徐（三三） 肝脾郁损。血崩。（郁损肝脾） 人参逍遥散去柴术炙草加桑螵蛸杜仲。
某 经漏不止。久风飧泄。（肝风胃虚）
人参 茯苓 木瓜 炒乌梅 赤石脂 余粮石
龚 脉数。寒热汗出。腹胁痛。病起经漏崩淋之后。是阴伤阳乘。消渴喜凉饮。不可纯以外邪论。
和营卫调中。甘缓主治。（营阴伤脏燥热）
当归 白芍 淮小麦 炙草 南枣 茯神
文（五五） 产育频多。冲任脉虚。天癸当止之年。有紫黑血如豚肝。暴下之后。黄水绵绵不断。三年来
所服归脾益气。但调脾胃补虚。未尝齿及奇经为病。论女科冲脉即是血海。今紫黑成块。几
月一下。必积贮之血。久而瘀浊。有不得不下之理。此属奇经络病。与脏腑无异。考古云。久崩
久带。宜清宜通。仿此为法。（奇脉虚血滞）
柏子仁 细生地 青蒿根 淡黄芩 泽兰 樗根皮
接服斑龙丸。
张（五十） 五旬天癸当止。而经淋周身牵掣。右肢渐不能举。不但冲任督带损伤。阳明胃脉衰微少
气。乃最难向安之病。（冲任胃皆虚）
人参 生黄 炙草 炒沙苑 炒杞子 炒归身
朱 崩漏两年。先有带下。始而半月发病。今夏季。每交申酉。其漏必至。思下午为阳中之阴。阴
虚阳动。冲脉任脉皆动。下无提防约束。夫奇经。肝肾主司为多。而冲脉隶于阳明。阳明久虚。
脉不固摄。有开无阖矣。医但以涩剂图旦夕苟安。未及按经论病。宜毫无一效。
海螵蛸 鲍鱼 茜草 生菟丝子 石壳广莲肉
接服乌贼鱼骨丸。
顾 髓虚。崩淋不止。筋掣痛。不能行。（髓虚筋痛）
苁蓉 枸杞 柏子仁 茯神 川斛 紫石英 羊内肾 青盐
成 冲任二脉损伤。经漏经年不痊。形瘦肤干畏冷。由阴气走乎阳位。益气以培生阳。温摄以
固下真。（冲任阳虚）
人参 鹿角霜 归身 蕲艾炭 茯神 炮姜
紫石英 桂心
张（四三） 经漏十二年。五液皆涸。冲任不用。冬令稍安。夏季病加。心摇动。腹中热。腰膝跗
骨皆热。此皆枯槁日着。方书谓暴崩宜温。久崩宜清。以血去阴耗耳。（冲任阴虚）
人参 生地 阿胶 天冬 人乳粉 柏子仁 茯神 枣仁 白芍 知母 蜜丸
张 固补冲任。凉肝宁血。
（方丸）人参（二两） 生地（二两） 阿胶（二两） 白芍（二两） 茯苓（二两） 鲜河车胶（一两）
石壳建莲肉（四两）
二胶如少。可加蒸熟山药捣浆为丸。早服四钱。参汤送。晚服二钱。
沈 天癸当止之年。经来淋漓不断。乃阴衰阳动。入秋深。夜寐甚少。汗泄四肢胸臆。夫冲脉隶
于阳明。其气行乎身前。阳明脉空。阳越卫疏。阴火升举。当宗丹溪补阴丸。或虎潜丸之属。久
病投汤太过。恐妨胃耳。
每早服丹溪补阴丸四钱 十服。
黄 长斋有年。脾胃久虚。疟由四末。必犯中宫。血海隶于阳明。苦味辛散。皆伤胃系。虽天癸久
绝。病邪药味。扰动血络。是为暴崩欲脱。阅医童便阿胶味咸润滑。大便溏泻。岂宜润下。即熟
地五味补敛阴液。咽汤停脘。顷欲吐净。滋腻酸浊之药。下焦未得其益。脘中先已受戕。议以
仲景理中汤。血脱有益气之法。坤土阳和旋转。喜其中流砥柱。倘得知味纳谷。是为转机。
重症之尤。勿得忽视。（苦寒辛散伤中阳） 理中汤。
某 停经三月。下漏成块。少腹膨痛。议通和奇脉。（奇脉不和）
鹿角霜 生杜仲 桂枝木 生沙苑 当归 茯苓 红枣
罗（二四） 病属下焦。肝肾内损。延及冲任奇脉。遂至经漏淋漓。腰脊痿弱。脉络交空。有终身不得孕
育之事。（肝肾冲任虚寒）
制熟地（砂仁制） 河车胶 当归 白芍 人参 茯苓 于术 炙草 蕲艾炭 香附 小茴 紫石英
陈（五十） 五旬年岁。经漏如崩。继以白带绵绵。昔形充。今瘦损。当年饮酒湿胜。大便久溏。自病经年。
便干不爽。夜热多汗。四肢皆冷。气短腹鸣。上噫气。下泄气。腰足跗酸 无力。食物日减。不知
其味。此阳明脉衰。厥阴风木由乎血去液伤。冲任交损。内风旋转而为风消之象。病在乎络。
故令久延。金匮谓络热则痿矣。（液伤络热风消）
人参 黄 苦参 茯神 牡蛎 小麦
滤清人参汤收。
张 外冷内热。食过如饥。唇燥裂。渴饮下漏。漏多则阴虚阳亢。便溏不实。不可寒润。（阴虚阳亢）
生地炭 阿胶 炒白芍 湖莲 樗根皮 茯神 蕲艾炭
又 消渴心悸。
阿胶 生鸡子黄 生地 天冬 生白芍 茯神
胡 心痛如饥。口吐腻涎浊沫。值经来甚多。因惊动肝。阳化内风。欲厥之象。治以咸苦。佐以微
辛。使入阴和阳。
阿胶（二钱） 牡蛎（三钱） 川楝子（一钱） 小川连（三分） 川芎（二分） 当归（一钱）
又 和阳固阴。诸病大减。因经漏阴伤。阳易浮越。心怔悸。肢末痛。内风未熄。药以甘柔。使胃汁
日充。则砥柱中流矣。
人参 阿胶 麦冬 生白芍 炙草 茯神
邱（四四） 经漏成带。年余医疗无功。乃冲任督带交病。古称久带久崩宜清。视其体丰松 。阳气久
亏。与内经血脱方法。乌 鱼丸鲍鱼汁丸。
又 照前方加阿胶人中白。
某 经漏三年。诊色脉俱夺。面浮跗肿。肌乏华色。纳谷日减。便坚不爽。自脊膂腰髀酸楚如堕。
入夏以来。形神日羸。思经水必诸路之血。贮于血海而下。其不致崩决淋漓者。任脉为之担
任。带脉为之约束。刚维跷脉之拥护。督脉以总督其统摄。今者但以冲脉之动而血下。诸脉
皆失其司。症固是虚。日饵补阳不应。未达奇经之理耳。考内经于胸胁支满妨食。时时前后
血。特制乌 丸。咸味就下。通以济涩。更以秽浊气味为之导引。同气相需。后贤谓暴崩暴漏。
宜温宜补。久漏久崩。宜清宜通。正与圣经相符。况乎 术皆守。不能入奇脉。无病用之。诚
是好药。借以调病。焉克有济。夏之月。大气正在泄越。脾胃主令。岁气天和。保之最要。议以早
进通阴以理奇经。午余天热气泄。必加烦倦。随用清暑益气之剂。顺天之气。以扶生生。安稳
