经血为水谷之精气，和调于五脏，洒陈于六腑，乃能入于脉也。凡其源源而来，生化于脾，总统于心，
藏受于肝，宣布于肺，施泄于肾，以灌溉一身。在男子则化而为精，妇人则上为乳汁，下归血海而为经脉。
但使精气无损，情志调和，饮食得宜，则阳生阴长，而百脉充实，又何不调之有？苟不知慎，则七情之伤
为甚，而劳倦次之。又或为欲不谨，强弱相陵（当作凌），以致冲任不守者，亦复不少。此外则外感、内
伤，或医药误谬，但伤营气，无不有以致之。凡人有衰弱多病，不耐寒暑，不胜劳役，虽先天禀弱者常有
之，然以气血方长，而纵情亏损，或精血未满，而早为斫丧，致伤生化之源，则终身受害，此未病之先，所
当深察而调之者也。
若欲调其既病，则惟虚实阴阳四者为要。丹溪曰∶“先期而至者，血热也；后期而至者，
血虚也。”王子亨曰∶“阳太过则先期而至，阴不及则后时而来。”其有乍多乍少、断绝不行、
崩漏不止，皆由阴阳盛衰所致。是固不调之大略也。然先期而至，虽曰有火，若虚而挟火，则所重在虚，
当以养营安血为主。矧亦有无火而先期者，则或补中气，或固命门，皆不宜过用寒凉也。后期而至者，
本属血虚，然亦有血热而燥瘀者，不得不为清补；有血逆而留滞者，不得不为疏利。总之，调经之法，但
欲得其和平，在详察其脉证耳。若形气、脉气俱有余，方可用清、用利。然虚者极多，实者极少，故调
经之要，贵在补脾胃以资血之源；养肾气以安血之室。知斯二者，则尽善矣。若营气本虚而不知培养，则未
有不日枯而竭者。不可不察也。
凡经行之际，大忌寒凉等药，饮食亦然。
初虞世曰∶“经以月至，有常也。其来过与不及，皆谓之病。若荣血亏损，不能滋养百骸，则发落面黄，
羸瘦燥热。燥气盛则金受邪，金受邪则为咳、为嗽、为肺痈、为肺痿必矣。但助胃壮气，则荣血生而经自行。若果怒气
逆，经闭不行，当用行气破血之剂”。
《褚氏遗书·精血篇》曰∶“男子精未通而御女以通其精，则五体有不满之处，异日有难状之疾；
阴已痿而思色以降其精，则精不出而内败，小便涩而为淋；精已耗而复竭之，则大小便牵痛，愈痛则愈便，
愈便则愈痛。女人天癸既至，逾十年无男子合则不调；未逾十年思男子合亦不调。不调则旧血不去，
新血误行，或溃而入骨，或变而为肿，后虽合而难子，合多则沥枯。虚人产众，则血枯杀人。观其精血，
思过半矣。”
《产宝方·序论》曰∶“妇人以血为基本，苟能谨于调护，则血气宣行，其神自清，月水如期，
血凝成孕。若脾、胃虚弱，不能饮食，营卫不足，月经不行，肌肤黄燥，面无光泽，寒热腹痛，难于子息，
或带下崩漏，血不流行，则成瘕证。”
薛立斋曰∶“经云∶‘二阳之病发心、脾，有不得隐曲，为女子不月。’故心、脾平和，则百
骸五脏皆润泽，而经候如常。苟或心、脾受伤，则血无所养，亦无所统，而月经不调矣。是故调经者，当理心、
脾为主。”丹溪先生亦曰∶“先期而至者，血热也；后期而至者，血虚也。”窃谓先期而至者，有因脾
经血燥；有因脾经郁火；有因肝经怒火；有因血分有热；有因劳役动火。过期而至者，有因脾经血虚；有
因肝经血虚；有因气虚血弱。主治之法∶脾经血燥者，加味逍遥散；脾经郁滞者，归脾汤；肝经怒火者，
加味小柴胡汤；血分有热者，加味四物汤；劳役动血者，补中益气汤。其过期而至者，若脾经血虚，宜人
参养营汤；肝经血少，宜六味地黄丸；气虚血弱，宜八珍汤。盖血生于脾，故云脾统血。凡血病当用辛
甘之剂，以助其阳气以生阴血，俱属不足也。大凡肝脾血燥，四物汤为
主，肝脾血弱，补中益气汤为主；肝脾郁结，归脾汤为主；肝经怒火，加味逍遥散为主。”
薛氏 加味逍遥散（见《古方八阵·补阵》） 治肝脾
血虚、发热、小水不利。
当归 芍药 白术 茯神 甘草 柴胡（各等分） 丹皮 栀子（各七分）
右加姜，水煎服。
归脾汤（见《古方八阵·补阵》） 治思虑伤脾，不能摄血，致血妄行，或健忘、怔忡、惊悸，盗汗，嗜
卧，少食，或大便不调，心、脾疼痛，疟痢郁结；或因病用药失宜，克伐伤脾，以致变证者，最宜用之。
人参 黄 白术 茯苓 枣仁（各二钱） 远志 当归（各一钱） 木香 炙甘草（各五分）
水二钟，加圆眼肉七枚，煎七分，食远（即食后隔一段时间）服。愚意∶此汤之用木香，特因郁结
