【歌】不甚粘稠比带轻，白淫白浊白崩名，真元下陷脾虚损，龙火蟠腾水不升，多欲房劳明伐肾，邪思妄
想暗伤情，要知经络根源病，察脉观形辨五行。
【论】吴梅坡曰∶妇人下赤白不甚稠者，名白淫，与男子白浊同，由于龙雷之扰而不澄清也，属足少阴、太
阴，治当清补。若有滑白稠粘者，名带下，属心包。手厥阴心包系于脊，络于带脉，通于任脉，治宜血肉之剂以培
之，此探本穷源之论也。时人泥于常套作湿痰治，用兜涩升提之类，岂知本原伤损，以致腐败而来彼涩滞不清之
物，则益加其滞，升提不正之气，则愈增其郁，惟宜六龙固本丸，十六味保元汤。
【脉】阳急为瘕，阴急为疝，浮则肠鸣，紧则腹痛，数则生疮，弦则筋掣，弦大虚芤，细小微涩，皆主下白。
心肾不交
深阖寂寞暗伤春，脚软腰疫气不匀，白滑下流多恶梦，耳鸣目眩少精神。
金锁正元丹。
思虑伤神
胸痞虚浮面色黄，多眠少食困野狼当，阴阳清浊相干混，若欲厘清四七汤。
怒气伤肝
往来寒热不安宁，胁痛心烦面带青，口苦脉弦小便数，便知郁怒在肝经。
加味逍遥丸。
固本调元
头晕心嘈气血亏，四肢乏力属于脾，时常麻木精神少，固本培元最合宜。
六龙固本元。
【歌】妇人二七天癸至，冲任始通匝月行，恚怒忧思宜谨慎，阴阳气血自和平。虽由心统经遂液，还赖脾资水
谷精，行后空虚劳即病，初来恍惚易生惊，猛然抚髀长虚叹，偶尔停针不作声，便是桃夭思讽咏。应知雎鸟欲和鸣，
脉弦出际三关透，情动于中百感生，旧血停留还渗入，骨蒸潮热症非轻，乘凉登厕风吹入，饮冷形寒血不营，若要调经
先去病，更推形色得其情，过期色淡知无血，带紫赶前热不清。未至先疼因气滞，行过腹痛自虚明，平
时发热因劳积，热在临经血不盈，气乱错经行口鼻，脾虚漏下若葵羹，去多不住宜滋养，来少无疼大补荣。经闭要
分虚实看，血枯气隔热痰名。
【论】经曰∶天地温和则经水安静，天寒地冻则经水凝泣，天暑地热则经水沸溢，卒风暴起则经水波涌而陇起。
任脉通，冲脉盛，男则营运，女则停止。营运者，无积而不满动也。停止者，有积而能满静也。不满者，阳气随
时而行运。满者，阴血以时而下溢。谓之信者，男子以气运，故阳气应日而一举，女子以血满，故阴血应月而一下。
褚侍中曰∶男子精未通，而御女以通其精，则五体有不满之处，异日有难状之疾。阴已痿而思色，以降其精，
则精不出而内败，小便道涩而为淋，精已耗而复竭之，则大小便道牵痛，愈痛则愈便，愈便则愈痛也。女人天癸既至，
逾十年无男子合则不调，未逾十年思男子合亦不调，不调则旧血不出，新血误行，或渍而入骨，或变而为肿，后虽
合而难子。又曰∶合多则沥枯，虚人产众则血枯杀人，观其精血思过半矣。
寡妇师尼异治
褚澄疗尼姑、寡妇别制方法，盖有谓也。此二种独阴无阳，欲心萌而不遂，是以阴阳交争，乍寒乍热，全类温疟，
久则为劳。尝读《史记·仓公传》，载济北王侍人韩女，病腰背痛寒热，众医皆以为寒热病，仓公曰∶病得之欲
男子而不得也。何以知之，诊其脉，肝脉弦，出寸口，是以知之。盖男子以精为主，女人以血为主，男子精盛则
思室，女子血盛则怀胎也。夫肝藏血者也。厥阴肝脉弦，出寸口上鱼际，则阴盛可知矣。大法宜《本事方》生地
黄丸、柏子仁丸、卫生汤。
调经先去病
月水循环，百病不生而有子，若六淫外感、七情内伤，气血不调，心腹作痛，或引腰背，上下攻利，吐逆不
食，或寒热 瘕，
或潮热腹痛，重则咳嗽，汗呕泄泻。盖潮热自汗则血液消耗，咳嗽呕吐则气往上行，泻则津泄于下，痛则积结于
中，是以必先去病，尔后可滋血调经。若血渗入骨便为骨蒸，血积于中，相搏则痛，血枯不能滋润百骸，则热蒸
于外，血枯包络火旺或挟外邪，变成劳瘵。
调经大法
妇人经病有月候不调者，有经水不通者，然不调不通之中，有兼疼痛者，有兼发热者，此又分为四也。四者细
推之，不调之中有赶前者，有退后者，赶前为热，退后为虚也。不通之中有血滞者，有血枯者。血滞宜破血，枯宜
补也。疼痛之中，有常时作痛，有临经作痛，常时痛为气滞，临经痛为血病也。发热之中，有常时发热，有经行发热，
常时发热为血虚有积，临经热为血虚有热也。此又分而为八也，大抵内因忧思忿怒，外则形寒饮冷，气血郁结不行，
此不调不通，疼痛发热之由也。气行血行，气止血止，故治血病以行气为先，香附之类是也。热则流通，寒则凝结，
故治血病以热为佐，姜桂是也。
经水异色
丹溪曰∶经水者，阴血也。阴必从阳，故其色红，禀火象也。血为气之配，气热则热，气寒则寒，升降清浊，
因气而行，故成块者，气之凝也。将行而痛者，气之滞也。行后痛者，气血虚也。错经妄行者，气之乱也。色淡者，
