《孫真人備急千金要方》Vol. 7

Essential Formulas for a Thousand Gold Pieces for Emergencies by the Perfected Sun, fascicle seven, second part

(Revised by Lin Yi and others, Court Gentleman for Attending the Heir Apparent, Acting Junior Director of the Court of Imperial Sacrifices, and Collator of the Secret Library)

Formulas for Women

Red and White Vaginal Discharge, Uterine Flooding, and Spotting, Section Three (Discussion, Formulas, and Moxibustion Methods)

The discussion says that the “thirty-six disorders” of women mentioned in various medical books comprise twelve patterns, nine kinds of pain, seven kinds of illness, five kinds of injury, and three chronic conditions.

What are the twelve patterns? They refer to twelve different appearances of menstrual blood or vaginal discharge: first, like grease; second, like black blood; third, like purple fluid; fourth, like raw flesh; fifth, like a scab of pus; sixth, like bean liquid; seventh, like soup made from mallow leaves; eighth, like clotted blood; ninth, like thin, clear blood, pale as water; tenth, like rice-washing water; eleventh, menstruation that comes and stops suddenly; and twelfth, menstrual cycles that are irregular.

What are the nine kinds of pain? First, pain and injury in the vagina; second, a persistent, dribbling pain in the vagina; third, pain during urination; fourth, pain from cold; fifth, abdominal pain when menstruation comes; sixth, distending pain caused by Qi; seventh, fluid flowing from the vagina with pain as if bitten by insects; eighth, pain on both sides below the ribs; and ninth, pain in the lower back and hips.

What are the seven kinds of illness? First, pain and obstruction in the orifices; second, alternating cold and heat within the body, accompanied by pain; third, cramping, hardness, and pain in the lower abdomen; fourth, numbness and diminished sensation in the organs; fifth, displacement of the uterine opening, drawing pain into the back; sixth, menstrual flow that suddenly becomes heavier or lighter; and seventh, symptoms of harmful vomiting.

What are the five kinds of injury? First, fullness and pain in both sides below the ribs; second, pain at the pit of the stomach that extends into the ribs; third, Qi stagnation and obstruction; fourth, diarrhea caused by pathogenic Qi, worry, and other factors; and fifth, chronic cold conditions that resist treatment in the front or back of the body.

What are the three chronic conditions? First, wasting of the body, with the skin and flesh unable to develop; second, infertility or inability to lactate; and third, cessation of menstruation. Though these disorders differ from one another, the formulas listed below are used to treat them.

Bai’e Wan: A formula for treating the thirty-six disorders of women (another version is given below).

Bai’e, dragon bone, and peony, eighteen zhu each; coptis, Chinese angelica, poria, scutellaria, dianthus, dahurian angelica, pyrrosia, licorice, oyster shell, asarum, aconite, Limonitum, halloysite, ginseng, cuttlebone, ligusticum, citrus peel, and rhubarb, half a liang each.

Zhu and liang are ancient units of weight. Pills were generally made by grinding the ingredients into powder and forming them into pills; this passage gives only the ingredients and dosages.

Grind the twenty-one ingredients listed above into a fine powder and mix them with honey to make pills the size of parasol tree seeds. Take them with water on an empty stomach, twice daily, ten pills each time. If you notice no effect, gradually increase the dose to twenty pills. Results should appear after twenty days; after a month, the various symptoms may be expected to subside.

To treat the “Twelve Abdominal Masses,” double the amounts of oyster shell, Limonite, cuttlebone, halloysite, and dragon bone. To treat the “Nine Pains,” double Coptis, Japanese honeysuckle, licorice, and Chinese angelica. To treat the “Seven Harms,” double Asarum, Ligusticum root, and citrus peel, and add one liang each of Sichuan pepper and Evodia fruit. To treat the “Five Injuries,” double rhubarb, Pyrrosia leaf, and Dianthus. To treat the “Three Chronic Conditions,” double ginseng and add half a liang each of red halloysite, alum stone, and Morinda root. Adjust the quantities when preparing the formula according to the condition being treated.

This formula is used to treat twelve kinds of illness in women’s abdomens: first, irregular menstrual cycles; second, menstrual blood that is thin and watery; third, absent menstruation; fourth, abnormal periods; fifth, lack of breast milk after childbirth; sixth, infertility; seventh, depletion of Yin-Yang, Qi, and blood; eighth, abdominal pain like needle pricks; ninth, coldness in the genital area; tenth, pulling pain in the uterus; eleventh, stagnant menstrual blood resembling the juice of leafy greens; and twelfth, tightness and pain in the lower back.

The scripture holds that these illnesses may be related to sexual activity, care during menstruation, exposure to cold, and overexertion. Examples include having intercourse before menstruation has ended, or sleeping on damp, cold ground or bathing in cold water. Although these may feel comfortable at the time, they can later lead to various illnesses. Intercourse before a wound has healed, getting up to work too soon after childbirth, or wearing too little clothing or bedding may also allow cold to enter through the lower body. This passage recounts the explanations of illness found in ancient medical texts.

Formula name: Red Halloysite Formula. Red halloysite and Pinellia, one liang and six zhu each; Sichuan pepper, dried ginger, Evodia fruit, Chinese angelica, cassia bark, red sage, Japanese honeysuckle, and Saposhnikovia root, one liang each; Veratrum, half a liang. Grind the eleven ingredients into a powder, mix with honey, and make pills the size of parasol tree seeds. Take ten pills with wine each morning on an empty stomach, three times daily. If there is no effect, gradually increase the dose until it takes effect.

White Halloysite Pills are used to treat women’s “Thirty-Six Ailments,” pain inside the womb, and disorders such as red or white vaginal discharge. The formula lists: white halloysite, cuttlebone, Limonite, and oyster shell, eighteen zhu each; red halloysite, dried rehmannia, dried ginger, dragon bone, cassia bark, Pyrrosia leaf, Japanese honeysuckle, Asarum, peony, Coptis, aconite, Chinese angelica, Scutellaria, Sichuan pepper, stalactite, angelica dahurica, Sichuan lovage, and licorice, half a liang each.

Grind the twenty-two ingredients above into a fine powder and mix with honey to form pills the size of Chinese parasol tree seeds. Take fifteen pills on an empty stomach with wine, twice daily. Another formula adds half a liang of huangbai.

