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The *Lingshu: Shanggu Tianzhen Lun* (Treatise on the Natural Truth of Antiquity) states: "When a girl reaches fourteen years of age, Tiangui (substances promoting reproductive maturation) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) flourishes. Menstruation occurs at regular intervals, thus enabling conception." By "Tiangui," it refers to postnatal Yin Qi (vital energy associated with Yin). When Yin Qi is sufficient, menstruation flows smoothly; this is what is meant by menstruation. Precisely because the female body belongs to Yin, its physiological rhythm corresponds to the moon. The moon undergoes a cycle of waxing and waning every thirty days, and menstruation also arrives approximately every thirty days. It comes monthly as scheduled, maintaining a constant regularity, hence it is called "Menstruation" (Yue Jing), also known as "Monthly Trust" (Yue Xin). "Jing" implies constancy or regularity. Once irregular, it loses its normal measure, and various diseases manifest. However, menstruation is fundamentally Yin Blood. Which Zang organ does not possess blood? It is merely that the blood of all Zang and Fu organs converges into the Chong Mai, which serves as the Sea of Blood for the Five Zang and Six Fu organs. Therefore, the text mentions that when the Chong Mai flourishes, menstruation occurs on time. This demonstrates that the Chong Mai is the root of menstruation.

Nevertheless, the transformation of Qi and Blood depends on Grain and Water (nutrients from food and drink). Abundant nutrients lead to abundant Qi and Blood; deficient nutrients lead to deficient Qi and Blood. The Sea of Grain and Water lies in the Yangming Stomach Channel. Examining the *Fei Lun* (Treatise on Flaccidity), it says: "The Yangming channel is the Sea of the Five Zang and Six Fu organs; it primarily moistens the Zong Jin (general term for tendons/membranes around the genitalia). The Zong Jin binds bones and facilitates joint movement. The Chong Mai is the Sea of the Meridians; it primarily infiltrates and irrigates the muscle spaces. It joins with the Yangming at the Zong Jin. Yin and Yang converge at the Zong Jin, meeting at the Qijie acupoint, with the Yangming taking the lead." Thus, male essence and female blood are both discharged from the anterior orifice. From this, we can see that the blood in the Chong Mai ultimately derives from the transformation of Grain and Water by the Yangming Stomach. And the Stomach Qi of Yangming is the root of the meridians. Therefore, regarding the root of menstruation, emphasis lies on the Chong Mai; emphasis lies on Stomach Qi; and emphasis lies on the source of transformation generated by the Heart and Spleen. Other factors such as emotional disturbances (Seven Emotions), pathogenic influences (Six Exogenous Factors), improper diet, and irregular lifestyle are nothing but thieves damaging the Qi of the Heart, Spleen, and Stomach. What should be protected and what should be eliminated? Students of medicine must understand how to proceed in this regard.

Women are governed by Blood. When Blood is robust, menstruation is regulated, and fertility is achieved. The flourishing or decline of the body invariably begins here. Therefore, in treating women's diseases, regulating menstrual blood should be the priority. Regarding the governance of Blood, ancient medical texts state that the Heart governs Blood, the Liver stores Blood, and the Spleen controls Blood. Thus, any injury to the Heart, Spleen, or Liver can cause meridian disorders. It is further stated: The Kidney is Yin within Yin and governs closure and storage; the Liver is Yang within Yin and governs dispersion and free flow. Both organs contain Xiang Huo (Ministerial Fire). Their channels connect upward to the Heart. Therefore, when Heart Fire stirs, Ministerial Fire rises vigorously with it, often causing Blood to become restless and bleed recklessly. This is indeed one perspective. However, while reckless bleeding due to stirring Ministerial Fire exists (caused by excessive Fire), there are also cases of reckless bleeding due to sinking of Middle Qi and failure of the orifices to secure, which stem from Spleen and Kidney deficiency. These cannot be entirely attributed to Fire. Furthermore, there are cases where the Qi mechanism is reversed and blocked, caused by Liver stagnation; and there are cases where Essence and Blood are degenerated and fail to flow, caused by exhaustion of True Yin. Such syndromes are numerous and must not be mistakenly identified as mere stagnation. These are indeed diseases of the Heart, Spleen, Liver, and Kidney, yet rarely mention the Lung. One fails to realize that the movement or immobility of Blood is inseparable from Qi. As the *Jingmai Bie Lun* (Separate Discussion on Meridians) states: "Drinking enters the Stomach, overflowing with essence and Qi, which is transported upward to the Spleen. The Spleen scatters the essence, sending it upward to return to the Lung. The Lung regulates water passages, transporting them downward to the Bladder. Water essence distributes in four directions, flowing through the five meridians, harmonizing with the Four Seasons, Five Elements, and Yin-Yang, serving as the standard for measurement." This describes the pathway from Stomach to Spleen, from Spleen to Lung, and then spreading to other meridians. Therefore, in cases of Blood depletion, one should tonify Qi; in cases of Blood stagnation, one should regulate Qi. Since Qi is primarily governed by the Lung, the principle is clear. These are the aspects of various meridians that require differentiation. However, regarding the severity, origin, and details, further differentiation is necessary. Generally, the onset of disease may arise from overthinking, depression/anger, chronic fatigue, or exposure to exogenous pathogens and dietary indiscretion. Most originate in the Heart, Lung, Liver, and Spleen. When the condition worsens, these four organs transmit the pathology, eventually converging on the Spleen and Kidney. If Yang levels decline daily, food intake decreases, leading to exhaustion of Spleen and Stomach Qi. If Yin levels decline daily, Essence and Blood dry up, leading to exhaustion of the Chong/Ren vessels and Kidney Qi. Hence, I say: When Yang pathogens arrive, harm inevitably returns to Yin; when the Five Zang are damaged, the extremity inevitably involves the Kidney. This is the inevitable course of origin and flow, and thus the key point of treatment. Therefore, when treating meridian diseases, if the condition is not severe, one should resolve the initial pathogen and address the primary cause first. If the condition is already critical, one must consider the destination of the disease and focus specifically on protecting the root. Even if the Spleen and Kidney are severely damaged, and the source dries up daily, manifesting as pale, scanty menses progressing to amenorrhea, this indicates extreme exhaustion. Ignorant practitioners, lacking knowledge, may claim it is accumulated blood and treat it with methods to promote flow or break stasis, bringing disaster upon themselves immediately.