血崩兼心痛者。(见心痛门。)
〔丹〕紫色成块者,血热,四物加黄连、柴胡之类。气虚血虚者,皆于四物内加参、 。急则治
其标,白芷汤调百草霜,甚者棕榈灰。后用四物加炒干姜调理,因劳者用人参带升补药,因热者用
黄芩,因寒者用炒干姜。
丹溪云∶涎郁胸中,清气不升,故经脉壅遏而降下,非开涎不足以行气,非气升则血不能归
隧道,此论血泄之义甚明。盖开胸膈浊涎,则清气升,清气升则血归隧道不崩矣。故其症或腹满
如孕,或脐腹 痛,或血结成片,或血出则快,止则闷,或脐上动。其治法宜开结痰,行滞气,
消污血。
江氏妇,三十五六岁,堕胎后血不止,食少中满,倦怠不起,躁烦,六脉沉大而数,重取微
弦。予作怒气伤肝,感动胃气。遂于二陈汤加川芎、白术、缩砂,二十帖而安。
〔仲〕旋复花汤 治半产漏下,脉弦而大。
旋复花(三两,本草云∶主留饮结气) 葱(十四茎) 新绛(少许)
上三味,以水三升,煮取一升,顿服之。
〔《千》〕治妇人崩中下血不止。以衣中白鱼、僵蚕等分为末,以井花水服之,日三服,瘥。
上三方开痰。
〔罗〕备金散 治妇人血崩不止。
香附子(四两,炒) 当归尾(一两二钱) 五灵脂(一两,炒)
上为细末,每服五钱,醋调,空心服,立效。
〔《本》〕治下血不止,或成五色崩漏。方用香附子,舂去皮毛,中断之,略炒为末,每服二钱,
用清米饮调下。此方徐朝奉传。其内人有是疾,遍服药不效,后服此方遂愈。须久服为佳。亦治产
后腹痛,大是妇人仙药,常服益血调气。
〔《大》〕醋附丸 治崩漏带下,积聚 瘕,脐腹 痛。
用香附子不以多少,擦去毛,用好醋煮出,焙碾末,醋煮糊为丸如桐子大,每服三十丸,米饮
送下,无时。妇人数堕胎者,此药尤妙。一方用香附子、白芷为丸。
缩砂散 治血崩。
用缩砂仁不以多少,于新瓦上炒香,为细末,米饮调下三钱。
上四方行滞气。
〔世〕治血崩。用干荷叶浓煎汤一碗,空心服之,立愈。或调醋炒香附末,尤妙。
〔云〕治血崩不止。五灵脂二钱,炒熟,加当归酒同煎,或水酒、童便各半盏,同煎服。一方,
五灵脂半生半熟为末,酒调服。一方,水煎五灵脂半干,去渣,澄清,再煎成膏,入神曲末,为丸如
桐子大,空心温酒下二三十丸,便止。
又方 鹿茸(醋炙) 当归(各二钱) 蒲黄(半两,炒)
上三味为末,温酒调下五钱匕,日三服。
〔仲〕桂枝茯苓丸治妇人有 ,在脐上动,下血不止。(方见胎动下血。)
上四方消污血。
〔垣〕当归芍药汤 治妇人经脉漏下不止,其色鲜红,时值七月处暑之间,先因劳役,脾胃虚弱,
气短逆,自汗不止,身热闷乱,恶见饮食,亦不思食,沉困懒倦,四肢无力,大便时泻;后复因心气
不足,其经脉再下不
止,惟觉气下脱,其元气逆上全无,惟觉心腹中气不行,气短则不能言,是无力以言,非懒语也,
此药主之。
黄 (一钱半) 白术 苍术(泔浸,去皮) 当归身 白芍药(各五钱) 甘草(炙) 生地(各三分)
柴胡(二分) 熟地黄 陈皮(去白。各五分)
上十味为粗末,作二服,水煎,去渣热服,空心。一服之后渐减,次日诸症悉去,顿喜饮食。所以者何?
盖气通而闻饮食之香,得平康故也。
〔仲〕妇人陷经、漏下黑不解,胶姜汤主之。即芎归胶艾汤。
芎 阿胶 甘草(各二两) 艾叶 当归(各三两) 芍药(四两) 熟地黄
上七味,以水五升,清酒三升,合煮取三升,去渣,纳胶令消尽,温服一升,日三服。不瘥更作。
(一云加干姜一两,胡洽治妇胞动无干姜。)
〔海〕四物胶艾汤。(方见妇人门大法条。)
〔垣〕益胃升阳汤 治血脱,益气,古人之法也。先补胃气,以助生长,故曰阳生阴长,诸甘药为之
先务。举世皆以为补气,殊不知甘能生血,此阳生阴长之理也,故先理胃气,人之一身,纳谷为宝。
黄 (二钱) 人参(有嗽者去之) 神曲(炒,各一钱半) 升麻 柴胡(各五分) 白术(三钱)
当归身(酒浸) 甘草(炙) 陈皮(各一钱) 生黄芩(二钱,泻盛暑之伏金肺逆,秋凉不用) 一方用生地。
上粗末,每服三钱或五钱,如食添,再加之。如食减,已定三钱内更减之,不可多服。每服二钱,水煎去
渣热服。如腹痛,每服加白芍药二分,中桂少许。如渴口干,加干葛二分。如嗽,去人参。服不计
时候。(盖先服此益胃气升阳汤,不止,却服后方柴胡调经汤,大举大升之也。)
宣德侯经历家人病崩漏,医莫能效。切脉之后,且以纸疏其症,至四十余种,为制调经升阳除湿汤疗之。
明日而十减其八,前后五六日良愈。
调经升阳除湿汤 治女子漏下恶血,月事不调,或暴崩不止,多下水浆之物。皆由饮食不节,或劳伤形体,或
素有心气不足,因饮酒劳倦,致令心火乘脾。其人必怠惰嗜卧,四肢不收,困倦乏力,无气以动,气短上气,
逆急上冲,其脉缓而弦急,按之洪大,皆中指下得之。脾土受邪也。脾主滋荣周身者也,心主血,血主脉,二
者受邪,病皆在脉。脉者血之府也,人者脉之神也,心不主令,胞络代之,故曰心之脉主属心系。心系者,
胞络命门之脉也,主月事生孕。皆由脾胃虚而心胞乘之,故漏下血水不调也。况脾胃为阴阳之根蒂,当除湿
去热,益风气上伸以胜其湿。又云∶火郁则发之。
柴胡 防风 甘草(炙) 本 升麻(各一钱) 羌活 苍术 黄 (各一钱半) 独活(五分)
当归(酒浸,五分) 蔓荆子(七分)
上 咀,水五大盏,煎至一大盏,去渣,稍热服。空心服药毕,待少时,以早膳压之。可一服而已。如灸
足太阴脾经中血海穴二七壮,或三七壮,立已。此药乃从权衡之法,用风胜湿,为胃气下陷而气迫于下,以
救其血之暴崩也。若病愈经血恶物已尽,主病虽除,后必须以黄 、甘草、人参、当归之类数服以补之,于
补气升阳汤中加和血药是也。若经血气恶物下之不绝,尤宜救其根源,治其本经,只益脾胃,退心火之亢,
乃治其根蒂也。若遇夏月白带下脱漏不止,宜用此汤,一服立止。
柴胡调经汤 治经水不止,鲜血,项筋急,脑痛,脊骨强痛,不思饮食。
羌活 独活 本 升麻(各五分) 苍术(一钱) 柴胡根(七分) 葛根 当归身 甘草(炙。各三分)
红花(少许)
上 咀,作一服,水煎,去渣,稍热空心服,微汗立止。
一妇人经候黑血凝结成块,左厢有血瘕,水泻不止,谷食有时一化,有时不化,至今岁四月,血块暴下,
并水注俱作,是前后二阴有形之血脱竭于下。既久,经候尤不调,水泻日见三两行,食罢心烦不快,饮食减少,
甚至瘦弱。东垣先生曰∶夫圣人治病,必本四时升降浮沉之理,权变之宜。若不本四时,以顺为逆,非其治也。
且治之大法,必先岁气,无伐天和,无盛盛,无虚虚,遗人夭殃;无致邪,无失正,绝人长命。故圣人云阳盛
阴虚,下之则愈,汗之则死。阴盛阳虚,汗之则愈,下之则死。大抵圣人立法,各自有义。且如升阳或发散之
剂,是助春夏之阳气,令其上升,乃泻秋冬收藏殒杀寒凉之气,此病是也。当用此法治之,乃升降浮沉之至理
也。夫天地之气,以升降浮沉,乃从四时,如治病逆之,则杀人矣。故经云顺天者昌,逆天者亡。可不畏哉!
