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The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states: When a girl reaches fourteen years of age, Tian Gui (substances that promote reproductive maturation) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant, causing menstruation to occur at regular intervals. The waxing and waning of the moon reflects the fluctuation of the true water in nature; therefore, tides rise and fall with a fixed cycle. Women belong to Yin, and blood is a type of water substance; thus, women also follow the lunar cycle with a fixed menstrual period. If the menstrual cycle is irregular, disease arises; hence, ancient physicians considered regulating menstruation to be the primary task in treating gynecological disorders. The emphasis on regulating menstruation is correct, but to regulate irregular menstruation, one must trace the root cause of the irregularity and treat accordingly for the menstruation to normalize. However, most formulas for regulating menstruation in medical texts consist of herbs that move Qi and break blood stasis. They fail to realize that human Qi and Blood only suffer from deficiency, never from excess; symptoms appearing as excess are actually caused by deficiency, where pathogens invade due to righteous Qi deficiency. How can severely damaging Qi and Blood possibly regulate menstruation? It is also said that women often suffer from Qi stagnation, so treatment must include opening stagnation. "Stagnation" refers to blocked Qi flow; it requires slightly acrid and moistening herbs that harmonize with the gentle warmth of spring, embodying the mechanism of growth and development, to smooth Qi dynamics. How could pungent, drying, and astringent herbs possibly unblock suppressed Qi? The *Classic of Poetry* mentions utilizing the Qi of Earth and Metal; Earth and Metal possess clear and descending properties. Slightly acrid and moistening herbs can unblock, while slightly bitter and cool herbs can descend. Moreover, white and round substances resemble the Heart and Lungs, thus they can resolve stagnation. Later scholars claimed these herbs clear heat and transform phlegm, but this is actually their function of dissipating nodules. By analogy, other principles can be deduced.

There is a theory that early menstruation indicates Heat and late menstruation indicates Cold, but this is not entirely accurate. I believe that to diagnose a patient's illness, one must first distinguish their constitutional Yin and Yang. Those with Metal-Water constitution are typically obese and pale, mostly suffering from Qi deficiency. Observing complexion and pulse—if the face, lips, and tongue appear pale and dull, and the pulse is soft and soggy—these are signs of Qi deficiency. Qi deficiency impairs Spleen and Stomach transportation, leading to poor appetite and slow digestion, thinning the source of transformation (Qi and Blood generation), causing the Chong and Ren vessels to weaken. Qi may fail to control blood, causing early menstruation or metrorrhagia/metrostaxis; or Qi may fail to transform into blood, causing blood deficiency and late menstruation with pale red color, without distension or pain. Yang deficiency generates dampness, resulting in yellow or white leukorrhea. The treatment should use formulas like Guipi Tang (Restore the Spleen Decoction) to tonify the source of Qi and Blood generation. If prolonged, Qi fails to transform blood, leading to blood deficiency transforming into dryness, resulting in dual deficiency of Qi and Blood.

Those with Wood-Fire constitution are typically lean and dark-complexioned, mostly suffering from blood deficiency. Observing complexion and pulse—if the face, lips, and tongue are red and dry, and the pulse is fine, choppy, wiry, or rapid—these are signs of blood deficiency. Blood deficiency fails to nourish Liver Yin, causing Liver Yang to blaze internally, or blood heat causes reckless bleeding, leading to early menstruation or metrorrhagia/metrostaxis; or blood deficiency leads to stasis, causing late menstruation and distending pain. The treatment should focus on nourishing dryness and nurturing the Ying (Nutritive) level. For cases of stasis due to deficiency, add salty and softening herbs to soften hardness, and acrid and moistening herbs to unblock collaterals, which will naturally yield results. If prolonged, Yin deficiency leads to dryness and urgency, causing amenorrhea, which may develop into Liver Wind vertigo, irritability, hypochondriac pain, cough, hemoptysis, sore throat, and bone-steaming fever, forming the syndrome of Dry Blood Consumptive Disease.

