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As the proverb goes: "It is better to treat ten men than one woman." This refers to the difficulty in treating women's diseases. Why? It stems from a lack of understanding that while the fundamental nature of women's diseases is the same as men's, their emotional constitution differs. Generally, women live in seclusion and are prone to depression, often feeling unable to express themselves freely. Their Yin nature tends to be rigid and difficult to comprehend. Furthermore, influenced by affection, love, hatred, jealousy, worry, and anger, they may fail to understand the principles of destiny, often harboring resentment or complaint. Some have unexpressed desires, some have illnesses they cannot disclose, some trust in shamans, and some fear medication. Consequently, their conditions become deeply entrenched and stubborn, making treatment difficult; this is due to the influence of their emotions. However, there are also difficulties arising from social circumstances. For instance, Kou Zongshi quotes the Yellow Emperor: "In treating diseases, one must observe the patient's form, Qi, complexion, and luster. If form and Qi are harmonious, it is termed 'treatable'; if the complexion is floating and lustrous, it is termed 'easy to cure'; if form and Qi are discordant, and the color is dull and lacking luster, it is termed 'difficult to treat'." He further states: "The way to diagnose involves observing whether a person is courageous or timid, examining their bones, muscles, and skin, to determine deficiency or excess, thereby establishing diagnostic methods." Thus it is said: "The ultimate key to treatment lies not neglecting the observation of complexion and pulse; this is the great principle of treatment." Nowadays, people of wealth reside in deep chambers, behind curtains, and often cover their hands with silk handkerchiefs. This prevents the physician from performing the divine art of observing complexion and fully utilizing the skill of pulse palpation. If the pulse does not conform to expectations, questioning becomes necessary. Patients may find excessive questioning tedious and accuse the physician of poor skill, often refusing to believe in the medicine. They do not realize that effective questioning is difficult; only a skilled physician can ask questions well. If one were to discard three of the four diagnostic methods—Inspection (Wang), Auscultation and Olfaction (Wen), Inquiry (Wen), and Palpation (Qie)—I fear even a divine healer would lose their efficacy. Such widespread issues are common, which explains why women's diseases are difficult to treat. Therefore, both physicians and patients should pay close attention to this.

The *Suwen: Shanggu Tianzhen Lun* states: "When a girl reaches fourteen years of age, Tian Gui (a subtle substance promoting reproductive development) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes vigorous. Menstruation occurs on time, enabling conception." Tian Gui refers to postnatal Yin Qi. When Yin Qi is sufficient, menstruation flows smoothly; this is what is called menstruation. Since the female body belongs to Yin, its Qi corresponds to the moon. The moon completes its cycle every thirty days, and menstruation arrives every thirty days, regularly and consistently, hence the name "Menstruation" (Yue Jing) or "Monthly Trust" (Yue Xin). "Jing" implies constancy. Once irregular, it loses its normal rhythm, leading to various diseases. Although menstrual blood is essentially Yin blood present in all organs, all blood from the Zang-Fu organs converges into the Chong Mai. As the Chong Mai is the "Sea of Blood" for the five Zang and six Fu organs, the text notes that when the Chong Mai is vigorous, menstruation occurs on time. This demonstrates that the Chong Mai is the root of menstruation. However, the transformation of Qi and Blood originates from Grain and Water (dietary nutrients). Abundant dietary intake leads to abundant Qi and Blood; deficient intake leads to deficiency. The "Sea of Grain and Water" resides in the Yangming Stomach Channel. Examining the *Suwen: Wei Lun*: "The Yangming Channel is the Sea of the Five Zang and Six Fu organs; it primarily moistens the Zong Jin (Major Sinews). The Zong Jin binds the bones and facilitates joint movement." The Chong Mai is the "Sea of the Twelve Primary Channels," primarily permeating and irrigating the muscle spaces (Xi Gu), merging with the Yangming at the Zong Jin. Yin and Yang converge at the Zong Jin, meeting at the Qichuan acupoint, with the Yangming serving as the leader. Thus, male essence and female blood descend through the anterior yin. This shows that the blood in the Chong Mai is ultimately transformed from Yangming dietary nutrients, and Yangming Stomach Qi is the root of the Chong Mai. Therefore, the root of menstruation lies in the Chong Mai, the Stomach Qi, and the source of transformation in the Heart and Spleen. Other factors such as the Seven Emotions (Joy, Anger, Worry, Thought, Sadness, Fear, Fright), Six Exogenous Pathogens (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), and improper diet and lifestyle are all thieves damaging the Qi of the Heart, Spleen, and Stomach. One must know what to protect and what to eliminate; students of medicine should understand the correct approach here.