妇人有经水前一二日，每腹痛而吐血者。此由于肝气之逆，与上条属火极盛者，又有异焉。法宜补肾而兼平肝。
傅氏顺经汤加贝母、决明、牛膝、茜草。
大熟地 粉丹皮 白茯苓 生白芍 象贝母 茜草 白归身 北条参 黑芥穗 石决明 怀牛膝
壮年之妇，经水偶逆，因而吐血，往往有之，若误作劳瘵治，辄成劳瘵也。慎之，戒之。
妇女有经前一二日，大便先下血者，此横行旁流所致也。经水先是循冲脉而上逆，幸冲气不甚逆，因而横行脂膜入
于大肠，亦血海有热，所以经水越涌也。但清血海，勿犯肠胃。
大生地 粉丹皮 白归身 淡黄芩 淡生姜 白茯苓 炒白芍 黑芥穗 怀牛膝
妇人有每月必先腹痛数日，而后经水始行者，其色多紫黑而成块。此肾虚火炽而肝郁所致也。溷水为火所煎熬，成
紫黑之块，肝郁失疏泄之令，故滞而作痛也。痛甚者，至于辗转呼号，俗谓之痛经。傅氏两地汤加味治之。
酒炒生地 地骨皮 元参 丹参 石决明 夏枯草 酒炒白芍 麦冬肉 阿胶 象贝 细青皮
每经水净后，少腹作痛，非块非寒，乃水亏木旺，肝阳横也。与傅氏调肝汤加熟地、女贞子。
傅氏调肝汤
炒淮药 阿胶珠 巴戟天（盐水浸） 酒白芍 女贞子 山萸肉（蒸） 甘草 全当归（酒洗） 大熟地
此方调经后皆宜，不独治少腹作痛一证而已也。
妇女在月经来潮前一二日，常常出现腹痛并伴有吐血的症状。这是由于肝气上逆所致，与上一条所述因火邪极盛导致的病症有所不同。治疗法则应当以补肾为主，同时兼顾平抑肝气。
推荐使用傅青主的顺经汤，并加入贝母、决明子、牛膝、茜草。
药物组成：大熟地、粉丹皮、白茯苓、生白芍、象贝母、茜草、白归身、北条参、黑芥穗、石决明、怀牛膝。
壮年妇女偶尔出现经血逆行而吐血的情况，往往时有发生。如果误当作虚劳病（劳瘵）来治疗，就会真的变成虚劳病。务必谨慎，引以为戒。
妇女在月经来潮前一二日，大便先出血的，这是血液横行旁流所致。经血原本应循冲脉上行，幸好冲脉之气没有严重上逆，于是血液横行进入脂膜，进而流入大肠。这也是血海有热，导致经血越涌而出的原因。治疗只需清泻血海之热，不要损伤肠胃。
药物组成：大生地、粉丹皮、白归身、淡黄芩、淡生姜、白茯苓、炒白芍、黑芥穗、怀牛膝。
妇女每月必定在腹痛数日后，月经才来潮，经血颜色多呈紫黑色且结成块状。这是由于肾阴亏虚、虚火炽盛以及肝气郁结所致。经血如同混水被火煎熬，凝结成紫黑色的血块；肝气郁结导致疏泄功能失常，因此气血阻滞而引发疼痛。疼痛剧烈者，甚至辗转反侧、大声呼号，俗称为痛经。使用傅青主的两地汤加味进行治疗。
药物组成：酒炒生地、地骨皮、元参、丹参、石决明、夏枯草、酒炒白芍、麦冬肉、阿胶、象贝、细青皮。
每次月经干净后，少腹部出现疼痛，既不是因为有瘀块，也不是因为寒邪，而是由于肾水亏虚、肝木旺盛，导致肝阳横逆。使用傅青主的调肝汤，并加入熟地黄、女贞子。
傅氏调肝汤的药物组成：炒淮山药、阿胶珠、巴戟天（盐水浸泡）、酒白芍、女贞子、山萸肉（蒸制）、甘草、全当归（酒洗）、大熟地。
此方调理月经后期皆适宜，不仅仅用于治疗少腹疼痛这一种症状而已。
Women who experience abdominal pain followed by hematemesis one or two days before menstruation. This is caused by the rebellion of Liver Qi, which differs from the previous case attributed to extreme excess of Fire. The treatment principle should be to tonify the Kidney while simultaneously soothing the Liver.