百日。秋半收肃令行。可望其藏聚气交。而奇络渐固。此久损难复。非幸试速功矣。（奇脉阴虚风阳动）
早上汤药议以通阴潜阳方法。早服。
龟甲心（秋石水浸） 鹿角霜 真阿胶 柏子霜 生牡蛎 锁阳
另煎清人参汤入清药。煎取五十沸。
鹿性阳。入督脉。龟体阴。走任脉。阿胶得济水沉伏。味咸色黑。熄肝风。养肾水。柏子芳香滑
润。养血理燥。牡蛎去湿消肿。咸固下。仲景云。病患腰以下肿者。牡蛎泽泻汤。锁阳固下焦
之阳气。乃治八脉之大意。乌 丸方。
乌 骨四分（米醋炙去甲另研水飞） 茹（一分）
上为细末。用雀卵量捣为丸。每服三钱。用药前先饮淡鲍鱼汤一小杯为导引。
又 进潜阳颇投。但左耳鸣甚。肠中亦鸣。肝阳内风升动未息。减气刚用柔。早服。
龟甲心（照前制） 真阿胶 柏子霜 天冬 女真实 旱莲草
另煎人参汤二钱。加入滤清药内。再煎五十余沸。
又 两进柔润清补颇投。询知病由乎悲哀烦劳。调理向愈。继因目病。服苦辛寒散太过。遂经
漏淋带。年前七八日始净。今则两旬而止。此奇脉内乏。前议非诬。据述周身累现瘾疹 累。
瘙痒不宁。想脂液久渗。阴不内营。阳气浮越。卫怯少固。客气外乘。凡六淫客邪。无有不从热
化。内经以疮痍诸病。皆属于火。然内症为急。正不必以肌腠见病为治。刻下两三日间。又值
经至之期。议进固脉实下。佐以东垣泻阴火意。经至之先用此方。
龟甲心 真阿胶 人参 桑螵蛸 生白龙骨 旱莲草 茯神 知母 早上服。
又 当经行。周身寒凛。腰酸腹膨。白疹大发。议用固气和血方。
人参 熟地 阿胶 川芎 当归 白芍 南山楂 蕲艾 早上服。
又 经来腹坠腰酸。疹现肌痒。鼻孔耳窍皆然。想阴血下注。必阳气鼓动。内风沸起。风非外
来。乃阳之化气耳。昨因经至。用胶艾四物汤。和补固经。今午诊脉。右大而涩。左小数。中有坚
疾如刃之象。洵乎液枯风动。初定乌 鱼丸当进。其早上汤药。凡气味之辛裁去。虽为补
剂。勿取动阳耗液也。早上服。
人参 生地 天冬 阿胶 生白芍 女贞子 旱莲膏 地榆 早上服。
又 两日早进清补柔剂。夕用通固下焦冲任。是月经来甚少。起居颇安。与先哲云。暴崩当温
涩。久漏宜宣通。若合符节矣。连次候脉。必小弱为少安。则知阳动不息。内风必旋。 术呆
守。归艾辛温。守则气壅。辛则阳动。皆不知变化之旨。坐失机宜耳。余未能久候。焉有经年经
月之恙。骤期速愈。故丸药创自内经七方之一。世多渺忽。实出轩岐秘奥。再议理阴熄风早
用。谅不致误。拟长夏调理二法
晚服乌 丸三钱。晨进养肝阴和阳熄风以安胃。盖冲脉。即血海。隶于阳明胃脉。乃仿经
旨立方。
人参 阿胶 白芍 生地 旱莲膏 女贞子 桑寄生 咸秋石 细子芩 三角胡麻
药末。胶膏。再加熟蜜三两。捣千余杵。丸。宜细光。早上服四钱。小暑至处暑。生脉散送。
又 此番经后。带下仍有。久漏奇脉少固。前案申说已着。丸剂专司通摄冲任。恪守定然必效。
但外来寒暄易御。内因劳嗔难调。余谆谆相告者为此。
人参 生地 阿胶 白芍 茯神 女贞子 旱莲膏 小黑 豆皮 早上服。（初十日）
又 昨晚烦冗。阳动气升。头额震痛。经再下注。更定镇摄一法。久后亦可备用。
人参 生地 阿胶 龟甲心 生牡蛎 天冬 黑壳建莲
又 十二日午。诊脉。仍用初十日早服方法。去 豆皮加生牡蛎。
交小暑后骤热。午后另煎生脉散微温服一次。
卢 停经半载。雨水节后。忽然暴崩。交春分节血止。黄白淋漓自下。寒则周身拘束。热时烦燥
口干。晡至天明。汗出乃止。寐必身麻如虫行。四肢骨节皆痛。盖血既大去。冲任之脉伤损。而
为寒为热。阴损及乎阳位矣。书云。崩中日久为白滞。漏下多时骨髓枯。由脂液荡尽。致形骸
枯槁。延为瘵疾矣。天热气暖。所当谨慎。
乌贼骨 阿胶 生地 生白芍 茜草 小麦
程 暴冷阳微后崩。（阳虚） 附子理中汤。
崩如山冢 崩。言其血之横决莫制也。漏如漏卮难塞。言其血之漫无关防也。经云。阴在
内。阳之守也。气得之以和。神得之以安。毛发得之以润。经脉得之以行。身形之中。不可斯
须离也。去血过多。则诸病丛生矣。原其致病之由。有因冲任不能摄血者。有因肝不藏血
者。有因脾不统血者。有因热在下焦。迫血妄行者。有因元气大虚。不能收敛其血者。又有
瘀血内阻。新血不能归经而下者。医者根据此类推。仿叶氏用笔灵活。于崩漏治法。无余蕴
矣。（秦天一）
徐评 崩漏必用补血大剂。而兼黑色之药。大概轻剂不能中病。
徐（三十三岁）：肝脾因郁结而受损。导致血崩。（病机为郁结损伤肝脾）
用人参逍遥散，去掉白术、柴胡和炙甘草，加入桑螵蛸、杜仲。
某患者：月经淋漓不尽。长期患有风邪导致的完谷不化的泄泻。（病机为肝风内动、胃气虚弱）
用人参、茯苓、木瓜、炒乌梅、赤石脂、余粮石。
龚患者：脉象数疾。出现寒热往来、出汗。腹部和胁肋疼痛。病症起因于经漏或血崩之后。这是阴液亏损、阳气乘虚侵袭的表现。出现消渴症状且喜欢喝冷饮。不能单纯按照外感邪气来论治。
采用调和营卫、调理中焦的方法，以甘缓之品为主治。（病机为营阴受伤、脏腑燥热）
用当归、白芍、淮小麦、炙甘草、南枣、茯神。
文（五十五岁）：生育次数过多，导致冲任二脉虚弱。到了天癸应当枯竭的年龄，却排出紫黑色如猪肝样的血液，大量出血后，又有黄水绵绵不断流出。三年来所服用的归脾汤和益气药，只是调理脾胃、补益虚损，未曾涉及奇经八脉的疾病。论述妇科时，认为冲脉即是血海。现在紫黑成块，几个月才来一次，这必定是积贮的血液，日久变得瘀浊，有不得不排出的道理。这属于奇经络脉的疾病，与脏腑疾病没有本质区别。古代医书说，久崩久带，宜清利宜通导。仿照此法治疗。（病机为奇脉虚弱、血液停滞）
