经脉者,风木之所化生也。人与天地相参也,与日月相应也,男子应日,女子应月,月满则海水西盛,
鱼脑充,蚌蛤实,经脉溢;月晦则海水东盛,鱼脑减,蚌蛤虚,经脉衰。月有圆缺,阴有长消,经脉调畅
,盈缩按时,月满而来,月亏而止者,事之
常也。调经养血之法,首以崇阳为主。盖经水之原,化于己土,脾阳左旋温升,而生营血,所谓中焦受
气取汁变化而赤是谓血也。血藏于肝,而总统于冲任,阴中阳盛,生意沛然,一承雨露,煦濡长养,是
以成孕而怀子也。如经脉闭结者,缘木气盘结,发生不遂,经血凝滞而不行,由是乙木沉郁而生下热,甲
木浮升而生上热。人知其经热之盛,而不知脾阳之虚,若以凉药投之误矣。以桂枝当归桃仁汤主之。如经脉
崩漏者,缘木气郁陷,升发不遂,经血陷流而不止。血之周行上下,赖中气有以运之。若中土不固,堤防
溃败,是以泛滥而倾注矣。以艾叶姜苓汤主之。如经水先期而至者,缘木气之疏泄,即崩漏之机也。仍以艾叶
姜苓汤主之。如经水后期而至者,缘木气之遏郁,即闭结之机也。以姜苓阿胶汤主之。如经水结瘀紫黑
者,缘血温则行,寒则滞,滞久则湮郁而腐败,是以成块而不鲜矣。以苓桂丹参汤主之。如经前腹痛者,缘水
土寒湿,乙木抑遏,血脉凝湮不畅,月满血盈,经水不利,木气郁勃冲突,克伤脾脏,是以腹痛也。中气
不运,胃气上逆,是以有恶心呕吐等证,以苓桂丹参汤主之。如经后腹痛者,缘经后血虚,肝木失荣,枯燥
生风,贼伤土气,是以腹痛也。以归地芍药汤主之。如热入血室者,缘经水适来之时,外感中风,发热恶寒
,七八日后,六经既遍,表解脉迟,热退身凉,而胸胁痞满,状如结胸,语言谵妄,神识不清,此谓热入
血室也。以柴胡地黄汤主之。如带下者,缘相火下衰,肾水澌寒,经血凝瘀,结于少腹,阻格阴精上济之路
,肾水失藏,肝木疏泄,是以精液淫 下流而为带也。水下泄而火上炎,故多有夜热毛蒸、掌烦口燥
之证。以温经汤主之。如骨蒸者,缘水寒土湿,肝木不升,温气下郁,陷于肾水,肾主骨,是以骨蒸而夜热
也。以苓桂柴胡汤主之。
桂枝当归桃仁汤
桂枝(三钱) 芍药(三钱) 当归(三钱) 桃
仁(三钱) 甘草(二钱) 茯苓(三钱) 川芎(三钱) 红花(三钱) 水煎大半杯,温服。治经脉闭结,上
热加黄芩,中寒加干姜,中气不足加人参,血块坚硬加鳖甲、 虫,脾郁加砂仁。
艾叶姜苓汤
甘草(二钱) 茯苓(三钱) 艾叶(三钱) 芍药(三钱) 生姜(三钱) 丹皮(三钱)
首乌(三钱) 阿胶(三钱炒珠) 水煎大半杯,温服。治经脉崩漏不效,即用生姜一两,阿胶五钱,
治之必效。
艾叶姜苓汤
(方见上) 治经水先期
姜苓阿胶汤
丹皮(三钱) 甘草(二钱) 桂枝(三钱) 茯苓(三钱) 干姜(三钱) 川芎(三钱) 当
归(三钱) 阿胶(三钱) 水煎大半杯,温服。治经水后期。
苓桂丹参汤
桂枝(三钱) 甘草(二钱) 生姜(三钱) 茯苓(三钱) 丹皮(三钱) 丹参(三钱) 当归
(三钱) 川芎(二钱) 水煎大半杯,温服。治经前腹痛。
归地芍药汤
当归(三钱) 地黄(三钱) 芍药(三钱) 甘草(二钱) 桂枝(三钱) 茯苓(三钱)
首乌(三钱) 水煎大半杯,温服。治经后腹痛。
柴胡地黄汤
柴胡(三钱) 黄芩(二钱) 甘草(二钱) 芍药(三钱) 丹皮(三钱) 地黄(三钱) 水
煎大
半杯,温服。治热入血室,表未解者,加苏叶、生姜。
温经汤
人参(三钱) 甘草(二钱) 生姜(三钱) 桂枝(三钱) 茯苓(三钱) 丹皮(三钱) 当归
(三
钱) 阿胶(三钱) 半夏(三钱) 芎 (二钱) 吴茱萸(二钱) 芍药(三钱) 水煎一杯,温服。治妇人
带下及少腹寒冷,久不受胎。或崩漏下血,或经来过多,或至期不来者。如阴精流泻加牡蛎,瘀血坚硬加桃
仁、鳖甲。
苓桂柴胡汤
茯苓(三钱) 甘草(二钱) 丹皮(三钱) 桂枝(三钱) 芍药(三钱) 柴胡(三钱) 半
夏
(三钱) 水煎大半杯,温服。治
妇人骨蒸,如热蒸不减,加生地、黄芩。蒸退,即用干姜、附子、以温水土。
经脉,是由风木之气所化生而成的。人与天地相互参合,与日月相应相通。男子对应太阳,女子对应太阴(月亮)。月亮圆满时,海水向西涌动充盈,鱼脑饱满,蚌蛤充实,人的经脉也随之充盈;月亮亏缺时,海水向东涌动,鱼脑减少,蚌蛤空虚,人的经脉也随之衰少。月亮有圆缺变化,阴气有长消过程,经脉通畅,随时间盈缩,月满时气血来盛,月亏时气血止息,这是事物运行的常态。调理月经、养血的方法,首要在于崇尚阳气。因为经血的源头,由脾土(己土)化生,脾阳向左旋转温升,从而生成营血,这就是所谓“中焦受气取汁,变化而赤是谓血”。血液贮藏于肝脏,并由冲脉和任脉统领,在阴中有阳盛的状态,生机充沛,一旦得到雨露般的滋养濡润,便能孕育怀胎。
