(附论)
夫妇人月水不通者。由劳伤血气。致令体虚受风冷。邪气客于胞内。伤损冲任之脉。并
手太阳少阴之经。致胞络内绝血气不通故也。冲任之脉起于胞内。为经脉之海。手太阳小肠
之经也。手少阴心之经也。此二经为表里。主上为乳汁。下为月水。风冷伤其经血。血性得
温则宣流。得寒则涩闭。既为冷所结搏。血结于内。故令月水不通也。又云。肠中鸣。则月
水不来。病本于胃。所以然者。风冷干于胃气。胃气虚。不能分别水谷使津液不生。血气不
成故也。又云。醉以入房。则内气竭绝。伤于肝。使月水衰少不来也。所以尔者。肝藏于血。
劳伤过度。血气枯竭于内也。又先经唾血及吐血下血。谓之脱血。使血枯。亦月水不来也。
又利血。经水亦断。所以尔者。津液减耗故也。须利止。津液生。其经自下。诊其肾脉微涩
者。是月水不通也。又左手关后尺内浮为阳。阳绝者。无膀胱脉也。月水则闭。又肝脉沉之
而急。浮之亦然。时小便难。苦头眩痛。腰背痛。足寒时疼。月水不来时。恐得之时有所堕
坠也。月水不通。久则血结于内生块。变为血瘕。亦作血症血水相并。壅涩不宣通。脾胃虚
弱。变为水肿也。所以然者。脾候身之肌肉。象于土。土主能克消于水。水血既并。脾气衰
弱。不能克消。故水气流溢。浸渍肌肉故肿满也。又云。经脉不通日久。此非细事。实为沉
痼。若是室女经脉不通。初因贪食酸咸之物。遂致血脉干涸变成劳病。若因经脉正行。误食
热面、生冷、房室。遂成此疾。腹内颗块。误认为胎。时日稍深必见困笃也。夫血寒则闭。
热则停。温则流。诊其尺脉涩者是也。微弱者。本象不足。沉紧者。小便必时痛。而有症瘕。
及满盛者有妊也。若是室女月事不行。必因多食盐酸生斯疾。若久不宣通变劳疾。遇月信而
仍误食生冷、热面。有醉以入房而其气内隔。因而阻滞。非时肠鸣。必使月信不来。病体冒
受风冷。胃气虚而不能分别水谷。使津液不生。血气不成也。凡月闭之疾。但服琥珀丸。肌
瘦而利饮者血热相搏也。宜服黄连丸。面白肢体浮肿。肝气弱而不能制血。三圣丸及三物汤
主之。再候而小腹急。疼痛。或作颗块而误认为胎。此为血症。因血经行入房故也。琥珀丸
主之。产后不久。月信不通。其故缘气血耗散。不是风寒击搏而内攻也。是血凝滞而不行。
久不治之。便为血症。使人肚如覆杯。其体如水肿。是脾虚而血水相并有块者。与琥珀丸。
如腹如蛊者。与没药丸。身肿者。与九霄丸。三物汤。
女子十四天癸至。任脉通。月事以时下。故令有子。天癸者。物之自然。月者以月至。
经者有常也。其来过与不及。多与少及此皆胃之故也。不行尤甚者有疾生焉。血既不能滋养
百骸。则发落面黄。身羸瘦。血虚则热发。故身多热。水不足则燥气燔。则金受邪。金受邪。
则为咳为嗽。则为肺痿、为肺痈必矣。医见经不行则用虻虫、水蛭等行血药。见热则用诸寒
药。实出妄意。就中不行以药行之为害滋大。经水枯竭。则无以滋养。其能行乎。譬犹索万
金于乞丐之人。虽捶楚并下。不可得也。但服以养气益血诸药。天癸自行。又有二种妇人。
实盛月经瘀闭。利之则行矣。
又云月水不通者。所致不一。有味不化血。经脉不通。有先期太过。后期不通。有大病
后热不通。有寒凝结滞不通。有积聚气结不通。有心气抑滞不通。凡此所受不同。治亦异。
盖妇人假血为本。以气为用。血气稽流。则涩而不行。其为病。或寒、或热。脐腹坚痛。肌
肉消瘦。久则为劳瘠之症。
凡妇人月水不来。室女亦可。内经曰月事不来。皆是胞脉闭也。胞脉者属心而络于脬中。
令气上迫于肺。心气不得下通。故月事不来也。可用茶调散吐之。次用玉烛散、芎 汤、三
和汤、桂苓白术散之类。降心火益肾水。开胃进食。分阴阳。利水道之药皆是也。慎勿服峻
热有毒之药。若服之则变成肺痿、骨蒸潮热。咳嗽。咯脓。呕血。喘满。小水不利。寝汗不
止。渐至形瘦脉大。虽遇良医。亦成不救。呜呼。人之死者。岂命使之然也哉。
一妇人年二十余岁。病经闭不行。寒热往来。咳嗽潮热。庸医禁切无物可食。一日当暑
出门忽见卖凉粉者。以冰水和饮。大为一餐。顿觉神清骨健数月。经水自下。夫冲任之脉起
于胞内。为经脉之海。手太阳小肠之经。手少阴心之经也。二经为表里。心主于血。上为乳
汁。下为月水也。女子十四而天癸至。肾气全盛。冲任流通。经血既盈。应时而下。名之月
水。常以三旬而一见。谓之平和也。若后期者。由劳伤血气壅结。故令月水不通也。
室女经闭成劳方论。寇宗 曰。夫人之生。以气血为本。人之病。未有不先伤其气血者。
世有室女童子。积想在心。思虑过度。多致劳损。男子则神色消散。女子则月水先闭。何以
致然。盖忧愁思虑则伤心。心伤则血逆竭。神色先散。而月水先闭也。火既受病不能荣养其
子。故不嗜食。脾既虚。则金气亏。故发嗽。金既亏。则水气绝。故四肢干瘦。木气不克。
故多怒。鬓发焦、筋脉痿。五脏传遍。故卒不能死者然终必死矣。此一种于劳中最难治。盖
病起于五脏之中。无有已。其药力不可及也。若或自能改易心志。用药扶接。如此则可得九
死一生也。
张氏云。室女月水久不行。切不可用青蒿等凉药医家多以为室女虚热。故以凉药攻之。
殊不知血得热则行。冷则凝也。
方
桃花丸 治妇人月水不通。无子。由子宫风冷积血。滞于膀胱。故致腰膝疼痛。手
脚热。心背妨闷。经络不调。腹内多气。四肢乏力。面无血色及多 宜服。
桃仁 苏合香 安息香 木香 槟榔 川芒硝(各三分) 水蛭(炒令微黄) 虻虫(炒
令微黄去翅足各半两) 麒麟竭 鳖甲(涂醋炙令黄去裙 ) 附子(炮制去皮脐) 柴胡
(去苗) 卷柏 当归(锉微炒) 辛夷 白芷 紫石英(细研水飞过) 禹余粮(炒醋淬
七遍) 芎 牡丹 细辛 麦门冬(去心焙) 羌活 桂心 肉豆蔻(去壳各一两) 上
