汪石山治一妇经行，必泻三日然后行，诊其脉皆濡弱，此脾虚也。脾属血，属湿。经
水将动，脾血先已流注血海，然后下流为经。脾血既亏，则虚而不能营运其湿。令作参苓
白术散，每服二钱，一日米饮调下二三次，月余经行不泻矣。 一妇年逾四十，形长色脆，
病经不调，右脉浮软而大，左脉虚软而小近驶，当时经前作泄。今年四月，感风咳嗽，用
汤洗浴汗多，因泄一月。六月，复因洗浴，发疟六七次，疟虽止而神思不爽。至八月尽而
经水过多，白带时下，泻泄，遂觉右脚疼痛。旧曾闪肭脚跟，今则假此延痛臀腿、腰胁、尻
骨，颈项右边筋皆掣痛，或咳嗽一声，则腰眼痛如腰札，日轻夜重，叫号不已，幸痛稍
止，饮食如常。今详月水过多，白带时下，日轻夜重，泻泄无时，亦属下多亡阴，宜作血
虚论治，服四物止痛之剂益甚。九月，汪复诊视，始悟此病乃合仲景所谓阳生则阴长之
法矣。夫经水多，白带下，常泄泻，皆由阳虚陷下而然，命曰阳脱是也。日轻夜重，盖
日阳旺而得健运之职，故血亦无凝滞之患，而日故轻也。夜则阴旺而阳不得其任，失其健
运之常，血亦随滞，故夜重也。遂以参、术助阳之药，煎服五七帖，痛减。此亦病证之
变，治法殊常，故记之。
〔月水不断〕
妇人月水不断，淋沥无时，或因劳损气血而伤冲任，或因经行而合阴阳，皆令气虚
不能摄血。若时止时行，腹痛脉沉细，此寒热邪气客于胞中，非因虚弱也。
〔薛〕前证若郁结伤脾，用归脾汤。恚怒伤肝，逍遥散。肝火妄动，加味四物汤。脾
气虚弱，六君子汤。元气下陷，补中益气汤。热伤元气，前汤加五味、麦门、炒黑黄柏。
儒者钱思习子室，年三十余无嗣，月经淋沥无期，夫妇异处几年矣。思习欲为娶外家，以
谋诸余。余谓此郁怒伤肝，脾虚火动，而血不归经。乃肝不能藏，脾不能摄也。当清肝
火、补脾气，遂与加味归脾、逍遥二药四剂，送至其家，仍告其姑曰∶服此病自愈，而当
受胎，外家可无娶也。果病愈，次年生子。
一妇人性急，每怒非太阳、耳、项、喉、齿、胸乳作痛，则胸满吞酸，吐泻少食，经行不
止。此皆肝火之证，肝自病则外证见，土受克则内证作。余先以四物加白术、茯苓、柴
胡、炒栀、炒龙胆，清肝养血。次用四君子加柴胡、芍药、神曲、吴茱萸、炒黄连，以
培土制肝，渐愈。惟月经不止，是血分有热，脾气尚虚，以逍遥散倍用白术、茯苓、陈皮，
又以补中益气加酒炒芍药，兼服而安。一妇人多怒，经行旬余方止，后淋沥无期，肌
体倦瘦，口干内热，盗汗如洗，日晡热甚。皆由肝脾亏损，无以生发元气，用参、 、归、
术、茯神、远志、枣仁、麦门、五味、丹皮、龙眼肉、炙草、柴胡、升麻治之，获痊。
一妇人怀抱不舒，腹胀少寐，饮食素少，痰涎上涌，月经频数。余曰∶脾统血而主涎，此
郁闷伤脾，不能摄血归源耳。用补中益气、济生归脾而愈。
胶艾汤 治劳伤血气，冲任虚损，月水过多，淋沥不断。
阿胶（炒） 川芎 甘草（炙，各二两） 当归 艾叶（炒，各三两） 熟地黄
白芍药（各四两）
上 咀，每服半两，水煎。一方有黄 。
续断丸 （《大全》）治月水不断，口干心烦，四肢羸乏，饮食减少。
川续断 当归 乌贼骨 黄 牛角 （烧） 五味子 甘草 龙骨（ 研） 赤石脂
熟地黄（各一两） 地榆（半两） 艾叶 附子 干姜 川芎（各七钱半）
上为末，炼蜜丸梧子大，每服三十丸，空心温酒下。
禹余粮丸 治久冷，月水不断，面黄肌瘦，虚烦减食。
禹余粮（二两） 鹿角胶（七钱半，粉炒） 紫石英 续断 赤石脂 熟地黄 川芎（各一两）
干姜 黄 艾叶 柏叶（炒） 当归（炒） 人参 白茯苓（各半两）
上为末，炼蜜丸梧子大，每三十丸，空心米饮下。
牡蛎丸 治血海虚损，月水不断。
牡蛎粉 赤石脂 代赭石（各一两） 阿胶 川芎 当归 鹿茸 续断 干姜（各三两）
甘草（二钱半）
上为末，炼蜜丸梧子大，每服三十丸，空心温酒下。
经验方 治经血不止。
黄芩（五分） 当归 柏叶 蒲黄（各四分） 生姜（二分） 艾叶（一分） 生地黄（二十四分）
伏龙肝（十二分）
上 咀，用水二升，煎取八合，分二服。
又经血不止，诗云∶妇人经血久淋漓，旧蕊莲蓬烧作灰，热酒一杯调八字，自然安乐
更无疑。
又方 莲蓬壳 拒霜花（二味等分）
为末，每服二钱，空心米饮调下。
伏龙肝散 （《和剂》）治血气劳伤，冲任脉虚，经血非时注下，或如豆汁，或成血片，或
五色相亲，脐腹冷痛，月经不止。
伏龙肝 麦门冬（去心） 赤石脂（各一钱） 熟地黄 艾叶（炒，各一钱半） 当归（去芦，炒）
川芎（各二钱半） 肉桂（去粗皮） 干姜（炮） 甘草（各半钱）
上作一服，水二盅，红枣二枚，煎至一盅，食前服。
固经丸 治经水过多不止，乃阴虚挟热所致，法当补阴清热。
黄柏（三两） 龟板（炙，四两） 黄芩（二两） 白芍药（三两） 樗根皮（一两半） 香附子（童便制，一
两半）
上为细末，酒糊丸梧子大，每以空心食前白汤下五、七十丸。
〔月水不利〕
〔良〕妇人月水不利者，由劳伤气血，体虚而风冷客于胞内，伤于冲任之脉故也。若
寸脉弦，关脉沉，是肝病也，兼主腹痛，孔窍生疮。尺脉滑，血气实，经络不利，或尺
脉绝不至，兼主小腹引腰痛，气攻胸隔也。
〔薛〕前证属肝胆二经，盖肝胆相为表里，多因恚怒所伤。若本经风热，用补肝散。
（方见胁痛门。）血虚用四物加酸枣仁，若肾水不足用六味丸，若患诸疮疡，治见后。
牛膝散 治月水不利，脐腹作痛，或小腹引腰，气攻胸膈。
牛膝（酒制，一两） 桂心 赤芍药 桃仁（去皮尖） 玄胡索（炒） 当归（酒浸） 牡丹皮
木香（各七钱半）
上为末，每服一钱，空心温酒调下。
牡丹散 治月候不利，腹脐疼痛，不欲食。
