妇女经水，有前后无定期，多少不一，或来或断，时痛时止者甚至寒热往来，颇似劳瘵，此皆肝气郁结不舒之故也。
治之无定法，大抵宜于温通者多，宜于清凉者亦有之，然其始必先舒肝。肝者，一水之子，而二火之母也，又主疏泄之
权。是故肝气不舒，则既济之化有乖，而疏泄之令不时矣，法宗逍遥渴意。
炒当归 白茯苓 川芎 象贝母 炒桅子 大生地 炙甘草 白芍 制白术 细青皮 甘杞子 石决明 山药 炒
竹茹 黑芥穗
服此数剂后，肝气已和，再按证施治之。
经水前后多少有无不一如上条者，统谓之不调。夫经水者，实生于脾胃水谷之精。《经》曰∶土大过则敦阜。敦阜者，
浓且高也。陈修园曰∶既高而又浓，则令除去。宜用平胃散，加大黄、白芍、枳实、桃仁之类。
增减陈修园先生加味平胃散
制苍术 广陈皮 全当归 生白芍 桃仁泥 制浓朴 炒枳实 川芎 怀牛膝（炒）
平胃散原有枳实，不必再加重，恐其太耗气也。大便不结，且非下血，不必加大黄。若加大黄，是合桃仁承气也。
虽无芒硝、桂枝、甘草，其意已备，是必施之物理而有实证者尚可耳。
（〔批〕膏粱之体，秉气薄弱者，此方宜轻用，宁多服二三剂耳，勿太骤也。壮实者不忌。）
经水不调，其因于土气太过者少，而因于土气不及者多。《经》曰∶土不及则卑监。卑监者，下而陷也。陈修园曰∶
既下且陷，则令培补，宜六君子汤，加归芎柴芍。
陈修园先生加味六君子汤
党参 甘草 陈皮 当归 柴胡 白术 茯苓 半夏 川芎 白芍
此方大旨不易，更审血室之寒热，加味温凉之。陈氏调经，又有统治方，以四物汤加香附、茯神、炙甘草为主。阴
胜而寒者，加干姜、桂、附、吴萸、桃仁、红花之类。阳胜而热者，加知、柏、芩、连、续断、麦冬之属。此虽至浅至
淡之方，亦可常用，正不必于平常之病，而务求为立异以眩俗也。陈氏又谓仲景温经汤，可以统治经闭，经多，崩漏不
止，久不受胎，女科经水各证。此乃誉圣太过，无殊诬圣。血海热者，岂宜吴萸、生姜。血液虚者，岂宜半夏、桂枝、
丹皮。故吾直以为诬圣也。圣人首重正名，仲景立方亦若是矣。方曰温经，首用吴萸，其温通下元之意可知矣。通如修
园，不免此谬，医道之难可畏哉！
妇女月经，有周期不固定、经量多少不一、或来或断、时痛时止，甚至出现寒热往来的症状，颇似虚劳痨病（一种慢性消耗性疾病），这都是由于肝气郁结、疏泄不畅所致。
治疗没有固定的法则，大体上适宜用温通法的较多，适宜用清凉法的也有，但起始阶段必须先疏理肝气。肝属木，为水之子，又为二火之母，主管疏泄的职权。因此，肝气不舒，则心肾相交的转化就会失常，疏泄的功能也会失去节律，治法以逍遥散（疏肝健脾、养血调经）的意旨为主。
炒当归 白茯苓 川芎 象贝母 炒栀子 大生地 炙甘草 白芍 制白术 细青皮 甘杞子 石决明 山药 炒竹茹 黑芥穗
服用此方数剂后，若肝气已调和，再根据具体证候进行治疗。
月经周期前后不定、经量多少不一、有无不调等，如上条所述的情况，统称为月经不调。月经实际上是由脾胃运化水谷所产生的精微物质生成的。《黄帝内经》说：“土气太过则变得敦厚高亢。”所谓“敦阜”，就是既浓厚又高亢的意思。陈修园说：“既然既高又厚，就应当予以削减。”适宜使用平胃散（燥湿运脾、行气和胃），加大黄、白芍、枳实、桃仁等药物。
加减后的陈修园先生加味平胃散：
制苍术 广陈皮 全当归 生白芍 桃仁泥 制厚朴 炒枳实 川芎 怀牛膝（炒）
平胃散原方中已有枳实，不必再加量，恐怕过于耗伤正气。如果大便不干燥，且非瘀血阻滞，不必加大黄。如果加大黄，就合成了桃仁承气汤（活血逐瘀）。虽然方中没有芒硝、桂枝、甘草，但立意已经完备，这必须应用于体质壮实且有实证的患者才合适。
（批注：对于饮食精细、禀赋薄弱的人，此方宜轻用，宁可多服二三剂，不要药力太猛。身体壮实者无禁忌。）
月经不调，因土气（脾胃之气）太过而致的较少，因土气不及而致的较多。《黄帝内经》说：“土气不及则卑下监临。”所谓“卑监”，就是低下且下陷的意思。陈修园说：“既然既低又陷，就应当培补。”适宜使用六君子汤（益气健脾、燥湿化痰），加入当归、川芎、柴胡、白芍。
陈修园先生加味六君子汤：
党参 甘草 陈皮 当归 柴胡 白术 茯苓 半夏 川芎 白芍
这个方子的主旨基本不变，还需审察血室（子宫/冲任）的寒热属性，加入温热或寒凉的药物进行加减。陈氏调理月经，还有通用的统治方，以四物汤（补血调血）为基础，加入香附、茯神、炙甘草为主药。如果是阴盛而寒的，加入干姜、桂枝、附子、吴茱萸、桃仁、红花等药物。如果是阳盛而热的，加入知母、黄柏、黄芩、黄连、续断、麦冬等药物。这些虽然是极其浅显平淡的方子，也可以常用，正不必在平常的疾病上，刻意追求标新立异来迷惑世俗之人。陈氏又说张仲景的温经汤，可以统治经闭、经量过多、崩漏不止、长期不孕以及妇科月经的各种病症。这是赞誉圣人太过，无异于诬蔑圣人。血海有热的人，哪里适合用吴茱萸、生姜？血液虚弱的人，哪里适合用半夏、桂枝、丹皮？所以我直接认为这是诬蔑圣人。圣人首先重视正名，张仲景创立方剂也是这样。方名叫温经，首用吴茱萸，其温通下元（肾与命门）的意图就可以知道了。像陈修园这样通达的人，也不免犯这种错误，医道的深奥令人敬畏啊！
