夫妇人八瘕者，皆由胞胎生产，月水往来，血脉精气不调之所生也。肾为阴，主开闭，
左为胞门，右为子户，主定月水，生子之道。胞门子户，主子精神气所出入，合于中黄门；
玉门四边，主持关元，禁闭子精；脐下三寸名曰关元，主藏魂魄。妇人之胞，三焦之腑，常
所从止。然妇人经脉，俞络合调，则月水以时来至，故能生子而无病。妇人荣卫经络断绝不
通，邪气便得往入合于其脏。若经血未尽而合阴阳，即令妇人血脉挛急，小腹重急、支满，
胸胁腰痛相引，四肢疼痛，饮食不调，结牢恶血不除，月水不时，或前或后，因生积聚如怀
胎状。邪气盛甚，令人恍惚多梦，寒热，四肢不举，阴中生气，肿内生风，甚者害于小便。
小腹筑痛、淋沥，面色黄黑，则不复生子。其八瘕者∶黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐
瘕、蛇瘕、鳖瘕是也。《千金》、《外台》方之详矣。
治妇人血瘕血积，经候不通。（出《本事方》）
桃仁 大黄（各一两） 虻虫（半两，炒黑） 川朴硝（二两）
上四味为末，以醇醋二升半，银石器中慢火煎取一升五合；下大黄、桃仁、虻虫等，不
住手搅，欲下手丸；下朴硝，更不住手搅，良久出之，丸如梧桐子大。前一日不用吃晚食，
五更初用温酒吞下五丸，日午取下如赤豆汁，或如鸡肝、虾蟆衣状。未下再作。如鲜血来
即止，续以调血气药补之。（此方出《千金》）
顷年在毗陵，有一贵官妻，患小便不通，脐腹胀不可忍。众医皆作淋治，如八正散之类
。数种皆治不通，痛愈甚。余诊之曰∶此血瘕也，非瞑眩药不可去。余用此药，更初服至日
午，疼痛不可忍，遂卧少顷，下血块如拳者数枚，小便如黑豆汁一、二升，痛止得愈。
此药治病的切，然猛烈太峻，气虚血弱者更宜斟酌与之。
妇女的八瘕病，都是由胞胎生产、月经往来过程中，血脉精气不调和所导致的。肾属阴，主管开闭功能；左侧称为胞门，右侧称为子户，主管调节月经及生育之道。胞门与子户，是母子精神气机出入的地方，与中黄门相合；玉门四周，主持关元穴，封闭子精；脐下三寸处名为关元，主管藏纳魂魄。妇女的胞宫，属于三焦之腑，常以此为止息之处。然而，如果妇女的经脉、俞穴与络脉调和，则月经能按时来潮，从而能够顺利生育且无疾病。若妇女的营卫经络断绝不通，邪气便能侵入并与脏腑相合。如果在经血未尽时行房事，就会导致妇人血脉拘挛紧急，小腹沉重急迫、胀满支撑，胸胁腰痛相互牵引，四肢疼痛，饮食失调，瘀血结滞不去，月经周期紊乱，或提前或推后，因而产生积聚，状如怀孕。邪气极盛时，令人神志恍惚多梦，寒热交替，四肢无法抬起，阴部有气感，体内生肿生风，严重时影响小便排泄。小腹阵痛、排尿淋漓不尽，面色黄黑，便不再能生育。所谓的八瘕，即：黄瘕、青瘕、燥瘕、血瘕、脂瘕、狐瘕、蛇瘕、鳖瘕。《千金方》和《外台秘要》中的方剂对此已有详细记载。
治疗妇女血瘕血积，月经不通。（出自《本事方》）
桃仁、大黄（各一两）、虻虫（半两，炒黑）、川朴硝（二两）。
以上四味药研为细末，用二升半优质醋，在银器或石器中以慢火煎取一升五合；加入大黄、桃仁、虻虫等药，不停地搅拌，待可下手制成丸药时；加入朴硝，继续不停地搅拌，过一会儿取出，制成梧桐子大小的丸药。服药前一天晚上不吃晚饭，五更初用温酒送服五丸，中午排出如赤豆汁样，或如鸡肝、虾蟆衣状的物质。若未排出则再次服用。若流出鲜血则停止服药，随后用调理气血的药物进行补益。（此方出自《千金方》）
前年在毗陵，有一位高官的妻子，患小便不通，脐腹胀痛难以忍受。众医生都按淋证治疗，使用八正散之类的方剂。多种方法治疗后仍不通，疼痛反而加剧。我诊察后说：这是血瘕病，非用猛烈的药物不能去除。我使用了此药，从初夜服至中午，患者疼痛难忍，于是躺卧片刻，排出数枚如拳头大的血块，小便如黑豆汁一、二升，疼痛停止而痊愈。
此药治病确切，但药性猛烈峻急，气虚血弱的患者更应斟酌使用。
The eight types of Jia (masses) in women are all caused by the imbalance of blood vessels and essence-qi during pregnancy, childbirth, and menstruation. The Kidney is Yin and governs opening and closing; the left side is called Baomen (Gate of the Womb), and the right side is called Zihu (House of the Child), governing the regulation of menstruation and the way of reproduction. Baomen and Zihu are the passages for the spirit and qi of the mother and child, connecting with Zhonghuangmen; the four sides of Yumen (Jade Gate) govern Guanyuan (CV4, a specific acupoint), sealing off the essence of the child; three cun below the navel is named Guanyuan (CV4, a specific acupoint), which stores the Hun and Po (ethereal and corporeal souls). The uterus of women belongs to the Sanjiao (Triple Burner) fu-organs, often resting here. However, if the meridians, Shu-points, and collaterals of women are harmonious, menstruation arrives on time, enabling reproduction without disease. If the Ying (Nutritive) and Wei (Defensive) meridians of women are severed and blocked, pathogenic Qi can enter and combine with the Zang-organs. If intercourse occurs while menstrual blood is not yet exhausted, it causes the blood vessels