又有癖块一证，虽因痰与血食三者而成。然成于血者居多，因痰与食而成块者，虽成而不
碍其经水。成于血者，亦有经虽来不时而断也，此必经水既来之候，尚有旧血未尽。或偶感
于寒气，或触于怒气，留滞于两胁小腹之间，则成血癖也。有经水月久不行，腹胁有块作痛
，是经血作 瘕，法当调经止痛，桃仁、浓朴、当归、红花、香附、元胡、肉桂、丹皮、乳
香、木香、牛膝、小茴、砂仁之类。有经行腹痛，麻痹头疼寒热，乃触经感冒也，宜加减五
积散。若经行时遍身疼痛，手足麻痹，寒热目眩，照前方去干姜，加羌活、独活、白芷、
当归、官桂、麻黄、川芎、白芍、陈皮、苍术之类。又有经水不调，小腹时痛，赤白带下，
乃子宫虚寒，治宜艾附暖宫丸。亦有行时气血虚弱，血海寒冷，经水不调，心腹疼痛，带下
如鱼脑，或如泔，错杂不分，信期淋漓不止，面黄肌瘦，四肢无力，头晕眼花者，宜补经汤
。
艾附暖宫丸
艾叶 香附（四制） 元胡 熟地 甘草
共为末，醋糊丸，如桐子大，每服八十丸，米汤下。
补经汤
人参 白术 川芎 香附 当归 熟地 元胡 肉桂 吴萸 砂仁 茯神 沉香 阿胶 黄
小茴 陈皮 白芍
水煎服。
妇人月信准而不受胎者，其故有三∶有因痰闭子宫者，有因气食生冷者，有因男子阳伤易泄
者。如痰闭子宫者，其妇必肥白，经来腹不痛，宜导痰汤，或人参半夏丸之类，或二陈合四
物汤。如气食生冷所致者，其腹多痛，宜温之，千金吉祥丸之类，如咳嗽，又不宜服，以四
物加陈皮、香附、山楂。如气作泻，用枳实丸。如男子精寒易泄，不能受孕者，与妇无干，
只宜男子服药。或谓经水正而子宫寒者，万无是理也。盖子宫若寒，经水必过期矣。或又云
∶子宫寒者，因产时阴户着寒所致，第产后阴户着寒，产妇即便不语，岂能语者，尚谓着寒
乎。
薛古蒙曰∶妇人经行不正，每不受胎，然参前而受胎者亦有之，其血热故也。女科书云∶先
期为血热，后期为血气，第有参前落后互兼者。何也?大抵妇人性执，多恼着气，则气不调
矣。夫气为血之母，气乱则经期亦乱矣。故调经以理气为先，宜以归附丸、四物丸之类。又
有冲任寒损，胎孕不成，或成而后多堕者，诜诜丸主之。
诜诜丸
干姜 白术 丹皮 元胡 肉桂 泽兰 熟地 川芎 白芍 当归 石斛
上为末，醋糊丸，煮酒送下。
异痰汤
半夏 南星 橘红 枳实 茯苓 人参 菖蒲 竹茹 甘草
加姜煎。
《千金》吉祥丸
天麻（煨，一两） 川芎 肉桂 丹皮 熟地 白术 柳絮 五味 茯苓 菟丝子 覆盆 枳
实桃花片（各一两）
上为末蜜丸，如豆大，每服五丸，空心，煮酒送下。
还有一种癖块（腹内结块，固定不移）的病症，虽然是由痰、血、食积三者共同形成。但是由血瘀形成的居多。因痰和食积形成块状的，即使形成了也不会阻碍月经来潮。由血瘀形成的，也有月经虽然按时来潮但经血断断续续的情况，这必定是在月经刚来的时候，体内还有未排尽的旧血。或者偶尔感受了寒气，或者触犯了怒气，导致气血留滞于两胁和小腹之间，就形成了血癖。
有的妇女月经数月不行，腹胁部有块状物且疼痛，这是经血凝结成瘕（腹内结块，聚散无常），治法应当调理月经、止痛，可用桃仁、厚朴、当归、红花、香附、延胡索、肉桂、牡丹皮、乳香、木香、牛膝、小茴香、砂仁等药物。
有的妇女行经时腹痛，伴有肢体麻木、头痛、恶寒发热，这是因为经期感冒所致，适宜用加减五积散。如果在行经期间全身疼痛，手足麻木，恶寒发热，头晕目眩，按照前面的方子去掉干姜，加入羌活、独活、白芷、当归、官桂、麻黄、川芎、白芍、陈皮、苍术等药物。
又有月经不调，小腹时常疼痛，白带与赤带夹杂而下，这是由于子宫虚寒所致，治疗适宜用艾附暖宫丸。
也有在行经时气血虚弱，血海寒冷，导致月经不调，心腹部疼痛，白带像鱼脑一样，或者像米泔水一样，红白混杂不分，到了经期淋漓不尽，面色萎黄，肌肉消瘦，四肢无力，头晕眼花的，适宜用补经汤。
艾附暖宫丸
艾叶、香附（经过四种方法炮制）、延胡索、熟地黄、甘草。
