VICARIOUS MENSTRUATION (INVERTED MENSTRUATION)

Clinical Manifestations	Vicarious menstruation or inverted menstruation is bleeding from extra-genital mucous membranes at the time one would normally expect the menstrual period. It is bleeding from any surface other than the mucous membrane of the uterine cavity, occurring periodically at the time when the normal menstruation should take place.
Treatment Principle
Herb Formulas
Points

Clinical Manifestations	Epistaxis, hematemesis or hemoptysis pre-menstrually or during menstruation Heartburn Irascibility Hypochondriac distention Abdominal pain just prior to menstruation A bitter taste in the mouth Thirst Loss of facial luster due to profuse hemorrhage T: Red C: Thin and yellow P: Wiry and rapid
Treatment Principle	Sedate the Liver Regulate Qi Nourish Liver Yin
Herb Formulas	Shun Jing Tang
Points	LI-4, LIV-3, PC-6

Clinical Manifestations	Sudden epistaxis or hemoptysis one to two days prior to the onset of menstruation Menstruation is reduced or clotted Painful abdomen Thirst Flushed face Insomnia due to heartburn T: Red C: Little P: Thready and rapid
Treatment Principle	Clear Heat Cool the Blood Nourish Yin
Herb Formulas	San Huang Si Wu Tang Qing Gan Yin Jing Tang For obvious Excess Heat with profuse bleeding: Xi Jiao Di Huang Tang
Points	LI-11, SP-6, SP-10, ST-44