丹溪云∶经不通，或因堕胎及多产伤血，或因久患潮热销血，或因久发盗汗耗血，或因
脾胃不和，饮食少进而不生血，或因痢疾失血，治宜生血补血，除热调和之剂，随证用之。
或因七情伤心，心气停结，故血闭而不行，宜调心气，通心经，使血生而经自行矣。（生血在补脾胃，
调饮食，适寒温，所谓脾旺则能生血也。至于心气结者，宜调心，又为心主血也）
玉烛散 治胃热消渴，善食渐瘦，津液为热燥竭，以致血海干枯。（此即四物汤与调胃
承气汤合方也。）
当归 川芎 白芍药 地黄 大黄 芒硝 甘草（各等分）
上锉。每服八钱，水煎，食前服。
三和散 治劳心，心火上行，以致胞脉闭塞，月事不来。（此即四物汤与凉膈散合方也）
（此治劳心之实热者也，如心虚而热收于内，与夫心虚而土衰者，不宜妄用）
当归 川芎 白芍药 地黄 大黄 朴硝 黄芩 栀子 连翘 薄荷 甘草（各等分）
上锉。每服八钱，水煎服。
二黄散 治妇人室女，经脉不通，服之如神。
大黄（烧存性，二钱） 生地黄（三钱）
上为末。作一服，空心好酒调下。
二气丸 治月水不调，断绝不产，面黄肌瘦，憔悴，不美食，有燥热，以柴胡引子相参
服之。
大黄（四两，另为末，醋一升，慢火熬为膏子） 当归 白芍药（各二两）
上为末，以膏子和丸，如桐子大。每服二十丸，淡醋汤下，食前服，日进三服。
（四方俱用大黄，而配合不离四物，自有轻重缓急不同，宜加详之）
五补丸 补诸虚，安五脏，坚骨髓，养精神。凡胞脉闭，先服降心火之剂，后服此丸及
卫生汤，以治脾养血也。
熟地黄 人参 牛膝（酒浸去芦，焙干） 白茯苓 地骨皮（各等分）
上为细末，炼蜜丸，如桐子大。每服三五十丸，空心温酒下。（熟地以补天一之水，人参以生天一之气，所谓水生
于气也，然气不降则水不生，故用白茯苓以降天气，地骨皮以清气中之火，牛膝引之下行，此立方之大意也）
卫生汤
当归 白芍药（各二两） 黄 （三两） 甘草（一两）
上为末。每服半两，水二盏，煎至一盏，空心温服。如虚者，加人参一两。
（五补丸补水之源，卫生汤行已生之血，盖地黄、茯苓、人参，俱补里气之不足，而黄 、甘草，又益表气之不足，
当归、芍药行肝血之不足，有先后天之意焉）
洁古先服降心火之剂者，盖亦芩连、三和、玉烛之类，后服五补，卫生者，亦补气之剂也
。
柏子仁丸 治血虚有火，月经耗损，渐至不通，日渐羸瘦，而生潮热，并治室女思虑成
劳经闭。慎勿以毒药通之，宜此兼服泽兰汤。
柏子仁（炒，另研） 牛膝（酒洗） 卷柏（各半两） 泽兰叶 续断（各二两） 熟地黄（三两，酒
浸半日，石臼内杵成膏）
上为细末，炼蜜丸，如桐子大。空心米饮下三十丸。（夫血生于心，心火旺则津枯而血不化，故用柏子仁以润心而
生津，火位之下，水气承之，故用熟地黄以滋水，其四种皆通血脉，而续绝有也）
泽兰汤 治证同前。
泽兰叶（三两） 当归（酒洗） 芍药（炒，各一两） 甘草（五钱）
上为粗末。每服五钱，水二盏，煎一盏，温服。
加味补中益气汤 治饮食劳倦，损伤脾胃，气弱体倦，发热作渴，饮食减少而不生血者
。
黄 人参 甘草（炙） 白术 当归 陈皮（各一钱） 升麻 柴胡（各三分） 生地黄 天花
粉（各八分）
上锉。加生姜，作一服，水煎服。（若胃寒，而色不华者，去生地、花粉，有虚火者宜加）
十全大补汤 治堕胎，及多产育伤血，或误服汗下克伐之药，以致血衰气乏，而经不行
者。（此方温补气血为主，所谓劳者温之，损者温之是也）
人参 白术 白茯苓 甘草（炙） 当归 川芎 白芍药 熟地黄 黄 肉桂（各二钱）
上锉。作一服，水煎服。
养真汤 治妇人经闭不通，脐下有块，已经三载，百药无效，服此数剂经行。又投数剂
，而块消矣。（以上十一方，重在血枯二字）
当归（酒洗） 川芎 白芍药（酒炒） 熟地黄（姜汁炒） 白茯苓 陈皮 栀子（炒） 山茱
萸（去核） 益母草 小茴香（酒炒） 香附子（醋浸炒，各等分）
上锉。每服一两，水煎服，五六剂后，经通，作丸服。（凡通经消块，俱用破气削坚、大热大毒之类，而此方俱以
行气调气血，散结气，暖下元之药等分，而又以山栀凉药佐之，何也？但闻山栀能治块中之火，未闻能治三年之块而
通经也，在善用之）
朱丹溪说：月经不通，可能是因为堕胎及多次生产损伤血液，可能是因为长期患潮热消耗血液，可能是因为长期盗汗耗损血液，可能是因为脾胃不和，饮食摄入少导致无法生成血液，可能是因为痢疾失血。治疗应当使用生血补血、清热调和的方剂，根据具体证候选用。
也有可能是因为七情（喜、怒、忧、思、悲、恐、惊）伤心，导致心气郁结停滞，所以血液闭阻而不运行。适宜调理心气，疏通心经，使血液生成而月经自然通畅。（生血的关键在于补益脾胃，调节饮食，适应寒温变化，这就是所谓脾脏功能旺盛就能生血。至于心气郁结的情况，适宜调理心脏，因为心主司血液。）
