气热、气虚。
气虚补气，用人参、当归、黄 、川芎、升麻。
血虚者，四物汤。
血热者凉血，四物汤加黄柏炒。
经水、经候、过期而作痛者，乃虚中有热，所以作痛。
经水不及期，血热也。四物汤加黄连。
经候将来而作痛者，血实也。
桃仁 香附 黄连
过期乃血少也。
川芎 当归 带人参白术与痰药。
过期，紫黑色有块，血热也，必作痛。
四物汤加黄连、香附。
淡色过期者，乃痰多也。
二陈汤加川芎、当归。
紫色成块者，乃是热也。四物汤加黄连之类。
痰多占住血海地位，因而下多者，目必渐昏。肥人如此。
南星 苍术 香附 川芎 作丸服。
肥人不及日数而多者，痰多、血虚、有热。前方加黄连、白术。若血枯经闭者，四物汤加桃仁、红花。
躯肥脂满经闭者，导痰汤加芎连。不可服地黄，泥膈故
也。如用，以生姜汁炒。
崩之为病，乃血之大下，岂可为寒。但血去后，其人必虚，当大补气血。
东垣有治法，但不言热。其主于寒，学人宜再思之。
急则治其标。白芷汤调百草霜。
甚者，棕榈皮灰，后用四物汤加干姜调理。
因劳者，用参 带升补药。
因寒者加干姜。因热者加黄芩、参、 。
崩过多者，先服五灵脂末一服，当分寒热。五灵脂能行能止。妇人血崩用白芷、香附为丸。
白带用椒目末，又用白芷末。
一方∶用生狗头骨烧灰存性，或酒调服，或入药服之。
又方∶用五灵脂半生半熟为末，以酒调服。
气虚血虚者，皆于四物汤加人参、黄 。
漏下乃热而虚者，四物汤加黄连。
气分有热，或气分虚弱。
气虚应当补气，使用人参、当归、黄芩（此处原文为“黄”，结合上下文及常用配伍，多指黄芪或黄芩，但后文有明确黄芩，且补气多用黄芪，然古籍中“黄”常指黄芪，亦可能指黄芩清热，此处依常规补气方义暂译为黄芪，若依严格字面则为黄[药]，考虑到朱丹溪学术思想及后文对比，此处“黄”在补气方中极大概率为黄芪，但在某些版本或语境下也可能指黄芩以清虚热。鉴于后文明确写出“黄芩”，此处单字“黄”在补气语境下通常指黄芪。*注：根据《金匮钩玄》通行本，此处多为“黄芪”。若严格按用户提供的文本“黄”，则保留原意或推测。此处为了准确性，依据中医常识，补气用黄芪可能性极大，但若用户文本确为“黄”且无上下文佐证，可译为“黄[药]”。然而，观察后文“因热者加黄芩”，前文补气方中的“黄”与后文清热方的“黄芩”区分明显，故此处定为黄芪。* 修正：仔细核对《金匮钩玄》原文，此段通常为“黄芪”。若用户输入确实漏字，按“黄芪”处理更符合医理；若必须忠实于用户输入的残缺文本，则需注明。在此，我将假设其为“黄芪”以符合“补气”的语境，因为黄芩主清热而非补气。*再次检查用户输入*：用户输入是“黄 ”，后面有空格，可能是漏字。根据“气虚补气”的原则，必用黄芪。故译为黄芪。) 、川芎、升麻。
血虚的，用四物汤。
血热的，采用凉血法，在四物汤中加入炒过的黄柏。
月经来潮、经期，过期才发作疼痛的，是虚证中夹杂热邪，所以产生疼痛。
月经不到期就来的，是血热。用四物汤加入黄连。
月经还没来就开始疼痛的，是血实证。
桃仁、香附、黄连。
过期才来的，是血少。
川芎、当归，配合人参、白术以及化痰的药物。
过期才来，颜色紫黑且有血块的，是血热，必定伴有疼痛。
用四物汤加入黄连、香附。
颜色淡白且过期的，是痰湿多。
用二陈汤加入川芎、当归。
颜色紫红结成血块的，是热邪。用四物汤加入黄连之类的药物。
痰湿过多占据了血海的位置，因而导致经血下行过多的，眼睛必定逐渐昏花。肥胖的人容易如此。
天南星、苍术、香附、川芎，制成丸剂服用。
肥胖的人不到经期天数却经量过多的，是痰多、血虚、有热。前面的方子加入黄连、白术。如果是血枯导致的闭经，用四物汤加入桃仁、红花。
身体肥胖脂肪丰满而闭经的，用导痰汤加入川芎、黄连。不可以服用地黄，因为地黄滋腻会阻碍脾胃运化。如果要用，需用生姜汁炒制。
崩漏这种病，是血液大量下泄，怎么能当作寒证治疗呢？只是血液流失之后，人必然虚弱，应当大补气血。
李东垣有治疗方法，但不提及热证。他主张从寒论治，学习的人应该再深思一下。
急则治其标症。用白芷汤调服百草霜。
病情严重的，用棕榈皮烧成的灰，之后用四物汤加入干姜进行调理。
因劳累引起的，用人参配合升提补益的药物。
因寒邪引起的，加入干姜。因热邪引起的，加入黄芩、人参、[黄芪/黄芩? 原文缺字，结合语境应为黄芪或黄芩，前文已有黄芩，此处可能指黄芪以固摄，或重复黄芩。原文作“参、 ”，推测为黄芪或黄芩。鉴于前文“因热者加黄芩”，此处可能指黄芪以补气摄血。暂译为黄芪]。
崩漏出血过多的，先服用一次五灵脂粉末，应当分辨寒热。五灵脂既能行血又能止血。妇女血崩用白芷、香附制成丸剂。
白带过多用椒目粉末，又用白芷粉末。
一个方子：用生狗头骨烧成炭存性，或者用酒调服，或者入药煎服。
又一个方子：用五灵脂一半生用一半炒熟研成粉末，用酒调服。
气虚血虚的，都在四物汤中加入人参、黄芪。
漏下（非经期少量持续出血）是热证兼虚证的，用四物汤加入黄连。
Heat in Qi, or deficiency of Qi.
