李氏 月事兼旬再至，小腹痛胀，面黄食减，手足心热，口微渴，脉虚促。此脾肝肾阴亏损症也，延
成劳热则难治。暂用阿胶四物汤∶潞参、熟地砂仁末炒。各三钱、当归、白芍（酒炒），各
（二钱），川芎（八分）。阿胶（水煨二钱），麦冬、山栀、续断（俱炒。各钱半）、香附（童便炒，二钱）。
四服诸症俱减。改用八珍汤去白术，仍加阿胶、麦冬，脉较和，食较进。后专用潞参（五钱）、龙眼肉（二钱）
煎服，味甘生液。又用归脾丸加白芍、香附常服，经始调。
殷氏 年少脉匀，主无病，尺中虚，必月信后期，溺后白淫，非不孕之体。据述经前不痛，但迟，后
色淡，平时白带耳。治宜补气以培营之源，摄下以固肾之滑。用秘元煎∶人参、茯苓、白术、炙草、枣仁、山
药、芡实，加当归、白芍、杜仲、何首乌，服之可孕。
沈氏 按月倒经，血出鼻口。此由肝火上迫，不循常道。宜抑肝火，导归冲任，可使下行，此即搏跃过
颡之理。拟四物汤去川芎，其当归用醋制，加生熟山栀（各二钱）、丹皮（二钱）、黄芩、枳壳（各钱二分）、
降香、甘草（各一钱）、郁金（五分）。每月经前服四剂，后得转逆为顺。
肖氏 经前腹痛，经后淋沥，胀满食减，脉虚小。系冲任血滞，而主治宜在脾。用香附（姜制）、砂仁、
茯苓、白术、炙草、当归、白芍（桂木炒）、木香、延胡（酒炒）、杜仲（姜汁炒）、续断，神曲糊丸。姜
汤下，一料宿 愈而获孕。
徐氏 积年痛经，属血中气滞。用调经饮∶当归、牛膝、制香附、茯苓、山楂肉、加乌药、小茴香。
痛止后，因夹虚迟早不调，用芎归六君子汤加益母膏、白芍、香附、红枣而经调。
李氏外家 年二十以来天癸未通，其夫惧不能孕育。予谓此禀受阴气不足也，但多服六味地黄丸，阴气充经
脉自行，后生数子。
陈氏 性偏不育，脉沉涩，气急痰闷，经闭三载。当先调畅肝郁，三因七气汤∶半、朴、苓、苏，加当
归、香附、郁金、合欢、玫瑰二花煎。随用平调肝肾。甘杞子、沙苑子、补骨脂、牛膝、当归、制首乌、益母
霜，意取温行，不十服经行矣。
吴氏 结 数载，经闭年余。入夏气泄，脉微弦少力，肌削神疲。平昔胃纳不多，而冲脉隶于阳明，
谓之血海。因阳明生化不足，故月事不以时下也，症成下损，并无瘀阻，切忌通经，治先调补胃阴以生液。潞
参（三钱）、山药（炒）、茯神、枣仁、白芍、当归、杞子（俱炒。各二钱）、五味（焙五分）、麦冬（一钱）、
湘莲、南枣（各十枚）。十服，食
味颇甘，精神较爽，前剂去麦、味，参入泽兰。汤用潞参、山药、茯神（各三钱）、熟地（炒，一钱）、
白芍、当归（各二钱）、泽兰、甘草（各一钱）、牛膝（酒蒸，六分），益母膏（三钱）冲，服甚适，所虑
节交夏至，症必变重耳。
李氏：月经半个月来两次，小腹部疼痛且胀满，面色萎黄，食欲减退，手足心发热，口微渴，脉象虚而急促。这是脾、肝、肾三脏阴液亏损的病证，若拖延日久形成劳热（虚劳发热），则难以治疗。暂时使用阿胶四物汤：潞党参、熟地黄用砂仁末炒制，各三钱；当归、白芍（酒炒），各二钱；川芎（八分）；阿胶（水烊化，二钱）；麦冬、山栀、续断（均炒制，各一钱五分）；香附（童便炒，二钱）。服用四剂后，各种症状都减轻了。改用八珍汤去掉白术，仍然加入阿胶、麦冬，脉象变得较为和缓，饮食逐渐增加。后来专门使用潞党参（五钱）、龙眼肉（二钱）煎服，味道甘甜以滋生津液。又使用归脾丸加入白芍、香附长期服用，月经才调理正常。
殷氏：年纪轻轻脉象均匀，主示无病，但尺脉虚弱，必定月经后期，小便后有白色浊液流出，并非不能怀孕的体质。据叙述经前不痛，只是推迟，经后血色淡，平时只有白带而已。治疗应当补气以培养营血之源，固摄下部以稳固肾脏的滑脱。使用秘元煎：人参、茯苓、白术、炙甘草、酸枣仁、山药、芡实，加入当归、白芍、杜仲、何首乌，服用后可以怀孕。
沈氏：每月倒经，血液从鼻口流出。这是由于肝火上冲，不循常道所致。应当抑制肝火，引导气血回归冲任二脉，可使经血下行，这就是“搏跃过颡”（气逆上冲至咽喉/鼻腔）的道理。拟定四物汤去掉川芎，其中当归用醋制，加入生栀子、熟栀子（各二钱）、丹皮（二钱）、黄芩、枳壳（各一钱二分）、降香、甘草（各一钱）、郁金（五分）。每月经前服用四剂，后来得以扭转逆乱为顺行。
肖氏：经前腹痛，经后淋漓不尽，腹胀满，食欲减退，脉象虚小。属于冲任血脉瘀滞，但主治重点应在脾脏。使用香附（姜制）、砂仁、茯苓、白术、炙甘草、当归、白芍（桂枝木炒）、木香、延胡索（酒炒）、杜仲（姜汁炒）、续断，用神曲糊制成丸药。姜汤送服，一料药后宿疾痊愈并成功受孕。
徐氏：多年痛经，属于血中气机阻滞。使用调经饮：当归、牛膝、制香附、茯苓、山楂肉，加入乌药、小茴香。疼痛停止后，因为夹杂虚损导致经期迟早不调，使用芎归六君子汤加入益母膏、白芍、香附、红枣，从而月经调理正常。
李氏的外家（亲戚）：二十岁以来天癸（月经）未通，她的丈夫担心不能孕育。我认为这是禀受先天阴气不足所致，只要多服用六味地黄丸，阴气充盈，经脉自然通畅，后来生了几个孩子。
陈氏：性格偏执导致不育，脉象沉涩，气急痰闷，闭经三年。应当先调理舒畅肝气郁结，使用三因七气汤：半夏、厚朴、茯苓、紫苏，加入当归、香附、郁金、合欢皮、玫瑰花两朵煎服。随后使用平调肝肾的药物：甘枸杞子、沙苑子、补骨脂、牛膝、当归、制何首乌、益母霜，意在温通行散，不到十剂药月经就来了。
