〔丹〕妇人有块，多是血块。
当归丸 治妇人月经不调血积证。
当归 赤芍 川芎 熟地 广术 京三棱（各半钱） 神曲 百草霜（各二钱半）
上为细末，酒糊为丸，桐子大，温水下。
〔《本》〕牛膝根净洗切，焙干捣，下酒煎温服，治妇人血块，立效。
（上轻剂）
〔杜〕尚书媳妇马氏年三十二，腹中血块作疼，经五六年，形已骨立，众皆曰不可为。奈其未死何？
家甚贫，而大小愍之，一日召杜至，告杜曰∶但以济物为怀则可，业已请召明公，非所言也。遂以少物帛赠
杜，杜不受。曰∶但服某药必获安，无以是为疑。遂示方∶用没药、牛膝、干漆、当归各半两， 砂、
木香、水蛭、炒红娘子、炒红花、牡丹皮、朱砂各一分，海马一个，斑蝥去翅足，炒十四个。为末，酒醋
各半升，熬为膏，每日天明，用一皂子大，酒醋化下，一月病退，六十日渐安。果如其言。
（上重剂）
〔垣〕加减四物汤 治妇人血积。
当归 川芎 芍药 熟地 广术 桂（去皮） 京三棱 干漆（炒烟尽，各等分）
上为粗末，每服二钱，水二盏，煎法如常，食前。
〔《大》〕黑神丸
神曲 茴香（各四两） 木香 川椒（炒香，出汗） 丁香（各半两） 槟榔（四个） 干漆（六两，半生半熟，
用姜汤煮半日令香）
上除椒漆外，五物皆半生半炒，为细末，用前生熟漆和丸，如弹子大。又用茴香十二两，铺阴地阴干，候
外干。并茴香收器中，至干，去茴香用。治肾气膀胱 癖，及疝坠五隔血崩，产后诸血，漏下赤白，并一丸，
分四服，死胎一丸，皆绵灰酒下。若难产，炒葵子四十九粒，杵碎，酒煎下。诸疾不过三服， 气十服，膈
气症癖五服，血瘕三丸。
一妇有块如杯，每发痛不可忍，诸药莫愈，投此丸尽三服，杯气尽消，终身不复作矣。
〔云〕没药散 治一切血气，脐腹撮痛，及产后恶露不行，儿枕痛。
血竭 没药（并细研） 桂心 当归 蒲黄 红花 木香 玄胡索 干漆（炒） 赤芍（各等分）
上为极细末，每服二钱，热酒调下，食前。若血块冲心痛甚，危者以大顺散三钱，酒调服，立止。
牡丹散 治妇人久虚羸瘦，血块走疰，心腹疼痛。
牡丹皮 桂心 当归 玄胡索（各一两） 莪术 牛膝 赤芍（各三两） 京三棱（一两半）
上为粗末，每服三钱，水酒各半盏。
〔罗〕木香 砂丸 治妇人 癖积聚，血块刺痛，脾胃虚寒，宿食不消，久不瘥者。
丁香 砂（研） 木香 官桂 附子（炮） 干漆（炒，烟尽） 细墨 大黄（炒锉） 乳香
广术 青皮 京三棱 巴豆霜（减半） 没药（研） 猪牙皂角 干姜（炮。各等分）
上除 砂、乳香、没药外，同为细末，以好醋一升，化开 砂，去渣脚，入银器中熳火熬。次下巴
豆霜、大黄末熬成膏，将前药末与膏为丸，如麻子大。每服三五十丸，食后温水送下，加至大便利为度。
治血积挟热之证，于产后血块求之。
〔《大》〕桃仁煎 治妇人血瘕血积，经候不通。（出《千金方》）
桃仁（去皮尖，炒黄） 大黄 虻虫 朴硝
上四味末之，以醇醋二升半，银石器中熳火煎取一升五合，下桃仁、大黄、虻虫等，不住手搅千下，次下
朴硝，更不住手搅，良久出之，丸如桐子大，前一日不用吃晚饭，五更初，用温酒吞下五丸，日午取下如黑
豆汁鸡肝虾蟆衣。未下再作，见鲜血即止，即以调气血药补之。
肠覃生于肠外，月事时下。石瘕生于胞中，月事不以时下。二病皆似蛊胀。（并见胀门。）
〔《脉》〕诊妇人疝癖积聚，脉弦急者生，虚弱小者死。
〔《甲》〕妇人子脏中有恶血，内逆满痛，石关主之。
【丹溪】妇女体内出现肿块，大多是由血瘀形成的血块。
当归丸：治疗妇女月经不调及血积证。
药材组成：当归、赤芍、川芎、熟地黄、广术（莪术）、京三棱（各半钱）；神曲、百草霜（各二钱半）。
制法与用法：将上述药物研成细末，用酒调糊制作成丸剂，大小如梧桐子，温开水送服。
【《本草》】取牛膝根洗净切片，焙干后捣碎，加酒煎煮后温服，可治疗妇女血块，效果显著且迅速。
（此为轻剂）
【杜】尚书之媳马氏，年三十二岁，腹中因血块作痛，病程长达五六年，身形已消瘦至骨立，众人都认为无法救治。但既然她尚未死亡，又怎能置之不理呢？
其家境贫寒，但家人都怜悯她。有一天请杜医生前来，对杜医生说：“只要您怀着济世救人的心意即可，既然已经聘请了明医，就不必多言酬谢之事。”于是赠送少量丝帛给杜医生，杜医生不接受，说：“只要服用此药必定能安康，不要对此有疑虑。”于是出示方剂：使用没药、牛膝、干漆、当归各半两；砂仁、木香、水蛭、炒红娘子、炒红花、牡丹皮、朱砂各一分；海马一个；斑蝥去翅足，炒制十四个。研为细末，用酒和醋各半升，熬制成膏状。每天天亮时，取一皂荚子大小的量，用酒醋化开送服。一个月后病情减退，六十天后日渐安康。果然像他说的那样。