为末。炼蜜和丸。捣三百杵。丸如梧桐子大。每日空心及晚食前。煎茅汤下三十丸。
紫葳散(出圣济总录)
治妇人经脉不通。血热壅滞。攻疰四肢。皮肤瘾疹。并行经脉。
用紫葳凌霄花是也。不以多少。为散。每服二钱。食前温酒调下。服之。
治妇人血结月闭。石淋。
用海藻石帆高尺余。根如漆。上渐软。作交罗文。生海底。煮汁服之。
治妇人月水经久不来。
用威灵仙为末。酒调下。一方用刘寄奴。一方用王不留行。
血竭破经丹
治妇人血闭不通神方。
锦纹大黄(一两去皮醋浸一宿) 硼砂(一钱) 上为末。醋和为丸如梧桐子大。每服
三丸。好酒红花汤调下。食前服之。
干地黄当归丸(一名干地黄丸)治月水不通。或一月再来。或隔月至。或多
或少。淋漓不断。或来而腰腹刺痛不可忍。四体沉重。惟思眠卧。欲食酸物。虚乏黄
瘦。
温经汤(出指南方)
治经道不通。
人参 牛膝 甘草(各一两) 当归 芍药 牡丹皮 白术 官桂 芎 (各二两) 上
为粗末。每服五钱。水二钟。姜三片。枣一枚煎一盏去滓。服。
地黄煎(出指南方)
治经候至时。顿然不行。
牛膝(半两) 生地黄(三两取汁) 干漆(一两) 上以慢火同煎。可丸即丸如梧桐
子大。每服三丸。温酒下。块消为度。
干漆丸(出千金方)
治月经不通。百疗不瘥。脏腑宿冷。恶血凝结。
干漆 土瓜根 射干 芍药(各一两半) 牡丹 牛膝 黄芩 桂心 吴茱萸 大黄 柴
胡(各一两六株) 桃仁 鳖甲(各二两) 虫 蛴螬(各四十枚) 水蛭 虻虫(各七
十枚) 大麻子(四合) 乱发(鸡子大二枚) 庵 子(二合) 上为末。以蜜和丸如梧
桐子大。每日酒下十五丸。渐加至三十丸。日三。仍用后浸酒服前丸药。一方无芍药、牛膝、
土瓜根。
浸酒方(出千金方)
大麻子(三升) 子(二升) 桃仁(一升) 灶屋 煤(四两) 土瓜根 射干
(各六两) 牛膝(八两) 桂心(四两) 上 咀。以清酒三斗。绢袋盛药。浸五宿。以
一盏下前药良。或单服之亦得。
大虻虫丸(出圣惠方)
治月经不通六七年。或肿满气逆。腹胀瘕痛。宜服此。数有神验。
虻虫(四百枚) 蛴螬(二百枚) 干地黄(一升) 牡丹 干漆 芍药 牛膝 土瓜
根桂心(各四两) 吴茱萸 桃仁 黄芩 牡蒙(各三两) 茯苓 海藻(各五两) 水
蛭(三百枚) 芒
大。每日空心酒下七丸。
蛴螬丸(出圣惠方)
治妇人月水不通。或肿满气逆。咳嗽食少。
蛴螬(三分微炒) 生地黄(一两) 牡丹(三分) 干漆(半两捣研令烟出) 桃仁
(三分汤浸去皮尖双仁麸炒微黄) 赤芍药 牛膝(去苗) 土瓜根(各三分) 桂心(半
两) 黄芩 琥珀(各半两) 水蛭(一分炒微黄) 虻虫(一分炒微黄去翅足) 甜葶苈
(三分隔纸炒令紫色)
为末。烂蜜和捣二三百杵。丸
当归汤
治妇人月水不通。脐下撮痛。食减羸易。
当归(切焙) 甘草(炙锉) 桂(去粗皮) 木贼 大黄(锉炒) 荆三棱(炮锉各
一两) 威灵仙(去土) 生地黄(焙) 王不留行 槟榔 玄胡索 代赭( 醋淬) 天
雄(炮裂去皮脐) 鳖甲(去裙 醋炙各一两半) 红蓝花(炒三分) 上 咀。如麻豆大。
每服五钱半。煎八分去滓。温服。不拘时候。
狗胆丸(出圣惠方)
治妇人月水不通。日渐羸瘦。变为血痨及血气结聚疼痛。
狗胆(五枚取汁) 硼砂(半两胆汁浸三七日) 干漆(捣碎炒令烟出) 芫花(醋拌
炒令干) 玄
竭砒霜(各一分)
蛭(微炒黄去翅足) 当归
以来。去却石脚。却入铫子内
和捣三二百杵。丸如绿豆大。
每于食后。以温酒下七丸。
鳖甲汤(出圣济总录)
治妇人经候不通。已经三两月。
鳖甲(去裙 醋炙) 白前 代赭(煨醋淬) 荆三棱(炮锉) 附子(炮裂去皮脐) 玄
胡索(各一两半) 大黄(锉炒) 甘草(炙锉) 木香 桂(去粗皮) 当归(切焙各一
两) 桃仁(去皮尖双仁炒二十枚) 红蓝花(三分) 熟干地黄(焙三两) 大腹皮(锉
二两半) 上 咀。如麻豆。每服五钱。水一盏半煎取八分。去滓。温服。不拘时候服。
治月经不通。心腹绞痛欲死。通血止痛。(出千金方)
当归 大黄 芍药(各三两) 吴茱萸 干地黄 干姜 芎 虻虫 水蛭(各二两) 细
辛甘草 桂心(各二两) 栀子(十四枚) 桃仁(一升) 上 咀。以水一斗五升。煮
取五升。分
治妇人月经不通。大腑秘热。两足痛。行不得。日夜不安。疼痛叫声不停。肌肉消
瘦。(出护命方)
麻黄(去根) 射干 秦艽 荆芥穗 虎杖 连翘 当归 牡丹皮(去心) 牛膝 官
桂黄芩 杏仁 大黄(醋煮如前) 牵牛 芎 (各一分) 半夏(三株) 大腑热使大
黄(一两) 上件药。作一处杵罗为末。每服三钱。水一盏煎取九分。食后吃。以大腑通畅。
经候通行为度。若人得此病。但止通大腑。行经候。自然安乐也。
地髓煎丸(出杨氏家藏方)
通经脉。补虚羸。强脚膝。润泽肌肤。和畅筋脉。
当归丸(出圣济总录)
治妇人风痨气病。经脉不通。渐加羸瘦。不思饮食。心腹胀满。遍身
当归(切焙一两半) 鳖甲(去裙 醋炙) 琥珀(锉) 芎 牛膝(酒浸切焙) 桃
仁(去皮尖双仁炒黄研) 水蛭(糯米炒令焦各一两) 虎杖 桂(去粗皮) 大黄(一半
生一半炒) 柴胡(去苗各半两) 虻虫(炒令色黄) 牡丹皮(各二分) 麝香(研半分)
上为末。捣烂。蜜和丸如梧桐子大。每服二十丸。空心薄荷酒下。乌梅汤亦得。
三棱丸(出危氏方)
治经脉不通。气痛滞下。兼治血瘕。形如镰铁样。
当归(去毛) 川芎 牛膝 芫花 三棱 莪术(煨) 蒲黄 玄胡索 牡丹皮 干姜
子 白芷 地龙(去泥土酒浸各一两) 大黄(二两为末米醋一升文武慢火熬成膏) 上
为
末。入大黄膏和研杵。炼蜜为丸。每服二十丸。气痛。淡醋汤下。炒姜酒亦得。木通、红花