疼痛者设，如无痛郁等证，必须除去木香，以避香燥，岂不于气虚血动者为尤善乎？又∶远志味辛气升而散，
凡多汗而躁热者，亦宜酌用。
薛氏 加味小柴胡汤（见《古方八阵·散阵》） 亦名柴胡栀子散。治乳母肝火发热，致儿为患，及
风热生痰等证。
柴胡（二三钱） 半夏 黄芩（各一二钱） 人参（二三钱） 甘草（五七分） 丹皮（二钱）
栀子（二钱）
上加姜、枣，水煎服。
薛氏 加味四物汤（见《古方八阵·补阵》）
熟地黄 当归（各三钱） 川芎（一钱） 芍药（二钱） 山栀（二钱） 柴胡（二钱） 丹皮（二钱）
水二钟煎服。
东垣 补中益气汤（见《古方八阵·补阵》） 治劳倦伤脾，中气不足，清阳不升，外感不解，
体倦食少，寒热疟痢，气虚不能摄血等证。
人参 黄 （炒） 白术（炒） 甘草（炙各钱半） 当归（一钱） 陈皮（五分） 升麻 柴胡（各三分）
上加姜、枣，水煎，空心午前服。
《局方》人参养营汤（见《古方八阵·补阵》） 治脾、肺俱虚，恶寒发热，肢体瘦倦，食少作泻，口
干，心悸，自汗等证。
人参 黄 当归 白术 炙甘草 桂心 陈皮（各一钱） 熟地 五味 茯苓（各七分） 白芍（钱半） 远
志（五分）
加姜、枣，水煎服。
《金匮》六味地黄丸（见《古方八阵·补阵》） 即《金匮》肾气丸，亦名地黄丸。治肾水亏损、小便淋
闭，头目眩晕，腰腿酸软，阴虚发热，自汗盗汗，憔悴瘦弱，精神疲困，失血失音，水泛为痰，病为肿胀。壮
水制火之剂也。
熟地黄（八两蒸捣） 山茱萸 山药（炒各四两） 丹皮 泽泻 白茯苓（各三两）
上为细末，和地黄膏，加炼蜜为丸，桐子大，每服七八十丸，空心食前滚白汤或淡盐汤任下。此方用水煎
汤即名六味地黄汤。
六味地黄丸并非《金匮》肾气丸，而是宋代钱乙以《金匮》肾气丸为温补肾阳之剂，而于小儿应滋养肾
阴，故于肾气丸去附桂，创制六味地黄丸以补益肾阴。景岳以六味地黄丸出自《金匮》，实误，今正之。
《局方》八珍汤（见《古方八阵·补阵》） 治气血两虚。调和阴阳。
人参 白术 茯苓（各二钱） 炙甘草（一钱） 熟地黄 当归（各三钱） 川芎（一钱） 芍药（二钱）
加姜、枣，水煎服，或加粳米百粒。
《局方》四物汤（见《古方八阵·补阵》）治血虚营弱，一切血病当以此为主。
熟地黄 当归（各三钱） 川芎（一钱） 芍药（二钱） 水二钟煎服。
又曰∶胃者卫之源，脾者荣之本。荣出中焦，卫出上焦。卫不足，益之必以辛；荣不足，补之必以甘。甘
辛相合，脾胃健而荣卫生，是以气血俱旺也。或因劳心，虚火妄动，月经错行，宜安心、补血、泻火。此东
垣先生治法也。
又曰∶人之少，有老态，不耐寒暑，不胜劳役，四时迭病，皆因气血方长，而劳心亏损；或精血未满，而
早年斫丧。故其见证，难以名状，若左尺脉虚弱或细数，是左肾之真阴不足也，用六味丸。右尺脉迟软或沉
细而数欲绝，是命门之相火不足也，用八味丸。至于两尺微弱，是阴阳俱虚。用十补丸。此皆滋其化源也，不
可轻用黄柏、知母之类。设或六淫外侵而见证，亦因其
气内虚，而外邪凑集耳，尤当用前药。
六味丸 （即六味地黄丸。见上段）。
崔氏 八味丸（见《古方八阵·补阵》） 治命门火衰，不能生土，以致脾、胃虚寒，饮食少思，
大便不实，或下元冷惫，脐腹疼痛等证。
熟地黄（八两蒸捣） 山茱萸 山药（炒各四两） 丹皮 泽泻 白茯苓（各三两） 肉桂 制附子
（各一两） 用法同六味丸。
十补丸（见《古方八阵·热阵》） 治肾脏虚冷，面黑足寒，耳聋膝软，小便不利等证。
附子（炮） 五味（各二两） 山药 山茱萸 丹皮 桂心
鹿茸（制） 茯苓 泽泻（各一两） 熟地（二两）
《古方八阵·热阵》中本方无熟地，今据《证治准绳》补入，合成十味药，符合十补之名。
经血是水谷精微化生的精气，在五脏中调和，散布于六腑，然后才能进入血脉。它源源不断地产生，由脾生化，由心统摄，由肝贮藏，由肺宣发，由肾施泄，从而灌溉全身。在男子身上化为精，在女子身上上行为乳汁，下行归入血海成为月经。只要精气不亏损，情志调和，饮食适宜，那么阳气生发、阴气增长，百脉就会充实，哪里还会有不调和的情况呢？如果不知道谨慎保养，那么七情（喜、怒、忧、思、悲、恐、惊）的伤害最为严重，劳累倦怠次之。或者因为房事不节制，强弱相凌（应当作“凌”，指欺侮、克制），导致冲任二脉不能固守的，也不在少数。此外还有外感邪气、内伤饮食，或者用药错误，只要损伤了营气，没有不导致月经不调的。凡是人体衰弱多病，不耐受寒暑变化，承受不了劳役，虽然先天禀赋虚弱的人常有这种情况，但如果气血正在生长旺盛时期，却放纵情欲造成亏损，或者精血尚未充盈，就过早地耗损，以致伤害了化生气血的源头，就会终身受害，这是在疾病发生之前，应当深入考察并加以调理的。
