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The *Suwen* (Basic Questions) states: When the climate of heaven and earth is mild and warm, the menstrual water remains calm and quiet; when the weather is cold and the earth frozen, the menstrual water becomes stagnant and sluggish; when the weather is hot and the earth heat rises, the menstrual water boils and overflows; when a sudden storm arises, the menstrual water surges like waves. ("Zu" is pronounced as "cu," meaning suddenly.)

Chu Cheng said: Once a woman's Tian Gui (the substance promoting reproductive maturity) has arrived, if she does not cohabit with a man for more than ten years, her menstruation will become irregular; if she desires cohabitation before ten years have passed, her menstruation will also become irregular. When menstruation is irregular, old blood does not exit, and new blood flows erroneously: it may seep into the bones, transform into swelling/masses, or even if cohabitation occurs, pregnancy may be difficult to achieve. Excessive cohabitation leads to seminal depletion and bodily weakness; excessive childbirth and lactation lead to blood depletion and death.

Wang Mengying’s commentary: This argument is not entirely accurate; retaining its general intent is sufficient. It is true that many cases of death due to blood depletion from excessive childbirth and lactation exist. However, in my hometown, Lady Xu, wife of Magistrate Wu Yunxiang, aside from three spontaneous abortions, gave birth to ten sons and four daughters, all of whom grew up healthy. Yet, at over fifty years of age, her vitality remained unimpaired, and she could still manage household affairs and command subordinates. (Regarding "death," the current stone-printed edition of *Wang Shi Shisi Zhong* reads "sudden death," which is incorrect.)

Fang Yuezhi said: Women often lack autonomy and are prone to anger. Qi stagnation leads to blood depletion.

Wang Mengying’s commentary: This is profound truth. Qi is the commander of Blood; therefore, regulating menstruation must begin with regulating Qi. However, regulating Qi cannot rely solely on aromatic and drying herbs, because郁怒 (depressive anger) is fire generated by emotional disorders. Frequent use of aromatic and drying herbs will further consume Ying Yin (Nutritive Yin).

Zhao Yangkui said: Menstruation arriving before schedule indicates Fire; Liuwei Wan (Six-Ingredient Pill with Rehmannia) should be used to nourish Kidney Water. If it arrives early and in large amounts, add Baishao (Radix Paeoniae Alba), Chaihu (Radix Bupleuri), and Haipiaoxiao (Endoconcha Sepiae). If it arrives every half month or ten days and persists without stopping, it belongs to Qi Deficiency; Buzhong Yiqi Tang (Decoction for Boosting the Middle and Augmenting Qi) is appropriate. Menstruation arriving after schedule indicates deficient Fire; Liuwei Wan with Aiye (Folium Artemisiae Argyi) is added. If the pulse is slow and the color pale, Guizhi (Ramulus Cinnamomi Cassiae) is added. This is the general principle. Among these, there are cases of early arrival without Fire, and late arrival with Fire. One must not adhere rigidly to fixed rules but should observe the pulse and constitution, focusing on nourishing Kidney Water, and modifying according to symptoms.

Wang Mengying’s commentary: In women's diseases, although regulating menstruation is prioritized, individual constitutions vary as much as facial features. Some women have irregular menstruation throughout their lives yet are fertile; others have perfectly regular cycles yet fail to conceive. Having extensive experience and knowledge in gynecology over many years, I have come to realize that ancient theories cannot be blindly adhered to, and medicines for non-existent conditions should not be administered recklessly.