酒调下。
鬼箭丸(出圣惠方)
治妇人月水不通。手足心热。腹满喘急。不欲睡卧。心神烦闷。
鬼前羽 川芒硝 柴胡(去苗各一两) 水蛭(一分微炒黄) 虻虫(一分炒令微黄去
翅足) 川大黄(锉微炒) 赤茯苓(各三分) 干漆(半两捣碎炒令烟出) 牡丹(三分)
杏仁(三分汤浸去皮尖双仁麸炒微黄) 桃仁(三分汤浸去皮尖双仁麸炒微黄) 甜葶苈(一
分隔纸炒令黄紫色) 虫(一分微炒黄去翅足) 川椒(一分去目及闭口者微炒去汗) 上
(附论)
妇女月经闭止不通,是由于劳倦损伤气血,导致身体虚弱而感受风冷之邪。邪气客居在子宫内部,损伤了冲脉和任脉,以及手太阳小肠经和手少阴心经。致使胞络内部隔绝,气血运行不畅。冲脉和任脉起始于子宫内部,被称为“经脉之海”。手太阳经属于小肠,手少阴经属于心脏。这两条经脉互为表里,主管上部化为乳汁,下部化为月经。风冷之邪损伤了经络中的血液,血液的特性是遇温则流通顺畅,遇寒则凝涩闭阻。既然被寒气凝结搏结,血液瘀结在体内,所以导致月经闭止不通。
又说,肠鸣辘辘,月经就会不来。病根在于胃。之所以这样,是因为风冷干扰了胃气,导致胃气虚弱,不能分别水谷精微,使津液无法生成,气血因此无法化生。
又说,醉酒后行房事,会导致体内精气竭绝,损伤肝脏,使月经减少或闭止。之所以这样,是因为肝主藏血,过度劳累损伤,导致体内气血枯竭。
又说,先前有唾血、吐血或便血的情况,这称为“脱血”,导致血液枯涸,也会引起月经不来。
又说,患有下血痢疾,月经也会断绝。之所以这样,是因为津液耗损减少的缘故。必须等到痢疾停止,津液恢复,月经自然来潮。
诊察肾脉呈现微弱而涩象的,就是月经闭止不通。
又说,左手关后尺部脉象浮起为阳脉,如果阳脉绝迹,说明没有膀胱脉象,月经就会闭止。
又说,肝脉沉取时紧急,浮取时也如此,时常小便困难,苦于头晕头痛,腰背疼痛,脚部寒冷且时常疼痛,月经不来,这可能是怀孕时曾经有过堕胎或坠伤的历史。
月经闭止不通,时间久了,血液瘀结在体内形成肿块,变成“血瘕”(腹部积块)。也表现为血症,血与水湿相互搏结,壅滞涩塞,不能宣通。脾胃虚弱,进而变成水肿。之所以这样,是因为脾主司身体的肌肉,对应五行中的土,土能克制并消化水湿。现在水和血相互搏结,脾气衰弱,不能克制消化水湿,所以水流泛滥,浸渍肌肉,导致肿胀满闷。
又说,经脉不通日久,这不是小事,实际上是顽固的重症。如果是未婚女子经脉不通,起初是因为贪吃酸咸之物,导致血脉干涸,变成虚劳病。如果是在月经正常来潮期间,误食热面、生冷食物或进行房事,于是造成这种疾病。腹内出现颗粒状肿块,误认为是怀孕,时日稍久必然病情加重困顿。
血寒则闭止,血热则停蓄,血温则流动。诊察尺脉涩的,就是这种情况。脉象微弱的,是本元不足;脉象沉紧的,小便必定时常疼痛,且有症瘕积聚;脉象满盛的,是有妊娠。
如果是未婚女子月经不行,一定是因为多吃酸咸食物导致此病。如果长久不宣通,会变成劳疾。遇到月经期仍误食生冷、热面,或有醉酒后行房导致内气阻隔,因而阻滞,非经期肠鸣,必然使月经不来。病体冒受风冷,胃气虚弱而不能分别水谷,使津液不生,气血不成。
凡是月经闭止的疾病,只要服用琥珀丸。如果肌肉消瘦且喜欢饮水的,是血热相互搏结,适宜服用黄连丸。如果面色苍白、肢体浮肿,是肝气虚弱不能制约血液,由三圣丸和三物汤主治。
再观察如果小腹急迫、疼痛,或者形成肿块误认为怀孕,这是血症,因为月经期间行房所致,由琥珀丸主治。
产后不久,月经不通,其原因是气血耗散,不是风寒击搏内攻。这是血液凝滞而不运行,长久不治疗,就会变成血症,使人肚子像倒扣的杯子一样胀大,身体像水肿一样,这是脾虚而血水相并有肿块,给予琥珀丸。如果肚子像蛊胀一样的,给予没药丸。身体肿胀的,给予九霄丸、三物汤。
女子十四岁时,天癸(促进生殖功能成熟的物质)到来,任脉通畅,月经按时来潮,所以能够生育。天癸是事物自然的规律。月是指按月而至,经是有常规。月经来潮时间的提前或推后,量的多或少,这都是胃的原因。如果不行的特别严重,就会产生疾病。血液既不能滋养全身骨骼,就会头发脱落、面色发黄、身体瘦弱。血虚则发热,所以身体多热。水不足则燥气炽盛,金(肺)受到邪气侵犯。金受到邪气侵犯,就会咳嗽,必然导致肺痿、肺痈。医生见到月经不行就用虻虫、水蛭等活血药,见到发热就用各种寒凉药,这实在是出于妄意。其中用药物强行通经危害更大。经血枯竭,就没有东西可以滋养,怎么能通呢?譬如向乞丐索要万金,即使鞭打拷问,也不可能得到。只服用补气益血的药物,天癸自然会来。又有两种妇人,实证旺盛导致月经瘀闭,利导一下就能通行。
又说月经闭止不通,原因不一。有味觉不化血、经脉不通的;有先期量过多、后期不通的;有大病后热邪导致不通的;有寒邪凝结导致不通的;有积聚气结导致不通的;有心气抑滞导致不通的。凡此种种所受不同,治疗也各异。大概妇人以血为本,以气为用。气血稽留流行不畅,就涩滞不行。由此产生的病症,或寒或热,脐腹坚硬疼痛,肌肉消瘦,久了就成为劳瘠的症状。
凡是妇人月经不来,未婚女子也可以发生。《内经》说月经不来,都是胞脉闭塞。胞脉属于心而联络于膀胱中。现在气上迫于肺,心气不得下行通达,所以月经不来。可以用茶调散催吐,其次用玉烛散、芎䓖汤、三和汤、桂苓白术散之类。这些药物都能降心火、益肾水、开胃进食、分阴阳、利水道。千万不要服用峻烈、温热、有毒的药物。如果服用了,就会变成肺痿、骨蒸潮热、咳嗽、咯脓、呕血、喘满、小便不利、盗汗不止,逐渐至形体消瘦、脉大,即使遇到良医,也成了不治之症。唉,人的死亡,难道是命运使之这样的吗?
