脉经曰∶妇人下利而经水反断者，何也？师曰∶但当止利，经当自下，勿怪。所以
利不止而经断者，但下利亡津液，故经断。利止津液复，经当自下。若妇人血下，咽干而不
渴，其经必断，此荣不足，本自有微寒，故不引饮。渴而引饮者，津液得通，荣卫自和，其
经必复下。
李氏曰∶妇人以血为主，天真气降，壬癸水合，肾气全盛，血脉流行，当以三旬一见，
以象月盈则亏，故曰月经。经行与产后一般，若其时余血一点未净，或外被风寒及湿冷暑热
邪气，或内伤生冷，七情郁结，为痰为瘀，凝积于中，曰血滞。或经止后，用力太过，入房
太甚，及服食燥热，以致火动，邪气盛而津液衰，曰血枯。
良方云∶经后被惊，则血气错乱妄行（惊则气乱，故错经妄行），逆于上，则从口鼻而出（怒则气逆上冲，
甚则呕血）；逆于身，则血水相
搏，变为水肿；恚怒，则气血逆于腰腿、心腹、背胁，手足之间重痛，经行则发，过期则止
；怒极伤肝，则有眩晕、呕血、瘰 、血风、疮疡等病，加之经血渗漏于其间，遂成窍血生疮
，淋沥不断；湿热相搏，遂为崩带；血结于内，变为 瘕。凡此变证百出，不过血滞与
枯而已（总结）。但血滞亦有虚热，血枯亦有虚热，故重则经闭不通。以滞、枯分言，轻则经水不调
，止言虚与热而已。血滞经闭宜破者，原因饮食毒热，或暴怒，凝瘀积痰，直须大黄、干漆
之类，推陈致新，俾旧血消而新血生也。若气旺血枯，起于劳役忧思，却宜温和滋补，或兼
有痰火湿热，尤宜清之凉之，每以肉桂为佐者，热则血行也。但不可纯用峻药，以亏阴道。
至于耗气益血之说，虽女科要法，但血为气配，气热则热，气寒则寒，气升则升，气降则降
，气行则行，气滞则滞。如果郁火，气盛于血者，方可单用香附丸散、抑气散，当加木香、
槟榔、枳壳，以开郁行气。若气乱则调，气冷则温，气虚则补，男女一般，阳生则阴自长，
气衰则血亦涸，岂可专耗其气耶？论者多泥叔和血旺气衰，不知叔和论肝肺二脉
（以肝藏血、肺主气也），则宜肝旺
于肺，其实气血平和有孕，故继曰两脏通和。但妇人见偏性鄙，婢外家志不得伸，郁怒无时不
起，故香附为女人仙药。经曰∶邪气胜则实，正气夺则虚。可不悟诸，大概只虚热痰气四证
而已。不调亦大相同，随证调治，饮食调和，自然血气流通。更有凝滞，然后可用红花当归
散、紫葳散、通经丸、导经丸之类。虚者只用当归散以通之。通后又须养血益阴，使津液流
通。苟不务气血充和，而惟以毒药攻逼，是求千金于乞丐，必死而后已。
《脉经》说：妇女患下利（腹泻），月经反而停止，这是什么原因？老师说：只要止住腹泻，月经自然会来潮，不必奇怪。之所以腹泻不止而月经停止，是因为下利导致津液（体内正常水液）耗损，所以月经停止。腹泻停止后津液恢复，月经自然就会来潮。如果妇女阴道出血，咽喉干燥但不口渴，她的月经必定停止，这是因为营血不足，原本体内就有轻微的寒气，所以不想要饮水。如果口渴并想喝水，说明津液得以通畅，营卫之气自然调和，月经必定会恢复来潮。
李氏说：妇女以血为根本，天真之气下降，壬癸之水（肾水）相合，肾气全盛，血脉流通，应当每三十天来一次月经，以象征月亮满则亏的道理，所以称为月经。经期与产后情况类似，如果此时余血未净，或者外受风寒及湿冷暑热等邪气侵袭，或者内伤生冷食物，加上七情（喜、怒、忧、思、悲、恐、惊）郁结，形成痰浊或瘀血，凝结积聚在体内，这叫做“血滞”。或者在月经结束后，用力过度，房事太频繁，以及服用燥热食物，导致火气妄动，邪气旺盛而津液衰少，这叫做“血枯”。
《良方》说：经期之后受到惊吓，会导致气血错乱妄行（惊则气乱，所以经络运行失常妄行），逆冲于上，则从口鼻而出（怒则气逆上冲，严重时呕血）；逆冲于身体，则血与水相互搏结，变为水肿；愤怒，则气血逆乱于腰腿、心腹、背胁及手足之间，出现沉重疼痛，经期发作，过期则停止；大怒伤肝，则会出现眩晕、呕血、瘰疬、血风、疮疡等疾病，加之经血渗漏其中，遂成窍血生疮，淋漓不断；湿热相互搏结，遂成崩漏和带下病；血液结聚于内，变为癥瘕。凡是这些变证百出，不过是血滞与血枯两种情况罢了（总结）。但血滞也有虚热，血枯也有虚热，所以严重的导致经闭不通。若将滞、枯分开来说，轻度的只是经水不调，只涉及虚与热而已。对于因血滞导致的经闭，适宜用破血药的情况，原因是饮食毒热，或暴怒，导致凝瘀积痰，必须使用大黄、干漆之类的药物，推陈致新，使旧血消除而新血生成。如果是气旺血枯，起因于劳役忧思，却适宜温和滋补，如果兼有痰火湿热，尤其适宜清热凉血，常常以肉桂作为佐药，因为热则血行。但是不可纯用峻猛的药物，以免亏损阴血之道。至于耗气益血的说法，虽然是妇科的重要法则，但血是气的配偶，气热则热，气寒则寒，气升则升，气降则降，气行则行，气滞则滞。如果是郁火，气盛于血的情况，才可以单独使用香附丸散、抑气散，应当加入木香、槟榔、枳壳，以开郁行气。如果气乱则调顺，气冷则温煦，气虚则补益，男女都一样，阳生则阴自长，气衰则血亦枯竭，怎么能专门耗损其气呢？论述者大多拘泥于叔和所说的“血旺气衰”，不知道叔和论述的是肝肺二脉（因为肝藏血、肺主气），应该是肝旺于肺，其实气血平和才能受孕，所以接着说两脏通和。但妇人见识偏狭鄙陋，婢女及外家女子志向不得伸展，郁怒无时无刻不起，所以香附被称为女人的仙药。经书说：邪气胜则实，正气夺则虚。难道不醒悟吗？大概只有虚、热、痰、气四种证候而已。月经不调也大致相同，随证调治，饮食调和，自然气血流通。如果有凝滞，然后可以使用红花当归散、紫葳散、通经丸、导经丸之类的药物。虚证只用当归散来通利。通利后又须养血益阴，使津液流通。如果不致力于气血充和，而只用毒药攻逼，这是向乞丐求千金，必然死而后已。
