杨仁斋曰∶女子经脉不行有三,一则血气盛实,经络遏闭,其脉滑实,治当通经疏利;一则风冷外伤,七
情内贼,以致经络痹滞,其脉浮涩,治之当解风散冷,去瘀涤热;一则形体憔悴,经络涸竭,其脉虚弱。治当
滋养气血。
慎斋按∶以上一条,序调经之法,兼有余不足,外感内伤处治。
陈良甫曰∶女子二七而天癸至,经血渐盈,应时而下,名曰月信。若遇经行,最宜谨慎,否则与产后证相
类。若被惊怒劳役,则血气错乱,经脉不行,多致劳瘵等证。若逆于头面肢体之间,则重痛不宁。若怒气伤肝,
则头晕胁痛,呕血瘰 。若经血内渗,则窍穴淋沥。凡此六淫外侵,变证百出,犯时微若秋毫,成患重于泰山,
可不畏哉。
孙真人曰∶凡女子十四以上,则有月事。
月事来时,得风冷湿热,四时之病相协者,皆自说之。不尔,与治误相触,动更增困,处方者亦应问之。
寇宗 曰∶凡看妇人病,入门先问经期。
张戴人曰∶凡治病妇,当先问娠,不可仓猝。凡看妇人病脉,不可纯用破气行血之药,恐有娠在疑似间也。
葛仙翁曰∶凡治妇人诸病,兼治忧恚,令宽其思虑,则病无不愈。
慎斋按∶以上六条,序女子经行宜谨,不可轻忽,以致成病。而并戒医者治妇人之病,不可不问经问娠为
要也。若病者讳而不言,医者略而不问,势必处治乖方,两致其误,可不戒哉。
Yang Renzhai stated: There are three causes for amenorrhea in women. The first is when blood and qi are abundant and solid, causing the meridians to be obstructed and closed; the pulse is slippery and forceful, and treatment should focus on unblocking the menses and promoting circulation. The second is when wind and cold invade from the exterior, combined with internal injury from the seven emotions, leading to meridian blockage and stagnation; the pulse is floating and choppy, and treatment should focus on dispersing wind and cold, removing blood stasis, and clearing heat. The third is when the body is emaciated and haggard, and the meridians are exhausted and dried up; the pulse is weak and deficient, and treatment should focus on nourishing blood and qi.
Shen Zhai commented: The above passage outlines methods for regulating menstruation, covering both excess and deficiency conditions, as well as treatments for external invasions and internal injuries.
Chen Liangfu stated: When a girl reaches fourteen years of age (two sevens), Tian Gui (heavenly water, referring to reproductive essence) arrives, menstrual blood gradually fills, and it flows down at regular intervals, known as Yue Xin (monthly trust/menstruation). During menstruation, utmost caution is required; otherwise, the condition may resemble postpartum syndromes. If subjected to fright, anger, or overexertion, blood and qi will become disordered, and menstruation will cease, often leading to consumptive diseases such as Lao Zhai (tuberculosis-like wasting disorders). If blood refluxes upward into the head, face, and limbs, it causes heavy pain and restlessness. If anger injures the Liver, it leads to dizziness, hypochondriac pain, hematemesis, and Luo Li (scrofula/neck lymph node tuberculosis). If menstrual blood渗 (seeps) inward, it results in dripping discharge from the orifices. All these six types of pathogenic influences invading from outside can generate myriad complications. Though symptoms may seem slight at onset like the tip of an autumn hair, the resulting harm is heavier than Mount Tai. Can one not revere this?
Sun Simiao stated: Generally, women above the age of fourteen begin to have menstruation.
When menstruation occurs, if affected by wind, cold, dampness, or heat, or by seasonal pathogens interacting, the patient should describe these factors herself. Otherwise, conflicting with the prescribed treatment will only increase distress. The prescriber should also inquire about these details.
Kou Zongshi stated: Whenever treating gynecological diseases, one must first ask about the menstrual period upon entering the consultation.
Peng Yongguang stated: Whenever female patients or unmarried girls suffer from Shang Han (cold damage) or various stagnations of cold and hot qi, one must inquire about their menstrual status.
Zhang Dairen stated: When treating female patients, one must first inquire about pregnancy; do not act hastily. When examining the pulses of female patients, one must not solely use herbs that break qi and promote blood circulation, lest there be a hidden pregnancy in doubt.
Ge Xianweng stated: When treating various diseases in women, one should simultaneously address their sorrow and indignation, helping them broaden their thoughts and relieve mental burden, so that no disease will fail to heal.
Shen Zhai commented: The above six passages emphasize that women must be cautious during menstruation and not neglect it, lest it lead to illness. They also warn physicians that the most crucial aspect of treating women's diseases is to inquire about menstruation and pregnancy. If the patient conceals information and the physician fails to ask, the treatment plan will inevitably be erroneous, causing mistakes on both sides. How can one not take this as a warning?