妇人经水过期，血少也，四物加参、术；带痰，加南星、半夏、陈皮之类。经水不及
期而来者，血热也，四物加黄连。过期，紫黑有块，亦血热也，必作痛，四物加香附、黄连；过期，
淡
皮、
之
玄胡
物
、玄
多
服之，肥人不及日数而多者，痰多血虚有热，亦用前丸，药中更加黄连、白术丸服。血枯经
闭者
如用，以姜汁炒。肥胖饮食过度之人，而经水不调者，乃是湿痰，宜苍术、半夏、滑石、茯苓
、白术、香附、川芎、当归。临经来时肚痛者，四物汤加陈皮、玄胡索、牡丹、甘草。痛
甚者，豆淋酒；痛缓者，童便煮莎，入炒条芩末为丸。经水去多不能住者，以三补丸加莎根
龟板、金毛狗脊。阴虚，经脉久不通，小便涩，身体疼痛，以四物加苍术、牛膝、陈皮、
生甘草。又用苍莎丸加苍耳、酒芍药为丸，就煎前药吞下。
入方
治经水过多。
黄芩（炒） 白芍（炒） 龟板（炙，各一两） 黄柏（炒，三钱） 椿树根皮（七钱半）香附子（二钱
上为末，酒糊丸。空心温酒或白汤下，五十丸。
又方 治积痰伤经不行，夜则妄语。
栝蒌子（一两） 黄连（半两） 吴茱萸（十粒） 桃仁（五十个） 红曲（二钱） 砂仁（三两）
上为末，生姜汁化炊饼为丸桐子大。服百丸，空心。
又方 治一切瘀血为痛。
香附（四两，醋煮） 瓦楞子（ ，二两，醋煮一昼夜） 桃仁（二两） 牡丹皮 大黄（熟蒸） 当
归（各一两） 川芎 红花（各半两）
上为末，蒸饼丸如桐子大。空心温酒下，三五十丸。
附方
四物汤 治冲任虚损，月水不调，脐腹 痛。
当归 川芎 芍药 熟地黄（等分）
上以水煎服。加减于后∶
若经候微少，渐渐不通，手足烦疼，渐瘦，生潮热，脉微数，本方去地黄、芎，加泽兰
叶三倍
，甘草半分；经候过多，本方去熟地黄，加生地黄，或只加黄芩、白术；经行身热，脉数，
头昏，本方加柴胡、芩；经行微少，或胀或疼，四肢疼痛，加延胡、没药、白芷与本方等
，淡
醋汤调下末子。经候不调，心腹 痛，只用芎、归二味，名君臣散。气冲经脉，故月事频
并，脐下多痛，加芍药；经欲行，脐腹绞痛，加玄胡、槟
榔、苦楝，炒木香减半；经水涩少，加葵花、红花；经水适来适断，或有往来寒热，先宜
服小柴胡汤，后以四物和之；经候过而作痛，血气俱虚也，宜本方对四君子汤服之。
治经事过期不行。
玄胡索（一钱） 香附 枳壳（各半钱）
上为末，杜牛膝捣汁半钟，空心调服。
交加地黄丸 治经水不调，血块气痞，肚腹疼痛。
生地黄（一斤） 老生姜（一斤） 玄胡索 当归 川芎 白芍（二两） 没药 木香（各一两） 桃仁
（去皮尖） 人参（各一两半）香附子（半斤）
上先将地黄、生姜各捣汁，以姜汁浸地黄渣，地黄汁浸
渣，皆以汁尽为度，次将余药为末，共作一处，
日干，同为末，醋糊丸如桐子大。空心服五十丸，姜汤下。
当归散 治经脉不通。
当归 穿山甲（灰炒） 蒲黄（各半两，炒） 辰砂（一钱） 麝香（少许）
上为末。酒调服二钱。
琥珀散 治月水不通，心膈迷闷，腹脏撮痛。
台乌（二两） 当归 莪术（各一两）
上为末。空心温酒调二钱，以食压之。产后诸疾，炒姜酒调下。
通经丸 治妇人室女，经候不通，脐腹疼痛，或成血瘕。
川椒（炒） 莪术 干漆（炒烟尽） 当归 青皮 干姜 大黄（煨） 桃仁（去皮尖，炒）
川乌（炮） 桂心（各等分）
上为末，将一半用米醋熬成膏子，和余药成剂，臼中杵之，丸如桐子，阴干。每服三五
十丸，醋汤下。严氏方无川乌，有红花。
红花当归散 治妇人血脏虚竭，或积瘀血，经候不行，时作痛腰胯重疼，小腹坚硬，及
室女经水不行。
红花 当归尾 紫葳（即凌霄花） 牛膝 甘草（炙） 苏木（各三两） 白芷 桂心（一两半）
赤芍（九两） 刘寄奴（五两）
上为末。空心热酒调三钱服。一名凌霄花散。
导痰汤 见痰类。
三补丸 见诸虚类。
苍莎丸 见咳嗽类。
越鞠丸 见六郁类。
妇女月经延期而至，是由于血虚所致，可用四物汤加入人参、白术；若兼有痰湿，则加入天南星、半夏、陈皮等药物。月经提前来潮的，是血热所致，用四物汤加入黄连。月经延期且颜色紫黑有血块的，也是血热所致，必然伴有疼痛，用四物汤加入香附、黄连；若服用后症状缓解，可继续服用。身体肥胖者，月经未到日期却量多，这是痰多血虚有热，也使用前面的丸剂，药方中再加入黄连、白术制成丸剂服用。若需姜汁炒制，则以姜汁炒药。对于饮食过度导致肥胖的人，出现月经不调的，乃是湿痰所致，宜用苍术、半夏、滑石、茯苓、白术、香附、川芎、当归。临近经期时腹痛的，用四物汤加入陈皮、玄胡索、牡丹皮、甘草。疼痛剧烈的，用豆淋酒送服；疼痛轻微的，用童便煮莎草根，加入炒过的黄芩末制成丸剂。月经量多不止的，用三补丸加入莎草根、龟板、金毛狗脊。阴虚导致经脉长期不通，小便涩痛，身体疼痛的，用四物汤加入苍术、牛膝、陈皮、生甘草。另外再用苍莎丸加入苍耳子、酒炒芍药制成丸剂，煎煮前药送服。
