尝闻经曰∶女子七岁，肾气盛，齿更发长，二七而天癸至，任脉通，太冲脉盛，月事以
时下
。夫天为天真之气，癸为壬癸之水。壬为阳水，癸为阴水。阴阳之气以冲任为都会也。盖冲
属血海，任主胞胎，胎脉流通，经水渐盈，应时而下，天真气降与之从事，故曰天癸(仲圭
曰∶天癸在男子为精虫，在女子为卵子，故两性同具而为媾胎之要素。世以月事当之，荒谬
甚矣)。常以三旬一见，以象月盈则亏，又曰月信(任脉主任一身之阴血，太冲属阳明，为血
之海，故谷气盛则血海满，而月事以时下。天真，天一也，天一之气升而为壬，降而为癸。
壬阳而癸阴也。三旬一见也，为一小会之周天，此其常也。然有大会、中会之不同，故又有
三月一行、一年一行之变异。究其盈亏之义则一也。其有数年不行而一行即受孕者，又超乎
理之外矣，岂医药所能为哉)。故经行最宜谨慎，与产后相类。若外被风寒，内伤生冷，及
七情郁结，余血未净，瘀积于中，名曰血滞。若用力太过，入房太甚，及服食偏燥，邪火妄
动，津血衰少，名曰血枯。若被惊恐恚怒(惊则气乱，故错经妄行，怒则气逆上冲，故从口
鼻而出)，则气血错乱，逆于上则从口鼻而出，变为吐衄。逆于身则与水气相搏，变为肿胀
。逆于腰腿心腹之间则重痛不宁，经行则发，过期则正。若外溢阳经则头眩呕血、瘰 痈毒
，若内渗阴络则窍穴生疮，淋沥不断，湿热相搏，遂为崩带。气血相滞，遂为 瘕。凡此
变症百出，不过血滞与血枯而已(总结)。犯时微若秋毫，成病重于山岳，可不畏哉!按妇人
童幼天癸未行属少阴，天癸既行属厥阴，天癸已极属太阴。此三者祖气生化之源也，故血之
资根在于肾，血之资生赖于脾，血之藏纳归于肝。三者并重，乃先天之体耳。若夫后天之用
，则独重于脾经，曰中焦受气取汁，变化而为赤，是为血。血者，水谷之精，和调五脏，洒
陈六腑。在男子则化为精，在女人则上为乳汁，下为月水，故虽心主血，肝藏血，亦皆统摄
于脾，补脾和胃，血自生矣(知水谷之精气是生血之原本，则知脾胃是生血之源，故脾胃不
健而血不生者，不可端主四物矣)。凡经行之时，禁用寒凉辛散，以伐生气。诗云∶妇人平
和则乐有子。和则阴阳不乖，平则气血无争，则天癸应时而下矣。
我曾听闻《黄帝内经》记载：女子到了七岁，肾气开始旺盛，牙齿更换，头发生长；到了十四岁（二七），天癸（促进生殖功能成熟的精微物质）到来，任脉通畅，太冲脉充盛，月经按时来潮。所谓“天”，指天真之气；“癸”指壬癸之水。壬属阳水，癸属阴水。阴阳之气以冲脉和任脉为汇聚之处。大概冲脉属于血海，任脉主管胞胎，胎脉流通，经血逐渐充盈，应时而下，天真之气下降与之配合，所以称为天癸。通常每三十天来一次月经，象征月亮满则亏，因此也称为月信。如果用力过度，房事不节制，以及服用过于燥热的食物，导致邪火妄动，津液和血液衰少，这叫做血枯。如果受到惊恐或愤怒（惊则气乱，故月经错乱妄行；怒则气逆上冲，故从口鼻而出），则气血错乱，气逆向上则从口鼻出血，变为吐衄；气逆于身体则与水气相搏，变为肿胀；气逆于腰腿心腹之间则剧烈疼痛不安，经期发作，过期后恢复正常。若外溢于阳经，则出现头晕、呕血、瘰疬痈毒；若内渗于阴络，则孔窍生疮，淋漓不断，湿热相搏，遂成崩漏带下。气血相互阻滞，遂形成瘕积。所有这些变化多端的病症，不过是血滞与血枯两种情况罢了。发病时症状轻微如秋毫，但形成疾病后却重如山岳，怎能不敬畏呢？按妇人童幼时期天癸未行，病属少阴；天癸已行，病属厥阴；天癸枯竭，病属太阴。这三者是祖气生化之源，所以血的根基在于肾，血的生成依赖于脾，血的贮藏归于肝。三者并重，构成了先天的本体。至于后天的作用，则特别重视脾经，中焦接受水谷之气，提取汁液，变化为红色，这就是血。血是水谷的精微，调和五脏，布散六腑。在男子则化为精，在女子则上为乳汁，下为月经，所以虽然心主血，肝藏血，也都统摄于脾，补脾和胃，血自然就会生成。凡是月经期间，禁用寒凉和辛散药物，以免损伤生气。诗云：妇人平和则快乐且有子。和则阴阳不乖戾，平则气血无争斗，那么天癸就能应时而下了。
I have heard it recorded in the *Huangdi Neijing* (Yellow Emperor's Inner Canon): When a girl reaches seven years of age, her Kidney Qi (vital energy of the kidneys) becomes abundant, her teeth change, and her hair grows. At fourteen years old (two times seven), Tian Gui (a subtle substance promoting reproductive maturity) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes vigorous, causing menstruation to occur on time. The term "Tian" refers to Tian Zhen Qi (innate true qi); "Gui" refers to the water of Ren and Gui. Ren belongs to Yang Water, and Gui belongs to Yin Water. The qi of yin and yang converges at the Chong and Ren vessels. Generally, the Chong Mai is considered the Sea of Blood, and the Ren Mai governs the fetus. As the fetal vessels circulate freely and menstrual blood gradually fills up, it flows down on schedule, with Tian Zhen Qi descending to cooperate with it; thus it is called Tian Gui. Typically, menstruation occurs once every thirty days, symbolizing that when the moon is full, it begins to wane; hence it is also called Yue Xin (monthly trust/regularity). If one exerts oneself excessively, engages