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Luo stated: The *Huangdi Neijing* (Yellow Emperor's Inner Canon) records a disease characterized by distension and fullness in the chest and hypochondrium, interfering with food intake. At the onset of the illness, one first smells a fishy or foul odor, secretes clear fluids (such as clear nasal discharge or saliva), experiences hemoptysis (spitting blood), cold limbs, dizziness, and frequent bleeding from both the upper and lower orifices (hematemesis/hematochezia). This disease is named "Blood Depletion" (Xue Ku) (this refers to the pathogenesis of the disease, which should be understood). This occurs because in youth, there was massive blood loss, or sexual intercourse occurred while intoxicated, damaging the Kidney and Liver. Since the Liver stores Blood and receives the Qi of Heaven and Earth (congenital essence) for nourishment and flourishing, its meridian ascends through the diaphragm and spreads over the hypochondrium. If blood is lost and essence is depleted, the Liver Qi is injured, and Liver Blood becomes depleted and dry, failing to nourish the body. Consequently, there is distension in the chest and hypochondrium, interfering with eating; the Liver disease transmits to the Spleen, causing the perception of fishy odors and the secretion of clear fluids. If the Liver disease allows the Lung Metal to overcome it, then hemoptysis, cold limbs, dizziness, and frequent bleeding from the upper and lower orifices occur; all these are symptoms of damaged Liver Blood. (Regarding the syndrome of chest and hypochondriac fullness, people usually employ methods to subdue the Liver, not realizing that this is due to Blood Depletion; one should nourish Liver Blood, and this must be recognized.)

The *Liangfang* states: In women, amenorrhea may result from sexual intercourse after excessive drinking and eating, from overexertion, or from vomiting blood and hemorrhage, which damages the Liver and Spleen. If the source of transformation and generation is nourished, menstruation will naturally resume. If there is difficulty in urination, severe headache and dizziness, pain in the waist and back, cold feet with intermittent pain, and if blood stagnates internally for a long time, it transforms into a mass (Jia); if blood and water combine, and the Spleen and Stomach are weak with obstruction and blockage, it transforms into edema; if Spleen Qi is weak and cannot control water, gradually infiltrating the muscles, it transforms into generalized swelling and fullness. One should replenish body fluids and greatly tonify the Spleen and Stomach to preserve life. Wang Jiezhai said: Amenorrhea in women is often caused by damage to the Spleen and Stomach; it should not be immediately diagnosed as amenorrhea due to dead blood, nor should drugs that promote menstruation and break blood stasis be used lightly (this expresses insights not previously mentioned, which is very correct. However, if Liver Qi stagnation causes the Spleen Earth to lose its transporting function and fail to transform blood, harmonizing Liver Qi becomes essential; physicians must know this). When encountering such cases, one must examine the condition of the Spleen and Stomach. If the Spleen and Stomach are damaged by diet and fatigue, leading to poor appetite, aversion to food, diarrhea, and pain, or if mistaken use of sweating, purging, or attacking drugs damages the Middle Qi, resulting in blood deficiency and cessation of menstruation, only tonifying and nourishing the Spleen and Stomach is appropriate. Use Bai Zhu (Atractylodis Rhizoma) as the sovereign drug, Fu Ling (Poria) and Shao Yao (Paeoniae Radix) as the minister drugs, assisted by Huang Qi (Astragali Radix), Gan Cao (Glycyrrhizae Radix), Chen Pi (Citri Reticulatae Pericarpium), Mai Ya (Hordei Fructus Germinatus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Chai Hu (Bupleuri Radix) in equal proportions. These Spleen and Liver herbs can generate blood, and menstruation will naturally flow. In cases where dietary stagnation damages the Spleen and Stomach, resolving stagnation and tonifying the Spleen are also appropriate. Only if the Spleen and Stomach are healthy and there are indeed blood clumps congealed, should blood-invigorating and menstruation-promoting drugs be used.