9克 木香4.5克 制香附6克 麦芽15克 当归9克 丹参12克 淮牛膝12克 炙鳖甲9克 炙山甲9克 赤芍9克 玫瑰花1.2克
加减法：输卵管积水或有囊肿者加红藤、败酱草；大便不畅加生军，能一日便下二、二次更佳。其余加减悉同加味舒肝汤方。
孟城按：本方与加减桃红汤为姐妹方，同为治疗月经不调之主方。本方侧重疏肝解郁，而加减桃红汤则侧重活血祛瘀。此两方及当归补血汤为先生临证时使用频率最高之方剂。先生曾谓其临证时所诊最多之证为经前乳房胀痛而有块，少腹两侧作痛不舒，经净则诸症如失。患者多婚后八、九年仍不育，治以逍遥散合调经之品加减(即本方)，肝舒经调则自能受孕。
临床亦可见到血热瘀滞型月经不调，证见经行先期，经前或经后腹痛，按之痛甚，经行量多色赤或紫，唇红口干，心烦失眠，尿黄便秘，脉象弦数，舌红苔黄。治当凉血活血以调经，先生常以生地、赤芍、丹皮、元胡、当归、川芎、红花、制香附、炙甘草等出入为剂，但先生未拟定处方，因而附志于此。
五、止带方
主治：白带
药物组成：白薇12克 藕节12克 扁豆花9克 玫瑰花1.2克
加减法：黄带加椿根皮9克、粉萆薢12克；赤带加银花炭12克、生地炭12克或加茜草炭、贯众炭。腰酸加川断、狗脊。纳差加焦六曲。预防子宫癌加土茯苓30克、鬼臼12克、龙牡各30克。
孟城按：本方为先生临证治疗带下之方，不论证之寒热虚实，随证加减，皆可应用。据先生经验，患者如见带净则经至，经净则带下现象，宜认真检查，须防宫颈癌。先生平素并不单独为病人治疗带下，而常于治疗其他妇科病之对症处方中，合入本方，病愈带净，一举两得。
侍诊时余曾就方中使用扁豆花，举以请益。师谓扁豆花不仅善清湿热，且有收敛作用，故白带频下者用之多效。
六、安胎方
主治：妊娠胎动不安。
药物组成：川断12克 狗脊12克 菟丝子12克 钩藤15克(后入)
加减法：习惯性流产孕妇，可用本方合补中益气汤同用。羊水过多者加黄芩、白术、焦六曲、茯苓、冬瓜皮、赤小豆、藿苏梗等品。先兆流产可以本方加党参12克，当归6克，白芍12克，生地炭12克，藕节炭12克，玫瑰花1.2克，以益气养血、安胎、止红，红止则胎自保。
Among the aforementioned three formulas, the first formula focuses on anti-cancer effects, while the second leans towards warming and nourishing, combining tonification with expulsion of pathogens (attacking). The final formula integrates attacking within tonifying, supporting healthy Qi to resist pathogenic factors, thereby achieving complete therapeutic success. The medication in these three formulas has its own emphasis, arranged in a clear hierarchy, conforming to the principle proposed by Pu Mingzi in *Yixue Xinwu* (Medical Enlightenment) of treating zheng jia (abdominal masses) using initial, middle, and terminal methods; thus, it achieves the effect of curing the disease upon administration of the medicine.