如果经脉闭结不通,是因为肝木之气盘结郁滞,生发功能受阻,导致经血凝滞而不行。由此乙木(肝)沉郁而产生下焦之热,甲木(胆)浮升而产生上焦之热。人们只知道经血有热,却不知道这是脾阳虚弱的缘故,如果用寒凉药物治疗就错了。应当用桂枝当归桃仁汤主治。
如果经脉崩漏(非经期大量出血或淋漓不尽),是因为肝木之气郁陷,升发功能受阻,经血下流不止。血液在周身上下循环,依赖中气来运化推动。如果中土不稳固,堤防溃败,就会导致血液泛滥倾注。应当用艾叶姜苓汤主治。
如果月经先期而至,是因为肝木之气疏泄太过,这其实是崩漏的机转。仍然用艾叶姜苓汤主治。
如果月经后期而至,是因为肝木之气遏抑郁滞,这其实是闭结的机转。应当用姜苓阿胶汤主治。
如果经血结成瘀块且颜色紫黑,是因为血得温则运行,得寒则凝滞。凝滞久了就会湮郁腐败,所以形成血块且不新鲜。应当用苓桂丹参汤主治。
如果经前腹痛,是因为水土寒湿,乙木被抑遏,血脉凝滞不畅。月满时血盈,经水排泄不利,木气郁勃冲突,克制损伤脾脏,所以产生腹痛。中气不运,胃气上逆,所以出现恶心呕吐等症状,应当用苓桂丹参汤主治。
如果经后腹痛,是因为经后血虚,肝木失去荣养,枯燥而生内风,贼害脾土之气,所以产生腹痛。应当用归地芍药汤主治。
如果发生热入血室证,是因为正值月经来潮之时,外感中风邪气,出现发热恶寒。七八日后,六经病证遍传,表证已解,脉象变迟,热退身凉,但胸胁部痞塞胀满,症状像结胸证,言语错乱妄言,神识不清,这叫做热入血室。应当用柴胡地黄汤主治。
如果出现带下病,是因为相火下衰,肾水寒冷,经血凝瘀,结聚于少腹,阻断了阴精上济的路径。肾水失于固藏,肝木疏泄失常,所以精液淫溢下流成为带下。水下泄而火上炎,所以多有夜间发热如蒸、手掌心烦热、口燥等证状。应当用温经汤主治。
如果出现骨蒸(阴虚发热,感觉热自骨内向外透发),是因为水寒土湿,肝木不能升发,温气下郁,陷入肾水。肾主骨,所以出现骨蒸和夜间发热。应当用苓桂柴胡汤主治。
桂枝当归桃仁汤
组成:桂枝三钱,芍药三钱,当归三钱,桃仁三钱,甘草二钱,茯苓三钱,川芎三钱,红花三钱。
用法:水煎至大半杯,温服。
主治:经脉闭结。若上热加黄芩,中寒加干姜,中气不足加人参,血块坚硬加鳖甲、䗪虫,脾郁加砂仁。
艾叶姜苓汤
组成:甘草二钱,茯苓三钱,艾叶三钱,芍药三钱,生姜三钱,丹皮三钱,首乌三钱,阿胶三钱(炒珠)。
用法:水煎至大半杯,温服。
主治:经脉崩漏。若无效,即用生姜一两,阿胶五钱治疗,必有效。
姜苓阿胶汤
组成:丹皮三钱,甘草二钱,桂枝三钱,茯苓三钱,干姜三钱,川芎三钱,当归三钱,阿胶三钱。
用法:水煎至大半杯,温服。
主治:经水后期而至。
苓桂丹参汤
组成:桂枝三钱,甘草二钱,生姜三钱,茯苓三钱,丹皮三钱,丹参三钱,当归三钱,川芎二钱。
用法:水煎至大半杯,温服。
主治:经前腹痛。
归地芍药汤
组成:当归三钱,地黄三钱,芍药三钱,甘草二钱,桂枝三钱,茯苓三钱,首乌三钱。
用法:水煎至大半杯,温服。
主治:经后腹痛。
柴胡地黄汤
组成:柴胡三钱,黄芩二钱,甘草二钱,芍药三钱,丹皮三钱,地黄三钱。
用法:水煎至大半杯,温服。
主治:热入血室。若表证未解者,加苏叶、生姜。
温经汤
组成:人参三钱,甘草二钱,生姜三钱,桂枝三钱,茯苓三钱,丹皮三钱,当归三钱,阿胶三钱,半夏三钱,川芎二钱,吴茱萸二钱,芍药三钱。
用法:水煎一杯,温服。
主治:妇人带下及少腹寒冷,久不受孕。或崩漏下血,或经来过多,或到期不来。若阴精流泻加牡蛎,瘀血坚硬加桃仁、鳖甲。
苓桂柴胡汤
组成:茯苓三钱,甘草二钱,丹皮三钱,桂枝三钱,芍药三钱,柴胡三钱,半夏三钱。
用法:水煎大半杯,温服。
主治:妇人骨蒸。若热蒸不减,加生地、黄芩。热退后,即用干姜、附子以温补水土。