《脉经》说：肾脉微涩，表示月经停止。（关于经闭的脉法，详见前文“调经”章节，应当参考查看。）
玉烛散：治疗胃热消渴，食欲旺盛但身体逐渐消瘦，津液因热邪燥竭，导致血海干枯。（此方即四物汤与调胃承气汤的合方。）
药材：当归、川芎、白芍药、地黄、大黄、芒硝、甘草（各等分）。
制法：切碎。每次服用八钱，加水煎煮，饭前服用。
三和散：治疗劳心过度，心火上行，导致胞脉闭塞，月经不来。（此方即四物汤与凉膈散的合方。）
（此方适用于劳心导致的实热证。如果是心虚内热收敛，或者心虚且脾土衰弱者，不宜随意使用。）
药材：当归、川芎、白芍药、地黄、大黄、朴硝、黄芩、栀子、连翘、薄荷、甘草（各等分）。
制法：切碎。每次服用八钱，加水煎煮后服用。
二黄散：治疗妇女及未婚女子经脉不通，服用后效果如神。
药材：大黄（烧至存性，二钱）、生地黄（三钱）。
制法：研为细末。作为一服量，空腹时用好酒调服。
二气丸：治疗月经不调，断绝不孕，面色萎黄肌肉消瘦，憔悴，食欲不振，有燥热感，配合柴胡引子一同服用。
药材：大黄（四两，另研为末，用醋一升，慢火熬成膏状）、当归、白芍药（各二两）。
制法：将其他药材研为细末，用膏剂和丸，如梧桐子大小。每次服用二十丸，淡醋汤送下，饭前服用，每日三次服用。
（以上四方都使用大黄，但配伍不离四物汤，自有轻重缓急的不同，应当仔细详察。）
五补丸：补益各种虚损，安定五脏，坚固骨髓，滋养精神。凡是胞脉闭阻，先服用降心火的方剂，然后服用此丸及卫生汤，以治疗脾脏并养血。
药材：熟地黄、人参、牛膝（酒浸去芦头，焙干）、白茯苓、地骨皮（各等分）。
制法：研为细末，炼蜜为丸，如梧桐子大小。每次服用三五十丸，空腹时温酒送下。（熟地黄用来补益天一之水，人参用来生发天一之气，这就是所谓水生源于气。然而气不下降则水不能生，所以用白茯苓以降天气，用地骨皮以清清气中之火，用牛膝引导药力下行，这是立方的大意。）
卫生汤
药材：当归、白芍药（各二两）、黄芪（三两）、甘草（一两）。
制法：研为粗末。每次服用半两，用水二盏，煎至一盏，空腹温服。如果体质虚弱者，加人参一两。
（五补丸补水之源，卫生汤运行已生成的血液。大概是因为地黄、茯苓、人参，都补益里气的不足；而黄芪、甘草，又补益表气的不足；当归、芍药行补肝血的不足，蕴含先后天之意。）
洁古先生所说的先服降心火之剂，大概也是黄芩、黄连、三和散、玉烛散之类的方剂；后服五补丸、卫生汤，也是补气类的方剂。
柏子仁丸：治疗血虚有火，月经耗损，逐渐至不通，日渐消瘦，产生潮热，并治疗未婚女子因思虑成劳导致的经闭。千万不要用毒药强行通经，适宜此方兼服泽兰汤。
药材：柏子仁（炒，另研）、牛膝（酒洗）、卷柏（各半两）、泽兰叶、续断（各二两）、熟地黄（三两，酒浸半天，在石臼中杵成膏状）。
制法：研为细末，炼蜜为丸，如梧桐子大小。空腹时用米饮送下三十丸。（血液生于心，心火旺则津液枯竭而血液不化，所以用柏子仁来润心生津。在水位之下，水气承接它，所以用熟地黄来滋水。这四种药材都能通血脉，而续断能接续绝伤。）
泽兰汤：治疗证候同前。
药材：泽兰叶（三两）、当归（酒洗）、芍药（炒，各一两）、甘草（五钱）。
制法：研为粗末。每次服用五钱，用水二盏，煎至一盏，温服。
加味补中益气汤：治疗因饮食和劳累倦怠，损伤脾胃，气弱体倦，发热口渴，饮食减少而无法生成血液的情况。
药材：黄芪、人参、甘草（炙）、白术、当归、陈皮（各一钱）、升麻、柴胡（各三分）、生地黄、天花粉（各八分）。
制法：切碎。加生姜，作为一服量，加水煎煮服用。（如果胃寒，且面色无华者，去掉生地、花粉；有虚火者适宜加入。）
十全大补汤：治疗堕胎，以及多次生育损伤血液，或误服发汗、攻下的克伐药物，导致血衰气乏，从而月经不行的情况。（此方以温补气血为主，这就是所谓“劳者温之，损者温之”的道理。）
药材：人参、白术、白茯苓、甘草（炙）、当归、川芎、白芍药、熟地黄、黄芪、肉桂（各二钱）。
制法：切碎。作为一服量，加水煎煮服用。
养真汤：治疗妇人经闭不通，脐下有肿块，已经三年，百药无效，服用此方几剂后月经通行。再投几剂，肿块就消除了。（以上十一个方子，重点都在“血枯”二字上。）
药材：当归（酒洗）、川芎、白芍药（酒炒）、熟地黄（姜汁炒）、白茯苓、陈皮、栀子（炒）、山茱萸（去核）、益母草、小茴香（酒炒）、香附子（醋浸炒，各等分）。
制法：切碎。每次服用一两，加水煎煮服用，五六剂后，月经通畅，改为丸药服用。（凡是用通经消块的方法，通常都用破气削坚、大热大毒之类的药物，而这个方子全部用行气调气血、散结气、暖下元的药物等分，而又用山栀这种凉药佐助，为什么呢？只听说山栀能治肿块中的火，没听说能治三年的肿块而通经的，关键在于善于运用它。）