用柏子仁、细生地、青蒿根、淡黄芩、泽兰、樗根皮。
接续服用斑龙丸。
张（五十岁）：五十岁天癸应当枯竭，但月经淋沥不止，周身牵掣疼痛，右肢逐渐不能抬起。不仅是冲任督带四脉受损，阳明胃脉也衰微少气。这是最难治愈安定的病症。（病机为冲任胃皆虚）
用人参、生黄芪、炙甘草、炒沙苑蒺藜、炒枸杞子、炒当归身。
朱患者：崩漏两年。起初有白带，开始半个月发病一次，现在夏季，每到申时酉时（下午3-7点），漏下必然发生。思考下午为阳中之阴，阴虚则阳动，冲脉任脉皆随之而动，下部失去提防约束。奇经八脉主要由肝肾主管，而冲脉隶属于阳明胃经。阳明久虚，脉管不能固摄，只有开泄没有闭合。医生只用涩剂谋求暂时的安宁，没有按经脉理论论治病情，所以毫无疗效。
用海螵蛸、鲍鱼、茜草、生菟丝子、石壳广莲肉。
接续服用乌贼鱼骨丸。
顾患者：髓海空虚。崩淋不止。筋脉拘挛疼痛，不能行走。（病机为髓虚筋痛）
用肉苁蓉、枸杞、柏子仁、茯神、川石斛、紫石英、羊内肾、青盐。
成患者：冲任二脉损伤，经漏经年不愈。形体消瘦，皮肤干燥，畏冷。这是由于阴气游走于阳位。通过益气来培补生发之阳，温摄以固护下焦真元。（病机为冲任阳虚）
用人参、鹿角霜、当归身、蕲艾炭、茯神、炮姜、紫石英、桂心。
张（四十三岁）：经漏十二年，五脏津液皆已枯竭，冲任二脉功能丧失。冬季稍好，夏季病情加重。心中悸动不安，腹中发热，腰膝脚背皆热。这都是日渐枯槁的表现。方书说暴崩宜温，久崩宜清，因为血液流失导致阴耗。（病机为冲任阴虚）
用人参、生地、阿胶、天冬、人乳粉、柏子仁、茯神、枣仁、白芍、知母，制成蜜丸。
张患者：固补冲任，凉肝宁血。
（方丸组成）人参（二两）、生地（二两）、阿胶（二两）、白芍（二两）、茯苓（二两）、鲜河车胶（一两）、石壳建莲肉（四两）。
如果两种胶类药材较少，可加蒸熟的山药捣浆做成丸药。早上服四钱，用人参汤送服；晚上服二钱。
沈患者：在天癸应当枯竭的年龄，月经淋漓不断。这是阴衰阳动。入秋深后，夜间睡眠很少，汗出遍及四肢胸臆。冲脉隶属于阳明，其气行于身前。阳明脉空，阳气外越，卫气疏泄，阴火升举。应当遵循丹溪的补阴丸，或者虎潜丸之类的方剂。久病投药太过，恐怕会妨碍胃气。
每天早上服丹溪补阴丸四钱，十服。
黄患者：长期吃素多年，脾胃久虚。疟疾从四肢末梢起，必定侵犯中焦脾胃。血海隶属于阳明，苦味和辛散的药物，都会损伤胃系。虽然天癸早已枯竭，但病邪和药味扰动血络，导致暴崩欲脱。看医生用童便、阿胶，味道咸润滑，导致大便溏泻，哪里适合用润下的方法？即使是熟地、五味子补敛阴液，喝下去停在胃脘，一会儿就想吐干净。滋腻酸浊的药物，下焦没得到益处，胃脘先已受伤害。建议用仲景的理中汤。血脱有益气的方法，坤土阳气温和旋转，喜其中流砥柱的作用。如果能知道滋味进食，就是转机。这是特别严重的重症，不可忽视。（病机为苦寒辛散损伤中阳）
用理中汤。
某患者：停经三个月，下漏成块。小腹胀痛。建议通调奇脉。（病机为奇脉不和）
用鹿角霜、生杜仲、桂枝木、生沙苑蒺藜、当归、茯苓、红枣。
罗（二十四岁）：病属下焦，肝肾内部受损，延及冲任奇脉。导致经漏淋漓，腰脊痿弱，脉络空虚。有终身不能孕育的事情。（病机为肝肾冲任虚寒）
用制熟地（砂仁制）、河车胶、当归、白芍、人参、茯苓、于术、炙甘草、蕲艾炭、香附、小茴香、紫石英。
陈（五十岁）：五十岁年纪，经漏如崩。继之以白带绵绵。过去身体丰满，现在瘦损。当年饮酒湿胜，大便长期溏泻。自生病以来一年，大便干结不爽，夜间发热多汗，四肢皆冷，气短腹鸣，上打嗝，下排气，腰足脚背酸痛无力，食物每日减少，不知其味。这是阳明脉衰，厥阴风木由于血去液伤，冲任交损，内风旋转而为风消之象。病在络脉，所以拖延很久。金匮要略说络热则痿了。（病机为液伤络热风消）
用人参、黄芪、苦参、茯神、牡蛎、小麦。
滤清的人参汤收丸。
张患者：外冷内热，吃过饭像饿一样，嘴唇干燥开裂，口渴饮水，下漏。漏多则阴虚阳亢，大便溏薄不实，不可用寒润药物。（病机为阴虚阳亢）
用地黄炭、阿胶、炒白芍、湖莲、樗根皮、茯神、蕲艾炭。
又症见：消渴心悸。
用阿胶、生鸡子黄、生地、天冬、生白芍、茯神。
胡患者：心痛如饥，口吐腻涎浊沫。正值经期量多，因惊动肝，阳化内风，有欲厥逆的现象。治疗用咸苦之法，佐以微辛，使入阴和阳。
用阿胶（二钱）、牡蛎（三钱）、川楝子（一钱）、小川连（三分）、川芎（二分）、当归（一钱）。
又症见：和阳固阴，诸病大减。因经漏阴伤，阳易浮越，心怔悸，肢末痛，内风未熄。用药以甘柔为主，使胃汁日渐充盈，则成为中流砥柱。
用人参、阿胶、麦冬、生白芍、炙甘草、茯神。
邱（四十四岁）：经漏成带，一年多医疗无功。这是冲任督带交相患病。古称久带久崩宜清。视其体质丰松，阳气久亏。与内经血脱的方法，用乌鱼丸、鲍鱼汁丸。
又症见：照前方加阿胶、人中白。
某患者：经漏三年，诊察面色脉象俱夺，面浮脚肿，肌肤缺乏华色，纳食日减，大便坚结不爽，自脊柱腰髀酸楚如堕。入夏以来，形神日渐羸弱。思考经水必是各路之血，贮于血海而下。其不致崩决淋漓者，任脉为之担任，带脉为之约束，刚维跷脉之拥护，督脉以总督其统摄。现在仅仅因为冲脉之动而血下，诸脉皆失其司职。症固然是虚，日日服用补阳药不应，是不懂奇经的道理。考内经关于胸胁支满妨食，时时前后出血，特制乌贼骨丸。咸味就下，通以济涩，更以秽浊气味为之导引，同气相需。后贤谓暴崩暴漏，宜温宜补；久漏久崩，宜清宜通。正与圣经相符。况且术皆守，不能入奇脉，无病用之，诚是好药，借以调病，焉克有济。夏之月，大气正在泄越，脾胃主令，岁气天和，保之最要。议以早进通阴以理奇经，午余天热气泄，必加烦倦，随用清暑益气之剂，顺天之气，以扶生生，安稳百日。秋半收肃令行，可望其藏聚气交，而奇络渐固。此久损难复，非幸试速功矣。（病机为奇脉阴虚风阳动）
