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[Da Lun] Childbirth injures Qi and Blood. If the subsequent deficiency is not restored, and one is injured by Wind-Cold pathogenic factors, the nature of Blood is to coagulate when exposed to Cold. Therefore, when Wind-Cold damages the menstrual Blood, causing it to coagulate between the uterus and its collaterals, menstruation becomes obstructed. Whenever Blood coagulation leads to amenorrhea, a Blood mass (Xue Jia) forms; if Water-Dampness and Blood bind together, compounded by weak Spleen-Stomach function and emaciated muscles, edema occurs.

The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) of women are the sea of the meridians and collaterals, both originating within the uterus. The Hand-Taiyin Small Intestine Meridian and the Hand-Shaoyin Heart Meridian transform into breast milk upwards and into menstruation downwards. If menstruation is obstructed postpartum, it is generally because after recent childbirth, Qi and Blood are exhausted by labor, or excessive blood loss has occurred, allowing breast milk to flow freely while menstruation naturally ceases. If menstruation does not resume during breastfeeding for six months to one year, this is a normal physiological state, not a disease, so why force menstruation? As the proverb says, "Nai Jia" (temporary amenorrhea due to lactation) refers to this. If menstruation resumes at half a year, or even four to five months postpartum, these are young and robust individuals with abundant Blood and Qi, who conceive easily and have many pregnancies and lactations. Their infants, deprived of breast milk, will inevitably suffer from limb emaciation, abdominal distension with visible veins, dry and scorched hair, and pica (eating dirt), a condition named "Wugu" (Innocent Disease). If there is an excess of menstrual Blood, it should not be stopped with medication. If menstruation is absent for one or two years postpartum but without other discomforts, why take medicine? If Qi and Blood are damaged by overwork, leading to deficiency of the Chong and Ren vessels, and insufficient Qi and Blood to flow, one should simply administer herbs that strengthen the Spleen and Stomach and nourish Qi and Blood, and menstruation will naturally resume. Using herbs such as Achyranthes Root (Niuxi), Safflower (Honghua), Bryony Root (Sumu), Drynaria Resin (Ganqi), Blister Beetle (Mangchong), and Leech (Shuizhi) to forcibly unblock menstruation causes great harm. When menstrual Blood is depleted, there is nothing to nourish the body, how can menstruation flow? Chu Yushi once said: This is like demanding ten thousand gold pieces from a beggar; even under beating and torture, it cannot be obtained. Scholars in later generations should examine carefully and treat accordingly.

[Xue Ji's Commentary] For the aforementioned syndromes caused by Spleen-Stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction). If complicated by constrained Fire injuring the Spleen, use Guipi Tang (Restore the Spleen Decoction) plus Mudanpi (Tree Peony Bark) and Shanzhi (Gardenia Fruit). If Anger-Fire injures Blood, Siwu Tang (Four Substances Decoction) combined with Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. For simultaneous deficiency of Qi and Blood, use Bazhen Tang (Eight Treasures Decoction) plus Mudanpi. Refer to the previous discussion for main treatment principles. A certain patient had no menstruation for over a year, accompanied by internal heat and afternoon tidal fever. After taking Fenqi Wan (Qi-Regulating Pill), menstruation became continuous, accompanied by aversion to cold, thirst, poor appetite, fatigue, chest fullness, and Qi stagnation. In the morning, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was administered; in the evening, Sijunzi Tang (Four Gentlemen Decoction) was given. After about a month, symptoms improved slightly. Then, Bazhen Tang (Eight Treasures Decoction) was added as an adjunct, taken concurrently for two months until recovery. The above three cases should be consulted in the Menstrual Regulation section for general application.