夫人之身亦有天地四时之气,不可止认在外,人体亦同天地也。今经漏不止,是前阴之气血已下脱矣;水泻又
数年不愈,是后阴之气血又下陷矣。后阴者主有形之物也,前阴者精气之门户,俱下竭,是病患周身之气常行
秋冬之令。阴主杀,此等收藏之病是也。阳生阴长,春夏是也,在人身之中,令气升浮者,谷气上行是也。既
病,则周身血气皆不生长,谷气又不升,其肌肉消少,是两仪之气俱将绝矣。既下元二阴俱脱,血气消竭,假
令当日元是热症,今下焦久脱,已化为寒矣。此病久沉久降,寒湿太胜,当急救之。泻寒以热,降湿以燥,大
升大举,以助长生,补养气血,不致偏枯。圣人立治之法,云∶湿气大胜,以所胜治之。助甲风木上升是也。
故经云风胜湿,是以所胜平之也。当调和胃气,次用白术之类,以燥其湿而滋元气。如其不止,后用风药,以
风胜湿,此之谓也。此药便是大举大升,以助春夏二湿之久陷下之至治也。又一本云∶此病次用四物,随湿症
加减。
〔《大》〕独圣散 治妇人血崩不止。
用防风去芦,不以多少,为细末,酒煮白面,清调下二钱,空心食前,日二服,更以面作糊,酒投之极验。
治血崩。夏枯草为细末,每服二钱,米饮调下,无时服。
〔《千》〕治崩中不止。芎 八两,清酒五升,煎至二升半,分三服。不耐者,徐徐进之。(义云∶芎不
可久服,令人暴死。)
上大举大升之剂治崩,脉沉弦而洪,或沉细而数者,皆胃气下陷也。或崩而又久泻者,亦胃气下陷也。
故举之升之,其病愈也。
〔垣〕经水漏不住有二,补前人之阙。妇人脾胃虚损,致命门脉沉细而数疾,或沉弦而洪大有力,寸关脉
亦然,皆由脾胃有亏,下陷于肾.与相火相合,湿热下迫,经漏不止,其色紫黑,如夏月腐肉之臭。中有白带
者,脉必弦细,寒作于中。有赤带者,其脉洪数,病热明矣。必腰痛或脐下痛,临经欲行而先发寒热往来,两
胁急缩,兼脾胃症出见,或四肢困热,心烦闷不得眠卧,心下急,宜大补脾胃而升降气血,可一服而愈。或先
贵而后贱,或先富而后贫,病名脱营者,心气不足,其火大炽,旺于血脉之中,又致脾胃饮食失节,火乘其中,
形质肌肉颜侣不病者,此心病也,不形于脉。故脾胃饮食不调,其症显矣。而经水不时而下,或适来适断,暴
下不止。治当先说恶死之言,劝谕令惧死而心不动,以大补血气之药补养脾胃,微加镇坠心火之药治其心,补
阴泻阳,经自止矣。痿论云∶悲哀太甚,则胞络绝,胞络绝则阳气内动,发则心下崩。(数溲血也。故经
曰∶大经空虚,发则肌痹,传为脉痿,此之谓也。)
丁未年冬,郭大方来说,其妻经水暴崩不止,先曾殒身失血,自后一次经数日而来,今次不止,其人心窄
性急多惊。以予料之,他日必因心气不足,饮食失节得之。大方曰∶容到彼。诊得掌中寒,脉沉细而缓,间而
沉数,九窍微不利,四肢无力,上喘,气短促,口鼻气皆不调,果有心气不足,饮食失节,脾胃虚弱之证。胃
脘当心而痛,左胁下急缩有积,当脐有动气,腹中鸣,下气,大便难,诸虚证极多,不能尽录。拟先治其本,
余证可以皆去。与安心定志,镇坠其惊,调和脾胃,大益元气,补其血脉,养其心神,以大热之剂,去其冬寒
凝在皮肤内,少加生地黄,去命门相火,不令四肢痿弱,黄 当归人参汤。
黄 (一钱) 当归(一钱半) 人参(一钱) 陈皮(五分) 草豆蔻(七分) 神曲(半钱,消食,去脾胃寒)
黄连(一钱,镇心惊) 杏仁(九个,研如泥) 麻黄(一钱,不去节,表闭汗) 桂枝(半钱,必先岁气,
无代天和也) 生地(三分,去肾火,大去冬月相火之旺)
上为粗末,水三大盏,先煮麻黄数沸,去渣,入前药同煎至一大盏,于巳午之前,食消尽服之。其胃脘痛,
乃胃上有客寒,与大热药,草豆蔻丸一十五丸,其痛立止。再与肝之积药,除其积之根源而愈。
上虚挟积滞而崩。尝治一老妇人血崩不止,流流不绝,满床皆血,起床不得者三月矣。腹满如孕。予作虚
挟痰积、污血治之。用四物四两,参、术各一两,甘草半两,以治虚;香附三两,半夏两半,茯苓、陈皮、
枳实、缩砂、玄胡各一两,以破痰积污血。分二十帖,每帖煎加干荷叶、侧柏叶汤再煎服之,服尽良愈。今
再不发,神效。
〔云〕柏黄散 疗经血不止。
黄芩(一两二钱半) 侧柏叶 蒲黄(各一两) 伏龙肝(一两)
上 咀,用水二升,煎取八合,分为二服。
又方 治患崩中不止,结作血片,如鸡肝色碎烂。
芎 (十二分) 阿胶 青竹茹(各八分) 续断 地榆 小蓟根(各三分) 当归(六分) 生地
伏龙肝(各十一分)
上用水九盏,煮取三盏,去渣,分作三服。
〔《衍》〕治妇人血露。蚕砂一两,炒伏龙肝半两,阿胶一两,同为末,温酒调,空心,二三钱,
以知为度(《大全》名无比散,无阿胶。)
〔罗〕伏龙肝散 治气血劳伤,冲任脉虚,经水非时忽然崩下,或如豆汁,或成血片,或五色相杂,
或赤白相兼,脐腹冷痛,经久未止,令人黄瘦,口干,饮食减少,四肢无力,虚烦惊悸。
伏龙肝(一两) 甘草(半两) 赤石脂(一两) 芎 (三两) 肉桂(半两) 熟地(二两) 当归
干姜(各七钱半) 艾叶(二两,微炒) 麦门冬(去心,一两半)
〔朱丹溪〕经血呈紫色且有血块的,属于血热证,用四物汤加入黄连、柴胡等药物。气虚和血虚的,都在四物汤中加入人参、[此处原文缺字,通常指白术或黄芪]。急则治其标,用白芷汤调服百草霜,严重的用棕榈灰。之后用四物汤加入炒干姜进行调理,因劳累引起的用人参配合升提补益药,因热引起的用黄芩,因寒引起的用炒干姜。
丹溪说:痰涎郁结于胸中,导致清气不能上升,所以经脉壅塞阻滞而下行出血,不开除痰涎不足以行气,气不升则血不能回归脉道,这个论述对血泄(出血)的道理非常明白。大概是因为开通胸膈的浊痰,清气就能上升,清气上升则血归脉道而不崩漏了。所以症状有的腹部胀满像怀孕一样,有的脐腹疼痛,有的血液结成片状,有的出血时感觉畅快,停止时感到胸闷,有的脐上有搏动感。治疗方法应当开通结聚之痰,运行滞涩之气,消除污秽之血。
江氏妇人,三十五六岁,堕胎后血不止,饮食减少,脘腹胀满,倦怠无力不起床,烦躁不安,六脉沉大而数,重按微弦。我认为是怒气伤肝,扰动胃气所致。于是用二陈汤加入川芎、白术、缩砂仁,服用二十帖后痊愈。
〔张仲景〕旋复花汤治疗半产(小产)后漏下不止,脉象弦而大。
旋复花(三两,本草记载:主治留饮结气) 葱(十四茎) 新绛(少许)
以上三味,用水三升,煮取一升,一次性服下。
〔《千金方》〕治疗妇人崩中下血不止。用衣中白鱼、僵蚕等分研为末,用井花水送服,每日三次,病愈。
以上三方旨在开痰。
〔罗天益〕备金散治疗妇人血崩不止。
香附子(四两,炒) 当归尾(一两二钱) 五灵脂(一两,炒)
以上研为细末,每次服用五钱,醋调匀,空腹服用,立即见效。
〔《本草》〕治疗下血不止,或成五色崩漏。方用香附子,舂去皮毛,折断,略炒研为末,每次服用二钱,用清米汤调下。此方由徐朝奉传授。他的内人有此疾,遍服药无效,后来服此方遂愈。需要久服为佳。也治疗产后腹痛,是妇女的仙药,常服可益血调气。
〔《大全》〕醋附丸治疗崩漏带下,积聚瘕块,脐腹疼痛。
用香附子不限多少,擦去毛,用好醋煮出,焙干碾末,醋煮糊为丸如梧桐子大,每次服用三十丸,米饮送下,不拘时候。妇女多次堕胎者,此药尤为奇妙。另一法用香附子、白芷为丸。
缩砂散治疗血崩。
用缩砂仁不限多少,在新瓦上炒香,研为细末,米饮调下三钱。
以上四方旨在行滞气。