早上汤药议以通阴潜阳方法。早上服。
用龟甲心（秋石水浸）、鹿角霜、真阿胶、柏子霜、生牡蛎、锁阳。
另煎清人参汤入清药，煎取五十沸。
鹿性阳，入督脉；龟体阴，走任脉；阿胶得济水沉伏，味咸色黑，熄肝风，养肾水；柏子芳香滑润，养血理燥；牡蛎去湿消肿，咸固下。仲景云：病患腰以下肿者，牡蛎泽泻汤。锁阳固下焦之阳气。乃治八脉之大意。乌贼骨丸方。
乌贼骨四分（米醋炙去甲另研水飞）、茹（一分）。
上为细末，用雀卵量捣为丸。每服三钱。用药前先饮淡鲍鱼汤一小杯为导引。
又症见：进潜阳颇投，但左耳鸣甚，肠中亦鸣，肝阳内风升动未息。减气刚用柔。早上服。
用龟甲心（照前制）、真阿胶、柏子霜、天冬、女贞子、旱莲草。
另煎人参汤二钱，加入滤清药内，再煎五十余沸。
又症见：两进柔润清补颇投。询知病由乎悲哀烦劳，调理向愈。继因目病，服苦辛寒散太过，遂经漏淋带。年前七八日始净。今则两旬而止。此奇脉内乏，前议非诬。据述周身累现瘾疹，瘙痒不宁。想脂液久渗，阴不内营，阳气浮越，卫怯少固，客气外乘。凡六淫客邪，无有不从热化。内经以疮痍诸病，皆属于火。然内症为急，正不必以肌腠见病为治。刻下两三日间，又值经至之期。议进固脉实下，佐以东垣泻阴火意。经至之先用此方。
用龟甲心、真阿胶、人参、桑螵蛸、生白龙骨、旱莲草、茯神、知母。早上服。
又症见：当经行，周身寒凛，腰酸腹膨，白疹大发。议用固气和血方。
用人参、熟地、阿胶、川芎、当归、白芍、南山楂、蕲艾。早上服。
又症见：经来腹坠腰酸，疹现肌痒，鼻孔耳窍皆然。想阴血下注，必阳气鼓动，内风沸起。风非外来，乃阳之化气耳。昨因经至，用胶艾四物汤，和补固经。今午诊脉，右大而涩，左小数，中有坚疾如刃之象。洵乎液枯风动。初定乌贼鱼丸当进。其早上汤药，凡气味之辛裁去。虽为补剂，勿取动阳耗液也。早上服。
用人参、生地、天冬、阿胶、生白芍、女贞子、旱莲膏、地榆。早上服。
又症见：两日早进清补柔剂，夕用通固下焦冲任。是月经来甚少，起居颇安。与先哲云：暴崩当温涩，久漏宜宣通。若合符节矣。连次候脉，必小弱为少安，则知阳动不息，内风必旋。术呆守，归艾辛温，守则气壅，辛则阳动，皆不知变化之旨，坐失机宜耳。余未能久候，焉有经年经月之恙，骤期速愈。故丸药创自内经七方之一，世多渺忽，实出轩岐秘奥。再议理阴熄风早用，谅不致误。拟长夏调理二法。
晚服乌贼丸三钱。晨进养肝阴和阳熄风以安胃。盖冲脉，即血海，隶于阳明胃脉。乃仿经旨立方。
用人参、阿胶、白芍、生地、旱莲膏、女贞子、桑寄生、咸秋石、细子芩、三角胡麻。
药末，胶膏，再加熟蜜三两，捣千余杵，丸。宜细光。早上服四钱。小暑至处暑，生脉散送。
又症见：此番经后，带下仍有。久漏奇脉少固。前案申说已着。丸剂专司通摄冲任，恪守定然必效。但外来寒暄易御，内因劳嗔难调。余谆谆相告者为此。
用人参、生地、阿胶、白芍、茯神、女贞子、旱莲膏、小黑豆皮。早上服。（初十日）
又症见：昨晚烦冗，阳动气升，头额震痛，经再下注。更定镇摄一法。久后亦可备用。
用人参、生地、阿胶、龟甲心、生牡蛎、天冬、黑壳建莲。
又症见：十二日午，诊脉。仍用初十日早服方法，去黑豆皮加生牡蛎。
交小暑后骤热，午后另煎生脉散微温服一次。
卢患者：停经半年。雨水节后，忽然暴崩。交春分节血止，黄白淋漓自下。寒则周身拘束，热时烦躁口干。晡至天明，汗出乃止。寐必身麻如虫行，四肢骨节皆痛。盖血既大去，冲任之脉伤损，而为寒为热，阴损及乎阳位矣。书云：崩中日久为白滞，漏下多时骨髓枯。由脂液荡尽，致形骸枯槁，延为瘵疾矣。天热气暖，所当谨慎。
用乌贼骨、阿胶、生地、生白芍、茜草、小麦。
崩如山冢崩。言其血之横决莫制也。漏如漏卮难塞。言其血之漫无关防也。经云：阴在内，阳之守也。气得之以和，神得之以安，毛发得之以润，经脉得之以行。身形之中，不可斯须离也。去血过多，则诸病丛生矣。原其致病之由，有因冲任不能摄血者，有因肝不藏血者，有因脾不统血者，有因热在下焦，迫血妄行者，有因元气大虚，不能收敛其血者，又有瘀血内阻，新血不能归经而下者。医者根据此类推，仿叶氏用笔灵活，于崩漏治法，无余蕴矣。（秦天一）
Xu (age 33): Liver and Spleen damaged by stagnation. Leading to metrorrhagia (uterine bleeding). (Pathogenesis: Stagnation damages Liver and Spleen)
Use Ren Shen Xiao Yao San (Ginseng and Bupleurum Powder), removing Bai Zhu, Chai Hu, and Zhi Gan Cao, adding Sang Piao Xiao, Du Zhong.
Certain patient: Menstrual leakage unceasing. Long-term wind-induced diarrhea with undigested food. (Pathogenesis: Liver Wind stirring internally, Stomach Qi deficiency)
