李士材曰∶阳明为二阳，胃伤而心脾受病者何也？脾与胃为夫归，夫伤则妻亦不利。
心与胃为子母，子伤则母亦不免。不得隐曲，阳事病也。胃为水谷气血之海，化荣卫而润宗筋。厥论曰∶前阴者，
宗筋之所聚，太阴阳明之所合。痿论曰∶阴阳总宗筋之会，而阳明为之长。故胃病则阳事衰也。女子不月者，心主
血，脾统血，胃为血气之海，三经病而血闭矣。
慎斋按∶以上八条，序女子不月证也。女子不月，自《内经》论二阳之病发心脾，因集洁古以下诸家之论，
以发明其经旨。大约均主脾胃立论，独叔卿一条，作气郁解，与诸家有异。
《金匮要略》曰∶妇人之病，因虚积冷结气，为证经水断绝，至有历年，血寒积结胞
门，寒伤经络，三十六病，千变万端。
齐仲甫曰∶妇人月事不来，此因风冷客于胞门，或醉以入房，或因风堕坠惊恐，皆令不通。《病源》云∶
血得温则宣通，得寒则凝泣。若月水不来，因冷于胃府，或醉入房，则内气耗损，劳伤肝经，或吐衄脱血，使血
枯于中也。
王子亨曰∶妇人月水不通，病本于胃，胃气虚不能消化水谷，使津液不生血气故也。又云，醉以入房，则内
气竭绝伤肝，使月水衰少。所以尔者，肝藏血，劳伤过度，血气枯竭于内也。又先吐血，及吐血下血，谓之脱
血，名曰血枯，亦月水不来。所以尔者，津液减耗故也。但益津液，其经自下。
慎斋按∶以上三条，序妇人经闭，属于积寒风冷，凝泣其血，而月水为之不通也。
李士材说：阳明经被称为“二阳”，如果胃受伤而心和脾也受病，这是为什么呢？脾与胃的关系如同夫妻，丈夫受伤则妻子也不利。心与胃的关系如同母子，子病则母也不能幸免。“不得隐曲”（指难以启齿的隐私疾病，如性功能或生殖系统障碍），属于阳事方面的病症。胃是水谷精微和气血汇聚的大海，能化生营卫之气并滋润宗筋（前阴部筋膜）。《素问·厥论》说：前阴部位，是宗筋汇聚之处，也是太阴脾经与阳明胃经相合的地方。《素问·痿论》说：阴阳诸经总汇于宗筋，而阳明经在其中起主导作用。所以胃病会导致阳事功能衰退。女子月经不来的原因，在于心主血、脾统血、胃为气血之海，这三条经脉生病就会导致血闭不通。
慎斋按语：以上八条内容，论述了女子月经不来的证候。女子月经不来，最早在《黄帝内经》中论述为“二阳之病发心脾”。此处汇集了洁古（张元素）以下各位医家的论述，以阐发经典的本旨。大体上都主张从脾胃立论，唯独叔卿的一条观点，认为是气机郁结所致，与其他医家不同。
《金匮要略》说：妇女的疾病，多因虚损、积冷、结气引起，导致经水断绝，甚至延续多年。血寒积结于胞门（子宫口），寒气损伤经络，形成三十六种妇科病，变化万千。
齐仲甫说：妇人月经不来，这是因为风冷邪气客居于胞门，或者醉酒后行房事，或者因风吹坠落、惊恐等原因，都会导致经血不通。《诸病源候论》说：血液得到温暖则宣通流畅，得到寒冷则凝滞涩少。如果月经不来，是因为胃府受冷，或者醉酒后行房事，导致内气耗损，劳伤肝经；或者有吐血、衄血（鼻出血等）及大量失血的情况，使体内血液枯竭。
王子亨说：妇人月经不通，病根在于胃。胃气虚弱不能消化水谷，导致津液无法化生为血气。又说，醉酒后行房事，会耗尽内气并损伤肝脏，导致月经量少。之所以这样，是因为肝藏血，过度劳累损伤后，内部血气枯竭。还有先出现吐血，以及吐血伴下血的情况，称为脱血，名为血枯，也会导致月经不来。之所以这样，是因为津液减少消耗的缘故。只要补充津液，月经自然就会来潮。
Li Shicai stated: The Yangming channel is referred to as the "Two Yangs." Why does injury to the Stomach lead to disease in the Heart and Spleen? The relationship between the Spleen and Stomach is like that of husband and wife; if the husband is injured, the wife is also adversely affected. The relationship between the Heart and Stomach is like that of mother and child; if the child is diseased, the mother cannot escape either. "Inability to disclose hidden matters" (referring to private ailments, such as sexual or reproductive dysfunction) belongs to disorders of Yang affairs. The Stomach is the sea of water and grain, and qi and blood; it transforms Ying and Wei (nutritive and defensive qi) and moistens the Zongjin (tendons of the anterior yin/genitals). The Treatise on Jue (Jue Lun) states: The anterior yin is the gathering place of the Zongjin, where the Taiyin (Spleen) and Yangming (Stomach) channels combine. The Treatise on Flaccidity (Wei Lun) states: All Yin and Yang channels converge at the Zongjin, with the Yangming channel acting as their leader. Therefore, Stomach disease leads to decline in Yang function. In cases of amenorrhea in women, the Heart governs Blood, the Spleen controls Blood, and the Stomach is the sea of Qi and Blood; disease in these three channels results in blood closure.
