（《素问·腹中论》）
帝曰∶有病胸胁支满者，妨于食，病至则先闻腥臊臭，出清液，先唾血，四肢清，目眩，时时前后血，病名为何？
何以得之？（支满者，满如支膈也。肺主气，其臭腥，肝主血，其臭臊，肺气不能平肝，则肝肺俱逆于上，浊气不降，
清气不升，故闻腥臊而吐清液也。口中唾血，血不归经也。四肢清冷，气不能周也。头目眩运，失血多而气随血去也。
血气既乱，故于前阴后阴，血不时见，而月信反无期矣。臊音骚。）岐伯曰∶病名血枯，此得之年少时，有所大脱血，若
醉入房，中气竭，肝伤，故月事衰少不来也。（血枯者，月水断绝也。致此之由，其源有二∶一则以少时有所大脱血，如
胎产既多及崩淋吐衄之类皆是也；一则以醉后行房，血盛而热，因而纵肆，则阴精尽泄，精去则气去，故中气竭也。夫
肾主闭藏，肝主疏泄，不惟伤肾，而且伤肝，及至其久，则三阴俱亏，所以有先见诸证如上文所云，而终必至于血枯，
则月事衰少不来也。此虽以女子为言，若丈夫有犯前证，亦不免为精枯之病，则劳损之属皆是也。）帝曰∶治之奈何？复
以何术？岐伯曰∶以四乌 骨，一 茹，二物并合之，丸以雀卵，大如小豆，以五丸为后饭，饮以鲍鱼汁，利肠中及伤
肝也。（复者，复其血气之原也。后饭者，先药后饭也。乌 ，即乌贼也，骨名海螵蛸，其气味咸温下行，故主女子赤白
漏下及血闭血枯，其性涩，故亦能令人有子。 茹，亦名茹 ，即茜草也，气味甘寒无毒，能止血治崩，又能益精气，
活血通经脉。按《甲乙经》及《太素》、《新校正》俱作 茹者非。盖 茹有毒，岂血枯者所宜？皆未之详察耳。雀，即
麻雀也。雀卵气味甘温，能补益精血，主男子阴痿不起，故可使多精有子，及女子带下，便溺不利。鲍鱼，即今之淡干
鱼也，诸鱼皆可为之，惟石首鲫鱼者为胜，其气味辛温无毒，鱼本水中之物，故其性能入水脏，通血脉，益阴气，煮汁
服之，能同诸药通女子血闭也。以上四药皆通血脉，血主于肝，故凡病伤肝者，亦皆可用之。愚按∶血枯一证，与血隔
相似，皆经闭不通之候；然而枯之与隔，则相反有如冰炭。夫枯者，枯竭之谓，血虚之极也。隔者，阻隔之谓，血本不
虚，而或气或寒或积有所逆也。隔者病发于暂，其证则或痛或实，通之则血行而愈，可攻者也。枯者其来也渐，冲任内
竭，其证无形，必不可通者也。常见今人之治此者，听其言，则明曰血枯经闭也；察其治，则每用四物加桃仁、红花，
甚至硝、朴、棱、莪之类无所不至。夫血既枯矣，只当补养阴气，使其血充，则弗招自至，奚俟通也？若勉强逼之，则
枯者愈枯矣，不危何待？若夫人者，非惟不知病情，即字义曰枯，犹然未解，其与目不识丁者何异？求其无害不可得，
安望其有济于人哉？ 音贼。 、 俱音闾。）
（出自《素问·腹中论》）
黄帝问道：有一个人患胸胁部胀满支撑不适，影响进食，发病时先闻到腥臊气味，流出清稀液体，先吐出唾血，四肢发冷，头晕目眩，时常大小便出血，这是什么病？
是怎么得的呢？（注：支满，指胀满感如同有物支撑膈膜。肺主气，其味为腥；肝主血，其味为臊。若肺气不能制约肝木，则肝肺之气俱逆于上，浊气不降，清气不升，所以会闻到腥臊味并吐出清液。口中唾血，是血液不能归经所致。四肢清冷，是阳气不能周流全身。头目眩晕，是因为失血过多，气随血脱。血气既已紊乱，所以在前阴和后阴不时见血，而月经反而没有定期了。臊，音同“骚”。）
岐伯回答说：这个病名叫血枯，这是他在年少时曾有过大量失血的经历，或者是在醉酒后进行房事，导致中气衰竭，肝脏受损，所以月经衰少甚至闭经不来。（注：血枯，即月经断绝。导致这种情况的原因有两个：一是年少时曾有大量失血，如多次生育、产后出血以及崩漏、吐血、鼻衄等都属于此类；二是醉酒后行房，此时血盛且热，因而放纵情欲，导致阴精耗尽，精去则气去，所以中气衰竭。肾主闭藏，肝主疏泄，这不仅伤了肾，也伤了肝，久而久之，三阴经都亏损，所以会出现前面所说的各种症状，最终必然导致血枯，月经衰少不来。这里虽然是以女子为例，如果男子犯了前面的病症，也不免患上精枯的病，属于劳损的一类。）
黄帝问道：怎么治疗呢？用什么方法？
