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Xue Lizhai stated: Blood is the essence of water and grain. It harmonizes the five zang organs and distributes to the six fu organs. In men, it transforms into essence; in women, it ascends as milk and descends as menstruation. Therefore, although the Heart governs blood and the Liver stores blood, both are controlled by the Spleen. By tonifying the Spleen and harmonizing the Stomach, blood will naturally generate. During menstruation, bitter-cold and acrid-dispersing herbs should be strictly avoided, and diet should also be regulated. (Understanding that the essence of water and grain is the root of blood generation reveals that the Spleen and Stomach are the source of blood. Thus, if blood fails to generate due to Spleen deficiency, one cannot rely solely on Siwu Tang [Four Substances Decoction].)

Chen stated: Menstrual irregularities in women arise when wind-pathogens invade the uterus (Bao Gong) due to deficiency, damaging the Chong and Ren vessels and injuring the Hand-Taiyang Small Intestine Meridian and Hand-Shaoyin Heart Meridian. The Chong and Ren vessels originate from the uterus and are known as the Sea of Meridians. They have a exterior-interior relationship with the Hand-Taiyang Small Intestine Meridian and Hand-Shaoyin Heart Meridian, ascending to form milk and descending to form menstruation. However, menstruation is merely the surplus of the meridians. If properly regulated, menstruation will occur on time. (The *Qianjin Fang* notes that menstrual conditions can be caused by wind invasion; how can one neglect caution? The classic states: "Diseases of the Two Yangs originate in the Heart and Spleen; men suffer from scanty essence, women from amenorrhea." This mentions the Small Intestine, which pairs with the Heart, but should not be conflated. Therefore, the account in the *Suwen* [Basic Questions] is correct.)

The *Mai Jing* [Pulse Classic] states: The Master said, "A faint pulse indicates deficiency of both Qi and Blood. In young people, this results from blood loss; in nursing mothers with diarrhea, it may be acceptable; otherwise, this is termed 'Ju Jing' [Resident Menses], occurring once every three months." (This refers to Ju Jing characterized by faint pulses and dual deficiency of Qi and Blood.) It further states: "At the Cun Kou position, the pulse is faint and choppy. Faintness indicates insufficiency of Wei Qi [Defensive Qi]; choppy nature indicates exhaustion of Ying and Blood. Insufficient Wei Qi leads to shortness of breath and restlessness. Insufficient Blood leads to physical disharmony. When both Ying and Wei are deficient, speech becomes erroneous. At the Zu Yang position, the pulse is floating and choppy. Choppy indicates weak Wei Qi, leading to shortness of breath. Dry throat and bitter taste indicate stagnant Stomach Qi and loss of fluids. At the Shao Yin position, the pulse is faint and slow. Faintness indicates lack of Essence; slowness indicates cold in the yin region; choppy nature indicates absence of blood flow. This is Ju Jing, occurring once every three months." (This refers to Ju Jing where the Cun pulse is faint and choppy, and the Stomach pulse is floating and choppy, representing Yang descending to generate Yin.)

Question: When a woman is three months pregnant, the physician palpates the pulse and declares she is not pregnant, but her menses should arrive. What does her pulse resemble? How can it be distinguished?

Answer: The Master said: "At the Cun Kou position, the Wei aspect is floating and large, while the Ying aspect is surprisingly weak. Floating and large indicate strong Qi; surprisingly weak indicates scanty Blood. Solitary Yang exhales alone, while Yin cannot inhale. The two Qi do not interact; Wei descends while Ying depletes. Yin accumulates cold; Yang gathers heat. Excessive Yang lacks moistening properties, and the meridians are insufficient. Yin deficiency allows Yang to advance (or excess), resulting in scanty Blood. Symptoms include occasional chills, dry throat, sweating, thick frequent urination, and excessive salivation. This constitutes double deficiency with leakage of body fluids, confirming non-pregnancy. Accumulated blood causing fullness follows one meridian per month, arriving once every three months. When Yin is excessive, it discharges, named Ju Jing." (Referring to the Right pulse being floating and large, while the Left pulse is surprisingly weak.) (Generally, the Chi pulse in women should be vigorous; seeing weakness here indicates deficiency of Ying Qi below. The floating and large Wei pulse at Cun Kou indicates abundance of Wei Qi above. The classic states: 'When Supreme Yang is excessive, Earth Qi is insufficient,' hence termed 'surprising.' This uses the Cun position to represent the Chi position, describing Ju Jing characterized by floating-large Yang pulses and surprisingly weak Yin pulses.)