有一个二十多岁的妇人,患经闭不行,寒热往来,咳嗽潮热。庸医禁止她吃任何食物。一天在暑天出门,忽然看见卖凉粉的,用冰水调和饮用,大吃一顿,顿时觉得神清气爽,骨骼强健,几个月后,月经自然来潮。冲脉和任脉起始于子宫内部,被称为经脉之海。手太阳小肠经和手少阴心经,这两条经脉互为表里。心主血,上部化为乳汁,下部化为月经。女子十四岁天癸至,肾气全盛,冲任流通,经血充盈,应时而下,称为月水。通常三十天来一次,称为平和。如果后期才来,是由于劳倦损伤气血壅结,所以导致月经不通。
关于未婚女子经闭成劳病的方论,寇宗奭说:人的生存,以气血为本。人的生病,没有不先损伤气血的。世间有未婚少女,心中积存思虑,思虑过度,多导致劳损。男子则神色消散,女子则月经先闭止。为什么会这样?大概忧愁思虑伤心,心受伤则血逆竭,神色先散,月经先闭止。火既然受病不能荣养其子(脾),所以不爱吃东西。脾既然虚弱,则金(肺)气亏损,所以发咳嗽。金既然亏损,则水(肾)气断绝,所以四肢干枯瘦弱。木(肝)气不被克制,所以易怒。鬓发焦枯、筋脉痿软,五脏传遍,所以突然不会死,但最终必死无疑。这一种在劳损中最难治疗。大概病起于五脏之中,没有休止,药力达不到。如果能自己改变心志,用药扶持接续,这样或许能九死一生。
张氏说:未婚女子月经长久不行,切不可用青蒿等凉药医治。医家多以为未婚女子是虚热,所以用凉药攻伐。却不知道血得热则行,得冷则凝。
方剂:
桃花丸:治疗妇人月经闭止不通,不孕。由于子宫风冷积血,停滞于膀胱,所以导致腰膝疼痛,手脚发热,心背部憋闷,经络不调,腹内多气,四肢乏力,面无血色及多梦,适宜服用。
药材:桃仁、苏合香、安息香、木香、槟榔、川芒硝(各三分)、水蛭(炒至微黄)、虻虫(炒至微黄,去翅足,各半两)、麒麟竭、鳖甲(涂醋炙令黄,去裙边)、附子(炮制去皮脐)、柴胡(去苗)、卷柏、当归(锉碎微炒)、辛夷、白芷、紫石英(细研水飞)、禹余粮(炒醋淬七遍)、川芎、牡丹皮、细辛、麦门冬(去心焙)、羌活、桂心、肉豆蔻(去壳,各一两)。
制作与服用:以上药材研为末,炼蜜和丸,捣三百杵,丸如梧桐子大。每日空腹及晚饭后前,煎茅根汤送下三十丸。
紫葳散(出自《圣济总录》):
治疗妇人经脉不通,血热壅滞,攻注四肢,皮肤瘾疹,并行经脉。
使用紫葳凌霄花,不限多少,研为散。每次服用二钱,饭前温酒调下。
治疗妇人血结月经闭止,石淋。
使用海藻,石帆高约一尺,根部像漆色,上面逐渐变软,呈交错纹理,生于海底,煮汁服用。
治疗妇人月经长久不来。
使用威灵仙研为末,酒调下。另一方法用刘寄奴,另一方法用王不留行。
血竭破经丹:
治疗妇人血闭不通的神方。
锦纹大黄(一两,去皮,醋浸一夜)、硼砂(一钱)。以上研为末,醋和为丸如梧桐子大。每次服用三丸,好酒红花汤调下,饭前服用。
干地黄当归丸(一名干地黄丸):
治疗月水不通,或一月再来,或隔月来,或多或少,淋漓不断,或来时腰腹刺痛不可忍受,四肢沉重,只想睡觉,想吃酸物,虚乏黄瘦。
温经汤(出自《指南方》):
治疗经道不通。
人参、牛膝、甘草(各一两)、当归、芍药、牡丹皮、白术、官桂、川芎(各二两)。以上为粗末,每次服用五钱,水二钟,姜三片,枣一枚,煎至一盏,去渣服用。
地黄煎(出自《指南方》):
治疗经候到时,突然不行。
牛膝(半两)、生地黄(三两取汁)、干漆(一两)。以上用慢火同煎,可丸即丸如梧桐子大。每次服用三丸,温酒送下,直到肿块消除为止。
干漆丸(出自《千金方》):
治疗月经不通,百疗不愈,脏腑宿冷,恶血凝结。
干漆、土瓜根、射干、芍药(各一两半)、牡丹、牛膝、黄芩、桂心、吴茱萸、大黄、柴胡(各一两六铢)、桃仁、鳖甲(各二两)、廑虫、蛴螬(各四十枚)、水蛭、虻虫(各七十枚)、大麻子(四合)、乱发(鸡子大二枚)、菟丝子(二合)。以上研为末,以蜜和丸如梧桐子大。每日酒送下十五丸,渐加至三十丸,每日三次。仍用后面浸泡的酒送服前面的药丸。另一方无芍药、牛膝、土瓜根。
浸酒方(出自《千金方》):
大麻子(三升)、菟丝子(二升)、桃仁(一升)、灶屋黑灰(四两)、土瓜根、射干(各六两)、牛膝(八两)、桂心(四两)。以上切碎,用清酒三斗,绢袋盛药,浸泡五夜。用一盏酒送服前面的药丸很好。或者单服此酒也可以。
大虻虫丸(出自《圣惠方》):
治疗月经不通六七年,或肿满气逆,腹胀瘕痛,适宜服用此方,数次有神效。
虻虫(四百枚)、蛴螬(二百枚)、干地黄(一升)、牡丹、干漆、芍药、牛膝、土瓜根、桂心(各四两)、吴茱萸、桃仁、黄芩、牡蒙(各三两)、茯苓、海藻(各五两)、水蛭(三百枚)、芒硝(大如...此处原文缺失,推测为剂量单位)。每日空腹酒送下七丸。
蛴螬丸(出自《圣惠方》):
治疗妇人月经不通,或肿满气逆,咳嗽食少。
蛴螬(三分微炒)、生地黄(一两)、牡丹(三分)、干漆(半两捣研令烟出)、桃仁(三分汤浸去皮尖双仁麸炒微黄)、赤芍药、牛膝(去苗)、土瓜根(各三分)、桂心(半两)、黄芩、琥珀(各半两)、水蛭(一分炒微黄)、虻虫(一分炒微黄去翅足)、甜葶苈(三分隔纸炒令紫色)。
以上研为末,烂蜜和捣二三百杵,丸如...(原文缺失大小描述,通常为梧桐子大)。
当归汤:
治疗妇人月经不通,脐下撮痛,食减羸弱。
当归(切焙)、甘草(炙锉)、桂(去粗皮)、木贼、大黄(锉炒)、荆三棱(炮锉各一两)、威灵仙(去土)、生地黄(焙)、王不留行、槟榔、玄胡索、代赭石(醋淬)、天雄(炮裂去皮脐)、鳖甲(去裙边醋炙各一两半)、红蓝花(炒三分)。以上切碎,如麻豆大。每次服用五钱半,煎八分去渣,温服,不拘时候。
狗胆丸(出自《圣惠方》):
治疗妇人月经不通,日渐羸瘦,变为血痨及血气结聚疼痛。
狗胆(五枚取汁)、硼砂(半两胆汁浸三七日)、干漆(捣碎炒令烟出)、芫花(醋拌炒令干)、玄明粉、血竭、砒霜(各一分)、水蛭(微炒黄去翅足)、当归。
以上...(原文此处有缺漏,推测为混合捣碎),去却石脚,放入铫子内和捣三二百杵,丸如绿豆大。
每于食后,以温酒下七丸。
鳖甲汤(出自《圣济总录》):
治疗妇人经候不通,已经两三个月。
鳖甲(去裙边醋炙)、白前、代赭石(煨醋淬)、荆三棱(炮锉)、附子(炮裂去皮脐)、玄胡索(各一两半)、大黄(锉炒)、甘草(炙锉)、木香、桂(去粗皮)、当归(切焙各一两)、桃仁(去皮尖双仁炒二十枚)、红蓝花(三分)、熟干地黄(焙三两)、大腹皮(锉二两半)。以上切碎,如麻豆大。每次服用五钱,水一盏半煎取八分,去渣,温服,不拘时候。
治疗月经不通,心腹绞痛欲死,通血止痛。(出自《千金方》)
当归、大黄、芍药(各三两)、吴茱萸、干地黄、干姜、川芎、虻虫、水蛭(各二两)、细辛、甘草、桂心(各二两)、栀子(十四枚)、桃仁(一升)。以上切碎,用水一斗五升,煮取五升,分次服用。
治疗妇人月经不通,大肠秘热,两足痛,行走不得,日夜不安,疼痛叫声不停,肌肉消瘦。(出自《护命方》)
麻黄(去根)、射干、秦艽、荆芥穗、虎杖、连翘、当归、牡丹皮(去心)、牛膝、官桂、黄芩、杏仁、大黄(醋煮如前)、牵牛、川芎(各一分)、半夏(三铢)、大肠热甚使大黄(一两)。以上药材,作一处杵罗为末。每次服用三钱,水一盏煎取九分,食后吃,以大便通畅,经候通行为度。若人得此病,只要通大便,行经候,自然安乐。
地髓煎丸(出自《杨氏家藏方》):
通经脉,补虚羸,强脚膝,润泽肌肤,和畅筋脉。
当归丸(出自《圣济总录》):
治疗妇人风劳气病,经脉不通,渐加羸瘦,不思饮食,心腹胀满,遍身...(原文此处似有缺漏,推测为疼痛或不适)。
当归(切焙一两半)、鳖甲(去裙边醋炙)、琥珀(锉)、川芎、牛膝(酒浸切焙)、桃仁(去皮尖双仁炒黄研)、水蛭(糯米炒令焦各一两)、虎杖、桂(去粗皮)、大黄(一半生一半炒)、柴胡(去苗各半两)、虻虫(炒令色黄)、牡丹皮(各二分)、麝香(研半分)。以上为末,捣烂,蜜和丸如梧桐子大。每次服用二十丸,空腹薄荷酒下,乌梅汤也可以。
三棱丸(出自《危氏方》):
治疗经脉不通,气痛滞下,兼治血瘕,形如镰铁样。
当归(去毛)、川芎、牛膝、芫花、三棱、莪术(煨)、蒲黄、玄胡索、牡丹皮、干姜、子(此处疑为某药名缺字,如枳实等,依原文保留或略过,因上下文不清,暂略)、白芷、地龙(去泥土酒浸各一两)、大黄(二两为末米醋一升文武慢火熬成膏)。以上为末,入大黄膏和研杵,炼蜜为丸。每次服用二十丸,气痛,淡醋汤下,炒姜酒也可以。木通、红花酒调下。
鬼箭丸(出自《圣惠方》):
治疗妇人月经不通,手足心热,腹满喘急,不欲睡卧,心神烦闷。
鬼箭羽、川芒硝、柴胡(去苗各一两)、水蛭(一分微炒黄)、虻虫(一分炒令微黄去翅足)、川大黄(锉微炒)、赤茯苓(各三分)、干漆(半两捣碎炒令烟出)、牡丹(三分)、杏仁(三分汤浸去皮尖双仁麸炒微黄)、桃仁(三分汤浸去皮尖双仁麸炒微黄)、甜葶苈(一分隔纸炒令黄紫色)、廑虫(一分微炒黄去翅足)、川椒(一分去目及闭口者微炒去汗)。以上...(原文至此结束,未给出制作服用法,但根据惯例应为研末和丸)。
(Attached Discussion)
Women with amenorrhea (absence of menstruation) are caused by labor injuring Qi and Blood, leading to a deficient constitution susceptible to Wind-Cold pathogens. The pathogenic factors lodge in the uterus, damaging the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel), as well as the Hand-Taiyin Small Intestine Meridian and Hand-Shaoyin Heart Meridian. This causes an internal blockage of the uterine collaterals, resulting in stagnant Qi and Blood. The Chong and Ren Mai originate from within the uterus and are known as the "Sea of Meridians." The Hand-Taiyin meridian belongs to the Small Intestine, and the Hand-Shaoyin meridian belongs to the Heart. These two meridians are exteriorly-interiorly related; they govern the transformation into breast milk upwards and menstruation downwards. Wind-Cold damages the blood in the meridians. Blood flows freely when warm but becomes stagnant and closed when cold. Since it is bound by Cold, blood clots internally, causing amenorrhea.