岐伯回答说：用四份乌贼骨，一份茜草，将两药混合，用麻雀卵做丸剂，大小如小豆，每次以五丸作为饭后服，用鲍鱼汁送服，这样可以通利肠道并补益受伤的肝脏。（注：“复”，是恢复其血气的本源。“后饭”，是先服药后进食。乌贼，就是乌贼鱼，其骨名为海螵蛸，气味咸温，性下行，所以主治女子赤白带下及血闭、血枯，因其性质涩，所以也能帮助受孕。茜草，又名茹草，气味甘寒无毒，能止血治疗崩漏，又能补益精气，活血通经脉。按《甲乙经》及《太素》、《新校正》都写作“茹”是错误的。因为茹草有毒，哪里是血枯患者所宜用的？这都是没有详细考察的缘故。雀，就是麻雀。雀卵气味甘温，能补益精血，主治男子阳痿不起，所以能使男子多精有子，以及女子带下、小便不利。鲍鱼，就是现在的淡干鱼，各种鱼都可以制作，只有石首鱼和鲫鱼制作的最好，气味辛温无毒。鱼本是水中的生物，所以其性能入水脏，通血脉，益阴气，煮汁服用，能配合其他药物通治女子的血闭。以上四种药都能通血脉，血由肝所主，所以凡是伤肝的疾病，也都适用。我按语认为：血枯这一证候，与血隔相似，都是经闭不通的表现；然而“枯”与“隔”，却相反得如同冰炭。所谓“枯”，是指枯竭，是血虚到了极点。所谓“隔”，是指阻隔，血本不虚，而是由于气滞、寒凝或积滞有所逆乱。隔证发病短暂，症状表现为痛或实，通利之后血行即可痊愈，是可以攻下的。枯证来势缓慢，冲任二脉内部枯竭，症状无形，绝对不可以通利。常见现在的人治疗此病，听他们说的，明明说是血枯经闭；看他们的治法，却每用四物汤加桃仁、红花，甚至用到硝石、朴硝、三棱、莪术之类无所不用。既然血已经枯竭，只应当补养阴气，使血液充盈，那么月经自然会来，何必等待通利呢？如果勉强逼迫它，那么枯竭的会更加枯竭，不危险还等什么？至于那些人，不仅不知道病情，就连“枯”字的含义都不理解，这和目不识丁的人有什么区别？指望他们不造成伤害是不可能的，又怎么能希望他们救人呢？贼，音同“仄”。茹、茜，都音同“吕”。）
(From *Suwen: Fuzhong Lun*)
The Yellow Emperor asked: There is a patient suffering from distension and fullness in the chest and hypochondrium, which interferes with eating. Upon the onset of the illness, they first perceive a fishy and gamey odor, discharge clear fluid, expectorate blood in saliva, experience cold limbs, dizziness, and frequent bleeding from both the anterior and posterior orifices. What is this disease called?
How did it arise? (Note: "Distension and fullness" refers to a sensation of fullness as if obstructed by a prop. The Lung governs Qi, and its odor is fishy; the Liver governs Blood, and its odor is gamey. If Lung Qi fails to regulate Liver Wood, both Liver and Lung Qi rebel upward, turbid Qi fails to descend, and clear Qi fails to ascend, hence the perception of fishy/gamey odors and vomiting of clear fluid. Expectorating blood indicates that Blood fails to return to its vessels. Cold limbs indicate that Yang Qi cannot circulate throughout the body. Dizziness of the head and eyes results from excessive blood loss, with Qi departing along with the Blood. Since Qi and Blood are disordered, bleeding occurs intermittently at the anterior and posterior orifices, while menstruation becomes irregular. "Gamey" is pronounced like "Sao".)