Powder of Young Ox Horn Sheath: Treats vaginal discharge and five kinds of uterine bleeding, known as the “Five Penetrating Bleeds.” The first is bleeding caused by a febrile illness; the second, bleeding during alternating bouts of chills and fever; the third, persistent bleeding after intercourse before menstruation has ended; the fourth, bleeding caused by carrying heavy loads during menstruation, which injures the Ren vessel; and the fifth, prolonged menstrual bleeding after childbirth, before the uterus has recovered. These conditions present with excess at the exterior and deficiency within, and this formula may be used for them.

One ox horn sheath, burned until red-hot; deer antler, Lygodium spore, Chinese angelica, dried ginger, and teasel root, two liang each; donkey-hide gelatin, three liang; cuttlebone and dragon bone, one liang each; red beans, two sheng.

Grind the ten ingredients above into a fine powder and sift. Take one square-inch spoonful with wine on an empty stomach, three times daily. The formula recorded in the Supplement to the Essential Prescriptions Worth a Thousand Gold omits deer antler and cuttlebone.

Dragon Bone Powder: Treats twelve kinds of “chunxia” disorders and infertility. The twelve conditions are white vaginal discharge, red vaginal discharge, obstructed menstruation, yin-tai, hardened uterine tissue, uterine masses, painful disorders of Yin and Yang, internal tension, cold in the abdomen, uterine obstruction, aching pain in the five viscera, and intercourse with ghosts in dreams. This formula is suitable for use. (Another edition reads “abdominal descent” instead of “chunxia.”)

Dragon bone, three liang; huangbai, pinellia, the yellow earth from a cooking stove, cassia bark, and dried ginger, two liang each; pyrrosia leaf and talc, one liang each; cuttlebone and hematite, four liang each; five white silkworms.

Grind the eleven ingredients above into a fine powder and sift. Take one square-inch spoonful with wine, three times daily. For abundant white discharge, add two liang each of cuttlebone and white silkworms; for abundant red discharge, add five liang of hematite; for cold in the lower abdomen, add two liang of huangbai; for hardened uterine tissue, add two liang each of dried ginger and cassia bark. The amounts may be increased as appropriate to the condition. If pregnancy occurs after three months of taking the medicine, stop taking it. An excessive dose may lead to twins, so consider the formula carefully. Widows and unmarried women should not take it casually.

Formula for Treating Various Disorders of Vaginal Discharge in Women: Rhubarb, steamed over three dou of rice; aconite; poria…

Take three liang each of Mudan, peony bark, Platycodon root, and Tinglizi; half a liang each of Magnolia bark, Ligusticum, ginseng, angelica, horsefly, Sichuan pepper, Evodia, bupleurum, dried ginger, and cinnamon heart; and two and a half liang of Asarum. Grind these eighteen ingredients into a fine powder and mix with honey to form pills the size of Chinese parasol tree seeds. Take two pills each day on an empty stomach, washed down with wine. If you feel no effect, gradually increase the dose until you feel warmth in the abdomen.

Another medical text records a version of this prescription that adds three liang of hemp seed and half a liang of Chinese motherwort, while omitting Sichuan pepper and Tinglizi.

This prescription treats vaginal discharge in women and various related conditions, and helps women who have not borne children to conceive. After fourteen days of taking it, blood will be discharged; after twenty days, long worms and bluish-yellow fluid will be discharged. The illness may be cured after thirty days, and after fifty days the body will become plump and fair.

Break rhubarb into pieces the size of beans and stir-fry it until black. Take one jin each of bupleurum and mirabilite, five liang of Ligusticum, one sheng each of dried ginger and Sichuan pepper, and one egg-sized piece of Poria. Grind these seven ingredients into a fine powder and mix with honey to form pills the size of Chinese parasol tree seeds. Take seven pills before meals, washed down with rice water. If you feel no effect, increase the dose to ten pills, or until the medicine takes effect.

This prescription treats vaginal discharge.

Take one jin of goji root and five jin of fresh rehmannia. Chop them and boil them in one dou of wine until five sheng remain. Divide the liquid into three doses. It may also be decocted in water.

This prescription treats red or white vaginal discharge in women and girls.

Take one and a half liang each of Limonite and angelica; and one liang each of red halloysite, white halloysite, donkey-hide gelatin, dragon bone, and Pyrrosia leaf; six zhu of cuttlebone, and one liang each of phellodendron bark, Baiji, baical skullcap root (another version uses coptis), teasel root, wood ear, and oyster shell. Grind these fifteen ingredients into a fine powder and mix with honey to form pills the size of Chinese parasol tree seeds. On an empty stomach, take fifteen pills twice a day, washed down with a decoction. Gradually increase the dose to thirty pills.

White Horse Hoof Pills: This prescription treats coldness in the lower burner in women, which causes red or white vaginal discharge and other symptoms.

Take one liang each of white horse hoof, turtle shell, carp scales, tortoise shell, and Sichuan pepper; also take magnetite, licorice, Eucommia bark, Tokoro root, angelica, teasel root, and Ligusticum.

Oryzite, mulberry fungus, and aconite (two liang each).

Grind these fifteen ingredients into a fine powder and mix with honey to make pills the size of Chinese parasol tree seeds. Take ten pills with wine, gradually increasing to thirty pills, three times a day. (Another edition omits tortoise shell.)

White Horse Mane Powder: A formula for treating vaginal discharge. Use white horse mane for white discharge and red horse mane for red discharge, choosing according to the color of the discharge.

White horse mane (two liang), tortoise shell (four liang), soft-shelled turtle shell (eighteen zhu), and oyster shell (one liang and eighteen zhu).

Grind these four ingredients into a fine powder and sift it. On an empty stomach, take one fangcunbi measure of the powder with wine—a level spoonful held by an ancient medicine spoon—three times a day, gradually increasing to one and a half measures.

Formula for Treating Five-Colored Vaginal Discharge

Take soybean and perilla soup three times a day (the formula is given in another volume).

Another formula: Burn the left hoof of a horse to ash and grind it into a fine powder. Take one fangcunbi measure with wine three times a day.

