01 Shape of the Uterus 胞形象 포의 형상
➀ The uterus is the ‘red palace (赤宮)’ and is also known as the cinnabar field or life gate. Men keep, spread, and transform essence here, and the uterus enables women to become pregnant. This is the foundation for human birth and growth. It does not pertain to the five phases, Water, or Fire. It is another name for the universe and takes after the Soil of Gon trigram (坤土) giving birth to all creation.
➁ In the Inner Classic (內經) it says, “The uterus holds yin and takes after the earth, so it is one of the extraordinary organs.” An Annotation states that it is very different from the ordinary six bowels. ➂ The uterus (胞) in this chapter is different from the bladder (胞) that holds the urine inside the urinary bladder.
02 Area of the Uterus 胞部位 포의 부위
➀ The place where the female contains the fetus is called the uterus and is also known as the uterine gate.
➁ The uterus is also called the cinnabar field or CV4. It is located 3 chon below the navel and occupies an area of 4 chon around it. It is attached to the spine and is the red place between the two kidneys. The left area is blue, right area white, upper area yellow, and the lower area is black. The 3 chon take after the three shades, the 4 chon take after the four seasons, and the five colors take after the five phases. The place between the two kidneys is called the Great Sea and it holds the qi and blood. It is also known as the great central pole, named for being the center of the whole body.
➂ The po (胞) is the uterus. If the uterus is cold, one cannot bear child.
03 The Uterus Is the Home of Blood 胞爲血室 포는 혈실이다
➀ Both the thoroughfare vessel and conception vessel start at the uterus and ascend to the abdomen, forming the sea of meridians.
➁ The Inner Classic said, “When women reach the age of 14, the conception vessel is opened up, and the thoroughfare vessel flourishes. This leads to menstruation which allows women to bear children.” The Annotation states, “Gye (癸) indicates Im (壬) and Gye (癸), which are the ten celestial stems representing Northern Water.” The conception and thoroughfare vessels are both extra meridians. When they flow freely, the meridian blood fills up and descends in time. The name heavenly tenth [This is the heavenly stem in charge of reproduction] comes from working together with the qi of heavenly essence. The thoroughfare vessel is the sea of blood and the conception vessel supervises the uterus and children can be born only when they work together. The name ‘monthly happening’,, meaning menstruation, comes from the fact that harmonious qi is gathered once every 30 days. An irregular menstrual cycle indicates the presence of disease.
➂ The home of blood, which is a place where the blood stays, nutrient and defense stops, and meridian flows come together, is another name for the thoroughfare vessel.
➃ The thoroughfare vessel, the sea of blood, is the place where all the meridian flows come together. Men have this vessel running whereas women keep it steady. As the men run this, it does not accumulate and thus does not become full. As for the women, it accumulates and becomes full as the women keep it steady. Once it is filled, it overflows in time. This is called monthly water, or menstruation, which is named after the fact that the moon wanes once it becomes full.
04 Diagnosis by Pulse Taking 脈法 맥법
➀ A faint pulse signifies the deficiency of both qi and blood. If the patient is young, it means blood collapse, and a breast feeding woman with diarrhea can also display a faint pulse. If this is not the case, it signifies trimonthly menstruation in which menstruation happens once every 3 months.
➁ In cases where the lesser eum pulse is slow or faint, the faint pulse signifies the absence of essence, and the slow pulse signifies the presence of coldness inside the eum part. A rough pulse signifies the state of trimonthly menstruation where the blood isn’t discharged properly and the menstruation happens once every 3 months.
➂ When a woman suffers from daily vaginal bleeding of several doe of red and whitish blood, a sudden and racing pulse means that the patient will die and a slow pulse means that the patient will live.
➃ When a woman suffers from continuous vaginal bleeding of red and whitish blood, a small, vacuous, slippery pulse means that the patient will live and a large, tight, replete, and rapid pulse means that the patient will die.
➄ If the inch pulse and bar pulse are regular but the pulse is severed and does not reach the cubit pulse, it means that menstruation isn’t smooth.
➅ If the cubit pulse is severed midway, it means that menstruation isn’t smooth.
➆ A sunken liver pulse means that menstruation isn’t smooth.
➇ A slippery cubit pulse represents prosperous blood qi, which for women mean an unsmooth menstruation.
