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The *Shengji Zonglu* states: In women, the obstruction of menstruation arises from various causes. Some cases involve qi failing to transform, resulting in slight stagnation of blood. Others present with early onset and excessive flow initially, followed by amenorrhea later. Some occur after severe illness, where heat and dryness cause obstruction. Some result from cold coagulation and stagnation, some from accumulations (masses) and qi knotting, and some from depression and stagnation of heart qi. Since the etiologies differ, the treatments must also vary. Women take "false blood" (menstrual blood) as their substance and qi as their function. When qi and blood stagnate, they become astringent and cease to flow. The resulting diseases may manifest as cold or heat syndromes, hardness and pain in the umbilical and abdominal regions, emaciation of muscles; if left untreated for a long time, it evolves into Laozai (consumptive disease/tuberculosis).

The *Chanbao Fang* states: Generally, when treating disease, one must first determine the primary focus. For men, regulate the qi; for women, regulate the blood. Qi and blood are the spirit of humans and must be carefully regulated and protected. However, women take blood as their foundation. When qi and blood circulate freely, the spirit remains clear. If the Blood Chamber (uterus) does not accumulate stasis, then qi and blood condense, leading to mutual pathological restriction between Wood (Liver) and Fire (Heart). Menstruation arriving on schedule is called Yuexin (monthly trust/period). If the blood does not come, it is due to wind-heat injuring the meridians and blood. Thus, blood obstruction may stem from external contraction of wind-cold, internal reception of pathogenic heat, or spleen-stomach deficiency leading to poor appetite. With insufficient food intake, Ying and Wei (nutritive and defensive qi) are suppressed, causing yellowish-dry skin, lackluster complexion, intermittent chills and fever, abdominal distension and pain, difficulty conceiving, cold-heat imbalance in the Zi Zang (uterus), chronic damage over time, inevitably accompanied by leukorrhea, frequent dribbling urination, and sudden onset of Beng Lou (metrorrhagia and metrostaxis). The classics state that masses felt in the abdomen that gather and scatter intermittently constitute the disease known as Jia (mobile mass). When blood is exhausted and fails to flow, it knots to cause abdominal distension and intermittent chills and fever; this forms a Zha accumulation. Whether periods are early or late, though flowing, if the volume is excessive or scanty, investigating the root of the disease reveals it stems from here.

Ye Yiqian stated: Women's menstrual disorders arise from internal factors such as worry, thought, anger, and depression causing qi stagnation, and external factors such as drinking cold liquids and exposure to cold, leading to stagnation of lochia. These are the causes of irregular menstruation, obstruction, pain, and fever. Treatment should regulate qi and break blood, open depression and tonify deficiency, cool blood and clear heat. To treat blood diseases, moving qi is paramount, as seen with herbs like Xiangfu (Cyperi Rhizoma). Heat promotes circulation, while cold causes hardening and coagulation; therefore, warm herbs must be used as assistants, such as Rougui (Cinnamon Bark). There are also cases where menstruation does not occur but limbs swell; this belongs to blood stasis infiltrating the Spleen meridian, and should be guided with acrid-warm herbs. There are also cases where menstruation flows upward to the mouth and nose; this is fire carrying blood upward, indicating chaotic qi, treated with Siwu Tang added with Zhizi (Gardeniae Fructus), Huanglian (Coptidis Rhizoma), Danpi (Moutan Cortex), and Xijiao (Rhinocerotis Cornu).

Shenzhai commented: The above three passages describe how menstrual obstruction leads to disease in women. Some women have menstrual irregularities caused by other illnesses, while others develop various diseases due to menstrual irregularities. All cases require careful differentiation and detailed examination before treatment.