以上药物共研为细末，用醋调糊制成丸药，大小如梧桐子大，每次服用八十丸，用米汤送服。
补经汤
人参、白术、川芎、香附、当归、熟地黄、延胡索、肉桂、吴茱萸、砂仁、茯神、沉香、阿胶、黄芪、小茴香、陈皮、白芍。
用水煎煮后服用。
妇女月经周期准确但不能受孕的原因，主要有三种：有的是因为痰湿闭塞子宫，有的是因为气滞和食用生冷食物，有的是因为男子阳气损伤容易早泄。
如果是痰湿闭塞子宫，这位妇女一定形体肥胖、肤色白皙，月经来时腹部不痛，适宜用导痰汤，或者人参半夏丸之类的方剂，或者将二陈汤与四物汤合用。
如果是因气滞和食用生冷食物导致的，其腹部多疼痛，适宜温中散寒，可用千金吉祥丸之类的方剂；如果伴有咳嗽，又不宜服用该方，可以用四物汤加上陈皮、香附、山楂。
如果是男子精液寒冷容易早泄，不能使妻子受孕，这与妇人无关，只适宜让男子服药。
有人说月经正常但子宫寒冷的，绝对没有这种道理。因为如果子宫寒冷，月经必然会推迟。又有人说：子宫寒冷，是因为生产时阴户受寒所致。然而产后阴户受寒，产妇就会立刻失语，怎么能说话呢？既然能说话，还能说是受寒吗？
薛古蒙说：妇女月经不正常，往往不能受孕，但也有在预期日期前受孕的，这是因为血热的原因。女科书籍说：月经先期（提前）是血热，后期（推后）是血气虚，只是有提前和推后互相兼夹的情况。为什么呢？大概妇人性情固执，多恼怒伤气，导致气机不调。气是血的母亲，气乱了则经期也会乱。所以调理月经以理气为先，适宜用归附丸、四物丸之类的方剂。
又有冲任二脉寒损，导致胎孕不成，或者成胎后容易流产的，用诜诜丸主治。
诜诜丸
干姜、白术、牡丹皮、延胡索、肉桂、泽兰、熟地黄、川芎、白芍、当归、石斛。
以上药物研为细末，用醋调糊制成丸药，用煮过的酒送服。
异痰汤
半夏、天南星、橘红、枳实、茯苓、人参、石菖蒲、竹茹、甘草。
加生姜煎煮。
《千金》吉祥丸
天麻（煨制，一两）、川芎、肉桂、牡丹皮、熟地黄、白术、柳絮、五味子、茯苓、菟丝子、覆盆子、枳实、桃花片（各一两）。
以上药物研为细末，用蜂蜜制成丸药，大小如豆粒，每次服用五丸，空腹时，用煮过的酒送服。
There is another condition known as "Pi Mass" (abdominal masses that are fixed and immovable), which, although formed by the combination of phlegm, blood stasis, and food stagnation, is mostly caused by blood stasis. When masses are formed due to phlegm and food stagnation, even if they form, they do not obstruct menstruation. When caused by blood stasis, there may also be cases where menstruation occurs on time but flows intermittently; this necessarily indicates that upon the onset of menstruation, there is still old blood remaining in the body. If one occasionally contracts cold pathogenic factors or is provoked by anger, causing qi and blood to stagnate between the hypochondrium and the lower abdomen, a blood-related Pi Mass forms.