➈ When the pulse beats in the form of a geomungo (traditional Korean string instrument) string and there is pain in the lower abdomen, it means that the menstruation isn’t smooth and that there is a sore in the genital area.
➉ The pulse of leukorrhea should be slow and slippery, so a floating and vacuous pulse indicates bad prognosis.
05 Variations in the Menstrual Cycle 經行有異 월경이 나오는 시기의 차이
The heavenly tenth arrives when a woman reaches the age of 14 and stops at the age of 49. If the menarche is early, sexual function is well-developed, and a late menarche means underdeveloped sexual function. The menstruation signifies the unification of eum and yang and makes it possible for women to bear children. The most appropriate age for menarche is 14. If a woman does not start her menstruation even after the age of 20, her life is like a candle light in front of wind and she will die of illness. Even if it does not lead to death, the chances are less than one case in a hundred, and even in that one case, the life will be filled with illnesses. It is okay to menstruate once every three months. However, it is extremely bad to have one menstruation per year, and if a woman does not have regular menstruation during her lifetime, she will develop a wicked disease in her later years that is difficult to heal.
06 The Color and Form of Menstrual Blood 月候形色 월경의 형색
➀ Menstruation is eum-blood. Eum always follows yang which is why the blood is the color of Fire. As blood is qi’s partner, when qi has heat so does the blood, and when the qi has cold so does the blood. When the qi goes up, so does the blood and when the qi goes down, the blood goes down too. If the qi lumps, so does the blood and if the qi is blocked then so is the blood. Clear qi means clear blood and turbid qi means turbid blood. The presence of blood clots from time to time means that the qi is stagnant. Premenstrual pain signifies the blockage of qi and postmenstrual pain means that both qi and blood are deficient. A clear color also means deficiency and this is because there is water in the mixture. Irregular menstrual cycles are due to the chaotic state of qi. Wine-colored menstrual blood means heat in the qi and a dark color means severe heat. People these days only look at the wine color, dark color, pain and lumps and jump to the conclusion the cause is wind-coldness and correspondingly use medicinal herbs with a warm property. This will definitely result in disaster.
➁ Because the heart is in charge of the blood, red is the best color for blood. Even if the menstrual cycle isn’t regular, a nice color means that the problem will be easily cured.
07 Treatment Methods to Improve the Color of Menstrual Blood 和血治法 월경의 색을 좋게 하는 치료법
➀ Wine-colored menstrual blood means a wind syndrome. Four Substances Decoction [see the chapter on Blood for the prescription] with Saposhnikoviae Radix (防風), Angelicae Dahuricae Radix (白芷), and Schizonepetae Spica (荊芥) can be used.
➁ A black color means severe heat. The presence of lumps in addition to a blackish-red color means heat in the blood. A Four Substances Decoction with Scutellariae Radix (黃芩), Coptidis Rhizoma (黃連), and Cyperi Rhizoma (香附子) can be used.
➂ A pale and whitish color means deficiency. Chuanxiong and Angelica Decoction [see the chapter on Gynecology for the prescription] with Ginseng Radix (人參), Astragali Radix (黃芪), Paeoniae Radix Alba (白芍藥), and Cyperi Rhizoma (香附子) can be used.
➃ A pale color means that there is water in the mixture, and a Syzygii Flos Relieve Stomach Decoction [see the chapter on Phlegm for the prescription] with Cnidii Rhizoma (川芎) and Angelica Gigantis Radix (當歸) can be used. Some said that a pale color means the deficiency of both qi and blood and that an Eight Substances Decoction [see the chapter on Deficiency Vexation for the prescription] can be used.
➄ Menstrual blood in the color of lye, water dripping from the roof, bean juice, or yellowish color all mean dampness-phlegm. A Syzygii Flos Relieve Stomach Decoction with Gentianae Macrophyllae Radix (秦芃), Saposhnikoviae Radix (防風), and Atractylodis Rhizoma (蒼朮) can be used. When it is the color of black bean juice, a Four Substances Decoction with Scutellariae Radix (黃芩) and Coptidis Rhizoma (黃連) can also be used.
➅ The presence of lumps with no changes in color means qi stagnation. A Four Substances Decoction with Cyperi Rhizoma (香附子), Corydalis Tuber (玄胡索), Aruantii Fructus Immaturus (枳殼), and Citrus Unshius Pericarpium (陳皮) can be used.