Surgical Category
Nourishing Blood and Promoting Hair Growth Cures Alopecia Areata
A certain accountant surnamed Sun was approximately fifty years old. In his early years, he suffered from pulmonary tuberculosis (consumption). Although he frequently took medication, his physical constitution continued to deteriorate. Consequently, upon reaching the age of fifty, his hair gradually turned gray and fell out intermittently. Between spring and summer of 1975, patches of hair suddenly fell out completely, resulting in alopecia areata: three large patches, each approximately 2×2 cm, located above the right ear, along the upper edge of the occipital bone at the back of the head, and above the left ear. Additionally, there were several smaller bald patches. A certain hospital employed both internal and external treatments for several months with no change. Milk was then injected intradermally into the affected areas. The pain was unbearable, but he endured it. This treatment was administered once a week for several more months, yet there was still no progress. He then invited me to treat him with Chinese herbal medicine. His pulse was wiry and fine, and his tongue was pale red. This indicated insufficiency of the primordial essence, compounded by mental exertion from work, leading to gradual deficiency of Qi and blood. The *Neijing* states: "Hair is the surplus of blood, and the kidney manifests in the hair." It also states: "The kidney stores essence, and the liver stores blood." When the essence and blood of the liver and kidney are sufficient, one has beautiful beard and lustrous hair; when essence and blood are deficient, the beard recedes and hair falls. Therefore, the treatment method should focus on regulating and tonifying the liver and kidney, benefiting essence and nourishing blood. When essence is abundant and blood is full, hair will naturally grow. I selected *Shenying Yangzhen Dan* (Divine Response Nourishing True Pill) from *Yizong Jinjian* (Golden Mirror of Medicine), modified it, altered the pill form to a decoction, and prescribed as follows:
Prepared Rehmanniae Radix (Shu Di Huang) 12g, Prepared Polygoni Multiflori Caulis (Zhi Shou Wu) 15g, Sesame Seed (Hei Zhi Ma) 15g, Angelica Dahurica Root (Bai Zhi) 3g, Tribulus Fruit (Bai Ji Li) 6g, Cuscutae Semen (Tu Si Zi) 9g, Angelica Sinensis Root (Dang Gui) 9g, Ligusticum Chuanxiong Rhizome (Chuan Xiong) 3g, Mulberry Fruit (Sang Shen Zi) 15g, Platycladi Cacumen (Ce Bai Ye) 15g.
From September 12 to December 5, he took a total of 55 doses. Black hair regrew in the bald patches. According to the patient's report, after taking 20 doses, hair loss stopped, and new hair began to grow in the bald areas. After taking another 30+ doses, his hair returned to normal.
Commentary: Hair loss is often caused by deficiency of the liver and kidney, where blood deficiency fails to nourish the scalp, allowing wind pathogens to enter due to deficiency. This is a deficiency syndrome, and *Shenying Yangzhen Dan* is an effective formula for this condition. If hair loss is due to stagnation of liver Qi leading to Qi stagnation and blood stasis, causing lack of nourishment to the hair, one must soothe the liver, resolve depression, invigorate blood, and resolve stasis; *Tongqiao Huoxue Tang* (Unblocking Orifices Invigorating Blood Decoction) from *Yilin Gaicuo* (Correction of Errors in Medical Forest) is effective. I have seen cases of hair loss accompanied by bitter taste in the mouth, dry throat, gallbladder heat, and spleen deficiency, which responded well to *Xiaochaihu Tang* (Minor Bupleurum Decoction) (see "Selected Cases of Xiaochaihu Tang"). However, in my clinical practice, most cases are due to liver and kidney deficiency. Besides *Shenying Yangzhen Dan*, black sesame, mulberry fruit, and platycladi cacumen are excellent herbs for nourishing blood and promoting hair growth. Adding a small amount of angelica dahurica root to unblock orifices enhances efficacy.