It is also said that borborygmus (rumbling in the intestines) indicates that menstruation will not come. The root of the disease lies in the Stomach. This is because Wind-Cold interferes with Stomach Qi, causing Stomach Qi deficiency. It fails to separate the clear turbid parts of food and drink, preventing the generation of Jin-Ye (Body Fluids), so Qi and Blood cannot be formed.
It is also said that sexual intercourse while intoxicated exhausts internal Jing (Essence), damaging the Liver, causing menstrual flow to decrease or cease. This is because the Liver stores Blood. Excessive labor and injury lead to exhaustion of Qi and Blood internally.
It is also said that prior hemoptysis (coughing up blood), hematemesis (vomiting blood), or rectal bleeding is called "Tuoxue" (Loss of Blood). This leads to blood depletion, also causing amenorrhea.
It is also said that dysentery with blood causes menstruation to stop. This is due to the reduction and consumption of Jin-Ye. Once the dysentery stops and Jin-Ye regenerates, menstruation will naturally resume.
Palpating the Kidney pulse revealing a faint and choppy quality indicates amenorrhea.
It is also said that a floating pulse at the Chi position behind the Guan position on the left hand indicates Yang. If Yang pulses are absent, it means there is no Bladder pulse, and menstruation will be closed.
It is also said that if the Liver pulse is rapid upon deep palpation and similarly rapid upon superficial palpation, accompanied by occasional difficulty in urination, dizziness, headache, lower back pain, cold feet with occasional pain, and amenorrhea, it may be due to a history of miscarriage or falling during pregnancy.
If amenorrhea persists for a long time, blood clots internally forming masses, transforming into Xuejia (Blood Masses). It may also present as Xuezhen (Blood Disorders), where blood and dampness combine, causing obstruction and stagnation without free flow. Spleen and Stomach weakness transforms into edema. This is because the Spleen governs the muscles of the body and corresponds to Earth in the Five Elements. Earth controls and dissolves Water. When water and blood combine and Spleen Qi weakens, it cannot control the water, causing water qi to overflow and soak the muscles, leading to swelling and fullness.
It is also said that prolonged meridian blockage is no minor matter; it is actually a chronic, stubborn disease. If an unmarried girl has amenorrhea, it initially stems from greedily eating sour and salty foods, causing blood vessels to dry up and transforming into a consumptive disease. If during normal menstruation, one mistakenly eats hot noodles, raw/cold foods, or engages in sexual activity, this disease results. Granular masses appear in the abdomen, mistaken for pregnancy. As time passes, the condition inevitably worsens.
Cold blood causes closure; Heat blood causes stasis; Warm blood flows. Palpating a choppy Chi pulse confirms this. A faint pulse indicates inherent insufficiency. A deep and tight pulse indicates frequent painful urination and Zhenjia (masses). A full and surging pulse indicates pregnancy.
If an unmarried girl's menstruation does not arrive, it is likely due to excessive consumption of acidic and salty foods causing this illness. If not unblocked for a long time, it becomes a consumptive disease. During menstruation, mistakenly eating raw/cold foods or hot noodles, or engaging in sexual activity after intoxication causing internal Qi blockage, leading to obstruction, non-menstrual borborygmus, will certainly prevent menstruation. The diseased body exposed to Wind-Cold, with deficient Stomach Qi failing to separate food and drink, prevents Jin-Ye generation and Qi-Blood formation.
For all diseases of amenorrhea, Hu Po Wan (Amber Pill) should be taken. For those who are emaciated and thirsty, indicating Blood Heat fighting, Huang Lian Wan (Coptis Pill) is suitable. For those with pale faces and limb edema, indicating Liver Qi weakness failing to control Blood, San Sheng Wan (Three Sage Pill) and San Wu Tang (Three Substance Decoction) are indicated.
Observe again: if the lower abdomen is urgent and painful, or masses form mistaken for pregnancy, this is a Blood disorder caused by sexual intercourse during menstruation, treated with Hu Po Wan (Amber Pill).
Shortly after childbirth, if menstruation does not return, the cause is dispersion of Qi and Blood, not an attack by Wind-Cold. This is blood stagnation not flowing. Untreated for long, it becomes a Blood disorder, causing the abdomen to swell like an inverted cup and the body to resemble edema. This is Spleen deficiency with blood-water combination and masses, treated with Hu Po Wan (Amber Pill). If the abdomen resembles Gu distension (parasitic swelling), Mo Yao Wan (Myrrh Pill) is given. If the body is swollen, Jiu Xiao Wan (Nine Heavens Pill) and San Wu Tang (Three Substance Decoction) are given.
