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The *Yin Yang Bie Lun* (Treatise on Differentiating Yin and Yang) states: Diseases of the Two Yang meridians (Yangming Stomach and Large Intestine) originating from the Heart and Spleen can lead to unspoken emotional constraints in patients, resulting in amenorrhea (absence of menstruation) in women. If the condition progresses to "Feng Xiao" (consumption due to deficiency-heat leading to emaciation) or "Xi Ben" (qi rebellion manifesting as asthma-like symptoms), it is a fatal and incurable syndrome.

In women, long-standing deficiency of the Spleen and Stomach, or extreme emaciation with exhaustion of both Qi and Blood, can cause the cessation of menstruation. Alternatively, patients suffering from Zhong Xiao (Middle Jiao consumption characterized by polyphagia) may have heat in the Stomach, increased appetite yet progressive emaciation, and failure to generate Body Fluids. Since menstruation is transformed from Blood vessels and Body Fluids, once Body Fluids are exhausted and scorched by Heat, muscles become emaciated, thirst and irritability frequently occur, and the Sea of Blood becomes depleted. This disease is named "Xue Ku" (Blood Depletion), characterized by the cessation of menstruation. Treatment should involve purging the dryness and heat of the Stomach and tonifying Qi and Blood, after which menstruation will resume naturally.

In such cases, some women may conceive shortly after their period begins, leading to fetal instability and fetal disease. Others may present with a surging, rapid, and restless pulse at the Pericardium channel, frequent constipation, clear but difficult urination, and amenorrhea. This indicates depletion of the Sea of Blood; treatment should regulate the Blood vessels and eliminate Fire pathogens in the Pericardium, allowing menstruation to resume naturally. As stated in the *Nei Jing*: "Heat transferred from the Small Intestine to the Large Intestine" forms masses (Jia), and a choppy, obstructed pulse leads to stagnant and obstructed menstruation, hence the formation of masses and choppy pulses.

Some cases arise from mental labor damaging the Heart, causing Heart Fire to ascend and preventing menstruation. Treatment should calm the mind, harmonize the Blood, and purge Fire, allowing menstruation to resume naturally.

Therefore, the *Nei Jing* states: Amenorrhea occurs because the Bao Mai (Uterine Vessels) are closed. The Bao Mai belongs to the Heart and connects to the Bao Zhong (Uterus). If Heart Qi forces upward against the Lungs, preventing Heart Qi from descending, menstruation will not occur.

The *Yin Yang Bie Lun* further states: Yin deficiency with vigorous Yang pulsation is termed Beng (Sudden Profuse Bleeding). In women, deficiency damage to the Spleen and Stomach causes the Ming Men (Gate of Life) pulse to be deep, fine, rapid, or deep, wiry, surging, and forceful, similarly affecting the Cun and Guan positions. These result from Spleen-Stomach deficiency where Qi sinks into the Kidneys, combining with Ministerial Fire to create Damp-Heat that forces downward, causing persistent metrorrhagia. The blood is purple-black and foul-smelling like rotting meat in summer. If accompanied by leukorrhea (white discharge), the pulse is likely wiry and fine, indicating Cold pathogenesis within. If accompanied by bloody leukorrhea, the pulse is surging, rapid, and swift, clearly indicating Heat. Symptoms inevitably include lower back pain or hypogastric pain, alternating chills and fever, and tightness/contraction of the hypochondrium prior to menstruation, along with Spleen-Stomach signs. If accompanied by limb fatigue, irritability, insomnia, and epigastric urgency, one must greatly tonify the Spleen and Stomach and raise/lift the Qi and Blood; recovery can be achieved with a single dose.

Individuals who lose high status or wealth may suffer from insufficient Heart Qi, causing excessive Fire blazing within the Blood vessels, further disrupting Spleen-Stomach digestion and allowing Fire to invade internally. Although physical appearance may seem healthy, this is actually a Heart disease not evident in pulse diagnosis, while Spleen-Stomach disharmony manifests clearly, leading to irregular menstruation or sudden profuse bleeding upon onset. Treatment requires first explaining the danger of death to counsel the patient into joy, stabilizing the Heart. Use herbs to greatly tonify Qi and Blood and nourish the Spleen-Stomach, combined with slightly sedating herbs to suppress Heart Fire, treating the Heart by tonifying Yin and purging Yang, so menstruation stops naturally.

The *Wei Lun* (Treatise on Flaccidity Syndromes) states: Excessive grief severs the Bao Luo (Pericardium Collaterals). Yang Qi moves internally; upon manifestation, it causes uterine bleeding (Beng) and frequent hematuria. Thus, the *Ben Bing* chapter states: When the major vessels are empty, Ji Bi (Muscle Flaccidity) manifests and transmits to Mai Wei (Vessel Flaccidity). This refers to the aforementioned situation.