如果想要调理已经发生的疾病，那么虚实阴阳四个方面是关键。朱丹溪说：“月经先期而至的，是血热；后期而至的，是血虚。”王子亨说：“阳气太过则月经先期而至，阴气不及则月经后期而来。”那些月经量忽多忽少、断绝不行、崩漏不止的，都是由阴阳盛衰所导致的。这大概是不调经的大略原则。然而，月经先期而至，虽然说是因为有火，如果是虚证兼夹火热，那么重点在于虚证，应当以滋养营血、安定血液为主。况且也有没有火热而月经先期的，那么或者补益中气，或者固护命门，都不宜过度使用寒凉药物。月经后期而至，本来属于血虚，但也有因血热而燥结瘀滞的，不得不进行清补；有因血逆而留滞的，不得不进行疏利。总之，调经的方法，只要求得其平和，关键在于详细诊察其脉象和症状。如果形体气质、脉象气息都有余（实证），才可以采用清热、通利的方法。但是虚证极多，实证极少，所以调经的要诀，贵在补益脾胃以资助血液的来源；滋养肾气以安固血液的居所。懂得这两个方面，就尽善尽美了。如果营气本来虚弱却不知道培养，那么没有不日渐干枯枯竭的。不可不仔细考察。
大凡在行经期间，非常忌讳寒凉等药物，饮食也是如此。
初虞世说：“月经按月而至，是有常度的。它的来潮过多或过少，都称为病。如果营血亏损，不能滋养全身骨骼肌肉，就会导致头发脱落、面色发黄、消瘦且伴有燥热。燥气旺盛则金（肺）受邪，肺受邪则必然出现咳嗽、吐痰、肺痈、肺痿等疾病。只要扶助胃气、壮大元气，那么营血就会生成，月经自然通畅。如果真的因为怒气逆乱，导致经闭不行，应当使用行气破血的方剂。”
《褚氏遗书·精血篇》说：“男子精气未通时便与女子交合以泄精，那么身体各部分会有不完善的地方，日后会有难以名状的疾病；阴茎已痿软却想着美色以泄精，那么精液排不出而在体内败坏，小便涩痛而成淋证；精气已耗损却又强行竭尽，那么大小便牵拉疼痛，越痛越想排便，越排便越痛。女子天癸（促进生殖功能发育的物质）已经到来，超过十年没有男子交合则月经不调；未满十年就想与男子交合也会月经不调。月经不调则旧血不去，新血误行，或者溃烂侵入骨头，或者变形成肿块，以后即使交合也难以受孕，交合频繁则精血枯竭。体质虚弱且生育众多子女的女性，会因血枯而死。观察男子的精血规律，思考女子的生理，道理已经过半了。”
《产宝方·序论》说：“妇女以血为基本，如果能谨慎调护，那么气血宣通运行，精神自然清爽，月经如期而至，血凝成孕。如果脾、胃虚弱，不能进食，营卫不足，月经不行，肌肤黄燥，面无光泽，寒热腹痛，难以孕育子女，或者带下崩漏，血行不畅，则形成瘕证（腹内结块）。”
薛立斋说：“医经说：‘阳明经的病发于心、脾，如果有难以言说的隐曲之情，会导致女子闭经。’所以心、脾平和，那么全身五脏都得到润泽，月经如常。如果心、脾受伤，那么血无所养，也无所统摄，月经就不调了。因此，调经的人，应当以调理心、脾为主。”丹溪先生也说：“先期而至者，是血热；后期而至者，是血虚。”我认为先期而至的，有因脾经血燥引起的；有因脾经郁火引起的；有因肝经怒火引起的；有因血分有热引起的；有因劳役动火引起的。过期而至的，有因脾经血虚引起的；有因肝经血虚引起的；有因气虚血弱引起的。主治方法：脾经血燥者，用加味逍遥散；脾经郁滞者，用归脾汤；肝经怒火者，用加味小柴胡汤；血分有热者，用加味四物汤；劳役动血者，用补中益气汤。其过期而至的，若脾经血虚，宜用人参养营汤；肝经血少，宜用六味地黄丸；气虚血弱，宜用八珍汤。因为血生于脾，所以说脾统血。凡是血病应当用辛甘的药物，以助其阳气以生阴血，都属于不足证。大凡肝脾血燥，以四物汤为主；肝脾血弱，以补中益气汤为主；肝脾郁结，以归脾汤为主；肝经怒火，以加味逍遥散为主。”
薛氏 加味逍遥散（见《古方八阵·补阵》） 治疗肝脾血虚、发热、小便不利。