牡丹皮 大黄（炒，各一两） 赤茯苓 桃仁 生地黄 当归 桂心 赤芍药 白术（各七钱半）
石韦（去毛） 木香（各半两）
上 咀，每服三钱，水一盏，姜三片，煎七分，空心温服。
产宝方 治女人月经不利，脐下气胀，上攻欲呕，不得睡。
当归（四钱） 干漆（三钱，炒令烟尽）
上为细末，蜜丸梧子大，空心温酒下十五丸。
养荣汤 治妇人血海虚弱，心中恍惚，时多惊悸，或发虚热，经候不调。
白芍药 川芎 熟地黄 姜黄 当归 川姜 青橘皮 五加皮 牡丹皮 海桐皮 白芷（各等分）
每服五钱，水一盏半，生姜五片，乌梅一个，煎至一盏，温服，不拘时，送紫桂丸五十粒。（紫桂丸
方见带下。）
〔过期不止〕
《产宝》云∶男子生于寅，寅属木，阳中有阴，故男子得八数。女子生于申，申属金，阴中有阳，
女子得七数。男以气为主，八八则卦数已尽，尽则阳精痿。女以血为主，七七则卦数已终，终则经水绝，
任冲脉虚衰，天癸绝，地道不通而无子矣。或劳伤过度，喜怒不时，经脉衰微之际，又为邪气攻冲，所
以当止不止而崩下也。
许学士云∶妇人经脉过期不及，腰腹疼痛，或七七数尽而月经下者，宜用当归散治
之。
当归散 治妇人天癸已过期，经脉不匀，或三四月不行，或一月再至，腰腹疼痛。
《素问》云∶七损八益。谓女子七数尽而经不根据时者，血有余也，不可止之，但令得
根据时，不腰痛为善。（方见前调经平剂条。）
〔竹〕芩心丸 治妇人四十九岁以后，天癸当住，每月却行，或过多不止。
用黄芩心枝条者二两，米泔浸七日，炙干，又浸又炙，如此七次，为末，醋丸如桐子大，
每服七十丸，空心温酒送下，日进二服。
上二方热者宜之。
茸附汤 补任冲，调血气。
干姜（四两） 肉桂（去粗皮） 附子 龙骨（生用） 防风（各一两） 牡蛎（ ） 当归（各二两）
鹿茸（三两，酒炙）
每服半两，水二盅，煎八分，温服。
补中芎 汤 治风虚冷热，劳伤冲任，月水不调，崩中暴下，产后失血过多，虚羸腹痛，或
妊娠胎动不安，下血。
当归 干姜（炮，各三两） 川芎（蜜炙） 黄 甘草（炙） 吴茱萸（炮黄）
杜仲（炒） 熟地黄 人参（各一两）
每服三钱，水一盅半，煎一盅，空心服。
上二方寒者宜之，盖亦有血海虚寒而不禁者也。
〔薛〕前证若肝肾虚热，用当归散。肝血虚热，四物加柴、栀、丹皮。肝火内动，小
柴胡加山栀、丹皮。肝火血燥，加味逍遥散。脾经郁火，加味归脾汤。肝脾郁火。归脾、逍
遥兼服。肝肾亏损，归脾、六味兼服。仍与前后月经不调治验同用。一妇人年五十，内
热晡热，经水两三月一至。此血虚有热，用逍遥散加山茱萸治之而愈。后有痰作渴，或
小便不调，或头晕白带，用六味丸而安。
〔脉〕问曰∶妇人年五十数，一朝而清血二三日不止，何以治之？师曰∶此妇人前绝生，
经水不下，今反清血，此为居经，不须治，当自止。经水下常五日止者，五日愈。
汪石山治疗一位妇女，每次月经来潮时，必定腹泻三天后月经才正式行经。诊察其脉象均呈现濡弱之象，这是脾虚所致。脾属血，主湿。月经将动之时，脾血先流注于血海，然后下行成为经血。既然脾血已经亏虚，则虚弱而不能运化体内的湿气。于是开具参苓白术散，每次服用二钱，一日用米汤调服两三次，一个多月后，月经来潮时不再腹泻了。
又治一位年过四十的妇女，身形修长但肤色脆嫩，患有月经不调，右脉浮软而大，左脉虚软而小且近于急促，当时正值经前作泻。今年四月，因感受风邪咳嗽，使用汤药洗浴导致汗出过多，因而腹泻持续一个月。六月，再次因洗浴，发作疟疾六七次，疟疾虽止但神志思维不清爽。到了八月末，月经量过多，白带时下，伴有腹泻，随即觉得右脚疼痛。旧日曾闪挫脚跟，如今借此部位牵连疼痛至臀部、腿部、腰部、胁部及尻骨，颈项右侧筋脉皆掣痛，有时咳嗽一声，则腰眼处疼痛如被腰扎一般，白天轻夜间重，叫喊不停，幸好疼痛稍止，饮食如常。现在详细分析：月经过多，白带时下，白天轻夜间重，腹泻无定时，这也属于下部失血导致亡阴，应当作为血虚论治，服用四物汤止痛类药物反而加重。九月，汪石山再次诊视，才明白此病符合张仲景所谓“阳生则阴长”的方法。月经多、白带下、常泄泻，皆由阳虚陷下所致，名为阳脱。白天轻夜间重，是因为白天阳气旺盛而能行使健运的功能，所以血液也没有凝滞的隐患，因此白天症状轻；夜晚则阴气旺盛而阳气不得其职，失去健运的常态，血液随之凝滞，所以夜间症状重。于是用人参、白术等助阳药物，煎服五七帖，疼痛减轻。这也是病证的变化，治疗方法不同于常规，故记录下来。
〔月水不断〕
妇女月经淋漓不断，无时休止，或因劳累损伤气血而伤及冲任二脉，或因经期行房事，皆令气虚不能摄血。若时止时行，腹痛脉沉细，这是寒热邪气客居于胞宫，并非因虚弱所致。
〔薛己〕上述证候若因郁结伤脾，用归脾汤。因愤怒伤肝，用逍遥散。肝火妄动，用加味四物汤。脾气虚弱，用六君子汤。元气下陷，用补中益气汤。热邪损伤元气，在前汤基础上加五味子、麦门冬、炒黑黄柏。
儒者钱思习的妻子，三十多岁无子嗣，月经淋漓无定期，夫妇分居几年了。思习想为妻子娶妾，以此征求我的意见。我说这是郁怒伤肝，脾虚火动，导致血不归经。乃是肝不能藏血，脾不能摄血。应当清肝火、补脾气，于是给予加味归脾汤和逍遥散两种药各四剂，送到他家，并告知他的岳母说：“服用这些药病会自愈，并且能够受孕，不必娶妾。”果然病愈，次年生子。
一位妇女性格急躁，每次发怒不是太阳经、耳、项、喉、齿、胸乳作痛，就是胸满吞酸，吐泻少食，月经不止。这都是肝火的证候，肝自病则外证显现，脾土受克则内证发作。我先用四物汤加白术、茯苓、柴胡、炒栀子、炒龙胆草，以清肝养血。接着用四君子汤加柴胡、芍药、神曲、吴茱萸、炒黄连，以培土制肝，逐渐痊愈。只有月经不止，是血分有热，脾气尚虚，用逍遥散倍用白术、茯苓、陈皮，又以补中益气汤加酒炒芍药，兼服而安。
