Written By Jun Heo(許浚, 1539~1615), Translated by Namil Kim, Wung Seok Cha et al., Published by Ministry of Health & Welfare (Korea)Buy vitamins and supplements
10 Absence of Menstruation (Amenorrhea) 血閉 월경이 나오지 않는 것
➀ The absence of menstruation is due to blockage in the uterine vessel. The uterine vessel reaches up to the heart and continues into the uterus. When qi rises up to the lungs, it does not allow the heart qi to descend, which then leads to amenorrhea.
➁ The shift of heat from the small intestine to the large intestine forms abdominal mass and eventually amenorrhea. An Annotation states that if the blood is too thick to flow freely, it can also lead to blocked menstruation.
➂ The Inner Classic (內經) states, “The disease of two yangs is caused from the heart and spleen. One cannot perform sexual activities and women cannot menstruate.” The thoroughfare vessel and conception vessel are the sea of the meridians and form the relationship of exterior and interior with the small intestine meridian and heart meridian. When the qi of the thoroughfare vessel and conception vessel are strong, the blood flows at the right time, but if one is suffering from great concern and anxiety, it damages the heart and blood formation. The spleen is the child of the heart. If the spleen isn’t nourished properly, one’s meal portion grows smaller and the life force is severed which leads to the absence or irregularity of menstruation. Therefore, one should always remember that the heart is the master of qi and blood, and the spleen and the stomach are the foundation of qi and blood.
➃ There are three types of amenorrhea. The first is when the stomach is weak which leads to body weight loss, causing weaknesses of qi and blood, which then lead to fluid formation failure and eventually the severance of menstruation. This is known as the ‘menstruation absence due to dried up blood’ type. It is caused by stomach heat binding in the middle energizer.
➄ The second type is when the beat of the pericardium pulse is surging and rapid, and impatient from time to time. Moreover, the patient has difficulties with urination and bowel movements and suffers from the absence of menstruation. In this case, the blood sea has been dried up and there is heat bound up in the uterine vessel of the lower energizer.
➅ The third is when the menstruation is absent because one worried so much that the heart-Fire ascended. The uterine vessel is blocked and there is heat bound up among the heart, liver and lungs of the upper energizer.
➆ Unmarried women and men may feel lonely with too many thoughts, which may cause fatigue and detrimental effects. The first sign for men is an unhealthy complexion, and for women, the absence of menstruation. Too many concerns, worries, and thoughts all damage the heart and use up blood. This is why the first signs are a bad complexion and amenorrhea. Also, if the spleen isn’t nourished properly due to heart illness, the patient will lose her/his appetite and as a deficiency of spleen causes the lung-Metal to fade away, the patient will also develop a cough.
11 Treatment Methods to Induce Menstruation 通血治法 월경을 나오게 하는 치료법
➀ When the uterine vessel has been blocked and menstruation has stopped, one must first take medicine to downbear the heart Fire. A Triple Harmonies Decoction or Jade for Turbidity Powder, followed by Five Tonifications Formula (see the chapter on Deficiency Vexation for the prescription) Can be taken. Subsequently, a Guarding Life Decoction should be taken to tonify the spleen and nourish blood.
➁ If menstruation has stopped due to two yang illness, one must first purge heart Fire. This will make it naturally possible for the blood to be released, and after the release, the aforementioned medicines should be used.
➂ When qi rises up to the lungs and menstruation is absent, menstruation can be restored only when the phlegm is removed and the Fire is downborn for the heart qi to be passed downwards. An Unblock Channels Decoction should be used.
➃ The wise ancestors mainly tonified blood and purged Fire to treat the absence of menstruation. A Four Substances Decoction can be used to tonify blood and a Regulate Stomach and Coordinate Qi Decoction can be used to purge Fire. Jade for Turbidity Powder is indeed the medicine for this.
➄ When the blood has dried up and menstruation has been severed due to a weak stomach, one can use a Tonify the Center to Augment the qi Decoction (see the chapter on Internal Damage for the prescription) with Cnidii Rhizoma (川芎), Rehmanniae Radix Crudus (生地黃), and Trichosanthis Radix (天花粉). ➅ When amenorrhea appears after the patient has suffered a great loss of blood after birth or miscarriage, an All Inclusive Greatly Tonify Decoction (see the chapter on Deficiency Vexation for the prescription) should be given.
