1.淋沥不断名为漏, 忽然大下谓之崩, 紫黑块痛属瘀热, 久多缘损
任冲经, 脾虚不摄中气陷, 暴怒伤肝血妄行, 临证审因虚细辨, 虚补
瘀消热用清.
【注】妇人行经之后, 淋沥不止, 名曰经漏. 经血忽燃大下不止, 名
为经崩. 若其色紫黑成块, 腹胁胀痛者, 属瘀热. 若日久不止, 及去
血过多而无块痛者, 多系损伤冲任二经所致. 更有优思伤脾, 脾虚不
能摄血者, 有中气下陷不能固血者, 有暴怒伤肝, 肝不藏血而血妄行
者.临证之时, 须详审其因而细细辨之. 虚者补之, 瘀者消之, 热者
清之, 治之得法, 自无不愈.
荆芩四物汤
2.崩漏血多物胶艾, 热多知柏少荆芩, 漏涩香附桃红破, 崩初胀痛
琥珀灵, 日久气血冲任损, 八珍大补养荣宁, 思虑伤脾归脾治, 伤肝
逍遥香附青.
【注】崩血漏血去血过多者, 宜用胶艾四物汤补之. 如属热多者, 宜
用知柏四物汤清之. 热少者, 宜用荆芩四物汤和之. 若漏血涩少, 此
属血滞, 宜用四物汤加香附, 桃仁, 红花破之. 若崩血初起胀痛, 此
属瘀凝, 宜用琥珀散攻之. 崩漏日久, 气血已亏, 冲任损伤者, 宜用
八珍汤, 十全大补汤, 人参养荣汤, 量补其损伤. 若因思虑伤脾者,
宜用归脾汤补之. 恚怒伤肝者, 宜用逍遥散加炒香附, 青皮平之.
胶艾四物汤 四物汤 琥珀散 十全大补汤 人参养荣汤 归脾汤
逍遥散 ( 方俱见前调经汇方内 )
补中益气汤 益胃升阳汤
3.气陷补中益气举, 保元升柴归术陈, 益胃升阳加面麴, 腹痛加芍
嗽减参.
【注】崩漏日久, 脾伤食少, 中气下陷, 不能载血者, 宜用补中益气
汤,升阳益胃汤升举之. 补中益气汤, 即人参, 黄耆, 甘草. 保元汤
加升麻, 柴胡, 当归, 白术, 陈皮也. 益胃升阳汤, 即补中益气汤加
黄芩, 神麴也. 若腹痛者, 宜加白芍药; 有热者, 用黄芩; 无热者,
用肉桂调之. 咳嗽者, 肺热也, 减人参.
调经升阳除湿汤
4.夹水水泻不甚弱, 调经升阳除湿汤, 耆草升柴归苍术, 羌独?? 本
蔓荆防.
【注】崩漏下血夹水, 或日水泻一二次, 形气不甚弱者, 宜宜用调经
升阳除湿汤. 其方即黄耆, 甘草, 升麻, 柴胡, 当归, 苍术, 羌活,
独活,?? 本, 蔓荆子, 防风也. 以风药先胜其湿, 若形气虚弱者, 则
当加人参, 陈皮, 合补中益气汤补中胜湿可也.
失笑散 地榆苦酒煎
5.杀血心统失笑散, 蒲黄五灵脂定疼, 崩血不已防滑脱, 地榆苦酒
煎止崩.
【注】崩血心腹痛甚者, 名曰杀血. 心痛乃血滞不散, 宜用失笑散.
其方即蒲黄, 五灵脂也. 先定其痛, 痛止然后随症治之. 若崩血补之
仍然不止者, 当防其滑脱, 宜用地榆一两, 醋煎, 露一宿, 次早温服
立止, 止后随症治之, 名地榆苦酒煎.