Meridians are generated from the transformation of Wind-Wood Qi. Humans correspond with Heaven and Earth, and resonate with the Sun and Moon. Men correspond to the Sun, while women correspond to the Moon (Taiyin). When the moon is full, the seawater surges westward and becomes abundant; fish brains become plump, and clams/shells become solid; human meridians also become full. When the moon wanes, the seawater surges eastward; fish brains diminish, and clams/shells become empty; human meridians also decline. The moon has waxing and waning phases, and Yin Qi has growth and decay processes. Meridians flow smoothly, expanding and contracting according to time; blood qi becomes abundant when the moon is full and subsides when it wanes. This is the normal course of events.
The method for regulating menstruation and nourishing blood primarily focuses on revering Yang Qi. The source of menstrual blood is transformed by Spleen Earth (Ji Earth). Spleen Yang rotates leftward and warms upward, thereby generating Ying-Blood. This is what is meant by "the Middle Jiao receives Qi, extracts essence, transforms it into red, and this is called Blood." Blood is stored in the Liver and is commanded by the Chong and Ren vessels. Within Yin, there is an abundance of Yang, resulting in vigorous vitality. Once nourished and moistened like rain and dew, pregnancy and conception can occur.
If menstrual flow is obstructed and closed, it is due to the stagnation and knotting of Liver Wood Qi, where the sprouting function fails. Consequently, menstrual blood coagulates and does not flow. From this, Yi Wood (Liver) sinks and depresses, generating Lower Heat, while Jia Wood (Gallbladder) floats and ascends, generating Upper Heat. People know that there is excessive heat in the menses but do not realize that Spleen Yang is deficient. Using cold medicines in such cases would be a mistake. One should use Guizhi Danggui Taoren Decoction as the primary treatment.
