素问曰。女子二七而天癸至。任脉通。太冲脉盛。月事以时下。故有子。七七任脉虚。太冲脉衰少。天癸竭。地
道不通。故形坏而无子。盖天癸者。女子之精。月事者。女子之血。谓血为月事者。以事应月也。谓血为月经
者。以月为常也。后人谓先期而至者为热。后期而至者为寒。其实先期有虚实。后期亦有虚实。故先不可
偏用寒。后不可偏用热。而况有先后不定。通闭无常者乎。况有避年居季。逆行暗行。盛胎漏胎者乎。然则
就形色而诊者。是或一道也。诊之之法。诸书以为根据期消长为安。血红不结为正。来去失时为弱。色杂而
凝为病。浓而多者血盛。淡而少者血衰。赤而紫者属热。淡而红者属虚。陷经漏下。黑不解者。治用胶姜。以
其下寒也。行经暴下。血去多者。则为夺血。以其中虚也。鲜紫而成块成条者。多由血热。黑败而或散或抟
者。必属虚寒。成块者气之滞。疼痛者血之凝。行后作痛者为虚。将行作痛者为实。非时血下。淋沥不止者。
谓之漏下。忽然暴下。倾注不断者。谓之崩中。至若如屋漏水。如豆汁水者。前人谓其病气实。而属于湿。吾
直以为形气虚。而感于寒。然必参之脉证。合之形容。以辨其虚实。而判其寒热焉。若夫五崩之诊。王氏脉
经以为白崩者形如涕。赤崩者形如绛津。黄崩者形如烂瓜。青崩者形如蓝色。黑崩者形如 血。释之者
曰。五色带下。伤肝则青如泥色。伤心则赤如红津。伤肺则白如鼻涕。伤脾则黄如烂瓜。伤肾则黑如 血。
五色各应五脏。五脏俱虚。五色并下。是皆血之为病也。愚谓带之为病属乎任。经之为病属乎冲。而经色
之分。又当以红紫辨寒热。浓淡分虚实。鲜败分新久。六法合观。则红紫浓淡鲜败之变。皆可交推以解。而
其寒热虚实新久之变。亦可错综而知。第色虽属望。而理不容观。其将因问而得欤。医为司命。尚其毋忽。
The *Suwen* states: When a girl reaches fourteen years of age, Tian Gui (substances that promote reproductive function and maturity) arrives. The Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant in Qi and Blood. Menstruation occurs at regular intervals, thus enabling conception. By forty-nine years of age, the Ren Mai becomes deficient, the Chong Mai declines in Qi and Blood, Tian Gui is exhausted, and the Di Dao (uterine cavity and menstrual pathway) becomes obstructed. Consequently, the body deteriorates, and childbearing ceases. Generally speaking, Tian Gui refers to the Jing Essence of women, while Yue Shi (menstrual blood) refers to the Xue Blood of women. It is called "Yue Shi" because it corresponds to the lunar month cycle; it is called "Jing Yue" because it follows a monthly regularity. Later generations believed that early onset indicates Heat syndrome, while late onset indicates Cold syndrome. In reality, early onset can be either Deficiency or Excess, just as late onset can be either Deficiency or Excess. Therefore, one should not exclusively use Cold-natured herbs for early onset, nor exclusively use Warm-natured herbs for late onset. Moreover, there are cases where the timing is irregular, and the flow alternates between obstruction and free flow. Furthermore, there are conditions such as Bi Nian (menstruation occurring once a year), Ju Ji (menstruation occurring once every three years), Ni Xing (retrograde menstruation, e.g., epistaxis during menses), An Xing (conception without visible menstruation), Sheng Tai (cyclic bleeding during pregnancy resembling menstruation), and Lou Tai (persistent slight vaginal bleeding during pregnancy). However, diagnosing based on complexion and the appearance of menstrual blood is indeed one valid approach. The methods of diagnosis hold that stability is determined by the regularity of the cycle; red, vibrant, and non-clotted blood is normal; irregular timing indicates weakness; mixed colors with clots indicate pathology; thick and abundant blood indicates Excess of Blood; pale and scanty blood indicates Deficiency of Blood; red-purple color belongs to Heat; pale-red color belongs to Deficiency. In cases of Xian Jing (prolapsed menstruation) with persistent leakage, if the blood remains black and does not resolve, treatment employs Jiao Jiang Tang (Gelatin and Ginger Decoction) because this indicates Lower Jiao Deficiency-Cold. During menstruation, if there is sudden profuse bleeding leading to significant blood loss, it is termed Duo Xue (Loss of Blood), indicating Middle Jiao Deficiency. Bright purple blood forming clots or strips is mostly due to Blood Heat; dark, spoiled blood that is either scattered or aggregated must belong to Deficiency-Cold. Clots indicate Qi Stagnation; pain indicates Blood Stasis. Pain occurring after menstruation indicates Deficiency; pain occurring before menstruation indicates Excess. Non-menstrual bleeding that drips continuously is called Lou Xia (Leaking Down); sudden profuse bleeding that pours without stopping is called Beng Zhong (Central Collapse). As for discharge resembling leaking roof water or bean dregs, predecessors considered it an Excess of pathogenic Qi belonging to Dampness, whereas I directly consider it a Deficiency of Form and Qi caused by Cold invasion. However, one must refer to the Pulse and Symptoms, and combine them with physical appearance, to differentiate Deficiency from Excess, and determine Cold from Heat. Regarding the diagnosis of Wu Beng (Five Types of Collapse), Wang’s *Mai Jing* states: White Beng resembles mucus; Red Beng resembles dark red fluid; Yellow Beng resembles rotten melon; Green Beng resembles blue color; Black Beng resembles congealed blood. Commentators explain: Five-colored leukorrhea: injury to the Liver results in green like mud; injury to the Heart results in red like red fluid; injury to the Lung results in white like nasal mucus; injury to the Spleen results in yellow like rotten melon; injury to the Kidney results in black like congealed blood. Each of the five colors corresponds to the Zang Organs. If all five Zang Organs are deficient, all five colors appear together. These are all diseases arising from Blood. I believe that leukorrhea disease pertains to the Ren Mai, while menstrual disease pertains to the Chong Mai. The differentiation of menstrual color should further distinguish Cold and Heat by red versus purple, Deficiency and Excess by thickness versus paleness, and new versus old by freshness versus spoilage. Observing these six aspects comprehensively allows one to deduce changes in red/purple, thick/pale, fresh/spoiled, and consequently understand the variations in Cold/Heat, Deficiency/Excess, and New/Old. Although color observation falls under Wang Zhen (Inspection), the underlying principles cannot be ignored. Is this not knowledge obtained through Wen Zhen (Inquiry)? Physicians hold the lives of people in their hands; they must not neglect this.