以下方剂治疗月经量过多：
黄芩（炒）、白芍（炒）、龟板（炙，各一两）、黄柏（炒，三钱）、椿树根皮（七钱半）、香附子（二钱）。
以上药物研为细末，用酒糊制成丸剂。空腹时用温酒或白开水送服五十丸。
又一方，治疗积痰损伤经脉导致经血不行，夜间胡言乱语：
栝蒌子（一两）、黄连（半两）、吴茱萸（十粒）、桃仁（五十个）、红曲（二钱）、砂仁（三两）。
以上药物研为细末，用生姜汁化开炊饼面团制成如梧桐子大小的丸剂。空腹服用一百丸。
又一方，治疗各种瘀血引起的疼痛：
香附（四两，醋煮）、瓦楞子（二两，醋煮一昼夜）、桃仁（二两）、牡丹皮、大黄（熟蒸）、当归（各一两）、川芎、红花（各半两）。
以上药物研为细末，用蒸饼制成如梧桐子大小的丸剂。空腹用温酒送服三五十丸。
附方：
四物汤，治疗冲任虚损，月经不调，脐腹疼痛。
组成：当归、川芎、芍药、熟地黄（等分）。
以上用水煎服。加减法如下：
若月经量少，逐渐不通，手足烦热疼痛，身体日渐消瘦，出现潮热，脉象微数，本方去掉地黄、川芎，加入泽兰叶三倍量，甘草半分；若月经量过多，本方去掉熟地黄，加入生地黄，或者只加黄芩、白术；行经时身热，脉数，头晕，本方加入柴胡、黄芩；行经量微少，或胀或疼，四肢疼痛，加入延胡索、没药、白芷与本方等量，用醋汤调下粉末。月经不调，心腹疼痛，只用川芎、当归两味药，名为君臣散。气冲经脉，导致月经频繁并至，脐下多痛，加入芍药；月经欲行时，脐腹绞痛，加入玄胡索、槟榔、苦楝子，木香减半；经血涩少，加入葵花、红花；月经刚来或刚断，或有往来寒热，先宜服用小柴胡汤，后用四物汤调和；月经过期而作痛，是血气俱虚，宜本方配合四君子汤服用。
治疗月经过期不行的方剂：
玄胡索（一钱）、香附、枳壳（各半钱）。
以上研为细末，用杜牛膝捣取汁半钟，空腹调服。
交加地黄丸，治疗月经不调，血块气痞，肚腹疼痛。
组成：生地黄（一斤）、老生姜（一斤）、玄胡索、当归、川芎、白芍（二两）、没药、木香（各一两）、桃仁（去皮尖）、人参（各一两半）、香附子（半斤）。
先将地黄、生姜分别捣汁，用姜汁浸泡地黄渣，用地黄汁浸泡姜渣，直到汁液浸尽为止。然后将其余药物研为细末，混合在一起，晒干后再次研为细末，用醋糊制成如梧桐子大小的丸剂。空腹服用五十丸，姜汤送服。
当归散，治疗经脉不通。
组成：当归、穿山甲（灰炒）、蒲黄（各半两，炒）、辰砂（一钱）、麝香（少许）。
以上研为细末。用酒调服二钱。
琥珀散，治疗月经不通，心膈迷闷，腹部脏腑撮痛。
组成：台乌（二两）、当归、莪术（各一两）。
以上研为细末。空腹用温酒调服二钱，并用食物压住药力。产后各种疾病，用炒姜酒调服。
通经丸，治疗妇女及未婚女子，月经不通，脐腹疼痛，或形成血瘕。
组成：川椒（炒）、莪术、干漆（炒至烟尽）、当归、青皮、干姜、大黄（煨）、桃仁（去皮尖，炒）、川乌（炮）、桂心（各等分）。
以上研为细末，将一半药物用米醋熬成膏状，与剩余药物混合成团，在臼中捣匀，制成如梧桐子大小的丸剂，阴干。每次服用三五十丸，醋汤送服。严氏方中没有川乌，有红花。
红花当归散，治疗妇人血脏虚竭，或积瘀血，月经不行，时常腰痛胯重疼，小腹坚硬，以及未婚女子月经不行。
组成：红花、当归尾、紫葳（即凌霄花）、牛膝、甘草（炙）、苏木（各三两）、白芷、桂心（一两半）、赤芍（九两）、刘寄奴（五两）。
以上研为细末。空腹用热酒调服三钱。又名凌霄花散。
For women whose menstruation is delayed, it is due to blood deficiency; Siwu Tang (Four Substances Decoction) should be used with added Renshen (Ginseng Root) and Baizhu (Atractylodis Rhizoma). If phlegm-dampness is present, add Nanxing (Arisaematis Rhizoma), Banxia (Pinelliae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). Menstruation arriving early is caused by blood heat; Siwu Tang should be used with added Huanglian (Coptidis Rhizoma). Menstruation that is delayed, dark purple in