Simple Prescription Cures Leg Ulcer (Lian Chuang)
I primarily study internal medicine, with secondary knowledge in gynecology and acupuncture, and usually do not treat surgical diseases. However, patients with minor surgical ailments often come seeking prescriptions, likely for convenience. One day, an elderly gentleman surnamed Huang came for consultation. He suffered from a leg ulcer (chronic lower leg ulcer). The lesion was located on the anterior aspect of the left tibia, lower third. The ulcer surface was approximately 1.5cm × 1.5cm, slightly depressed, with exudate flowing out, dark, turbid, and foul-smelling. The surrounding area was red, swollen, and inflamed, measuring 6cm × 6cm. The patient had injured his shin in a motorcycle accident two months prior. After辗转 medical treatment, spending over a thousand yuan, the condition remained unchanged. I had a spontaneous idea, unconstrained by conventional methods, prescribing medication according to my own judgment, employing both internal and external treatments. Internally, I used *Simiao Tang* (Four Marvels Decoction) with modifications to clear damp-heat toxins and benefit Qi and invigorate blood. The prescription was:
Raw Astragali Radix (Sheng Huang Qi) 30g, Lonicerae Japonicae Flos (Jin Yin Hua) 30g, Complete Angelicae Sinensis Radix (Quan Dang Gui) 15g, Raw Glycyrrhizae Radix et Rhizoma (Sheng Gan Cao) 6g, Sanguisorbae Radix (Di Yu) 15g, Stir-fried Phellodendri Cortex (Chao Huang Bo) 9g, Red Paeoniae Radix (Chi Shao) 9g. One dose daily, decocted in water and taken orally.
Externally, I applied Sanguisorba powder to the ulcer surface and bandaged it, changing once daily. After six days of treatment, redness and swelling significantly subsided, exudate dried up, and the ulcer healed by nearly half. Internal medication was then stopped, focusing solely on external application. Unexpectedly, after ten days of continuous application, although the lesion retracted, it did not fully heal. A friend of the patient visited and suggested boiling eggs, extracting the yolk, and simmering it over low heat to obtain egg yolk oil. This oil was mixed with Sanguisorba powder for external application. Following this advice, within a few days, the wound closed flat, and the skin healed, leaving only some brown discoloration at the site, but clinical cure was achieved.
Although leg ulcers are not major diseases, they often persist despite long-term treatment, consuming Qi and blood, depressing the spirit, and damaging true Yuan energy. In rare cases with strong toxicity, malignant transformation is possible. Therefore, one must not underestimate the disease due to its apparent mildness, lest it cause disaster. The etiology of this disease is generally attributed to damp-heat sinking downward and blood stasis condensing. Thus, whether treating internally or externally, the major principle must be clearing heat, draining dampness, invigorating blood, and resolving stasis. In the previously used *Simiao Tang*, honeysuckle flower, licorice root, sanguisorba root, and phellodendron cortex detoxify, drain dampness, and clear heat; angelica sinensis root and red paeonia root invigorate blood and resolve stasis; astragalus root benefits Qi, supports Yuan energy, and internally pushes out pus to promote healing. The entire formula contains only seven ingredients but has comprehensive intent, hence achieving rapid results.
Sanguisorba root and egg yolk oil are key items in this treatment. Sanguisorba root is bitter and sour, cold in nature, entering the liver and large intestine meridians. It has the functions of cooling blood, stopping bleeding, purging fire, detoxifying, and promoting healing. Stir-frying and grinding sanguisorba into powder for external application to burns is highly effective, which is an example of its efficacy. Its effect in treating leg ulcers is also good. Chicken egg yolk is sweet and neutral, entering the heart and kidney meridians. It functions to nourish Yin, tonify blood, moisten dryness, and extinguish wind. Therefore, egg yolk oil can be taken internally to treat consumptive diseases like pulmonary tuberculosis, and externally to treat burns, hot/wet herpes, and skin ulcers. Due to its nourishing quality, it improves local nutritional conditions at the lesion site, making it unique in promoting ulcer healing. Used synergistically with sanguisorba powder, they enhance each other's effects.
[Appendix] Method for Preparing Egg Yolk Oil
Take several fresh eggs, preferably with red shells. Boil them hard, remove the shell and white, and place the yolks in a metal spoon. Heat over low fire, stirring the yolks occasionally. After about ten minutes, oil will emerge, and the yolks will turn dark brown. Pour the oil into a container immediately, continue simmering until the yolks are charred and dry. One yolk yields approximately 2ml of oil. Store for future use.