〔世传〕治疗血崩。用干荷叶浓煎一碗汤,空腹服下,立即痊愈。或者调服醋炒香的香附末,尤其奇妙。
〔云〕治疗血崩不止。五灵脂二钱,炒熟,加当归酒同煎,或者用水、酒、童便各半盏,同煎服。一方,五灵脂半生半熟研为末,酒调服。一方,水煎五灵脂至半干,去渣,澄清,再煎成膏,入神曲末,为丸如梧桐子大,空腹温酒送下二三十丸,即可止血。
又一方 鹿茸(醋炙) 当归(各二钱) 蒲黄(半两,炒)
以上三味研为末,温酒调下五钱匕,每日三次服。
〔张仲景〕桂枝茯苓丸治疗妇人有癥块,在脐上有动气,下血不止。(方剂见胎动下血条。)
以上四方旨在消污血。
〔李东垣〕当归芍药汤治疗妇人经脉漏下不止,血色鲜红,正值七月处暑之间,先前因劳役,脾胃虚弱,气短逆,自汗不止,身热闷乱,厌恶见到食物,也不想吃东西,沉重困倦懒怠,四肢无力,大便时常腹泻;后来又因心气不足,经脉再次漏下不止,只感觉气向下脱失,元气逆上全无,只感觉心腹中气不行,气短则不能说话,这是无力说话,不是懒于说话,此药主治。
黄芪(一钱半) 白术 苍术(泔水浸,去皮) 当归身 白芍药(各五钱) 甘草(炙) 生地(各三分)
柴胡(二分) 熟地黄 陈皮(去白。各五分)
以上十味为粗末,分成两份,水煎,去渣热服,空腹。服一次后逐渐减量,第二天各种症状全部去除,顿时喜欢饮食。为什么呢?因为气通而闻到饮食的香气,得到平和安康的缘故。
〔张仲景〕妇人陷经、漏下黑不解,胶姜汤主治。即芎归胶艾汤。
川芎 阿胶 甘草(各二两) 艾叶 当归(各三两) 芍药(四两) 熟地黄
以上七味,用水五升,清酒三升,合煮取三升,去渣,纳胶令其溶尽,温服一升,每日三次服。不好转再制作服用。
(一说加干姜一两,胡洽治疗妇胞动无干姜。)
〔海藏〕四物胶艾汤。(方剂见妇人门大法条。)
〔李东垣〕益胃升阳汤治疗血脱,益气,这是古人的方法。先补胃气,以助生长,所以说阳生阴长,各种甘味药作为首要任务。举世都以为这是补气,却不知道甘能生血,这是阳生阴长的道理,所以先理胃气,人的一身,以纳谷为宝。
黄芪(二钱) 人参(有咳嗽者去掉) 神曲(炒,各一钱半) 升麻 柴胡(各五分) 白术(三钱)
当归身(酒浸) 甘草(炙) 陈皮(各一钱) 生黄芩(二钱,泻盛暑之伏金肺逆,秋凉不用) 一方用生地。
以上粗末,每次服用三钱或五钱,如果食量增加,再加量。如果食量减少,已在定量的三钱内再减量,不可多服。每次二钱,水煎去渣热服。如果腹痛,每次加白芍药二分,肉桂少许。如果口渴口干,加干葛二分。如果有咳嗽,去人参。服用不计时候。(大概先服此益胃气升阳汤,如果不止,却服后方柴胡调经汤,大举大升之也。)
宣德侯经历家人的仆人患崩漏,医生没有能奏效的。切脉之后,且用纸详细记录其症状,多达四十余种,为他配制调经升阳除湿汤来治疗。第二天病情减轻十分之八,前后五六日完全痊愈。
调经升阳除湿汤治疗女子漏下恶血,月事不调,或暴崩不止,多下水浆之物。皆由饮食不节,或劳伤形体,或素有心气不足,因饮酒劳倦,致令心火乘脾。其人必定怠惰嗜卧,四肢不收,困倦乏力,无气以动,气短上气,逆急上冲,其脉缓而弦急,按之洪大,皆中指下得之。这是脾土受邪。脾主滋荣周身者也,心主血,血主脉,二者受邪,病皆在脉。脉是血的府库,人是脉的神气所在,心不主令,胞络代之,所以说心的脉主属心系。心系者,胞络命门的脉也,主月事生孕。皆由脾胃虚而心包乘之,所以漏下血水不调。况且脾胃为阴阳之根蒂,当除湿去热,益风气上伸以胜其湿。又说:火郁则发之。
柴胡 防风 甘草(炙) 本 升麻(各一钱) 羌活 苍术 黄芪(各一钱半) 独活(五分)
当归(酒浸,五分) 蔓荆子(七分)
以上切碎,水五大盏,煎至一大盏,去渣,稍热服。空腹服药毕,待少时,以早膳压之。可以一服而已。如果灸足太阴脾经中血海穴十四壮,或二十一壮,立即停止。此药乃从权衡之法,用风胜湿,为胃气下陷而气迫于下,以救其血之暴崩也。如果病愈经血恶物已尽,主病虽除,后必须以黄芪、甘草、人参、当归之类数服以补之,于补气升阳汤中加和血药是也。若经血气恶物下之不绝,尤宜救其根源,治其本经,只益脾胃,退心火之亢,乃治其根蒂也。若遇夏月白带下脱漏不止,宜用此汤,一服立止。
柴胡调经汤治疗经水不止,鲜血,项筋急,脑痛,脊骨强痛,不思饮食。
羌活 独活 本 升麻(各五分) 苍术(一钱) 柴胡根(七分) 葛根 当归身 甘草(炙。各三分)
红花(少许)
以上切碎,作一服,水煎,去渣,稍热空心服,微汗立止。
一妇人经候黑血凝结成块,左厢有血瘕,水泻不止,谷食有时一化,有时不化,至今岁四月,血块暴下,并水注俱作,是前后二阴有形之血脱竭于下。既久,经候尤不调,水泻日见三两行,食罢心烦不快,饮食减少,甚至瘦弱。东垣先生曰:圣人治病,必本四时升降浮沉之理,权变之宜。若不本四时,以顺为逆,非其治也。且治之大法,必先岁气,无伐天和,无盛盛,无虚虚,遗人夭殃;无致邪,无失正,绝人长命。故圣人云阳盛阴虚,下之则愈,汗之则死。阴盛阳虚,汗之则愈,下之则死。大抵圣人立法,各自有义。且如升阳或发散之剂,是助春夏之阳气,令其上升,乃泻秋冬收藏殒杀寒凉之气,此病是也。当用此法治之,乃升降浮沉之至理也。夫天地之气,以升降浮沉,乃从四时,如治病逆之,则杀人矣。故经云顺天者昌,逆天者亡。可不畏哉!夫人之身亦有天地四时之气,不可止认在外,人体亦同天地也。今经漏不止,是前阴之气血已下脱矣;水泻又数年不愈,是后阴之气血又下陷矣。后阴者主有形之物也,前阴者精气之门户,俱下竭,是病患周身之气常行秋冬之令。阴主杀,此等收藏之病是也。阳生阴长,春夏是也,在人身之中,令气升浮者,谷气上行是也。既病,则周身血气皆不生长,谷气又不升,其肌肉消少,是两仪之气俱将绝矣。既下元二阴俱脱,血气消竭,假令当日元是热症,今下焦久脱,已化为寒矣。此病久沉久降,寒湿太胜,当急救之。泻寒以热,降湿以燥,大升大举,以助长生,补养气血,不致偏枯。圣人立治之法,云:湿气大胜,以所胜治之。助甲风木上升是也。故经云风胜湿,是以所胜平之也。当调和胃气,次用白术之类,以燥其湿而滋元气。如其不止,后用风药,以风胜湿,此之谓也。此药便是大举大升,以助春夏二湿之久陷下之至治也。又一本云:此病次用四物,随湿症加减。
〔《大全》〕独圣散治疗妇人血崩不止。
用防风去芦,不限多少,为细末,酒煮白面,清调下二钱,空心食前,日二服,更以面作糊,酒投之极验。
治疗血崩。夏枯草为细末,每次服用二钱,米饮调下,不拘时候服。
〔《千金方》〕治疗崩中不止。川芎八两,清酒五升,煎至二升半,分三次服。不耐受者,徐徐进之。(楼英按:川芎不可久服,令人暴死。)
以上大举大升之剂治疗崩漏,脉沉弦而洪,或沉细而数者,都是胃气下陷。或者崩漏而又久泻的,也是胃气下陷。
所以举之升之,其病愈也。
〔李东垣〕经水漏不住有二,补前人之阙。妇人脾胃虚损,致命门脉沉细而数疾,或沉弦而洪大有力,寸关脉亦然,皆由脾胃有亏,下陷于肾.与相火相合,湿热下迫,经漏不止,其色紫黑,如夏月腐肉之臭。中有白带者,脉必弦细,寒作于中。有赤带者,其脉洪数,病热明矣。必腰痛或脐下痛,临经欲行而先发寒热往来,两胁急缩,兼脾胃症出见,或四肢困热,心烦闷不得眠卧,心下急,宜大补脾胃而升降气血,可一服而愈。或先贵而后贱,或先富而后贫,病名脱营者,心气不足,其火大炽,旺于血脉之中,又致脾胃饮食失节,火乘其中,形质肌肉颜侣不病者,此心病也,不形于脉。故脾胃饮食不调,其症显矣。而经水不时而下,或适来适断,暴下不止。治当先说恶死之言,劝谕令惧死而心不动,以大补血气之药补养脾胃,微加镇坠心火之药治其心,补阴泻阳,经自止矣。痿论云:悲哀太甚,则胞络绝,胞络绝则阳气内动,发则心下崩。(数溲血也。故经曰:大经空虚,发则肌痹,传为脉痿,此之谓也。)