Another formula: Burn a dog’s head, including its fur and bones, to ash and grind it into a fine powder. Take one fangcunbi measure with wine.

Another formula: Boil the strap from a rice steamer and drink a cup of the liquid, which is said to be effective.

Another formula: Dry the hoof sheath from the bottom of a horse’s hoof by burning it, then grind it into a fine powder. Take one fangcunbi measure with wine three times a day.

Mica and Chuanxiong Powder: Used by Duke Wei to treat the five forms of uterine bleeding, as well as wasting, coughing with counterflow of Qi, distress in the chest, shortness of breath, pain in the pit of the stomach, sores on the face, lower back pain that prevents bending forward or backward, swelling of the genital area as if there were sores, itching around the pubic hair with occasional pain, pain that feels connected to the womb, and difficulty urinating. It may also be used for frequent cramping, dizziness, tight and painful neck, heat in the hands and feet, Qi surging upward, restlessness that prevents sleep, cramping abdominal pain, loss of appetite, acid regurgitation and belching, bitter taste in the mouth, and intestinal rumbling. Other symptoms include discharge of red, white, green, yellow, or black fluid, foul-smelling like glue and soiling clothing. The original text attributes these symptoms to internal injury: exposure to cold causes white discharge; internal heat causes red discharge; drinking too much water causes black discharge; overeating causes yellow discharge; and taking too much medicine causes green discharge. Alternating between joy and anger, living in constant fear, or suffering from worry and exhaustion may also bring on the illness. Those affected are especially sensitive to wind and cold. The ingredients in this formula are:

Mica, chuanxiong (Sichuan lovage), hematite, and wood from beside the eastern gate (one liang each, calcined); silkworms stiffened by disease and without silk, cuttlebone, white chalk, and hedgehog skin (six zhu each); soft-shelled turtle shell (another edition gives tortoise shell), cinnamon bark, hearth earth from beneath the cooking stove, and carp head (used fresh; eighteen zhu each).

Grind these twelve ingredients into a fine powder and sift it. Take one fangcunbi measure with wine three times a day, including once at night.

(The original commentary says that one version also adds dragon bone and dried kudzu root.)

Shenhuocao Powder is used to treat flooding and spotting: menstrual blood that gushes out in large quantities or continues to trickle without stopping. The blood may be red, white, blue-green, or black, and may even have a foul, rotting smell. The patient may have a darkened, bloodless complexion and be emaciated to the point of being skin and bone. Menstruation may be irregular and unpredictable. The lower abdomen may feel taut and painful; at times, the pain is severe and extends to the chest and both flanks. The flanks and abdomen may feel distended and full. Food may fail to restore the patient’s flesh, and other possible symptoms include wasting or weakness on one side of the body, shortness of breath and fatigue, pain in the lower back and flanks, inability to stand for long, and persistent weariness with a desire to lie down. (Another version appears later.)

Shenhuocao, white alumina clay, Yu Yuliang, soft-shelled turtle shell, dried ginger, asarum, Chinese angelica, Chuanxiong (also called Sichuan lovage), dendrobium, peony, and oyster shell, two liang each; Coptis, rose root bark, and dried rehmannia, four liang each; processed mugwort and cassia bark, one liang each.

Grind the sixteen ingredients into a fine powder. On an empty stomach, take one square-inch spoonful (an ancient small spoon for measuring powders; the precise amount varies with the utensil) with wine, three times daily for seven days. Then gradually increase the amount to two spoonfuls each time. If cold signs are pronounced, add aconite and Sichuan pepper. If heat signs are pronounced, add anemarrhena and baical skullcap, one liang each. If there is more white-colored bleeding, add dried ginger and white alumina clay. If there is more red-colored bleeding, add cassia bark and hematite, two liang each.

Yu Yuliang Pill is used to treat flooding with persistent red or white bloody discharge in severe cases.

Yu Yuliang, five liang; white horse hoof, ten liang; dragon bone, three liang; deer antler, two liang; cuttlefish bone, one liang.

Grind the five ingredients into a powder and use honey to form pills the size of parasol-tree seeds. Take twenty pills with wine twice daily, continuing until the condition improves.

Modified Yu Yuliang Pill is used to treat flooding and spotting in women after exhaustion and debility. The bleeding recurs like menstruation, comes in large quantities and is difficult to stop, and continues day after day. The Five Viscera are weakened, and the patient’s complexion loses its luster and becomes yellow as she grows thin. The bleeding may stop for a few days and then return; even light activity or exertion can make it worse. During an active episode, first use a decoction; this pill should not be taken at that time. Once the decoction reduces the bleeding, take the pill. For a long-standing condition, this prescription may be taken over an extended period.

Yu Yuliang, dragon bone, ginseng, cassia bark, purple fluorite, aconite, mulberry mistletoe, Eucommia bark, Schisandra, and polygala, two liang each; Alisma, Chinese angelica, dendrobium, cistanche, and dried ginger, three liang each.

The source text breaks off here, before giving the remaining preparation and administration instructions.

Sichuan pepper, oyster shell, and licorice (one liang each).

Grind the eighteen ingredients into powder and mix with honey to make pills about the size of parasol tree seeds. Take ten pills on an empty stomach with wine, gradually increasing to twenty pills, three times a day.

A prescription for treating women’s flooding and hemorrhoids

Pagoda tree fungus, white amur cork tree bark, mugwort leaves, cattail pollen, and angelica dahurica (two liang each); astragalus, ginseng, teasel root, Chinese angelica, limonite, tangerine peel, poria, dried rehmannia, and hedgehog skin (three liang each); ox horn (four liang); twenty pig hind dewclaws; and white horse hooves (four liang, soaked in wine overnight and then simmered).

Grind the seventeen ingredients into powder and mix with honey to make pills. Take twenty pills on an empty stomach with wine twice daily, gradually increasing the dose.

A prescription for treating sudden heavy bleeding in women that will not stop, or discharge resembling the liver of a goose or duck

Chinese thistle root (six liang); Chinese angelica, donkey-hide gelatin, teasel root, fresh bamboo shavings, and chuanxiong (three liang each); fresh rehmannia root (eight liang); earth from beneath a cauldron’s base, wrapped in silk, and great burnet root (four liang each); and one sheng of horse dung—use dung from a chestnut horse if the blood is red, and from a white horse if it is pale.

