芩心丸 益阴煎
经断复来血热甚，芩心醋丸温酒吞。益阴知柏龟生地，缩砂炙草枣姜寻。血多热去伤冲任，十全
大补与八珍。暴怒忧思肝脾损，逍遥归脾二药斟。
【注】妇人七七四十九岁后，天癸不行。若止而复来，无他证者，乃血有余，不得用
药止之。若因血热者，宜芩心丸，用黄芩心末二两，醋丸温酒送下。或用益阴煎，即知
母、黄柏、龟版、生地、缩砂、炙草也。若血去过多，热随血去，冲任虚损，其血不固
者，宜十全大补汤、八珍汤。若因怒气伤肝，肝不藏血，忧思伤脾，脾不摄血者，宜于逍
遥散、归脾汤二方斟酌用之。
十全大补汤 八珍汤 逍遥散 归脾汤（俱见前调经门）
大黄 虫丸 泽兰叶汤 柏子仁丸
室女经闭多血结，大黄 虫桃杏仁，虻蛭蛴螬甘草芍，干漆生地及黄芩；不足泽兰归草芍。柏子
仁丸用柏仁，熟地泽兰牛卷续，相兼久服自然行。师尼寡妇逍遥散，附兰丹地郁栀芩。
【注】室女经闭，多有气血凝结者，宜用大黄 虫丸，破血行气，其经自通。方用大
黄、 虫、桃仁、杏仁、 虫、水蛭、蛴螬、甘草、白芍、干漆、生地、黄芩，蜜丸服。若
其人虚弱不任攻下，则用泽兰叶汤，即泽兰叶、当归、甘草、白芍也。兼服柏子仁丸，方
用柏子仁、熟地、泽兰叶、牛膝、卷柏、续断，丸服。煎丸并进，久久其血自行。至于
师尼、寡妇经闭之证，多属郁热，宜用逍遥
散，加香附、泽兰叶、丹皮、生地、郁金、黑栀、黄芩以和肝理脾、清心开郁，其经自通
也。
逍遥散（方见前调经门）
月经停止后又复来潮，若因血热严重所致，可用芩心丸制成醋丸，以温酒送服。益阴煎由知母、黄柏、龟版、生地黄组成，另加缩砂仁、炙甘草，并配合大枣、生姜煎服。若出血过多导致热随血去，进而损伤冲脉和任脉，宜选用十全大补汤或八珍汤。若因暴怒或忧思导致肝脾受损，则斟酌使用逍遥散或归脾汤。
【注释】妇女到了四十九岁左右（七七之年），天癸（促进生殖功能发育成熟的物质）枯竭，月经自然停止。如果月经停止后再次来潮，且没有其他病症，这是血气有余的表现，不应用药强行止血。如果是因血热引起的，适宜用芩心丸，取黄芩心粉末二两，用醋制成丸剂，以温酒送下。或者使用益阴煎，即知母、黄柏、龟版、生地黄、缩砂仁、炙甘草。如果失血过多，热邪随血液流失，导致冲任二脉虚损，血液固摄无力，适宜服用十全大补汤、八珍汤。如果是因怒气伤肝，导致肝不藏血；或因忧思伤脾，导致脾不统血，则应在逍遥散和归脾汤两方中斟酌选用。
未婚女子经闭多因血结所致，可用大黄䗪虫丸，方含大黄、䗪虫、桃仁、杏仁、虻虫、水蛭、蛴螬、甘草、白芍、干漆、生地黄及黄芩；若属虚证不足，则用泽兰叶汤，方含当归、甘草、白芍。柏子仁丸由柏子仁组成，配伍熟地黄、泽兰叶、牛膝、卷柏、续断，长期兼服，月经自然通畅。尼姑、寡妇经闭多用逍遥散，加入香附、泽兰叶、丹皮、生地黄、郁金、黑栀子、黄芩。
【注释】未婚女子经闭，多伴有气血凝结的情况，适宜使用大黄䗪虫丸，以破血行气，月经自然通畅。该方由大黄、䗪虫、桃仁、杏仁、虻虫、水蛭、蛴螬、甘草、白芍、干漆、生地黄、黄芩组成，炼蜜为丸服用。如果患者体质虚弱，不能耐受攻下之法，则使用泽兰叶汤，即泽兰叶、当归、甘草、白芍。同时兼服柏子仁丸，方用柏子仁、熟地黄、泽兰叶、牛膝、卷柏、续断，制成丸剂服用。汤剂与丸剂并进，久而久之，经血自然通行。至于尼姑、寡妇经闭的证候，多属于郁热，适宜使用逍遥散，加入香附、泽兰叶、丹皮、生地黄、郁金、黑栀子、黄芩，以调和肝脾、清心解郁，月经自然通畅。
逍遥散（方剂见前文调经门）
Qinxin Wan (Cortex Scutellariae Pill) and Yiyin Decoction (Nourish Yin Decoction)
If menstruation resumes after cessation due to severe blood heat, Qinxin Wan (Cortex Scutellariae Pill), prepared as vinegar pills, should be taken with warm wine. Yiyin Decoction (Nourish Yin Decoction) consists of *Anemarrhenae Rhizoma* (Zhimu, 知母), *Phellodendri Cortex* (Huangbai, 黄柏), *Testudinis Carapax et Plastrum* (Guiban, 龟版), and *Rehmanniae Radix* (Shengdi, 生地黄), along with *Amomi Fructus* (Suosha, 缩砂仁) and *Glycyrrhizae