（此为重剂）
【李东垣】加减四物汤：治疗妇女血积。
药材组成：当归、川芎、芍药、熟地黄、广术、桂枝（去皮）、京三棱、干漆（炒至烟尽，以上各等分）。
制法与用法：将上述药物研为粗末，每次服用二钱，加水两盏，按常规方法煎煮，饭前服用。
【《大全》】黑神丸
药材组成：神曲、小茴香（各四两）；木香、川椒（炒香至出汗）；丁香（各半两）；槟榔（四个）；干漆（六两，一半生用一半熟用，用姜汤煮半天至散发香味）。
制法与用法：除川椒和干漆外，其余五味药均半生半炒，研为细末，用前述生熟相间的干漆调和制成丸剂，大小如弹丸。另取小茴香十二两，铺在阴凉处阴干，待外部干燥后，连同容器一起收存，直至完全干燥，去掉茴香备用。用于治疗肾气膀胱癖，以及疝气坠胀、五隔血崩、产后各种出血、漏下赤白带下等症。每次服用一丸，分四次服完；死胎阻滞者服用一丸，均用绵灰酒送服。若遇难产，取炒葵子四十九粒，捣碎，用酒煎服。各种疾病不过三服见效，气滞需十服，膈气症癖需五服，血瘕需三丸。
曾有一位妇女腹部有肿块如杯状，每次发作疼痛难忍，各种药物无效，服用此丸剂共三服后，肿块之气尽消，终身不再复发。
【云岐子】没药散：治疗一切血气病，脐腹部拘急疼痛，以及产后恶露不行、儿枕痛。
药材组成：血竭、没药（并细研）；桂心、当归、蒲黄、红花、木香、玄胡索、干漆（炒）、赤芍（各等分）。
制法与用法：研为极细末，每次服用二钱，热酒调服，饭前服用。若血块冲逆心痛严重，情况危急者，服用大顺散三钱，酒调服，疼痛立即停止。
牡丹散：治疗妇女久病体虚羸瘦，血块走注窜动，心腹疼痛。
药材组成：牡丹皮、桂心、当归、玄胡索（各一两）；莪术、牛膝、赤芍（各三两）；京三棱（一两半）。
制法与用法：研为粗末，每次服用三钱，用水和酒各半盏煎服。
【罗天益】木香砂仁丸：治疗妇女癖积聚，血块刺痛，脾胃虚寒，宿食不消化，久治不愈者。
药材组成：丁香、砂仁（研）；木香、官桂、附子（炮制）；干漆（炒，烟尽）；细墨、大黄（炒锉）；乳香；广术；青皮；京三棱；巴豆霜（减半）；没药（研）；猪牙皂角；干姜（炮制。以上各等分）。
制法与用法：除砂仁、乳香、没药外，其余药物共同研为细末，用好醋一升，化开砂仁，滤去渣滓，放入银器中用慢火熬制。随后加入巴豆霜、大黄末继续熬成膏状，将前面的药末与膏混合制成丸剂，大小如麻子。每次服用三五十丸，饭后温水送服，加量以大便通畅为度。
用于治疗血积挟热的证候，多见于产后血块病症。
【《大全》】桃仁煎：治疗妇女血瘕血积，月经不通。（出自《千金方》）
药材组成：桃仁（去皮尖，炒黄）、大黄、虻虫、朴硝。
制法与用法：将上述四味药研为末，用醇醋二升半，在银石器中用慢火煎取一升五合，然后加入桃仁、大黄、虻虫等，不停手搅拌千次，接着加入朴硝，继续不停手搅拌，过一会儿取出，制成如梧桐子大的丸剂。服药前一天晚上不吃晚饭，五更初，用温酒吞服五丸，中午排出如黑豆汁、鸡肝、虾蟆衣样的物质。若未排出则再制作服用，见到鲜血即停药，随即用调理气血的药物进行补养。
肠覃生于肠外，月经按时来潮。石瘕生于胞宫（子宫），月经不能按时来潮。这两种病都类似蛊胀。（均见胀满门。）
【《脉经》】诊察妇女疝癖积聚，脉象弦急者预后良好（生），脉象虚弱细小者预后不良（死）。
[Danxi] Masses in women are mostly blood stasis masses.
Danggui Wan (Angelica Sinensis Pill): Treats menstrual irregularities and blood accumulation syndromes in women.
Ingredients: Danggui Radix Angelicae Sinensis, Chishao Radix Paeoniae Rubra, Chuanxiong Rhizoma Ligustici Chuanxiong, Shudi Radix Rehmanniae Preparata, Guangzhu Rhizoma Curcumae Longae, Jingsanleng Rhizoma Sparganii (each 0.5 qian); Shenqu Massa Medicata Fermentata, Baicaoshuang Carbonis Herbae Artemisiae Argyi (each 2.5 qian).
