张洁古曰∶女子月事不来者，先泻心火，血自下也。经云∶二阳之病发心脾，有不得隐曲，故女子不月，其
传为风消。太仆注曰∶大肠、胃热也，心脾受之。心主血，心病则血不流；脾主味，脾病则味不化，味不化则
精不足，故其病不能隐曲。脾土已亏，则风邪胜而气愈消。又经云∶月事不来者，胞脉闭也。胞脉属于心，络于
胞中。今气上迫肺，心气不得下通，故月事不来。先服降心火之剂，后服五补丸、卫生汤，治脾以养其血。
王安道曰∶二阳，足阳明与手阳明脉也。肠胃有病，心脾受之。发于心脾，犹言延及心脾也。虽然，脾胃为
合，胃病而及脾，理固宜矣。大肠与心，本非合也，以大肠而及
心，何哉？盖胃为受纳之府，大肠为传化之府。食入于胃，浊气归心，饮入于胃，输精于脾者，以胃之能纳，
大肠之能化耳。肠胃既病，则不能受，不能化，心脾何所资？心脾既无所资，则无以运化而生精血。故肠胃
有病，心脾受之，则男子为少精，女子为不月。心脾总男女言之，至隐曲不月，方主女子说。
马玄台曰∶二阳者，足阳明胃脉也，为仓廪之官，主纳水谷，乃不能纳受者何也？此病由心脾所发耳。正
以女子有不得隐曲之事，郁之于心，故心不能生血，血不能养脾。始焉胃有所受，脾不能运化，而继则渐不能
纳受，故胃病发于心脾也。由是水谷衰少，无以化精微之气，而血脉遂枯，月事不能时下矣。王注谓肠胃为病，
心脾受之。何以谓心脾受肠胃之病，又以心血不流，为女子不月；脾味不化，为男女少精。岂女子无关于脾，
而男子无关于心乎？况此节专为女子而发，未论及男子少精之义，学人详推之。
Zhang Jiegu said: For women whose menstruation does not arrive, first purge Heart Fire (Xin Huo), and the blood will flow naturally. The Classic says: Diseases of the Yangming channels originate in the Heart and Spleen; there is a condition of "hidden difficulty" (bu de yin qu), thus women's menstruation does not arrive, and it transmits to become Wind Consumption (Feng Xiao). Wang Bing, the Taipu, annotated: This refers to heat in the Large Intestine and Stomach, which affects the Heart and Spleen. The Heart governs Blood; when the Heart is diseased, Blood does not circulate; the Spleen governs taste/processing; when the Spleen is diseased, food is not transformed. If food is not transformed, Essence is insufficient, hence the condition of "hidden difficulty." When Spleen Earth is already deficient, Wind pathogens prevail and Qi is further consumed. Furthermore, the Classic says: Menstruation does not arrive because the Baomai (Uterine Vessels) are closed. The Baomai belongs to the Heart and connects to the Baozhong (Uterus). Now, Qi presses upward against the Lung, and Heart Qi cannot descend to communicate, thus menstruation does not arrive. First administer agents that descend Heart Fire, then administer Wubu Wan (Five Tonics Pill) and Weisheng Tang (Health Preservation Decoction); treat the Spleen to nourish its Blood.
Wang Andao said: Yangming refers to the Foot-Yangming Stomach Meridian and Hand-Yangming Large Intestine Meridian. When the intestines and stomach are diseased, the Heart and Spleen are affected. Saying diseases originate in the Heart and Spleen means they extend to involve the Heart and Spleen. Although the Spleen and Stomach are interior-exterior paired, if Stomach disease extends to the Spleen, the principle is indeed appropriate. However, the Large Intestine and Heart are not inherently paired; why does Large Intestine disease affect the Heart? The Stomach is the fu-organ of reception; the Large Intestine is the fu-organ of transmission and transformation. Food enters the Stomach, turbid Qi returns to the Heart; drinks enter the Stomach, essence is transported to the Spleen. This is due to the Stomach's ability to receive and the Large Intestine's ability to transform. If the intestines and stomach are diseased, they cannot receive nor transform; from where do the Heart and Spleen derive their resources? Since the Heart and Spleen have no resources, they cannot transport, transform, and generate Essence and Blood. Thus, when the intestines and stomach are diseased and the Heart and Splein are affected, men present with scanty Essence, and women with amenorrhea. The terms Heart and Spleen refer to both men and women generally; however, regarding "hidden difficulty" and amenorrhea, the discussion specifically focuses on women.
Ma Xuantai said: Yangming refers to the Foot-Yangming Stomach Meridian, which serves as the official of granaries, governing the reception of water and grain. Why can it not receive? This disease originates from the Heart and Spleen. Precisely because women have matters of "hidden difficulty" that are depressed in the Heart, the Heart cannot generate Blood, and Blood cannot nourish the Spleen. Initially, the Stomach receives food, but the Spleen cannot transport and transform; subsequently, it gradually fails to receive. Thus, Stomach disease originates from the Heart and Spleen. Consequently, water and grain diminish, failing to transform into subtle Qi, causing the blood vessels to wither, and menstruation fails to arrive on time. Wang Bing's annotation states that intestinal and stomach diseases affect the Heart and Spleen. Why is it said that the Heart and Spleen are affected by intestinal and stomach diseases, and furthermore, that stagnant Heart Blood causes amenorrhea in women, while untransformed Spleen taste causes scanty Essence in both men and women? Are women unrelated to the Spleen, and men unrelated to the Heart? Moreover, this section was specifically expounded for women, without discussing the meaning of scanty Essence in men; students should examine this carefully.