in sexual intercourse too frequently, or consumes overly drying foods, causing evil fire to move recklessly and depleting body fluids and blood, this is called Blood Deficiency (Blood Withering). If one suffers from fright or anger (fright causes qi chaos, leading to irregular menstruation; anger causes qi rebellion upward, leading to bleeding from the mouth or nose), then qi and blood become disordered. If qi rebels upward, bleeding occurs from the mouth or nose, transforming into hematemesis or epistaxis. If qi rebels within the body, it contends with water-qi, transforming into swelling. If qi rebels between the waist, legs, heart, and abdomen, severe pain ensues without peace; it manifests during menstruation and resolves after the period passes. If it overflows into the Yang meridians, symptoms such as dizziness, vomiting blood, scrofula, and carbuncles appear. If it infiltrates the Yin collaterals, sores arise in the orifices, dripping continuously; damp-heat contend, resulting in metrorrhagia and leukorrhea. When qi and blood stagnate mutually, masses (Zhang Jia) form. All these myriad variations of symptoms are merely due to either Blood Stasis or Blood Deficiency. The onset may be slight as an autumn feather, but the resulting disease can be heavy as a mountain; how can one not revere this? According to analysis, for girls before menarche, the condition belongs to the Shaoyin (Lesser Yin) stage; after menarche, it belongs to the Jueyin (Terminal Yin) stage; and when Tian Gui is exhausted, it belongs to the Taiyin (Greater Yin) stage. These three constitute the source of ancestral qi transformation. Therefore, the root of blood lies in the Kidney, its generation relies on the Spleen, and its storage returns to the Liver. These three are equally important, forming the congenital structure. Regarding postnatal function, particular emphasis is placed on the Spleen Meridian: the Middle Jiao receives qi from food and drink, extracts juices, transforms them into red fluid, which is blood. Blood is the essence of grain and water, harmonizing the Five Zang organs and distributing to the Six Fu organs. In men, it transforms into essence; in women, it goes upward to become milk and downward to become menstrual water. Thus, although the Heart governs blood and the Liver stores blood, both are controlled by the Spleen. By tonifying the Spleen and harmonizing the Stomach, blood will naturally generate. During menstruation, cold-natured and acrid-dispersing drugs must be prohibited to avoid damaging the generating qi. The poem states: "A woman who is peaceful and harmonious finds joy and bears children." Harmony ensures yin and yang do not conflict; balance ensures qi and blood do not struggle, allowing Tian Gui to descend on time.