当归、芍药、白术、茯神、甘草、柴胡（各等分），丹皮、栀子（各七分）。
上方加生姜，水煎服。
归脾汤（见《古方八阵·补阵》） 治疗思虑伤脾，不能摄血，导致血液妄行，或者健忘、怔忡、惊悸、盗汗、嗜睡、食欲不振，或者大便不调，心、脾疼痛，疟疾痢疾郁结；或者因病用药不当，克伐伤脾，以致产生变证的，最适合使用此方。
人参、黄芪、白术、茯苓、酸枣仁（各二钱），远志、当归（各一钱），木香、炙甘草（各五分）。
水两钟，加桂圆肉七枚，煎至七分，食后隔一段时间服用。我的意见：此方中使用木香，特意是为郁结疼痛的患者设立的，如果没有疼痛郁结等症状，必须去掉木香，以避免香燥之气，难道对气虚血动的患者不是更好吗？另外：远志味辛气升而散，凡是多汗且躁热的患者，也应当酌情使用。
薛氏 加味小柴胡汤（见《古方八阵·散阵》） 又名柴胡栀子散。治疗乳母肝火发热，致使婴儿患病，以及风热生痰等证。
柴胡（二三钱），半夏、黄芩（各一二钱），人参（二三钱），甘草（五七分），丹皮（二钱），栀子（二钱）。
上方加生姜、大枣，水煎服。
薛氏 加味四物汤（见《古方八阵·补阵》）
熟地黄、当归（各三钱），川芎（一钱），芍药（二钱），山栀（二钱），柴胡（二钱），丹皮（二钱）。
水两钟煎服。
东垣 补中益气汤（见《古方八阵·补阵》） 治疗劳倦伤脾，中气不足，清阳不升，外感不解，身体疲倦、食欲减少，寒热疟痢，气虚不能摄血等证。
人参、黄芪（炒）、白术（炒）、甘草（炙，各钱半），当归（一钱），陈皮（五分），升麻、柴胡（各三分）。
上方加生姜、大枣，水煎，空腹午前服用。
《局方》人参养营汤（见《古方八阵·补阵》） 治疗脾、肺俱虚，恶寒发热，肢体瘦倦，食少腹泻，口干，心悸，自汗等证。
人参、黄芪、当归、白术、炙甘草、桂心、陈皮（各一钱），熟地黄、五味子、茯苓（各七分），白芍（钱半），远志（五分）。
加生姜、大枣，水煎服。
《金匮》六味地黄丸（见《古方八阵·补阵》） 即《金匮》肾气丸，也称地黄丸。治疗肾水亏损、小便淋闭，头目眩晕，腰腿酸软，阴虚发热，自汗盗汗，憔悴瘦弱，精神疲困，失血失音，水泛为痰，病为肿胀。这是壮水制火的方剂。
熟地黄（八两蒸捣），山茱萸、山药（炒，各四两），丹皮、泽泻、白茯苓（各三两）。
上方研为细末，和地黄膏，加炼蜜制成丸，如梧桐子大，每次服用七八十丸，空腹食前用滚开的白开水或淡盐水送下。此方用水煎汤即名为六味地黄汤。
六味地黄丸并非《金匮》肾气丸，而是宋代钱乙以《金匮》肾气丸为温补肾阳之剂，考虑到小儿应滋养肾阴，故于肾气丸中去掉附子、肉桂，创制六味地黄丸以补益肾阴。张景岳认为六味地黄丸出自《金匮》，实际上是错误的，现在予以纠正。
《局方》八珍汤（见《古方八阵·补阵》） 治疗气血两虚。调和阴阳。
人参、白术、茯苓（各二钱），炙甘草（一钱），熟地黄、当归（各三钱），川芎（一钱），芍药（二钱）。
加生姜、大枣，水煎服，或者加粳米一百粒。
《局方》四物汤（见《古方八阵·补阵》） 治疗血虚营弱，一切血病应当以此方为主。
熟地黄、当归（各三钱），川芎（一钱），芍药（二钱）。水两钟煎服。
又说：胃是卫气的源头，脾是荣气的根本。荣气出于中焦，卫气出于上焦。卫气不足，补充它必须用辛味药；荣气不足，补益它必须用甘味药。甘辛相合，脾胃强健而荣卫生成，因此气血都旺盛。或者因为劳心，虚火妄动，月经错行，应当安心、补血、泻火。这是东垣先生的治疗方法。
又说：人年少时有老态，不耐受寒暑，承受不了劳役，四季交替生病，都是因为气血正在生长，却劳心亏损；或者精血尚未充盈，就早年耗损。所以其见证，难以名状，如果左尺脉虚弱或细数，是左肾真阴不足，用六味丸。右尺脉迟软或沉细而数欲绝，是命门相火不足，用八味丸。至于两尺脉微弱，是阴阳俱虚，用十补丸。这些都是滋生化之源，不可以轻率使用黄柏、知母之类。假如六淫外侵而出现见证，也是因为其气内虚，而外邪凑集罢了，尤其应当使用前文提到的药物。
崔氏 八味丸（见《古方八阵·补阵》） 治疗命门火衰，不能生土，以致脾、胃虚寒，饮食少思，大便不成形，或者下元冷惫，脐腹疼痛等证。
熟地黄（八两蒸捣），山茱萸、山药（炒，各四两），丹皮、泽泻、白茯苓（各三两），肉桂、制附子（各一两）。用法同六味丸。