When Qi and Blood are deficient, pathogenic Dryness and Dampness may invade due to deficiency, causing frequent complications. Qi is the mother of Water; fluids ingested into the Stomach rely on the suction of Spleen and Lung Qi to distribute essence throughout the body and circulate through the five meridians. In Qi deficiency, silent movement is powerless, fluids do not return to the proper pathway, transforming into turbid leukorrhea. There is hidden depletion of essence, abdominal pain during menstruation radiating from the shoulder and back down to the waist and feet, accompanied by soreness and weakness in all limbs, subcutaneous fever, and purple-black dull menstrual blood. Downward flow of Damp-Heat, blood stasis, and turbidity resembles rotten fish intestines, extremely foul-smelling, followed by yellow discharge after menstruation. If Damp-Heat and stasis do not descend, abdominal pain worsens. Treatment should add acrid and moistening herbs to unblock within blood-nourishing formulas, and bitter-acrid herbs to transform dampness. The ratio of bitter to acrid herbs must depend on whether Heat or Dampness is heavier to be effective. If untreated for long, Damp-Heat and stasis condense into masses. Initially gathered but not yet hardened, Ying Qi still circulates within, so palpation produces sound and tenderness. Ancient texts call this "Qi gathering forms Jia (irregular mass)," characterized by shifting location. Chao Yuanfang failed to investigate the origin, merely establishing names for Eight Jia (Yellow Jia, Green Jia, Fat Jia, Fox Jia, Snake Jia, Turtle Jia, Dry Jia, Blood Jia), which is misleading. He stated that Green Jia and Yellow Jia discharge green-yellow turbid fluid, and Fat Jia discharges essence and blood mixed like fat. This proves downward flow of Damp-Heat. Using the previous method plus salty softening herbs like Bie Jia (Turtle Shell), Gui Ban (Tortoise Shell), Jue Ming Zi (Cassiae Semen), and Mu Li (Oyster Shell) can both dry dampness, clear heat, soften hardness, and nourish Yin, ensuring efficacy. I have seen dysmenorrhea cases where prolonged blood deficiency transforms into dryness, forming hard masses outside the intestines and stomach within the collaterals. Ying Qi cannot circulate there, so they are firm and immovable, non-tender upon pressure. Ancient texts call this "Blood knotting forms Zheng (fixed mass)," characterized by immobility. Treatment should nourish dryness and nurture Ying, using clearing-moistening or warming-moistening methods based on cold/heat, combined with acrid-moistening and salty-softening herbs to gradually resolve them.

Another condition is Chang Tan (Intestinal Polyp/Mass). The *Neijing* states that Cold pathogen lodges outside the intestine, combats Wei Qi (Defensive Qi), adheres internally, causing flesh to grow, initially egg-sized, then enlarging like pregnancy, hard upon pressure but movable. Menstruation occurs regularly. This is disease of the adipose membrane outside the intestine, not entering the vessels. Another condition is Shi Xia (Stone Jia), arising in the Bao Zhong (uterus). The *Neijing* states Cold lodges in Zi Men (cervical os), blocking it, preventing expulsion of evil blood, which stays and enlarges daily, resembling pregnancy but hard as stone, with no menstruation. This is blood coagulation in the uterus. Another condition is Pi Ji (accumulated mass). Medical books say lateral rib-side accumulation is called Pi, hidden near the umbilicus, shaped like a hard string, triggered by labor and Cold, appearing with pain and hiding when painless. This is accumulation in the Jue Yin and Yang Ming meridians. These three conditions are treated with warming-moistening methods assisted by acrid-moistening methods. Warming-moistening and acrid-moistening herbs have Yang Qi quality and Yin substance, possessing the power to harmonize and dissolve凝滞 without the risk of drying and consuming fluids, using softness to overcome hardness—a fixed principle. Mr. Ju Tong said: The *Neijing* states that excessive Dryness causes Hernia in men and lower abdominal pain in women. This is Dryness extending to the Lower Jiao, combing the Blood level, forming hard knots. Regardless of gender, Hua Zheng Hui Sheng Dan (Transform Masses and Revive Life Pill) is indicated. If one does not know that Collateral diseases require gradual unblocking, or recklessly uses aggressive purgatives, one risks turning Jia into Gu (blood poisoning/toxin). Gu refers to Blood Gu, more common in women, a critical difficult-to-treat syndrome. Practitioners must prevent this. Hua Zheng Hui Sheng Dan treats excessive Dryness with Bitter-Warm assisted by Sweet-Acrid, using Bitter to purge. It is derived from Bie Jia Jian Wan (Turtle Shell Decoction for Reducing Masses) in *Jin Gui Yao Lue* and Hui Sheng Dan. For chronic hard knots, this formula is essential. Also, the *Nan Jing* states Ren Mai disease causes Seven Hernias in men and Jia Ju (masses) in women. This is Dryness in Lower Jiao not combing Blood, so pain/swelling is有形 (tangible) during attacks and无形 (intangible) when pain stops. One must not injure innocent Ying Blood, so Hua Zheng Dan is used. Elderly people with empty Eight Extraordinary Vessels should not take Hua Zheng Dan; Fu Heng Dan (Restore Prosperity Pill) is indicated instead. My comment: Hua Zheng Dan has too many aromatic drying herbs and should be reduced; Fu Heng Dan is appropriately warm-moistening and sweet-acrid.