Radix et Rhizoma Praeparata cum Melle* (Zhigancao, 炙甘草), decocted with *Jujubae Fructus* (Dazao, 大枣) and *Zingiberis Rhizoma Recens* (Shengjiang, 生姜). If excessive bleeding leads to the dissipation of heat with the blood, resulting in deficiency and damage to the Chong and Ren vessels, Shiquan Dabu Decoction (Ten Substance Great Tonifying Decoction) or Bazhen Decoction (Eight Treasure Decoction) is indicated. If liver and spleen damage results from sudden anger or worry and overthinking, Xiaoyao Powder (Free and Easy Wanderer Powder) or Guipi Decoction (Restore the Spleen Decoction) should be considered.
[Note] After the age of forty-nine (seven times seven years), Tian Gui (the substance governing reproductive maturity) ceases in women, and menstruation naturally stops. If menstruation resumes after a period of cessation without other symptoms, it indicates an excess of blood; medication should not be used to forcibly stop it. If caused by blood heat, Qinxin Wan (Cortex Scutellariae Pill) is appropriate: two taels of powdered Cortex Scutellariae Core are formed into pills with vinegar and taken with warm wine. Alternatively, Yiyin Decoction (Nourish Yin Decoction) may be used, comprising *Anemarrhenae Rhizoma*, *Phellodendri Cortex*, *Testudinis Carapax et Plastrum*, *Rehmanniae Radix*, *Amomi Fructus*, and *Glycyrrhizae Radix et Rhizoma Praeparata cum Melle*. If blood loss is excessive, heat dissipates with the blood, causing deficiency and damage to the Chong and Ren vessels, leading to unstable blood retention, Shiquan Dabu Decoction (Ten Substance Great Tonifying Decoction) and Bazhen Decoction (Eight Treasure Decoction) are suitable. If anger injures the liver, impairing its function of storing blood, or worry and overthinking injure the spleen, impairing its function of controlling blood, one should choose between Xiaoyao Powder (Free and Easy Wanderer Powder) and Guipi Decoction (Restore the Spleen Decoction).
Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill), Zelanye Tang (Lycopus Leaf Decoction), and Baiziren Wan (Biota Seed Pill)
Amenorrhea in unmarried girls is often due to blood stasis; Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) is indicated, containing *Rhei Radix et Rhizoma* (Dahuang, 大黄), *Eupolyphaga seu Steleophaga* (Zhechong, 䗪虫), *Persicae Semen* (Taoren, 桃仁), *Armeniaca Semen* (Xingren, 杏仁), *Blaberus* (Mengchong, 虻虫), *Hirudo* (Shuizhi, 水蛭), *Gryllotalpa* (Qicao, 蛴螬), *Glycyrrhizae Radix et Rhizoma* (Gancao, 甘草), *Paeoniae Radix Alba* (Baishao, 白芍), *Dryobalanops Resina* (Ganqi, 干漆), *Rehmanniae Radix* (Shengdi, 生地黄), and *Scutellariae Radix* (Huangqin, 黄芩); for deficiency, Zelanye Tang (Lycopus Leaf Decoction) is used, containing *Angelicae Sinensis Radix* (Danggui, 当归), *Glycyrrhizae Radix et Rhizoma* (Gancao, 甘草), and *Paeoniae Radix Alba* (Baishao, 白芍). Baiziren Wan (Biota Seed Pill) uses Biota Seed (*Biotae Semen*, Baiziren), combined with *Rehmanniae Radix Praeparata* (Shudi, 熟地), Lycopus Leaf (*Lycopi Herba*, Zelanye), *Achyranthis Bidentatae Radix* (Niuxi, 牛膝), *Selaginellae Herba* (Juanbai, 卷柏), and *Dipsaci Radix* (Xuduan, 续断). Long-term concurrent use will naturally restore menstruation. For nuns and widows with amenorrhea, Xiaoyao Powder (Free and Easy Wanderer Powder) is used, added with Cyperus Rhizome (*Cyperi Rhizoma*, Xiangfu), Lycopus Leaf, Moutan Cortex (*Moutani Cortex*, Danpi), *Rehmanniae Radix*, Curcuma Aromatica Rhizome (*Curcumae Rhizoma*, Yujin), Black Gardenia Fruit (*Gardeniae Fructus*, Heizhi), and *Scutellariae Radix*.
[Note] Amenorrhea in unmarried girls often involves qi and blood stagnation; Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) is appropriate to break blood stasis and move qi, allowing menstruation to resume naturally. The formula contains *Rhei Radix et Rhizoma*, *Eupolyphaga seu Steleophaga*, *Persicae Semen*, *Armeniaca Semen*, *Blaberus*, *Hirudo*, *Gryllotalpa*, *Glycyrrhizae Radix et Rhizoma*, *Paeoniae Radix Alba*, *Dryobalanops Resina*, *Rehmanniae Radix*, and *Scutellariae Radix*, formed into honey pills. If the patient is weak and cannot tolerate purgative treatment, Zelanye Tang (Lycopus Leaf Decoction), consisting of Lycopus Leaf, *Angelicae Sinensis Radix*, *Glycyrrhizae Radix et Rhizoma*, and *Paeoniae Radix Alba*, should be used. Concurrently, Baiziren Wan (Biota Seed Pill) is administered, containing Biota Seed, *Rehmanniae Radix Praeparata*, Lycopus Leaf, *Achyranthis Bidentatae Radix*, *Selaginellae Herba*, and *Dipsaci Radix*, taken as pills. The combination of decoction and pills, used over time, will naturally promote blood flow. Regarding amenorrhea in nuns and widows, it is mostly due to constrained heat; Xiaoyao Powder (Free and Easy Wanderer Powder) is indicated, added with Cyperus Rhizome, Lycopus Leaf, Moutan Cortex, *Rehmanniae Radix*, Curcuma Aromatica Rhizome, Black Gardenia Fruit, and *Scutellariae Radix* to harmonize the liver and spleen, clear the heart, and resolve constraint, thereby restoring menstruation.
Xiaoyao Powder (Formula seen in the preceding Menstrual Regulation Section)