The *Mai Jing* (Pulse Classic) states: "When a woman suffers from diarrhea and her menstruation unexpectedly ceases, what is the reason?" The Master said: "One should only stop the diarrhea, and the menstruation will resume naturally; do not be surprised." The reason why continuous diarrhea leads to amenorrhea is that diarrhea depletes the body's Jin-Ye (body fluids), causing the cessation of menses. Once the diarrhea stops and Jin-Ye recovers, menstruation will naturally return. If a woman has vaginal bleeding, dry throat but no thirst, her menstruation must cease; this is due to insufficient Ying-Blood (nutritive blood). She inherently has slight cold in her body, hence she does not desire to drink. If she feels thirsty and desires to drink, it indicates that Jin-Ye are flowing freely, and Ying-Wei (nutritive and defensive qi) are harmonized; consequently, her menstruation will surely resume.
Li stated: Women are primarily governed by blood. When Tian-Zhen Qi (innate vital energy) descends and Ren-Gui water (Kidney water) combines, with Kidney Qi at its peak, blood vessels flow smoothly. Menstruation should occur every thirty days, mirroring the waxing and waning of the moon, hence it is called "Jing-Yue" (regular menstruation). The condition during menstruation is similar to the postpartum period. If residual blood remains uncleaned at this time, or if external pathogens such as Wind-Cold, Damp-Cold, Summer-Heat, or Heat invade, or if internal injury occurs from consuming raw and cold foods, combined with emotional stagnation (Seven Emotions) leading to Phlegm or Blood Stasis condensing within, this is termed "Blood Stagnation". Alternatively, after menstruation ends, excessive physical exertion, excessive sexual intercourse, or consumption of drying and heating foods may cause Fire to flare up, leading to excess pathogenic factors and depletion of Jin-Ye; this is termed "Blood Withering".