Use Ren Shen, Fu Ling, Mu Gua, Chao Wu Mei, Chi Shi Zhi, Yu Liang Shi.
Gong patient: Pulse rapid. Alternating chills and fever, sweating. Abdominal and hypochondriac pain. The illness originated after menstrual leakage or metrorrhagia. This is Yin injury with Yang encroaching. Symptoms of Xiao Ke (wasting-thirst) with preference for cold drinks. Cannot be solely treated as an external pathogenic factor.
Adopt the method of harmonizing Ying and Wei, regulating the Middle Jiao, primarily using sweet and緩 (soothing) agents. (Pathogenesis: Ying Yin injured, Zang organs dry and hot)
Use Dang Gui, Bai Shao, Huai Xiao Mai, Zhi Gan Cao, Nan Zao, Fu Shen.
Wen (age 55): Frequent childbirth leading to deficiency of the Chong and Ren meridians. At the age when Tian Gui (menstruation/reproductive essence) should cease, purple-black blood resembling pig liver is discharged. After sudden heavy bleeding, yellow fluid flows continuously. For three years, prescribed Gui Pi Tang and Qi-tonifying medicines only regulated the Spleen and Stomach and tonified deficiency, never addressing diseases of the extraordinary vessels. In gynecology, it is discussed that the Chong vessel is the Sea of Blood. Now, purple-black clumps appear once every few months; this must be accumulated blood, becoming turbid over time, which inevitably needs to be expelled. This belongs to diseases of the extraordinary collaterals, no different from Zang-Fu diseases. Ancient texts state that for long-standing metrorrhagia and leukorrhea, clearing and unblocking are appropriate. Imitate this method for treatment. (Pathogenesis: Extraordinary vessels deficient, blood stasis)
Use Bai Zi Ren, Xi Sheng Di, Qing Hao Gen, Dan Huang Qin, Ze Lan, Chu Gen Pi.
Follow up with Ban Long Wan.
Zhang (age 50): At fifty, Tian Gui should cease, yet menstrual leakage persists, accompanied by whole-body pulling sensations. The right limb gradually cannot lift. Not only are the Chong, Ren, Du, and Dai meridians damaged, but the Yangming Stomach meridian is also weak with little Qi. This is a difficult condition to stabilize. (Pathogenesis: Chong, Ren, and Stomach all deficient)
Use Ren Shen, Sheng Huang Qi, Zhi Gan Cao, Chao Sha Yuan Ji Li, Chao Qi Zi, Chao Dang Gui Shen.