十补丸（见《古方八阵·热阵》） 治疗肾脏虚冷，面黑足寒，耳聋膝软，小便不利等证。
附子（炮），五味子（各二两），山药、山茱萸、丹皮、桂心、鹿茸（制）、茯苓、泽泻（各一两），熟地黄（二两）。
《古方八阵·热阵》中本方无熟地黄，现在根据《证治准绳》补入，合成十味药，符合十补之名。
Menses are the essence and qi transformed from food and water. They harmonize within the five Zang organs, distribute to the six Fu organs, and then enter the vessels. Originating continuously, they are generated by the Spleen, controlled by the Heart, stored by the Liver, distributed by the Lung, and excreted by the Kidney, thereby irrigating the whole body. In men, they transform into Jing (Essence); in women, they ascend as breast milk and descend into the Sea of Blood to become the menstrual flow. Provided that essence and qi are not damaged, emotions are harmonious, and diet is appropriate, Yang generates and Yin grows, filling all vessels. How could there be irregularity? If one fails to exercise caution, injury from the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright) is most severe, followed by fatigue and overexertion. Alternatively, imprudence in sexual activity, where strength overwhelms weakness, leads to a failure of the Chong and Ren vessels to maintain control, which is also common. Additionally, external pathogens, internal injuries, or medical errors that damage Ying Qi (Nutritive Qi) can all cause such conditions. People who are weak and prone to illness, intolerant of cold and heat, and unable to bear labor, often have congenital deficiency. However, if one squanders health while Qi and Blood are still developing, or depletes essence and blood before they are fully mature, damaging the source of transformation and generation, lifelong harm ensues. This must be deeply observed and regulated before disease occurs.