Fu’s Shunjing Tang (Cinnamon Twig and Rehmannia Decoction) with added Fritillariae Bulbus (Beimu), Cassiae Semen (Juemingzi), Achyranthis Bidentatae Radix (Niuxi), and Rubiae Cordifoliae Radix et Rhizoma (Qiancao).
Ingredients: Prepared Rehmanniae Radix (Shudihuang), Moutan Cortex (Danpi), Poria (Fuling), Raw Paeoniae Radix Alba (Baishao), Fritillariae Cirrhosae Bulbus (Xiangbeimu), Rubiae Cordifoliae Radix et Rhizoma (Qiancao), Angelicae Sinensis Radix (Baiguishen), Codonopsis Radix (Baitianshen), Sappan Wood/Blackened Schizonepeta? (Heijieshei - *Note: Heijieshui usually refers to blackened Schizonepeta*, Blackened Schizonepeta Spike), Concha Arcae (Shijueming), Achyranthis Bidentatae Radix (Huainiuxi).
It is common for mature women to occasionally experience retrograde menstruation resulting in hematemesis. If mistakenly treated as Consumption Disease (Laozai), it may indeed develop into such a condition. One must be cautious and heed this warning.
Women who pass blood via stool one or two days before menstruation are suffering from lateral flow of blood. The menstrual blood originally intends to ascend along the Chong Mai (Penetrating Vessel); fortunately, the rebellious Qi of the Chong Mai is not severe, so the blood flows laterally into the adipose membrane and enters the Large Intestine. This is also due to Heat in the Blood Sea causing the menstrual blood to surge excessively. Treatment should focus on clearing Heat from the Blood Sea without damaging the Stomach and Intestines.
Ingredients: Raw Rehmanniae Radix (Shengdihuang), Moutan Cortex (Danpi), Angelicae Sinensis Radix (Baiguishen), Scutellariae Radix (Huangqin), Ginger (Shengjiang), Poria (Fuling), Stir-fried Paeoniae Radix Alba (Chaobaishao), Blackened Schizonepeta Spike (Heijieshui), Achyranthis Bidentatae Radix (Huainiuxi).
Women whose menstruation is preceded by several days of abdominal pain, with menstrual blood appearing dark purple and clotted, suffer from Kidney Yin deficiency with blazing Empty Fire and Liver Qi stagnation. The menstrual blood, like muddy water boiled by fire, forms dark purple clots. Due to Liver stagnation failing to perform its function of free flow and discharge, Qi and Blood stagnate causing pain. Severe pain may cause the patient to toss and turn and cry out; this is commonly known as Dysmenorrhea. It is treated with Fu’s Liangdi Tang modified.
Ingredients: Wine-processed Rehmanniae Radix (Jiuchaoshengdi), Lycii Cortex (Digupi), Scrophulariae Radix (Yuanshen), Salviae Miltiorrhizae Radix (Danshen), Concha Arcae (Shijueming), Prunellae Spica (Xiakucao), Wine-processed Paeoniae Radix Alba (Jiuchaobaishao), Ophiopogonis Tuber (Maidong), Donkey-hide Gelatin (Ejiao), Fritillariae Cirrhosae Bulbus (Xiangbei), Citri Reticulatae Pericarpium Viride (Xiqingpi).
After menstruation ends, lower abdominal pain occurs, neither due to masses nor Cold, but because of Water deficiency and Wood hyperactivity, leading to horizontal flaring of Liver Yang. Use Fu’s Tiaogan Tang with added Prepared Rehmanniae Radix (Shudihuang) and Ligustri Lucidi Fructus (Nvzhenzi).
Fu’s Tiaogan Tang (Regulate Liver Decoction):
Stir-fried Dioscoreae Rhizoma (Chuaishanyao), Fried Donkey-hide Gelatin beads (Ejiaozhu), Morinda Officinalis Radix (Bajitian, soaked in salt water), Wine-processed Paeoniae Radix Alba (Jiubaishao), Ligustri Lucidi Fructus (Nvzhenzi), Corni Fruit (Shanzhuyu, steamed), Licorice Root (Gancao), Whole Angelicae Sinensis Radix (Quan Danggui, washed in wine), Prepared Rehmanniae Radix (Da Shudihuang).
This formula is suitable for regulating menstruation after its completion, not merely for treating lower abdominal pain.