➆ A Cyperus and Angelica Ancient Scholars Pill [See the chapter on Gynecology for the prescription] and an Amber Regulate Channels Pill are widely used to improve the color of menstrual blood.
-Amber Regulate Channels Pill 琥珀調經丸 호박조경환: It regulates the menstrual cycle and treats infertility from a cold uterus. Cyperi Rhizoma (香附子) 1 geun (divide into 2 bags and soak in children’s urine and rice vinegar for 9 days and after refining, evenly mix with 4 nyang of old mugwort. Prepare by putting the mixture into a porcelain china bowl along with 5 bowls of vinegar and boiling down until it’s dry), 2 nyang each of Cnidii Rhizoma (川芎), Angelica Gigantis Radix (當歸), Paeoniae Radix Alba (白芍藥), Rehmanniae Radix Preparata (熟地黃), ehmanniae Radix (生乾地黃), and Myrrha (沒藥), 1 nyang of Succinum (琥珀). Grind up these herbs and knead with vinegar added paste. Form pills as big as the seed of a royal foxglove tree and take 100 pills with a Zingiberis Rhizoma Crudus (生薑) and mugwort decoction on an empty stomach.
08 Uneven Menstruation 月候不調 월경이 고르지 못한 것
➀ What is the reason behind a woman’s menstruation being reduced from what it used to be? The master says, “The amount of menstruation has been reduced because the fluid and humor have been depleted from diarrhea, too much urination or sweating.” If the amount has increased, this is due to some arduous and heavy work and the master would have probably said, ‘There would be symptoms of constipation and lack of sweating’.
➁ Irregular menstruation means a change in the menstrual cycle or amount of menstrual blood. Postmenstrual pain is due to deficiency. A small amount and pale color mean a blood eficiency and large amount means a qi deficiency. Pain and the presence of lumps before menstruation indicate obstructed qi flow. A dark red color signifies the presence of heat and qi obstruction.
➂ When the menstruation state is irregular, it can either be accompanied by pain or by a fever. Irregular menstruation cycles can be categorized into lengthened cycles or shortened cycles. A short cycle is due to heat and long cycle is due to qi deficiency. Pain can appear either constantly or just before and after the menstruation. Constant and premenstrual pain is due to the accumulation of blood and postmenstrual pain is due to a blood deficiency. A fever can either appear constantly or during menstruation. A constant fever is due to accumulation in the midst of a blood deficiency and a fever during menstruation is due to heat in the midst of a blood deficiency.
09 Treatments to Regulate the Menstrual Cycle 調血治法 월경을 고르게 하는 치료법
➀ A lengthened or shortened menstrual cycle, increased or decreased amounts of menstrual blood, and no menstruation even after a month or twice in a month are all due to disharmony. Regulate Menses Powder has to be used. Some said that one should primarily use a Four Substances Decoction in cases of irregular menstruation.
➁ Abdominal pain at the beginning of menstruation is because the blood is too thick to flow freely, and a Clear the Heat and Regulate the Blood Decoction should be used. A Four Substances Decoction with Corydalis Tuber (玄胡索), Meliae Radix (苦練根), Curcumae Rhizoma (蓬朮), Cyperi Rhizoma (香附子), Persicae Semen (桃仁), Carthami Flos (紅花), and Coptidis Rhizoma can also be used.
➂ Abdominal pain after menstruation is due to both deficiency and heat and variations of an Eight Substances Decoction [see the chapter on Deficiency Vexation for the prescription] can be used.
➃ A shorter menstrual cycle means heat in both the qi and blood for which a Four Substances Clear Channels Decoction can be used. A Four Substances Decoction with Bupleuri Radix (柴胡), Scutellariae Radix (黃芩), and Coptidis Rhizoma (黃連) can also be used.
➄ No menstruation even past its due date means a blood deficiency. A Four Substances Unblock Channels Decoction or Four Substances Decoction with Astragali Radix (黃芪), Citrus Unshius Pericarpium (陳皮), Cimicifugae Rhizoma (升麻), and Ginseng Radix (人參) can be used.
➅ When the state of menstruation is generally irregular, a Boiled Aconite Pill, Ink and Cyperus Pill, Four Processed Cyperus Pill, or Seven Refined Ingredients Cyperus Pill can be used widely.