If one wishes to regulate menses after disease has occurred, the key lies in four aspects: Deficiency, Excess, Yin, and Yang. Zhu Danxi said: "Menses arriving early indicate Blood Heat; those arriving late indicate Blood Deficiency." Wang Ziheng said: "Excessive Yang causes early arrival; insufficient Yin causes late arrival." Cases of fluctuating volume, cessation, metrorrhagia, and metrostaxis are all caused by the excess or deficiency of Yin and Yang. These are the general principles of irregular menstruation. However, although early arrival is often attributed to Fire, if it is a deficiency pattern with accompanying Fire, the focus should be on deficiency, primarily nourishing Ying Qi and stabilizing Blood. Moreover, there are cases of early arrival without Fire, where one should tonify Middle Qi or secure the Gate of Vitality (Mingmen), avoiding excessive use of cold and cool herbs. Late arrival is fundamentally due to Blood Deficiency, but there are cases of dryness and stasis due to Blood Heat requiring clear and tonifying methods, and cases of Blood rebellion and stagnation requiring dispersing and promoting methods. In summary, the method of regulating menses seeks harmony, relying on detailed observation of pulse and symptoms. Only when both physical constitution and pulse Qi indicate excess can clearing and draining methods be used. Since deficiency patterns are very common and excess patterns rare, the essence of regulating menses lies in tonifying the Spleen and Stomach to nourish the source of Blood, and nourishing Kidney Qi to secure the residence of Blood. Understanding these two aspects ensures perfection. If Ying Qi is inherently deficient and not cultivated, it will inevitably wither and exhaust itself. This must not be overlooked.
During menstruation, cold and cool herbs and foods are strictly contraindicated.
Chu Yushi said: "Menses arrive monthly with regularity. Deviations in timing or amount are pathological. If Ying Blood is deficient and cannot nourish the bones and muscles, hair loss, sallow complexion, emaciation, and dry heat occur. Excessive Dryness damages Metal (Lung), leading to cough, expectoration, lung abscess, and lung flaccidity. By assisting Stomach Qi and strengthening Yuan Qi, Ying Blood generates, and menses flow naturally. If anger causes Qi rebellion and amenorrhea, formulas that move Qi and break Blood stasis should be used."
*Chu Shi Yi Shu · Jing Xue Chapter* states: "If a man engages in intercourse to release Jing before his essence is unblocked, his body will have imperfections, leading to difficult-to-describe diseases later. If he ejaculates while impotent due to lust, the essence does not exit but rots internally, causing painful urination and strangury. If essence is exhausted and further depleted, it causes pain during defecation and urination, creating a vicious cycle. For women, if Tian Gui (menstrual essence) has arrived, remaining celibate for over ten years causes irregularity; seeking intercourse before ten years also causes irregularity. Irregularity prevents old blood from leaving and new blood from flowing correctly, potentially rotting into bones or forming masses. Subsequent intercourse may fail to conceive, and frequent intercourse depletes essence and blood. Women with weak constitutions and many births may die from blood exhaustion. Observing male Jing and female blood reveals half the truth."
*Chan Bao Fang · Preface* states: "Women are based on Blood. With careful regulation, Qi and Blood circulate freely, spirit remains clear, menses return on schedule, and conception occurs. If the Spleen and Stomach are weak, preventing eating, and Ying and Wei are insufficient, menses cease, skin becomes yellow and dry, face lacks luster, chills and fever, abdominal pain occur, and conception is difficult. Leukorrhea and metrorrhagia may arise, with stagnant blood forming Jia masses (abdominal masses)."
Xue Lizhai said: "The Classic states: 'Diseases of the Two Yangs originate in the Heart and Spleen; hidden grievances lead to amenorrhea in women.' Thus, when the Heart and Spleen are harmonious, all organs are moistened, and menses are regular. If the Heart and Spleen are injured, Blood lacks nourishment and control, leading to irregular menses. Therefore, regulating menses should focus on managing the Heart and Spleen." Mr. Danxi also said: "Early arrival indicates Blood Heat; late arrival indicates Blood Deficiency." I believe early arrival can be caused by Spleen channel Blood dryness, Spleen channel depressed Fire, Liver channel angry Fire, Heat in the Blood level, or Fire stirred by labor. Late arrival can be caused by Spleen channel Blood Deficiency, Liver channel Blood Deficiency, or Qi deficiency with weak Blood. Treatment methods: For Spleen channel Blood dryness, use Modified Xiao Yao San; for Spleen channel depression, use Gui Pi Tang; for Liver channel angry Fire, use Modified Xiao Chai Hu Tang; for Heat in the Blood level, use Modified Si Wu Tang; for Blood disturbance due to labor, use Bu Zhong Yi Qi Tang. For late arrival: if due to Spleen channel Blood Deficiency, use Ren Shen Yang Ying Tang; if due to Liver channel Blood insufficiency, use Liu Wei Di Huang Wan; if due to Qi deficiency and weak Blood, use Ba Zhen Tang. Since Blood is born in the Spleen, it is said that the Spleen controls Blood. Blood disorders require pungent and sweet herbs to assist Yang Qi in generating Yin Blood, as these are all deficiency patterns. Generally, for Liver-Spleen Blood dryness, Si Wu Tang is primary; for Liver-Spleen Blood weakness, Bu Zhong Yi Qi Tang is primary; for Liver-Spleen depression, Gui Pi Tang is primary; for Liver channel angry Fire, Modified Xiao Yao San is primary.