Preparation and Administration: Grind the above ingredients into fine powder, mix with wine paste to form pills the size of paulownia seeds, taken with warm water.
[Bencao] Clean and slice the root of Niuxi Radix Achyranthis Bidentatae, dry by baking, crush, decoct with wine, and take warm. It treats women's blood masses with immediate effect.
(This is a mild formula.)
[Dushu] The wife of the Minister of Works, Ms. Ma, aged thirty-two, suffered from abdominal pain due to blood masses for five or six years. Her body had become emaciated to the point of being skeletal. Everyone said it was incurable. However, since she was not yet dead, how could one leave her?
Her family was very poor, but both senior and junior members pitied her. One day, they summoned Doctor Du. She told Doctor Du, "As long as you have the intention to save lives, that is sufficient. Since we have already invited a renowned physician, there is no need to discuss rewards." She then presented a small amount of silk to Doctor Du, which he refused. He said, "Just take this medicine, and you will surely recover; do not doubt it." He then presented the prescription: Moyao Resina Myrrhae, Niuxi Radix Achyranthis Bidentatae, Ganqi Resina Cinnamomi (processed), Danggui Radix Angelicae Sinensis (each 0.5 liang); Sharen Fructus Amomi Rotundus, Muxiang Radix Aucklandiae, Shuizhi Hirudo, Hongniangzi Cicada (fried), Honghua Flos Carthami Tinctorii (fried), Mudanpi Cortex Moutan, Zhusha Cinnabaris (each 1 fen); Haema Hippocampus (one individual); Banmao Mylabris (remove wings and feet, fried, 14 individuals). Grind into fine powder. Use half a sheng of wine and half a sheng of vinegar, boil down to an ointment. Every morning at dawn, take an amount the size of a soap pod, dissolve in wine and vinegar, and swallow. After one month, the disease receded; after sixty days, she gradually recovered. It happened exactly as he said.