Women's menstruation may present with irregular cycles, varying amounts of flow, intermittent onset and cessation, intermittent pain, and even alternating chills and fever, resembling consumptive disease (a chronic wasting condition). All these are caused by the stagnation and discomfort of Liver Qi.
There is no fixed method for treatment; generally, warming and unblocking methods are more commonly used, though cooling methods are also applicable. However, the initial approach must always be to soothe the Liver. The Liver is the child of Water and the mother of Fire, and it holds the authority of dispersion and descent. Therefore, when Liver Qi is not free-flowing, the transformation of Heart-Kidney intersection becomes abnormal, and the command of dispersion and descent loses its rhythm. The therapeutic principle follows that of Xiaoyao San (Free and Easy Wanderer Powder).
Chao Danggui (Fried Angelicae Sinensis Radix), Baifuling (Poria), Chuanxiong (Ligusticum Wallichii Rhizome), Xiang Beimu (Fritillariae Thunbergii Bulbus), Chao Zhizi (Fried Gardeniae Fructus), Da Shengdi (Rehmanniae Radix Preparata), Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma), Baishao (Paeoniae Radix Alba), Zhi Baizhu (Processed Atractylodis Macrocephalae Rhizoma), Xi Qingpi (Citri Reticulatae Pericarpium Viride), Gan Qizi (Lycii Fructus), Shijueming (Argonautae Oca), Shanyao (Dioscoreae Rhizoma), Chao Zhuru (Fried Bambusae Caulis in Materia Medica), Hei Jiesui (Schizonepetae Spica Carbonisata).
After taking several doses of this prescription, if the Liver Qi has harmonized, further treatment should be administered according to the specific syndrome.
Menstrual irregularities characterized by variable timing, volume, and presence or absence, as described in the previous section, are collectively termed "Irregular Menstruation" (Jingshui Budiao). Menstrual blood is essentially generated from the essence of food and water transformed by the Spleen and Stomach. The Classic states: "When Earth Qi is excessive, it becomes Dunfu." "Dunfu" means thick and high. Chen Xiuyuan stated: "Since it is both high and thick, it should be reduced." It is appropriate to use Pingwei San (Peaceful Stomach Powder) with added Dahuang (Rhei Radix et Rhizoma), Baishao (Paeoniae Radix Alba), Zhishi (Aurantii Fructus Immaturus), and Taoren (Persicae Semen).