一位妇女多怒，月经行经十余天方止，之后淋漓无期，机体疲倦消瘦，口干内热，盗汗如雨，傍晚发热严重。皆由肝脾亏损，无以生发元气，用人参、黄芪、当归、白术、茯神、远志、枣仁、麦门冬、五味子、丹皮、龙眼肉、炙甘草、柴胡、升麻治疗，获得痊愈。
一位妇人怀抱不舒，腹胀少寐，饮食素少，痰涎上涌，月经频数。我说：脾统血而主涎，这是郁闷伤脾，不能摄血归源。用补中益气汤、济生归脾汤而愈。
胶艾汤 治疗劳伤血气，冲任虚损，月经过多，淋漓不断。
阿胶（炒） 川芎 甘草（炙，各二两） 当归 艾叶（炒，各三两） 熟地黄 白芍药（各四两）
以上切碎，每次服用半两，水煎。一方中有黄芪。
续断丸 （《大全》）治疗月经淋漓不断，口干心烦，四肢羸乏，饮食减少。
川续断 当归 乌贼骨 黄芪 牛角鳔（烧） 五味子 甘草 龙骨（研） 赤石脂 熟地黄（各一两） 地榆（半两） 艾叶 附子 干姜 川芎（各七钱半）
以上为末，炼蜜制成梧桐子大小的丸药，每次服用三十丸，空腹温酒送下。
禹余粮丸 治疗久冷，月经淋漓不断，面色黄肌肉瘦，虚烦减食。
禹余粮（二两） 鹿角胶（七钱半，粉炒） 紫石英 续断 赤石脂 熟地黄 川芎（各一两） 干姜 黄芪 艾叶 侧柏叶（炒） 当归（炒） 人参 白茯苓（各半两）
以上为末，炼蜜制成梧桐子大小的丸药，每次三十丸，空腹米饮送下。
牡蛎丸 治疗血海虚损，月经淋漓不断。
牡蛎粉 赤石脂 代赭石（各一两） 阿胶 川芎 当归 鹿茸 续断 干姜（各三两） 甘草（二钱半）
以上为末，炼蜜制成梧桐子大小的丸药，每次服用三十丸，空腹温酒送下。
经验方 治疗经血不止。
黄芩（五分） 当归 柏叶 蒲黄（各四分） 生姜（二分） 艾叶（一分） 生地黄（二十四分） 伏龙肝（十二分）
以上切碎，用水二升，煎取八合，分两次服用。
又治经血不止，诗云：妇人经血久淋漓，旧蕊莲蓬烧作灰，热酒一杯调八字，自然安乐更无疑。
又方 莲蓬壳 拒霜花（二味等分）
为末，每次服用二钱，空腹米饮调下。
伏龙肝散 （《和剂局方》）治疗血气劳伤，冲任脉虚，经血非时注下，或如豆汁，或成血片，或五色相杂，脐腹冷痛，月经不止。
伏龙肝 麦门冬（去心） 赤石脂（各一钱） 熟地黄 艾叶（炒，各一钱半） 当归（去芦，炒） 川芎（各二钱半） 肉桂（去粗皮） 干姜（炮） 甘草（各半钱）
以上为一服，水二盅，红枣二枚，煎至一盅，食前服。
固经丸 治疗经水过多不止，乃阴虚挟热所致，法当补阴清热。
黄柏（三两） 龟板（炙，四两） 黄芩（二两） 白芍药（三两） 樗根皮（一两半） 香附子（童便制，一两半）
以上为细末，酒糊制成梧桐子大小的丸药，每次空腹食前白开水送下五、七十丸。
〔月水不利〕
〔良〕妇女月经不畅，由劳伤气血，体虚而风冷客居于胞内，伤于冲任之脉所致。若寸脉弦，关脉沉，是肝病，兼主腹痛，孔窍生疮。尺脉滑，血气实，经络不利，或尺脉绝不至，兼主小腹牵引腰痛，气攻胸膈。
〔薛己〕上述证候属肝胆二经，盖肝胆相为表里，多因恚怒所伤。若本经风热，用补肝散。（方见胁痛门。）血虚用四物汤加酸枣仁，若肾水不足用六味丸，若患诸疮疡，治法见后。
牛膝散 治疗月经不畅，脐腹作痛，或小腹引腰，气攻胸膈。
牛膝（酒制，一两） 桂心 赤芍药 桃仁（去皮尖） 玄胡索（炒） 当归（酒浸） 牡丹皮 木香（各七钱半）
以上为末，每次服用一钱，空腹温酒调下。
牡丹散 治疗月经不利，腹脐疼痛，不欲食。
牡丹皮 大黄（炒，各一两） 赤茯苓 桃仁 生地黄 当归 桂心 赤芍药 白术（各七钱半） 石韦（去毛） 木香（各半两）
以上切碎，每次服用三钱，水一盏，姜三片，煎至七分，空腹温服。
产宝方 治疗女人月经不利，脐下气胀，上攻欲呕，不得睡。
当归（四钱） 干漆（三钱，炒令烟尽）
以上为细末，蜜丸梧桐子大小，空腹温酒送下十五丸。
养荣汤 治疗妇人血海虚弱，心中恍惚，时多惊悸，或发虚热，经候不调。
白芍药 川芎 熟地黄 姜黄 当归 川姜 青橘皮 五加皮 牡丹皮 海桐皮 白芷（各等分）
每次服用五钱，水一盏半，生姜五片，乌梅一个，煎至一盏，温服，不拘时候，送服紫桂丸五十粒。（紫桂丸方见带下。）
〔过期不止〕
《产宝》说：男子生于寅，寅属木，阳中有阴，故男子得八数。女子生于申，申属金，阴中有阳，女子得七数。男以气为主，八八则卦数已尽，尽则阳精痿。女以血为主，七七则卦数已终，终则经水绝，任冲脉虚衰，天癸绝，地道不通而无子矣。或劳伤过度，喜怒不时，经脉衰微之际，又为邪气攻冲，所以当止不止而崩下也。
许学士说：妇人经脉过期不及，腰腹疼痛，或七七数尽而月经下者，宜用当归散治之。
当归散 治疗妇人天癸已过期，经脉不匀，或三四月不行，或一月再至，腰腹疼痛。
《素问》说：七损八益。谓女子七数尽而经不根据时者，血有余也，不可止之，但令得根据时，不腰痛为善。（方见前调经平剂条。）
〔竹〕芩心丸 治疗妇人四十九岁以后，天癸当住，每月却行，或过多不止。
用黄芩心枝条者二两，米泔浸七日，炙干，又浸又炙，如此七次，为末，醋丸如桐子大，每服七十丸，空腹温酒送下，日进二服。
上二方热者宜之。
茸附汤 补任冲，调血气。
干姜（四两） 肉桂（去粗皮） 附子 龙骨（生用） 防风（各一两） 牡蛎（煅） 当归（各二两） 鹿茸（三两，酒炙）
每次服用半两，水二盅，煎八分，温服。
补中芎 汤 治疗风虚冷热，劳伤冲任，月水不调，崩中暴下，产后失血过多，虚羸腹痛，或妊娠胎动不安，下血。