Treatment Case of Penile Traumatic Inflammation and Swelling
Section Chief Zhu, over forty years old, experienced spontaneous hematuria in early 1977 without pain. Bleeding stopped after taking hemostatic drugs for over ten days. In early March, hematuria recurred, visible to the naked eye as red, and microscopic examination showed blood filling the field. Cystoscopy at a certain hospital revealed no bleeding site or lesions. However, the penis had been severely abraded by instruments and subsequently infected, leading to intermittent discharge of pus and blood. Urination became frequent, and each urination caused excruciating pain. At night, warmth under the blankets caused penile erection, which was intolerably painful, forcing him to sleep with the penis exposed outside the blanket. Dozens of injections of chymotrypsin reduced pus and blood slightly, but pain remained unchanged. By April 16, after more than a month, he finally took Chinese herbal medicine. I palpated his left pulse as floating and rapid, soft upon pressure, especially at the left chi position. The right pulse was wiry, fine, and slippery. The tongue coating was thin and greasy, the tongue body fat, pale, with many cracks in the center. Synthesizing the four diagnostic methods, it clearly indicated insufficiency of the liver and kidney internally, and blood stasis/swelling in the genitalia externally. The male external genitalia are nourished by kidney essence, and the liver meridian winds around them. The treatment method should start from the liver and kidney, nourishing the true Yin of the liver and kidney to treat the root, draining the ministerial fire of the liver and kidney to treat the branch, and slightly dispelling stasis, unblocking collaterals, clearing heat, and detoxifying to reduce swelling. I prescribed the following formula:
Rehmanniae Radix (Sheng Di) 9g, Lycii Fructus (Gou Qi Zi) 15g, Prepared Testudinis Carapax et Plastrum (Zhi Gui Ban) 24g, Stir-fried Phellodendri Cortex (Chao Huang Bo) 6g, Anemarrhenae Rhizoma (Zhi Mu) 6g, Lonicerae Japonicae Flos (Jin Yin Hua) 9g, Vitex Semen (Liu Xing Zi) 6g, Dendrobii Caulis (Shi Hu) 12g, Stir-fried Paeoniae Radix Alba (Chao Bai Shao) 9g, Achyranthis Bidentatae Radix (Huai Niu Xi) 15g, Notoginseng Powder (San Qi Fen) 1.5g (swallowed).
After taking nine doses of the above formula with modifications, pus and blood decreased significantly, pain diminished, and he could sleep covered at night again. After three more doses, all symptoms disappeared.
Gynecological Category
Application of Clinical Experience Formulas of Mr. Wu Zhutian
My teacher, Mr. Wu Zhutian, was an Associate Chief Physician at Shuguang Hospital affiliated with Shanghai University of Traditional Chinese Medicine. He was from Yuyao, Zhejiang Province, and graduated early from the "China Medical College" founded by Mr. Ding Garen. Mr. Wu specialized in gynecology, studied medical principles deeply, and was proficient in clinical diagnosis, gaining widespread fame. Patients flocked to his clinic daily. Over decades of practice, he cured countless difficult gynecological diseases and infertility cases. *Jiefang Daily* reported on him with the title "Children Everywhere." Since the 1970s, various newspapers and magazines have reported on his deeds, which are too numerous to list here. Due to busy clinical duties, he had no time to write books. Taking this opportunity of publishing my humble work, I selected seven of his experience formulas to spread widely, honoring his lifelong wish to "cultivate the medical forest and benefit patients."
1. Danggui Buxue Tang (Angelica Tonifying Qi and Blood Decoction)
Function: Benefit Qi and nourish blood, consolidate collapse and stop leakage.
Indications: Menstruation prolonged beyond normal duration, dripping menstrual blood, metrorrhagia and leukorrhea.
Composition: Codonopsis Radix (Dang Shen) 12g, Angelicae Sinensis Radix (Dang Gui) 9g, Stir-fried Paeoniae Radix Alba (Chao Bai Shao) 12g, Aucklandiae Radix (Mu Xiang) 4.5g, Prepared Cyperi Rhizoma (Zhi Xiang Fu) 6g, Charred Rehmanniae Radix (Sheng Di Tan) 12g, Charred Nelumbinis Petalum (Ou Jie Tan) 12g, Dipsaci Radix (Chuan Duan) 12g, Cibotii Rhizoma (Gou Ji) 12g, Rosae Rugosae Flos (Mei Gui Hua) 1.2g, Zhenling Dan 12g (wrapped).
