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7. Women often lack autonomy in the family, making them prone to emotional injury from worry, resentment, and depression. The flow and cessation, smoothness and reversal of blood are all governed by Qi (vital energy) for its movement.

[Note] Women depend on their husbands and cannot take full charge of matters. Injury caused by worry, anger, and stagnant Qi means that menstrual disorders are mostly due to the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright). This is because the movement, cessation, smoothness, or reversal of blood are all directed by Qi.

8. Blood is the refined essence derived from water and grain. If the Spleen and Stomach are injured, how can it be generated? Disorders such as irregular menstruation, exhaustion of fluids, and withered blood are often caused by damage from improper sexual conduct.

[Note] Blood is the refined essence of water and grain. In men, it transforms into Essence (Jing); in women, it transforms into Blood. It ascends to become milk and descends to become menstruation. If internal injury damages the Spleen and Stomach, impairing their transportation and transformation functions, leading to reduced dietary intake, Blood cannot be generated, resulting in irregular menstruation. There are also cases where a woman has reached menarche but has not cohabited with a man past the appropriate age, or desires cohabitation before the appropriate age, or engages in intercourse during normal menstruation. These constitute improper sexual conduct, which also leads to irregular menstruation. Excessive lust and frequent intercourse deplete Body Fluids; multiple births and frequent breastfeeding deplete Blood. All these can damage Yin and Blood, causing menstrual disorders.

9. When Blood transforms according to Yang, its color is normally red. A change to purple-black indicates Heat. Yellow like rice washings or pale red indicates transformation from Dampness and Deficiency. One must further examine whether there is Blood Stasis, clots, and whether the color is dull or bright.

[Note] Blood belongs to Yin but transforms under the influence of Yang; thus, its normal color is red. Even if menstrual disorders exist, they are easy to treat. If the color becomes deep red or purple-black, it is a sign of Heat. If yellow like rice washings, it indicates transformation from Dampness. Pale red or white indicates Deficiency. One must further examine for Blood Stasis, clots, and whether the color is dull or bright to guide treatment. If the color is dull and purple-black, accompanied by Cold symptoms, it mostly belongs to Cold Coagulation. If the color is bright and purple-black, accompanied by Heat symptoms, it mostly belongs to Heat Binding.