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It is difficult to adhere rigidly to a single perspective; does the condition of delayed menstruation alone exemplify this? Physicians should devote their attention to investigating these matters.

Wei Yuheng stated: The daughter of Xu Dezhi, nearly twenty years old, had a history of liver disease manifesting as hypochondriac pain. Her menses usually arrived early, but recently it was delayed by several days. Upon palpation, the pulses at both Guan positions were restless and rapid, while the pulses at both Cun positions overflowed upward. Observing her complexion, there were dozens of spots resembling rashes, varying in color from cyanotic to purplish. Inquiry revealed similar spots on her body and even a few on her tongue. This closely resembled a syndrome of blazing Yang-heat, yet she lacked headache or aversion to cold with fever, and could consume two bowls of rice. This was primarily due to Liver Fire blazing internally and ascending to invade the Lung and Stomach. She was prescribed Sheng Di Huang (Rehmanniae Radix), Gou Qi Zi (Lycii Fructus), Mai Dong (Ophiopogonis Radix), Mu Dan Pi (Moutan Cortex), Shan Zhi Zi (Gardeniae Fructus), Dang Gui (Angelicae Sinensis Radix), Sheng Bai Shao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), and Xuan Shen (Scrophulariae Radix) for one dose. On the following day, during the afternoon, her menses finally arrived. She was found lying prone, her upper body bent over the edge of the bed, vomiting approximately one basin of blood. It was learned that bleeding had started like a gush around 9–11 AM, followed by a sensation of a mass attacking upward from the epigastrium. Thus, she had to lie prone, pressing against the bed edge for slight relief; otherwise, the rising qi would cause chest oppression and suffocation. Palpation revealed a pulse that was faint and indistinct. It was surmised that her delayed menses, combined with rebellious Liver Fire, caused the bleeding, a condition commonly known as "Reverse Menstruation" (Dao Jing). However, given the suddenness and severity of the condition, compounded by the upward attack of pathogenic qi from the lower jiao, the prognosis was critical. Only large doses of pure Yin-nourishing herbs could reverse this crisis. She was administered Shu Di Huang (Prepared Rehmanniae Radix) two taels and Gou Qi Zi (Lycii Fructus) one tael, to be taken consecutively in two doses. After ingestion, she could lie supine, the bleeding stopped, and her pulse returned. The next day, she suddenly developed dry cough, indicating Dryness of Metal (Lung) and unextinguished Liver Fire. The previous formula was halved, with additions of Mai Dong (Ophiopogonis Radix), Sha Shen (Glehniae Radix), Gua Lou Ren (Trichosanthis Semen), and Sheng Di Huang (Rehmanniae Radix). After eight doses, she recovered. Subsequently, the rashes on her face subsided, and those on her tongue peeled off like scabs. Additionally, a female servant of Gu Bozhou suffered from hemorrhage, appearing near death, and was also cured with a few doses of the aforementioned prescription. [Commentary: Water, fire, and wind all belong to the category of Earth Qi (pathogenic factors arising from the lower body/earth element). Ginger, Aconite, and Bai Tong Tang are used to treat the rebellion of water qi within the earth, employing Yang-acrid substances to sweep away turbid Yin. In this case, Wind moved and Fire rose, so treatment employed pure Yin substances to suppress and calm.]

The daughter of Fan, having reached the age of fifteen (coming of age), suddenly fell ill. She experienced nocturnal enuresis while sleeping at night, and upon waking in the morning, felt dizzy and intoxicated-like, with mental spirit completely disconnected from normal state. By late afternoon, she gradually became clear-headed. She presented with skin urticaria/rashes, chest and diaphragm oppression, and reduced appetite. Initially, she complained of sore throat and dizziness, which had persisted for more than ten days. Pulse diagnosis revealed a wiry, thin, and rapid pulse, indicative of Blood deficiency with excessive Fire. Inquiry into her Tian Gui (menstrual function) revealed that her last menstrual period was heavy, involving significant blood loss, lasting until the seventh day before stopping. This was attributed to excessive Liver Wood suppressing Spleen Earth, insulting Stomach Earth, and attacking Lung Metal. Suppression of Spleen Earth leads to the Spleen's failure to control blood, resulting in heavy menses; insulting Stomach Earth causes overflow of Stomach collaterals, leading to distension, oppression, and anorexia; attacking Lung Metal generates Lung Heat, causing urticaria and sore throat. Furthermore, since the Liver stores the Hun (Ethereal Soul) and the Lung stores the Po (Corporeal Soul), disharmony between these two organs resulted in nocturnal enuresis and mental confusion. She was treated with a modified formula containing Sheng Di Huang (Rehmanniae Radix), Gou Qi Zi (Lycii Fructus), Ling Yang Jiao (Capris Cornu), Hei Shan Zhi Zi (Gardeniae Fructus Carbonized), Mai Dong (Ophiopogonis Radix), Gua Lou Ren (Trichosanthis Semen), Huang Lian (Coptidis Rhizoma), Mu Dan Pi (Moutan Cortex), Sha Shen (Glehniae Radix), and Niu Bang Zi (Arctii Fructus). After six doses, her condition stabilized. Later, her menses failed to arrive for several months due to the prior excessive blood loss. She was again treated with Sheng Di Huang (Rehmanniae Radix), Gou Qi Zi (Lycii Fructus), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Mu Dan Pi (Moutan Cortex), Mai Dong (Ophiopogonis Radix), with a small addition of Hong Hua (Carthami Flos). After eight doses, her menstruation resumed.