虚而有水混之也。紫者，气之热也。黑者，热甚也。今人见紫黑成块作痛，指为风冷乘之，用温热药，祸不旋踵。
经曰∶亢则害，承乃制。热甚必兼水化，所以热则紫黑也，四物加黄连、香附。淡白者，气虚也，芎、归、参、
、芍、附。多而色淡者，痰也，二陈芎、归。如烟尘屋漏水者，湿也，二陈汤加秦艽、防风、二术。成块作片，
白不变者，气滞也，四物、枳壳、香附、延胡索、陈皮。
居经
月水一月一来，乃其常也。有三月一来者，谓之居经，气血不足故也。又有一年一来者，又有石女无经者，
亦有频年不来，一来即孕者，皆其变也。亦如脉之有反关耳。
【脉】脉微，气血俱虚，年少者，亡血也。乳子下利，则可否者，此为居经三月一来。少阴脉微而迟，微则
无精，迟则阴中寒，涩则血不来，此为居经三月一来。寸口脉卫浮而大，荣反而弱，浮大则气强，反弱则血少，孤
阳独呼，阴不能吸，二气不停，卫降荣竭。阴为积寒，阳为积热，阴虚阳实故令少血。时发洒淅、咽燥、汗出，或
溲稠数，多唾涎沫，此今重虚，津液浊泄，故知非躯，名曰居经。
经病血厥
血厥者，妇人平居无病，忽如死人，身不动摇，目闭口噤，重者不救，轻者移时乃寤，此名血厥。由汗多血少，
阳气独上，气塞不行，故身如死，气过血还，阴阳复通，故移时方寤。妇人多有此症，比痫症大不相同，但此条
混见大方全书之内，未曾指出讲明，所以卒然莫救，今特表而出之。经曰∶诸乘寒者，则为厥，郁冒不仁，其脉微弱，
初或呕吐，便尔昏沉，阴阳乖隔，荣卫不和，比之中风，身不发热，喉无痰声，手不握搐，为异耳。急宜握住顶心发，
令人扶起，不得平卧，外用通关散吹鼻取嚏，有嚏则吉，无嚏则凶，或以铁秤锤烧红入碗内，以醋沃之，熏鼻下，醋
气入内，透隔立苏。口噤不能灌药者，针少商及三阳，五会等穴。或以作筒吹其两耳，或以童便灌之，切记不可灌热
汤，盖灌热汤则血得热而泛滥。犯胃冲心，多致不救，心为君主，心不受邪，一丝血入心即死矣。经所谓经水波涛而
涌起也，名曰血厥，治宜花蕊石散，童便调服，或苏合香丸，醒后白薇汤、八珍散、归脾汤调理也。《家秘》曰∶经隧
乖戾，血上冲心，所以神昏，缓则不救，治以八宝丹。
[Song]
Bai Zhuo (White Turbidity) and Bai Yin (White Emission) are less viscous than Dai Xia (Leukorrhea), indicating a lighter condition, collectively named Bai Yin, Bai Zhuo, or Bai Beng (White Collapse). This is due to the sinking of True Yuan (True Origin/Essence) and Spleen deficiency, causing Mingmen Fire (Ministerial Fire/Dragon Fire) to flare up while Kidney Water fails to ascend. It is often caused by excessive sexual activity damaging the Kidneys, or by evil thoughts and delusions secretly injuring the Spirit (Shen). One must understand the root cause in the meridians; diagnosis requires observing the pulse and physical form to differentiate the Five Phases (Wu Xing).
[Discussion]
Wu Meipo stated: When women discharge red and white fluids that are not thick, it is called Bai Yin (White Emission), identical to Bai Zhuo (White Turbidity) in men. It arises from the disturbance of Ministerial Fire failing to clarify, belonging to the Foot Shaoyin (Kidney) and Foot Taiyin (Spleen) meridians. Treatment