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According to *Zhunsheng*: Women's diseases are mostly caused by menstrual flow being sometimes excessive and sometimes scanty, or arriving either early or late. If practitioners fail to examine carefully and indiscriminately label all such conditions as "menstrual disorders" without understanding the principles of Yin-Yang excess and deficiency, medication will be ineffective. Generally, when Yin Qi overcomes Yang Qi, the uterus (Bao Gong) is filled with cold, and blood circulation fails to operate smoothly. As stated in the classics: "When heaven is cold and earth frozen, water congeals into ice," thus causing scanty menstruation that arrives after its due time. Conversely, if Yang Qi overcomes Yin Qi, blood flow becomes scattered and overflowing. As stated in the classics: "When heaven is hot and earth warm, menstrual waters boil and overflow," thus causing excessive menstruation that arrives before its due time. Treatment should harmonize Qi and Blood and balance Yin and Yang; this is the appropriate approach.

Commentary: For the aforementioned syndromes, when Yang is in excess and Yin is deficient leading to early menstruation, use Danggui San (Cinnamon Twig Decoction, i.e., Siwu Tang added with Huangqin and Baizhu). When Yin is in excess and Yang is deficient leading to scanty and delayed menstruation, use Qifei Tang (Seven Boiling Decoction, i.e., Siwu Tang added with Pengzhu, Chuanxiong, and Muxiang). In general, menstruation arriving two to three days late indicates Blood Deficiency; treat with Siwu Tang added with Renshen, Fuling, and Baizhu to tonify Qi and regulate Blood. Menstruation arriving three to five days early indicates Heat in Blood; treat with Siwu Tang added with Jiu Chao Huangqin (Wine-fried Scutellariae Radix) and Lianzi (Lotus Plumule) to clear Heat and harmonize Ying (Nutritive Qi). Furthermore, treatment must be differentiated based on the patient's body constitution (fat or thin), presence of Phlegm, or presence of Fire.

Wang Ziheng states: Menstruation is a regular indicator. By observing it, one can discern the fluctuations of Yin and Yang throughout the body and thereby know the state of safety or danger. Hence, it arrives once a month. Any excess or deficiency constitutes irregularity. Excess of Yang leads to early arrival; deficiency of Yin leads to late arrival. Conditions such as fluctuating volume (excessive or scanty), cessation of flow, or continuous metrorrhagia/menorrhagia are caused by the waxing and waning of Yin and Yang. These should be treated according to the differentiation of meridians.

Commentary based on Lizhai's theory: Early arrival is caused by dryness of Blood in the Spleen Meridian; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). It may also be caused by stagnant Fire in the Spleen Meridian; use Guipi Tang (Restore the Spleen Decoction). It may be caused by Fire from anger in the Liver Meridian; use Jiawei Xiao Chai Hu Tang (Modified Minor Blue Green Dragon Decoction). It may be caused by Heat in the Blood level; use Jiawei Siwu Tang (Modified Four Substance Decoction). It may be caused by Fire stirred by overwork; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Late arrival may be caused by Blood Deficiency in the Spleen Meridian; use Renshen Yangrong Tang (Ginseng Nourishing the Vigor Decoction). It may be caused by Blood insufficiency in the Liver Meridian; use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill). It may be caused by Qi decline and Blood weakness; use Bazhen Tang (Eight Treasures Decoction). Generally, Blood is born from Spleen Earth; therefore, it is said that the Spleen controls Blood. All Blood diseases should be treated with bitter and sweet agents to assist Yang Qi and generate Yin Blood. Lizhai’s classification into Liver, Spleen, Blood Level, and Overwork categories is indeed detailed and clear.

Danyizi says: Spleen Deficiency with Qi Stagnation warrants Guipi Tang. Spleen Excess with Qi Stagnation warrants Yuequ Wan (Yuequ Pill) and similar formulas.