- Regulate Menses Powder 調經散 조경산: ➀ It is also known by the name of a Warm the Menstruation Decoction (溫經湯). It treats irregular menstruation. 2 geun of Liriopis Tuber (麥門冬), 1.5 don of Angelica Gigantis Radix (當歸), 1 don each of Ginseng Radix (人參), Pinelliae Tube (半夏) (processed), Paeoniae Radix Alba (白芍藥), Cnidii Rhizoma (川芎), and Moutan Cortex (牧丹皮), 7.5 pun each of Asini Corii Colla (阿膠珠) and Glycyrrhizae Radix (甘草) (roasted), 5 pun each of Evodiae Fructus (吳茱萸) and Cinnamomi Cortex Spissus (肉桂). Grind up these herbs and decoct them in water with 3 pieces of Zingiberis Rhizoma (生薑) as 1 package. ➁ The Regulate the Menstruation Decoction (調經湯) prescription mentioned in the Essential Formulas worth a thousand Gold for Emergencies (千金方) also treats irregular menstruation. 1 don each of Angelica Gigantis Radix (當歸), Cnidii Rhizoma (川芎), and Paeoniae Radix Alba (白芍藥), 7 pun each of Liriopis Tuber (麥門冬) and Pinelliae Tuber (半夏), 5 pun each of Ginseng Radix (人參), Asini Corii Colla (阿膠珠), Moutan Cortex (牧丹皮), Evodiae Fructus (吳茱萸), and Cinnamomi Cortex Spissus (肉桂), 3 pun of Glycyrrhizae Radix (甘草). Grind up these herbs and take in the aforementioned way.
- Clear Heat and Regulate the Blood Decoction 淸熱調血湯 청열조혈탕: Pain inside the stomach at the beginning of menstruation means excessive qi and blood. 7 pun each of Angelica Gigantis Radix (當歸), Cnidii Rhizoma (川芎), Paeoniae Radix Alba (白芍藥), Rehmanniae Radix (生乾地黃), Coptidis Rhizoma (黃連), Cyperi Rhizoma (香附子), Persicae Semen (桃仁), Carthami Flos (紅花), Curcumae Rhizoma (蓬朮), Corydalis Tuber (玄胡索), and Moutan Cortex (牧丹皮). Grind up these herbs and decoct them with water as 1 package.
- Four Substances Clear Channels Decoction 淸經四物湯 청경사물탕: Menstruation before its due date is because of a blood deficiency and heat. 1.5 pun of Angelica Gigantis Radix (當歸), 1 don each of Rehmanniae Radix (生乾地黃), Scutellariae Radix (黃芩) (thin and full inside), and Cyperi Rhizoma (香附子), 8 pun each of Paeoniae Radix Alba (白芍藥), Coptidis Rhizoma (黃連) (moistened in Zingiberis Rhizoma (生薑) juice and stir-fried), 5 pun each of Cnidii Rhizoma (川芎), Asini Corii Colla (阿膠珠), Phellodendri Cortex (黃柏), and Anemarrhenae Rhizoma (知母), 3 pun each of Artemisiae Argyi Folium (艾葉) and Glycyrrhizae Radix (甘草). Grind up these herbs and decoct them with water as 1 package.
- Four Substances Unblock Channels Decoction 通經四物湯 통경사물탕: No menstruation past its due date is because of a blood deficiency and cold. 1.5 don of Angelica Gigantis Radix (當歸), 1 don each of Rehmanniae Radix Preparata (熟地黃), Paeoniae Radix Alba (白芍藥), Cyperi Rhizoma (香附子), Curcumae Rhizoma (蓬朮), and Sappan Lignum (蘇木), 8 pun of Akebiae Caulis, 5 pun each of Cnidii Rhizoma (川芎), Cinnamomi Cortex Spissus (肉桂), and Glycyrrhizae Radix (甘草), 3 pun of Carthami Flos (紅花), and 20 Persicae Semen (桃仁). Grind up these herbs, decoct them with water as 1 package, and take on an empty stomach.