color, and contains clots is also due to blood heat, and must be accompanied by pain; Siwu Tang should be used with added Xiangfu (Cyperi Rhizoma) and Huanglian. If symptoms alleviate after taking these, they may continue to be taken. In obese individuals, if menstruation arrives before the expected date and is excessive, this indicates excessive phlegm, blood deficiency, and heat; the aforementioned pill formula should be used, with additional Huanglian and Baizhu processed into pills. If ginger juice stir-frying is required, process the herbs with ginger juice. For obese individuals who have overindulged in food and suffer from irregular menstruation, this is due to damp-phlegm; Cangzhu (Atractylodis Rhizoma), Banxia, Shishi (Talcum), Fuling (Poria), Baizhu, Xiangfu, Chuanxiong (Ligustici Chuanxiong Rhizoma), and Danggui (Angelicae Sinensis Radix) are indicated. For abdominal pain occurring near the time of menstruation, Siwu Tang should be used with added Chenpi, Yanhusuo (Corydalis Rhizoma), Mudanpi (Moutan Cortex), and Gancao (Licorice Root). For severe pain, Doulin Jiu (Soybean-infused Wine) should be administered; for mild pain, Suogen (Rubia Cordifolia Root) should be boiled in child's urine, mixed with powdered, stir-fried Huangqin (Scutellariae Radix), and formed into pills. For excessive menstrual flow that cannot be stopped, Sanbu Wan (Three Tonics Pill) should be used with added Suogen, Guiban (Testudinis Carapax et Plastrum), and Jinmao Gouji (Cibotii Rhizoma). For yin deficiency causing long-term obstruction of the meridians, astringent urination, and body pain, Siwu Tang should be used with added Cangzhu, Niuxi (Achyranthis Bidentatae Radix), Chenpi, and Sheng Gancao (Raw Licorice Root). Additionally, Cangsha Wan (Cangzhu and Rubia Pill) with added Cang'erzi (Xanthii Fructus) and Jiushaoyao (Wine-processed Peony Root) should be made into pills and taken while decocting the previous prescription.