Zhu Danxi stated: Amenorrhea may be caused by abortion and multiple childbirths damaging the blood, prolonged tidal fever consuming the blood, chronic night sweats depleting the blood, spleen and stomach disharmony with insufficient dietary intake leading to failure in blood generation, or dysentery causing blood loss. Treatment should employ formulas that generate and tonify blood, clear heat, and harmonize, selected according to the specific syndrome.
Alternatively, it may be due to the Seven Emotions (Joy, Anger, Worry, Pondering, Sorrow, Fear, Fright) injuring the Heart, causing Heart Qi stagnation and knotting, thus blocking blood flow and preventing menstruation. It is appropriate to regulate Heart Qi and unblock the Heart Meridian, allowing blood to generate and menstruation to resume naturally. (The key to generating blood lies in tonifying the Spleen and Stomach, regulating diet, and adapting to cold and warmth; this is what is meant by "when the Spleen is prosperous, it can generate blood." Regarding cases of Heart Qi knotting, it is appropriate to regulate the Heart, as the Heart governs the Blood.)
The Mai Jing (Pulse Classic) states: A faint and choppy Kidney pulse indicates amenorrhea. (For pulse methods regarding amenorrhea, refer to the preceding "Regulating Menstruation" section.)
Yuzhu San (Jade Candle Powder): Treats stomach heat with thirst and excessive hunger, gradual emaciation despite good appetite, fluid depletion due to heat dryness, leading to the drying up of the Blood Sea. (This formula is a combination of Siwu Tang [Four Substances Decoction] and Tiaowei Chengqi Tang [Regulate the Stomach and Direct Downward Da Huang Decoction].)
Herbs: Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Dihuang (Rehmanniae Radix), Dahuang (Rhei Radix et Rhizoma), Mangxiao (Natrii Sulfas), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Preparation: Coarsely chopped. Take 8 qian per dose, decoct in water, take before meals.