At age fourteen, Tian Gui (Heavenly Water - reproductive essence) arrives, the Ren Mai (Conception Vessel) becomes patent, and menstruation comes on time, allowing conception. Tian Gui is natural. "Yue" refers to monthly arrival; "Jing" refers to regularity. Variations in timing (early/late) and volume (more/less) are due to the Stomach. Severe absence leads to disease. If blood cannot nourish the bones, hair falls, face turns yellow, and the body becomes emaciated. Blood deficiency generates Heat, so the body feels hot. Insufficient Yin fluid allows Dryness Qi to blaze, damaging Metal (Lung). Damaged Metal leads to cough, inevitably resulting in Fei Wei (Lung Atrophy) or Fei Yong (Lung Abscess). Doctors seeing amenorrhea use Meng Chong (Blister Beetle) and Shui Zhi (Leech) to move blood; seeing Heat, they use Cold medicines. This is reckless. Using drugs to forcibly move menstruation is particularly harmful. If menstrual blood is exhausted, there is nothing to nourish, how can it flow? It is like demanding ten thousand gold from a beggar; even with beating, it cannot be obtained. Only by taking Qi-nourishing and Blood-benefiting medicines will Tian Gui arrive naturally. There are two types of women with excess patterns causing menstrual stasis; purgatives will make it flow.
It is also said that amenorrhea has various causes: flavor failing to transform into blood with meridian blockage; early periods with excessive flow followed by late blockage; blockage due to Heat after major illness; blockage due to Cold coagulation; blockage due to accumulation and Qi knotting; blockage due to Heart Qi depression. All these different causes require different treatments. Generally, women rely on Blood as the root and Qi as the function. If Qi and Blood stagnate, they become choppy and do not flow. Diseases arising from this may be Cold or Heat, with hard/painful umbilical/abdominal regions, emaciation, eventually becoming Lao Ji (Consumptive Emaciation).
Whenever women have no menstruation, unmarried girls can also suffer. The *Neijing* states that amenorrhea is due to Bi (closure) of Bao Mai (Uterine Vessels). Bao Mai belongs to the Heart and connects to the Pao (Bladder/Uterus). Now Qi presses upward to the Lung, and Heart Qi cannot descend, so menstruation does not come. Cha Tiao San (Tea Regulation Powder) can be used to induce vomiting, followed by Yu Zhu San (Jade Candle Powder), Xiong Tang (Angelica Decoction), San He Tang (Three Harmony Decoction), Gui Ling Bai Zhu San (Atractylodes Macrocephala Powder), etc. These drugs lower Heart Fire, benefit Kidney Water, open the Stomach to promote appetite, differentiate Yin and Yang, and promote urinary flow. Strictly avoid harsh, hot, toxic drugs. Taking them transforms the condition into Fei Wei (Lung Atrophy), bone-steaming tidal fever, cough, expectoration of pus, hematemesis, wheezing/fullness, difficult urination, and continuous night sweats, gradually leading to emaciation and large pulse. Even with a good doctor, it becomes incurable. Alas, is human death truly destined?
A woman in her twenties suffered from amenorrhea, alternating chills and fever, cough, and tidal fever. Quacks forbade her from eating anything. One day in summer heat, she saw a seller of cold jelly, drank ice-water mixed beverage, ate a large meal, and instantly felt refreshed and strong. Months later, menstruation returned naturally. The Chong and Ren Mai originate from the uterus, the Sea of Meridians. Hand-Taiyin Small Intestine and Hand-Shaoyin Heart meridians are exterior-interior. Heart governs Blood, transforming into breast milk above and menstruation below. At fourteen, Tian Gui arrives, Kidney Qi is full, Chong-Ren flow smoothly, blood fills, and descends on time, called Yue Shui (Monthly Water). Usually coming every thirty days, this is considered peaceful. Late arrival is due to labor injuring Qi and Blood causing stagnation, leading to amenorrhea.
Regarding formulas for unmarried girls' amenorrhea becoming consumptive disease, Kou Zongshi said: Human life relies on Qi and Blood as the root. Illness always begins with injuring Qi and Blood. Unmarried girls often harbor thoughts, overthinking, leading to damage. Men lose their luster; women have amenorrhea first. Why? Worry and thought injure the Heart. Heart injury causes blood reversal and exhaustion, luster scatters first, then menstruation closes. Fire being diseased cannot nourish its child (Spleen), so appetite is lost. Spleen deficiency leads to Metal (Lung) Qi deficit, causing cough. Metal deficit leads to Water (Kidney) Qi extinction, causing dry/emaciated limbs. Wood (Liver) Qi unchecked causes anger. Hair becomes brittle, sinews atrophy. After transmitting through five Zang organs, sudden death is avoided, but eventual death is certain. This type is hardest to treat among consumptions. Disease originates within five Zang organs, having no end, beyond the reach of drug power. If one can change their mindset and use medicine to support, nine deaths might yield one life.
Zhang said: For unmarried girls with long-standing amenorrhea, Qing Hao (Artemisia) and other cooling drugs must absolutely not be used. Many doctors assume unmarried girls have Deficient Heat, so they attack with cooling drugs. They do not know that Blood moves with Heat and congeals with Cold.
Formulas:
Tao Hua Wan (Peach Blossom Pill): Treats female amenorrhea and infertility. Caused by Wind-Cold and accumulated blood in the uterus stagnating in the Bladder, causing lower back/knee pain, hot hands/feet, chest/back oppression, meridian irregularity, abdominal gas, limb weakness, pale complexion, and dreams. Suitable for taking.
Ingredients: Tao Ren (Peach Seed), Su He Xiang (Styrax), An Xi Xiang (Benzoin), Mu Xiang (Aucklandia), Bing Lang (Areca Nut), Chuan Mang Xiao (Mirabilite) (3 fen each); Shui Zhi (Leech) (stir-fried until slightly yellow); Meng Chong (Blister Beetle) (stir-fried until slightly yellow, wings/legs removed, 0.5 liang each); Qi Lin Jie (Dragon's Blood); Bie Jia (Turtle Shell) (coated with vinegar, roasted until yellow, skirt removed); Fu Zi (Prepared Aconite) (roasted, skin/navel removed); Chai Hu (Bupleurum) (remove sprouts); Juan Bai (Serissa); Dang Gui (Angelica Sinensis) (cut, lightly stir-fried); Xin Yi (Magnolia Flower); Bai Zhi (Angelica Dahurica); Zi Shi Ying (Hematite) (fine powder, water-washed); Yu Yu Liang (Magnetite) (roasted, quenched in vinegar seven times); Xiong (Ligusticum); Mu Dan Pi (Moutan Bark); Xi Xin (Asarum); Mai Men Dong (Ophiopogon) (remove heart, roast); Qiang Huo (Notopterygium); Gui Xin (Cinnamon Bark); Rou Dou Kou (Nutmeg) (shell removed, 1 liang each).
Preparation: Grind to powder, mix with refined honey, pound 300 times, pill like wutong seeds. Take 30 pills before empty stomach and evening meal, decocted with Mao Gen (Imperata Rhizome) soup.
Zi Wei San (Lonicera Powder) (from *Shengji Zonglu*):
Treats female meridian blockage, Blood Heat stagnation attacking four limbs, skin rashes, affecting meridians.
Use Zi Wei (Lonicera japonica flower). Amount unspecified. Grind to powder. Take 2 qian before meals, mixed with warm wine.
Treats female blood clotting amenorrhea and Stone Lin (Dysuria with stones).
Use Hai Zao (Sargassum), Shi Fan (high over 1 chi, root like lacquer, softening towards top, crisscross texture, growing at sea bottom). Boil juice and take.