Zhu patient: Metrorrhagia and leukorrhea for two years. Initially with leukorrhea, occurring every half month at first. Now in summer, leakage occurs precisely during Shen and You hours (3 PM - 7 PM). Considering the afternoon as Yin within Yang, Yin deficiency leads to Yang movement, causing the Chong and Ren meridians to move. The lower part lacks restraint. The extraordinary vessels are mostly governed by the Liver and Kidney, while the Chong meridian belongs to the Yangming Stomach. Long-term Yangming deficiency means the pulse cannot secure and hold, having only opening without closing. Doctors only use astringent agents for temporary peace, failing to diagnose according to meridians, hence no effect.
Use Hai Piao Xiao, Bao Yu, Qian Cao, Sheng Tu Si Zi, Shi Ke Guang Lian Rou.
Follow up with Wu Zei Gu Wan.
Gu patient: Marrow deficiency. Unceasing metrorrhagia and leukorrhea. Tendon spasms and pain, inability to walk. (Pathogenesis: Marrow deficiency, tendon pain)
Use Cong Rong, Gou Qi, Bai Zi Ren, Fu Shen, Chuan Hu, Zi Shi Ying, Yang Nei Shen, Qing Yan.
Cheng patient: Damage to Chong and Ren meridians. Menstrual leakage unhealed for years. Emaciated, dry skin, aversion to cold. Due to Yin qi wandering to Yang positions. Tonify Qi to cultivate generating Yang, warm and secure to consolidate lower True Yuan. (Pathogenesis: Chong and Ren Yang deficiency)
Use Ren Shen, Lu Jiao Shuang, Dang Gui Shen, Qi Ai Tan, Fu Shen, Pao Jiang, Zi Shi Ying, Gui Xin.
Zhang (age 43): Menstrual leakage for twelve years. Five fluids exhausted. Chong and Ren functions lost. Slightly better in winter, worsened in summer. Heart palpitations, abdominal heat, heat in waist, knees, and dorsum of feet. All due to progressive emaciation. Formulas state sudden metrorrhagia should be warmed, long-standing metrorrhagia cleared, because blood loss consumes Yin. (Pathogenesis: Chong and Ren Yin deficiency)
Use Ren Shen, Sheng Di, E Jiao, Tian Dong, Ren Ru Fen, Bai Zi Ren, Fu Shen, Zao Ren, Bai Shao, Zhi Mu, made into honey pills.
Zhang patient: Solidify and tonify Chong and Ren, cool Liver and calm blood.
(Formula/Pill composition) Ren Shen (2 liang), Sheng Di (2 liang), E Jiao (2 liang), Bai Shao (2 liang), Fu Ling (2 liang), Xian He Che Jiao (1 liang), Shi Ke Jian Lian Rou (4 liang).
If the two jiaos are insufficient, add steamed Shan Yao mashed into paste for pills. Take 4 qian in the morning, delivered with Ren Shen decoction; take 2 qian in the evening.
Shen patient: At the age when Tian Gui should cease, menstruation leaks continuously. This is Yin decline with Yang movement. Deep in autumn, very little sleep, sweating on limbs, chest, and abdomen. The Chong meridian belongs to Yangming; its Qi moves forward. Yangming pulse is empty, Yang floats outward, Wei Qi is loose, Yin fire rises. Should follow Danxi's Bu Yin Wan or Hu Qian Wan categories. Long-term illness with excessive decoctions may hinder the Stomach.
Take Danxi Bu Yin Wan 4 qian every morning, ten doses.
Huang patient: Vegetarian for years, long-term Spleen and Stomach deficiency. Malaria starts from extremities, invading the Central Palace. The Sea of Blood belongs to Yangming. Bitter and acrid-dispersing drugs damage the Stomach system. Although Tian Gui has ceased long ago, pathogens and drug flavors disturb blood collaterals, causing sudden metrorrhagia approaching collapse. Observing doctors using Tong Bian (child urine) and E Jiao, salty and slippery, causing loose stools, how can lubricating purgatives be suitable? Even if Shu Di and Wu Wei Zi tonify and astringe Yin fluids, stopping in the epigastrium, inducing vomiting soon. Greasy and sour-turbid drugs benefit the Lower Jiao not, but harm the epigastrium first. Propose Zhongjing's Li Zhong Tang. There is a method of tonifying Qi for blood loss. Kun Earth Yang rotates harmoniously, acting as a pillar. If appetite returns, it is a turning point. Particularly severe, do not ignore. (Pathogenesis: Bitter-cold and acrid-dispersing damage Middle Yang)
Use Li Zhong Tang.
Certain patient: Amenorrhea for three months, leakage forms clumps. Lower abdominal distension and pain. Propose unblocking and harmonizing extraordinary vessels. (Pathogenesis: Extraordinary vessels disharmony)
Use Lu Jiao Shuang, Sheng Du Zhong, Gui Zhi Mu, Sheng Sha Yuan, Dang Gui, Fu Ling, Hong Zao.
Luo (age 24): Disease in Lower Jiao, internal damage to Liver and Kidney, extending to Chong, Ren, and extraordinary vessels. Resulting in continuous menstrual leakage, weak lumbar spine, empty collaterals. Possibility of lifelong infertility. (Pathogenesis: Liver, Kidney, Chong, Ren deficiency and cold)
Use Zhi Shu Di (processed with Sha Ren), He Che Jiao, Dang Gui, Bai Shao, Ren Shen, Fu Ling, Yu Zhu, Zhi Gan Cao, Qi Ai Tan, Xiang Fu, Xiao Hui, Zi Shi Ying.