should employ clearing and tonifying methods. If the discharge is slippery, white, thick, and sticky, it is called Dai Xia (Leukorrhea), belonging to the Pericardium (Xin Bao). The Hand Jueyin Pericardium meridian connects to the spine, networks with the Dai Mai (Girdle Vessel), and communicates with the Ren Mai (Conception Vessel). Treatment is suitable for using "flesh and blood" substances (animal-derived tonics) to nourish the root. This is a theory exploring the source. Contemporary practitioners, stuck in routine, treat it as Damp-Phlegm, using astringent and ascending drugs. They fail to realize that the root damage leads to putrefaction; using astringents only increases stagnation, and using ascending drugs exacerbates the depression of abnormal Qi. Only Liulong Guben Wan (Six Dragons Root-Fortifying Pill) and Shiliuwei Baoyuan Tang (Sixteen-Ingredient Essence-Preserving Decoction) are appropriate.
[Pulse Diagnosis]
A rapid/tight pulse indicates Jia Masses (abdominal masses); an Yin-pulse tightness indicates Shan Hernia. A Floating pulse indicates intestinal borborygmus; a Tight pulse indicates abdominal pain; a Rapid pulse indicates sores/ulcers; a Wiry pulse indicates muscle spasms. Pulse qualities such as Wiry-Large, Deficient, Hollow (Kou), Fine, Minute, or Choppy all indicate lower body discharge of white fluids.
Heart-Kidney Non-Interaction
Deep solitude secretly harms spring vitality; weak legs and sore waist with uneven breath; white slippery discharge flows down accompanied by many nightmares; tinnitus and dizziness with low spirit.
Formula: Jin Suo Zheng Yuan Dan (Golden Lock Correct Origin Pill).
Overthinking Injures the Spirit
Chest stuffiness, bodily edema, yellow complexion; excessive sleep, poor appetite, extreme fatigue; interference between Yin/Yang and Clear/Turbid Qi. To clarify, use Si Qi Tang (Four-Seven Decoction).