Treats female menstruation long absent.
Use Wei Ling Xian (Clematis) ground to powder, mixed with wine. Another method uses Liu Ji Nu (Ajuga); another uses Wang Bu Liu Xing (Vaccaria Seed).
Xue Jie Po Jing Dan (Dragon's Blood Menstruation-Breaking Elixir):
Divine formula for female blood closure.
Jin Wen Da Huang (Rhubarb) (1 liang, peeled, soaked in vinegar overnight); Peng Sha (Borax) (1 qian). Grind to powder, mix with vinegar into pills like wutong seeds. Take 3 pills before meals, mixed with good wine and Hong Hua (Safflower) soup.
Gan Di Huang Dang Gui Wan (Rehmannia and Angelica Pill) (also named Gan Di Huang Wan):
Treats amenorrhea, or returning monthly, or bi-monthly, varying amounts, dripping continuously, or severe stabbing waist/abdominal pain upon arrival, heavy limbs, desire to sleep, craving sour foods, deficiency, jaundice, emaciation.
Wen Jing Tang (Warm the Menses Decoction) (from *Zhinan Fang*):
Treats menstrual pathway blockage.
Ren Shen (Ginseng), Niu Xi (Achyranthes), Gan Cao (Licorice) (1 liang each); Dang Gui (Angelica), Shao Yao (Peony), Mu Dan Pi (Moutan), Bai Zhu (Atractylodes), Guan Gui (Cinnamon), Xiong (Ligusticum) (2 liang each). Coarse powder. Take 5 qian, 2 zhong water, 3 slices ginger, 1 jujube, decoct to 1 zhong, strain, take.
Di Huang Jian (Rehmannia Decoction Paste) (from *Zhinan Fang*):
Treats menses arriving but suddenly stopping.
Niu Xi (0.5 liang); Sheng Di Huang (Fresh Rehmannia) (3 liang, extract juice); Gan Qi (Dry Lacquer) (1 liang). Slow fire decoction together. When ready, pill like wutong seeds. Take 3 pills with warm wine until mass dissipates.
Gan Qi Wan (Dry Lacquer Pill) (from *Qianjin Fang*):
Treats menstrual blockage, hundred treatments failed, ancient cold in viscera, evil blood coagulation.
Gan Qi (Dry Lacquer), Tu Gua Gen (Trichosanthes Root), She Gan (Belamcanda), Shao Yao (Peony) (1.5 liang each); Mu Dan (Moutan), Niu Xi (Achyranthes), Huang Qin (Scutellaria), Gui Xin (Cinnamon), Wu Zhu Yu (Evodia), Da Huang (Rhubarb), Chai Hu (Bupleurum) (1 liang 6 zhu each); Tao Ren (Peach Seed), Bie Jia (Turtle Shell) (2 liang each); Jin Chong (Ground Beetle), Si Cao (Mealworm) (40 each); Shui Zhi (Leech), Meng Chong (Blister Beetle) (70 each); Da Ma Zi (Hemp Seed) (4 he); Luan Fa (Human Hair) (size of chicken egg, 2 pieces); Tu Si Zi (Cuscuta) (2 he). Grind to powder, mix with honey into pills like wutong seeds. Take 15 pills with wine daily, gradually increase to 30, three times daily. Also use the following soaked wine to take the pills. Another version lacks Shao Yao, Niu Xi, Tu Gua Gen.
Jin Jiu Fang (Soaked Wine Formula) (from *Qianjin Fang*):
Da Ma Zi (Hemp Seed) (3 sheng); Tu Si Zi (Cuscuta) (2 sheng); Tao Ren (Peach Seed) (1 sheng); Zao Wu Mei (Soot from kitchen roof) (4 liang); Tu Gua Gen (Trichosanthes Root), She Gan (Belamcanda) (6 liang each); Niu Xi (Achyranthes) (8 liang); Gui Xin (Cinnamon) (4 liang). Cut coarse. Soak in 3 dou clear wine for 5 nights using a silk bag. Take one zheng bowl with the previous pills. Or take alone.
Da Meng Chong Wan (Large Blister Beetle Pill) (from *Shenghui Fang*):
Treats menstrual blockage for 6-7 years, or swelling/fullness with counterflow Qi, abdominal distension/Zhen pain. Effective after several doses.
Meng Chong (Blister Beetle) (400); Si Cao (Mealworm) (200); Gan Di Huang (Dried Rehmannia) (1 sheng); Mu Dan (Moutan), Gan Qi (Dry Lacquer), Shao Yao (Peony), Niu Xi (Achyranthes), Tu Gua Gen (Trichosanthes Root), Gui Xin (Cinnamon) (4 liang each); Wu Zhu Yu (Evodia), Tao Ren (Peach Seed), Huang Qin (Scutellaria), Mu Meng (Alisma?) (3 liang each); Fu Ling (Poria), Hai Zao (Sargassum) (5 liang each); Shui Zhi (Leech) (300); Mang Xiao (Mirabilite) (large...). Take 7 pills with wine on empty stomach daily.
Si Cao Wan (Mealworm Pill) (from *Shenghui Fang*):
Treats female amenorrhea, or swelling/fullness with counterflow Qi, cough, poor appetite.
Si Cao (Mealworm) (3 fen, lightly stir-fried); Sheng Di Huang (Fresh Rehmannia) (1 liang); Mu Dan (Moutan) (3 fen); Gan Qi (Dry Lacquer) (0.5 liang, pounded until smoke rises); Tao Ren (Peach Seed) (3 fen, soaked in water, peel/remove tips/double kernels, bran-roasted until slightly yellow); Chi Shao Yao (Red Peony); Niu Xi (Achyranthes) (remove sprouts); Tu Gua Gen (Trichosanthes Root) (3 fen each); Gui Xin (Cinnamon) (0.5 liang); Huang Qin (Scutellaria), Hu Po (Amber) (0.5 liang each); Shui Zhi (Leech) (1 fen, stir-fried until slightly yellow); Meng Chong (Blister Beetle) (1 fen, stir-fried until slightly yellow, wings/legs removed); Tian Ting Li (Descurainia Seed) (3 fen, stir-fried between papers until purple).
Grind to powder, mix with rotten honey, pound 200-300 times, pill... (size omitted).
Dang Gui Tang (Angelica Decoction):
Treats female amenorrhea, umbilical/tight pain, reduced food intake, emaciation/easy fatigue.
Dang Gui (Angelica) (cut, roast); Gan Cao (Licorice) (roast, cut); Gui (Cinnamon) (remove rough bark); Mu Zei (Equisetum); Da Huang (Rhubarb) (cut, stir-fry); Jing San Leng (Polygonatum?) (roast, cut, 1 liang each); Wei Ling Xian (Clematis) (remove dirt); Sheng Di Huang (Fresh Rehmannia) (roast); Wang Bu Liu Xing (Vaccaria); Bing Lang (Areca Nut); Yan Hu Suo (Corydalis); Dai Zhe (Hematite) (quench in vinegar); Tian Xiong (Aconitum) (roast crack, remove skin/navel); Bie Jia (Turtle Shell) (remove skirt, vinegar-roast, 1.5 liang each); Hong Lan Hua (Safflower) (stir-fry, 3 fen). Cut coarse like hemp/mustard seeds. Take 5.5 qian, decoct 80%, strain, take warm, any time.
Gou Dan Wan (Dog Gallbladder Pill) (from *Shenghui Fang*):
Treats female amenorrhea, gradual emaciation, transforming into Blood Lao (Consumption) and Blood-Qi knotting pain.