In cases where menstruation has been absent for months and there are painful masses in the abdomen and hypochondrium, this is "Jia Mass" (abdominal masses that gather and disperse irregularly) formed by menstrual blood. The treatment method should focus on regulating menstruation and relieving pain, using herbs such as Tao Ren (Peach Kernel), Hou Po (Magnolia Bark), Dang Gui (Angelica Sinensis), Hong Hua (Safflower), Xiang Fu (Cyperus Rhizome), Yuan Hu (Corydalis Rhizome), Rou Gui (Cinnamon Bark), Mu Dan Pi (Moutan Cortex), Ru Xiang (Frankincense), Mu Xiang (Aucklandiae Radix), Niu Xi (Achyranthes Root), Xiao Hui Xiang (Fennel Fruit), and Sha Ren (Amomum Fruit).
In cases where abdominal pain occurs during menstruation accompanied by limb numbness, headache, aversion to cold, and fever, this is due to catching a cold during the menstrual period. It is appropriate to use Jiajian Wuji San (Modified Five Accumulations Powder). If throughout the body there is pain during menstruation, with numbness in hands and feet, aversion to cold, fever, and dizziness, remove Gan Jiang (Dried Ginger) from the previous prescription and add Qiang Huo (Notopterygii Rhizoma et Radix), Du Huo (Angelicae Pubescentis Radix), Bai Zhi (Angelicae Dahuricae Radix), Dang Gui (Angelicae Sinensis Radix), Guan Gui (Cassiae Ramulus), Ma Huang (Ephedrae Herba), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Chen Pi (Citri Reticulatae Pericarpium), and Cang Zhu (Atractylodis Rhizoma).
In cases of irregular menstruation with occasional lower abdominal pain and mixed leukorrhea (white and red discharge), this is due to deficiency-cold of the uterus. The treatment should employ Aifu Nuangong Wan (Mugwort and Cyperus Warming Uterus Pill).
In cases where qi and blood are weak during menstruation, the Sea of Blood is cold, leading to irregular menstruation, heart and abdominal pain, leukorrhea resembling fish brains or rice water, mixed and indistinguishable, continuous dripping beyond the expected period, sallow complexion, emaciation, weakness in the four limbs, dizziness, and blurred vision, Bu Jing Tang (Menstruation-Nourishing Decoction) is appropriate.
**Aifu Nuangong Wan (Mugwort and Cyperus Warming Uterus Pill)**
Ai Ye (Artemisiae Argyi Folium), Xiang Fu (Cyperi Rhizoma - processed by four methods), Yuan Hu (Corydalidis Rhizoma), Shu Di Huang (Rehmanniae Radix Praeparata), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Grind all into fine powder, make pills with vinegar paste, size of paulownia seeds. Take 80 pills per dose, washed down with rice soup.
**Bu Jing Tang (Menstruation-Nourishing Decoction)**
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Xiang Fu (Cyperi Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata), Yuan Hu (Corydalidis Rhizoma), Rou Gui (Cinnamomi Cortex), Wu Zhu Yu (Evodiae Fructus), Sha Ren (Amomi Fructus), Fu Shen (Poria Cum Radice), Chen Xiang (Aquilariae Lignum Resinatum), E Jiao (Colla Corii Asini), Huang Qi (Astragali Radix), Xiao Hui Xiang (Foeniculi Fructus), Chen Pi (Citri Reticulatae Pericarpium), Bai Shao (Paeoniae Radix Alba).
Decoct in water and take orally.
For women whose menstruation is regular but who fail to conceive, there are three main causes: obstruction of the uterus by phlegm-dampness, qi stagnation combined with consumption of raw/cold foods, or male yang deficiency leading to premature ejaculation.