Anger Injures the Liver
Alternating chills and fever, restlessness; hypochondriac pain, irritability, bluish facial hue; bitter taste, wiry pulse, frequent urination. Know that depression and anger reside in the Liver Meridian.
Formula: Jiawei Xiaoyao Wan (Modified Free and Easy Wanderer Pill).
Root-Fortifying and Yuan-Regulating
Dizziness, palpitations, Qi and Blood deficiency; four-limb weakness attributed to Spleen deficiency; frequent numbness and low spirit. Root-fortifying and origin-nourishing is most appropriate.
Formula: Liulong Guben Yuan (Six Dragons Root-Fortifying Origin/Pill).
[Song]
At age fourteen (two sevens), Tian Gui (Menstrual Essence) arrives; Chong and Ren meridians open, menstruation occurs monthly. Caution against anger and worry; Yin and Yang, Qi and Blood will naturally harmonize. Although menstruation is governed by the Heart, it relies on the Spleen for grain essence. After menstruation, emptiness makes one prone to illness; at onset, confusion makes one prone to fright. Suddenly patting the thigh, sighing at deficiency; occasionally stopping needling without speaking, like reciting poems about young brides. One should know the desire for harmony like the Guan Ju bird. A Wiry pulse extending beyond the Cun-Guan-Chi positions indicates emotion stirring within and myriad feelings arising. Stagnant old blood infiltrating bones causes bone-steaming tidal fever, a serious condition. Exposure to cold while cooling off or using the toilet, or drinking cold liquids causing cold limbs, prevents blood from nourishing. To regulate menstruation, first treat the disease; analyze appearance and color to understand the condition. Delayed period with pale color indicates Blood deficiency; purple color advancing early indicates unclarified Heat. Pain before the period indicates Qi Stagnation; pain after the period indicates Deficiency. Fever during normal times indicates accumulation from labor; fever just before the period indicates insufficient Blood due to Heat. Chaotic Qi causes retrograde menstruation (epistaxis/melena); Spleen deficiency causes leakage like mallow soup. Heavy flow requiring nourishment; light flow without pain requiring strong Ying-Blood tonification. Amenorrhea must be differentiated as Excess or Deficiency, named Blood Dryness, Qi Heat, or Phlegm Obstruction.
[Discussion]
The Classics state: When heaven and earth are mild, menstrual water is calm; when cold, it coagulates; when hot, it boils over; when storms arise suddenly, it surges. When the Ren Mai is open and Chong Mai is abundant, in men it circulates continuously, while in women it stops and accumulates. Circulation means no accumulation, always moving. Stopping means accumulation, full yet static. Not full means Yang Qi moves with time. Full means Yin Blood overflows according to schedule. It is called "Trustworthy" (regular): Men operate by Qi, so Yang Qi rises daily; Women fill by Blood, so Yin Blood descends monthly.
Attendant General Chu stated: If a man whose Jing (Essence) has not yet matured engages in intercourse to release it, his five bodies will have unfulfilled areas, leading to difficult-to-describe diseases later. If he is impotent but desires sexual stimulation, forcing ejaculation, the Jing does not exit but rots internally, causing urinary obstruction and strangury. If Jing is exhausted and further depleted, the urinary and anal passages pull and hurt; the more it hurts, the more he defecates; the more he defecates, the more it hurts. When a woman's Tian Gui has arrived, if she has no male partner for ten years, her cycle becomes irregular; if under ten years she desires a partner, it also becomes irregular. Irregularity means old blood does not exit, new blood flows wrongly, either soaking into bones or turning into swelling. Later, even if she mates, she cannot conceive. He also said: Excessive intercourse drains fluids; a deficient person bearing many children suffers Blood Dryness which can kill. Observing Jing and Blood reveals half the truth.