➆ If menstruation has stopped due to the stagnation of phlegm, one should use a Guide Out Phlegm Decoction (See the chapter on Phlegm for the prescription) with Cnidii Rhizoma (川芎),
Angelica Gigantis Radix (當歸), and Coptidis Rhizoma (黃連) but refrain from taking Rehmanniae Radix Crudus (生地黃) (Terra).
➇ When an unmarried woman has many worries and no menstruation, one should use a Thujae Seed Pill or Lycopus Decoction.[B210] ➈ If there is no menstruation even with prosperous qi and blood, one should use a Ten Thousand Aches and Pains Pill or Blood Extremity Paste.
➉ Pain at the sea of blood (usually refers to pain in the lower abdomen that originates from the uterus) can be treated with a Lindera Decoction.
⑪ A Supplemented Four Substances Decoction, Guide Channels Pill, Auspicious Golden Deity Powder, and Six Combinations Decoction can be widely used for absent menstruation.
⑫ If there is no menstruation because the blood has been consumed by stagnated Fire of the spleen and stomach, one should use a Restore Spleen Decoction (see the chapter on Spirit for the prescription). And if menstruation is absent because blood has been damaged from blockage of the liver and spleen by anger, an Augmented Spleen-Restoring Decoction should be used.
- Triple Harmonies Decoction 三和湯 삼화탕: ➀ It treats the absence of menstruation due to a heat bind. 7 pun each of Rehmanniae Radix (生乾地黃), Paeoniae Radix Alba (白芍藥), Cnidii Rhizoma (川芎), Angelica Gigantis Radix (當歸), Forsythiae Fructus (連翹), Rhei Radix et Rhizoma (大黃), Mirabilitum (朴硝), Menthae Herba (薄荷), Scutellariae Radix (黃芩), Gardeniae Fructus (梔子), and Glycyrrhizae Radix (甘草). Cut up these herbs, decoct in water, and take as 1 package. ➁ This prescription is a combination of a Four Substances Decoction (四物湯), Regulate Stomach and Coordinate Qi Decoction (調胃承氣湯) and Cool Rib Cage Powder (凉膈散).
Jade for Turbidity Powder 玉燭散 옥촉산: It treats the condition in which menstruation is blocked and is gradually advancing into aggregation. 1 don each of Angelica Gigantis Radix (當歸), Paeoniae Radix Alba (白芍藥), Cnidii Rhizoma (川芎), Rehmanniae Radix Preparata (熟地黃), Rhei Radix et Rhizoma (大黃), Natrii Sulfas (芒硝), and Glycyrrhizae Radix (甘草). Cut up these herbs, decoct in water, and take as 1 package. It cannot be used by patients with diarrhea. - Guarding Life Decoction 衛生湯 위생탕: It can tonify the spleen and nourish the blood. 2 don of Astragali Radix (黃芪), 1 don each of Angelica Gigantis Radix (當歸), Paeoniae Radix Alba (白芍藥), and Glycyrrhizae Radix (甘草). Cut up these herbs, decoct in water, and take as 1 package.
- Unblock Channels Decoction 通經湯 통경탕: ➀ It treats the absence of menstruation. 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), Rhei Radix et Rhizoma (大黃), Cinnamomi Cortex Spissus (肉桂) (with a fine fragrance and rolled up in balls), Magnoliae Cortex (厚朴), Aruantii Fructus Immaturus (枳殼), Ponciri Fructus Immaturus (枳實), Scutellariae Radix (黃芩), Sappan Lignum (蘇木), and Carthami Flos (紅花). Cut up these herbs and decoct in water as 1 package with 3 pieces of Zingiberis Rhizoma (生薑) and 2 Zizyphi Fructus (大棗). ➁ Menstruation cannot be restored unless the heart qi is passed downwards. Menstruation can be restored when the phlegm is removed and Fire purged using Coptidis Rhizoma (黃連) and Magnoliae Cortex (厚朴). This is the appropriate prescription for this purpose. One must add 7 pun of Coptidis Rhizoma (黃連).
- Thujae Seed Pill 柏子仁丸 백자인환: It treats the absence of menstruation due to too many concerns. 2 nyang of Lycopi Herba (澤蘭), and 1 nyang each of Thujae Semen (柏子仁) (stir-fried and ground into powder separately), Achyranthis Radix (牛膝) (soaked in wine and dried by the fire), and Selaginellae Herba (卷柏). Grind up these herbs and knead with honey to form pills as big as the seed of a royal foxglove tree. Take 50~70 pills at a time with thin rice gruel on an empty stomach.