丁未年冬,郭大方来说,其妻经水暴崩不止,先曾殒身失血,自后一次经数日而来,今次不止,其人心窄性急多惊。以予料之,他日必因心气不足,饮食失节得之。大方曰:容到彼。诊得掌中寒,脉沉细而缓,间而沉数,九窍微不利,四肢无力,上喘,气短促,口鼻气皆不调,果有心气不足,饮食失节,脾胃虚弱之证。胃脘当心而痛,左胁下急缩有积,当脐有动气,腹中鸣,下气,大便难,诸虚证极多,不能尽录。拟先治其本,余证可以皆去。与安心定志,镇坠其惊,调和脾胃,大益元气,补其血脉,养其心神,以大热之剂,去其冬寒凝在皮肤内,少加生地黄,去命门相火,不令四肢痿弱,黄芪当归人参汤。
黄芪(一钱) 当归(一钱半) 人参(一钱) 陈皮(五分) 草豆蔻(七分) 神曲(半钱,消食,去脾胃寒)
黄连(一钱,镇心惊) 杏仁(九个,研如泥) 麻黄(一钱,不去节,表闭汗) 桂枝(半钱,必先岁气,无代天和也) 生地(三分,去肾火,大去冬月相火之旺)
以上为粗末,水三大盏,先煮麻黄数沸,去渣,入前药同煎至一大盏,于巳午之前,食消尽服之。其胃脘痛,乃胃上有客寒,与大热药,草豆蔻丸一十五丸,其痛立止。再与肝之积药,除其积之根源而愈。
上虚挟积滞而崩。曾治一老妇人血崩不止,流流不绝,满床皆血,起床不得者三月矣。腹满如孕。我认为是虚挟痰积、污血所致。用四物汤四两,人参、白术各一两,甘草半两,以治虚;香附三两,半夏两半,茯苓、陈皮、枳实、缩砂、玄胡索各一两,以破痰积污血。分二十帖,每帖煎加干荷叶、侧柏叶汤再煎服之,服尽良愈。如今不再复发,神效。
〔云〕柏黄散治疗经血不止。
黄芩(一两二钱半) 侧柏叶 蒲黄(各一两) 伏龙肝(一两)
以上切碎,用水二升,煎取八合,分为两次服。
又一方 治疗患崩中不止,结作血片,如鸡肝色碎烂。
川芎(十二分) 阿胶 青竹茹(各八分) 续断 地榆 小蓟根(各三分) 当归(六分) 生地
伏龙肝(各十一分)
以上用水九盏,煮取三盏,去渣,分作三次服。
〔《衍义》〕治疗妇人血露。蚕砂一两,炒伏龙肝半两,阿胶一两,同为末,温酒调,空腹,二三钱,以知为度(《大全》名无比散,无阿胶。)
〔罗天益〕伏龙肝散治疗气血劳伤,冲任脉虚,经水非时忽然崩下,或如豆汁,或成血片,或五色相杂,或赤白相兼,脐腹冷痛,经久未止,令人黄瘦,口干,饮食减少,四肢无力,虚烦惊悸。
伏龙肝(一两) 甘草(半两) 赤石脂(一两) 川芎(三两) 肉桂(半两) 熟地(二两) 当归
干姜(各七钱半) 艾叶(二两,微炒) 麦门冬(去心,一两半)
Metrorrhagia accompanied by heart pain. (See the section on Heart Pain.)
[Zhu Danxi] If the menstrual blood is purple and forms clots, it indicates Blood Heat. Use Siwu Tang (Four Substances Decoction) added with Huanglian (Coptis Rhizome) and Chaihu (Bupleurum Root). For cases of Qi Deficiency or Blood Deficiency, add Renshen (Ginseng Root) [text missing, usually Baizhu or Huangqi] to Siwu Tang. In acute cases, treat the branch symptoms first: use Baizhi Tang (Angelica Dahurica Decoction) to mix with Baicaoshuang (Charred Grass), or for severe cases, use Zonglvhui (Ash of Palm Leaf). Afterwards, regulate with Siwu Tang added with Chao Ganjiang (Stir-fried Dried Ginger). For cases caused by overexertion, use Renshen combined with herbs that tonify and raise; for cases caused by Heat, use Huangqin (Scutellaria Root); for cases caused by Cold, use Chao Ganjiang.
Danxi stated: "Phlegm-fluids stagnate in the chest, preventing Clear Qi from ascending, causing the meridians to become obstructed and blood to descend. Without opening the phlegm, Qi cannot move; without ascending Qi, Blood cannot return to its vessels." This explanation of metrorrhagia is very clear. Generally, by clearing turbid phlegm from the chest and diaphragm, Clear Qi ascends; once Clear Qi ascends, Blood returns to the vessels and metrorrhagia ceases. Therefore, symptoms may include abdominal distension resembling pregnancy, pain around the umbilicus and abdomen, blood forming sheets, a feeling of relief during bleeding but oppression when it stops, or pulsation above the umbilicus. The treatment method should involve resolving accumulated phlegm, moving stagnant Qi, and eliminating turbid blood.
