〔大〕夫产伤动于血气，其后虚损未复，而为风冷所伤，血之为性，得冷则凝结，故
风冷伤于经血，结于胞络之间，故令月水不通也。凡血结月水不通，则成血瘕，水血相
并，复遇脾胃衰弱，肌肉虚者，则为水肿也。
妇人冲任之脉，为经络之海，皆起于胞内，而手太阳小肠之经、手少阴心之经，此
二经上为乳汁，下为月水，若产后月水不通者，盖新产之后，劳伤气血，或去血过多，乳
汁通行，自是不通，若乳子岁半或一岁之内，而月经不行，此是常候，即非病也，何必通
之。谚云奶假是也。若半岁而行者，或四五个月便经行者，皆是少壮血盛之人，注受极
易，产乳必众，其子失乳，必四肢 羸，肚大青筋，头大发焦，好啖泥土，病名无辜。若
经血有余者，不可以药止之。若产后一二岁，月经不通，而无疾苦，何必服药。或劳伤气
血，冲任脉虚，气血衰少而不能行者，但服健脾胃，资气血之药，自然通行。若用牛膝、
红花、苏木、干漆、虻虫、水蛭等药以通之，
则为害滋大，经水枯竭则无以滋养，其能行乎。初虞世所谓譬犹索万金于乞丐之手，虽
捶楚并下，而不可得也。后之学人，更宜详番而疗之。
〔薛〕前证脾胃虚弱，用六君子汤。若兼郁火伤脾，用归脾汤加丹皮、山栀。若怒
火伤血，宜用四物合小柴胡。气血俱虚，用八珍、牡丹皮。仍参前论主之。一产妇月
经年余不通，内热晡热，服分气丸，经行不止，恶寒作渴，食少倦怠，胸满气壅。朝用
加味逍遥散，夕用四君子汤，月许，诸证稍愈。佐以八珍汤，兼服两月而愈。
以上三证，宜于调经门中参看通用。
【戴元礼】妇女因分娩损伤了血气，此后虚损未能恢复，又受到风冷邪气的侵袭。血的性质是遇到寒冷就会凝结，所以风冷邪气侵犯经血，在胞宫络脉之间凝结，导致月经不通。凡是血液凝结导致月经不通的，会形成血瘕（腹内结块）；如果水湿与血液相互搏结，再加上脾胃功能衰弱、肌肉消瘦的人，就会发生水肿。
妇女的冲脉和任脉，是经络之海，都起源于胞宫内部。手太阳小肠经和手少阴心经这两条经脉，向上化生为乳汁，向下化为月经。如果产后月经不通，大概是因为新近分娩后，劳倦损伤了气血，或者失血过多，导致乳汁运行通畅而月经停止，这是自然现象。如果在哺乳半年或一年之内，月经没有来潮，这属于正常情况，并不是疾病，何必强行通经呢？谚语所说的“奶假”（哺乳期停经）就是这个道理。如果是半岁就来月经，或者四五个月就来月经的，都是年轻体壮、血气旺盛的人，受孕极易，生育众多，孩子失去母乳，必然四肢瘦弱，腹部胀大且青筋暴露，头发干枯焦黄，喜欢吞食泥土，这种病名叫“无辜疳”。如果经血有余，不可以用药物强行止住。如果产后一两年，月经不通，但没有其他病痛，何必服药呢？或者是由于劳倦损伤气血，冲任脉虚弱，气血衰少而不能运行，只需服用健脾胃、滋养气血的药物，月经自然会通行。如果使用牛膝、红花、苏木、干漆、虻虫、水蛭等药物来强行通经，危害就太大了。经血枯竭就无法滋养身体，怎么能行得通呢？初虞世曾说：这就像向乞丐索要万金，即使鞭打拷问，也是得不到的。后来的学医者，更应当仔细审察并治疗。
【薛己】上述证候若属脾胃虚弱，使用六君子汤（Six Gentlemen Decoction）。如果兼有郁火伤脾，使用归脾汤加牡丹皮、山栀。如果因怒气伤血，宜用四物汤合小柴胡汤。气血俱虚，使用八珍汤加牡丹皮。仍参考前面的论述作为主治依据。有一位产妇月经一年多不通，伴有内热和傍晚发热，服用了分气丸后，月经淋漓不止，出现恶寒、口渴、食欲减退、倦怠、胸满气壅等症状。早晨服用加味逍遥散，晚上服用四君子汤，约一个月后，各种症状稍有好转。再辅以八珍汤，连续服用两个月而痊愈。
以上三个病例，适宜在调经章节中参考通用治法。
[Dai Yuanli] Women, having suffered damage to their blood and qi during childbirth, may find that their postpartum deficiency has not yet recovered. If they are subsequently injured by wind-cold pathogens, the nature of blood is to coagulate when exposed to cold. Therefore, when wind-cold invades the menstrual blood and coagulates within the collaterals of the uterus (Bao Luo), it results in amenorrhea (absence of menstruation). Whenever blood coagulation leads to amenorrhea, a blood mass (Xue Jia) may form. If water-dampness and blood bind together, compounded by spleen-stomach weakness and emaciation, edema (Shui Zhong) will ensue.