- Lycopus Decoction 澤蘭湯 택란탕: It treats the same condition as the previous prescription. 2 don of Lycopi Folium, and 1 don each of Angelica Gigantis Radix (當歸), Paeoniae Radix Alba (白芍藥) (stir-fried), and Glycyrrhizae Radix (甘草). Grind up these herbs, decoct in water, and take as 1 package.
- Ten Thousand Aches and Pains Pill 萬痛丸 만통환: ➀ It treats pain around the navel caused by the absence of menstruation. 1 nyang each of Lacca Sinica Exsiccata (乾漆) (smashed and stir-fried until no smoke comes out) and Achyranthis Radix (牛膝) (soaked in wine overnight and dried by the fire). Grind these herbs and boil down with a slight fire in a silver bowl along with 1 doe of Rehmanniae Radix Crudus (生地黃) juice until the concoction attains a pasty texture. Form pills as big as the seed of a royal foxglove tree and take 20~30 pills at a time with thin rice gruel on an empty stomach.➁ This is also known by the name Ten Thousand Diseases Pill (萬病丸).
- Blood Extremity Paste 血極膏 혈극고: ➀ It treats the absence of menstruation. Grind Rhei Radix et Rhizoma (大黃) into powder and simmer in vinegar until pasty, and make pills the size of chicken heads [there are statements that have described the size as egg yolk-like]. Take one pill at a time by melting it in warm wine. The menstruation returns after the patient defecates 1~2 times, which is why it is known as an enchanted medicine for women. If one adds a head of Angelica Gigantis Radix (當歸) to this prescription, it is called Unaccompanied Rhubarb Paste (單大黃膏).➁ It is known to treat severe patients to whom tonification medicines have shown no effect. 4 nyang of Rhei Radix et Rhizoma (大黃) (steamed in wine and processed nine times), 5 don each of Draconis Sanguis (血竭) and Myrrha (沒藥). Grind these herbs, knead with water to form pills, and take 70~80 pills at a time with a Four Substances Decoction (四物湯).
- Lindera Decoction 烏藥湯 오약탕: It can treat a woman’s pain around the sea of blood. 2 don of Cyperi Rhizoma (香附子), 1.5 don of Linderae Radix (烏藥), 1 don of Angelica Gigantis Radix (當歸), 5 pun each of Aucklandiae Radix (木香), and Glycyrrhizae Radix (甘草). Cut up these herbs and decoct in water.
- Guide Channels Pill 導經丸 도경환: It treats absence of menstruation and pain in the back and abdomen. 2 nyang of Rhei Radix et Rhizoma (大黃), 1 nyang each of Angelica Gigantis Radix (當歸) Cnidii Rhizoma (川芎), Paeoniae Radix Alba (白芍藥), Cinnamomi Cortex Spissus (肉桂) (with a fine fragrance and rolled up in balls), Persicae Semen (桃仁) and Glycyrrhizae Radix (甘草), 2.5 don of Draconis Sanguis (血竭), 1 don of Carthami Flos (紅花), and 20 Mylabris (sitr-fried with glutinous rice). Grind up these herbs and knead with honey to form pills as big as the
seed of a royal foxglove tree. Take 30 pills with wine. - Auspicious Golden Deity Powder 瑞金散 서금산: It can treat absent menstruation and pain due to blood qi accumulation. 1.5 don of Curcumae Longae Rhizoma (薑黃), 7 pun each of outan Cortex (牧丹皮), Curcumae Rhizoma (蓬朮), Carthami Flos (紅花), Angelica Gigantis Radix (當歸), Paeoniae Radix (赤芍藥), Cnidii Rhizoma (川芎), Corydalis Tuber (玄胡索), and Cinnamomi Cortex Spissus (肉桂) (with a fine fragrance and rolled up in balls). Cut up these herbs and decoct in one glass of water and half a glass of wine as 1 package.
- Six Combinations Decoction 六合湯 육합탕: It can treat the absence of menstruation and pain due to lumps. Add equal amounts of chopped Curcumae Rhizoma (蓬朮) and Cinnamomi Cortex Spissus (肉桂) (with a fine fragrance and rolled up in balls) to Four Substances Decoction (四物湯) and take in decocted form.
- Augmented Spleen-Restoring Decoction 加味歸脾湯 가미귀비탕: It treats the absence of menstruation due to accumulated anger qi at the liver and spleen. This prescription is formed by adding 1 don each of Bupleuri Radix (柴胡) and Gardeniae Fructus (梔子) to a Restore Spleen Decoction (歸脾湯). Cut up these herbs and decoct in water.