1. 经血淋漓不断称为“漏”，突然大量出血称为“崩”。血色紫黑且有血块、伴有疼痛，属于瘀热证；病程长久多因损伤了任脉和冲脉所致。脾气虚弱不能统摄血液，导致中气下陷；暴怒伤肝，导致血液妄行。临证时必须审察病因，仔细辨别虚实。虚证用补法，瘀证用消法，热证用清法。
【注】妇女行经之后，淋沥不止，称为“经漏”。经血忽然大量涌出不止，称为“经崩”。如果血色紫黑成块，腹部和胁肋胀痛，属于瘀热证。如果日久不止，以及失血过多而没有血块和疼痛的，多系损伤了冲脉和任脉二经所致。更有忧思伤脾，脾气虚弱不能摄血的，有中气下陷不能固摄血液的，有暴怒伤肝，肝脏不能藏血而血液妄行的。临证之时，必须详细审察其病因并细细辨别。虚证则补益，瘀滞则消散，热证则清热，治疗得法，自然没有不愈的。
荆芩四物汤
2. 崩漏出血量多，宜用胶艾四物汤；热象明显者，宜用知柏四物汤；热象轻微者，宜用荆芩四物汤调和。漏下涩少，属血滞，宜用桃红四物汤（即四物汤加桃仁、红花）破瘀；崩漏初起伴有胀痛，属瘀凝，宜用琥珀散攻逐。崩漏日久，气血亏损，冲任受损，宜用八珍汤、十全大补汤或人参养荣汤大补以滋养安宁。若因思虑伤脾，宜用归脾汤治疗；若因愤怒伤肝，宜用逍遥散加炒香附、青皮平肝。
【注】崩漏去血过多的，宜用胶艾四物汤补益。如属热多者，宜用知柏四物汤清热。热少者，宜用荆芩四物汤调和。若漏血涩少，此属血滞，宜用四物汤加香附、桃仁、红花破瘀。若崩血初起胀痛，此属瘀凝，宜用琥珀散攻逐。崩漏日久，气血已亏，冲任损伤的，宜用八珍汤、十全大补汤、人参养荣汤，酌情补益其损伤。若因思虑伤脾的，宜用归脾汤补益。恚怒伤肝的，宜用逍遥散加炒香附、青皮平肝。
（胶艾四物汤、四物汤、琥珀散、十全大补汤、人参养荣汤、归脾汤、逍遥散，方剂均见前文调经汇方内）
补中益气汤、益胃升阳汤
3. 中气下陷，用补中益气汤升举；该方由保元汤加升麻、柴胡、当归、白术、陈皮组成。益胃升阳汤即在补中益气汤基础上加黄芩、神曲。若腹痛加白芍药；有热者用黄芩；无热者用肉桂调理。咳嗽者属肺热，需减少人参用量。
【注】崩漏日久，脾脏受伤食欲减退，中气下陷，不能载血上行，宜用补中益气汤、升阳益胃汤升举阳气。补中益气汤，即由人参、黄芪、甘草等组成（注：原文此处简略，实际含补气升阳诸药），保元汤加升麻、柴胡、当归、白术、陈皮而成。益胃升阳汤，即补中益气汤加黄芩、神曲。若腹痛者，宜加白芍药；有热者，用黄芩；无热者，用肉桂调之。咳嗽者，乃肺热也，应减用人参。
调经升阳除湿汤
4. 夹有水湿、水泻且体质不甚虚弱者，用调经升阳除湿汤。该方由黄芪、甘草、升麻、柴胡、当归、苍术、羌活、独活、藁本、蔓荆子、防风组成。以风药先胜其湿，若形体气息虚弱者，则应当加人参、陈皮，合用补中益气汤以补中胜湿即可。
【注】崩漏下血夹杂水样便，或者每日水泻一二次，形体气势不甚虚弱的，宜用调经升阳除湿汤。其方即由黄芪、甘草、升麻、柴胡、当归、苍术、羌活、独活、藁本、蔓荆子、防风组成。利用风药先胜其湿气，若形体气息虚弱者，则应当加人参、陈皮，配合补中益气汤补益中气、胜湿即可。
失笑散、地榆苦酒煎
5. 杀血心痛用失笑散止痛，方由蒲黄、五灵脂组成，可定痛。崩血不止以防滑脱，用地榆一两，醋煎，露置一夜，次日清晨温服可立止，名曰地榆苦酒煎。
【注】崩血伴有心腹剧烈疼痛的，名为“杀血”。心痛乃是血滞不散所致，宜用失笑散。其方即由蒲黄、五灵脂组成。先安定其疼痛，痛止然后随症治疗。若崩血经过补益仍然不止的，应当防止滑脱不禁，宜用地榆一两，用醋煎煮，露天放置一夜，第二天早晨温服，立刻止血，止血后随症治疗，名为地榆苦酒煎。
1. Continuous dripping of menstrual blood is called "Lou" (Leukorrhea/Menorrhagia with prolonged duration), while sudden massive bleeding is called "Beng" (Metrorrhagia/Uterine hemorrhage). Purple-black clots with pain belong to Blood Stasis and Heat; long-standing cases are often due to damage to the Ren Mai (Conception Vessel) and Chong Mai (Penetrating Vessel). Spleen Qi deficiency fails to control blood, leading to sinking of Middle Qi; violent anger injures the Liver, causing blood to flow recklessly. In clinical practice, one must investigate the etiology and carefully differentiate between deficiency and excess. Deficiency is treated with tonification, stasis with resolution, and heat with clearing.
