戴元礼曰∶经事来而腹痛，不来腹亦痛，皆血之调故也。欲调其血，先调其气，四物加香附、吴茱，或和
气饮加吴茱。痛甚者，加玄胡索汤。
《产宝百问》曰∶经水者，行气血，通阴阳，以荣于身者也。气血盛，阴阳和，则形体通。或外亏卫气之充
养，内乏荣血之灌溉，血气不足，故经候欲行，而身体先痛也，趁痛散主之。
朱丹溪曰∶经水过后作痛，是气血俱虚也，宜八珍汤。亦有虚中有热，经后亦作痛，宜逍遥散。亦有经行
过后，腹中绵绵走痛者，是血行而气滞未尽行也，四物加木香。
《准绳》按∶经后腹痛为虚，明甚。若脉不数，证不显热，未可断其为热也，八珍为宜。有热，方以逍遥散主之。
慎斋按∶以上八条，序经行腹痛，有寒热虚实之分也。主于风冷寒湿者，经文与良甫、伯仁之论是也。主
于血涩气滞者，海藏、丹溪之论是也。若经行后腹痛，是有虚无实，有寒无热矣。而丹溪则又兼热与气滞论病
机，不可不审。
李氏曰∶经行潮热有时，为内伤，属于虚。潮热无时，为外感，属于实。虚者大温经汤，实者四物加柴、
芩。
《大全良方》曰∶经行客热者，因体虚而将温过度，外热加之，非脏腑自生，故云客热。其状上焦胸膈之
间，虚热、口燥、心烦，手足壮热是也。
《女科撮要》曰∶有经后发热倦怠，两目如帛蔽。夫脾为诸阴之首，目为血脉之宗。此脾伤而五脏皆为失
所，不能归于目也。用补中汤、归脾汤，专主脾胃而愈。凡发久者，阳气亦自病，须调补之。
慎斋按∶以上三条，序经行有潮热、客热、发热之证也。经行潮热、客热，兼虚实论。若经后发热，则是
血脉空虚，阴虚不足，为有虚而无实也。
Dai Yuanli stated: Abdominal pain occurring during menstruation, or even when menstruation does not occur, is due to the disharmony of blood and qi. To regulate the blood, one must first regulate the qi; Siwu Tang (Four Substances Decoction) added with Xiangfu (Cyperus Rhizome) and Wuzhuyu (Evodia Fruit), or Heqi Yin (Harmonizing Qi Decoction) added with Wuzhuyu can be used. For severe pain, Xuanhusuo Tang (Corydalis Decoction) should be added.
Chanbao Baiwen (Hundred Questions on Obstetrics) states: Menstrual blood serves to circulate qi and blood, harmonize yin and yang, and nourish the body. When qi and blood are abundant and yin and yang are harmonious, the physical form remains unobstructed. If there is a deficiency in the nourishment of defensive qi externally, and a lack of nourishing blood irrigation internally, resulting in insufficient qi and blood, the body may experience pain prior to the onset of menstruation. This condition is primarily treated with Chentong San (Pain-Relieving Powder).
Zhu Danxi stated: Pain occurring after menstruation indicates a deficiency of both qi and blood, for which Bazhen Tang (Eight Treasures Decoction) is appropriate. There are also cases where deficiency is accompanied by heat, causing pain after menstruation, which is treated with Xiaoyao San (Free and Easy Wanderer Powder). In cases where there is a lingering, wandering pain in the abdomen after menstruation, it indicates that while blood circulation has resumed, qi stagnation has not yet fully resolved; Siwu Tang (Four Substances Decoction) added with Muxiang (Aucklandia Root) is indicated.
Zhunsheng Commentary: Abdominal pain following menstruation is clearly a deficiency pattern. If the pulse is not rapid and the signs do not manifest heat, it cannot be definitively diagnosed as a heat pattern; Bazhen Tang (Eight Treasures Decoction) is suitable. If heat is present, Xiaoyao San (Free and Easy Wanderer Powder) should be used.
Shenzhai Commentary: The above eight passages discuss menstrual abdominal pain, distinguishing between cold, heat, deficiency, and excess patterns. Those attributed to wind-cold-dampness align with the classical texts and the theories of Liangfu and Boren. Those attributed to blood stasis and qi stagnation align with the theories of Haicang and Danxi. However, abdominal pain occurring *after* menstruation indicates a pattern of deficiency without excess, and cold without heat. Zhu Danxi’s inclusion of heat and qi stagnation in the pathogenesis requires careful scrutiny.
Li Shi stated: Periodic tidal fever during menstruation indicates internal injury and belongs to deficiency. Tidal fever without a fixed time indicates external contraction and belongs to excess. Deficiency patterns are treated with Da Wen Jing Tang (Major Warming the Menses Decoction), while excess patterns are treated with Siwu Tang (Four Substances Decoction) added with Chaihu (Bupleurum Root) and Huangqin (Scutellaria Root).
Daquan Liangfang (Great Comprehensive Good Prescriptions) states: "Guest heat" during menstruation arises because the constitution is weak and excessive warming treatments have been applied, allowing external heat to invade; it is not generated spontaneously by the zang-fu organs, hence termed "guest heat." Its manifestations include deficient heat in the upper jiao chest and diaphragm, dry mouth, irritability, and intense heat in the hands and feet.
Nuke Cuoyao (Essentials of Gynecology) states: Some patients experience fever and fatigue after menstruation, along with visual obstruction described as eyes being covered by silk. The spleen is the head of all yin channels, and the eyes are the gathering place of blood vessels. Injury to the spleen causes the five zang organs to lose their proper function, preventing essence from ascending to the eyes. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Guipi Tang (Restore the Spleen Decoction) should be used to specifically regulate the spleen and stomach for recovery. In chronic cases, yang qi is also compromised and requires tonification and regulation.
Shenzhai Commentary: The above three passages discuss syndromes of tidal fever, guest heat, and fever during menstruation. Tidal fever and guest heat during menstruation involve both deficiency and excess considerations. Fever occurring *after* menstruation, however, indicates emptiness of the blood vessels and insufficiency of yin, representing a pattern of deficiency without excess.