Sanhe San (Three Harmonies Powder): Treats mental overexertion causing Heart Fire to ascend, leading to obstruction of the Bao Mai (Uterine Vessels) and absence of menstruation. (This formula is a combination of Siwu Tang [Four Substances Decoction] and Liangge San [Cool the膈 Powder].)
(This treats excess heat from mental overexertion. If there is Heart deficiency with internal heat retention, or Heart deficiency with Spleen Earth decline, do not use indiscriminately.)
Herbs: Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Dihuang (Rehmanniae Radix), Dahuang (Rhei Radix et Rhizoma), Puxiao (Natrii Sulfas), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Lianqiao (Forsythiae Fructus), Bohe (Menthae Haplocalycis Herba), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Preparation: Coarsely chopped. Take 8 qian per dose, decoct in water and take.
Erhuang San (Two Yellows Powder): Treats amenorrhea in married women and unmarried girls; its efficacy is miraculous.
Herbs: Dahuang (Rhei Radix et Rhizoma) (burned until carbonized but retaining nature, 2 qian), Shengdihuang (Rehmanniae Radix Recens) (3 qian).
Preparation: Pulverized into fine powder. As one dose, mix with good wine and take on an empty stomach.
Erqi Wan (Two Qi Pill): Treats irregular menstruation, cessation of menses with infertility, sallow complexion, emaciation, fatigue, poor appetite, and dry heat. Take in conjunction with Chaihu Yinzi (Bupleurum Infusion).
Herbs: Dahuang (Rhei Radix et Rhizoma) (4 liang, separately pulverized, boiled with 1 sheng of vinegar over slow fire until a paste forms), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba) (2 liang each).
Preparation: Pulverize other herbs into fine powder, mix with the paste to form pills the size of paulownia seeds. Take 20 pills per dose, swallow with light vinegar soup, before meals, three times daily.
(All four formulas above use Dahuang, but their combinations always include elements of Siwu Tang [Four Substances Decoction], differing in severity and urgency; careful consideration is required.)
Wubu Wan (Five Tonics Pill): Tonifies various deficiencies, calms the Five Zang Organs, strengthens bone marrow, and nourishes the Spirit. For any obstruction of the Bao Mai (Uterine Vessels), first administer a formula to descend Heart Fire, then take this pill along with Weisheng Tang (Health Preservation Decoction) to treat the Spleen and nourish blood.
Herbs: Shudihuang (Rehmanniae Radix Preparata), Renshen (Ginseng Radix), Niuxi (Achyranthis Bidentatae Radix) (soaked in wine, remove rhizome, dry-roasted), Baifuling (Poria), Digupi (Lycii Cortex) (equal parts).
Preparation: Pulverize into fine powder, bind with refined honey to form pills the size of paulownia seeds. Take 30-50 pills per dose, swallow with warm wine on an empty stomach. (Shudihuang tonifies the Water of Tianyi [Heavenly One]; Renshen generates the Qi of Tianyi. This is what is meant by "Water is born from Qi." However, if Qi does not descend, Water cannot generate; therefore, Baifuling is used to descend Heavenly Qi, and Digupi clears fire in the Clear Qi. Niuxi guides the action downward. This constitutes the general principle of the prescription.)
Weisheng Tang (Health Preservation Decoction)
Herbs: Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba) (2 liang each), Huangqi (Astragali Membranacei Radix) (3 liang), Gancao (Glycyrrhizae Radix et Rhizoma) (1 liang).
Preparation: Pulverize into coarse powder. Take 0.5 liang per dose, decoct in 2 zhan of water until 1 zhan remains, take warm on an empty stomach. If deficient, add Renshen (Ginseng Radix) 1 liang.
(Wubu Wan [Five Tonics Pill] replenishes the source of Water; Weisheng Tang [Health Preservation Decoction] moves already generated blood. Essentially, Dihuang, Fuling, and Renshen all tonify the insufficiency of Interior Qi; while Huangqi and Gancao further supplement Exterior Qi; Danggui and Shaoyang move and supplement Liver Blood. This embodies the concepts of Pre-Heaven and Post-Heaven.)
Mr. Jiegou stated that the initial administration of formulas to descend Heart Fire generally refers to agents like Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Sanhe San (Three Harmonies Powder), and Yuzhu San (Jade Candle Powder). The subsequent administration of Wubu Wan (Five Tonics Pill) and Weisheng Tang (Health Preservation Decoction) are also Qi-tonifying formulas.