[Note] After menstruation, if bleeding continues in a dripping manner without cessation, it is named "Jing Lou" (Menstrual Leaking). If menstrual blood suddenly flows out massively without stopping, it is named "Jing Beng" (Menstrual Hemorrhage). If the color is purple-black forming clots, accompanied by distending pain in the abdomen and hypochondrium, it belongs to Blood Stasis and Heat. If it persists for a long time, or if there is excessive blood loss without clots or pain, it is mostly caused by injury to the Chong and Ren meridians. Furthermore, worry and overthinking injure the Spleen, where Spleen deficiency fails to hold blood; there are cases of Middle Qi sinking failing to consolidate blood; and cases of violent anger injuring the Liver, where the Liver fails to store blood, causing blood to flow recklessly. At the time of clinical examination, one must carefully examine the cause and distinguish meticulously. For deficiency, tonify; for stasis, resolve; for heat, clear. If the treatment is appropriate, recovery will naturally follow.
Jingqin Siwu Decoction
2. For Beng and Lou with excessive blood loss, use Jiao'ai Siwu Decoction; for cases with predominant heat, use Zhibai Siwu Decoction; for cases with slight heat, use Jingqin Siwu Decoction to harmonize. For Lou with scanty, obstructed flow, which belongs to Blood Stasis, use Siwu Decoction plus Xiangfu (Cyperus Rhizome), Taoren (Peach Kernel), and Honghua (Carthamus Flower) to break stasis. For initial Beng with distending pain, which belongs to Blood Coagulation, use Hupo San (Amber Powder) to attack and dispel. For long-standing Beng and Lou with Qi and Blood deficiency and injury to Chong and Ren, use Bazhen Tang (Eight Treasure Decoction), Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction), or Renshen Yangrong Tang (Ginseng Nourishing Vigor Decoction) to greatly tonify and nourish. If injured by overthinking affecting the Spleen, use Guipi Tang (Restore the Spleen Decoction); if injured by anger affecting the Liver, use Xiaoyao San (Free and Easy Wanderer Powder) plus fried Xiangfu and Qingpi (Aurantium Peel) to level the Liver.
[Note] For Beng and Lou with excessive blood loss, use Jiao'ai Siwu Decoction to tonify. If heat is predominant, use Zhibai Siwu Decoction to clear heat. If heat is slight, use Jingqin Siwu Decoction to harmonize. If leakage is scanty and obstructed, this belongs to Blood Stasis; use Siwu Decoction plus Xiangfu, Taoren, and Honghua to break stasis. If hemorrhage begins with distending pain, this belongs to Blood Coagulation; use Hupo San to attack. For long-standing Beng and Lou where Qi and Blood are already deficient and Chong and Ren are damaged, use Bazhen Tang, Shiquan Dabu Tang, or Renshen Yangrong Tang to tonify the damage according to circumstances. If the Spleen is injured by overthinking, use Guipi Tang to tonify. If the Liver is injured by rage, use Xiaoyao San plus fried Xiangfu and Qingpi to level.