12 Amenorrhea in Unmarried Women 室女月經不行 처녀의 무월경
When a woman reaches the age of 14, the thoroughfare vessel and conception vessel prosper and menstruation begins naturally. If menstruation does not appear past its due age, Safflower and Angelica Powder, Blood Extremity Paste [prescription has been mentioned previously], Three Spirits don each of Cassiae Cortex Interior (桂心), Citri Unshius Pericarpium Immaturus (靑皮), Rhei Radix et Rhizoma (大黃), Zingiberis Rhizoma (乾薑), Zanthoxyli Pericarpium (川椒), Curcumae Rhizoma (蓬朮), Lacca Sinica Exsiccata (乾漆) (stir-fried), Angelica Gigantis Radix (當歸), Persicae Semen (桃仁), and Carthami Flos (紅花). Grind these herbs into fine powder and first mix 2 nyang with vinegar and simmer until pasty. Then, put in the rest of the powder and knead evenly to form pills as big as the seed of a royal foxglove tree. Take 50~70 pills at a time with vinegar-added water.
13 Aggregation Caused by Blood Bind 血結成瘕 혈결성가
➀ Both the thoroughfare vessel and conception vessel all come out from the uterus and form the sea of blood. If the blood is too thick to flow freely, aggregations form and cause pain.
➁ When the conception vessel is diseased, seven kinds of genital diseases are formed in men and aggregations and abdominal mass are formed in women.
➂ The absence of menstruation and formation of aggregations caused by the blood bind can be treated with an Angelica and Atractylodes Break Up Abdominal Masses Decoction (歸朮破癥湯), Supplemented Four Substances Decoction, Four Substances Regulate Channels Decoction (四物調經湯), Instant Effect Powder (立效散), Rehmannia Open Channels Formula, Limitless Pill (無極丸), or Peach Pit Decoction (桃仁煎).
- Angelica and Atractylodes Break Up Abdominal Masses Decoction 歸朮破癥湯 귀출파징탕: It treats the absence of menstruation and painful lumps in the stomach. 1.5 don of Cyperi Rhizoma (香附子) (moistened with vinegar and stir-fried), 1 don each of Sparganii Rhizoma (三稜) and Curcumae Rhizoma (蓬朮) (decocted together in vinegar), Paeoniae Radix (赤芍藥), Paeoniae Radix Alba (白芍藥), Angelica Gigantis Radix (當歸) (fine roots), and Citri Unshius Pericarpium Immaturus (靑皮), 7 pun of Linderae Radix (烏藥), and 5 pun each of Carthami Flos (紅花), Sappan Lignum (蘇木), and Cinnamomi Cortex Spissus (肉桂) (with a fine fragrance and rolled up in balls). Cut up these herbs and decoct in water with a bit of wine as 1 package.
- Supplemented Four Substances Decoction 增味四物湯 증미사물탕: It can treat pain caused by blood aggregation. Add 1 don of Sparganii Rhizoma (三稜) and Curcumae Rhizoma (蓬朮) (moistened in vinegar and stir-fried together), Lacca Sinica Exsiccata (乾漆) (stir-fried), Cinnamomi Cortex Spissus (肉桂) (with a fine fragrance and rolled up in balls) respectively to a Four Substances Decoction (四物湯). Cut up these herbs and decoct together.
- Four Substances Regulate Channels Decoction 四物調經湯 사물조경탕: It can treat the absence of menstruation and painful lumps that move around. 1 don of Cyperi Rhizoma (香附子) (moistened with vinegar and stir-fried), 7 pun each of Angelica Gigantis Radix (當歸), Cnidii Rhizoma (川芎), Paeoniae Radix Alba (白芍藥) (moistened with wine and stir-fried), Bupleuri Radix (柴胡), Scutellariae Radix (黃芩), and Aruantii Fructus Immaturus (枳殼), 5 pun each of Rehmanniae Radix Preparata (熟地黃), Citrus Unshius Pericarpium (陳皮), Atractylodis Rhizoma (白朮), Sparganii Rhizoma (三稜) and Curcumae Rhizoma (蓬朮) (moistened with wine and stir-fried together), Angelicae Dahuricae Radix (白芷), Foeniculi Fructus (茴香) (moistened with salty water and stir-fried), and Corydalis Tuber (玄胡索), and 3 pun each of Citri Unshius Pericarpium Immaturus (靑皮), Amomi Fructus (縮砂), Carthami Flos (紅花), and Glycyrrhizae Radix (甘草). Cut up these herbs and decoct in water along with 3 pieces of Zingiberis Rhizoma (生薑) and 3 roots of Allii Fistulosi Bulbus (葱白) as 1 package.