Different Treatment for Widows and Nuns
Chu Cheng treated nuns and widows with special methods because they are "Yin alone without Yang." Their desires stir but are unfulfilled, causing Yin-Yang conflict, alternating chills and fevers resembling Warm Malaria, eventually becoming Consumption. Reading *Records of the Grand Historian*, the story of Han Nu, attendant to King of Jibei, who suffered back pain, chills, and fevers. Most doctors thought it was a chills-fever disease. Cang Gong said: The disease comes from desiring a man but being unable to obtain him. How did I know? Her Liver pulse was Wiry, emerging from the Cun position. Thus I knew. Generally, men focus on Jing, women on Blood. When men's Jing is abundant, they desire sex; when women's Blood is abundant, they conceive. The Liver stores Blood. A Wiry Jueyin Liver pulse emerging from Cun to the Fish-Space indicates Yin abundance. The general method suggests *Ben Shi Fang* Sheng Di Huang Wan (Rehmannia Pill), Baizi Ren Wan (Biota Seed Pill), or Weisheng Tang (Life-Preserving Decoction).
Treat Disease Before Regulating Menstruation
If menstrual circulation is normal, hundred diseases do not arise, and conception occurs. If Six Evils (external pathogens) invade or Seven Emotions (internal injuries) harm, causing Qi-Blood disharmony, heart/abdominal pain radiating to the back, upper/lower attacks, vomiting, refusal to eat, chills/fever masses, tidal fever with abdominal pain, or severe coughing, sweating, vomiting, diarrhea: Tidal fever and spontaneous sweating consume Blood; coughing/vomiting pushes Qi upward; diarrhea leaks fluids downward; pain accumulates internally. Therefore, one must first eliminate the disease, then nourish Blood and regulate menstruation. If blood infiltrates bones, it becomes bone-steaming; blood accumulating internally clashing causes pain; Blood Dryness failing to nourish the body causes external heat steaming; Blood Dryness with Pericardium Fire flaring or combined with external pathogens transforms into Consumption Tuberculosis.
General Principles of Regulating Menstruation
Women's menstrual diseases include irregular cycles and amenorrhea. Among these, some have pain, some have fever, dividing them into four categories. Analyzing these eight sub-types: Irregularity includes early arrival (Heat) and late arrival (Deficiency). Amenorrhea includes Blood Stasis (needs breaking/stagnation-resolving) and Blood Dryness (needs tonifying). Pain includes constant pain (Qi Stagnation) and pre-menstrual pain (Blood pathology). Fever includes constant fever (Blood Deficiency with accumulation) and pre-menstrual fever (Blood Deficiency with Heat). These divide into eight. Generally, internal causes are worry/sorrow/anger; external causes are cold exposure and cold drinks. Qi-Blood stagnation causes irregularity, amenorrhea, pain, and fever. Qi moves Blood; Qi stops, Blood stops. Thus, treating Blood diseases prioritizes moving Qi (e.g., Xiang Fu). Heat promotes flow; Cold causes coagulation. Thus, treating Blood diseases uses Heat as an assistant (e.g., Ginger, Cinnamon).
Abnormal Menstrual Colors
Danxi said: Menstrual blood is Yin Blood. Yin follows Yang, hence its red color, embodying the Fire image. Blood is the companion of Qi; Qi Hot makes Blood Hot, Qi Cold makes Blood Cold. Ascending/descending and Clear/Turbid movements follow Qi. Clots indicate Qi congealing. Pain before flow indicates Qi stagnation. Pain after flow indicates Qi-Blood deficiency. Retrograde/wrongful flow indicates Qi chaos. Pale color indicates Deficiency mixed with Water (Dampness). Purple indicates Qi Heat. Black indicates severe Heat. Today, people see purple-black clots with pain and attribute it to Wind-Cold, using warm/hot drugs, bringing disaster quickly. The Classics say: Hyperactivity brings harm; control brings balance. Severe Heat must combine with Water transformation, hence Heat causes purple/black colors. Formula: Si Wu Tang plus Huang Lian and Xiang Fu. Pale white indicates Qi Deficiency: Xiong Gui Shen [missing herb?] Shao Fu. Profuse pale flow indicates Phlegm: Er Chen Tang plus Xiong Gui. Like smoke/dust or roof leak water indicates Dampness: Er Chen Tang plus Qin Jiao, Fang Feng, Zhu Ru/Zhu Ling (Er Shu likely refers to Cang Zhu/Bai Zhu). Clots forming sheets, white unchanged, indicate Qi Stagnation: Si Wu Tang plus Zhi Ke, Xiang Fu, Yan Hu Suo, Chen Pi.