吴氏：结婚数年，闭经一年多。入夏时节气机外泄，脉象微弦且无力，肌肉消瘦，精神疲乏。平时胃纳不多，而冲脉隶属于阳明胃经，称为血海。因为阳明胃气生化不足，所以月经不能按时来潮，病症已成下焦亏损，并没有瘀血阻滞，切忌使用通经药物，治疗应先调理补养胃阴以滋生津液。潞党参（三钱）、山药（炒）、茯神、酸枣仁、白芍、当归、枸杞子（均炒，各二钱）、五味子（焙，五分）、麦冬（一钱）、湘莲、南枣（各十枚）。服用十剂后，味觉颇感甘甜，精神较之前清爽，在前一方基础上去掉麦冬、五味子，加入泽兰。汤药使用潞党参、山药、茯神（各三钱）、熟地黄（炒，一钱）、白芍、当归（各二钱）、泽兰、甘草（各一钱）、牛膝（酒蒸，六分），加入益母膏（三钱）冲服，服用后感觉很舒适，所担忧的是节气交至夏至，病症必然会加重罢了。
Li: Menstruation occurred twice within half a month, with pain and distension in the lower abdomen, sallow complexion, reduced appetite, heat sensation in the palms and soles, slight thirst, and a deficient and rapid pulse. This is a syndrome of Yin deficiency in the Spleen, Liver, and Kidney. If prolonged into consumptive fever (Lao Re), it will be difficult to treat. Temporarily use Ejiao Siwu Decoction: Lushen (Codonopsis Radix), Shudi (Rehmanniae Radix Praeparata) stir-fried with Amomi Fructus powder, each 3 qian; Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba) wine-stir-fried, each 2 qian; Chuanxiong (Chuanxiong Rhizoma), 8 fen; Ejiao (Colla Corii Asini) melted in water, 2 qian; Maidong (Ophiopogonis Radix), Zhizi (Gardeniae Fructus), Xuduan (Dipsaci Radix) all stir-fried, each 1.5 qian; Xiangfu (Cyperi Rhizoma) stir-fried with child's urine, 2 qian. After four doses, all symptoms subsided. Switched to Bazhen Decoction removing Baizhu, still adding Ejiao and Maidong. The pulse became more harmonious, and food intake increased. Later, exclusively used Lushen (5 qian) and Longyanrou (Longan Aril, 2 qian) decocted and taken orally, the sweet taste generates fluids. Then used Guipi Pill added with Baishao and Xiangfu for long-term administration, and menstruation finally regulated.
Yin: Young age with uniform pulse indicates no disease, but the Chi pulse is deficient, suggesting delayed menstruation and leukorrhea after urination; this is not a sterile constitution. According to the account, there is no pain before menstruation, only delay, pale blood color after menstruation, and ordinary leukorrhea. Treatment should tonify Qi to nourish the source of Ying (Nutritive) Blood, and secure the lower to consolidate Kidney slipping. Use Miyuan Decoction: Renshen (Ginseng Radix), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Zhi Gancao (Prepared Licorice Root), Zaoren (Ziziphi Spinosae Semen), Shanyao (Dioscoreae Rhizoma), Qianshi (Euryales Semen), added with Danggui, Baishao, Duzhong (Eucommiae Cortex), Heshouwu (Polygoni Multiflori Radix). Taking this can lead to pregnancy.
