薛新甫曰∶经曰∶饮食入谓，游溢精气，上输于脾，脾气散精，上归于肺，通调水道，下输膀胱，水精
四布，五经并行。东垣先生谓脾为生化之源，心统诸经之血，诚哉是言也。窃谓心脾平和，则经候如常。苟
七情内伤，六淫外侵，饮食失节，起居不时，脾胃虚损，心火妄动，则月经不调矣。有先期而至者。盖血生
于脾土，故云脾统血。凡血当用苦甘之剂，以助阳气而生阴血也。盖先期而至者，有因脾经血燥，宜加味逍
遥散；有因脾经郁滞者，宜归脾汤；有因肝经怒火者，宜加味小柴胡汤；有因血分有热者，宜加味四物汤∶有
因劳役火动者，宜补中益气汤。过期而至者，有因脾经血虚者，宜人参养荣汤；有因肝经血少者，宜六味地
黄丸；有因气虚血弱者，宜八珍汤。
又曰∶血者，水谷之精气也，和调五脏，洒陈六腑，在妇人上为乳汁，下为血海，故虽心主血，肝藏
血，亦皆统摄于脾胃。补脾和胃，血自生矣。凡经行禁用苦寒、辛散之药。
东垣曰∶经闭不行有三。妇女肠胃久虚，形体羸弱，气血俱衰，而致经水断绝不行。或病中消胃热，善
食渐瘦，津液不生。夫经者，血脉津液所化，津液既竭，为热所烁，肌肉渐瘦，时见燥渴，血海枯竭，名曰血
枯经绝，宜泻胃之燥热，补益血气，经自行矣。此病适行而有子，子亦不成，而为胎病者有矣。或心包络脉洪
数，躁作时见，大便秘涩，小便虽不利，而经水闭绝不行，此乃血海干枯，宜调血脉，除包络中火邪，而经自
行矣。或因劳心，心火上行，月事不来者，胞脉闭也。胞脉属于心而络于胞中，今气上迫脉，心气不得下通，
故月事不来，宜安心补血泻火，经自行矣。
薛立斋曰∶经闭者何？夫经水，阴血也，属冲任二脉主，上为乳汁，下为月水。其为患有因脾虚而不能
生血者，有因脾郁伤而血耗损者，有因胃火而血销铄者，有因脾胃损而血少者，有因劳伤心而血少者，有因
怒伤肝而血少者，有因肾水不能生肝而血少者，有因肺气虚不能行血而闭者。治疗之法，若脾虚而不行者，调
而补之；脾郁而不行者，解而补之；胃火而不行者，清而补之∶脾胃损而不行者，调而补之；劳伤心血而不行
者，静而补之；怒伤肝而不行者，和而补之；肺气虚而不行，补脾胃；肾虚而不行，补脾肺。经云∶损其肺
益其气，损其心补其荣卫，损其脾补其饮食，适其寒温，损其肝缓其中，损其肾益其精。审而治之，庶无误
矣。
王宇泰曰∶薛氏治血枯大法，以补养真元为主，盖本易水师弟之旨而广之。
方约之曰∶妇人之经病，有月候不调者，有月候不通者。
然不调不通之中，有兼疼痛者，有兼发热者，此分而为四也。不调之中，有趱前，有迟后者，则趱前为热，
退后为虚也。不通之中，有血滞者，有血枯者，则血滞者宜破，血枯宜补也。疼痛之中，有常时作痛者，有经
后经前作痛者，则常时与经前作痛为血积，经后为血虚也。发热之中，有常时发热者，有经行发热者，则常时
为血虚有积，经行为血虚有热也。则又分而为八焉，大抵经痛内因忧思愤怒，外因饮冷形寒。愤怒所触，则郁
结不行。经前产后，饮冷形寒，则恶露不尽。此经候不调不通，作痛发热之所由也。调气破血，开郁补虚，凉
血清热，治之有道也欤！然气行血行，气止血止，故治血病以行气为先，香附之类是也。热则流通，寒则凝
结，故治血病以热药为佐，肉桂之类是也。
薛新甫说：《内经》记载：“饮食进入胃中，游溢精气，向上输送到脾；脾气散布精微物质，向上归于肺；肺通调水道，向下输送到膀胱；水液精微四布全身，五脏经脉并行运行。”李东垣先生认为脾是气血生化之源，心统摄各经之血，这话说得确实正确。我认为心脾平和，则月经周期正常。如果七情内伤，六淫外侵，饮食不节制，起居无规律，导致脾胃虚损，心火妄动，就会月经不调。月经先期而至的，因为血生于脾土，所以说脾统血。凡是血证应当用苦甘味的药剂，以助阳气而生阴血。其中先期而至的，有因脾经血燥的，宜用加味逍遥散；有因脾经郁滞的，宜用归脾汤；有因肝经怒火的，宜用加味小柴胡汤；有因血分有热的，宜用加味四物汤；有因劳役火动的，宜用补中益气汤。月经后期而至的，有因脾经血虚的，宜用人参养荣汤；有因肝经血少的，宜用六味地黄丸；有因气虚血弱的，宜用八珍汤。
又说：血，是水谷的精气，调和五脏，布散六腑，在妇人身上，上行化为乳汁，下行成为血海（冲脉），所以虽然心主血，肝藏血，也都统摄于脾胃。补脾和胃，血自然就能生成。凡是在行经期间，禁用苦寒、辛散的药物。
李东垣说：经闭不行有三种情况。妇女肠胃长期虚弱，形体瘦弱，气血俱衰，导致经水断绝不行。或者患有消渴病中的中消症，胃热善食但逐渐消瘦，津液不生。经血是由血脉津液化生的，津液既已枯竭，被热邪灼烧，肌肉逐渐消瘦，时常出现燥渴，血海枯竭，名叫血枯经绝，应当泻胃中的燥热，补益血气，经血自然能通行。这种病如果在经期怀孕，胎儿也成不了，而成为胎病的也有。或者心包络脉洪数，躁动发作时常见，大便秘涩，小便虽不通利，但经水闭绝不行，这是血海干枯，应当调理血脉，清除心包络中的火邪，经血自然能通行。或者因为劳心过度，心火上炎，导致月事不来的，是胞脉闭塞。胞脉属于心而联络于子宫，现在气上迫脉道，心气不能下通，所以月事不来，应当安心补血泻火，经血自然能通行。
薛立斋说：什么是经闭？经水是阴血，由冲任二脉主管，上行化为乳汁，下行成为月水。其致病原因有因脾虚而不能生血的，有因脾郁受伤而血耗损的，有因胃火而血销铄的，有因脾胃损伤而血少的，有因劳伤心而血少的，有因怒伤肝而血少的，有因肾水不能生肝而血少的，有因肺气虚不能行血而闭经的。治疗的方法，如果是脾虚而不行的，调理并补益它；脾郁而不行的，解郁并补益它；胃火而不行的，清热并补益它；脾胃损伤而不行的，调理并补益它；劳伤心血而不行的，静养并补益它；怒伤肝而不行的，调和并补益它；肺气虚而不行的，补脾胃；肾虚而不行的，补脾肺。《内经》说：损伤肺的，益其气；损伤心的，补其营卫；损伤脾的，补其饮食，适应寒温；损伤肝的，缓其急迫；损伤肾的，益其精。仔细审察而治疗，才没有错误。
王宇泰说：薛氏治疗血枯的大法，以补养真元为主，大概是基于易水（张元素）师弟的宗旨而推广的。