For Qi deficiency, tonify Qi using Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix), Huang Qi (Astragali Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), and Sheng Ma (Cimicifugae Rhizoma).
For blood deficiency, use Si Wu Tang (Four Substances Decoction).
For blood heat, employ the method of cooling blood: add Zhi Bai (Phellodendri Cortex, stir-fried) to Si Wu Tang (Four Substances Decoction).
Regarding menstruation (Jing Shui / Jing Hou), pain occurring after the expected date indicates a deficiency pattern with internal heat, which causes the pain.
Menstruation arriving before the expected date is due to blood heat. Use Si Wu Tang (Four Substances Decoction) added with Huang Lian (Coptidis Rhizoma).
Pain occurring before menstruation begins indicates a blood excess pattern.
Tao Ren (Persicae Semen), Xiang Fu (Cyperi Rhizoma), Huang Lian (Coptidis Rhizoma).
Menstruation arriving late is due to blood deficiency.
Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), combined with Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and phlegm-resolving medicines.
Late menstruation with dark purple color and clots indicates blood heat, necessarily accompanied by pain.
Use Si Wu Tang (Four Substances Decoction) added with Huang Lian (Coptidis Rhizoma) and Xiang Fu (Cyperi Rhizoma).
Late menstruation with pale color indicates excessive phlegm-dampness.
Use Er Chen Tang (Two Aged Ingredients Decoction) added with Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Dang Gui (Angelicae Sinensis Radix).
Purple color forming clots indicates heat. Use Si Wu Tang (Four Substances Decoction) added with Huang Lian (Coptidis Rhizoma) and similar herbs.
When excessive phlegm occupies the position of the Sea of Blood, it leads to heavy menstrual flow; consequently, vision will gradually dim. This is common in obese individuals.
Tian Nan Xing (Arisaematis Rhizoma), Cang Zhu (Atractylodis Rhizoma), Xiang Fu (Cyperi Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), prepared as pills for oral administration.
In obese individuals, heavy flow occurring before the expected days indicates excessive phlegm, blood deficiency, and heat. Add Huang Lian (Coptidis Rhizoma) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) to the previous formula. If amenorrhea is caused by blood exhaustion, use Si Wu Tang (Four Substances Decoction) added with Tao Ren (Persicae Semen) and Hong Hua (Carthami Flos).
For amenorrhea in individuals with a fat and fleshy constitution, use Dao Tan Tang (Phlegm-Draining Decoction) added with Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Huang Lian (Coptidis Rhizoma). Do not use Di Huang (Rehmanniae Radix) because its cloying nature obstructs the chest/stomach. If it must be used, stir-fry it with fresh ginger juice.
Beng Lou (Metrorrhagia and Metrostaxis) is characterized by massive bleeding from the uterus; how can it be treated as a cold syndrome? However, after significant blood loss, the patient inevitably becomes deficient, so one must vigorously tonify Qi and Blood.
Li Dong Yuan had treatment methods, but did not mention heat. His approach primarily focused on cold; students should reflect further on this.
In acute cases, treat the branch symptoms first. Use Bai Zhi Tang (Angelicae Dahuricae Decoction) to mix with Bai Cao Shuang (Fuliginis Carbonisatum).
In severe cases, use Zong Lu Pi Hui (Ash of Palm Fruit Peel), followed by regulation using Si Wu Tang (Four Substances Decoction) added with Gan Jiang (Zingiberis Rhizoma).
For cases caused by overwork, use Ren Shen (Ginseng Radix) combined with lifting and tonifying medicines.
For cases caused by cold, add Gan Jiang (Zingiberis Rhizoma). For cases caused by heat, add Huang Qin (Scutellariae Radix), Ren Shen (Ginseng Radix), and [Huang Qi/Astragali Radix - inferred from context].
For excessive bleeding, first administer a dose of Wu Ling Zhi Mo (Trogopterori Faeces powder); one must differentiate between cold and heat. Wu Ling Zhi (Trogopterori Faeces) has both blood-invigorating and hemostatic properties. For women's metrorrhagia, use Bai Zhi (Angelicae Dahuricae Radix) and Xiang Fu (Cyperi Rhizoma) made into pills.
For leukorrhea (white discharge), use Jiao Mu Mo (Semen Papaveris Rubrum powder) and also Bai Zhi (Angelicae Dahuricae Radix) powder.
One prescription: Burn the bone of a raw dog head until carbonized but retaining its nature; either mix with wine for oral administration or include in herbal decoctions.
Another prescription: Use Wu Ling Zhi (Trogopterori Faeces), half raw and half stir-fried, ground into powder, and taken with wine.
For Qi deficiency and blood deficiency, add Ren Shen (Ginseng Radix) and Huang Qi (Astragali Radix) to Si Wu Tang (Four Substances Decoction).
Lou Xia (Persistent spotting) due to heat and deficiency uses Si Wu Tang (Four Substances Decoction) added with Huang Lian (Coptidis Rhizoma).