《准绳》云∶妇人之病，咸因月经乍多乍少，或前或后，治者不审，一例呼为经病
，而不
知阴阳偏胜之道，所以服药无效。盖阴气乘阳则包藏寒气，血不营运，经所谓天寒地冻，水
凝成冻，故令乍少而在月后。若阳气乘阴，则血流散溢，经所谓天暑地热，经水沸溢，故令
乍多而在月前。治当和气血，平阴阳，斯为当也。
按∶前证治法，阳胜阴月候多者，当归散(即四物汤加黄芩、白术)。阴胜阳月候少者，
七沸
汤(即四物汤加蓬术、川芎、木香)。大概后期二三日为血虚，四物汤加参、 、苓、术，
补
气而调血。先期三五日为血热，四物汤加酒炒芩、连，清热而和荣。更当参以人之肥瘦、挟
痰、挟火而分治之。
王子亨云∶经者，常候也。谓候其一身之阴阳愆伏，知其安危，故每月一至，太过不及
，皆
为不调。阳太过则先期而至，阴不及则后时而来。其有乍多乍少、断绝不行、崩漏不止，由
阴阳盛衰所致，审各经分治之。
按立斋云∶先期而至者，则因脾经血燥，宜加味逍遥散。有因脾经郁火，宜归脾汤。有
因肝
经怒火，宜加味小柴胡汤。有因血分受热，宜加味四物汤。有因劳役火动，宜补中益气汤。
后期而至者，有因脾经血虚，宜人参养荣汤。有因肝经血少，宜六味地黄汤。有因气衰血弱
，宜八珍汤。盖血生于脾土，故云脾统血。凡血病当用苦甘之剂，以助阳气而生阴血也。
立斋分肝、脾、血分、劳役五种，可谓详明。
澹漪子曰∶脾虚气郁，宜归脾汤。脾实气郁，宜越曲丸之类为当。
《准绳》说：妇女的疾病，大多因为月经有时多有时少，或者提前或者推后。治疗者如果不仔细审察，一概称之为“经病”，而不知道阴阳偏盛的道理，所以服药无效。大概阴气胜过阳气时，胞宫受寒，血液运行不畅，正如经文所说“天寒地冻，水凝成冻”，所以导致月经量少且推迟。如果阳气胜过阴气，则血液流动散漫溢出，正如经文所说“天暑地热，经水沸溢”，所以导致月经量多且提前。治疗应当调和气血，平衡阴阳，这才是恰当的方法。
按语：上述证候的治疗方法，对于阳胜阴、月经提前的情况，用当归散（即四物汤加黄芩、白术）。对于阴胜阳、月经量少推迟的情况，用七沸汤（即四物汤加蓬术、川芎、木香）。大抵而言，月经后期两三天属于血虚，用四物汤加入人参、茯苓、白术，补气以调血。月经提前三五天属于血热，用四物汤加入酒炒的黄芩、黄连，清热以和营。更应当参考患者的胖瘦、是否兼夹痰湿、是否兼夹火邪来分别治疗。
王子亨说：月经，是常规的征候。通过观察它来判断全身阴阳的盈亏伏藏，从而知道身体的安危，所以每月来潮一次。太过或不及，都属于不调。阳气太过则月经提前到来，阴气不足则月经推后而来。如果有月经忽多忽少、中断不行、崩漏不止等情况，都是由阴阳盛衰引起的，应当审查各经进行分治。
按立斋的说法：月经提前的，是因为脾经血燥，宜用加味逍遥散。有的因脾经郁火，宜用归脾汤。有的因肝经怒火，宜用加味小柴胡汤。有的因血分受热，宜用加味四物汤。有的因劳役导致火动，宜用补中益气汤。月经推后的，有的因脾经血虚，宜用人参养荣汤。有的因肝经血少，宜用六味地黄汤。有的因气衰血弱，宜用八珍汤。大概血生于脾土，所以说脾统血。凡是血病应当使用苦甘味的药剂，以助阳气而生阴血。立斋将病因分为肝、脾、血分、劳役五种，可以说非常详细明了。
According to *Zhunsheng*: Women's diseases are mostly caused by menstrual flow being sometimes excessive and sometimes scanty, or arriving either early or late. If practitioners fail to examine carefully and indiscriminately label all such conditions as "menstrual disorders" without understanding the principles of Yin-Yang excess and deficiency, medication will be ineffective. Generally, when Yin Qi overcomes Yang Qi, the uterus (Bao Gong) is filled with cold, and blood circulation fails to operate smoothly. As stated in the classics: "When heaven is cold and earth frozen, water congeals into ice," thus causing scanty menstruation that arrives after its due time. Conversely, if Yang Qi overcomes Yin Qi, blood flow becomes scattered and overflowing. As stated in the classics: "When heaven is hot and earth warm, menstrual waters boil and overflow," thus causing excessive menstruation that arrives before its due time. Treatment should harmonize Qi and Blood and balance Yin and Yang; this is the appropriate approach.