(This is a potent/heavy formula.)
[Lidongyuan] Jiawei Siwu Tang (Modified Four Substances Decoction): Treats blood accumulation in women.
Ingredients: Danggui Radix Angelicae Sinensis, Chuanxiong Rhizoma Ligustici Chuanxiong, Shaoyao Radix Paeoniae Alba seu Rubra, Shudi Radix Rehmanniae Preparata, Guangzhu Rhizoma Curcumae Longae, Guizhi Ramulus Cinnamomi Cassiae (bark removed), Jingsanleng Rhizoma Sparganii, Ganqi Resina Cinnamomi (fried until smoke ceases, all equal parts).
Preparation and Administration: Grind into coarse powder. Take 2 qian per dose, add two zhan of water, decoct as usual, take before meals.
[Daqanquan] Heishen Wan (Black Spirit Pill)
Ingredients: Shenqu Massa Medicata Fermentata, Huixiang Fructus Foeniculi Vulgaris (each 4 liang); Muxiang Radix Aucklandiae, Chuanjiao Pericarpium Zanthoxyli Schinifolii (fried until fragrant and sweating); Dingxiang Flos Syzygii Aromatici (each 0.5 liang); Binglang Semen Arecae (four pieces); Ganqi Resina Cinnamomi (6 liang, half raw half processed, boiled in ginger soup for half a day until fragrant).
Preparation and Administration: Except for Chuanjiao and Ganqi, the other five herbs are half-raw and half-fried. Grind into fine powder. Use the aforementioned raw-and-processed Ganqi to bind into pills the size of a bullet. Additionally, use 12 liang of Huixiang, spread on the ground in the shade to dry. When the exterior is dry, store together with the container until completely dry, then remove the Huixiang. Used to treat Qi stagnation in Kidney and Bladder, Pi accumulation, hernia descent, Wuge bleeding and metrorrhagia, various postpartum bleeding, leukorrhea with red and white discharge. Take one pill, divided into four doses; for retained dead fetus, take one pill. All are taken with wine mixed with cotton ash. For difficult labor, fry 49 Kuizi Semen Abelmoschi Moschatus, crush, decoct in wine, and take. Various diseases resolve within three doses; Qi stagnation requires ten doses; Ge Qi and Pi masses require five doses; Xuejia requires three pills.
A woman had a mass like a cup in her abdomen, unbearable pain upon onset, unresponsive to various medicines. After taking three doses of this pill, the Qi of the cup-shaped mass dissipated completely, and it never recurred in her lifetime.
[Yunqizi] Moyao San (Myrrha Powder): Treats all types of Blood and Qi disorders, cramping pain in the umbilical and abdominal regions, failure of lochia discharge postpartum, and Erzhen pain (afterbirth pain).
Ingredients: Xuexie Sanguis Draconis, Moyao Resina Myrrhae (both finely ground); Guixin Cortex Cinnamomi Cassiae, Danggui Radix Angelicae Sinensis, Puhuang Pollen Typhae, Honghua Flos Carthami Tinctorii, Muxiang Radix Aucklandiae, Yuanhusuo Rhizoma Corydalis Yanhusuo, Ganqi Resina Cinnamomi (fried), Chishao Radix Paeoniae Rubra (all equal parts).
Preparation and Administration: Grind into extremely fine powder. Take 2 qian per dose, mix with hot wine, take before meals. If blood mass attacks the heart causing severe pain and critical condition, take Dasunsan 3 qian mixed with wine, and pain stops immediately.
Mudan San (Tree Peony Powder): Treats chronic deficiency and emaciation in women, wandering blood masses, and pain in the heart and abdomen.