Modifications: For severe bleeding, add Donkey-hide Gelatin (E Jiao) melted and taken with the decoction. If there is no abdominal pain, reduce Mu Xiang and Xiang Fu. If there is no sore waist, remove Chuan Duan and Gou Ji.
Commentary by Mengcheng: When Mr. Wu uses this formula, he rarely omits Mu Xiang, Xiang Fu, Chuan Duan, and Gou Ji, because women often suffer from soreness and weakness of the waist and spine, so Chuan Duan and Gou Ji are commonly used. Regarding Mu Xiang and Xiang Fu, Mr. Wu once said: "Blood in the human body values free flow; regulating menstruation should prioritize moving Qi. As the ancients said, 'Qi is the commander of blood; when Qi moves, blood moves.' Even for formulas that consolidate menstruation and stop leakage, one cannot rely solely on astringent hemostatics; one must combine them with Qi-moving herbs to be correct, avoiding the drawback of blood stasis remaining after menstruation stops." For treating metrorrhagia and leukorrhea, he often uses Charred Rehmanniae Radix and Charred Nelumbinis Petalum for hemostasis, rather than other charred herbs. Rehmannia is tonifying and cool in nature; Nelumbinis petalum is astringent and also unblocking. These two are often used together with Zhenling Dan. For women whose menstruation is ending but continues to drip, wrapping Zhenling Dan (12g) in cloth and decocting it has remarkable efficacy in stopping bleeding and cleansing the menses, but it is ineffective at the beginning of menstruation. This is called "avoiding their sharp vigor and striking when they retreat."
Mr. Wu consistently uses Rosae Rugosae Flos in gynecological formulas. When I asked him about this, he said: "Rosae Rugosae Flos not only soothes Qi but also moves blood. Regulating Qi and blood is paramount in gynecological diseases, so this herb is commonly used. If a female patient habitually suffers from constipation, substitute Rosa chinensis Flower (Yue Ji Hua), because it breaks blood, unblocks menstruation, and promotes bowel movement. The common dosage is 4.5g."
2. Jiajian Taohong Tang (Modified Peach and Safflower Decoction)
Function: Move Qi and invigorate blood, regulate menstruation and relieve pain.
Indications: Irregular menstruation, sore waist and abdominal pain before menstruation, dysmenorrhea, or persistent dripping of menstrual blood due to blood stasis obstruction.
Composition: Dipsaci Radix (Chuan Duan) 12g, Cibotii Rhizoma (Gou Ji) 12g, Angelicae Sinensis Radix (Dang Gui) 9g, Ligusticum Chuanxiong Rhizome (Chuan Xiong) 9g, Persicae Semen (Tao Ren) 12g, Carthami Flos (Hong Hua) 6g, Aucklandiae Radix (Mu Xiang) 4.5g, Prepared Cyperi Rhizoma (Zhi Xiang Fu) 6g, Salviae Miltiorrhizae Radix (Dan Shen) 12g, Spatholobi Caulis (Ji Xue Teng) 12g, Rosae Rugosae Flos (Mei Gui Hua) 1.2g.
Modifications: For amenorrhea, add Curcumae Rhizoma (San Leng), Curcuma Longa Rhizoma (E Zhu) (15-30g each), Vitex Semen (Liu Xing Zi), Leonuri Fructus (Chong Wei Zi), Red Paeoniae Radix (Chi Shao), etc. For a cold uterus, add Epimedii Folium (Xian Ling Pi), Equiseti Herba (Yang Qi Shi), Halloysit Rubra (Zi Shi Ying), etc. For severe deficiency-cold of the lower origin, Cinnamon Bark (Rou Gui) and Zingiberis Rhizoma (Gan Jiang) are more beneficial. For abdominal distension, add Linderae Cortex (Wu Yao) and Saposhnikoviae Radix (Suo Lu Zi).