Women's Sea of Blood is often deficient, Liver Yang often boils, making them prone to such syndromes. Ancients only distinguished Qi vs. Blood diseases, naming Accumulation and Jia, without detailing why Qi/Blood cause disease. Later scholars did not investigate, simply breaking Qi when seeing Qi issues and moving Blood when seeing Blood issues, using aromatics like Xiang Fu, Wu Yao, Hou Po, Qing Pi, Mu Xiang, Bing Lang to break Qi, believing "Qi is commander of Blood, Qi moves then Blood moves." When ineffective, they added blood-moving herbs like San Leng, E Zhu, Gan Qi, Yuan Hu, Su Mu, or even Ba Dou, Mang Xiao, Da Huang to break accumulations. This makes knots larger and harder, leading to emaciation, board-like abdomen, Gu syndrome, consumptive disease, tidal fever, epistaxis, cough, diarrhea, until death. This method has misled generations. Mr. Chun Shan said: "Qi is commander of Blood; Blood is the vessel for Qi." Where water is shallow, silt settles; where water is sufficient, rivers do not block. Where juice dries, things knot; where juice is sufficient, branches do not harden. Heaven covers Earth, inside and out are Water. Humans are bodies of flesh and blood, inside and out are Water. Formless Yang is based on Formative Yin. Blood movement relies on Qi movement; Qi movement relies on Blood movement because Blood carries Qi. In short, for Qi-caused disease, regulate Qi and Blood flows naturally; for Blood-caused disease, nourish Blood and Qi moves naturally; for Dryness/Dampness/Cold/Heat affecting Qi/Blood, treat the pathogen and Qi/Blood self-regulate. The *Neijing* says: "Treating disease must seek its root." This is crucial.