Ingredients: Mudanpi Cortex Moutan, Guixin Cortex Cinnamomi Cassiae, Danggui Radix Angelicae Sinensis, Yuanhusuo Rhizoma Corydalis Yanhusuo (each 1 liang); Ezhu Rhizoma Curcumae Longae, Niuxi Radix Achyranthis Bidentatae, Chishao Radix Paeoniae Rubra (each 3 liang); Jingsanleng Rhizoma Sparganii (1.5 liang).
Preparation and Administration: Grind into coarse powder. Take 3 qian per dose, decoct with half a zhan of water and half a zhan of wine.
[Luo Tianyi] Muxiang Sharen Wan (Aucklandia and Amomi Pill): Treats Pi accumulation and masses in women, stabbing pain from blood masses, Spleen and Stomach deficiency-cold, retention of undigested food, and conditions that persist without healing.
Ingredients: Dingxiang Flos Syzygii Aromatici, Sharen Fructus Amomi Rotundus (ground); Muxiang Radix Aucklandiae, Guanzi Gui Cortex Cinnamomi Cassiae, Fuzii Radix Aconiti Lateralis Preparata (pao); Ganqi Resina Cinnamomi (fried until smoke ceases), Xi Mo (fine ink stick), Dahuang Radix et Rhizoma Rhei (fried and cut), Ruxiang Resina Olibani; Guangzhu Rhizoma Curcumae Longae, Qingpi Pericarpium Citri Reticulatae Viride, Jingsanleng Rhizoma Sparganii, Badoushuang Semen Crotonis Tiglii (halved); Moyao Resina Myrrhae (ground); Zhuyazaojiao Fructus Gleditsiae Sinensis; Ganjiang Rhizoma Zingiberis Recens (pao. All equal parts).
Preparation and Administration: Except for Sharen, Ruxiang, and Moyao, grind the rest into fine powder. Use one sheng of good vinegar to dissolve Sharen, filter out dregs, put in a silver vessel, and simmer slowly. Then add Badoushuang and Dahuang powder, continue boiling into an ointment. Mix the previous herb powder with the ointment to form pills the size of hemp seeds. Take 30-50 pills per dose, send down with warm water after meals. Increase dosage until bowel movement occurs freely.
Used to treat blood accumulation complicated by heat, often sought for postpartum blood masses.
[Daqanquan] Tao Ren Jian (Peach Kernel Decoction): Treats Xuejia and blood accumulation in women, amenorrhea. (From Qianjin Fang)
Ingredients: Taoren Semen Pruni Persicae (remove skin and tip, fried yellow), Dahuang Radix et Rhizoma Rhei, Mengchong Aspis, Pu Xiao Natrii Sulfas.
Preparation and Administration: Grind the four ingredients into powder. Add two and a half sheng of strong vinegar, simmer slowly in a silver or earthenware vessel to reduce to one and a half sheng. Add Taoren, Dahuang, Mengchong, etc., stir constantly for a thousand turns. Then add Pu Xiao, continue stirring constantly. Remove after a while. Form into pills the size of paulownia seeds. Do not eat dinner the day before. At early dawn (Wugeng), swallow five pills with warm wine. By noon, pass material resembling black bean juice, chicken liver, or frog skin. If not passed, prepare again. Stop when fresh blood appears, then tonify with Qi and Blood regulating medicines.
Changtan (Intestinal Polyp/Tumor) arises outside the intestine, menstruation comes on time. Shijia (Uterine Fibroid/Mass) arises in the Baozhong (uterus), menstruation does not come on time. Both diseases resemble Guzhang (ascites/mass). (See Meniscus/Abdominal Distension section.)
[Maijing] In diagnosing women's Shanpi and accumulations, if the pulse is Xianji (wiry and urgent), prognosis is good (life); if the pulse is Ruoxiao (weak and small), prognosis is poor (death).
[Jiayi Jing] When evil blood exists in the Zizang (uterus) of women, causing internal reversal, fullness, and pain, Shiguan (KI15) is the primary acupoint for treatment.