Commentary by Mengcheng: Chuan Xiong in this formula is a herb Mr. Wu masters well. He once told me: "In small doses, it ascends and disperses, moving blood, and can treat headaches and eye pain. The common dosage is 2.4-4.5g. At general doses (9g), it regulates menstruation, combining Qi-moving and blood-invigorating functions. In heavy doses (15g), it contracts the uterus and reduces bleeding volume." Mr. Wu often uses heavy doses of Chuan Xiong to treat malpresentation in pregnant women, adding it to fetal-calming formulas, often achieving good results.
3. Jiawei Shugan Tang (Modified Soothing Liver Decoction)
Function: Move Qi and invigorate blood, soothe liver and regulate menstruation, clear heat and unblock collaterals, resolve stasis and dissipate masses.
Indications: Breast distension and abdominal bloating before menstruation, fallopian tube obstruction or hydrosalpinx, adnexitis, ovarian cysts, etc.
Composition: Bupleuri Radix (Chai Hu) 9g, Toosendan Fructus (Chuan Lian Zi) 9g, Aucklandiae Radix (Mu Xiang) 4.5g, Prepared Cyperi Rhizoma (Zhi Xiang Fu) 6g, Sargentodoxae Caulis (Hong Teng) 30g, Hordei Fructus Germinatus (Mai Ya) 15g, Patriniae Herba (Bai Jiang Cao) 30g, Prepared Trionycis Carapax (Zhi Bie Jia) 12g, Prepared Manis Squama (Zhi Shan Jia) 12g, Persicae Semen (Tao Ren) 12g, Coicis Semen (Yi Yi Ren) 12g, Rosae Rugosae Flos (Mei Gui Hua) 1.2g.
Modifications: For cold uterus, add Epimedii Folium (Xian Ling Pi), Equiseti Herba (Yang Qi Shi), Halloysit Rubra (Zi Shi Ying), Curculiginis Rhizoma (Xian Mao), etc. For constipation, add Raw Rheum Palmatum Radix et Rhizoma (Sheng Da Huang) 4.5-9g (added later). For sore waist,酌情 add Dipsaci Radix (Chuan Duan), Cibotii Rhizoma (Gou Ji), Curculiginis Rhizoma (Xian Mao), Epimedii Folium (Xian Ling Pi), Psoraleae Fructus (Bu Gu Zhi), Eucommiae Cortex (Du Zhong), etc. For abdominal masses, add Curcumae Rhizoma (San Leng), Curcuma Longa Rhizoma (E Zhu).
Commentary by Mengcheng: Mr. Wu has cured many ovarian cysts using this formula with modifications. I once used this formula with modifications to cure a case of uterine fibroid. The patient, a cadre surnamed Xia, was nearly forty. Ultrasound showed one fibroid of 2cm×3cm and another of 4cm×4cm. She had irregular menstruation and breast/chest distension during menstruation. After taking the modified formula for over two months, follow-up ultrasound showed disappearance of the fibroids, and her menstruation normalized.
Mr. Wu once explained the etiology, pathogenesis, and treatment principles of ovarian cysts to me: "This disease often occurs due to intercourse during menstruation or catching cold after intercourse. Yang Qi in the lower jiao is depressed and fails to circulate, leading to Qi stagnation and blood coagulation, forming a mass. The main principle of treating this disease is resolving stasis and reducing inflammation, assisted by soothing the liver, harmonizing Qi, and developing the uterus. Equiseti Herba (Yang Qi Shi), Epimedii Folium (Xian Ling Pi), and Halloysit Rubra (Zi Shi Ying) are all herbs for developing the uterus. Adding Angelicae Sinensis Radix (Dang Gui) and Achyranthis Bidentatae Radix (Huai Niu Xi) warms and tonifies the liver and kidney, facilitating blood circulation, accelerating efficacy. Manis Squama (Shan Jia) and Ostrea Concha (Mu Li) soften hardness and unblock collaterals; select based on condition. If Patriniae Herba (Bai Jiang Cao) is unavailable, Viola Yedoensis Herba (Zi Hua Di Ding) can be substituted, but its efficacy is inferior to Bai Jiang Cao. Treating this disease requires attention to bowel movements. Constipation must be resolved first; smooth bowels eliminate intestinal accumulation, facilitating meridian flow and removing masses. Therefore, Pericarpium Citri Reticulatae Viride (Lou Ren) and Raw Rheum Palmatum Radix et Rhizoma (Sheng Da Huang) are often used; adding Aurantii Fructus (Zhi Ke) is even better. Do not forcefully attack this disease; guide according to trends. When menstruation approaches, heavily use Qi-moving and blood-breaking herbs. Abundant menstrual flow is desirable; when blood flows freely, stasis goes, and when stasis goes, the disease disappears."
