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Cheng Zhongling's *Nüke Yi Juan* (One Volume on Gynecology) is entirely refined from the discussions of various renowned physicians, striving for perfection. Every word and phrase is flawless, lacking the delicate and frivolous habits found in modern works such as *Linzheng Zhinan* (Guide to Clinical Practice). Therefore, treatments based on this work often yield practical results. This volume largely follows this principle, establishing it as the orthodox model for gynecology. Other conditions that are treated similarly to internal medicine pulse diagnoses are not repeated here.

Women's ailments are often kept secret, similar to how children cannot speak for themselves; both present difficulties in treatment. Physicians find it inconvenient to inquire in minute detail, making diagnosis akin to groping in the dark. However, the primary cause generally lies in emotional depression. Due to their yin-natured reserve and limited perspectives, any dissatisfaction becomes firmly lodged in the chest. Unable to vent this frustration externally, prolonged stagnation leads to disease. The main therapeutic approach, after excluding external contraction, internal injury, or other miscellaneous conditions, consists of four characters: "nourishing blood and soothing the liver" (Yangxue Shugan). Formulas such as Siwu Tang (Four Substances Decoction) and Xiaoyao San (Free and Easy Wanderer Powder) can address eight or nine out of ten cases. All other miscellaneous conditions are treated identically to internal medicine, so they are not elaborated upon here. As for conditions before and after childbirth, which involve life-and-death stakes, these will be detailed later; do not neglect them.

For unmarried women (Shinv), if Tian Gui (menstrual essence) has not yet arrived, diseases should be discussed according to pediatric principles. Once Tian Gui begins, treatment aligns with that of adult women. However, since their spirit is complete and qi and blood are abundant, menstruation should occur without delay. If amenorrhea occurs, unless it is due to the dryness of the Blood Sea (Xuehai), it must be due to the reversal of meridians. Blood dryness leads to internal heat and coughing, gradually developing into consumptive disease (Qiezheng). Meridian reversal manifests as hematemesis or epistaxis, with blood flowing recklessly; these are not mild conditions and require prompt treatment. If menstruation has just started but accidentally obstructs the urethral orifice, causing urinary retention and severe abdominal distension and pain, it is urgent to regulate the menses, after which urination will naturally resume. Use Tiaojing Yin (Regulate Menses Decoction).

"Jing" (menses) implies constancy. The moon has a fixed orbit, and menstruation has a fixed cycle. Deviations from this norm indicate disease. Medical texts state that early menstruation indicates heat, while late menstruation indicates cold; however, this view cannot be fully trusted. In summary, observing the color, red is considered normal. A change to purple-black indicates heat; yellow like rice washings indicates dampness; pale red or white indicates deficiency. Clumps that are purple-black and dark in luster indicate cold coagulation; clumps that are purple-black and bright in luster indicate heat accumulation. Abdominal pain during pre-menstruation that refuses pressure indicates qi stagnation and blood coagulation; abdominal pain after menstruation that welcomes pressure indicates qi deficiency and blood insufficiency. Fever before menstruation indicates blood heat; fever after menstruation indicates blood deficiency. Abdominal distension indicates qi stagnation; abdominal pain indicates blood stagnation. Diarrhea indicates spleen deficiency; loose stools indicate cold-dampness. Any upward regurgitation of blood resulting in hematemesis or epistaxis, or downward flooding resulting in sudden metrorrhagia, belongs to reckless bleeding due to blood heat, though some cases are caused by collateral damage, blood stasis accumulation, or hyperactive liver. If menstrual flow is excessive, pale color indicates deficiency, while deep color indicates heat. If accompanied by leukorrhea (red and white discharge), an foul odor indicates damp-heat, while a fishy odor indicates cold-dampness.

For blood dryness and meridian reversal, Yimu Shengjin Dan (Motherwort Golden Pill) combined with Niuxi (Achyranthes Root) is used. For obstruction of the urinary tract by menstrual blood, Tiaojing Yin combined with Zelan Tang (Lycopus Decoction) is used. For purple-black menstrual blood, Shengdi Siwu Tang (Rehmannia Four Substances Decoction) added with Danshen (Salvia Root), Danpi (Moutan Bark), and Yimucao (Motherwort Herb) is used. For pale red blood, Bazhen Tang (Eight Treasures Decoction) is used. For yellow, rice-wash-like discharge, Liujunzi Tang (Six Gentlemen Decoction) added with Yiren (Coix Seed) and Biandou (Hyacinth Bean) is used. For cold coagulation forming clumps, Siwu Tang added with Guixin (Cinnamon Heart) and Niuxi is used. For heat accumulation forming clumps, Shengdi Siwu Tang added with Danshen, Danpi, and Yimucao is used. For pain and distension due to qi-blood stagnation, Tiaojing Yin or Siwu Tang added with Yanhu (Corydalis Rhizome), Xiangfu (Cyperus Rhizome), and Muxiang (Aucklandiae Radix) is used. For qi deficiency and blood insufficiency causing intermittent pain or fever, Siwu Tang added with Renshen (Ginseng Root) and Baizhu (Atractylodes Macrocephala Rhizome) is used. For diarrhea and loose stools, Liujunzi Tang is used. For reckless bleeding above and below due to blood heat, Siwu Tang added with Danpi, Ejiao (Donkey-Hide Gelatin), Huangqin (Scutellaria Root), and Heishanzhi (Black Gardenia Fruit) is used. For reckless bleeding due to collateral damage, whether from excessive anger/joy or overwork, Bazhen Tang is used. For blood returning to its vessels improperly due to blood stasis accumulation, Dusheng Wan (Single Holy Pill) is used. For hyperactive liver fire failing to store blood, Xiaoyao San is used. For cases complicated by red and white leukorrhea, Wuling San (Five Ling Powder) modified is used.