典藏书目

The *Shengji Zonglu* states: The disease of metrorrhagia and metrostaxis (irregular uterine bleeding) in women refers to the continuous dripping of menstrual blood. The Chong and Ren meridians (two of the eight extraordinary vessels, governing reproduction and menstruation) have their specific times for qi and blood circulation. If bleeding occurs outside the normal menstrual period, it is like a vessel leaking, hence named "Lou Xia" (dripping down). This is primarily due to deficiency of blood and decline of qi, which fail to constrain and control the menstrual blood. Additionally, there may be retained blood stasis within; caused by imbalance of cold and heat, leading to the deterioration of blood. Its color may be red like bean juice, yellow like rotten melon, black like lacquer, greenish-blue like indigo, or turbid like pus. These five colors correspond to the five zang organs; due to visceral deficiency and damage, corresponding types of dripping occur.

Zhu Danxi stated: Metrorrhagia (sudden heavy bleeding) is caused by damage to the zang-fu organs, resulting in both qi and blood deficiency in the Chong and Ren meridians. These two meridians are the sea of the twelve regular meridians; the circulation of qi and blood runs outward along the collaterals and nourishes the viscera inwardly. If excessive labor and injury lead to deficiency of qi in the Chong and Ren meridians, they cannot constrain and control the menstrual blood, resulting in sudden massive bleeding, termed "Beng Zhong Bao Xia" (sudden collapse and violent downward flow). Treatment should focus on greatly tonifying qi and blood, raising the qi of the spleen and stomach, and slightly adding herbs that settle and subdue heart fire to treat the heart. By nourishing yin and draining yang, the bleeding will naturally stop. Li Dongyuan has treatment methods, but he does not emphasize heat syndromes; his main approach targets cold syndromes. Students should ponder this carefully.

Zhao Yangkui stated: The disease of bloody collapse should be treated by distinguishing between yin and yang. Qi and blood constitute the yin and yang of the human body. Yang governs ascending, while yin governs descending. Yang is rooted in yin, and yin is rooted in yang. Ascending and descending, moving along the meridians, prevents metrorrhagia and metrostaxis. If there is an excess of yang, the ascending force prevails, and blood exits from the upper orifices. If there is a deficiency of yang, the descending force prevails, and blood exits from the lower orifices. In summary, blood rises and falls following yang qi. Yang qi is like wind; wind can ascend, but it must rely on the warmth of the East (Liver Wood) for the wind qi to rise; therefore, the formula *Zhu Feng Yi Qi Tang* (Wind-Assisting Qi-Tonifying Decoction) is used. For those whose bloody collapse is caused by qi deficiency failing to hold blood, the person must present with a pale complexion, a deficient and large chi pulse (pulse felt at the wrist), loss of taste in food and drink, which is common in chronic diseases.

Shenzhai commented: The above three passages discuss bloody collapse belonging to blood deficiency, qi deficiency, and insufficient yang. Bloody collapse is fundamentally a blood disease, yet cases involving yang deficiency exist because when blood is lost, qi is also lost. Yin and yang mutually sustain each other and serve as roots for one another. When yin blood flows out massively, yang cannot maintain and secure it. One must use formless "qi" to generate formed "blood."