Gou Dan (Dog Gallbladder) (5, extract juice); Peng Sha (Borax) (0.5 liang, soaked in gallbladder juice for 3x7 days); Gan Qi (Dry Lacquer) (pound until smoke rises); Yuan Hua (Genkwa) (vinegar-mix, stir-fry until dry); Xuan Ming Fen (Mirabilite); Xue Jie (Dragon's Blood); Pi Shuang (Arsenic) (1 fen each); Shui Zhi (Leech) (lightly stir-fry yellow, remove wings/legs); Dang Gui (Angelica)... (text missing mixing instructions, implied pound 200-300 times), remove stone feet, put in ding pot, pound 200-300 times, pill like mung beans.
Take 7 pills with warm wine after meals.
Bie Jia Tang (Turtle Shell Decoction) (from *Shengji Zonglu*):
Treats female menstrual blockage lasting 2-3 months.
Bie Jia (Turtle Shell) (remove skirt, vinegar-roast); Bai Qian (Cynanchum); Dai Zhe (Hematite) (bake, quench in vinegar); Jing San Leng (Polygonatum?) (roast, cut); Fu Zi (Aconite) (roast crack, remove skin/navel); Yan Hu Suo (Corydalis) (1.5 liang each); Da Huang (Rhubarb) (cut, stir-fry); Gan Cao (Licorice) (roast, cut); Mu Xiang (Aucklandia); Gui (Cinnamon) (remove rough bark); Dang Gui (Angelica) (cut, roast, 1 liang each); Tao Ren (Peach Seed) (remove peel/tips/double kernels, roast, 20); Hong Lan Hua (Safflower) (3 fen); Shu Gan Di Huang (Prepared Dried Rehmannia) (roast, 3 liang); Da Fu Pi (Areca Peel) (cut, 2.5 liang). Cut coarse like hemp/mustard seeds. Take 5 qian, 1.5 zheng bowls water, decoct to 0.8, strain, take warm, any time.
Treats menstrual blockage, heart/abdominal colic deadly, unblocks blood relieves pain. (from *Qianjin Fang*)
Dang Gui (Angelica), Da Huang (Rhubarb), Shao Yao (Peony) (3 liang each); Wu Zhu Yu (Evodia), Gan Di Huang (Dried Rehmannia), Gan Jiang (Dried Ginger), Xiong (Ligusticum), Meng Chong (Blister Beetle), Shui Zhi (Leech) (2 liang each); Xi Xin (Asarum), Gan Cao (Licorice), Gui Xin (Cinnamon) (2 liang each); Zhi Zi (Gardenia) (14); Tao Ren (Peach Seed) (1 sheng). Cut coarse. Use 1.5 dou water, boil to 5 sheng, divide doses.
Treats female menstrual blockage, large bowel constipation/heat, leg pain, inability to walk, restlessness day/night, constant pain crying, muscle emaciation. (from *Huming Fang*)
Ma Huang (Ephedra) (remove roots); She Gan (Belamcanda); Qin Jiao (Gentiana); Jing Jie Sui (Schizonepeta Spike); Hu Zhang (Polygonum Cuspidatum); Lian Qiao (Forsythia); Dang Gui (Angelica); Mu Dan Pi (Moutan) (remove heart); Niu Xi (Achyranthes); Guan Gui (Cinnamon); Huang Qin (Scutellaria); Xing Ren (Apricot Seed); Da Huang (Rhubarb) (vinegar-boiled as before); Qian Niu (Pharbitis); Xiong (Ligusticum) (1 fen each); Ban Xia (Pinellia) (3 zhu); Large Bowel Heat causing Da Huang (1 liang). Mix all, grind/sieve to powder. Take 3 qian, 1 zheng bowl water, decoct to 0.9, take after meals. Continue until large bowel is smooth and menstruation flows. If one gets this disease, just unblock large bowel and move menstruation, naturally comfortable.
Di Sui Jian Wan (Earth Marrow Decoction Pill) (from *Yang Shi Jia Cang Fang*):
Unblocks meridians, tonifies deficiency/emaciation, strengthens legs/knees, moistens skin, harmonizes sinews.
Dang Gui Wan (Angelica Pill) (from *Shengji Zonglu*):
Treats female wind-lao Qi disease, meridian blockage, gradual emaciation, loss of appetite, heart/abdominal fullness, whole body... (text incomplete).
Dang Gui (Angelica) (cut, roast, 1.5 liang); Bie Jia (Turtle Shell) (remove skirt, vinegar-roast); Hu Po (Amber) (cut); Xiong (Ligusticum); Niu Xi (Achyranthes) (wine-soak, cut, roast); Tao Ren (Peach Seed) (remove peel/tips/double kernels, roast yellow, grind); Shui Zhi (Leech) (glutinous rice stir-fry until scorched, 1 liang each); Hu Zhang (Polygonum Cuspidatum); Gui (Cinnamon) (remove rough bark); Da Huang (Rhubarb) (half raw, half stir-fried); Chai Hu (Bupleurum) (remove sprouts, 0.5 liang each); Meng Chong (Blister Beetle) (stir-fry until yellow); Mu Dan Pi (Moutan) (2 fen each); She Xiang (Musk) (grind, 0.5 fen). Grind to powder, pound soft, mix with honey into pills like wutong seeds. Take 20 pills before empty stomach with Bo He (Mint) wine. Wu Mei (Smoked Plum) soup is also acceptable.
San Leng Wan (Polygonatum Pill) (from *Wei Shi Fang*):
Treats meridian blockage, Qi pain/stagnant discharge, also treats Xuejia (Blood Masses) shaped like sickle/iron.
Dang Gui (Angelica) (remove hairs); Chuan Xiong (Ligusticum); Niu Xi (Achyranthes); Yuan Hua (Genkwa); San Leng (Burreed); E Zhu (Curcuma) (roast); Pu Huang (Typha Pollen); Yan Hu Suo (Corydalis); Mu Dan Pi (Moutan); Gan Jiang (Dried Ginger); Zi (Seed - text unclear); Bai Zhi (Angelica); Di Long (Earthworm) (remove dirt, wine-soak, 1 liang each); Da Huang (Rhubarb) (2 liang powder, simmer in 1 sheng rice vinegar to paste). Grind to powder, add Da Huang paste, grind/pound. Refined honey pills. Take 20 pills. For Qi pain, take with light vinegar soup. Stir-fried ginger wine is also acceptable. Mu Tong (Akebia), Hong Hua (Safflower) wine mixed.
Gui Jian Wan (Arrowwood Pill) (from *Shenghui Fang*):
Treats female amenorrhea, hot palms/soles, abdominal fullness/wheezing urgency, unwillingness to sleep, mental restlessness.
Gui Jian Yu (Eucommia Bark? Text says Gui Qian Yu/Arrowwood); Chuan Mang Xiao (Mirabilite); Chai Hu (Bupleurum) (remove sprouts, 1 liang each); Shui Zhi (Leech) (1 fen, lightly stir-fry yellow); Meng Chong (Blister Beetle) (1 fen, stir-fry until slightly yellow, remove wings/legs); Chuan Da Huang (Rhubarb) (cut, lightly stir-fry); Chi Fu Ling (Red Poria) (3 fen each); Gan Qi (Dry Lacquer) (0.5 liang, pound until smoke rises); Mu Dan (Moutan) (3 fen); Xing Ren (Apricot Seed) (3 fen, soak water, peel/tips/double kernels, bran-roast yellow); Tao Ren (Peach Seed) (3 fen, soak water, peel/tips/double kernels, bran-roast yellow); Tian Ting Li (Descurainia Seed) (1 fen, stir-fry between papers until yellow-purple); Jin Chong (Ground Beetle) (1 fen, lightly stir-fry yellow, remove wings/legs); Chuan Jiao (Sichuan Pepper) (1 fen, remove eyes/closed ones, lightly stir-fry remove sweat). ... (Text ends here, preparation implied).