Regarding the use of Tao Ren and Yi Yi Ren in the formula, Mr. Wu explained: "Ovarian cysts necessarily involve retained blood stasis. Using Tao Ren aims to unblock stasis and reduce swelling. Since the ovary has a cyst, it causes blockage, and bodily secretions (mostly mucus) accumulate there. Thus, Yi Yi Ren is used to dissolve it."
4. Shugan Tiaojing Tang (Soothing Liver and Regulating Menstruation Decoction)
Function: Soothe liver, resolve depression, invigorate blood, and regulate menstruation.
Indications: Irregular menstruation, breast distension and pain during menstruation, infertility after marriage.
Composition: Bupleuri Radix (Chai Hu) 9g, Toosendan Fructus (Chuan Lian Zi) 9g, Aucklandiae Radix (Mu Xiang) 4.5g, Prepared Cyperi Rhizoma (Zhi Xiang Fu) 6g, Hordei Fructus Germinatus (Mai Ya) 15g, Angelicae Sinensis Radix (Dang Gui) 9g, Salviae Miltiorrhizae Radix (Dan Shen) 12g, Achyranthis Bidentatae Radix (Huai Niu Xi) 12g, Prepared Trionycis Carapax (Zhi Bie Jia) 9g, Prepared Manis Squama (Zhi Shan Jia) 9g, Red Paeoniae Radix (Chi Shao) 9g, Rosae Rugosae Flos (Mei Gui Hua) 1.2g.
Modifications: For hydrosalpinx or cysts, add Sargentodoxae Caulis (Hong Teng) and Patriniae Herba (Bai Jiang Cao). For poor bowel movements, add Raw Rheum Palmatum Radix et Rhizoma (Sheng Jun); having two bowel movements per day is ideal. Other modifications are the same as Jiawei Shugan Tang.
Commentary by Mengcheng: This formula and Jiajian Taohong Tang are sister formulas, both main formulas for treating irregular menstruation. This formula focuses on soothing the liver and resolving depression, while Jiajian Taohong Tang focuses on invigorating blood and resolving stasis. These two formulas, along with Danggui Buxue Tang, are the most frequently used formulas by Mr. Wu in clinical practice. Mr. Wu stated that the most common syndrome he diagnosed was pre-menstrual breast distension with lumps, and pain/discomfort in both sides of the lower abdomen, with all symptoms disappearing after menstruation. Many patients were infertile for eight or nine years after marriage. Treatment with Xiaoyao San combined with menstruation-regulating herbs with modifications (i.e., this formula) soothes the liver and regulates menstruation, enabling conception.
Clinically, one may also see irregular menstruation due to blood heat and stasis stagnation, presenting with early menstruation, abdominal pain before or after menstruation (severe upon pressure), heavy flow with red or purple color, red lips, dry mouth, irritability, insomnia, yellow urine, constipation, wiry-rapid pulse, red tongue with yellow coating. Treatment should cool blood and invigorate blood to regulate menstruation. Mr. Wu often uses variations of Rehmanniae Radix (Sheng Di), Red Paeoniae Radix (Chi Shao), Moutan Cortex (Dan Pi), Corydalis Rhizoma (Yuan Hu), Angelicae Sinensis Radix (Dang Gui), Ligusticum Chuanxiong Rhizome (Chuan Xiong), Carthami Flos (Hong Hua), Prepared Cyperi Rhizoma (Zhi Xiang Fu), and Prepared Glycyrrhizae Radix et Rhizoma (Zhi Gan Cao), but he did not formulate a specific prescription, so I record it here.