Qibo replied: This disease is named Xueku (Blood Depletion). It arises from a history of massive blood loss during youth, or from sexual activity while intoxicated, leading to exhaustion of Middle Qi and injury to the Liver, resulting in scanty or absent menstruation. (Note: "Xueku" refers to the cessation of menstrual flow. There are two main causes for this condition: First, massive blood loss in youth, such as from multiple pregnancies, postpartum hemorrhage, metrorrhagia, hematemesis, or epistaxis. Second, sexual intercourse after intoxication; when Blood is abundant and hot, indulgence leads to the complete depletion of Yin Essence. When Essence is lost, Qi is also lost, causing exhaustion of Middle Qi. The Kidney governs storage, and the Liver governs dispersion. This injures not only the Kidney but also the Liver. Over time, the Three Yin meridians become deficient, leading to the symptoms described above, ultimately resulting in Xueku and the cessation or scarcity of menstruation. Although this example focuses on women, if men suffer from these conditions, they may develop Jingku (Essence Depletion), which falls under the category of consumptive diseases.)
The Yellow Emperor asked: How should it be treated? What method should be used?
Qibo replied: Use four parts of Hai Piao Xiao (Cuttlebone) and one part of Qian Cao (Madder Root). Combine these two substances and form pills using sparrow eggs, sized like small beans. Take five pills after meals, washed down with Abalone Fish juice. This will benefit the intestines and nourish the injured Liver. (Note: "Fu" means to restore the source of Qi and Blood. "Hou fan" means taking medicine before eating food. Hai Piao Xiao is the bone of the cuttlefish. Its flavor is salty and warm, with a descending action, so it treats leukorrhea and blood stasis/depletion in women. Due to its astringent nature, it can also promote fertility. Qian Cao, also known as Ru Cao, has a sweet and cold flavor and is non-toxic. It stops bleeding, treats metrorrhagia, tonifies Essence and Qi, and invigorates Blood to unblock meridians. According to *Jiayi Jing*, *Tai Su*, and *Xin Zheng Xiao*, the character "Ru" is incorrect. Ru Cao is toxic and unsuitable for Xueku patients; this error stems from a lack of detailed examination. Sparrow eggs have a sweet and warm flavor, tonifying Essence and Blood. They treat male impotence, promote fertility in men, and address leukorrhea and difficult urination in women. Baoyu refers to dried salted fish, preferably made from Stonehead fish or Crucian carp. It has a pungent and warm flavor and is non-toxic. As aquatic creatures, their properties enter the Water Zang organs, unblock Blood vessels, and nourish Yin Qi. Boiled juice taken with other herbs can treat blood stasis in women. All four ingredients unblock Blood vessels. Since the Liver governs Blood, these are applicable to any disease injuring the Liver. My commentary: Xueku resembles Xuege (Blood Obstruction), both presenting as amenorrhea. However, "Ku" (Depletion) and "Ge" (Obstruction) are opposites, like ice and charcoal. "Ku" means dryness/exhaustion, representing extreme Blood deficiency. "Ge" means blockage, where Blood is not deficient but obstructed by Qi stagnation, Cold, or accumulation. Ge is acute, presenting with pain or excess signs, and resolves with unblocking therapies (purging). Ku develops gradually, with internal exhaustion of the Chong and Ren meridians, presenting without distinct forms, and absolutely contraindicates unblocking therapies. I often see practitioners today who claim to diagnose Xueku amenorrhea but prescribe Si Wu Tang plus Tao Ren (Peach Kernel) and Hong Hua (Safflower), even using harsh purgatives like Xiao Shi (Mirabilite), Pu Xiao (Niter), San Leng (Burreed Rhizome), and E Zhu (Curcuma Rhizome). If Blood is already depleted, one must tonify Yin Qi to replenish Blood, allowing menstruation to return naturally; why insist on unblocking? Forcing it will worsen the depletion, leading to danger. Such practitioners not only misunderstand the pathology but fail to comprehend the meaning of "Ku," equating them with the illiterate. It is impossible for them to avoid harm, let alone heal patients. "Ze" is pronounced like "Zhi". "Ru" and "Qian" are pronounced like "Lu".)