Cut the ten ingredients into small pieces. Boil them with eight sheng of water and the horse dung juice until three sheng of decoction remain, then divide into three doses. If the bleeding has not stopped, take three or four doses in succession. If it still has not fully stopped, continue with the pill prescription below.

Pills to take afterward

Teasel root, licorice, great burnet root, deer antler, Chinese thistle root, and red sage root (thirty zhu each); dried rehmannia root (two and a half liang); chuanxiong, red halloysite, donkey-hide gelatin, and Chinese angelica (one and a half liang each); tortoise shell and Qin ox horn (three liang each, chopped and simmered until black); and arborvitae seeds (one liang; the Jiyan Fang records arborvitae leaves instead).

Grind the fourteen ingredients into powder and mix with honey to make pills about the size of parasol tree seeds. Take ten pills on an empty stomach with wine twice daily, gradually increasing to thirty pills.

A prescription for treating women’s flooding with red or pale blood

White horse hooves (five liang); cattail pollen, deer antler, limonite, white horse mane, and Chinese thistle root.

White peony root, teasel root (four liang each); ginseng, dried rehmannia root, arborvitae seed, cuttlefish bone, astragalus root, poria, Chinese angelica root (three liang each); mugwort leaf, cistanche, and Fulonggan (the three ingredients each two liang).

Grind the eighteen ingredients into a fine powder and use honey to form pills the size of parasol tree seeds. Take twenty pills with water on an empty stomach, twice a day. The dose may be gradually increased to forty pills each time.

Chinese Angelica Decoction: A formula for uterine bleeding, weakness, and emaciation

Chinese angelica root, Sichuan lovage root, scutellaria root, peony root, and licorice root (two liang each), and two sheng of fresh bamboo shavings.

Cut the six ingredients into pieces. First boil the bamboo shavings in one dou of water until the liquid is reduced to six sheng, then strain out the residue. Add the remaining ingredients and simmer until three and a half sheng remain. Divide into two doses. While taking the medicine, avoid overexertion and anger, and abstain from sexual intercourse for one hundred days.

A formula for uterine bleeding occurring more than ten times by day and night, when no physician can cure it

Eight liang of Sichuan lovage root, cut into pieces. Simmer it in five sheng of wine until three sheng remain, and divide into three doses. Those who cannot drink alcohol may simmer it in water instead.

A formula for profuse uterine bleeding that continues even after a hu of blood has been lost; it may also be taken for excessive menstrual flow or when menstruation does not resume after the period has ended

Chinese magnolia vine and Chinese angelica root (three liang each); Sichuan lovage root, ginseng, peony root, moutan bark, cassia bark, donkey-hide gelatin, fresh ginger, and licorice root (two liang each); pinellia tuber, eight liang; and one sheng of dwarf lilyturf root.

Cut the twelve ingredients into pieces and simmer them in one dou of water until three sheng remain. Divide into three doses.

A formula for sudden uterine bleeding that does not stop

Oyster shell and rabbit bone (two and a half liang each, roasted).

Grind the two ingredients into a fine powder. Take one square-inch spoonful with wine each time, three times a day.

A formula for abnormal white discharge in women

Sichuan lovage root, cassia bark, donkey-hide gelatin, red halloysite, and Japanese thistle root (two liang each); dried rehmannia root, four liang; and seven pieces of Fulonggan (the soil from the center of a stove, each about the size of an egg).

Cut the seven ingredients into pieces. Simmer them in six sheng of wine and four sheng of water until three sheng remain, then strain out the residue. Add the donkey-hide gelatin and simmer until it melts. Divide into three doses and take three times a day. The version recorded in the Supplement to Prescriptions Worth a Thousand Gold contains only six ingredients and omits Fulonggan.

Fulonggan Decoction is used to treat metrorrhagia and metrostaxis—heavy or persistent uterine bleeding—when the blood is red or pale, or resembles bean-milk. Take seven pieces of Fulonggan (the clay from the heart of a stove, each about the size of a marble), five liang of fresh ginger, four sheng of fresh Rehmannia root (another version gives five liang), and two liang each of licorice, mugwort leaf, red halloysite, and cinnamon bark. Cut all seven ingredients into pieces, add one dou of water, and decoct until three sheng remain. Divide into four doses; take three times during the day and once at night.

Powder of the Inner Pith of a Large Ox Horn is used to treat metrorrhagia and metrostaxis caused by accumulated cold, with unceasing bleeding, pain in the lower back and back, heaviness in the limbs, and extreme bodily weakness. Take one ox-horn pith, roasted, and three liang each of teasel root, dried Rehmannia root, mulberry fungus, white atractylodes, red halloysite, alum, dried ginger, aconite, dragon bone, and Chinese angelica; one liang of ginseng; and two liang each of cattail pollen, fangfeng, and limonite. Grind all fifteen ingredients into a fine powder. Before meals, take one square-inch spoonful—the amount of powder held by an ancient square measuring spoon—with warm wine, three times daily. If you feel no effect after taking it, gradually increase the dose.

A formula for metrorrhagia and metrostaxis with bleeding that continues for many days is said to be suitable for emergencies. Take three jin of fatty mutton, three liang each of dried ginger and Chinese angelica, and two sheng of fresh Rehmannia root. Cut all four ingredients into pieces. Add two dou of water and boil the mutton until one dou and three sheng remain. Then add the Rehmannia juice and the other ingredients, and continue decocting until three sheng remain. Divide into four doses. The bleeding should stop after taking it; it is especially suitable for people who are thin and weak.

Fresh Rehmannia Decoction is used to treat metrorrhagia and metrostaxis, including persistent light bleeding, with blood loss reaching several sheng per day. Take one jin of fresh Rehmannia root and three liang of asarum. Cut them into pieces, add one dou of water, and decoct until six sheng remain. Take seven ge per dose. It is best taken over a prolonged period.

A formula for metrorrhagia and metrostaxis, with unceasing red or pale bleeding and depletion of upright Qi, uses three liang each of tortoise shell and oyster shell. Grind them into a fine powder and take one square-inch spoonful with wine, three times daily.