The following formulas treat menorrhagia (excessive menstrual bleeding):
Huangqin (Stir-fried Coptidis Rhizoma), Shaoyao (Stir-fried Peony Root), Guiban (Roasted Testudinis Carapax et Plastrum, each 1 liang), Huangbai (Stir-fried Phellodendri Cortex, 3 qian), Chunshugenpi (Bark of Toona sinensis, 7.5 qian), Xiangfuzi (2 qian).
Grind all ingredients into powder, bind with wine paste into pills. Take 50 pills on an empty stomach with warm wine or plain water.
Another formula treats amenorrhea caused by accumulated phlegm damaging the menses, accompanied by delirium at night:
Gualouzi (Trichosanthis Semen, 1 liang), Huanglian (Coptidis Rhizoma, 0.5 liang), Wuzhuyu (Evodiae Fructus, 10 grains), Taoren (Persicae Semen, 50 grains), Hongqu (Red Yeast Rice, 2 qian), Sharen (Amomi Fructus, 3 liang).
Grind into powder, dissolve cooking cake dough in fresh ginger juice to form pills the size of loquat seeds. Take 100 pills on an empty stomach.
Another formula treats pain caused by all types of blood stasis:
Xiangfu (Cyperi Rhizoma, 4 liang, boiled in vinegar), Walengzi (Arcae Shell, 2 liang, boiled in vinegar for one day and night), Taoren (Persicae Semen, 2 liang), Mudanpi (Moutan Cortex), Dahuang (Rhubarb Root and Rhizome, steamed), Danggui (Angelicae Sinensis Radix, each 1 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma), Honghua (Carthami Flos, each 0.5 liang).
Grind into powder, bind with steamed wheat cake into pills the size of loquat seeds. Take 30–50 pills on an empty stomach with warm wine.
Attached Formulas:
Siwu Tang (Four Substances Decoction) treats deficiency and damage to the Chong and Ren vessels, irregular menstruation, and umbilical/abdominal pain.
Ingredients: Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shaoyao (Peony Root), Shudihuang (Prepared Rehmanniae Radix) in equal parts.
Decoct in water and take orally. Modifications are as follows:
If menstrual flow is slightly scanty and gradually stops, accompanied by vexation and pain in hands and feet, gradual emaciation, tidal fever, and a faint, rapid pulse, remove Dihuang (Rehmanniae Radix) and Chuanxiong from the base formula, and add Zelan Ye (Leonuri Herba) in triple quantity, plus 0.5 fen of Gancao (Licorice Root). If menstrual flow is excessive, remove Shudihuang from the base formula and add Shengdihuang (Fresh Rehmanniae Radix), or simply add Huangqin (Scutellariae Radix) and Baizhu (Atractylodis Rhizoma). If fever occurs during menstruation with a rapid pulse and dizziness, add Chaihu (Bupleuri Radix) and Huangqin. If menstrual flow is slightly scanty, or accompanied by distension/pain and limb pain, add Yanhusuo (Corydalis Rhizoma), Moyao (Myrrha), and Baizhi (Angelicae Dahuricae Radix) in equal amounts to the base formula, taken as powder mixed with vinegar water. For irregular menstruation with heart/abdominal pain, use only Chuanxiong and Danggui, named Junchen San (Monarch-Minister Powder). If qi rushes to the meridians causing frequent and overlapping menses with much pain below the umbilicus, add Shaoyao. If menstruation is about to start with cramping pain in the umbilical/abdominal region, add Yanhusuo, Binglang (Areca Seed), and Koushen (Meliae Cortex); reduce Muxiang (Aucklandiae Radix) by half. If menstrual flow is scanty and difficult, add Kuihua (Sunflower Pollen) and Honghua (Carthami Flos). If menstruation has just started or just stopped, or if there are alternating chills and fever, first administer Xiaochaihu Tang (Minor Bupleurum Decoction), then harmonize with Siwu Tang. If pain occurs after menstruation has passed, it indicates deficiency of both blood and qi; take the base formula together with Sijunzi Tang (Four Gentlemen Decoction).
Formula treating delayed menstruation not arriving:
Yanhusuo (Corydalis Rhizoma, 1 qian), Xiangfu (Cyperi Rhizoma), Zhike (Aurantii Fructus Immaturus, each 0.5 qian).
Grind into powder, mix with half a zhong of juice extracted from crushing Du Niuxi (Dipsaci Radix), and take on an empty stomach.
