阴阳别论云二阳之病发心脾有不得隐曲女子不月其传为风消为息贲者死不治妇人脾胃久
虚或
形嬴气血俱衰而致经水断绝不行或病中消胃热善食渐瘦津液不生夫经者血脉津液所化津液既
绝为热所烁肌肉消瘦时见渴躁血海枯竭病名曰血枯经绝宜泻胃之燥热补益气血经自行矣此证
或经适行而有子子不安为胎病者有矣或心包脉洪数躁作时见大便秘涩小便虽清不利而经水闭
绝不行此乃血海干枯宜调血脉除包络中火邪而经自行矣内经所谓小肠移热于大肠为 瘕为沉
脉涩不利则月事沉滞而不利故云为 瘕为沉也或因劳心心火上行月事不来安心和血泻火经自
行矣
故内经云月事不来者胞脉闭也胞脉者属心而络于胞中令气上迫肺心气不得下故月事不来也
阴阳别论云阴虚阳搏谓之崩妇人脾胃虚损致命门脉沉细而数疾或沉弦而洪大有力寸关脉
亦然
皆由脾胃有亏下陷于肾与相火相合湿热下迫经漏不止其色紫黑如夏月腐肉之臭中有白带者脉
必弦细寒作于中中有赤带者其脉洪数疾热明矣必腰痛或脐下痛临经欲行先见寒热往来两胁
急缩兼脾胃证出见或四肢困热心烦不得眠卧心下急宜大补脾胃而升举血气可一服而愈或人故
贵脱势人事疏少或先富后贫心气不足其火大炽旺于血脉之中又致脾胃饮食失节火乘其中形质
肌肉容颜似不病者此心病也不形于诊故脾胃饮食不调其证显矣而经水不时而下或适来适断暴
下
不止治当先说恶死之言劝谕令欢死而心不动以大补气血之药养脾胃微加镇坠心火之药治其心
补阴泻阳经自止矣痿论云悲哀太甚则胞络绝也阳气内动发则心下崩数溲血也故本病曰大经空
虚发则肌痹传为脉痿此之谓也
《阴阳别论》中说：二阳经（阳明胃与大肠）的病变发于心脾，会导致患者有难以启齿的隐情或情绪郁结，女子会出现月经闭止。若病情传变发展为“风消”（因虚热消耗形体而消瘦）或“息贲”（气逆上冲如喘息之状），则属于死证，无法治愈。
妇女如果脾胃长期虚弱，或者身体极度消瘦、气血两衰，从而导致经血断绝不行；或者患有中消症（多食易饥），胃中有热，食欲旺盛但逐渐消瘦，津液不生。因为月经是由血脉和津液化生的，既然津液枯竭，又被热邪煎熬，导致肌肉消瘦，时常出现口渴烦躁，血海枯竭，这种病名叫“血枯”，经血断绝。治疗应当泻除胃中的燥热，补益气血，经血自然就会通行。
此证候中，有的可能在月经刚来时怀孕，胎儿不安导致胎病；有的表现为心包络脉象洪数躁动，时常大便秘涩，小便虽然清利但不通畅，经血闭绝不行。这是血海干枯，应当调理血脉，清除心包络中的火邪，经血自然就会通行。《内经》所谓“小肠移热于大肠”，形成瘕积，脉象涩而不利，导致月经沉滞不通，所以说形成瘕积和沉脉。
有的因为劳伤心神，心火上炎，导致月经不来。应当安心、和血、泻火，经血自然就会通行。
所以《内经》说：月经不来的原因是胞脉闭塞。胞脉属于心并联络于子宫（胞中）。如果心气向上逼迫肺脏，使心气不能下行，就会导致月经不来。
《阴阳别论》又说：阴虚而阳脉搏击有力，称为崩漏（阴道大量出血）。妇人脾胃虚损，导致命门脉象沉细而数疾，或者沉弦而洪大有力，寸部和关部脉象也是如此。这都是因为脾胃亏损，气机下陷于肾，与相火相结合，湿热下迫，导致经漏不止。血色紫黑，像夏天腐烂的肉一样发臭，其中夹杂白带者，脉象必定是弦细，寒邪作祟于体内；其中夹杂赤带者，脉象洪数疾速，热象明显。必然伴有腰痛或脐下疼痛，在月经将要来潮之前先出现寒热往来、两胁紧急收缩等症状，兼见脾胃症状。如果出现四肢困倦、心烦不得眠卧、心下急迫等症状，应当大补脾胃并升举血气，一服药即可痊愈。
有的人原本地位尊贵后来失势，房事减少，或者先富后贫，导致心气不足，其火邪在大炽旺于血脉之中，又导致脾胃饮食失调，火邪乘袭其中。形体、肌肉、容颜似乎没有生病的样子，但这其实是心病，不表现在脉诊上，所以脾胃饮食不调的症状表现得很明显，而经血不时而下。或者月经刚来就突然中断，暴下不止。治疗时应当先讲明死亡的危险言语，劝谕使其欢喜，使心神不被惊扰，用大补气血的药物滋养脾胃，稍加镇坠心火的药物来治疗心脏，通过补阴泻阳的方法，经血自然停止。
《痿论》说：悲哀太过会导致胞络隔绝。阳气在内扰动，发作时会出现心下崩漏（下部出血）和多次尿血的情况。所以《本病》篇说：大经空虚，发作时肌痹，传变为脉痿。说的就是这种情况。
The *Yin Yang Bie Lun* (Treatise on Differentiating Yin and Yang) states: Diseases of the Two Yang meridians (Yangming Stomach and Large Intestine) originating from the Heart and Spleen can lead to unspoken emotional constraints in patients, resulting in amenorrhea (absence of menstruation) in women. If the condition progresses to "Feng Xiao" (consumption due to deficiency-heat leading to emaciation) or "Xi Ben" (qi rebellion manifesting as asthma-like symptoms), it is a fatal and incurable syndrome.