当归 干姜（炮，各三两） 川芎（蜜炙） 黄芪 甘草（炙） 吴茱萸（炮黄） 杜仲（炒） 熟地黄 人参（各一两）
每次服用三钱，水一盅半，煎一盅，空腹服。
上二方寒者宜之，盖亦有血海虚寒而不禁者也。
〔薛己〕上述证候若肝肾虚热，用当归散。肝血虚热，四物汤加柴胡、栀子、丹皮。肝火内动，小柴胡汤加山栀、丹皮。肝火血燥，加味逍遥散。脾经郁火，加味归脾汤。肝脾郁火，归脾、逍遥兼服。肝肾亏损，归脾、六味兼服。仍与前后月经不调治验同用。一妇人年五十，内热晡热，经水两三月一至。此血虚有热，用逍遥散加山茱萸治之而愈。后有痰作渴，或小便不调，或头晕白带，用六味丸而安。
〔脉〕问曰：妇人年五十数，一朝而清血二三日不止，何以治之？师曰：此妇人前绝生，经水不下，今反清血，此为居经，不须治，当自止。经水下常五日止者，五日愈。
Wang Shishan treated a woman who, upon the onset of menstruation, would experience diarrhea for three days before the menstrual flow actually began. Her pulse was diagnosed as soggy and weak throughout, indicating Spleen deficiency. The Spleen governs Blood and is associated with Dampness. When menstruation is about to commence, Spleen Blood first flows into the Sea of Blood (Xuehai), then descends to become menstrual flow. Since the Spleen Blood was already deficient, its weakness prevented it from transforming and transporting Dampness. Therefore, Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) was prescribed. Two qian were taken each time, mixed with rice water and administered two or three times a day. After more than a month, her menstruation occurred without accompanying diarrhea.
Another case involved a woman over forty years old, tall in stature but delicate in complexion, suffering from irregular menstruation. Her right pulse was floating, soft, and large, while her left pulse was deficient, soft, small, and rapid. At that time, she experienced diarrhea before her period. In April of this year, she contracted wind causing coughing; excessive sweating resulted from bathing in herbal decoctions, leading to diarrhea lasting for a month. In June, another bath triggered malaria six or seven times. Although the malaria subsided, her mental clarity remained impaired. By late August, she suffered from menorrhagia (excessive menstrual bleeding), leukorrhea (vaginal discharge), and diarrhea, followed by pain in her right foot. She had previously sprained her heel, which now caused radiating pain to the buttocks, legs, lower back, hypochondrium, and sacrum. The tendons on the right side of her neck and nape were also pulling and painful. A single cough caused sharp pain in the lumbar region as if pierced by a needle. Symptoms were lighter during the day and heavier at night, accompanied