If there is metrorrhagia or uterine bleeding (Beng Lou), it is because Liver Wood Qi is depressed and sunken, failing to ascend and sprout properly, causing menstrual blood to flow downward uncontrollably. The circulation of blood throughout the body relies on Middle Qi to transport and move it. If the Middle Earth is unstable and the dikes collapse, blood will flood and pour out uncontrollably. One should use Aiye Jiangling Decoction as the primary treatment.
If menstruation arrives early, it is due to excessive dispersing and draining of Liver Wood Qi, which is essentially the mechanism of metrorrhagia. One should still use Aiye Jiangling Decoction as the primary treatment.
If menstruation arrives late, it is due to the suppression and depression of Liver Wood Qi, which is essentially the mechanism of obstruction. One should use Jiangling Ejiao Decoction as the primary treatment.
If menstrual blood forms clots and appears purple-black, it is because blood flows when warm and stagnates when cold. Prolonged stagnation leads to blockage and corruption, resulting in clots that are not fresh. One should use Linggui Danshen Decoction as the primary treatment.
If there is abdominal pain before menstruation, it is due to Cold-Dampness in Water and Earth, suppressing Yi Wood. Blood vessels become stagnant and unsmooth. When the moon is full and blood is abundant, menstrual flow is difficult. Wood Qi becomes turbulent and conflicts, attacking and damaging the Spleen, causing abdominal pain. Middle Qi fails to transport, and Stomach Qi rebels upward, leading to symptoms such as nausea and vomiting. One should use Linggui Danshen Decoction as the primary treatment.
If there is abdominal pain after menstruation, it is because blood deficiency after menstruation causes Liver Wood to lose nourishment. Dryness generates internal Wind, which attacks Earth Qi, causing abdominal pain. One should use Guide Shaoyao Decoction as the primary treatment.
If "Heat Entering the Blood Chamber" occurs, it is because during the onset of menstruation, external Wind-Stroke pathogens invade, causing fever and aversion to cold. After seven or eight days, when the Six Meridians have been traversed, the exterior resolves, the pulse becomes slow, fever subsides, and the body feels cool, yet there is stuffiness and fullness in the chest and hypochondrium, resembling Jie Xiong (Chest Binding), with delirious speech and unclear consciousness. This is called Heat Entering the Blood Chamber. One should use Chaihu Dihuang Decoction as the primary treatment.
If leukorrhea (Dai Xia) occurs, it is because Minister Fire declines downward and Kidney Water becomes icy cold. Menstrual blood coagulates and stasis knots in the Lower Abdomen, blocking the path for Yin Essence to ascend and nourish. Kidney Water loses its storing capacity, and Liver Wood disperses excessively, causing essence fluids to overflow and flow downward as leukorrhea. As water drains downward and fire flares upward, there are often symptoms of night fevers feeling like steaming, vexation in the palms, and dry mouth. One should use Wenjing Decoction as the primary treatment.
If Bone Steaming (Gu Zheng) occurs, it is due to Cold Water and Damp Earth, preventing Liver Wood from ascending. Warm Qi sinks and depresses, falling into Kidney Water. Since the Kidney governs bones, bone steaming and night fevers result. One should use Linggui Chaihu Decoction as the primary treatment.
Guizhi Danggui Taoren Decoction
Ingredients: Guizhi (Cinnamon Twig) 3 qian, Shaoyao (Peony Root) 3 qian, Danggui (Angelica Sinensis) 3 qian, Taoren (Peach Kernel) 3 qian, Gancao (Licorice Root) 2 qian, Fuling (Poria) 3 qian, Chuanxiong (Sichuan Lovage Rhizome) 3 qian, Honghua (Safflower) 3 qian.
Usage: Decoct in water until half a cup remains, take warm.
Indications: Obstructed menstruation. Add Huangqin (Scutellaria Root) for Upper Heat, Ganjiang (Dried Ginger) for Middle Cold, Renshen (Ginseng) for insufficient Middle Qi, Biejia (Turtle Shell) and E chong (Ground Beetle) for hard blood clots, and Sharen (Amomum Fruit) for Spleen Depression.
Aiye Jiangling Decoction
Ingredients: Gancao (Licorice Root) 2 qian, Fuling (Poria) 3 qian, Aiye (Mugwort Leaf) 3 qian, Shaoyao (Peony Root) 3 qian, Shengjiang (Fresh Ginger) 3 qian, Danpi (Moutan Cortex) 3 qian, Shouwu (Polygonum Multiflorum) 3 qian, Ejiao (Donkey-Hide Gelatin) 3 qian (stir-fried until charred).
