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[Dai Yuanli] Women, having suffered damage to their blood and qi during childbirth, may find that their postpartum deficiency has not yet recovered. If they are subsequently injured by wind-cold pathogens, the nature of blood is to coagulate when exposed to cold. Therefore, when wind-cold invades the menstrual blood and coagulates within the collaterals of the uterus (Bao Luo), it results in amenorrhea (absence of menstruation). Whenever blood coagulation leads to amenorrhea, a blood mass (Xue Jia) may form. If water-dampness and blood bind together, compounded by spleen-stomach weakness and emaciation, edema (Shui Zhong) will ensue.

The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) of women serve as the sea of the meridians and collaterals, both originating from within the uterus. The Hand-Taiyang Small Intestine Meridian and the Hand-Shaoyin Heart Meridian transform upwards into breast milk and downwards into menstrual blood. If menstruation does not resume after childbirth, it is likely due to labor-induced injury to blood and qi, or excessive blood loss, which causes the flow of breast milk to be smooth while menstruation ceases; this is a natural phenomenon. If menstruation remains absent during breastfeeding for six months to one year, this is a normal physiological state and not a disease; there is no need to forcibly induce menstruation. As the proverb states, "breastfeeding induces temporary amenorrhea." Conversely, if menstruation resumes at half a year, or even four to five months postpartum, these individuals are typically young, vigorous, and possess abundant blood and qi. They conceive easily and bear many children. Their infants, deprived of breast milk, will inevitably suffer from limb emaciation, abdominal distension with prominent veins, dry and brittle hair, and pica (geophagia), a condition known as "Wugu" (Innocent Disease/Infantile Malnutrition). If there is an excess of menstrual blood, it should not be stopped by medication. If menstruation is absent one to two years postpartum but without other discomforts, medication is unnecessary. However, if amenorrhea results from labor-induced injury to blood and qi, leading to deficiency of the Chong and Ren vessels and insufficient blood and qi to propel flow, one should administer herbs that strengthen the spleen and stomach and nourish blood and qi; menstruation will naturally resume. Using herbs such as Achyranthes Root (Niuxi), Safflower (Honghua), Broussonetia Wood (Sumu), Drynaria Resin (Ganqi), Blister Beetle (Mangchong), and Leech (Shuizhi) to forcibly unblock menstruation would cause significant harm. With depleted menstrual blood, there is no source for nourishment, making flow impossible. Chu Yushi stated: "This is like demanding ten thousand gold pieces from a beggar; even under torture, it cannot be obtained." Scholars of later generations must examine cases carefully before treating them.

[Xue Ji] For the aforementioned syndromes attributed to spleen-stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction). If complicated by constrained fire injuring the spleen, use Guipi Tang (Restore the Spleen Decoction) added with Moutan Cortex (Danpi) and Gardenia Fruit (Shanzhi). If anger injures the blood, combine Siwu Tang (Four Substances Decoction) with Xiaochaihu Tang (Minor Bupleurum Decoction). For combined deficiency of qi and blood, use Shazhen Tang (Eight Treasures Decoction) with Moutan Cortex (Danpi). Refer to the preceding discussion for primary treatment principles. A postpartum woman presented with amenorrhea lasting over a year, accompanied by internal heat and afternoon tidal fever. After taking Fenqi Wan (Qi-Regulating Pill), her menstruation became prolonged and unstoppable, accompanied by aversion to cold, thirst, poor appetite, fatigue, chest fullness, and qi stagnation. She was prescribed Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) in the morning and Sijunzi Tang (Four Gentlemen Decoction) in the evening. After about a month, her symptoms improved slightly. This was supplemented with Shazhen Tang (Eight Treasures Decoction), and she recovered after two months of concurrent administration.

The above three cases should be consulted alongside the general methods in the chapter on regulating menstruation.