然而在不调与不通之中，有兼疼痛的，有兼发热的，这就分为四类了。在不调之中，有提前的，有推后的，那么提前为热，推后为虚。在不通之中，有血滞的，有血枯的，那么血滞的应当破血，血枯的应当补血。在疼痛之中，有平时作痛的，有经前经后作痛的，那么平时与经前作痛为血积，经后作痛为血虚。在发热之中，有平时发热的，有行经时发热的，那么平时为血虚有积，行经时为血虚有热。这样又分为八类，大抵经痛的内因是忧思愤怒，外因是饮冷形寒。愤怒所触，则气机郁结不行。经前产后，饮冷形寒，则恶露不尽。这就是月经不调、不通、作痛、发热的原因所在。调气破血，开郁补虚，凉血清热，治疗是有方法的啊！然而气行血行，气止血止，所以治血病以行气为先，如香附之类的药物。热则流通，寒则凝结，所以治血病以热药为佐使，如肉桂之类的药物。
Xue Xinpu said: The *Neijing* states: "When food and drink enter the stomach, their essence floats and overflows, transporting upwards to the Spleen; the Spleen scatters the essence, sending it upwards to return to the Lung; the Lung regulates the water passages, transporting downwards to the Bladder; water and essence are distributed in all directions, and the five meridians run together." Master Dongyuan (Li Dongyuan) stated that the Spleen is the source of transformation and production, and the Heart commands the blood of all meridians. Indeed, these words are true. I hold that when the Heart and Spleen are harmonious and peaceful, menstruation proceeds normally. However, if internal injury by the seven emotions, external invasion by the six climatic factors, irregular diet, or improper daily routine cause deficiency and damage to the Spleen and Stomach, and reckless movement of Heart Fire occurs, menstrual irregularities will arise. For menstruation arriving early: since blood is generated from Spleen Earth, it is said that the Spleen controls blood. Generally, for blood disorders, bitter and sweet agents should be used to assist Yang Qi and generate Yin Blood. Specifically, for those arriving early due to dryness of blood in the Spleen Meridian, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is indicated; due to stagnation in the Spleen Meridian, Guipi Tang (Restore the Spleen Decoction) is indicated; due to anger-fire in the Liver Meridian, Jiawei Xiao Chai Hu Tang (Modified Minor Bupleurum Decoction) is indicated; due to heat in the blood level, Jiawei Siwu Tang (Modified Four Substance Decoction) is indicated; due to fire movement from labor and exertion, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. For menstruation arriving late: due to blood deficiency in the Spleen Meridian, Renshen Yangrong Tang (Ginseng Nourishing Grace Decoction) is indicated; due to blood insufficiency in the Liver Meridian, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) is indicated; due to Qi deficiency and weak blood, Bazhen Tang (Eight Treasures Decoction) is indicated.