- Instant Effect Powder 立效散 입효산: It treats pain in the stomach caused by accumulated blood that has continued for several years. Equal amounts of Citri Unshius Pericarpium Immaturus (靑皮), Citrus Unshius Pericarpium (陳皮), Linderae Radix (烏藥), Zingiberis Rhizoma (乾薑), Cyperi Rhizoma (香附子), Curcumae Rhizoma (蓬朮), and Sparganii Rhizoma (三稜). Cut up these herbs and simmer in vinegar. Then, dry them by fire, and grind into powder. Mix 2 don respectively with Citrus Unshius Pericarpium (陳皮)-decocted water and take on an empty stomach.
- Rehmannia Open Channels Formula 地黃通經丸 지황통경환: It treats the condition in which there is a cup-shaped blood aggregation under the navel causing pain. 2 nyang of Rehmanniae Radix Preparata (熟地黃), 50 each of Tabanus (朴硝) (stir-fried), Hirudo (stir-fried with glutinous rice and the rice is removed), and Persicae Semen (桃仁). Grind up these herbs and knead with honey to form pills as big as the seed of a royal foxglove tree. Take 70~80 pills with warm wine on an empty stomach.
- Limitless Pill 無極丸 무극환: It treats the absence of menstruation and great pain caused by blood aggregation. Prepare 4 nyang of Rhei Radix et Rhizoma (大黃) (Silk-textured kind; divided into 4 groups of 1 nyang and decocted 7 times in wine, vinegar, children’s urine and salty water respectively, steamed 7 times all together, dried under the sun 7 times and ground into powder.) And knead with paste made using water that has been richly decocted with 1.5 nyang each of Angelica Gigantis Radix (當歸) and Rehmanniae Radix Preparata (熟地黃). Form pills as big as the seed of a royal foxglove tree and take 30 at a time with Carthami Flos (紅花)-decocted water.
- Worth a Thousand Pieces of Gold Peach Seed Decoction 千金桃仁煎 천금도인전: It treats the absence of menstruation due to blood aggregation or blood accumulation. 2 nyang each of Persicae Semen (桃仁), Rhei Radix et Rhizoma (大黃), and Mirabilitum (朴硝), and 5 don of Tabanus (朴硝). Grind up these herbs and mix with 2.5 doe of fine vinegar in a silver or stone bowl. Boil down with a weak fire until it becomes 1.5 doe. Add Persicae Semen (桃仁), Rhei Radix et Rhizoma (大黃), and Tabanus (蝱蟲) into the mix and stir countlessly. Add Mirabilitum (朴硝) and stir sufficiently. Wait for a good while and make pills as big as the seed of a royal foxglove tree. Skip dinner the previous night, swallow 5 pills along with warm wine at daybreak, and the bad elements will come out. If they do not come out, take once again; if there is the sign of fresh blood, stop the medication.
14 Blood Dryness 血枯 혈고
➀ Huangdi (黃帝) asked, “There is fullness in the chest and hypochondrium and one cannot eat well. The disease first manifests a fishy and stenchy smell and clear rhinorrhea. There is also blood in the saliva, cold limbs, dizzy vision, and sometimes even bleeding through the genitals and rectum. What is the name of this disease and how is if formed?”. Qibo (岐伯) answered, “This condition is known as blood dryness. It is caused by a great loss of blood during childhood or performance of sexual activities under the influence of alcohol which leads to consumption of middle qi and liver damage. It will then lead to reduced amounts of menstrual blood and eventually amenorrhea. A Cuttlefish Pill can be used to treat this condition.
➁ A Cuttlefish Bone Pill (烏賊骨丸), Eight Substances Decoction (八物湯) see the chapter on Deficiency Vexation for the prescription] should be used to treat blood dryness.
- Cuttlefish Bone Pill 烏賊骨丸 오적골환: ➀ Grind equal amounts of Sepiae Os (烏賊魚骨) and Euphorbiae Ebracteolatae Radix (䕡茹) into powder and knead into moderate sparrow egg-sized balls. Then make it into pills the size of red beans. Swallow 10 pills with fish-decocted water 3 times a day and wash down with fine food.➁Absence of menstruation due to blood dryness can be treated with a Four Substances Decoction (四物湯) [see the chapter on Blood for the prescription] with the addition of Persicae Semen (桃仁) and Carthami Flos (紅花).