of the woman to become spasmodic and tense, resulting in heaviness and urgency in the lower abdomen, distension and fullness, pulling pain between the chest, hypochondrium, waist, and back, pain in the four limbs, irregular diet, retention of stubborn evil blood, irregular menstruation (either early or late), leading to the formation of accumulations resembling pregnancy. When pathogenic Qi is extremely strong, it causes mental restlessness, frequent dreams, alternating chills and fever, inability to move the four limbs, sensation of Qi in the vagina, internal swelling and wind generation, and in severe cases, impairment of urination. Throbbing pain in the lower abdomen, dribbling urination, yellowish-black complexion, indicate that reproduction is no longer possible. The eight Jia are: Huang-Jia (Yellow Mass), Qing-Jia (Green Mass), Zao-Jia (Dry Mass), Xue-Jia (Blood Mass), Zhi-Jia (Fat Mass), Hu-Jia (Fox Mass), She-Jia (Snake Mass), and Die-Jia (Turtle Mass). Detailed prescriptions for these are found in *Qianjin Fang* and *Waitai Mi Yao*.
Treating Xue-Jia (Blood Mass) and blood accumulation in women, with amenorrhea. (From *Benshi Fang*)
Taoren (Peach Seed), Dahuang (Rhubarb Root and Rhizome) (1 liang each), Mengchong (Meadow Bug, stir-fried until black) (0.5 liang), Chuan Puxiao (Sodium Sulfate) (2 liang).
Grind the above four ingredients into powder. Add 2.5 sheng of strong vinegar, and slowly simmer in a silver or earthenware vessel to reduce to 1.5 sheng. Add Dahuang, Taoren, Mengchong, etc., stirring continuously. When ready to form pills, add Puxiao, continue stirring vigorously, then remove after a while. Form pills the size of Sophora seeds. Do not eat dinner the day before. At dawn (Wugeng), swallow five pills with warm wine. By noon, discharge material resembling red bean juice, or chicken liver, or frog skin. If not discharged, repeat administration. If fresh blood flows, stop medication and subsequently supplement with formulas regulating blood and Qi. (This formula is from *Qianjin Fang*)
In previous years in Piling, the wife of a high official suffered from urinary retention and unbearable abdominal distension and pain. Many physicians treated it as Lin syndrome (dysuria), using formulas like Bazheng San. Multiple treatments failed to relieve obstruction, and pain intensified. Upon diagnosis, I stated: This is Xue-Jia (Blood Mass); only potent medicine can eliminate it. I used this prescription. From nightfall to noon, the patient endured unbearable pain, rested briefly, and then passed several blood clumps the size of fists, and one to two sheng of urine resembling black bean juice. Pain ceased, and she recovered.
This medicine is effective but extremely potent and harsh; it should be used with caution in patients with Qi deficiency and Blood weakness.