He further said: Blood is the essence of water and grain, harmonizing the five Zang organs and spreading throughout the six Fu organs. In women, it transforms upward into milk and downward into the Sea of Blood (Chong Mai). Therefore, although the Heart governs blood and the Liver stores blood, both are controlled by the Spleen and Stomach. By tonifying the Spleen and harmonizing the Stomach, blood will naturally be generated. During menstruation, bitter-cold and acrid-dispersing herbs are strictly prohibited.
Li Dongyuan said: There are three causes for amenorrhea (cessation of menstruation). When a woman's intestines and stomach have been deficient for a long time, her body becomes emaciated, and both Qi and blood decline, leading to the cessation of menstruation. Or, she suffers from "Middle Xiao" (middle consumption) with stomach heat, eating well but gradually losing weight, failing to generate fluids. Menstrual blood is transformed from blood vessels and fluids; once fluids are exhausted and scorched by heat, muscles become emaciated, dryness and thirst frequently appear, the Sea of Blood dries up, a condition named "Blood Withered Amenorrhea" (Xue Ku Jing Jue). One should drain the dryness and heat of the Stomach and tonify Qi and blood, after which menstruation will resume naturally. If conception occurs during this disease, the fetus may not develop, resulting in fetal pathology. Alternatively, if the Pericardium Collateral pulse is surging and rapid, with frequent irritability, constipation, and difficult urination, yet menstruation is completely absent, this indicates a dried-up Sea of Blood. One should regulate the blood vessels and eliminate the pathogenic fire in the Pericardium, after which menstruation will resume. Or, due to mental overwork, Heart Fire flares upward, causing amenorrhea because the Uterine Vessels are closed. The Uterine Vessels belong to the Heart and connect to the uterus. Now, Qi presses upward against the vessels, preventing Heart Qi from descending smoothly, thus causing amenorrhea. One should calm the mind, tonify blood, and drain fire, after which menstruation will resume.
Xue Lizhai said: What is amenorrhea? Menstrual water is Yin blood, governed by the Chong and Ren meridians, transforming upward into milk and downward into menstrual flow. Causes include: Spleen deficiency failing to generate blood; Spleen depression injuring and depleting blood; Stomach fire consuming blood; Spleen and Stomach damage reducing blood; Mental labor injuring the Heart and reducing blood; Anger injuring the Liver and reducing blood; Kidney Water failing to nourish the Liver and reducing blood; Lung Qi deficiency failing to move blood causing closure. Treatment methods: For Spleen deficiency, regulate and tonify; for Spleen depression, resolve depression and tonify; for Stomach fire, clear heat and tonify; for Spleen/Stomach damage, regulate and tonify; for mental labor injuring Heart blood, rest and tonify; for anger injuring the Liver, harmonize and tonify; for Lung Qi deficiency, tonify Spleen and Stomach; for Kidney deficiency, tonify Spleen and Lungs. The Classics state: Damage to the Lung benefits Qi; damage to the Heart nourishes Ying and Wei; damage to the Spleen supplements through diet, adapting to cold and warmth; damage to the Liver soothes its interior; damage to the Kidney benefits Essence. Examining carefully and treating accordingly ensures no errors.
Wang Yutai said: Xue’s general principle for treating blood withered conditions focuses on tonifying and nourishing True Yuan, expanding upon the principles of the Yishui (Zhang Yuansu) master-disciple lineage.
Fang Yuezhi said: Women's menstrual diseases include irregular menstruation and obstructed menstruation.
Within irregularity and obstruction, there are cases accompanied by pain and cases accompanied by fever, dividing them into four categories. Within irregularity, there are early arrivals and late arrivals; early arrival indicates Heat, while late arrival indicates Deficiency. Within obstruction, there is blood stasis and blood withering; blood stasis requires breaking, while blood withering requires tonifying. Within pain, there is constant pain and pre/post-menstrual pain; constant and pre-menstrual pain indicate blood accumulation, while post-menstrual pain indicates blood deficiency. Within fever, there is constant fever and menstrual fever; constant fever indicates blood deficiency with accumulation, while menstrual fever indicates blood deficiency with Heat. This divides them into eight categories. Generally, internal causes of menstrual pain are worry, thought, anger, and indignation; external causes are drinking cold liquids and exposure to cold. Anger causes Qi stagnation and obstruction. Drinking cold or exposure to cold before or after menstruation leads to incomplete expulsion of lochia. These are the origins of irregular, obstructed, painful, and febrile menstruation. Regulating Qi and breaking blood, resolving depression and tonifying deficiency, cooling blood and clearing heat—there is a method to treat these! Since Qi moves Blood, and stopping Qi stops Blood, treating blood disorders prioritizes moving Qi, using herbs like Xiangfu (Cyperus Rhizome). Heat promotes circulation, while Cold causes coagulation; therefore, treating blood disorders uses hot herbs as assistants, such as Rougui (Cinnamon Bark).