Madam Jiang, aged thirty-five or thirty-six, suffered from continuous bleeding after an abortion, with poor appetite, epigastric fullness, fatigue unable to rise, and irritability. Her six pulses were deep, large, and rapid, becoming slightly wiry upon heavy pressure. I diagnosed this as Liver injury due to anger affecting Stomach Qi. Thus, I prescribed Erchen Tang (Two Aged Decoction) added with Chuanxiong (Ligusticum Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), and Suosha (Amomum Fruit). After twenty doses, she recovered.
[Zhang Zhongjing] Xuanfuhua Tang (Inula Flower Decoction) treats post-miscarriage leakage with a wiry and large pulse.
Xuanfuhua (Inula Flower) (3 liang, Materia Medica states: treats retained fluid and qi stagnation) Cong (Green Onion) (14 stems) Xinjiang (New Crimson Dye/Safflower) (a small amount)
The above three ingredients are boiled in 3 sheng of water to obtain 1 sheng, taken at once.
[Qianjin Fang] Treats continuous metrorrhagia in women. Use Yizhongbaiyu (White Fish found in clothes) and Jiangcan (Silkworm) in equal parts, powdered, taken with Jinghua Shui (well water drawn early in the morning), three times daily until cured.
The above three formulas are used to resolve phlegm.
[Luo Tianyi] Beijin San (Precious Metal Powder) treats continuous metrorrhagia in women.
Xiangfu (Cyperus Rhizome) (4 liang, stir-fried) Dangguiwei (Tail of Angelica Sinensis Root) (1 liang 2 qian) Wulingzhi (Trogopterus Dung) (1 liang, stir-fried)
Powder the above ingredients finely. Take 5 qian each time, mixed with vinegar, on an empty stomach. Effect is immediate.
[Bencao] Treats continuous lower bleeding or five-color leukorrhea. Use Xiangfu (Cyperus Rhizome), pound off hairs, break in the middle, stir-fry slightly, and powder. Take 2 qian each time, mixed with clear rice drink. This formula was passed down by Xu Chaofeng. His wife had this disease, tried many medicines without effect, but was cured by this formula. Long-term use is best. It also treats postpartum abdominal pain; it is a wonderful medicine for women, regular use benefits blood and regulates qi.
[Daqan] Cu Fu Wan (Vinegar-Processed Cyperus Pill) treats metrorrhagia, leukorrhea, accumulations, masses, and umbilical/abdominal pain.
Use Xiangfu (Cyperus Rhizome) in any quantity, rub off hairs, boil in good vinegar, dry, powder, and make pills with vinegar paste the size of paulownia seeds. Take 30 pills each time, with rice drink, at any time. For women who have had multiple miscarriages, this medicine is especially excellent. Another method uses Xiangfu and Baizhi made into pills.
Suosha San (Amomum Powder) treats metrorrhagia.
Use Suosha Ren (Amomum Fruit) in any quantity, stir-fry until fragrant on a new tile, powder finely. Take 3 qian mixed with rice drink.
The above four formulas are used to move stagnant qi.
[Popular Transmission] Treats metrorrhagia. Use dried lotus leaf, decoct strongly to one bowl, take on an empty stomach. Cure is immediate. Alternatively, mix with vinegar-stir-fried Xiangfu powder, which is even better.