Commentary: For the aforementioned syndromes, when Yang is in excess and Yin is deficient leading to early menstruation, use Danggui San (Cinnamon Twig Decoction, i.e., Siwu Tang added with Huangqin and Baizhu). When Yin is in excess and Yang is deficient leading to scanty and delayed menstruation, use Qifei Tang (Seven Boiling Decoction, i.e., Siwu Tang added with Pengzhu, Chuanxiong, and Muxiang). In general, menstruation arriving two to three days late indicates Blood Deficiency; treat with Siwu Tang added with Renshen, Fuling, and Baizhu to tonify Qi and regulate Blood. Menstruation arriving three to five days early indicates Heat in Blood; treat with Siwu Tang added with Jiu Chao Huangqin (Wine-fried Scutellariae Radix) and Lianzi (Lotus Plumule) to clear Heat and harmonize Ying (Nutritive Qi). Furthermore, treatment must be differentiated based on the patient's body constitution (fat or thin), presence of Phlegm, or presence of Fire.
Wang Ziheng states: Menstruation is a regular indicator. By observing it, one can discern the fluctuations of Yin and Yang throughout the body and thereby know the state of safety or danger. Hence, it arrives once a month. Any excess or deficiency constitutes irregularity. Excess of Yang leads to early arrival; deficiency of Yin leads to late arrival. Conditions such as fluctuating volume (excessive or scanty), cessation of flow, or continuous metrorrhagia/menorrhagia are caused by the waxing and waning of Yin and Yang. These should be treated according to the differentiation of meridians.
Commentary based on Lizhai's theory: Early arrival is caused by dryness of Blood in the Spleen Meridian; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). It may also be caused by stagnant Fire in the Spleen Meridian; use Guipi Tang (Restore the Spleen Decoction). It may be caused by Fire from anger in the Liver Meridian; use Jiawei Xiao Chai Hu Tang (Modified Minor Blue Green Dragon Decoction). It may be caused by Heat in the Blood level; use Jiawei Siwu Tang (Modified Four Substance Decoction). It may be caused by Fire stirred by overwork; use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Late arrival may be caused by Blood Deficiency in the Spleen Meridian; use Renshen Yangrong Tang (Ginseng Nourishing the Vigor Decoction). It may be caused by Blood insufficiency in the Liver Meridian; use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill). It may be caused by Qi decline and Blood weakness; use Bazhen Tang (Eight Treasures Decoction). Generally, Blood is born from Spleen Earth; therefore, it is said that the Spleen controls Blood. All Blood diseases should be treated with bitter and sweet agents to assist Yang Qi and generate Yin Blood. Lizhai’s classification into Liver, Spleen, Blood Level, and Overwork categories is indeed detailed and clear.
Danyizi says: Spleen Deficiency with Qi Stagnation warrants Guipi Tang. Spleen Excess with Qi Stagnation warrants Yuequ Wan (Yuequ Pill) and similar formulas.