(Jiao'ai Siwu Decoction, Siwu Decoction, Hupo San, Shiquan Dabu Tang, Renshen Yangrong Tang, Guipi Tang, Xiaoyao San - formulas are all found in the preceding Harmonizing Menstruation Collection of Formulas.)
Buzhong Yiqi Tang, Yiwei Shengyang Tang
3. For sinking Qi, use Buzhong Yiqi Tang to lift; [this formula consists of] Baoyuan Tang plus Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). Yiwei Shengyang Tang is Buzhong Yiqi Tang plus Huangqin (Scutellariae Radix) and Shenqu (Massa Medicata Fermentata). If abdominal pain occurs, add Baishao (Paeoniae Radix Alba); if heat exists, use Huangqin; if no heat, use Rougui (Cinnamomi Cortex) to regulate. Cough indicates Lung Heat, so reduce the dosage of Renshen (Ginseng Radix).
[Note] For long-standing Beng and Lou, where the Spleen is injured and appetite is poor, Middle Qi sinks, and cannot carry blood upward, use Buzhong Yiqi Tang and Shengyang Yigang Tang to raise Yang. Buzhong Yiqi Tang... [Note: The original text simplifies the composition here, referring to previous context], essentially derived from Baoyuan Tang plus Shengma, Chaihu, Danggui, Baizhu, and Chenpi. Yiwei Shengyang Tang is Buzhong Yiqi Tang plus Huangqin and Shenqu. If there is abdominal pain, add Baishao; if there is heat, use Huangqin; if there is no heat, use Rougui for regulation. Cough is due to Lung Heat, so reduce Renshen.
Tiaojing Shengyang Chushi Tang
4. For bleeding mixed with water/watery diarrhea where constitution is not severely weak, use Tiaojing Shengyang Chushi Tang. This formula consists of Huangqi (Astragali Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Shengma, Chaihu, Danggui, Cangzhu (Atractylodis Rhizoma), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Gaoben (Ligustici Rhizoma et Radix), Manjingzi (Vernoniae Fructus), and Fangfeng (Saposhnikoviae Radix). Use wind-dispelling herbs first to overcome dampness. If the constitution and Qi are weak, add Renshen and Chenpi, combining with Buzhong Yiqi Tang to tonify the Middle and overcome dampness.
[Note] For Beng and Lou with bloody discharge mixed with watery stool, or watery diarrhea once or twice a day, where the physical form and Qi are not severely weak, use Tiaojing Shengyang Chushi Tang. Its formula consists of Huangqi, Gancao, Shengma, Chaihu, Danggui, Cangzhu, Qianghuo, Duhuo, Gaoben, Manjingzi, and Fangfeng. Utilize wind-dispelling herbs to first overcome the dampness. If the physical form and Qi are weak, then add Renshen and Chenpi, combining with Buzhong Yiqi Tang to tonify the Middle and overcome dampness.
Shixiao San, Diyukujiu Jian
5. For "Sha Xue" (killing blood) with heart pain, use Shixiao San; composed of Puhuang (Lygodii Spora) and Wulingzhi (Trogopterori Faeces), it stabilizes pain. For unceasing Beng hemorrhage to prevent slipping/depletion, use Diyukujiu Jian (Diyu decocted in vinegar).
[Note] Severe heart and abdominal pain accompanying Beng hemorrhage is named "Sha Xue". Heart pain is due to stagnant blood not dispersing; use Shixiao San. Its formula consists of Puhuang and Wulingzhi. First stabilize the pain; after pain ceases, treat according to symptoms. If Beng hemorrhage continues despite tonification, one must guard against slipping/depletion; use one liang of Diyü (Sanguisorbae Radix), decocted in vinegar, exposed overnight, taken warm the next morning to stop bleeding immediately. After stopping, treat according to symptoms. This is named Diyukujiu Jian.