Chen (age 50): At fifty, menstrual leakage like metrorrhagia. Followed by continuous leukorrhea. Formerly plump, now emaciated. Past alcohol consumption led to dampness, long-term loose stools. Since illness began a year ago, dry stool, incomplete evacuation. Night fever, heavy sweating, cold limbs, shortness of breath, borborygmus, belching, flatus, soreness/weakness in waist and feet, decreased appetite, loss of taste. This is Yangming pulse decline. Jueyin Wind Wood arises from blood loss and fluid injury. Chong and Ren mutually damaged. Internal wind rotation manifests as Feng Xiao (wind wasting). Disease is in collaterals, hence prolonged. Jingui states collateral heat causes flaccidity. (Pathogenesis: Fluid injury, collateral heat, wind wasting)
Use Ren Shen, Huang Qi, Ku Shen, Fu Shen, Mu Li, Xiao Mai.
Collected with filtered Ren Shen Tang.
Zhang patient: External cold, internal heat. Hunger after eating. Dry cracked lips, thirst, drinking, lower leakage. Heavy leakage leads to Yin deficiency and Yang hyperactivity. Loose stools, unsolid. Cannot use cold-moistening. (Pathogenesis: Yin deficiency, Yang hyperactivity)
Use Sheng Di Tan, E Jiao, Chao Bai Shao, Hu Lian, Chu Gen Pi, Fu Shen, Qi Ai Tan.
Also symptoms: Xiao Ke (wasting-thirst), heart palpitations.
Use E Jiao, Sheng Ji Zi Huang, Sheng Di, Tian Dong, Sheng Bai Shao, Fu Shen.
Hu patient: Heart pain like hunger. Spitting thick saliva and turbid foam. During heavy menstruation, startled Liver, Yang transforms into internal wind, signs of syncope. Treat with salty-bitter, assisted by slightly acrid, entering Yin to harmonize Yang.
Use E Jiao (2 qian), Mu Li (3 qian), Chuan Liu Zi (1 qian), Xiao Chuan Lian (3 fen), Chuan Xiong (2 fen), Dang Gui (1 qian).
Also symptoms: Harmonize Yang, solidify Yin, major reduction in diseases. Due to menstrual leakage Yin injury, Yang easily floats. Heart palpitations, limb pain, internal wind not extinguished. Use sweet-soft agents to daily replenish Stomach juices, becoming the central pillar.
Use Ren Shen, E Jiao, Mai Dong, Sheng Bai Shao, Zhi Gan Cao, Fu Shen.
Qiu (age 44): Menstrual leakage becomes leukorrhea. Over a year of medical treatment ineffective. Chong, Ren, Du, Dai intersect in disease. Ancients say long leukorrhea and metrorrhagia should be cleared. Constitution is plump and loose, Yang Qi long deficient. Following Jingui's blood-loss methods, use Wu Yu Wan, Bao Yu Zhi Wan.
Also: Add E Jiao, Ren Zhong Bai to previous formula.
Certain patient: Menstrual leakage for three years. Complexion and pulse both depleted. Facial edema, foot swelling, lack of luster in skin, decreasing appetite, hard stool, incomplete evacuation. Soreness/heaviness from spine to hips. Since summer, spirit and form daily weaken. Consider menstrual blood comes from various sources, stored in Sea of Blood and descends. To prevent bursting/leaking, Ren Meridian bears it, Dai Meridian constrains it, Yang/Qiao meridians support it, Du Meridian supervises it. Now only Chong Meridian moves, blood descends, all meridians lose control. Symptom is deficiency, daily Yang-tonics fail, lacking understanding of extraordinary vessels. Jingui mentions chest/hypochondriac fullness, frequent bleeding, specifically makes Wu Zei Gu Wan. Salty flavor goes down, unblocking aids astringing, turbid odor guides. Similar qi assists. Later sages say sudden metrorrhagia/leakage should be warmed/tonified; long leakage/metrorrhagia should be cleared/unblocked. Matches classics. However, Zhu/Bai are static, cannot enter extraordinary vessels. Good medicine for health, but useless for disease. Summer, atmospheric Qi escapes, Spleen/Stomach govern, natural harmony, preservation key. Propose morning intake to unblock Yin and regulate extraordinary vessels. Afternoon heat/vapors cause fatigue, use Qing Shu Yi Qi agents, following Heaven's Qi to support life, stable for 100 days. Mid-autumn,收敛 (collecting) command acts, expecting storage/qi intersection, extraordinary collaterals gradually solidify. Long damage hard to recover, not for quick success. (Pathogenesis: Extraordinary vessel Yin deficiency, wind-Yang movement)
Morning decoction proposes unblocking Yin and subduing Yang. Morning dose.
Use Gui Jia Xin (steeped in Qiu Shi water), Lu Jiao Shuang, Zhen E Jiao, Bai Zi Shuang, Sheng Mu Li, Suo Yang.
Separately decoct clear Ren Shen Tang, add clear medicine, boil 50 times.
Deer nature is Yang, enters Du Meridian; Turtle body is Yin, travels Ren Meridian; E Jiao sinks in Ji Water, salty/black, extinguishes Liver Wind, nourishes Kidney Water; Bai Zi aromatic/slippery, nourishes blood, resolves dryness; Mu Li removes dampness/swelling, salty secures lower. Zhongjing says: Patient with swelling below waist, Mu Li Ze Xie Tang. Suo Yang secures Lower Jiao Yang Qi. This is the general idea of treating eight pulses. Wu Zei Gu Wan Formula.
Wu Zei Gu 4 fen (vinegar-fried, remove shell, grind separately, water-washed), Ru 1 fen.
Grind to fine powder. Use sparrow egg yolk to make pills. Take 3 qian each time. Before medication, drink small cup of light Bao Yu Tang as guide.
Also: Subduing Yang works well, but left ear tinnitus severe, intestinal rumbling. Liver Yang/internal wind rising not settled. Reduce Qi-gang, use soft. Morning dose.
Use Gui Jia Xin (as before), Zhen E Jiao, Bai Zi Shuang, Tian Dong, Nv Zhen Zi, Han Lian Cao.
Separately decoct 2 qian Ren Shen Tang, add to filtered medicine, boil 50+ times.
Also: Two advances of soft/moist/clear/tonic work well. Learned illness caused by sorrow/fatigue,调理 (regulation) towards recovery. Then eye disease, took bitter/acrid/cold dispersants too much, resulting in menstrual leakage/leukorrhea/drainage. Started clean 7-8 days ago. Now stops after 20 days. This is internal lack of extraordinary vessels, previous discussion not false. Describes recurrent urticaria, itching restless. Imagine fat/fluid long seeping, Yin not nourishing internally, Yang floating, Wei weak/lacking solidity, external guests attacking. All six excess pathogens transform into heat. Jingui says sores/allergic diseases belong to Fire. However, internal symptoms are urgent, no need to treat skin manifestations. Currently 2-3 days, period approaches. Propose solidifying vessels, strengthening lower, assisting Dongyuan's draining Yin-fire intent. Use this formula before period.
