Library

Qibo said: When a woman reaches the age of seven, her kidney qi (Kidney Qi) becomes abundant, her teeth change, and her hair grows. At the age of fourteen (two times seven), Tian Gui (subtle substances promoting reproductive maturity) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes vigorous, causing menstruation to occur on time. "Tian" refers to Heavenly True Qi; "Gui" refers to the name of Gui Water, hence it is called Tian Gui. However, the Chong Mai is the Sea of Blood, and the Ren Mai governs the fetus and uterus. When Kidney Qi is fully abundant and these two vessels flow smoothly, menstrual blood gradually fills up and flows down at the appropriate time. The so-called "Yue Shi" (Menstruation) is the Qi of peace and harmony, usually occurring once every thirty days, symbolizing the principle that when the moon is full, it begins to wane. During the menstrual period, one must be most cautious in regulation and care. If management is improper, illness may be contracted as if after childbirth; mild cases result in chronic diseases, while severe cases lead to death. For instance, if startled during this time, Qi and Blood become disordered, and the meridians gradually cease to flow, leading to conditions such as Blood-type Consumption Disease (Xue Fen Lao Zhai) throughout the body. If laboring excessively at this time, deficiency heat arises, becoming the root of pain. If angered, Qi rebels; when Qi rebels, Blood rebels. Rebellion in the waist and legs causes pain and swelling, which resolves after the menstrual period ends. Furthermore, regarding symptoms like metrorrhagia and metrostaxis (Beng Lou) that do not stop, they initially arise from Hyperactive Heart Fire (Xin Huo Kang Sheng), causing blood vessels to overflow, resulting in Liver Excess where the Liver fails to store blood, rendering the mechanisms of excretion and reception useless. The Classic states: "The child can make the mother excessive." Therefore, the Ministerial Fire (Xiang Huo) of the Liver and Kidneys, carrying the momentum of Heart Fire, fans each other, causing menstrual irregularities, erratic flow, and flooding. If not treated early, this gradually develops into leukorrhea (Dai Xia), white turbidity (Bai Zhuo), white vaginal discharge (Bai Yin), Blood Depletion (Xue Ku), fever, and extreme exhaustion (Lao Ji). Generally speaking, amenorrhea and persistent metrorrhagia are both caused by emotional insufficiency leading to menstrual irregularity. If left untreated for a long time, myriad complications arise, which cannot be fully described. To touch upon it lightly is like an autumn hair, but contracting the disease is heavy as a mountain; how can one not fear it?

Labor injuring Qi and Blood, invasion of Wind-Cold Qi, Seven Emotions (Qi Qing), Six Evils (Liu Yin).

The term "Jing" (Menstrual Period) means to observe or wait, used to observe the盈虚 (fullness and emptiness) of Yin and Yang in the entire body to know safety and danger. Thus, its arrival must follow the monthly cycle. Both excess and deficiency are termed irregular. Excess of Yang leads to early arrival; excess of Yin leads to late arrival. There are cases of fluctuating volume, cessation of flow, metrorrhagia, and metrostaxis, which are also due to the rise and fall of Yin and Yang and the pathogenic factors of Cold and Heat. Chao Yuanfang stated: Women's menstrual irregularity is caused by labor injuring Qi and Blood, leading to physical weakness. If Wind-Cold Qi attacks the interior of the uterus, damaging the Chong and Ren vessels and harming the Taiyang and Shaoyin meridians, it causes issues. The Chong and Ren vessels all originate from the interior of the uterus and are the Sea of Meridians. The Hand Taiyang Small Intestine Meridian and the Hand Shaoyin Heart Meridian are exterior-interior pairs, governing the transformation of milk upwards and menstruation downwards. Since menstruation is the surplus blood of the meridians, if Cold and Heat are harmonious, the Chong and Ren vessels are vigorous, and the blood generated by the Taiyang and Shaoyin meridians flows freely and descends on time. If Cold and Warmth are mismatched, the meridians become deficient, and if Wind-Cold Qi takes advantage, evil transmits into the blood. If Cold, blood coagulates; if Warm, blood dissipates. Thus, menstrual volume fluctuates, which is termed irregular.

As for diseases of menstrual irregularity, they are generally caused by blood injury from abortion or postpartum, or by Spleen-Stomach disharmony with reduced food intake failing to generate blood, or by Seven Emotions injuring the Heart Qi, causing stagnation, thus leading to menstrual irregularity.

I have observed: Blood is paired with Qi and moves with Qi. Formation of masses indicates Qi stagnation; pain before menstruation indicates Qi stasis; pain after menstruation indicates deficiency of both Qi and Blood; pale color indicates deficiency; erratic menstrual flow indicates Qi disorder; purple color indicates Heat in Qi; black color indicates severe Heat. Nowadays, people attribute everything to Wind-Cold, often making mistakes. In the aforementioned conditions, when Qi moves, Blood moves; when Qi stops, Blood stops. Wang Jiezhai said: Women's amenorrhea is mostly caused by Spleen-Stomach damage. One should not immediately diagnose it as amenorrhea due to dead blood and lightly use blood-invigorating and blood-breaking herbs. When encountering such symptoms, one must examine the Spleen. If the Spleen-Stomach is damaged by diet and fatigue, leading to poor appetite, aversion to food, diarrhea, and pain, or if mistaken use of sweating and purging methods damages Middle Qi with harsh drugs, causing insufficient Blood and subsequent amenorrhea, only tonifying and nourishing the Spleen-Stomach is suitable. When robust, it generates Blood, and menstruation proceeds naturally. In cases where dietary stagnation damages the Spleen-Stomach, resolving stagnation and tonifying the Stomach is also appropriate. Only if the Spleen-Stomach is healthy and there are indeed blood clots should blood-invigorating and menstruation-promoting treatments be used.