Another formula: burn tangled hair to ash, mix one square-inch spoonful with wine, and take it three times daily.

Another formula: take two and a half liang of mulberry fungus and eighteen zhu of deer antler. Soak them in five sheng of vinegar, then remove and roast until dry. Repeat the soaking and drying until all the vinegar is used. Grind into a fine powder and take one square-inch spoonful per dose, three times daily.

Another formula: burn deer antler to ash and grind it into powder. Take one square-inch spoonful with wine, three times daily.

Another remedy: Burn peach stones to ash and grind them into powder. Take one fangcun bi (a square-spoon measure used for medicines in ancient times, roughly a small spoonful) with wine, three times a day.

Another remedy:

Take about a finger-thick, one-foot-long piece each of garden burnet root and anemarrhena root, then chop them. Boil them in three sheng of vinegar on a stove facing east. When the liquid has reduced to a thick extract, strain out the herbs and take it.

Another remedy: Burn the droppings of a lizard found in a mulberry tree to ash. Take one fangcun bi with wine.

Remedy for flooding uterine bleeding, emaciation, and shortness of breath: regulate the middle Qi, replenish deficiency, and stop bleeding

Five-spice herb, Sichuan pepper (two liang and six zhu), ligusticum root, arborvitae seeds, cornus fruit, and magnolia bark (eighteen zhu each); dried rehmannia root and oyster shell (one and a half liang each); hematite, cassia bark, saposhnikovia root, asarum, and dried ginger (one liang each); licorice, Chinese angelica root, and ligusticum rhizome (one liang and eighteen zhu each); and elm seeds (half a liang).

Grind these seventeen ingredients coarsely and sift them. On an empty stomach, take one fangcun bi with warm wine, three times a day. The text describes this as a highly effective remedy. Another version adds eighteen zhu each of angelica dahurica root and dragon bone, and one liang and eighteen zhu of ginseng, for a total of twenty ingredients.

Remedy for flooding uterine bleeding:

Three jin of cogongrass rhizome and five jin of little thistle root. Chop the two ingredients, add five dou of water, and boil down to four dou of liquid. Take it in small portions over time. The Waitai Miyao records that this remedy is prepared by boiling the ingredients in wine.

Salvia Wine: for blood loss from flooding uterine bleeding and lingering postpartum disorders

Five jin each of danshen, mugwort leaf, rehmannia root, Japanese honeysuckle, and garden burnet root. Chop the five ingredients. First wash the medicinal mortar, then pound the herbs until finely mashed. Soak them in water for three nights, strain out the herbs, and boil the liquid. Steam one hu of broomcorn millet into rice, then ferment it with the herbal liquid to make wine. When fermentation is complete, press out the wine. Take four he at first, then gradually increase the amount.

Moutan Bark Decoction: for flooding uterine bleeding and heavy blood loss. Three doses taken consecutively are said to cure it

Three liang each of moutan bark, dried rehmannia root, and “hu mai”; two liang each of yu yuliang, mugwort leaf, dragon bone, arborvitae leaf, magnolia bark, angelica dahurica root, fulonggan, fresh bamboo shavings, ligusticum rhizome, and garden burnet root; one liang of donkey-hide gelatin; and four liang of peony root.

Chop the fifteen ingredients, add one dou and five sheng of water, and boil down to five sheng of liquid. The source ends here and does not record how the decoction should subsequently be taken.

Divide the medicine into five portions and take one portion at a time, leaving roughly enough time between doses to travel ten li by road.

Simple Remedies for Sudden Heavy Uterine Bleeding

For sudden, heavy vaginal bleeding in women: burn a cow’s horn to ash, grind it into powder, and swallow it with wine. Take one square-inch spoonful each time, three times a day. This also treats abnormal vaginal discharge.

Another remedy: burn mulberry fungus until black, grind it into powder, and swallow it with wine. Take one square-inch spoonful each time, twice a day. This also treats abnormal vaginal discharge.

Another remedy: take one and a half jin of fresh thistle root, crush it and extract the juice, then warm and drink it. It may also be boiled in wine and taken.

Another remedy: take one sheep’s [uncertain medicinal substance], boil it in vinegar until cooked, remove the blood, and eat it; the bleeding should stop. Avoid pork, fish, vinegar, and greasy or slippery foods. Breaking these dietary prohibitions may be fatal. This also treats abnormal vaginal discharge.

Remedy for White Uterine Bleeding

Apply one hundred moxibustion cones to the transverse crease of the lower abdomen, directly below the navel. Then apply one hundred cones on each side, three cun above the inner ankle. A “cone” is a unit of moxibustion, usually referring to one ignited moxa cone.

Discussion

When treating persistent bleeding, if it follows a recent miscarriage or childbirth and retained blood has not been expelled, the blood may congeal and harden, preventing the uterine opening from closing and causing prolonged spotting. If this continues for more than a month, do not immediately use various hemostatic decoctions. Instead, temporarily take a medicine such as Mudan Pills or Mudan Powder, and stop once the congealed blood has dispersed. After it disperses, the spotting will cease on its own and the amount of bleeding will gradually diminish.

If damage remains afterward and the condition does not return to normal, only then should specific treatments be used.

If a woman loses too much blood during childbirth or miscarriage, or from sudden heavy uterine bleeding, a knife wound, or tooth extraction, and the bleeding will not stop, she may feel hollow inside, have chest tightness, dizziness, a heavy head, dim vision, or deafness; raising her head may bring on chest tightness and a feeling that she is about to faint. In such cases, first boil three liang each of Danggui and Chuanxiong in four sheng of water until only two sheng remain. Strain out the herbs and drink the liquid in two doses; the symptoms should then settle. Afterward, continue treatment with other decoctions as appropriate.

Baie Pills

Baie Pills, made with white chalk and other ingredients, treat the “thirty-six disorders” of women, diseases of the womb, and persistent bleeding. Another version of the prescription appears earlier in the text.

Take half a liang each of Handan white chalk, Yuyuliang, Baizhi, white talc, dried ginger, dragon bone, Guixin, Qumai, rhubarb, Shiwei, Baijian, Xixin, Shaoyao, licorice, Huanglian, Fuzi, Danggui, Fuling, Zhongru, Sichuan pepper, and Huangqin; take eighteen zhu each of oyster shell and cuttlebone.