Chen Xiuyuan's Modified Pingwei San:
Zhi Cangzhu (Processed Atractylodis Rhizoma), Guang Chenpi (Citri Reticulatae Pericarpium), Quan Danggui (Angelicae Sinensis Radix), Sheng Baishao (Raw Paeoniae Radix Alba), Taoren Ni (Persicae Semen Paste), Zhi Houpo (Processed Magnoliae Officinalis Cortex), Chao Zhishi (Fried Aurantii Fructus Immaturus), Chuanxiong (Ligusticum Wallichii Rhizome), Huainiuxi (Achyranthis Bidentatae Radix, fried).
Pingwei San already contains Zhishi, so there is no need to increase the dose, lest it excessively deplete Qi. If the stool is not dry and there is no stasis bleeding, Dahuang need not be added. Adding Dahuang would combine it with Tao Ren Cheng Qi Tang (Peach Kernel Decoction to Order the Qi). Although Mangxiao (Natrii Sulfas), Guizhi (Cinnamomi Ramulus), and Gancao (Glycyrrhizae Radix et Rhizoma) are absent, the intent is complete. This must only be applied to patients with robust constitution and excess syndromes.
(Parenthetical note: For individuals of refined diet and weak constitution, this formula should be used lightly; it is better to take two or three additional doses rather than acting too abruptly. There are no contraindications for robust individuals.)
Irregular menstruation is less often caused by excessive Earth Qi (Spleen/Stomach Qi) and more often by deficient Earth Qi. The Classic states: "When Earth Qi is deficient, it becomes Beijian." "Beijian" means low and sinking. Chen Xiuyuan stated: "Since it is both low and sinking, it should be fortified." It is appropriate to use Liujunzi Tang (Six Gentlemen Decoction) with added Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Wallichii Rhizome), Chaihu (Bupleuri Radix), and Baishao (Paeoniae Radix Alba).
Chen Xiuyuan's Modified Liujunzi Tang:
Dangshen (Codonopsis Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Banxia (Pinelliae Rhizoma), Chuanxiong (Ligusticum Wallichii Rhizome), Baishao (Paeoniae Radix Alba).
The main purport of this formula remains unchanged; one must further examine the cold or heat in the Blood Chamber (Uterus/Chong and Ren vessels) and add warming or cooling herbs accordingly. Mr. Chen also had a general governing formula for regulating menstruation, based on Siwu Tang (Four Substances Decoction) with added Xiangfu (Cyperi Rhizoma), Fushen (Poria with Hostwood), and Zhi Gancao (Prepared Glycyrrhizae Radix et Rhizoma). In cases of Yin excess and cold, add Ganjiang (Zingiberis Rhizoma), Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata), Wuyu (Evodiae Fructus), Taoren (Persicae Semen), Honghua (Carthami Flos), etc. In cases of Yang excess and heat, add Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Lianzu (Coptidis Rhizoma), Xuduan (Dipsaci Radix), Maidong (Ophiopogonis Radix), etc. Although these are very simple and plain formulas, they can be used routinely. One need not seek novelty to dazzle the common people for ordinary diseases. Mr. Chen also claimed that Zhang Zhongjing's Wenjing Tang (Warming the Meridian Decoction) could govern amenorrhea, menorrhagia, metrorrhagia and metrostaxis, infertility due to long-term failure to conceive, and various menstrual disorders in gynecology. This is an over-praise of the Sage, tantamount to slandering him. How suitable are Wuyu and Shengjiang for those with Heat in the Sea of Blood? How suitable are Banxia and Guizhi for those with Blood deficiency? Thus, I directly consider this slander of the Sage. The Sage first emphasized correct naming, and Zhang Zhongjing established formulas in the same manner. The formula is named "Warming the Meridian," yet it uses Wuyu first, revealing its intent to warm and unblock the Lower Yuan (Kidney and Mingmen). Even someone as erudite as Chen Xiuyuan falls into this error; how awe-inspiring is the difficulty of the medical Dao!