Baiziren Wan (Biota Seed Pill): Treats Blood deficiency with Fire, menstrual depletion leading gradually to amenorrhea, progressive emaciation, and tidal fever. It also treats amenorrhea in unmarried girls caused by labor from excessive thinking. Do not use toxic drugs to forcibly induce menstruation; this formula combined with Zelan Tang (Eupatorium Decoction) is appropriate.
Herbs: Baiziren (Biotae Semen) (stir-fried, separately ground), Niuxi (Achyranthis Bidentatae Radix) (washed in wine), Juanbai (Selaginellae Tamariscinae Herba) (0.5 liang each), Zelan Ye (Eupatorii Herba), Xuduan (Dioscoreae Nipponicae Rhizoma) (2 liang each), Shudihuang (Rehmanniae Radix Preparata) (3 liang, soaked in wine for half a day, pounded into a paste in a stone mortar).
Preparation: Pulverize into fine powder, bind with refined honey to form pills the size of paulownia seeds. Take 30 pills on an empty stomach with rice drink. (Blood is generated by the Heart; when Heart Fire is hyperactive, fluids dry up and blood fails to transform. Therefore, Baiziren is used to moisten the Heart and generate fluids. Below the Fire position, Water Qi supports it; thus, Shudihuang is used to nourish Water. These four herbs all unblock blood vessels, while Xuduan repairs ruptures.)
Zelan Tang (Eupatorium Decoction): Treats the same syndromes as above.
Herbs: Zelan Ye (Eupatorii Herba) (3 liang), Danggui (Angelicae Sinensis Radix) (washed in wine), Shaoyao (Paeoniae Radix) (stir-fried, 1 liang each), Gancao (Glycyrrhizae Radix et Rhizoma) (5 qian).
Preparation: Pulverize into coarse powder. Take 5 qian per dose, decoct in 2 zhan of water until 1 zhan remains, take warm.
Jiawei Buzhong Yiqi Tang (Modified Tonify the Middle and Augment the Qi Decoction): Treats damage to the Spleen and Stomach due to improper diet and fatigue/overwork, resulting in weak Qi, physical fatigue, fever, thirst, reduced food intake, and failure to generate blood.
Herbs: Huangqi (Astragali Membranacei Radix), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (roasted), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium) (1 qian each), Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix) (0.3 qian each), Shengdihuang (Rehmanniae Radix Recens), Tianhua Fen (Trichosanthis Radix) (0.8 qian each).
Preparation: Coarsely chopped. Add fresh ginger, decoct in water as one dose. (If there is Stomach Cold and lackluster complexion, remove Shengdihuang and Tianhua Fen; if there is Deficient Fire, addition is appropriate.)
Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction): Treats amenorrhea due to blood deficiency and Qi exhaustion caused by abortion, multiple childbirths, or accidental ingestion of diaphoretic or purgative drugs that attack and weaken. (This formula focuses on warming and tonifying Qi and Blood, embodying the principle "for exhaustion, use warming"; "for injury, use warming.")
Herbs: Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma) (roasted), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba), Shudihuang (Rehmanniae Radix Preparata), Huangqi (Astragali Membranacei Radix), Rougui (Cinnamomi Cortex) (2 qian each).
Preparation: Coarsely chopped. Decoct in water as one dose.
Yangzhen Tang (Nourish Truth Decoction): Treats female amenorrhea with lower abdominal masses persisting for three years, unresponsive to hundreds of medicines. After taking several doses of this formula, menstruation resumes. After a few more doses, the mass dissipates. (The eleven formulas above emphasize the concept of "Blood Dryness".)
Herbs: Danggui (Angelicae Sinensis Radix) (washed in wine), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba) (stir-fried in wine), Shudihuang (Rehmanniae Radix Preparata) (stir-fried in ginger juice), Baifuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Zhizi (Gardeniae Fructus) (stir-fried), Shanzhuyu (Corni Fructus) (pitted), Yimucao (Leonuri Herba), Xiaohuixiang (Foeniculi Fructus) (stir-fried in wine), Xiangfuzi (Cyperi Rhizoma) (soaked in vinegar and stir-fried) (equal parts).
Preparation: Coarsely chopped. Take 1 liang per dose, decoct in water. After 5-6 doses, when menstruation flows, switch to pill form. (Generally, formulas for inducing menstruation and reducing masses use drugs that break Qi, harden, and possess great heat or toxicity. This formula uses equal parts of drugs that move Qi, regulate Qi and Blood, dissipate nodules, and warm the Lower Yuan, assisted by Zhizi, a cooling herb. Why? It is known that Zhizi treats fire within masses, but it is unheard of treating a three-year-old mass to induce menstruation. The key lies in skilled application.)