by incessant crying out. Fortunately, the pain subsided slightly, and her appetite remained normal. Upon detailed analysis: menorrhagia, leukorrhea, diurnal lightness and nocturnal heaviness, and uncontrolled diarrhea all point to Yin depletion due to lower body blood loss. It should be treated as Blood deficiency. However, taking Siwu Tang (Four Substances Decoction) for pain relief worsened the condition. In September, Wang re-examined the patient and realized this illness aligned with Zhang Zhongjing’s principle of "Yang generates, thus Yin grows." Menorrhagia, leukorrhea, and chronic diarrhea are all caused by Yang deficiency sinking downward, termed Yang collapse. Symptoms are lighter during the day because Yang Qi is vigorous and performs its transformative functions effectively, preventing Blood stasis. At night, Yin is dominant, and Yang fails to perform its duties, losing its normal transformative function, causing Blood to stagnate, hence symptoms are heavier at night. Consequently, herbs that assist Yang, such as Ginseng and Atractylodes Macrocephala, were decocted and taken for five to seven doses, reducing the pain. This illustrates a variation in disease presentation requiring unconventional treatment methods, hence recorded here.
[Menstrual Flow Unceasing]
Women may experience continuous, dripping menstrual flow without cessation. This can result from labor damaging Qi and Blood, injuring the Chong and Ren meridians, or engaging in intercourse during menstruation, all leading to Qi deficiency failing to control Blood. If the flow stops and starts intermittently with abdominal pain and a deep, fine pulse, it indicates Cold-Heat pathogenic factors lodging in the Uterus, not due to deficiency.
[Xue Ji] For the above syndromes: if constrained accumulation injures the Spleen, use Guipi Tang (Restore the Spleen Decoction). If anger injures the Liver, use Xiaoyao San (Free and Easy Wanderer Powder). If Liver Fire moves recklessly, use Jiawei Siwu Tang (Modified Four Substances Decoction). If Spleen Qi is deficient, use Liujunzi Tang (Six Gentlemen Decoction). If Yuan Qi sinks, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If Heat damages Yuan Qi, add Schisandra, Ophiopogon, and charred Phellodendron to the previous formula.