[Yun] Treats continuous metrorrhagia. Wulingzhi (Trogopterus Dung) 2 qian, stir-fried ripe, decoct with Danggui (Angelica Sinensis Root) and wine. Or decoct with half a cup of water, half wine, and half child's urine. Another method: Wulingzhi half raw half cooked, powdered, taken with wine. Another method: Decoct Wulingzhi in water until half dry, strain, clarify, re-decoct into a paste, add Shenqu (Medicated Leaven) powder, make pills size of paulownia seeds. Take 20-30 pills with warm wine on an empty stomach to stop bleeding.
Another Formula Lurong (Deer Antler, processed with vinegar) and Danggui (Angelica Sinensis Root) (each 2 qian), Huyang (Pollen Typhae, stir-fried) (half liang).
Powder the above three ingredients. Take 5 qian bi-sized spoonfuls mixed with warm wine, three times daily.
[Zhang Zhongjing] Guizhi Fuling Wan (Cinnamon Twig and Poria Pill) treats women with masses, pulsation above the umbilicus, and continuous bleeding. (Formula see section on Fetal Movement with Bleeding.)
The above four formulas are used to eliminate turbid blood.
[Li Dongyuan] Danggui Shaoyao Tang (Angelica and Peony Decoction) treats continuous uterine bleeding in women, bright red color, occurring during the period of July and End of Heat. Initially due to labor, leading to Spleen-Stomach weakness, shortness of breath, spontaneous sweating, body heat, mental confusion, aversion to food, heaviness, laziness, limb weakness, and frequent loose stools; later due to Heart Qi deficiency, bleeding recurs. The patient feels Qi sinking, Yuan Qi failing to ascend, Qi stagnation in the heart and abdomen, inability to speak due to weakness (not laziness). This medicine governs.
Huangqi (Astragalus Root) (1.5 qian) Baizhu (Atractylodes Macrocephala Rhizome) Cangzhu (Atractylodes Lancea Rhizome, soaked in rice water, peeled) Dangguishen (Body of Angelica Sinensis Root) Shaoyao (Peony Root) (each 5 qian) Gancao (Licorice Root, honey-fried) Shengdi (Rehmannia Root, fresh) (each 3 fen) Chaihu (Bupleurum Root) (2 fen) Shudihuang (Rehmannia Root, prepared) Chenpi (Citrus Peel, white part removed) (each 5 fen)
The above ten ingredients are coarsely powdered. Divide into two doses. Decoct in water, strain, and take hot on an empty stomach. After one dose, gradually reduce. By the next day, all symptoms disappear, and appetite returns. Why? Because Qi flows smoothly, allowing the scent of food to be perceived, restoring health.
[Zhang Zhongjing] For women with sinking meridians and black leakage that does not resolve, Jiaojiang Tang (Gelatin and Ginger Decoction) is the primary treatment. This is Xionggui Jiao'ai Tang (Ligusticum, Angelica, Gelatin, and Mugwort Decoction).
Xiong (Ligusticum Rhizome) Ejiao (Donkey-hide Gelatin) Gancao (Licorice Root) (each 2 liang) Aiye (Mugwort Leaf) Danggui (Angelica Sinensis Root) (each 3 liang) Shaoyao (Peony Root) (4 liang) Shudihuang (Rehmannia Root, prepared)
The above seven ingredients are boiled in 5 sheng of water and 3 sheng of clear wine to obtain 3 sheng. Strain, add gelatin until dissolved. Take 1 sheng warm, three times daily. Repeat if not cured.
(One version adds Ganjiang (Dried Ginger) 1 liang; Hu Qia treats uterine movement without Ganjiang.)
[Hai Zang] Siwu Jiaoai Tang (Four Substances, Gelatin, and Mugwort Decoction). (Formula see Women's Section, General Principles.)
[Li Dongyuan] Yiwei Shengyang Tang (Benefit Stomach and Raise Yang Decoction) treats blood loss and tonifies Qi, following ancient methods. First tonify Stomach Qi to aid growth, hence "Yang generates Yin." Sweet-flavored herbs are prioritized. The world thinks this tonifies Qi, not knowing sweet flavors generate Blood, illustrating the principle of Yang generating Yin. Thus, regulating Stomach Qi first is crucial, as nourishment from food is precious to the body.
Huangqi (Astragalus Root) (2 qian) Renshen (Ginseng Root) (remove if coughing) Shenqu (Medicated Leaven, stir-fried) (each 1.5 qian) Shengma (Cimicifuga Rhizome) Chaihu (Bupleurum Root) (each 5 fen) Baizhu (Atractylodes Macrocephala Rhizome) (3 qian) Dangguishen (Angelica Sinensis Root Body, wine-soaked) Gancao (Licorice Root, honey-fried) Chenpi (Citrus Peel) (each 1 qian) Sheng Huangqin (Scutellaria Root, raw) (2 qian, clears latent metal-lung rebellion in summer heat, not used in autumn cool) One version uses Shengdi (Rehmannia Root, fresh).
Coarsely powdered. Take 3 or 5 qian each time. Increase if appetite increases; decrease within 3 qian if appetite decreases. Do not overdose. Take 2 qian, decoct in water, strain, and take hot. If abdominal pain, add Shaoyao (Peony Root) 2 fen and Rougui (Cinnamon Bark) a little per dose. If thirsty/dry mouth, add Gegen (Kudzu Root) 2 fen. If coughing, remove Renshen. Take at any time. (Generally, take this Yiwei Shengyang Tang first; if bleeding continues, then take the subsequent Chaihu Tiaojing Tang for strong lifting.)
The wife of the Official of Experience to Prince Xuande suffered from metrorrhagia and leukorrhea; doctors could not achieve efficacy. After pulse diagnosis, I wrote down her symptoms on paper, totaling over forty types, and prescribed Tiaojing Shengyang Chushi Tang (Regulate Menstruation, Raise Yang, and Expel Dampness Decoction). The next day, eight-tenths of symptoms reduced; fully recovered in five to six days.
Tiaojing Shengyang Chushi Tang treats women with leakage of foul blood, irregular menstruation, or sudden severe metrorrhagia, often passing watery fluids. All caused by irregular diet, physical exhaustion, or inherent Heart Qi deficiency, leading to Heart Fire invading the Spleen due to alcohol and fatigue. The patient must be lethargic, preferring to lie down, limbs unresponsive, fatigued, lacking Qi to move, short of breath, upward rushing Qi, with a slow and wiry-rapid pulse, large upon pressure, felt under the middle finger. This is Spleen Earth pathogen invasion. The Spleen nourishes the whole body; the Heart governs Blood, Blood governs Vessels. Pathogens in both affect the vessels. Vessels are the house of Blood; humans are the spirit of vessels. When the Heart does not command, the Pericardium Collateral commands, hence the Heart vessel belongs to the Heart System. The Heart System refers to the vessels of the Pericardium Collateral and Mingmen, governing menstruation and pregnancy. All due to Spleen-Stomach deficiency allowing Heart Pericardium to invade, causing irregular bloody/watery leakage. Since Spleen-Stomach is the root of Yin-Yang, one must expel dampness and heat, benefit Wind Qi to ascend to overcome dampness. Also: "Fire depression requires dispersal."