Ju Jing (Resident Menstruation)
Monthly menstruation is normal. Tri-monthly menstruation is called Ju Jing, due to insufficient Qi and Blood. Annual menstruation exists. Stone girls (women born without a uterus/vagina) have no menstruation. Some do not menstruate for years, then conceive immediately upon starting. These are variations, like the Reverse Guan pulse.
[Pulse Diagnosis]
Minute pulse indicates Qi and Blood deficiency. In youth, this indicates loss of Blood. Nursing mother with diarrhea: if possible, this is Ju Jing tri-monthly. Shaoyin pulse minute and slow: Minute means no Jing; Slow means cold in the Yin region; Choppy means Blood does not come. This is Ju Jing tri-monthly. Cun Kou pulse: Wei (Defensive) is Floating and Large, Ying (Nutritive) is Reverse and Weak. Floating/Large means Qi is strong; Reverse/Weak means Blood is scarce. Solitary Yang calls out alone, Yin cannot absorb. Two Qi do not stop; Wei descends, Ying exhausts. Yin is accumulated Cold; Yang is accumulated Heat. Yin Deficiency and Yang Excess cause little Blood. Occasional chills/shivering, dry throat, sweating, or thick/frequent urination, excessive saliva/phlegm. This is current severe deficiency, turbid fluid leakage. Hence known as non-standard constitution, named Ju Jing.
Jing Disease Blood Jue (Syncope)
Blood Jue: A woman usually healthy suddenly appears dead, body motionless, eyes closed, jaw clenched. Severe cases are incurable; mild cases wake after a while. This is Blood Jue. Caused by excessive sweating leading to Blood deficiency, Yang Qi rising alone, Qi blockage preventing flow, so the body seems dead. When Qi passes and Blood returns, Yin-Yang reconnects, so waking takes time. Women often have this, distinct from Epilepsy. This item is mixed in *Da Fang Quan Shu* without explanation, causing sudden inability to save. Now specifically highlighted. Classics say: All affected by Cold become Jue, with depression/dizziness and insensibility. Pulse is minute/weak. Initially vomiting, then coma. Yin-Yang separation, Ying-Wei disharmony. Unlike Stroke: no fever, no phlegm sound in throat, no hand grasping/spasms. Urgently grasp hair at vertex, help patient sit up, do not lie flat. Externally, use Tong Guan San blown into nose to induce sneezing. Sneezing is auspicious; no sneeze is ominous. Or, heat an iron scale weight, put in bowl, pour vinegar, fumigate nose. Vinegar vapor enters, penetrating barriers, immediate revival. If jaw clenched preventing oral medication, needle Shao Shang and San Yang, Wu Hui acupoints. Or blow air into ears via tube, or灌 (pour/administer) child's urine. Remember: Do NOT administer hot soup. Hot soup makes Blood boil and flood. Invading Stomach rushing to Heart often leads to death. Heart is the Monarch, does not accept Evil; one thread of Blood entering Heart causes death. As Classics say regarding menstrual waves surging: Named Blood Jue. Treatment: Hua Rui Shi San (Flower Rhyolite Powder) mixed with child's urine, or Su He Xiang Wan. After waking, regulate with Bai Wei Tang, Ba Zhen San, Gui Pi Tang. *Jia Mi* says: Meridian rebellion, Blood rushing to Heart causes unconsciousness. Slow treatment is incurable. Treat with Ba Bao Dan.