If the cause is phlegm-dampness obstructing the uterus, the woman will likely be obese with fair skin, and experience no abdominal pain during menstruation. Dao Tan Tang (Phlegm-Resolving Decoction) or Renshen Banxia Wan (Ginseng and Pinellia Pill) are appropriate, or a combination of Er Chen Tang (Two-Aged Decoction) and Si Wu Tang (Four Substances Decoction).
If caused by qi stagnation and consumption of raw/cold foods, abdominal pain is common. Warmth is required, so Qianjin Jixiang Wan (Thousand Gold Auspicious Pill) may be used. However, if cough is present, this formula is contraindicated; instead, use Si Wu Tang (Four Substances Decoction) added with Chen Pi (Citri Reticulatae Pericarpium), Xiang Fu (Cyperi Rhizoma), and Shan Zha (Crataegi Fructus).
If qi stagnation causes diarrhea, use Zhi Shi Wan (Immature Bitter Orange Pill).
If the man suffers from cold sperm and premature ejaculation, preventing conception, this is unrelated to the woman; only the man needs medication.
Some argue that regular menstruation with a cold uterus makes conception impossible. This is logically flawed. If the uterus were cold, menstruation would inevitably be delayed. Others claim uterine coldness results from cold exposure of the vaginal opening during childbirth. However, if the vaginal opening were cold postpartum, the mother would immediately lose her voice; since she can speak, it cannot be attributed to cold exposure.
Xue Gumeng stated: Women with irregular menstruation often fail to conceive, but some conceive before their expected date due to blood heat. Gynecological texts state: Early menstruation indicates blood heat, while late menstruation indicates blood and qi deficiency. However, early and late patterns may coexist. Why? Generally, women have stubborn temperaments and are prone to anger, which disrupts qi flow. Since qi is the mother of blood, chaotic qi leads to chaotic menstruation. Therefore, regulating menstruation prioritizes regulating qi. Guifu Wan (Angelica and Cyperus Pill) or Si Wu Wan (Four Substances Pill) are appropriate.
For damage to the Chong and Ren meridians due to cold, resulting in failure to conceive or frequent miscarriages, Shenshen Wan (Shenshen Pill) is the primary treatment.
**Shenshen Wan (Shenshen Pill)**
Gan Jiang (Zingiberis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Mu Dan Pi (Moutan Cortex), Yuan Hu (Corydalidis Rhizoma), Rou Gui (Cinnamomi Cortex), Ze Lan (Lycopus Herba), Shu Di Huang (Rehmanniae Radix Praeparata), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba), Dang Gui (Angelicae Sinensis Radix), Shi Hu (Dendrobii Caulis).
Grind into powder, make pills with vinegar paste, take with boiled wine.
**Yi Tan Tang (Strange Phlegm Decoction)**
Ban Xia (Pinelliae Tuber), Nan Xing (Arisaematis Rhizoma), Ju Hong (Citri Reticulatae Pericarpium Rubrum), Zhi Shi (Aurantii Fructus Immaturus), Fu Ling (Poria), Ren Shen (Ginseng Radix), Chang Pu (Acori Tatarinowii Rhizoma), Zhu Ru (Bambusae Caulis in Taenia), Gan Cao (Glycyrrhizae Radix et Rhizoma).
Decoct with ginger slices.
**Qianjin Jixiang Wan (Thousand Gold Auspicious Pill)**
Tian Ma (Gastrodiae Rhizoma - roasted, 1 liang), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Rou Gui (Cinnamomi Cortex), Mu Dan Pi (Moutan Cortex), Shu Di Huang (Rehmanniae Radix Praeparata), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Liu Xu (Poplar Catkin), Wu Wei Zi (Schisandrae Chinensis Fructus), Fu Ling (Poria), Tu Si Zi (Cuscutae Semen), Fu Pen Zi (Rubi Fructus), Zhi Shi (Aurantii Fructus Immaturus), Tao Hua Pian (Peach Blossom Slices) (each 1 liang).
Grind into powder, make honey pills, size of beans. Take 5 pills per dose on an empty stomach, washed down with boiled wine.