Usage: Decoct in water until half a cup remains, take warm.
Indications: Metrorrhagia. If ineffective, use Shengjiang (Fresh Ginger) 1 liang and Ejiao (Donkey-Hide Gelatin) 5 qian for treatment, which will be effective.
Aiye Jiangling Decoction (Formula seen above)
Indications: Early menstruation.
Jiangling Ejiao Decoction
Ingredients: Danpi (Moutan Cortex) 3 qian, Gancao (Licorice Root) 2 qian, Guizhi (Cinnamon Twig) 3 qian, Fuling (Poria) 3 qian, Ganjiang (Dried Ginger) 3 qian, Chuanxiong (Sichuan Lovage Rhizome) 3 qian, Danggui (Angelica Sinensis) 3 qian, Ejiao (Donkey-Hide Gelatin) 3 qian.
Usage: Decoct in water until half a cup remains, take warm.
Indications: Late menstruation.
Linggui Danshen Decoction
Ingredients: Guizhi (Cinnamon Twig) 3 qian, Gancao (Licorice Root) 2 qian, Shengjiang (Fresh Ginger) 3 qian, Fuling (Poria) 3 qian, Danpi (Moutan Cortex) 3 qian, Danshen (Salvia Miltiorrhiza) 3 qian, Danggui (Angelica Sinensis) 3 qian, Chuanxiong (Sichuan Lovage Rhizome) 2 qian.
Usage: Decoct in water until half a cup remains, take warm.
Indications: Premenstrual abdominal pain.
Guide Shaoyao Decoction
Ingredients: Danggui (Angelica Sinensis) 3 qian, Dihuang (Rehmannia Root) 3 qian, Shaoyao (Peony Root) 3 qian, Gancao (Licorice Root) 2 qian, Guizhi (Cinnamon Twig) 3 qian, Fuling (Poria) 3 qian, Shouwu (Polygonum Multiflorum) 3 qian.
Usage: Decoct in water until half a cup remains, take warm.
Indications: Postmenstrual abdominal pain.
Chaihu Dihuang Decoction
Ingredients: Chaihu (Bupleurum Root) 3 qian, Huangqin (Scutellaria Root) 2 qian, Gancao (Licorice Root) 2 qian, Shaoyao (Peony Root) 3 qian, Danpi (Moutan Cortex) 3 qian, Dihuang (Rehmannia Root) 3 qian.
Usage: Decoct in water until half a cup remains, take warm.
Indications: Heat Entering the Blood Chamber. If the exterior syndrome has not resolved, add Zisuye (Perilla Leaf) and Shengjiang (Fresh Ginger).
Wenjing Decoction
Ingredients: Renshen (Ginseng) 3 qian, Gancao (Licorice Root) 2 qian, Shengjiang (Fresh Ginger) 3 qian, Guizhi (Cinnamon Twig) 3 qian, Fuling (Poria) 3 qian, Danpi (Moutan Cortex) 3 qian, Danggui (Angelica Sinensis) 3 qian, Ejiao (Donkey-Hide Gelatin) 3 qian, Banxia (Pinellia Tuber) 3 qian, Xiong (Chuanxiong/Sichuan Lovage Rhizome) 2 qian, Wuzhuyu (Evodia Fruit) 2 qian, Shaoyao (Peony Root) 3 qian.
Usage: Decoct in water until one cup remains, take warm.
Indications: Leukorrhea in women, coldness in the lower abdomen, and infertility over a long period. Also for metrorrhagia, excessive menstrual flow, or delayed menstruation. If Yin essence leaks, add Muli (Oyster Shell); if blood stasis is hard, add Taoren (Peach Kernel) and Biejia (Turtle Shell).
Linggui Chaihu Decoction
Ingredients: Fuling (Poria) 3 qian, Gancao (Licorice Root) 2 qian, Danpi (Moutan Cortex) 3 qian, Guizhi (Cinnamon Twig) 3 qian, Shaoyao (Peony Root) 3 qian, Chaihu (Bupleurum Root) 3 qian, Banxia (Pinellia Tuber) 3 qian.
Usage: Decoct in water until half a cup remains, take warm.
Indications: Bone steaming in women. If the steaming heat does not subside, add Shengdi (Rehmannia Root) and Huangqin (Scutellaria Root). Once the heat recedes, use Ganjiang (Dried Ginger) and Fuzi (Aconite Root) to warm Water and Earth.