Xue's Modified Xiao Yao San (see *Gu Fang Ba Zhen · Bu Zhen*) treats Liver-Spleen Blood deficiency, fever, and difficult urination.
Dang Gui, Bai Shao, Bai Zhu, Fu Shen, Gan Cao, Chai Hu (equal parts), Mu Dan Pi, Zhi Zi (each 0.7 qian).
Add fresh ginger, decoct in water, and take orally.
Gui Pi Tang (see *Gu Fang Ba Zhen · Bu Zhen*) treats spleen injury from overthinking, inability to control Blood leading to hemorrhage, forgetfulness, palpitations, fright, night sweats, lethargy, poor appetite, irregular bowels, Heart-Spleen pain, malaria-dysentery depression; or complications from inappropriate medication damaging the Spleen. It is highly suitable for these.
Ren Shen, Huang Qi, Bai Zhu, Fu Ling, Suan Zao Ren (each 2 qian), Yuan Zhi, Dang Gui (each 1 qian), Mu Xiang, Zhi Gan Cao (each 0.5 qian).
Decoct 2 zhong of water with 7 longan arils to 0.7 zhong. Take after meals. My opinion: Mu Xiang is included specifically for depression-pain. If no pain-depression exists, remove Mu Xiang to avoid aromatic dryness, which is better for Qi deficiency with moving Blood. Also, Yuan Zhi is pungent, ascending, and dispersing; use cautiously in patients with excessive sweating and restlessness.
Xue's Modified Xiao Chai Hu Tang (see *Gu Fang Ba Zhen · San Zhen*), also named Chai Hu Zhi Zi San, treats breastfeeding mothers with Liver Fire fever affecting the infant, and phlegm due to Wind-Heat.
Chai Hu (2-3 qian), Ban Xia, Huang Qin (each 1-2 qian), Ren Shen (2-3 qian), Gan Cao (0.5-0.7 qian), Mu Dan Pi (2 qian), Zhi Zi (2 qian).
Add fresh ginger and dates, decoct in water, and take orally.
Xue's Modified Si Wu Tang (see *Gu Fang Ba Zhen · Bu Zhen*)
Shu Di Huang, Dang Gui (each 3 qian), Chuan Xiong (1 qian), Bai Shao (2 qian), Shan Zhi (2 qian), Chai Hu (2 qian), Mu Dan Pi (2 qian).
Decoct in 2 zhong of water and take orally.
Dongyuan's Bu Zhong Yi Qi Tang (see *Gu Fang Ba Zhen · Bu Zhen*) treats spleen injury from fatigue, Middle Qi deficiency, failure of Clear Yang to ascend, unresolved external contraction, fatigue, poor appetite, chills-fever-malaria-dysentery, and Qi deficiency failing to control Blood.
Ren Shen, Huang Qi (stir-fried), Bai Zhu (stir-fried), Zhi Gan Cao (roasted, each 1.5 qian), Dang Gui (1 qian), Chen Pi (0.5 qian), Sheng Ma, Chai Hu (each 0.3 qian).
Add fresh ginger and dates, decoct in water. Take on an empty stomach before noon.
*Ju Fang* Ren Shen Yang Ying Tang (see *Gu Fang Ba Zhen · Bu Zhen*) treats combined Spleen-Lung deficiency, aversion to cold and fever, emaciated limbs, poor appetite with diarrhea, dry mouth, palpitations, and spontaneous sweating.
Ren Shen, Huang Qi, Dang Gui, Bai Zhu, Zhi Gan Cao, Gui Xin, Chen Pi (each 1 qian), Shu Di Huang, Wu Wei Zi, Fu Ling (each 0.7 qian), Bai Shao (1.5 qian), Yuan Zhi (0.5 qian).
Add fresh ginger and dates, decoct in water, and take orally.
*Jin Gui* Liu Wei Di Huang Wan (see *Gu Fang Ba Zhen · Bu Zhen*), also known as *Jin Gui* Shen Qi Wan or Di Huang Wan, treats Kidney Water deficiency, strangury, dizziness, soreness/weakness of waist and legs, Yin deficiency fever, spontaneous/night sweats, emaciation, mental fatigue, blood loss/aphonia, edema due to water overflowing, and swelling. It is a formula to strengthen Water to control Fire.