Use Gui Jia Xin, Zhen E Jiao, Ren Shen, Sang Piao Xiao, Sheng Bai Long Gu, Han Lian Cao, Fu Shen, Zhi Mu. Morning dose.
Also: During menstruation, whole body cold/shivering, waist sore, abdomen distended, white rash erupts. Propose solidifying Qi and harmonizing blood formula.
Use Ren Shen, Shu Di, E Jiao, Chuan Xiong, Dang Gui, Bai Shao, Nan Shan Zha, Qi Ai. Morning dose.
Also: Period brings abdominal heaviness/waist sore, rash/skin itch, nose/ears affected. Imagine Yin blood descending, Yang Qi stirring, internal wind boiling. Wind not external, but Yang transforming Qi. Yesterday due to period, used Jiao Ai Si Wu Tang, harmonizing/tonifying/solidifying period. Today noon pulse: Right large/rough, Left small/rapid, middle firm/fast like blade. Truly fluid exhaustion, wind movement. Initially decided Wu Zei Yu Wan should advance. Morning decoction, remove acrid aromas. Though tonic, avoid moving Yang/consuming fluid. Morning dose.
Use Ren Shen, Sheng Di, Tian Dong, E Jiao, Sheng Bai Shao, Nv Zhen Zi, Han Lian Gao, Di Yu. Morning dose.
Also: Two days morning clear/tonic/soft agents, evening unblock/solidify Lower Jiao Chong/Ren. This period flow very little,起居 (daily life) quite safe. With ancients saying: Sudden metrorrhagia should be warm/astringent, long leakage should be unblocking. Like matching seals. Continuous pulse watching, slight weakness indicates slight peace, knowing Yang movement unceasing, internal wind must rotate. Zhu/Bai rigidly adhere, Gui/Ai acrid/warm, adhering causes Qi congestion, acrid causes Yang movement, all lacking understanding of change, missing opportunity. I cannot wait long, how can yearly/monthly illness expect quick cure? Thus pill created from Jingui's Seven Categories, world ignores, actually from Xuanni secret profoundness. Re-propose Li Yin Xi Feng early use, surely not wrong. Plan mid-summer regulation two methods.
Evening take Wu Zei Wan 3 qian. Morning enter nourish Liver Yin, harmonize Yang, extinguish wind, calm Stomach. As Chong Meridian is Sea of Blood, belongs to Yangming Stomach Meridian. Imitate classic intent to formulate.
Use Ren Shen, E Jiao, Bai Shao, Sheng Di, Han Lian Gao, Nv Zhen Zi, Sang Ji Sheng, Xian Qiu Shi, Xi Zi Qin, San Jiao Hu Ma.
Medicine powder, gelatin paste, add 3 liang cooked honey, pound 1000+ times, make pills. Should be fine/smooth. Morning take 4 qian. Minor Heat to Major Heat, send with Sheng Mai San.
Also: After this period, leukorrhea remains. Long leakage, extraordinary vessels lack solidity. Previous case explanation already effective. Pill specifically manages unblocking/securing Chong/Ren, strictly observing will definitely be effective. But external cold/warmth easy to defend, internal labor/anger hard to adjust. I earnestly tell you for this.
Use Ren Shen, Sheng Di, E Jiao, Bai Shao, Fu Shen, Nv Zhen Zi, Han Lian Gao, Xiao Hei Dou Pi. Morning dose. (10th day)
Also: Last night busy/restless, Yang movement/Qi rising, forehead throbbing pain, period re-descending. Redefine sedation method. Can prepare for later.
Use Ren Shen, Sheng Di, E Jiao, Gui Jia Xin, Sheng Mu Li, Tian Dong, Hei Ke Jian Lian.
Also: 12th day noon, pulse diagnosis. Still use 10th day morning method, remove Dou Pi, add Sheng Mu Li.
After Minor Heat, sudden heat, afternoon separately decoct Sheng Mai San, take warm once.
Lu patient: Amenorrhea half year. After Rain Water solar term, suddenly metrorrhagia. At Spring Equinox blood stops, yellow/white drainage continues. Cold causes whole-body stiffness, heat causes irritability/dry mouth. From dusk to dawn, sweating stops it. Sleep causes body numbness like insects crawling, limb joints all pain. Since blood largely lost, Chong/Ren meridians damaged, manifesting cold/heat, Yin injury affecting Yang positions. Book says: Metrorrhagia lasting long becomes leukorrhea stagnation, leakage lasting long marrow dries. By fat/fluid exhausted, causing emaciation, extending to consumptive disease. Heaven heat/warm, should be cautious.
Use Wu Zei Gu, E Jiao, Sheng Di, Sheng Bai Shao, Qian Cao, Xiao Mai.
Cheng patient: Sudden cold/Yang微弱 (weak) then metrorrhagia. (Pathogenesis: Yang deficiency)
Use Fu Zi Li Zhong Tang.
Metrorrhagia like mountain collapse. Speaking of blood rushing uncontrollably. Leakage like leaking vessel hard to plug. Speaking of blood flowing without defense. Classic says: Yin inside, Yang guards it. Qi gets harmony, Spirit gets peace, hair gets moisture, meridians get movement. Within body form, cannot leave for a moment. Losing too much blood, various diseases arise. Original causes: Chong/Ren cannot hold blood; Liver does not store blood; Spleen does not control blood; Heat in Lower Jiao forcing blood recklessly; Yuan Qi greatly deficient unable to converge blood; Blood stasis internally blocking, new blood cannot return to vessels and descends. Doctors deduce from these, imitating Ye's flexible writing, leaving no hidden aspects in metrorrhagia/leukorrhea treatment. (Qin Tianyi)
Xu comment: Metrorrhagia/leukorrhea must use large blood-tonifying doses. And include black-colored medicines. Generally light doses cannot hit the disease.