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Zhou, a patient, had been expelling small white worms resembling maggots after defecation since childhood, accompanied by slight itching inside the anus. In middle age, the condition came and went intermittently. This was caused by intestinal deficiency allowing wind pathogen invasion; the chronic disease was again forced and injected by damp-heat, leading to the transformation of parasites. It dragged on for a long time without healing. I recall a friend who suffered from this in childhood; he took purgative and insect-killing medicines with no effect. Later, someone advised him to consume human milk for several months, after which the worms disappeared. This showed that merely discussing purgative and insect-killing methods is of no help. Therefore, I prescribed Wenzang Wan (Warm Viscera Pill), using Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Yiyiren (Coicis Semen), Lianzi (Nelumbinis Semen), Chuanjiao (Sichuan Pepper), Feishi (Torreya Seed), Shijunzi (Quisqualis Fruit)—all roasted or processed—along with Jiangtan (Prepared Ginger) and Binglang (Areca Seed). These were ground into powder and made into pills using Shenqu paste as a binder. Taken on an empty stomach with plain warm water, it was often effective.

In gynecology, conception is prioritized, and conception depends first on regulating menstruation. The *Suwen* states: "When a girl reaches fourteen (two sevens), Tian Gui arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant, causing menses to arrive on time." This means when the primordial essence is sufficient, menstrual flow becomes regular, enabling pregnancy. It is called "monthly affairs" because women belong to Yin; their blood rises and falls like tides, corresponding to the waxing and waning of the moon, having a fixed cycle, hence termed "Jing" (Menses). If there is any delay, the normal rhythm is lost, giving rise to various diseases. The Ren Mai governs the uterus, and the Chong Mai is the Sea of Blood; when these two vessels flow smoothly, blood from the Zang-Fu organs converges here. Both are extraordinary vessels, yet the generation and transformation of blood depend on the Spleen and Stomach. If internal injury from the Seven Emotions, external invasion by the Six Excesses, combined with improper diet and overwork, cause daily decline of the Spleen and Stomach, thinning the source of transformation, weakening the Chong and Ren, and diminishing complexion and spirit, particular emphasis must be placed on regulating the Liver. Women tend toward depression; if Wood fails to flourish freely, branches wither; if the Liver fails to store blood, menstruation becomes irregular. However, among irregularities, there are early periods, late periods, disorderly flow, dysmenorrhea, retrograde menstruation, periodic menstruation (once every three months), continuous dripping, and amenorrhea due to dryness. Irregular menstruation inevitably prevents conception, though one should also consider conception occurring a few days before expected dates. During menstruation, raw and cold foods must be avoided, and cold-natured herbs are contraindicated, because blood coagulates and stagnates when exposed to cold. Failure to observe these taboos leads to abdominal pain, masses, and diarrhea, also causing irregular menstruation. Moreover, blood follows Qi; irregular menstruation often stems from Qi issues. Danxi said: Clots in menstruation indicate Qi stagnation; pain before flow indicates Qi obstruction; pain after flow indicates Qi and Blood deficiency. Early periods suggest Blood Heat; late periods suggest Blood Deficiency, both related to Qi. Erratic flow indicates Chaotic Qi; pale color indicates Deficiency with Dampness; purple color indicates Qi Heat; black color indicates severe Heat; fluctuating amounts with continuous dripping indicate Qi's failure to control Blood. Thus, regulating menstruation must include Qi-regulating herbs. If amenorrhea results from organ damage, it arises from grief injuring the Lung, worry injuring the Heart, overthinking injuring the Spleen, anger injuring the Liver, and sexual excess injuring the Kidney. Lung injury causes Qi sinking and Blood loss; Heart injury causes palpitations and night sweats; Spleen injury causes poor appetite and emaciation; Liver injury causes brittle hair and flaccid sinews; Kidney injury causes leukorrhea, bone-steaming fever, and even cough with fever and diarrhea. When Chong and Ren are depleted and sources exhausted, as the *Suwen* says: "Diseases of the Two Yangs originate in the Heart and Spleen; hidden grievances exist; in women, this manifests as amenorrhea." The Heart governs Blood, and the Spleen controls Blood. Excessive thinking and unfulfilled desires lead to depression and depletion, resulting