《素问》云∶天地温和，则经水安静；天寒地冻，则经水凝泣；天暑地热，则经水沸溢；卒风暴起，则
经水波涌而陇起。（卒，读猝然之猝。）
褚澄曰∶女子天癸既至，逾十年无男子合，则不调；未逾十年思男子合，亦不调。不调则旧血不出，新
血误行∶或渍而入骨，或变而为肿，或虽合而难子。合多则沥枯虚人，产乳众则血枯杀人。
王孟英按∶此论甚不尽然，存其意可也。惟产乳众而血枯至死者颇多。然吾乡吴酝香大令徐夫人，
半产三次不计外，凡生十男四女，并已长成，而夫人年逾五旬，精力不衰，犹能操家政而抚驭群下也。（至死，
今石印本《王氏十四种》作“卒死”，非是。）
方约之曰∶妇人不得自专，每多忿怒，气结则血亦枯。
王孟英按∶此至言也。气为血帅，故调经必先理气。然理气不可徒以香燥也，盖郁怒为情志之火，频
服香燥，则营阴愈耗矣。
赵养葵曰∶经水不及期而来者，有火也，宜六味丸滋水；如不及期而来多者，加白芍、柴胡、海螵蛸；如
半月或十日而来，且绵延不止者，属气虚，宜补中汤。如过期而来者，火衰也，六味加艾叶；如脉迟而色淡
者加桂。此其大略也。其间有不及期而无火者，有过期而有火者，不可拘于一定，当察脉视禀，滋水为主，
随证加减。
王孟英按∶妇人之病，虽以调经为先，第人禀不同，亦如其面。有终身月汛不齐而善于生育者，有
经期极准而竟不受孕者。雄于女科，阅历多年，见闻不少，始知古人之论，不可尽泥；无妄之药，不可妄施也。
《素问》说：天地气候温和，月经就平静正常；天气寒冷、大地冻结，月经就会凝滞不畅；天气炎热、地热蒸腾，月经就会沸腾溢出；突然狂风大作，月经就像波浪涌起一样起伏不定。（“卒”字读作猝然之“猝”。）
褚澄说：女子天癸（指促进生殖机能成熟的物质）已经到来，如果超过十年没有与男子交合，月经就会不调；如果未满十年就思念与男子交合，月经也会不调。月经不调则旧血排不出，新血妄行：有的渗入骨骼，有的变成肿块，有的虽然交合却难以受孕。交合过多会导致精液枯竭、人体虚弱，生育哺乳过多会导致血液枯竭甚至死亡。
王孟英按语：这种说法并不完全正确，保留其大意即可。只有生育哺乳过多导致血枯而死的案例确实很多。然而我家乡吴酝香县令的徐夫人，除去三次小产不计，共生了十个儿子四个女儿，且都已长大成人，而夫人年过五十，精力依然充沛，还能操持家务并管理下属。（关于“至死”，今本石印版《王氏十四种》作“卒死”，是不对的。）
方约之说：妇人不能自主，常常容易愤怒，气机郁结则血液也会干枯。
王孟英按语：这是至理名言。气是血的统帅，所以调理月经必须先调理气机。然而调理气机不能单纯使用香燥药物，因为郁怒属于情志之火，频繁服用香燥药，会使营阴更加耗损。
赵养葵说：月经不到期就来的，是有火，适宜用六味丸滋补肾水；如果不到期就来且量多的，加白芍、柴胡、海螵蛸；如果半个月或十天就来，并且绵延不止的，属于气虚，适宜用补中益气汤。如果过期才来的，是火衰，六味丸加艾叶；如果脉迟且经色淡的，加桂枝。这大概是一般规律。其中也有不到期来却没有火的，有过期来却有火的，不能拘泥于固定模式，应当观察脉象和体质，以滋补肾水为主，随证加减。
王孟英按语：妇女的疾病，虽然以调理月经为先务，但人的禀赋不同，也如同面容各异。有终身月经不规律但善于生育的，有经期非常准确却竟然不能怀孕的。我在女科方面雄辩多识，阅历多年，见闻不少，才知道古人的论述，不能完全拘泥；无病之药，不可随意施用。
The *Suwen* (Basic Questions) states: When the climate of heaven and earth is mild and warm, the menstrual water remains calm and quiet; when the weather is cold and the earth frozen, the menstrual water becomes stagnant and sluggish; when the weather is hot and the earth heat rises, the menstrual water boils and overflows; when a sudden storm arises, the menstrual water surges like waves. ("Zu" is pronounced as "cu," meaning suddenly.)
Chu Cheng said: Once a woman's Tian Gui (the substance promoting reproductive maturity) has arrived, if she does not cohabit with a man for more than ten years, her menstruation will become irregular; if she desires cohabitation before ten years have passed, her menstruation will also become irregular. When menstruation is irregular, old blood does not exit, and new blood flows erroneously: it may seep into the bones, transform into swelling/masses, or even if cohabitation occurs, pregnancy may be difficult to achieve. Excessive cohabitation leads to seminal depletion and bodily weakness; excessive childbirth and lactation lead to blood depletion and death.
Wang Mengying’s commentary: This argument is not entirely accurate; retaining its general intent is sufficient. It is true that many cases of death due to blood depletion from excessive childbirth and lactation exist. However, in my hometown, Lady Xu, wife of Magistrate Wu Yunxiang, aside from three spontaneous abortions, gave birth to ten sons and four daughters, all of whom grew up healthy. Yet, at over fifty years of age, her vitality remained unimpaired, and she could still manage household affairs and command subordinates. (Regarding "death," the current stone-printed edition of *Wang Shi Shisi Zhong* reads "sudden death," which is incorrect.)
Fang Yuezhi said: Women often lack autonomy and are prone to anger. Qi stagnation leads to blood depletion.
Wang Mengying’s commentary: This is profound truth. Qi is the commander of Blood; therefore, regulating menstruation must begin with regulating Qi. However, regulating Qi cannot rely solely on aromatic and drying herbs, because郁怒 (depressive anger) is fire generated by emotional disorders. Frequent use of aromatic and drying herbs will further consume Ying Yin (Nutritive Yin).
Zhao Yangkui said: Menstruation arriving before schedule indicates Fire; Liuwei Wan (Six-Ingredient Pill with Rehmannia) should be used to nourish Kidney Water. If it arrives early and in large amounts, add Baishao (Radix Paeoniae Alba), Chaihu (Radix Bupleuri), and Haipiaoxiao (Endoconcha Sepiae). If it arrives every half month or ten days and persists without stopping, it belongs to Qi Deficiency; Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting Qi) is appropriate. Menstruation arriving after schedule indicates deficient Fire; Liuwei Wan with Aiye (Folium Artemisiae Argyi) is added. If the pulse is slow and the color pale, Guizhi (Ramulus Cinnamomi Cassiae) is added. This is the general principle. Among these, there are cases of early arrival without Fire, and late arrival with Fire. One must not adhere rigidly to fixed rules but should observe the pulse and constitution, focusing on nourishing Kidney Water, and modifying according to symptoms.
Wang Mengying’s commentary: In women's diseases, although regulating menstruation is prioritized, individual constitutions vary as much as facial features. Some women have irregular menstruation throughout their lives yet are fertile; others have perfectly regular cycles yet fail to conceive. Having extensive experience and knowledge in gynecology over many years, I have come to realize that ancient theories cannot be blindly adhered to, and medicines for non-existent conditions should not be administered recklessly.