The wife of Confucian scholar Qian Sixi, aged thirty-plus, had no offspring. Her menstruation dripped continuously without regularity, and they had lived apart for several years. Sixi wished to take a concubine and sought my advice. I stated this was Liver injury from constrained anger, Spleen deficiency with Fire movement, causing Blood to fail to return to its vessels. The Liver failed to store Blood, and the Spleen failed to control it. One must clear Liver Fire and tonify Spleen Qi. Thus, Jiawei Guipi Tang and Xiaoyao San were given, four doses of each. I informed her mother-in-law that the illness would heal naturally and pregnancy would occur, so there was no need for a concubine. Indeed, she recovered and gave birth the following year.
A woman with an irritable temper would suffer pain in the Taiyang channel, ears, neck, throat, teeth, chest, and breasts, or chest fullness with acid regurgitation, vomiting, diarrhea, and reduced food intake, along with unceasing menstruation, whenever angry. These are all manifestations of Liver Fire. When the Liver itself is diseased, external symptoms appear; when Earth (Spleen/Stomach) is overcome, internal symptoms arise. I initially used Siwu Tang plus Atractylodes, Poria, Bupleurum, fried Gardenia, and fried Gentiana to clear Liver Fire and nourish Blood. Then, using Lizijunzi Tang plus Bupleurum, Peony, Medicated Leaven, Evodia, and fried Coptis to cultivate Earth and restrain Liver, she gradually improved. Only the unceasing menstruation remained, indicating Heat in the Blood level and remaining Spleen deficiency. I used Xiaoyao San with doubled Atractylodes and Poria, plus Chenpi, and combined it with Buzhong Yiqi Tang plus wine-fried Peony, resulting in stability.
Another woman, prone to anger, had menstruation lasting over ten days, followed by continuous dripping. Her body became tired and emaciated, mouth dry with internal heat, night sweats profuse like washing, and fever severe in the afternoon. All resulted from Liver and Spleen damage, unable to generate Yuan Qi. Treatment with Ginseng, Astragalus, Angelica, Atractylodes, Poria, Polygala, Ziziphus seed, Ophiopogon, Schisandra, Moutan Cortex, Longan Aril, roasted Licorice, Bupleurum, and Cimicifuga led to recovery.
A woman with suppressed emotions suffered abdominal distension, insomnia, poor diet, surging phlegm-saliva, and frequent menstruation. I said: The Spleen controls Blood and governs saliva. This is Spleen injury from depression, failing to control Blood and return it to its source. Recovery was achieved with Buzhong Yiqi Tang and Jisheng Guipi Tang.
Jiao'ai Tang (Donkey-hide Gelatin and Mugwort Decoction) treats labor-induced damage to Qi and Blood, deficiency and impairment of the Chong and Ren meridians, menorrhagia, and continuous dripping.
Asini Corii Colla (fried), Chuanxiong Radix, Glycyrrhiza Radix et Rhizoma (roasted, 2 liang each), Angelicae Sinensis Radix, Artemisiae Argyi Folium (fried, 3 liang each), Rehmanniae Radix Preparata, Paeoniae Radix Alba (4 liang each).
Chop these ingredients. Take 0.5 liang per dose, decoct in water. Another version includes Astragali Radix.
Xuduan Wan (Dipsacus Pill) [from *Daquan*] treats unceasing menstruation, dry mouth, irritability, limb emaciation, and reduced appetite.
Dipsaci Radix, Angelicae Sinensis Radix, Sepiae Endoconcha, Astragali Radix, Tauri Corneus Colla (burnt), Schisandrae Fructus, Glycyrrhiza Radix et Rhizoma, Longgu (ground), Red Clay (1 liang each), Sanguisorbae Radix (0.5 liang), Artemisiae Argyi Folium, Aconiti Lateralis Radix Preparata, Zingiberis Rhizoma, Chuanxiong Radix (0.75 qian each).
Grind into powder, mix with refined honey to make pills the size of paulownia seeds. Take 30 pills per dose with warm wine on an empty stomach.
Yuyuliang Wan (Ilmenite Pill) treats chronic cold, unceasing menstruation, sallow complexion, emaciation, empty irritability, and reduced appetite.
Ilmenitum (2 liang), Cornu Cervi Degelatinatum (0.75 qian, fried with powder), Purpurascens Fluorspar, Dipsaci Radix, Red Clay, Rehmanniae Radix Preparata, Chuanxiong Radix (1 liang each), Zingiberis Rhizoma, Astragali Radix, Artemisiae Argyi Folium, Platycodi Radix (fried), Angelicae Sinensis Radix (fried), Ginseng Radix, Poria (0.5 liang each).
Grind into powder, mix with refined honey to make pills the size of paulownia seeds. Take 30 pills per dose with rice water on an empty stomach.
Muli Wan (Oyster Shell Pill) treats deficiency and impairment of the Sea of Blood, resulting in unceasing menstruation.
Concha Ostreae, Red Clay, Haematitum (1 liang each), Asini Corii Colla, Chuanxiong Radix, Angelicae Sinensis Radix, Cornu Cervi, Dipsaci Radix, Zingiberis Rhizoma (3 liang each), Glycyrrhiza Radix et Rhizoma (0.25 qian).
Grind into powder, mix with refined honey to make pills the size of paulownia seeds. Take 30 pills per dose with warm wine on an empty stomach.
