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10. When transformed by heat, the menstrual blood becomes thick and sticky with a foul odor; when transformed by cold, it is clear and thin with a fishy smell. If internal organs are ulcerated, the discharge will mix five colors and carry the qi of the viscera. If bleeding is profuse and incessant at this time, life will surely be endangered.
[Note] Whenever blood is transformed by heat, it must be thick, sticky, and foul-smelling. When transformed by cold, it must be clear and thin with a fishy odor. If it is due to internal ulceration, the discharged material will show mixed five colors, resembling pus and blood. If there is additionally a rotting odor of the viscera, and the bleeding is profuse and incessant, this is a critical condition, and life will surely be lost!

11. Menstruation occurring earlier or later than expected is called irregular menstruation (Qianqi). Early onset involves heat and stagnation, distinguishing deficiency and excess; pale color and scant flow indicate deficiency without distension or pain; purple color and abundant flow indicate excess with distension and pain.
[Note] Menstruation coming early or late is termed Qianqi (irregular menstruation), all belonging to menstrual disorders. Menstruation arriving in less than thirty days belongs to Blood Heat. If the bleeding is profuse, deep red in color and turbid, it indicates an Excess Heat. If the bleeding is scant, pale in color and clear, it indicates a Deficient Heat. Menstruation arriving after thirty days belongs to Blood Stagnation. If the color is pale, the blood is scant, and there is no distension or pain, it belongs to Blood Deficiency, a disease of insufficiency due to scant blood causing涩滞 (astringent stagnation). If the color is purple, the blood is abundant, and there is abdominal distension and pain, it belongs to Qi Excess, a disease of surplus due to abundant blood causing stasis.

12. Fever during menstruation or tidal fever: fever before menstruation is due to Blood Heat, while fever after menstruation is due to Blood Deficiency. Fever without fixed timing requires examination for external pathogenic heat; tidal fever in the afternoon should be assessed as Yin Deficiency heat.
[Note] Fever during menstruation includes intermittent fever and tidal fever. If it occurs before menstruation, it is heat from Blood Heat. If it occurs after menstruation, it is heat from Blood Deficiency. Fever without fixed timing is mostly due to external contraction, requiring examination of pathogenic heat from external evils. Tidal fever in the afternoon mostly belongs to interior heat, requiring assessment of heat from Yin Deficiency.

13. Chills, fever, and body pain during menstruation require differentiation between Ying and Wei states and deficiency/excess. Sweating without distension indicates Wei Qi deficiency; no sweating with distension indicates Ying Blood excess.
[Note] During menstruation, if there are chills, fever, and body pain, one must differentiate the deficiency and excess of Ying and Wei. If there is fever, chills, body pain without distension, and sweating, it belongs to Wei deficiency and Ying deficiency; if there is fever, chills, body distension and pain without sweating, it belongs to Ying excess and Wei excess.