first in amenorrhea and then dry cough. Over months or years, this becomes Dry Blood Consumption Disease (Gan Xue Lao Zhai), which is difficult to treat. Ancient texts say do not tonify before menstruation and do not purge after, referring specifically to those with abdominal pain during menstruation. Actually, the key to regulating menstruation is ensuring Harmony of Qi and Blood, so that menses become regular and conception occurs naturally. If Yang is excessive, periods come early due to Fire; however, if Fire arises from Deficiency, one should nourish Ying (Nutritive) Blood and secure Blood. There are also cases of early periods without Fire, where one should tonify Middle Qi or secure the Kidney gate, avoiding excessive use of Cold/Cool herbs. If Yin is insufficient, periods come late, originally due to Blood Deficiency, but some have Blood Heat causing dryness and stasis, requiring Clearing and Tonifying. Others have Blood rebellion and stagnation, requiring Dispersion and Drainage, without prematurely adhering to Warm Tonification. For Yin-Yang disharmony and erratic flow; whether due to Fire Pathogen clashing with Ying, causing alternating timing; or due to rebellious Jing Qi rushing upward to the mouth and nose; one must examine Deficiency/Excess and Cold/Heat to regulate. Regarding abdominal pain before and after menstruation, the difference between Deficiency and Excess is significant. Pain before flow indicates Blood stagnated by Qi; once flow begins, pain ceases. Pain continuing after flow indicates inherent Chong Mai Deficiency; as Blood leaves, pain intensifies. For stagnation, regulate Qi and move with Warmth; for Deficiency, tonify Ying and fill vigorously. If dripping continues, it must be secured and controlled. Some experience worsening pain with heavier flow, even to the point of near-death; this is Fire clashing with Blood, requiring Blood-invigorating herbs like Xiong (Chuanxiong Rhizome) and Gui (Danggui). To astringe Blood, use Qin (Huangqin) and Shao (Shaoyao). To regulate Spleen, use Ling (Fuling) and Zhu (Baizhu). Use Yimucao (Leonuri Herba) to break Blood within Qi; Yanhusuo (Corydalis Rhizoma) to break Qi within Blood; Xiangfu (Cyperi Rhizoma) to open Depression; add Renshen (Ginseng Radix) for Deficiency. Regulating Spleen ensures Blood has a master; breaking knots eliminates Fire-pain. Thus, nothing regulates menstruation better than Bazhen Tang (Eight Treasures Decoction) added with Yimucao and Yanhusuo. For amenorrhea, obese individuals often have Phlegm obstruction; use Daotan Tang (Great Phlegm Decoction) added with Chuanxiong and Huanglian. Thin individuals often have Depression-Fire; use Siwu Tang (Four Substances Decoction) added with Mudanpi (Moutan Cortex), Zhizi (Gardeniae Fructus), and Zelan (Lycopus Herba). For poor appetite due to Spleen-Stomach deficiency, enhance transport and reception functions using Guixie Yigong San (Angelica and White Atractylodes Powder for Strengthening the Spleen). For bone-steaming due to Liver-Kidney deficiency, strengthen the root of Ying-Yin using Dihuang Tang (Rehmannia Decoction) removing Shanzhuyu and Zexie, adding Guiban (Testudinis Carapax et Plastrum) and Wuweizi (Schisandrae Fructus). For Heart-Spleen injury due to overthinking and depression, use Guipi Wan (Restore the Spleen Pill) or Xiaoying Jian (Minor Nourishing Decoction). For Lung-Qi injury due to labor-induced cough, use Jielao San (Rob Labor Powder) or Ziwan Tang (Aster Decoction). Or warm and nourish the Lower Jiao using Shudi (Rehmanniae Radix Preparata), Shayuanzi (Astragali Complanati Semen), Duzhong (Eucommiae Cortex), Longyanrou (Longan Aril), Qianshi (Euryales Semen), and Lujiaojiao (Colla Cornus Asini). Or unblock the Extraordinary Vessels using Gouqi (Lycii Fructus), Niuxi (Achyranthis Bidentatae Radix), Danggui, Zelan, Fushen (Poria Cum Radix), and Xiangfu. If amenorrhea persists for a long time, lightly using Blood-breaking and menstruation-inducing herbs will further deplete the body. Another symptom is fever and fatigue after menstruation, with eyes feeling covered by silk and vision unclear; this is because Spleen-Kidney essence cannot ascend to the eyes. Take Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) in the morning, and Dihuang Wan (Rehmannia Pill) with Gouqi in the evening. At forty-nine (seven sevens), menstruation should cease; if it does not, or if it stops and returns due to surplus Qi and Blood, it is Beng Lou (Metrorrhagia and Leukorrhea). One should secure the Chong Mai using Dabu Yuanjian (Great Supplement to the Origin Decoction) added with Xuduan (Dipsaci Radix), Ejiao (Colla Corii Asini), Haipiaoxiao (Sepiae Endoconcha), and Tusizi (Cuscutae Semen). In elderly women, if heavy bleeding occurs with unrelenting abdominal pain, the condition is critical.