Empirical Formula for Unceasing Menstrual Bleeding.
Scutellariae Radix (0.5 fen), Angelicae Sinensis Radix, Platycladi Cacumen, Polygoni Multiflori Semen (4 fen each), Zingiberis Rhizoma Recens (2 fen), Artemisiae Argyi Folium (1 fen), Rehmanniae Radix Recens (24 fen), Longcum Cinis (12 fen).
Chop ingredients. Use 2 sheng of water, decoct to obtain 8 he. Divide into two doses.
Another remedy for unceasing menstrual bleeding, from poetry: "For women with long-term dripping menstrual blood, burn old lotus pods to ash. Mix eight characters' worth with a cup of hot wine, and natural peace will follow without doubt."
Another Formula: Lotus Pod Shell and Frost-resisting Flower (equal parts).
Grind into powder. Take 2 qian per dose with rice water on an empty stomach.
Fulonggan San (Dragon's House Soil Powder) [from *Heji Ju Fang*] treats Qi and Blood damage from labor, deficiency of Chong and Ren meridians, non-timed vaginal bleeding resembling bean juice, blood clots, or mixed colors, cold pain in the umbilical and abdominal regions, and unceasing menstruation.
Longcum Cinis, Ophiopogonis Radix (heart removed), Red Clay (1 qian each), Rehmanniae Radix Preparata, Artemisiae Argyi Folium (fried, 1.5 qian each), Angelicae Sinensis Radix (de-stemmed, fried), Chuanxiong Radix (2.5 qian each), Cinnamomi Cortex (bark removed), Zingiberis Rhizoma (processed), Glycyrrhiza Radix et Rhizoma (0.5 qian each).
Take as one dose. Use 2 zhong of water and 2 red dates. Decoct to 1 zhong. Take before meals.
Gu Jing Wan (Stabilize the Menses Pill) treats excessive and unceasing menstruation caused by Yin deficiency with夹杂 Heat. The method requires tonifying Yin and clearing Heat.
Phellodendri Cortex, Testudinis Carapax et Plastrum (roasted, 4 liang), Scutellariae Radix (2 liang), Paeoniae Radix Alba (3 liang), Alstoniae Scholaris Cortex (1.5 liang each), Cyperi Rhizoma (processed with child's urine, 1.5 liang).
Grind into fine powder, bind with rice paste to make pills the size of paulownia seeds. Take 50-70 pills per dose with plain warm water on an empty stomach before meals.
[Unfavorable Menstrual Flow]
[Liang] Unfavorable menstrual flow in women results from labor damaging Qi and Blood, bodily weakness allowing Wind-Cold to lodge in the Uterus, injuring the Chong and Ren meridians. If the Cun pulse is wiry and Guan pulse is deep, it indicates Liver disease, accompanied by abdominal pain and ulcers in orifices. If Chi pulse is slippery, Blood and Qi are excess, and meridians are unfavorable. If Chi pulse is absent, it accompanies lower abdominal pain radiating to the lower back and Qi attacking the chest and diaphragm.
[Xue Ji] The above syndromes belong to the Liver and Gallbladder meridians, which are interior-exterior related, often injured by anger. If Wind-Heat affects the meridian itself, use Bugan San (Tonify the Liver Powder) [see Hypochondriac Pain section]. For Blood deficiency, use Siwu Tang plus Ziziphi Spinosae Semen. If Kidney Water is insufficient, use Liuwei Wan (Six-Ingredient Pill). For various sores and ulcers, see treatment later.
Niuxi San (Achyranthes Powder) treats unfavorable menstrual flow, pain in the umbilical and abdominal regions, lower abdominal pain radiating to the waist, and Qi attacking the chest and diaphragm.
Achyranthis Bidentatae Radix (wine-processed, 1 liang), Cinnamomi Cortex, Paeoniae Radix Rubra, Persicami Semen (skin and tip removed), Corydalis Rhizoma (fried), Angelicae Sinensis Radix (wine-soaked), Moutani Cortex, Amomi Fructus (0.75 qian each).
Grind into powder. Take 1 qian per dose with warm wine on an empty stomach.
Mudan San (Tree Peony Powder) treats unfavorable menstruation, abdominal and umbilical pain, and loss of appetite.
Moutani Cortex, Rheum Palmati Radix (fried, 1 liang each), Polyporus, Persicami Semen, Rehmanniae Radix Recens, Angelicae Sinensis Radix, Cinnamomi Cortex, Paeoniae Radix Rubra, Atractylodis Macrocephalae Rhizoma (0.75 qian each), Pyri Folium (de-hair), Amomi Fructus (0.5 liang each).
Chop ingredients. Take 3 qian per dose with 1 cup of water and 3 slices of ginger. Decoct to 0.7 cup. Take warm on an empty stomach.
Chanbao Fang (Child Treasure Formula) treats unfavorable menstruation in women, Qi distension below the umbilicus, upward attack causing nausea, and inability to sleep.
Angelicae Sinensis Radix (4 qian), Drynariae Rhizoma (3 qian, fried until smoke ceases).
Grind into fine powder, make pills the size of paulownia seeds with honey. Take 15 pills with warm wine on an empty stomach.
Yangrong Tang (Nourish Glory Decoction) treats deficiency of the Sea of Blood in women, mental vagueness, frequent palpitations, occasional deficiency fever, and irregular menstruation.