Jiaojiao Dihuang Wan (Interlacing Rehmannia Pill) treats irregular menstruation, blood clumps and qi stagnation, and abdominal pain.
Ingredients: Shengdihuang (Fresh Rehmanniae Radix, 1 jin), Lao Shengjiang (Old Ginger Rhizome, 1 jin), Yanhusuo (Corydalis Rhizoma), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (White Peony Root, 2 liang), Moyao (Myrrha), Muxiang (Aucklandiae Radix, each 1 liang), Taoren (Persicae Semen, peeled and pitted, 1.5 liang), Renshen (Ginseng Root, 1.5 liang), Xiangfuzi (Cyperi Rhizoma, 0.5 jin).
First, crush Dihuang and Shengjiang separately to extract juice. Soak the residue of Dihuang in Shengjiang juice, and soak the residue of Shengjiang in Dihuang juice, until the juices are fully absorbed. Then, grind the remaining herbs into powder, mix them together, dry them under the sun, grind again into fine powder, bind with vinegar paste into pills the size of loquat seeds. Take 50 pills on an empty stomach with ginger soup.
Danggui San (Angelica Powder) treats obstruction of the menstrual channels.
Ingredients: Danggui (Angelicae Sinensis Radix), Chuanshanjia (Pangolin Scale, ash-fried), Puhuang (Typhae Pollen, each 0.5 liang, stir-fried), Chensha (Cinnabar, 1 qian), Shexiang (Moschus, a small amount).
Grind into powder. Mix with wine and take 2 qian.
Hupo San (Amber Powder) treats amenorrhea, mental confusion and oppression in the chest/diaphragm, and pinching pain in the abdominal organs.
Ingredients: Taiwu (Curculiginis Rhizoma, 2 liang), Danggui (Angelicae Sinensis Radix), Ezhu (Curcumae Rhizoma, each 1 liang).
Grind into powder. Take 2 qian mixed with warm wine on an empty stomach, followed by food to suppress the medication. For various postpartum disorders, take with stir-fried ginger wine.
Tongjing Wan (Menstruation-Unblocking Pill) treats amenorrhea in married or unmarried women, umbilical/abdominal pain, or formation of blood masses (blood lei).
Ingredients: Chuanjiao (Sichuan Pepper, stir-fried), Ezhu (Curcumae Rhizoma), Ganqi (Dry Resin of Toxicodendron vernicifluum, stir-fried until smoke ceases), Danggui (Angelicae Sinensis Radix), Qingpi (Green Citrus Peel), Ganjiang (Dried Ginger Rhizome), Dahuang (Rhubarb Root and Rhizome, baked), Taoren (Persicae Semen, peeled, pitted, and stir-fried), Chuanwu (Aconiti Radix, processed), Guixin (Cinnamon Twig Bark, all in equal parts).
Grind into powder. Take half of the powder, boil with rice vinegar into a paste, mix with the remaining powder to form a mass, pound in a mortar, and shape into pills the size of loquat seeds. Dry in the shade. Take 30–50 pills per dose with vinegar water. The Fang from Yan Shi does not contain Chuanwu but includes Honghua (Carthami Flos).
Honghua Danggui San (Safflower and Angelica Powder) treats exhaustion of the blood viscera in women, or accumulation of stagnant blood causing amenorrhea, occasional lower back and hip pain/heaviness, hardness of the lower abdomen, and amenorrhea in unmarried girls.
Ingredients: Honghua (Carthami Flos), Dangguiwei (Tail of Angelicae Sinensis Radix), Ziwei (Campsis grandiflora Flower, i.e., Lingxiaohua), Niuxi (Achyranthis Bidentatae Radix), Gancao (Licorice Root, roasted), Sumu (Sappan Wood, each 3 liang), Baizhi (Angelicae Dahuricae Radix), Guixin (Cinnamon Twig Bark, 1.5 liang), Chishao (Red Peony Root, 9 liang), Liujinu (Artemisiae Annuae Herba, 5 liang).
Grind into powder. Take 3 qian mixed with hot wine on an empty stomach. Also known as Lingxiaohua San (Lingxiaohua Powder).
Daotan Tang (Phlegm-Conducting Decoction), see section on Phlegm.
Sanbu Wan (Three Tonics Pill), see section on Various Deficiencies.
Cangsha Wan (Cangzhu and Rubia Pill), see section on Cough.
Yueju Wan (Overcoming Depression Pill), see section on Six Stagnations.