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Fang stated: Women's menstrual diseases include irregular menstruation (menstrual cycle irregularity) and amenorrhea (absence of menstruation). Among these conditions of irregularity and obstruction, some are accompanied by pain, and some by fever; thus, they are divided into four categories. Upon detailed examination, among irregularities, there are those with early onset and those with delayed onset. Early onset indicates heat syndrome, while delayed onset indicates deficiency syndrome. Among obstructions, there are cases of blood depletion (blood exhaustion) and cases of blood stasis (blood stagnation). Blood stasis should be treated with blood-breaking methods, and blood depletion with blood-nourishing methods. Regarding pain, there is constant pain and pain occurring before or after menstruation. Constant pain and pre-menstrual pain indicate blood accumulation (stagnant blood accumulation), whereas post-menstrual pain indicates blood deficiency. Regarding fever, there is constant fever and fever during menstruation. Constant fever indicates blood deficiency with accumulation, while menstrual fever indicates blood deficiency with internal heat. Thus, within these four categories, eight sub-categories are further distinguished. Human qi and blood circulate throughout the body; if one suddenly experiences sorrow, worry, or anger, qi becomes depressed and fails to flow smoothly. Before or after menstruation, if one suddenly consumes cold drinks or is exposed to cold, lochia may fail to clear. These are the causes of irregular menstruation, obstruction, pain, and fever. Generally, when qi moves, blood moves; when qi stops, blood stops. Therefore, in treating blood diseases, promoting qi movement is prioritized, as seen with herbs like Cyperi Rhizoma (Xiangfu). Heat promotes circulation, while cold causes coagulation and blockage; thus, in treating blood diseases, warm-natured herbs serve as assistants, such as Cinnamomi Cortex (Rougui).

Shenzhai commented: Some women develop menstrual irregularities due to prior illness, while others develop various diseases due to menstrual irregularities. If illness precedes menstrual irregularity, the illness should be treated first; once the illness is resolved, menstruation will naturally regulate itself. If menstrual irregularity precedes the development of disease, menstruation should be regulated first; once menstruation is regulated, the disease will naturally disappear. Li’s discussion can be considered the key principle for regulating menstruation. However, it is partial and incomplete; therefore, I supplement his unfinished points. Fang’s method of distinguishing causes and detailing symptoms indeed grasps the general principles of regulating menstruation.

The *Jisheng Fang* states: The medical classics say that all diseases arise from qi. There are seven qi and nine qi. Joy, anger, worry, thought, grief, fear, and shock constitute the seven qi. Adding cold and heat makes nine qi. Qi-related diseases occur in both men and women, but they are particularly severe in women. This is because blood follows qi in its movement; when qi stagnates, blood accumulates with it. This may result in irregular menstruation with abdominal pain; or pain preceding the onset of menstruation; or prolonged, dripping bleeding after menstruation has started; or alternating chills and fever; or the formation of masses (zheng jia); or pain radiating to the waist and hypochondrium, extending to the back and spine, with stabbing sensations up and down, vomiting, inability to eat, and emaciation. Not only does this prevent conception, but if left untreated for a long time, it often transforms into consumptive disease (lao zhai). All these are caused by qi dysfunction. Therefore, in regulating menstruation and nourishing blood, nothing is more important than smoothing qi.