Reproduction involves two methods: regulating menstruation and preserving Essence. Ancient song says: Mountains need vegetation; humans need fertility. Women need regulated menstruation; men need sufficient Essence. Regulating menstruation was explained earlier. Preserving Essence requires detailed study. The *Neijing* says: Two spirits combine to form shape, born before the body, called Jing (Essence)—this is congenital original Essence. It also says: Grain enters, Qi fills, moist essence pours into bones, called Ye (Fluids)—this is acquired daily Essence. Congenital Essence is received at birth; Acquired Essence comes from Grain Qi, hence the character Jing contains Rice and Green. To preserve Essence, one needs not just medicine but diet regulation. Fried/spicy/drying foods generate Heat and should be avoided. Treatment depends on constitution. Qi deficiency: treat Spleen and Lung. Earth is Mother of Metal; Metal is Source of Water. Dietary essence relies on Spleen Qi distribution and Lung Qi irrigation. Tonifying Spleen/Lung Qi enriches the source of transformation, hence "Qi returns to Essence." Yin deficiency: treat Lung, Heart, Kidney. The *Neijing* says above the diaphragm/hum region are Parents (Lung and Heart); beside the 7th vertebra is Small Heart (Kidney). Lung, Heart, Kidney respiration connects; Minister Fire follows Lord Fire. Heart generates Essence; Heart damages Essence. Essence comes from Grain Qi (White color, base of five colors); Grain Qi goes to Heart, transforms to Red Blood via Lord Fire; Red Blood receives Metal Qi distribution, descends to Kidney to become Essence, returning to origin (White). Essence comes from Blood vessels, so "Heart generates Essence." Generating is hard; damaging is easy. Lord Fire moves, Minister Fire follows; latent floating Yang consumes more than it generates. Thus, Yin deficiency requires nourishing Lung/Heart/Kidney Yin to generate, and attracting Heart/Kidney Yang to prevent consumption. When Heart-Kidney Kan-Li balance is achieved, Lung-Spleen-Kidney Taiji is peaceful. True Yin/Yang deficiency: treat Spleen and Kidney. Benefit Fire to treat Earth's Mother; cultivate Earth to generate Water source—this is congenital/acquired Qi mutual generation. Use warm-moistening/sweet-moistening herbs; avoid rigid-drying mineral drugs. I have seen infertility cases where patients took warming-tonic formulas for Ming Men year-round, believing it tonifies Kidney Fire. But Fire in Water should be warm-moistening, not warm-drying. With inherent Yin deficiency, adding rigid-drying herbs causes headache, toothache, blindness, ulcers, paralysis, etc., due to this misconception. Even correct medicine only treats disease; plants cannot add Essence. Preserving Essence is self-controlled. Mei Cheng's *Seven Prompts* says: Carriages cause paralysis; secluded rooms cause cold/heat; beauty axes destroy nature; rich food rots intestines. Thus, preserving Essence requires few desires, moderate labor, calming Heart Fire so Minister Fire rests, protecting True Yin, adjusting temperature/diet to enrich source. This is the truth of non-medical preservation. Sufficient Essence leads to spirit return and likely male offspring. Ancient theories about odd/even days determining gender are fragmented. Men with superior Essence have more sons; Women with superior Tian Gui have more daughters (Qian creates Male, Kun creates Female). Male Essence arriving first births Male; Female Tian Gui arriving first births Female (Inner Yang/Outer Yin of Qian/Kun six children). Tian Gui is Woman's True Yin. Ma Yuantai said: Tian Gui is Yin Essence. Kidney is Water; Gui is Water. Generated from accumulated congenital Qi, thus Tian Gui is Yin Essence. Wang Taipu mistook menstruation for Tian Gui. *I Ching* says: Male/Female combine essence, ten thousand things arise. Both have essence at intercourse. Female essence arrives at 14, coinciding with menstruation, hence Chong Mai abundance and regular periods. Western science says: Uterus has 15-18 ova like quail eggs, wrapped in membrane, containing Yin Essence. At puberty, ova begin; at menopause, they cease. Intercourse ruptures ova, Yin/Yang essence combine for pregnancy. This matches Ma's view. Chickens lay finite eggs; once exhausted, no more. Similarly, obese women rarely conceive due to uterine damp-phlegm/fat obstruction, treated with Er Chen Tang and Er Zhu. Women with early/excessive sexual activity or post-hemorrhage rarely conceive, likely due to depleted ova. Thus, preserving Essence applies to women too.