Grind the twenty-three ingredients into powder and form pills with honey, each the size of a parasol tree seed. Take on an empty stomach with wine.

Take five pills twice daily. If there is no effect, increase the dose to ten pills.

A formula for treating women’s persistent uterine bleeding—bleeding that waxes and wanes but continues over a long period, causing the body to waste away and appetite to diminish. The blood may be red, white, or yellow. The original text says this condition can make a woman unable to conceive.

Oyster shell, Fulong Gan (hearth earth), red stone resin, white dragon bone (a white, dragon-bone-like medicinal substance), cinnamon heartwood, cuttlebone, and Yu Yu Liang (a mineral medicinal substance), in equal proportions.

Grind the ingredients into a fine powder. On an empty stomach, take one square-inch spoonful—the measure of an ancient medicinal spoon—with wine. The original phrase “three white times a day” appears to contain an error or omission, and its meaning is unclear.

For copious white discharge, add oyster shell, dragon bone, and cuttlebone. For bright-red bleeding, add red stone resin and Yu Yu Liang. For yellowish bleeding, add Fulong Gan and cinnamon heartwood. Add the ingredients according to the symptoms. Zhang Wenzhong’s formula is the same and can also treat sudden, profuse uterine bleeding. The Zhouhou Fang omits white dragon bone and says to take the powder with rice-gruel liquid.

A powder for treating women’s persistent uterine bleeding:

Deer antler velvet and donkey-hide gelatin, three liang each; cuttlebone and Chinese angelica, two liang each; cattail pollen, one liang.

Grind the five ingredients into a fine powder. On an empty stomach, take one square-inch spoonful with wine three times a day, and once more at night.

A formula for treating persistent bleeding after childbirth, as well as bleeding from hemorrhoids:

Alum, one liang; aconite, one tuber.

Grind the two ingredients into powder and make pills with honey, each the size of a Chinese parasol tree seed. On an empty stomach, take two pills with wine three times a day, then gradually increase the dose to five pills. The original text says the condition may be cured after several days, and that taking the medicine for one hundred days will “stop it permanently.”

Chuanxiong Decoction: a formula for treating vaginal discharge and persistent bleeding.

Chuanxiong, prepared Rehmannia root, astragalus, peony, Evodia, and licorice, two liang each; Chinese angelica and dried ginger, three liang each.

Cut the eight ingredients into pieces. Boil them in one dou of water until three sheng of liquid remain, then divide into three doses.

If red or white discharge continues after menstruation ends, remove Rehmannia root and Evodia, and add two liang each of Eucommia bark and ginseng.

A formula for treating persistent uterine bleeding:

Take leeches, grind them into a fine powder, and swallow about one qian with wine twice a day. The original text says recovery follows once the stagnant blood has dispersed.

A “divine formula” for treating persistent uterine bleeding:

Burn Sophora seeds to ash and grind them into powder. Take one square-inch spoonful with wine three times a day. The original text says this brings a rapid cure.

A formula for treating persistent uterine bleeding with the passage of black clots:

Dry lacquer, ephedra, asarum, and cinnamon heartwood, one liang each; licorice, half a liang.

The original text ends here, incomplete.

Grind the five medicines on the right into a fine powder. Each time, pinch up a little with your fingers and take it in rice water.

Formula for treating persistent uterine bleeding with red menstrual blood

White atractylodes (two liang), white silkwormwood (half a liang), and phellodendron bark (two and a half liang).

Grind the three medicines into a fine powder. Take on an empty stomach with wine, one square-inch spoonful each time, three times a day.

Formula for treating persistent uterine bleeding with yellow menstrual blood

Coptis, rhubarb, and cassia bark (half a liang each); scutellaria, ground beetle, and dried rehmannia (six zhu each).

Grind the six medicines into a fine powder. Take on an empty stomach with wine, one square-inch spoonful each time, three times a day.

Formula for treating persistent uterine bleeding with green menstrual blood

Rhubarb, scutellaria, and white silkwormwood (half a liang each); cassia bark and oyster shell (six zhu each).

Grind the five medicines into a fine powder. Take on an empty stomach with wine, one square-inch spoonful each time, three times a day.

Formula for treating persistent uterine bleeding with white menstrual blood

Deer antler (one liang), white ampelopsis root (eighteen zhu), and Japanese climbing fern root (half a liang).

Grind the three medicines into a fine powder. Take on an empty stomach with rice water, one square-inch spoonful each time, three times a day.

Formula for treating severe, persistent uterine bleeding in women that has continued for many years

Burn a magpie’s double nest to ash, grind it into powder, and take it. The dose is one square-inch spoonful each time, three times a day. After thirty days, the condition will be cured; the effect is excellent. A “double nest” means that the magpie raised young in its nest last year, then built another nest on top of the old one and raised young there this year.

Ma Tong Decoction: formula for treating persistent uterine bleeding that has continued for several months

One sheng of juice from a red horse’s droppings (squeeze the juice from fresh droppings; if using dried droppings, first soak them in water, then squeeze out the juice); fresh mugwort leaves and donkey-hide gelatin (three liang each); Chinese angelica and dried ginger (two liang each); good-quality ink (half a round piece).

Cut up the six ingredients. Add eight sheng of water and two sheng of wine, and boil until three sheng of liquid remain. Strain out the dregs, then add the horse-dropping juice and donkey-hide gelatin. Simmer over low heat until two sheng remain. Divide into two doses, leaving between them the time it takes to walk ten li.

White Horse Hoof Shavings Decoction: formula for treating persistent white discharge

White horse hoof and red halloysite (five liang each); Dayu-yuliang mineral, cuttlefish bone, dragon bone, and oyster shell (four liang each); aconite, dried rehmannia, and Chinese angelica (three liang each); licorice (two liang); white silkworm (one liang).

The original text ends here; the preparation and dosage instructions that follow are not preserved.

Coarsely chop the following eleven ingredients. Add two dou of water and decoct until reduced to nine sheng. Divide into six doses and take three times daily.

Horseshoe Pill: For Persistent Vaginal Discharge

Four liang each of white horse hoof and Limonite; three liang of dragon bone; two liang each of cuttlebone, white silkworm, and Red Halloysite.