Shu Di Huang (8 liang, steamed and pounded), Shan Zhu Yu, Shan Yao (stir-fried, each 4 liang), Mu Dan Pi, Ze Xie, Bai Fu Ling (each 3 liang).
Grind into fine powder, mix with Di Huang paste, add refined honey to make pills the size of tung tree seeds. Take 70-80 pills per dose on an empty stomach before meals with boiling plain water or light salt water. Decocting this formula in water yields Liu Wei Di Huang Tang.
Note: Liu Wei Di Huang Wan is not *Jin Gui* Shen Qi Wan. Song Dynasty physician Qian Yi created Liu Wei Di Huang Wan by removing Fu Zi and Rou Gui from *Jin Gui* Shen Qi Wan to nourish Kidney Yin for children, whereas the original was for warming Kidney Yang. Zhang Jingyue's claim that Liu Wei Di Huang Wan originates from *Jin Gui* is erroneous; this corrects the record.
*Ju Fang* Ba Zhen Tang (see *Gu Fang Ba Zhen · Bu Zhen*) treats dual Qi-Blood deficiency and harmonizes Yin-Yang.
Ren Shen, Bai Zhu, Fu Ling (each 2 qian), Zhi Gan Cao (1 qian), Shu Di Huang, Dang Gui (each 3 qian), Chuan Xiong (1 qian), Bai Shao (2 qian).
Add fresh ginger and dates, decoct in water, and take orally. Optionally add 100 grains of rice.
*Ju Fang* Si Wu Tang (see *Gu Fang Ba Zhen · Bu Zhen*) treats Blood deficiency and Ying weakness; it is the primary formula for all Blood disorders.
Shu Di Huang, Dang Gui (each 3 qian), Chuan Xiong (1 qian), Bai Shao (2 qian). Decoct in 2 zhong of water and take orally.
It is also stated: The Stomach is the source of Wei Qi; the Spleen is the root of Ying Qi. Ying Qi emerges from the Middle Jiao; Wei Qi emerges from the Upper Jiao. If Wei Qi is insufficient, tonify with Pungent herbs; if Ying Qi is insufficient, tonify with Sweet herbs. Pungent and Sweet combined strengthen the Spleen and Stomach, generating Ying and Wei, thus making Qi and Blood robust. If mental labor causes deficient Fire to flare and disrupt menses, calm the Heart, nourish Blood, and drain Fire. This is Dongyuan's method.
It is also stated: Youth showing signs of old age, intolerance to cold/heat, inability to bear labor, and seasonal illnesses are due to mental labor damaging developing Qi/Blood, or early depletion of immature essence/blood. Symptoms are hard to describe. If the Left Chi pulse is weak, fine, or rapid, it indicates Left Kidney True Yin deficiency; use Liu Wei Wan. If the Right Chi pulse is slow, soft, deep, fine, or nearly absent, it indicates Mingmen Minister Fire deficiency; use Ba Wei Wan. If both Chi pulses are weak, it indicates dual Yin-Yang deficiency; use Shi Bu Wan. These tonify the source of transformation. Do not lightly use Huang Bo or Zhi Mu. If Six Evils invade externally, it is because internal Qi is weak and pathogens gather; prior formulas are especially indicated.
Liu Wei Wan (i.e., Liu Wei Di Huang Wan. See above).
Cui's Ba Wei Wan (see *Gu Fang Ba Zhen · Bu Zhen*) treats Mingmen Fire decline failing to generate Earth, leading to Spleen-Stomach deficiency-cold, poor appetite, loose stools, lower burner coldness, and umbilical-abdominal pain.
Shu Di Huang (8 liang, steamed and pounded), Shan Zhu Yu, Shan Yao (stir-fried, each 4 liang), Mu Dan Pi, Ze Xie, Bai Fu Ling (each 3 liang), Rou Gui, Zhi Fu Zi (each 1 liang). Usage same as Liu Wei Wan.
Shi Bu Wan (see *Gu Fang Ba Zhen · Re Zhen*) treats Kidney deficiency-cold, dark face, cold feet, deafness, knee weakness, and difficult urination.
Fu Zi (processed), Wu Wei Zi (each 2 liang), Shan Yao, Shan Zhu Yu, Mu Dan Pi, Gui Xin, Lu Rong (processed), Fu Ling, Ze Xie (each 1 liang), Shu Di Huang (2 liang).
Note: *Gu Fang Ba Zhen · Re Zhen* omits Shu Di Huang. Added here based on *Zheng Zhi Zhun Sheng* to complete the ten ingredients, fitting the name "Ten Tonics".