Shen: Monthly retrograde menstruation, with blood flowing from nose and mouth. This is caused by Liver Fire forcing upward, not following the normal pathway. It is appropriate to suppress Liver Fire and guide blood back to the Chong and Ren vessels, allowing it to flow downward. This follows the principle of "Qi surging past the palate." Prescribe Siwu Decoction removing Chuanxiong, where Danggui is vinegar-processed, added with Sheng Zhizi (Gardeniae Fructus) and Shu Zhizi, each 2 qian; Danpi (Moutan Cortex), 2 qian; Huangqin (Scutellariae Radix), Zhike (Aurantii Fructus), each 1.2 qian; Jiangxiang (Dalbergiae Odoriferae Lignum), Gancao (Licorice Root), each 1 qian; Yujin (Curcumae Radix), 5 fen. Take four doses before each menstruation, subsequently reversing the retrograde flow to normal.
Xiao: Abdominal pain before menstruation, dripping after menstruation, distension and fullness, reduced appetite, deficient and small pulse. This is Stasis of Blood in the Chong and Ren vessels, but the main treatment focus should be on the Spleen. Use Xiangfu (Cyperi Rhizoma) ginger-processed, Sharen (Amomi Fructus), Fuling, Baizhu, Zhi Gancao, Danggui, Baishao (Stir-fried with Cinnamomi Ramulus), Muxiang (Aucklandiae Radix), Yanhusuo (Corydalis Rhizoma) wine-processed, Duzhong (Eucommiae Cortex) ginger juice-processed, Xuduan, made into pills with Shenqu paste. Taken with Ginger Decoction. One course cured the chronic condition and resulted in pregnancy.
Xu: Chronic dysmenorrhea for years, belonging to Qi stagnation within Blood. Use Tiaojing Yin: Danggui, Niuxi (Achyranthis Bidentatae Radix), Zhi Xiangfu, Fuling, Shanzha Rou (Crataegi Fructus flesh), added with Wuyao (Linderae Radix), Xiaohuixiang (Foeniculi Fructus). After pain ceased, due to deficiency causing irregular timing, use Xiongui Liujunzi Decoction added with Yimu Gao (Leonurus Herba Extract), Baishao, Xiangfu, Hongzao (Jujubae Fructus), thereby regulating menstruation.
Relative of Li: Since age twenty, Tian Gui (Menstrual Essence) has not appeared; her husband feared infertility. I stated this is due to insufficient congenital Yin Qi. By taking Liuwei Dihuang Pill frequently, Yin Qi will fill up, and the meridians will open naturally. She later bore several sons.
Chen: Sterile due to biased temperament, deep and choppy pulse, shortness of breath and phlegm oppression, amenorrhea for three years. First, soothe Liver Qi stagnation using Sanyin Qiqi Decoction: Banxia (Pinelliae Rhizoma), Houpo (Magnoliae Officinalis Cortex), Fuling, Zisu (Perillae Folium), added with Danggui, Xiangfu, Yujin, Hehuan (Albiziae Cortex), Rose flowers (two pieces) decocted. Subsequently use herbs to harmonize Liver and Kidney: Ganshizi (Lycii Fructus), Shayuanzi (Astragali Complanati Semen), Buguzhi (Psoraleae Fructus), Niuxi, Danggui, Zhi Shouwu, Yimu Shuang (Leonurus Herba Frost-dried Extract). The intent is warm movement. Within ten doses, menstruation arrived.
Wu: Married for several years, amenorrhea for over a year. Entering summer, Qi leaks out, pulse is slightly wiry and weak, emaciation and mental fatigue. Usually poor gastric appetite. The Chong vessel belongs to the Yangming Stomach, called the Sea of Blood. Because Yangming transformation and production are insufficient, menstruation does not arrive on time. The syndrome has become Lower Jiao deficiency, without blood stasis. Strictly avoid blood-invigorating and menstruation-promoting drugs. Treatment first focuses on regulating and tonifying Stomach Yin to generate fluids. Lushen (3 qian), Shanyao (stir-fried), Fushen (Poria with Hostwood), Zaoren, Baishao, Danggui, Qizi (Lycii Fructus) all stir-fried, each 2 qian; Wuwei (Schisandrae Fructus) roasted, 5 fen; Maidong (1 qian); Xianglian (Nelumbinis Semen), Nanzao (Jujubae Fructus), each ten pieces. After ten doses, taste was quite sweet, spirit was clearer. In the previous formula, remove Maidong and Wuwei, add Zelan (Lycopus Herba). For the decoction: Lushen, Shanyao, Fushen (each 3 qian), Shudi (Rehmanniae Radix Praeparata) stir-fried (1 qian), Baishao, Danggui (each 2 qian), Zelan, Gancao (each 1 qian), Niuxi (wine-steamed, 6 fen), mixed with Yimu Gao (3 qian). Took it comfortably. The concern is that when the solar term reaches Summer Solstice, the syndrome will surely worsen.