The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) of women serve as the sea of the meridians and collaterals, both originating from within the uterus. The Hand-Taiyang Small Intestine Meridian and the Hand-Shaoyin Heart Meridian transform upwards into breast milk and downwards into menstrual blood. If menstruation does not resume after childbirth, it is likely due to labor-induced injury to blood and qi, or excessive blood loss, which causes the flow of breast milk to be smooth while menstruation ceases; this is a natural phenomenon. If menstruation remains absent during breastfeeding for six months to one year, this is a normal physiological state and not a disease; there is no need to forcibly induce menstruation. As the proverb states, "breastfeeding induces temporary amenorrhea." Conversely, if menstruation resumes at half a year, or even four to five months postpartum, these individuals are typically young, vigorous, and possess abundant blood and qi. They conceive easily and bear many children. Their infants, deprived of breast milk, will inevitably suffer from limb emaciation, abdominal distension with prominent veins, dry and brittle hair, and pica (geophagia), a condition known as "Wugu" (Innocent Disease/Infantile Malnutrition). If there is an excess of menstrual blood, it should not be stopped by medication. If menstruation is absent one to two years postpartum but without other discomforts, medication is unnecessary. However, if amenorrhea results from labor-induced injury to blood and qi, leading to deficiency of the Chong and Ren vessels and insufficient blood and qi to propel flow, one should administer herbs that strengthen the spleen and stomach and nourish blood and qi; menstruation will naturally resume. Using herbs such as Achyranthes Root (Niuxi), Safflower (Honghua), Broussonetia Wood (Sumu), Drynaria Resin (Ganqi), Blister Beetle (Mangchong), and Leech (Shuizhi) to forcibly unblock menstruation would cause significant harm. With depleted menstrual blood, there is no source for nourishment, making flow impossible. Chu Yushi stated: "This is like demanding ten thousand gold pieces from a beggar; even under torture, it cannot be obtained." Scholars of later generations must examine cases carefully before treating them.
[Xue Ji] For the aforementioned syndromes attributed to spleen-stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction). If complicated by constrained fire injuring the spleen, use Guipi Tang (Restore the Spleen Decoction) added with Moutan Cortex (Danpi) and Gardenia Fruit (Shanzhi). If anger injures the blood, combine Siwu Tang (Four Substances Decoction) with Xiaochaihu Tang (Minor Bupleurum Decoction). For combined deficiency of qi and blood, use Shazhen Tang (Eight Treasures Decoction) with Moutan Cortex (Danpi). Refer to the preceding discussion for primary treatment principles. A postpartum woman presented with amenorrhea lasting over a year, accompanied by internal heat and afternoon tidal fever. After taking Fenqi Wan (Qi-Regulating Pill), her menstruation became prolonged and unstoppable, accompanied by aversion to cold, thirst, poor appetite, fatigue, chest fullness, and qi stagnation. She was prescribed Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) in the morning and Sijunzi Tang (Four Gentlemen Decoction) in the evening. After about a month, her symptoms improved slightly. This was supplemented with Shazhen Tang (Eight Treasures Decoction), and she recovered after two months of concurrent administration.
The above three cases should be consulted alongside the general methods in the chapter on regulating menstruation.