5. Zhidai Fang (Leukorrhea-Stopping Formula)
Function: Clear heat, cool blood, transform dampness, and stop leukorrhea.
Indications: Leukorrhea (white discharge).
Composition: Angustifoliae Radix (Bai Wei) 12g, Nelumbinis Petalum (Ou Jie) 12g, Dolichoris Flos (Bian Dou Hua) 9g, Rosae Rugosae Flos (Mei Gui Hua) 1.2g.
Modifications: For yellow discharge, add Phellodendri Amurensis Cortex (Chun Gen Pi) 9g and Dioscoreae Hypoglaucae Rhizoma (Fen Bi Xie) 12g. For red discharge, add Charred Lonicerae Japonicae Flos (Yin Hua Tan) 12g and Charred Rehmanniae Radix (Sheng Di Tan) 12g, or add Charred Qian Cao Radix (Qian Cao Tan) and Charred Cyathulae Radix (Guan Zhong Tan). For sore waist, add Dipsaci Radix (Chuan Duan) and Cibotii Rhizoma (Gou Ji). For poor appetite, add Stir-fried Medicated Leaven (Jiao Liu Qu). To prevent uterine cancer, add Smilacis Glabrae Rhizoma (Tu Fu Ling) 30g, Podophylli Fructus (Gui Jiao) 12g, and Oyster Shell (Long Gu) and Dragon Bone (Mu Li) 30g each.
Commentary by Mengcheng: This formula is used by Mr. Wu clinically for treating leukorrhea. Regardless of cold, heat, deficiency, or excess syndromes, it can be applied with modifications. According to Mr. Wu's experience, if leukorrhea stops and menstruation begins, or if menstruation ends and leukorrhea appears, careful examination is necessary to rule out cervical cancer. Mr. Wu usually does not treat leukorrhea alone but often incorporates this formula into prescriptions for other gynecological diseases, achieving both cure of the disease and cessation of leukorrhea in one stroke.
During my attendance at his clinic, I asked him about the use of Dolichoris Flos (Bian Dou Hua) in the formula. He said: "Dolichoris Flos not only clears damp-heat but also has an astringent effect, so it is effective for frequent white discharge."
6. Antai Fang (Fetal-Calming Formula)
Function: Tonify kidney, clear heat, calm fetus, and preserve pregnancy.
Indications: Restless fetus in pregnancy.
Composition: Dipsaci Radix (Chuan Duan) 12g, Cibotii Rhizoma (Gou Ji) 12g, Cuscutae Semen (Tu Si Zi) 12g, Uncaria Ramulus cum Uncis (Gou Teng) 15g (added later).
Modifications: For pregnant women with habitual abortion, this formula can be combined with Buzhong Yiqi Tang. For polyhydramnios, add Scutellariae Radix (Huang Qin), Atractylodis Macrocephalae Rhizoma (Bai Zhu), Stir-fried Medicated Leaven (Jiao Liu Qu), Poria (Fu Ling), Benincasae Exocarpium (Dong Gua Pi), Adzuki Bean (Chi Xiao Dou), and Perillae Caulis (Huo Su Geng). For threatened abortion, add Codonopsis Radix (Dang Shen) 12g, Angelicae Sinensis Radix (Dang Gui) 6g, Paeoniae Radix Alba (Bai Shao) 12g, Charred Rehmanniae Radix (Sheng Di Tan) 12g, Charred Nelumbinis Petalum (Ou Jie Tan) 12g, and Rosae Rugosae Flos (Mei Gui Hua) 1.2g to this formula, to benefit Qi, nourish blood, calm the fetus, and stop bleeding. Once bleeding stops, the fetus is naturally preserved.