After preserving Essence, protect the Fetus. Protection relies on Qi and Blood. The fetus is like Heaven covering Earth or Hen incubating Egg, nourished by Blood around, held by Qi, connected to Kidney via Bao Mai (Uterine Vessel). If Qi is too weak to hold, or Blood too weak to nourish, the fetus falls. Chao Yuanfang's theory of Twelve Meridians nourishing fetus via Five Elements/Seasons is unreliable. Meridians are one continuous Qi, not divided. Regarding Kidney connection: Waist is Kidney's residence; Kidney is root. Kidney deficiency loses suction power, causing miscarriage; thus, low back pain predicts miscarriage. Generally, 20-30% miscarriages are Qi deficiency; 60-70% are Blood deficiency. Miscarriages at 2-3 months are usually Yin deficiency with Heat scorching, like fish in dried pond. Treat by clearing/nourishing Kidney Yin; avoid rich/greasy/drying herbs. Ancient Huang Qin and Bai Zhu for stabilizing fetus are bitter-dry/acrid-dry, unsuitable for fetus; perhaps used for Spleen Damp-Heat in pregnant women, later mistaken as holy medicine. Wu Youke said Da Huang stabilizes fetus, referring to exterior pathogens transmitting to Stomach Fu; eliminating pathogen stabilizes fetus. Would one use it without excess syndrome? Ancient Yinzhu Jiu stabilized fetus by suppressing rebellion, clearing heat, harmonizing Qi/Blood. Using it for trauma-induced threatened abortion accelerates miscarriage. In short, if pathogen causes instability, eliminate pathogen to stabilize fetus ("If there is pathology, no injury"). If no pathogen, find root cause. If trauma, nourish Qi/Blood, mildly regulate Qi.

Prenatal miscellaneous diseases like Zi Xian (eclampsia), Zi Fan (restlessness), Zi Yun (vertigo), Zi Lin (dysuria), Zi Zhong (edema), Zi Xuan (distension), Zi Sou (cough) are mostly Yin deficiency transforming Dryness or Yang deficiency transforming Dampness. Adjust according to syndrome.

Pregnant women should exercise lightly to circulate Qi/Blood, avoiding dystocia. Ancient Daseng San contains pungent-drying/dissipating herbs; do not take. Mr. Ju Tong said: "World has no trouble, fools create it." Correct. For easy delivery, eat tofu skin with honey or Duck Soup/Pig Skin Soup to "float the boat with water." During labor, remain quiet. "Melon ripe, stem falls" is apt. *Daseng Bian* six words: Sleep, Endure Pain, Slow Delivery. Crucial. For fused pubic symphysis, Jiawei Danggui Tang (Dang Gui, Chuan Xiong, Xue Yu Tan, Zhi Gui Ban) is safe. Rabbit Brain Pill, Liying San are harsh; avoid. For dystocia lasting 2-3 days with exhausted fluids/blood/Qi/Blood, urgently use Bazhen Tang minus Fu Ling/Bai Zhu, add E Jiao, Gou Qi, Sha Yuan, Huang Qi, Shan Yao to tonify Qi/Blood. For extreme deficiency with coma/unconsciousness, decoct large amount of Bazhen ingredients slowly in room, inhale aroma to move Qi/Blood, wake patient, then feed soup. Verified method. For dead fetus, tongue is blue-dark, abdomen cold, chills, fetus decomposing. Use large dose blood-nourishing herbs, slight Rou Gui. If Qi deficiency, add Qi tonics. Do not rigidly use Pingwei San/Po Xiao to purge, damaging Qi/Blood. Old rhyme: Red face/blue tongue, mother lives/child dies; Blue face/red tongue, mother dies/child lives; Both blue, both die. Valid. Postpartum Qi/Blood greatly deficient; be cautious. Locally use Shenghua Tang (Dang Gui, Chuan Xiong, Zhi Cao, Pao Jiang, Tao Ren) or Pepper/Ai soup. Shenghua Tang moves blood/resolves stasis, suitable for Erzhen (lower abdominal mass) pain. Pepper dissipates True Yin; Ai warms/generates Wind; both contraindicated. Liver-deficient/blood-dry constitutions with rising Liver Yang should not take Shenghua Tang (pungent-warm-moving); some developed spasms/coma. Postpartum safest is Dang Gui, Dan Shen, Zhi Cao to harmonize blood, slight Tao Ren to guide residual stasis. Chuan Xiong is pungent-scattering; Pao Jiang is warm-drying; use sparingly. Houwu Baoyou Baosheng Tang creators unknown, harmful, strictly forbidden. Cases of Qi/Blood...