Grind these six ingredients into a fine powder and use honey to form pills the size of Chinese parasol tree seeds. Take ten pills with wine. If they have no effect, gradually increase the dose to thirty pills.

Sedum Powder: For Persistent Uterine Bleeding

Another formula appears earlier.

Ten liang of sedum, stir-fried until yellow; four liang each of Chinese angelica, deer antler, and donkey-hide gelatin; half a liang of dragon bone.

Grind these five ingredients into a fine powder and sift it. Before meals, take one square-inch spoonful with wine, three times daily for seven days.

Cattail Pollen Powder: For Persistent Uterine Bleeding

Half a sheng of cattail pollen; two liang each of deer antler and Chinese angelica.

Grind these three ingredients into a fine powder and sift it. Take five fen with wine, three times daily for seven days. If it has no effect, gradually increase the dose to one square-inch spoonful.

Moxibustion Methods

For women with persistent, uncontrollable bleeding from the womb: apply moxibustion three cun to either side of Guanyuan.

For women with pain in the vagina that draws up to the area below the heart, accompanied by cramping in the lower abdomen and coldness in the abdomen: apply one hundred cones of moxibustion at Guanyi. This point lies in a hollow one cun above the outer side of the knee.

For women with persistent red or white vaginal discharge, or bleeding: apply fifty cones of moxibustion at Sanyinjiao on the Foot Taiyin meridian. This point lies three cun above the inner ankle.

For women with persistent red or white vaginal discharge and irregular menstruation: apply thirty cones of moxibustion at Jiaoyi. This point lies five cun above the inner ankle.

For women with persistent red or white vaginal discharge: apply thirty cones of moxibustion at each of the four Yingchi points. These points lie in the hollows on either side of the inner ankle, front and back, where the pulse can be felt. They are also called the Yin-Yang points.

For women with persistent red or white vaginal discharge and aching, weakness, and lack of strength in the limbs: apply thirty cones of moxibustion at Louyin. This point lies five fen below the inner ankle, where a faint pulse can be felt in the foot.

For women with persistent red or white vaginal discharge and profuse, pouring diarrhea: apply moxibustion at the Yin-Yang point, using a number of cones equal to the person’s age, and repeat the treatment three times. This point lies at the border of the white flesh where the inner and outer sides beneath the big toe meet when the toe is flexed.

Irregular Menstruation, Fourth: Formulas and Moxibustion

White Chalk Pill: For women whose menstruation comes twice in one month or fails to come for a month.

Sometimes menstrual bleeding is heavy or scanty and continues as spotting. At times, attacks bring pain in the lower back and abdomen, shortness of breath, inability to eat, and pain in the chest and abdomen. The menstrual blood may be bluish, yellow, or black, or as thin as water. The whole body feels heavy.

Formula: One and a half liang each of white chalk, white talc, oyster shell, limonite, dragon bone, asarum, and cuttlebone; one liang each of Chinese angelica, peony root, coptis, poria, dried ginger, cinnamon bark, ginseng, dianthus, pyrrosia, angelica dahurica, ampelopsis root, aconite, and licorice; half a liang of Sichuan pepper.

Grind the twenty-one ingredients into a fine powder and mix with honey to form pills the size of parasol tree seeds. Take twenty pills on an empty stomach with wine, three times a day. During menstruation, it is best to take them continuously for four or five days.

Peach Kernel Decoction: Used after childbirth or miscarriage for irregular menstruation and persistent spotting, or when bleeding stops for a while and then resumes, with blood flowing as thinly as water. The limbs feel weak, breathing is short, and eating is impossible; the abdomen is distended, hard, and painful, making movement difficult. Menstruation may come early or late, or may not come for several months. The whole body feels heavy, there is a strong desire to lie down and sleep, and one often craves sour foods.

Fifty peach kernels; two liang each of eupatorium, licorice, chuanxiong, and ginseng; three liang each of achyranthes, cinnamon bark, moutan bark, and Chinese angelica; four liang each of peony root, fresh ginger, and pinellia; eight liang of rehmannia; and seven ge of cattail pollen.

Cut the fourteen ingredients into pieces and decoct them in two dou of water. Reduce the liquid to six sheng, then divide it into six doses.

Apricot Kernel Decoction: Used for irregular menstruation, such as bleeding twice in one month or only once every two or three months; the period may come early or late, or may even be obstructed and fail to flow.

Two liang of apricot kernels, one liang of peach kernels, three liang of rhubarb, and thirty leeches and thirty gadflies.

Cut the five ingredients into pieces and decoct them in six sheng of water. Reduce the liquid to two sheng and divide it into three doses. After taking the medicine, some matter should be discharged in the urine and stool. If a large amount is discharged, stop taking it; if only a little is discharged, finish all three doses.

Rhubarb and Mirabilite Decoction: Used when menstrual flow has been obstructed for many years. This is attributed to wind-cold in the womb and its associated organs, and should be treated by purgation.

Five liang each of rhubarb and Achyranthes root; mirabilite; three liang each of peony bark, licorice, and aster root (another version reads “Crape Myrtle”); one liang of ochre; two liang each of peach kernels, gadfly, leeches, dried ginger, asarum, and sodium sulfate; and five ge of hemp seed.

Chop the fourteen ingredients. Boil them in one dou and five sheng of water until reduced to five sheng, then strain out the dregs. Add the mineral salts and wait for them to dissolve. Divide the decoction into five doses. Begin taking it at the fifth watch, just before dawn, with about the time of one meal between doses. After taking it, the bowels will discharge; afterward, rest and avoid exposure to wind.

Evodia and Gadfly Decoction

Used for menstrual obstruction caused by prolonged cold, or for menstrual flow that varies between heavy and scant.

Three sheng of Evodia fruit; one liang each of gadflies, leeches, ground beetles, and peony bark; one jin of fresh ginger; one sheng each of wheat and pinellia; twenty jujubes; fifty peach kernels; three liang each of ginseng and Achyranthes root; six liang of cassia bark; one and a half liang of licorice; and two liang of peony root.