Shenzhai commented: The above eight items outline the syndromes of amenorrhea in women. Amenorrhea was first discussed in the *Huangdi Neijing* (Yellow Emperor's Inner Canon) as "diseases of the Two Yang affecting the Heart and Spleen." Here, the discussions of various physicians from Jiegu (Zhang Yuansu) onwards are collected to elucidate the canonical principles. Generally, they all advocate establishing the theory based on the Spleen and Stomach. Only one point by Shuqing differs, attributing the condition to Qi stagnation, which contrasts with other physicians.
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: Women's diseases often arise from deficiency, accumulation of cold, and constrained Qi, leading to the cessation of menstruation, sometimes persisting for years. Cold blood accumulates in the Baomen (uterine gate), injuring the meridians, resulting in thirty-six types of gynecological diseases with myriad variations.
Qi Zhongfu stated: When a woman's menstruation fails to arrive, it is due to wind-cold pathogens lodging in the Baomen, or sexual intercourse while intoxicated, or due to falling from exposure to wind, or fright and shock, all of which cause obstruction. The *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Symptoms of All Diseases) states: Blood flows freely when warm but coagulates and becomes sluggish when cold. If menstruation does not arrive, it may be because the Stomach Fu organ is cold, or due to sexual activity while intoxicated, causing depletion of internal Qi and injury to the Liver channel; or due to hematemesis, epistaxis, or massive hemorrhage, leading to exhaustion of blood within.
Wang Ziheng stated: Menstrual obstruction in women originates in the Stomach. Deficient Stomach Qi fails to digest food and drink, preventing Jin Ye (body fluids) from transforming into Qi and Blood. He further stated that sexual activity while intoxicated exhausts internal Qi and injures the Liver, causing scanty menstruation. This is because the Liver stores Blood; excessive labor and injury lead to exhaustion of Qi and Blood internally. Additionally, prior hematemesis, or hematemesis accompanied by lower bleeding, is termed Tuoxue (loss of blood), known as Xueku (blood exhaustion), which also prevents menstruation. This occurs because of the reduction and consumption of Jin Ye. By replenishing Jin Ye, the menses will naturally resume.
Shenzhai commented: The above three items discuss menstrual obstruction in women, attributing it to accumulated wind-cold, which causes blood to coagulate and become sluggish, thereby obstructing menstruation.