- Boiled Aconite Pill 煮附丸 자부환: ➀ It treats a syndrome consisting of irregular menstruation, sudden pain around the navel, yellowish face, and decreased food intake. It can also be used for vaginal discharge and flooding and spotting. Rub the Cyperi Rhizoma (香附子) together to get rid of the hair and boil down in fine vinegar for half a day. Dry the results by fire and grind into powder. Then, knead with vinegar-added paste and form pills as big as the seed of a royal foxglove tree. Take 50~70 pills with thin rice gruel. ➁ It is known as a Cyperus Pill or Vinegar and Aconite Pill. It treats excessive and irregular menstruation due to qi stagnation.
- Ink and Cyperus Pill 墨附丸 묵부환: It can treat infertility due to irregular menstruation. Take 1 geun of Cyperi Rhizoma (香附子) (processed in 4 ways) and 4 nyang of old mugwort and boil down in a bowl of vinegar until dry. Take the results and mash in a stone mortar. Continue until a cakelike form is attained, and set on a new roof tile and dry by a fire. Add 1 nyang each of Poria Sclerotium (白茯苓), Angelica Gigantis Radix (當歸), Ginseng Radix (人參), Cindi Rhizoma (川芎), Rehmanniae Radix Preparata (熟地黃), and Atramentum (京墨) (heated red with fire and tempered in vinegar), and 5 don of Aucklandiae Radix (木香) and grind into powder. Then, knead with vinegar-added paste and form pills as big as the seed of a royal foxglove tree. Take 70~80 pills with warm wine.
- Four Processed Cyperus Pill 四製香附丸 사제향부환: ➀ It treats irregular menstruation and can harmonize the meridians. First, take 1 geun of Cyperi Rhizoma (香附子) and process it in 4 different ways. ➁ Take 1 portion and soak in salt water with added Zingiberis Rhizoma (生薑) juice, boil down, and then stir-fry for a little while. This helps pull the phlegm downward. ➂ Take 1 portion and soak in rice vinegar, boil down, and then stir-fry for a little while. This helps tonify blood. ➃ Take 1 portion and stir-fry along with 4 nyang of Gardeniae Fructus (梔子) and remove the Gardeniae Fructus (梔子). This helps dissipate blockage. ➄ Take 1 portion and wash with children’s urine without stir-frying. This helps pull Fire downward. ➅ Take all portions and grind into powder, and add 2 nyang of ground Cnidii Rhizoma (川芎) and Angelica Gigantis Radix (當歸). Knead with wine-added flour paste and form pills as big as the seed of a royal foxglove tree. Take 50~70 pills at a time, or prescribe additionally in a decocted form to swallow when necessary. ➆ The prescription from Introduction to Medicine (入門) is as follows. Divide 1 geun of Cyperi Rhizoma (香附子) into 4 bags and soak each bag in wine, vinegar, children’s urine, and salty water separately for 7 days. Dry them by the fire and grind up into powder. Knead with vinegar-added paste to form pills and take with salt-added wine.
- Seven Refined Ingredients Cyperus Pill 七製香附丸 칠제향부환: ➀ It treats aggregation-accumulation or bone-steaming fever caused by irregular menstruation. Take 14 nyang of Cyperi Rhizoma (香附子) and divide them into 7 bags. ➁ Put the first bag in wine along with 2 nyang of Angelica Gigantis Radix (當歸). ➂ Put the second bag in children’s urine along with 2 nyang of Curcumae Rhizoma (蓬朮). ➃ Soak the third bag in used water left from washing rice along with 1 nyang each of Moutan Cortex (牧丹皮) and Artemisiae Argyi Folium (艾葉). ➄ Soak the fourth bag in used water left from washing rice along with 2 nyang of Linderae Radix (烏藥). ➅ Put the fifth bag in plain water along with 1 nyang each of Cnidii Rhizoma (川芎) and Corydalis Tuber (玄胡索). ➆ Put the sixth bag in vinegar along with 1 nyang each of Sparganii Rhizoma (三稜) and Bupleuri Radix (柴胡). ➇ Put the seventh bag in salty water along with 1 nyang each of Carthami Flos (紅花) and Mume Fructus Praeparatum (烏梅). ➈ Dry all the bags under the sun for 5 days in spring, 3 days in summer, 7 days in autumn, and for 10 days in winter. Then, pick out only the Cyperi Rhizoma (香附子) and grind into powder. Knead with paste made with the water the herbs were soaked in, and form pills as big as the seed of a royal foxglove tree. Take 80 pills at a time with wine before sleeping.