Paeoniae Radix Alba, Chuanxiong Radix, Rehmanniae Radix Preparata, Curcumae Longae Rhizoma, Angelicae Sinensis Radix, Zingiberis Rhizoma, Citri Reticulatae Pericarpium Viride, Acanthopanacis Cortex, Moutani Cortex, Saposhnikoviae Radix (equal parts).
Take 5 qian per dose with 1.5 cups of water, 5 slices of ginger, and 1 mume fruit. Decoct to 1 cup. Take warm at any time, accompanied by 50 Zigui Wan pills. (Zigui Wan formula see Leukorrhea section.)
[Overdue and Unceasing]
*Chanbao* states: Men are born in Yin, Yin belongs to Wood, containing Yin within Yang, thus men correspond to the number Eight. Women are born in Shen, Shen belongs to Metal, containing Yang within Yin, thus women correspond to the number Seven. Men prioritize Qi; after eight cycles of eight (64 years), the hexagram numbers are exhausted, and Yang essence withers. Women prioritize Blood; after seven cycles of seven (49 years), the hexagram numbers end, menstruation ceases, Chong and Ren meridians become deficient and weak, Tian Gui (heavenly water) ends, the earthly pathway is blocked, and conception becomes impossible. Or, due to excessive labor, irregular emotions, and pathogenic factors attacking during the decline of meridians, menstruation does not stop but collapses downward.
Scholar Xu states: For women with overdue or insufficient menstruation, lower back and abdominal pain, or menstruation occurring after the completion of seven cycles (49 years), Danggui San should be used.
Danggui San (Angelica Powder) treats women whose Tian Gui has passed its due time, irregular menstruation, absence for three to four months, or twice monthly occurrence, with lower back and abdominal pain.
*Suzhen* states: Seven losses and eight benefits. For women whose seven-cycle number ends and menstruation is not timely, it indicates Blood excess. Do not stop it; merely ensure it becomes timely and free of lower back pain. (Formula see Regulating Menstruation Balanced Formulas section.)
[Zhu] Qin Xin Wan (Scutellaria Heart Pill) treats women after age forty-nine, when Tian Gui should cease, yet menstruates monthly, or excessively and unceasingly.
Use Scutellariae Radix heart branches (2 liang), soak in rice wash water for seven days, roast dry, soak again, roast again. Repeat seven times. Grind into powder, make pills the size of paulownia seeds with vinegar. Take 70 pills per dose with warm wine on an empty stomach, twice daily.
The above two formulas are suitable for Heat patterns.
Rongfu Tang (Antler and Aconite Decoction) tonifies Chong and Ren, regulates Qi and Blood.
Zingiberis Rhizoma (4 liang), Cinnamomi Cortex (bark removed), Aconiti Lateralis Radix Preparata, Longgu (raw), Saposhnikoviae Radix (1 liang each), Concha Ostreae (calcined), Angelicae Sinensis Radix (2 liang each), Cornu Cervi (3 liang, wine-roasted).
Take 0.5 liang per dose. Use 2 zhong of water, decoct to 0.8 portion. Take warm.
Buzhong Xiong Tang (Tonify Middle and Cyperus Decoction) treats Wind-Deficiency Cold-Heat, labor injury to Chong and Ren, irregular menstruation, sudden metrorrhagia, postpartum excessive blood loss, deficiency emaciation and abdominal pain, or fetal restlessness during pregnancy with bleeding.
Angelicae Sinensis Radix, Zingiberis Rhizoma (processed, 3 liang each), Chuanxiong Radix (honey-roasted), Astragali Radix, Glycyrrhiza Radix et Rhizoma (roasted), Evodiae Fructus (processed with yellow earth), Eucommiae Cortex (fried), Rehmanniae Radix Preparata, Ginseng Radix (1 liang each).
Take 3 qian per dose. Use 1.5 zhong of water, decoct to 1 zhong. Take on an empty stomach.
The above two formulas are suitable for Cold patterns, addressing cases of Cold-Deficiency in the Sea of Blood failing to contain Blood.
[Xue Ji] For the above syndromes: if Liver-Kidney Deficiency-Heat, use Danggui San. Liver Blood Deficiency-Heat, Siwu Tang plus Bupleurum, Gardenia, Moutan Cortex. Internal moving Liver Fire, Xiao Chaihu Tang plus Gardenia, Moutan Cortex. Liver Fire with Blood Dryness, Jiawei Xiaoyao San. Spleen Meridian Constrained Fire, Jiawei Guipi Tang. Liver-Spleen Constrained Fire, combine Guipi Tang and Xiaoyao San. Liver-Kidney Damage, combine Guipi Tang and Liuwei Wan. Still apply together with previous successful treatments for irregular menstruation. A fifty-year-old woman suffered internal heat and afternoon fever, with menstruation every two to three months. This was Blood deficiency with Heat, treated with Xiaoyao Tang plus Corni Fructus, resulting in recovery. Later, with phlegm-induced thirst, irregular urination, dizziness, and leukorrhea, she was stabilized with Liuwei Wan.
[Pulse] Question: A woman in her fifties suddenly experiences clear blood flowing for two to three days without stopping. How to treat? Master says: This woman previously ceased bearing children and menstruation did not flow. Now she suddenly has clear blood flow; this is called Ju Jing (Residing Menstruation). No treatment is needed; it will stop spontaneously. If menstrual flow normally lasts five days, it will heal in five days.