Chop the fifteen ingredients. Boil them in one dou of wine and two dou of water until reduced to one dou, then strain out the dregs. When the liquid has cooled to a suitable temperature, take one sheng three times a day. Those who cannot drink alcohol may use water instead of wine. Add the various insect ingredients only when the decoction is nearly ready. Those who cannot tolerate its strength should take seven ge per dose.

Di-Hu Decoction

Used for menstrual obstruction with abdominal distension that sometimes eases on its own, and also for men with bladder distension and acute discomfort. Two liang each of tiger-palm (the Qianjin Yifang reads “Japanese knotweed”) and rhubarb; thirty peach kernels; and twenty leeches.

Boil the four ingredients in three sheng of water until reduced to one sheng. Drink the entire decoction at once, continuing until the stagnant blood is discharged.

Seven-Roasted Pills

Used for menstrual obstruction accompanied by burning discomfort in the hands and feet, abdominal distension, a listless state with reluctance to wake, and inner agitation.

One and a half liang of rhubarb; five liang each of bupleurum root (another version reads “Chaihu”) and sodium sulfate, roasted beforehand; six zhu each of draba and Sichuan pepper, also roasted beforehand; eighteen zhu each of fresh ginger and chuanxiong; fifteen zhu of poria; and nine zhu of apricot kernels, roasted beforehand.

Peach kernels (20, dry-fried); leeches (half a ge, dry-fried); gadflies (dry-fried).

Grind all twelve ingredients into a fine powder and form pills with honey, each the size of a parasol tree seed. Take seven pills with water on an empty stomach, three times a day. If there is no response, double the dose. The Qianjin Yifang omits Ligusticum rhizome; another version adds two liang each of ground beetle and moutan bark, making fourteen ingredients in all.

Peach Kernel Powder: For pain that circles the navel when menstruation begins and rises into the chest and heart area, accompanied by alternating chills and fever like an attack of malaria.

Peach kernels (50); ground beetles (20); cinnamon bark (5 cun); poria (1 liang); coix seed, Achyranthes root, and hematite (2 liang each).

Grind the eight ingredients into a fine powder and sift. Fast from the previous evening. Take one qian with warm wine; the original text says “seven days, three times,” which may mean three times daily for seven consecutive days.

A formula for abdominal swelling and pain in the waist and abdomen when menstruation comes and goes.

Ground beetles (4); Sichuan pepper and dried ginger (6 zhu each); rhubarb, Lady Green, cinnamon bark, and Ligusticum rhizome (half a liang each).

Grind the seven ingredients into a fine powder and sift. Take one dao gui—a small unit of measure in antiquity—with wine before meals, three times a day. Continue for thirty days. If mild diarrhea occurs, take care to recuperate.

A formula for irregular menstruation, when the period sometimes comes at the start of the month and sometimes later, or the menstrual blood resembles bean juice; for pain in the lower back as if it were about to break, pain in both legs, and wind-cold in the Baozhong (uterus).

Rhubarb and mirabilite (4 liang each); moutan bark (3 liang); peach kernels (1 sheng); ginseng, yangqi stone, poria, licorice, leeches, and gadflies (2 liang each).

Cut the ten ingredients into pieces and decoct them in nine sheng of water until three sheng of liquid remain. Strain out the dregs, then add the mirabilite and stir until it dissolves completely. Divide into three doses, taking each about the time it takes to eat a meal apart.

Yangqi Stone Decoction: A formula for irregular menstruation, when periods sometimes come early and sometimes late, the flow varies between heavy and light, and the color shifts between red and white.

Yangqi stone, licorice, teasel root, dried ginger, ginseng, and cinnamon bark (2 liang each); aconite (1 liang); red stone resin (3 liang); dragon’s hearth earth (5 liang); fresh rehmannia root (1 sheng).

The original text does not include instructions for preparation or dosage.

Add one dou of water to the ten medicinal ingredients listed above. Boil until reduced to three sheng, then divide into four doses. Take three doses during the day and one at night.

A prescription for women whose worry and anger cause fullness and distention below the heart, pent-up heat between the chest and diaphragm, and irregular menstruation: It may be used for symptoms such as Blood and Qi surging up into the heart and chest, nausea, inability to eat much, fatigue and weakness, and difficulty moving.

Rhubarb, peony, and gadfly (two liang each); root of Chinese cucumber, Sichuan pepper, Scutellaria, white atractylodes, dried ginger, and root bark of Chinese wolfberry (called “tan pi” in some versions; one liang each); cinnamon heartwood and dried lacquer (one and a half liang each).

Grind the twelve ingredients into a fine powder and use honey to form pills the size of parasol tree seeds. Take ten pills three times a day. If you feel no effect after taking them, gradually increase the dose.

Achyranthes Pill: For postpartum menstruation that comes and goes, with the flow suddenly increasing or decreasing, or stopping altogether, accompanied by frequent pain, cramping in the lower abdomen, pain extending to the lower back, and a heavy feeling in the body.

Achyranthes, peony, ginseng, and rhubarb (three liang each); moutan bark, licorice, Chinese angelica, and chuanxiong (two liang each); cinnamon heartwood (one liang); ground beetles, scarab larvae, and cockroaches (forty each); gadflies and leeches (seventy each).

Grind the fourteen ingredients into a fine powder and use honey to form pills the size of parasol tree seeds. Take five pills with wine three times a day. If you feel no effect after taking them, increase the dose slightly.

Other treatments include taking powdered deer antler; taking three sheng of fresh Rehmannia juice, boiled down to two sheng; drinking three he of human milk; burning menstrual cloth to ash and swallowing it with well water; burning white dog feces until charred, grinding them to powder, and taking one square-inch spoonful with wine three times a day; or taking one sheng of white horse urine.

A prescription for continuous menstruation:

Take one jin of Chuanru, wash it, and boil it in four and a half sheng of river water. Strain off two sheng of liquid and take it in two doses.

Other treatments include taking Rehmannia wine or soybean wine; burning the tongue-shaped part of a winnowing basket to ash and taking it with wine; or applying moxibustion below the inner ankle, where a blue vein is visible at the boundary between the white flesh and the skin. The number of moxa applications is determined by the person’s age.

The names of the medicines and the dosage units “liang,” “sheng,” “he,” “pieces,” and “square-inch spoonful,” among others, follow the source text. “Moxa application” is the unit used to count each application of moxibustion.