妇人有经未行之前一二日忽然腹疼而吐血，人以为火热之极也，谁知是肝气之逆乎！夫肝之性最急，宜顺而不
宜逆，顺则气安，逆则气动；血随气为行止，气安则血安，气动则血动，亦勿怪其然也。或谓经逆在肾不在肝，何以
随血妄行，竟至从口上出也，是肝不藏血之故乎？抑肾不纳气而然乎？殊不知少阴之火急如奔马，得肝火直冲而上，
其势最捷，反经而为血，亦至便也，正不必肝不藏血，始成吐血之症，但此等吐血与各经之吐血有不同者。盖各经
之吐血，由内伤而成，经逆而吐血，乃内溢而激之使然也，其症有绝异，而其气逆则一也。治法似宜平肝以顺气，而
不必益精以补肾矣。虽然，经逆而吐血，虽不大损夫血，而反复颠倒，未免太伤肾气，必须于补肾之中，用顺气之
法始为得当。
方用顺经汤。
当归（五钱，酒洗） 大熟地（五钱，九蒸） 白芍（二钱，酒炒） 丹皮（五钱） 白茯苓（三钱） 沙参（三
钱） 黑芥穗（三钱）
水煎服。一剂而吐血止，二剂而经顺，十剂不再发。此方于补肾调经之中，而用引血归经之品，是和血之法，
实寓顺气之法也。肝不逆而肾气自顺，肾气既顺，又何经逆之有哉！
眉批∶妇人年壮吐血往往有之，不可作劳症治。若认为劳症，必至肝气愈逆，非劳反成劳矣。方加茜草一钱，
怀牛膝八分尤妙。
歌括∶经前腹痛吐血浆，误认火热乃荒唐。
肝气不舒经逆上，治宜顺气补肾良。
顺经当归熟地黄，芍丹茯沙芥穗襄。
一剂吐止二经顺，连服十剂永泰康。
妇女在月经来潮前一两天，突然腹痛并吐血，人们认为是火热之极所致，哪里知道这是肝气上逆造成的呢！肝的生理特性最为刚急，适宜顺其性而不宜逆其性，顺则气机安宁，逆则气机躁动；血液随着气的运行而运行或停止，气安宁则血安宁，气躁动则血妄行，也不必对此感到奇怪。有人问：经血逆行是在肾而不在肝，为什么随着血液妄行，竟然从口中涌出呢？这是肝不藏血的原因吗？还是肾不能纳气导致的呢？殊不知少阴（肾）之火急如奔马，得到肝火的直冲而上，其势头最迅猛，反而使经血变为吐血，也是非常容易发生的，并不一定是因为肝不藏血，才形成吐血的病症，只是这种吐血与各个经络引起的吐血有所不同。大概各经的吐血，是由内伤而成，而经血逆行导致的吐血，乃是经血内溢而激惹所致，症状截然不同，但气机上逆这一病机是一致的。治疗方法似乎应该平抑肝木以顺气，而不必通过益精来补肾了。虽然如此，经血逆行导致吐血，虽然不至于大量损耗血液，但反复发作，未免太损伤肾气，必须在补肾的同时，运用顺气的方法才算得当。
方剂用顺经汤。
当归（五钱，酒洗），大熟地（五钱，九蒸），白芍（二钱，酒炒），丹皮（五钱），白茯苓（三钱），沙参（三钱），黑芥穗（三钱）。
水煎服。服用一剂后吐血停止，两剂后月经顺畅，十剂后不再复发。此方在补肾调经之中，使用了引血归经的药物，这是和血的方法，实际上蕴含了顺气的方法。肝气不逆则肾气自然顺，肾气既然顺了，又怎么会有经血逆行呢！
眉批：壮年妇女吐血往往有这种情况，不可当作劳损症治疗。如果认为是劳损症，必然导致肝气更加上逆，不是治劳反而成了劳损。方中加茜草一钱，怀牛膝八分尤其妙。
歌括：经前腹痛吐血浆，误认火热乃荒唐。
肝气不舒经逆上，治宜顺气补肾良。
顺经当归熟地黄，芍丹茯沙芥穗襄。
一剂吐止二经顺，连服十剂永泰康。
Women who experience sudden abdominal pain and hematemesis one or two days before the onset of menstruation are often thought by others to be caused by extreme heat-fire. However, who would know that this is actually due to the rebellion of Liver Qi! The nature of the Liver is most urgent and rigid; it should be guided smoothly rather than opposed. When smooth, Qi remains tranquil; when rebellious, Qi becomes agitated. Blood follows Qi in its movement and cessation: when Qi is tranquil, blood is tranquil; when Qi is agitated, blood moves recklessly. One need not be surprised by this phenomenon. Some might ask: If menstrual blood rebels in the Kidney rather than the Liver, why does it follow the blood's reckless flow and emerge from the mouth? Is this because the Liver fails to store blood? Or is it because the Kidney fails to grasp Qi? In fact, the fire of Shaoyin (Kidney) rushes like a galloping horse. When it receives the direct upward rush of Liver Fire, its momentum is extremely swift, causing menstrual blood to transform into hematemesis with great ease. It is not necessary for the Liver to fail in storing blood to cause hematemesis. However, this type of hematemesis differs from that caused by other meridians. Generally, hematemesis from various meridians results from internal injury, whereas hematemesis due to menstrual rebellion is caused by the overflow and agitation of menstrual blood internally. Although the symptoms are vastly different, the underlying mechanism of Qi rebellion is the same. The treatment method seems to favor calming the Liver to smooth Qi, rather than tonifying essence to nourish the Kidney. Nevertheless, although menstrual rebellion leading to hematemesis does not severely deplete blood, the recurrent episodes inevitably damage Kidney Qi significantly. Therefore, it is appropriate to employ methods to smooth Qi within the context of tonifying the Kidney.
The formula used is Shunjing Tang (Smooth Menstruation Decoction).
Danggui (Radix Angelicae Sinensis, 5 qian, washed with wine), Dushudi (Radix Rehmanniae Preparata, 5 qian, steamed nine times), Baishao (Radix Paeoniae Alba, 2 qian, stir-fried with wine), Danpi (Cortex Moutan, 5 qian), Bai Fuling (Poria, 3 qian), Shashen (Radix Glehniae, 3 qian), Hei Jiesui (Fructus Schisandrae Carbonized, 3 qian).
Decoct in water and take orally. After one dose, hematemesis stops; after two doses, menstruation becomes regular; after ten doses, it will not recur. This formula employs herbs that guide blood back to its vessels within the context of tonifying the Kidney and regulating menstruation. This is a method of harmonizing blood, which actually embodies the principle of smoothing Qi. When Liver Qi does not rebel, Kidney Qi naturally flows smoothly. Once Kidney Qi is smooth, how can menstrual rebellion occur?
Marginal Note: Hematemesis in young women occurs frequently and should not be treated as a consumptive disease (Lao Zheng). If treated as such, Liver Qi will become even more rebellious, turning a non-consumptive condition into a consumptive one. Adding Qiancao (Radix Rubiae, 1 qian) and Huainiu Xi (Radix Achyranthis Bidentatae, 8 fen) to the formula is particularly effective.
Verse:
Abdominal pain and bloody vomit before menses,
Mistaking it for heat-fire is absurd.
Liver Qi stagnates, menstruation rebels upward,
Treatment should smooth Qi and tonify Kidney.
Shunjing uses Danggui and Shudi,
Baishao, Danpi, Fuling, Shashen, and Jiesui aid.
One dose stops vomiting, two regulate menses,
Ten doses taken continuously ensure lasting health.