The *Liang Fang* states: Being startled after menstruation causes Qi and Blood to become chaotic and flow recklessly ("Startling causes Qi chaos, thus meridians run erratically"). If Qi rebels upward, blood may exit through the mouth and nose ("Anger causes Qi to rebel upward, severely leading to hematemesis"); if it rebels within the body, Blood and Water contend, transforming into edema. Anger causes Qi and Blood to rebel in the waist, legs, heart, abdomen, back, flanks, and between hands and feet, causing heavy pain that manifests during menstruation and subsides afterward. Extreme anger injures the Liver, leading to dizziness, hematemesis, scrofula, Blood Wind, sores, and other diseases. With menstrual blood leaking into these areas, it forms ulcers in orifices, dripping continuously. Damp-Heat contending together leads to metrorrhagia and leukorrhea. Blood coagulating internally transforms into masses (Zheng-Jia). All these varied complications stem merely from Blood Stagnation and Blood Withering (summary). However, Blood Stagnation can involve Deficient Heat, and Blood Withering can also involve Deficient Heat; severe cases result in complete amenorrhea. Speaking separately of Stagnation and Withering, mild cases involve only irregular menstruation, pertaining solely to Deficiency and Heat. For amenorrhea caused by Blood Stagnation suitable for breaking methods, the cause is often toxic heat from diet or violent anger, leading to condensed stasis and accumulated phlegm. One must use herbs like Da Huang (Rhubarb Rhizome) and Gan Qi (Drywood Lacquer) to push out the old and generate the new, eliminating old blood so new blood can arise. If Qi is robust but Blood is withered, originating from labor and worry, one should employ gentle warming and tonifying methods. If accompanied by Phlegm-Fire or Damp-Heat, clearing and cooling are especially appropriate; Cinnamon Twig (Rou Gui) is often used as an assistant herb because heat promotes blood circulation. However, one must not use purely harsh drugs, lest they damage the Yin pathway. Regarding the theory of exhausting Qi to benefit Blood, although it is a key method in Gynecology, Blood is the companion of Qi; if Qi is hot, it is hot; if cold, it is cold; if ascending, it ascends; if descending, it descends; if moving, it moves; if stagnant, it stagnates. Only if there is constrained Fire and Qi exceeds Blood can one solely use Xiang Fu Wan Powder or Yi Qi San, adding Mu Xiang (Costus Root), Bing Lang (Areca Seed), and Zhi Ke (Aurantium Fruit) to open constraints and move Qi. If Qi is chaotic, regulate it; if cold, warm it; if deficient, tonify it. This applies to both men and women; when Yang grows, Yin naturally lengthens; when Qi declines, Blood also dries up. How can one exclusively exhaust Qi? Commentators often cling to Shu He's statement that "Blood is abundant while Qi is deficient," unaware that Shu He was discussing the Liver and Lung pulses (since the Liver stores Blood and the Lung governs Qi), implying the Liver should be more robust than the Lung. Actually, harmonious Qi and Blood are required for conception, hence he subsequently stated that the two organs must be harmonious. However, women often have narrow perspectives and humble status, with unfulfilled ambitions, leading to constant depression and anger; thus, Cyperus Rhizome (Xiang Fu) is considered a celestial medicine for women. The Classics state: "Excess pathogenic factors lead to Excess patterns; loss of healthy Qi leads to Deficiency patterns." Should one not realize this? Generally, there are only four syndromes: Deficiency, Heat, Phlegm, and Qi. Irregular menstruation is largely similar; treat according to the syndrome, harmonize diet, and naturally Qi and Blood will flow. If there is still stagnation, then one may use formulas such as Hong Hua Dang Gui San, Zi Wei San, Tong Jing Wan, or Dao Jing Wan. For Deficiency, only Dang Gui San should be used to promote flow. After promoting flow, one must nourish Blood and benefit Yin to ensure Jin-Ye circulate. If one neglects to strive for the fullness and harmony of Qi and Blood, relying instead on toxic drugs to attack, it is like seeking a thousand gold from a beggar; death is the inevitable outcome.