In women, long-standing deficiency of the Spleen and Stomach, or extreme emaciation with exhaustion of both Qi and Blood, can cause the cessation of menstruation. Alternatively, patients suffering from Zhong Xiao (Middle Jiao consumption characterized by polyphagia) may have heat in the Stomach, increased appetite yet progressive emaciation, and failure to generate Body Fluids. Since menstruation is transformed from Blood vessels and Body Fluids, once Body Fluids are exhausted and scorched by Heat, muscles become emaciated, thirst and irritability frequently occur, and the Sea of Blood becomes depleted. This disease is named "Xue Ku" (Blood Depletion), characterized by the cessation of menstruation. Treatment should involve purging the dryness and heat of the Stomach and tonifying Qi and Blood, after which menstruation will resume naturally.
In such cases, some women may conceive shortly after their period begins, leading to fetal instability and fetal disease. Others may present with a surging, rapid, and restless pulse at the Pericardium channel, frequent constipation, clear but difficult urination, and amenorrhea. This indicates depletion of the Sea of Blood; treatment should regulate the Blood vessels and eliminate Fire pathogens in the Pericardium, allowing menstruation to resume naturally. As stated in the *Nei Jing*: "Heat transferred from the Small Intestine to the Large Intestine" forms masses (Jia), and a choppy, obstructed pulse leads to stagnant and obstructed menstruation, hence the formation of masses and choppy pulses.
Some cases arise from mental labor damaging the Heart, causing Heart Fire to ascend and preventing menstruation. Treatment should calm the mind, harmonize the Blood, and purge Fire, allowing menstruation to resume naturally.
Therefore, the *Nei Jing* states: Amenorrhea occurs because the Bao Mai (Uterine Vessels) are closed. The Bao Mai belongs to the Heart and connects to the Bao Zhong (Uterus). If Heart Qi forces upward against the Lungs, preventing Heart Qi from descending, menstruation will not occur.
The *Yin Yang Bie Lun* further states: Yin deficiency with vigorous Yang pulsation is termed Beng (Sudden Profuse Bleeding). In women, deficiency damage to the Spleen and Stomach causes the Ming Men (Gate of Life) pulse to be deep, fine, rapid, or deep, wiry, surging, and forceful, similarly affecting the Cun and Guan positions. These result from Spleen-Stomach deficiency where Qi sinks into the Kidneys, combining with Ministerial Fire to create Damp-Heat that forces downward, causing persistent metrorrhagia. The blood is purple-black and foul-smelling like rotting meat in summer. If accompanied by leukorrhea (white discharge), the pulse is likely wiry and fine, indicating Cold pathogenesis within. If accompanied by bloody leukorrhea, the pulse is surging, rapid, and swift, clearly indicating Heat. Symptoms inevitably include lower back pain or hypogastric pain, alternating chills and fever, and tightness/contraction of the hypochondrium prior to menstruation, along with Spleen-Stomach signs. If accompanied by limb fatigue, irritability, insomnia, and epigastric urgency, one must greatly tonify the Spleen and Stomach and raise/lift the Qi and Blood; recovery can be achieved with a single dose.
Individuals who lose high status or wealth may suffer from insufficient Heart Qi, causing excessive Fire blazing within the Blood vessels, further disrupting Spleen-Stomach digestion and allowing Fire to invade internally. Although physical appearance may seem healthy, this is actually a Heart disease not evident in pulse diagnosis, while Spleen-Stomach disharmony manifests clearly, leading to irregular menstruation or sudden profuse bleeding upon onset. Treatment requires first explaining the danger of death to counsel the patient into joy, stabilizing the Heart. Use herbs to greatly tonify Qi and Blood and nourish the Spleen-Stomach, combined with slightly sedating herbs to suppress Heart Fire, treating the Heart by tonifying Yin and purging Yang, so menstruation stops naturally.
The *Wei Lun* (Treatise on Flaccidity Syndromes) states: Excessive grief severs the Bao Luo (Pericardium Collaterals). Yang Qi moves internally; upon manifestation, it causes uterine bleeding (Beng) and frequent hematuria. Thus, the *Ben Bing* chapter states: When the major vessels are empty, Ji Bi (Muscle Flaccidity) manifests and transmits to Mai Wei (Vessel Flaccidity). This refers to the aforementioned situation.