Chaihu (Bupleurum Root) Fangfeng (Saposhnikovia Root) Gancao (Licorice Root, honey-fried) Bencao (Ligusticum Chuanxiong Rhizome - *Note: Text says 'Ben', likely Chuanben or similar*) Shengma (Cimicifuga Rhizome) (each 1 qian) Qianghuo (Notopterygium Rhizome) Cangzhu (Atractylodes Lancea Rhizome) Huangqi (Astragalus Root) (each 1.5 qian) Duohuo (Angelica Pubescens Root) (5 fen) Danggui (Angelica Sinensis Root, wine-soaked) (5 fen) Manjingzi (Vitex Fruit) (7 fen)
Cut roughly. Decoct in 5 large bowls of water to 1 large bowl. Strain, take slightly hot. Take on empty stomach. Wait a moment, then eat breakfast to settle. One dose suffices. If moxibustion is applied to Xuehai (SP10) on Foot-Taiyin Splein Meridian for 14 or 21 moxa cones, it stops immediately. This medicine uses the method of balance, using Wind to overcome Dampness, treating Stomach Qi sinking and Qi pressing downward to save from sudden metrorrhagia. If illness resolves and foul blood clears, although main disease is gone, subsequently use Huangqi, Gancao, Renshen, Danggui etc. to tonify, adding blood-regulating herbs to Buqi Shengyang Tang. If foul blood continues, save the root, treat the primary meridian, only benefit Spleen-Stomach, subdue Heart Fire excess, treating the root. If encountering summer leukorrhea and continuous leakage, use this decoction; one dose stops it immediately.
Chaihu Tiaojing Tang (Bupleurum Regulate Menstruation Decoction) treats continuous menstruation, bright red blood, stiff neck tendons, headache, rigid spine pain, and lack of appetite.
Qianghuo (Notopterygium Rhizome) Duohuo (Angelica Pubescens Root) Bencao (Ligusticum Chuanxiong Rhizome) Shengma (Cimicifuga Rhizome) (each 5 fen) Cangzhu (Atractylodes Lancea Rhizome) (1 qian) Chaihu Gen (Bupleurum Root) (7 fen) Gegen (Kudzu Root) Dangguishen (Angelica Sinensis Root Body) Gancao (Licorice Root, honey-fried) (each 3 fen) Honghua (Carthamus Flower) (a small amount)
Cut roughly. One dose. Decoct in water, strain, take slightly hot on empty stomach. Mild sweating stops it immediately.
A woman had dark blood clots in menstruation, a blood mass in the left hypochondrium, continuous watery diarrhea, food digestion intermittent. In April this year, blood clots burst forth along with watery discharge, indicating depletion of有形 (formative) blood from both anterior and posterior orifices. Long-standing, menstruation remains irregular, watery diarrhea 2-3 times daily, irritability after eating, reduced appetite, emaciation. Mr. Dongyuan said: "The Sage treats disease based on the principles of rising, falling, floating, and sinking of the four seasons, and appropriate flexibility. Not basing on four seasons leads to reversal, which is not proper treatment. The great method of treatment must first consider annual Qi, not harm Heavenly Harmony, do not reinforce excess or deplete deficiency, leaving people to premature death; do not induce pathogens or lose correctness, cutting off long life. Thus the Sage said: Yang excess Yin deficiency, purgation cures, sweating kills. Yin excess Yang deficiency, sweating cures, purgation kills. Generally, Sage laws have their own meaning. Such as Shengyang or dispersing agents, they assist Spring-Summer Yang Qi to rise, thereby draining Autumn-Winter storage/killing/cold Qi. This disease fits. Treat with this law, it is the ultimate principle of rising/floating/sinking/yielding. Heaven and Earth Qi rise/float/sink/yield following four seasons; treating disease against this kills. Thus Scripture says: Follow Heaven prosper, defy Heaven perish. Must we not fear! Human body also has Heaven-Earth Four Seasons Qi, not just external; human body is same as Heaven-Earth. Now continuous leakage means anterior orifice Qi-Blood has sunk/depleted; watery diarrhea for years means posterior orifice Qi-Blood has sunk. Posterior orifice governs formative matter; anterior orifice is gate of essence-Qi. Both depleted downward, patient's whole-body Qi constantly follows Autumn-Winter commands. Yin governs killing; this is a storage-type disease. Yang generates Yin, Spring-Summer; in human body, making Qi rise/floating is Grain Qi ascending. Once ill, whole-body Qi-Blood does not grow, Grain Qi does not rise, muscles waste, Two Powers Qi about to perish. Since Lower Origin two orifices both depleted, Qi-Blood exhausted, even if originally Heat syndrome, long-term lower jiao depletion has turned to Cold. This disease has been sunken/downward for long, Cold-Damp too dominant, must urgently rescue. Drain Cold with Heat, drain Damp with Dryness, greatly lift and raise to assist growth, tonify Qi-Blood, prevent hemiplegia. Sage established treatment law: When Dampness greatly dominates, treat with what overcomes it. Assist Jia Wind-Wood to rise. Thus Scripture says: Wind overcomes Damp, treat with what overcomes it. Should harmonize Stomach Qi, next use Baizhu etc. to dry Damp and nourish Yuan Qi. If not stopped, subsequently use Wind herbs to overcome Damp, this is called. This medicine is great lifting/rising to assist Spring-Summer Dampness long-sunk downward, ultimate treatment. Another version says: Next use Siwu Tang, modify according to Damp symptoms."
[Daquan] Dusheng San (Single Holy Powder) treats continuous metrorrhagia in women.
Use Fangfeng (Saposhnikovia Root) removing radicle, any quantity, powder finely. Boil white flour with wine, mix clearly, take 2 qian, empty stomach before meals, twice daily. Even better: make flour paste, throw in wine, extremely effective.
Treat metrorrhagia. Xiakucao (Prunella Vulgaris) powder, take 2 qian mixed with rice drink, at any time.
[Qianjin Fang] Treats continuous metrorrhagia. Xiong (Ligusticum Rhizome) 8 liang, clear wine 5 sheng, decoct to 2.5 sheng, divide into three doses. Those intolerant, advance slowly. (Lou Ying notes: Xiong should not be taken long-term, causes sudden death.)
The above great lifting/rising agents treat metrorrhagia with deep-wiry-large or deep-thin-rapid pulses, all indicating Stomach Qi sinking. Or metrorrhagia with chronic diarrhea, also Stomach Qi sinking. Thus lifting raises it, disease heals.
[Li Dongyuan] There are two types of continuous menstrual leakage, supplementing predecessors' omissions. Women with Spleen-Stomach deficiency cause Mingmen pulse deep-thin-rapid or deep-wiry-large-forceful, Cun-Guan pulses same. All due to Spleen-Stomach deficit, sinking to Kidney, combining with Minister Fire, Damp-Heat pressing downward, continuous leakage, color purple-black, smelling like rotting meat in summer. With white discharge, pulse must be thin-wiry, Cold acting inside. With red discharge, pulse large-rapid, Heat disease obvious. Must have waist pain or umbilical pain, chills/fever alternating before menstruation, tight/shrinking bilateral hypochondrium, plus Spleen-Stomach symptoms appearing, or limb heat, mental irritability insomnia, upper heart urgency. Should greatly tonify Spleen-Stomach and regulate Qi-Blood rising/falling, one dose cures. Or those who were noble then humble, rich then poor, disease named Tuoying (Depleted Camp), Heart Qi deficiency, Fire blazing in blood vessels, plus Spleen-Stomach dietary irregularity, Fire invading middle, physical muscle face not diseased, this is Heart disease, not manifesting in pulse. Thus Spleen-Stomach dietary irregularity symptoms obvious. But menstruation comes/goes irregularly, sudden continuous flow. Treatment should first speak of fearful death words, advise fear of death so Heart moves not, use great Qi-Blood tonifying medicine to nourish Spleen-Stomach, slightly add calming Heart Fire medicine to treat Heart, tonify Yin drain Yang, menstruation stops naturally. Wei Lun says: Excessive grief cuts Pericardium Collateral; cut Pericardium Collateral causes internal Yang movement, erupts as Heart collapse (frequent urination of blood). Thus Scripture says: Great vessels empty, erupts as muscle Bi, transmits to vessel Wei, this is called.
Winter of Dingwei Year, Guo Dafang said his wife had sudden severe metrorrhagia, previously lost blood from miscarriage, since then menstruation came every few days, now continuous. She has narrow mind, impatient nature, easily startled. I predicted: Future illness due to Heart Qi deficiency, dietary irregularity. Dafang said: Wait till I go there. Pulse: palm cold, deep-thin-slow, intermittently deep-rapid, nine orifices slightly blocked, limb weakness, upper panting, short breath, nose/mouth Qi irregular. Indeed Heart Qi deficiency, dietary irregularity, Spleen-Stomach weakness signs. Epigastric pain center-left, left hypochondrium tight/shrinking with accumulation, pulsation at umbilicus, borborygmus, lower Qi, difficult stool, many deficiency signs, cannot record all. Plan to treat root first, other signs can go. Give calming Spirit, settling fright, harmonizing Spleen-Stomach, greatly benefiting Yuan Qi, tonifying blood vessels, nourishing Heart Spirit, with great-hot agent to remove winter cold condensed in skin, slightly add Shengdi (Rehmannia Root, fresh) to remove Mingmen Minister Fire, preventing limb flaccidity. Huangqi Danggui Renshen Tang (Astragalus, Angelica, Ginseng Decoction).
Huangqi (Astragalus Root) (1 qian) Danggui (Angelica Sinensis Root) (1.5 qian) Renshen (Ginseng Root) (1 qian) Chenpi (Citrus Peel) (5 fen) Caodoukou (Black Cardamom Seed) (7 fen) Shenqu (Medicated Leaven) (0.5 qian, digest food, remove Spleen-Stomach cold) Huanglian (Coptis Rhizome) (1 qian, calm Heart fright) Xingren (Apricot Seed) (9 pieces, ground to paste) Mahuang (Ephedra Stem) (1 qian, do not remove joints, close exterior sweat) Guizhi (Cinnamon Twig) (0.5 qian, must first consider annual Qi, no replacing Heavenly Harmony) Shengdi (Rehmannia Root, fresh) (3 fen, remove Kidney fire, greatly remove Winter Minister Fire excess)
Coarsely powdered. Water 3 large bowls. First boil Mahuang several boils, strain, add previous medicines, decoct to 1 large bowl. Before Si-Wu hours (9am-1pm), after food digested, take. Epigastric pain is guest-cold on Stomach, give great-hot medicine, Caodoukou Wan (Black Cardamom Pill) 15 pills, pain stops immediately. Then give Liver accumulation medicine, remove accumulation root, cure.
Above is deficiency with accumulation stagnation causing metrorrhagia. Once treated an old woman with continuous metrorrhagia, flowing endlessly, bed full of blood, unable to get up for three months. Abdomen full like pregnancy. I treated as deficiency with phlegm-accumulation and turbid blood. Used Siwu Tang 4 liang, Renshen (Ginseng Root) and Baizhu (Atractylodes Macrocephala Rhizome) 1 liang each, Gancao (Licorice Root) half liang to treat deficiency; Xiangfu (Cyperus Rhizome) 3 liang, Banxia (Pinellia Tuber) 1.5 liang, Fuling (Poria), Chenpi (Citrus Peel), Zhishi (Immature Bitter Orange), Suosha (Amomum Fruit), Yuanhu (Corydalis Rhizome) each 1 liang to break phlegm-accumulation and turbid blood. Divided into 20 doses. Each dose decocted with Gan Heye (Dried Lotus Leaf) and Cebaiye (Platycladus Leaf) soup, re-decocted and taken. Finished curing well. Now not recurring again, miraculous effect.
[Yun] Baihuang San (Cypress and Scutellaria Powder) treats continuous menstrual blood.
Huangqin (Scutellaria Root) (1 liang 2.5 qian) Cebaiye (Platycladus Leaf) Huyang (Pollen Typhae) (each 1 liang) Fulonggan (Dragon's Bone/Stove Hearth Soil) (1 liang)
Cut roughly. Water 2 sheng, decoct to 8 he. Divide into two doses.
Another Formula Treats continuous metrorrhagia, forming blood sheets, broken like chicken liver color.
Xiong (Ligusticum Rhizome) (12 fen) Ejiao (Donkey-hide Gelatin) Qingzhuru (Green Bamboo Shavings) (each 8 fen) Xuduan (Dipsacus Root) Diyü (Sanguisorba Root) Xiaoji Gen (Cirsium Root) (each 3 fen) Danggui (Angelica Sinensis Root) (6 fen) Shengdi (Rehmannia Root, fresh) Fulonggan (Dragon's Bone/Stove Hearth Soil) (each 11 fen)
Water 9 bowls, decoct to 3 bowls. Strain, divide into three doses.
[Yanyi] Treats women's blood loss. Can Sha (Mulberry Silkworm Frass) 1 liang, stir-fried Fulonggan (Dragon's Bone/Stove Hearth Soil) half liang, Ejiao (Donkey-hide Gelatin) 1 liang, all powdered. Mixed with warm wine, empty stomach, 2-3 qian, until known effect (Daquan names Bibi San, no Ejiao).
[Luo Tianyi] Fulonggan San (Dragon's Bone/Stove Hearth Soil Powder) treats Qi-Blood labor injury, Chong-Ren meridian deficiency, menstruation suddenly bursting down out of time, or like bean curd dregs, or forming blood sheets, or five colors mixed, or red-white combined, cold pain in umbilicus/abdomen, long duration not stopping, causing yellow-thinness, dry mouth, reduced diet, limb weakness, empty irritability, palpitations.
Fulonggan (Dragon's Bone/Stove Hearth Soil) (1 liang) Gancao (Licorice Root) (half liang) Chishizhi (Red Halloysite) (1 liang) Xiong (Ligusticum Rhizome) (3 liang) Rougui (Cinnamon Bark) (half liang) Shudi (Prepared Rehmannia Root) (2 liang) Danggui (Angelica Sinensis Root) Ganjiang (Dried Ginger) (each 7.5 qian) Aiye (Mugwort Leaf) (2 liang, slightly stir-fried) Maidong (Ophiopogon Tuber, heart removed) (1.5 liang)