居经者，月事三月一至也。盖妇人之体血盛怀胎，胎孕之脉滑疾流利。《金匮》云∶寸
口卫
脉浮而大，荣反而弱(盖女子尺脉宜盛，今反见弱，是荣不足于下也。寸口卫脉浮大者，卫
气盛于上也)。浮大则气强，反弱则血少。孤阳独呼，阴不能吸，二气不停，卫强荣弱，阴
为积寒，阳为聚热，阳盛不润，经络不足，阴虚阳实，故令少血。时发洒淅，咽燥汗出，或
溲溺稠数，多唾涎沫，此令重虚。津漏液泄，故知非蓄血烦满，月禀一经，三月一来，阴盛
则泻，名曰居经。
按∶卫浮而大，右脉浮大也。荣反而弱，左脉反弱也。盖左脉主血，乃心肝肾部。右脉
主气
，乃肺脾肾部。妇人之身，气血调匀，脉来滑利，方能受孕。今荣血不足，卫气独强，是阴
衰阳旺之象，安得成胎?故虽月事不至三月，此居经之症，非孕也。宜养血调荣治之。
妇人经水将行，必泄泻三日，然后经行。其脉濡弱者，此脾虚也。脾属土属湿，经水将
动，
脾血先已流注血海，然后下流为经。脾血既亏，则虚而不能营运其湿，宜服参苓白术散(濡
弱二字足征脾虚，此脾气虚而非脾血虚也，用药当矣。而血亏不运之说欠妥)。
《产宝方》云∶经水者，行气血，通阴阳，以荣于身者也。气血盛，阴阳和，则形体通
泰。
或外亏卫气之充养，内乏荣气之灌溉，血气不足，故经候欲行，身体先痛(据此宜用十全大
补、八珍汤、人参养荣汤之类)。
按∶前症有属血虚者，有属血风者，有痰滞者，有血瘀者，所因不同。如《良方》云∶
妇人
血风，由气血不足，腠理不密，风冷乘之，以致邪正相搏，故骨节疼痛，肢体发热，口苦咽
干，此血风也。东垣云∶饮食失节，脾胃虚弱，乃血所生病，故口中津液不足。若火热来乘
土位，则肢体痛，皮肤发热，此血虚也。立斋治法∶肝经风热，用四物加羌、防、秦艽、黄
芩。肝
经血虚，逍遥散加熟地、川芎、丹皮。风湿兼痰，四物加星、半、羌活、苍术。风湿伤脾，
羌活胜湿汤。暑湿伤气，清燥汤。肝气郁脾，四君子加木香、枳壳、槟榔。瘀血流注，四物
加桃仁、红花。
居经，是指月经每三个月来潮一次。大概妇女的体质血气旺盛才能怀胎，怀孕后的脉象滑利疾速。《金匮要略》说：寸口卫脉浮而大，营脉反而弱（大概女子尺脉应当盛实，现在反而见弱，这是营血在下部不足。寸口卫脉浮大的，是卫气在上部亢盛）。浮大说明气强，反弱说明血少。孤阳独自呼气，阴不能吸气，二气不相协调，卫强营弱，阴成为积寒，阳成为聚热，阳气盛而不能滋润，经络不足，阴虚而阳实，所以导致血少。时常发作恶寒战栗，咽喉干燥出汗，或者小便短赤频数，多唾涎沫，这叫做重虚。津液漏泄流失，所以知道这不是蓄血烦满，而是每月禀受一经之气，三个月来潮一次，阴气盛则泻下，名叫居经。
按语：卫脉浮大，指右脉浮大。营脉反而弱，指左脉反而弱。大概左脉主血，属于心、肝、肾的部位。右脉主气，属于肺、脾、肾的部位。妇女的身体，气血调和均匀，脉象滑利，才能受孕。现在营血不足，卫气独强，这是阴衰阳旺的现象，怎么能成胎呢？所以虽然月经不到三个月才来，这是居经的症状，不是怀孕。应当用养血调营的方法治疗。
妇人月经将要来潮时，必定先腹泻三天，然后月经才来。其脉象濡弱的，这是脾虚。脾属土属湿，月经将要发动时，脾血先已流注到血海，然后下行成为经血。脾血既然亏损，就虚弱而不能运化湿气，适宜服用参苓白术散（“濡弱”二字足以证明脾虚，这是脾气虚而不是脾血虚，用药得当。但说血亏不能运化的说法欠妥）。
《产宝方》说：月经，是运行气血，沟通阴阳，以荣养身体的。气血旺盛，阴阳和谐，身体就通畅安泰。如果外因缺乏卫气的充养，内因缺乏营气的灌溉，血气不足，所以月经将要来时，身体先痛（据此情况适宜使用十全大补汤、八珍汤、人参养荣汤之类）。
按语：前面的病症有属于血虚的，有属于血风的，有痰滞的，有血瘀的，病因不同。如《良方》说：妇人血风，由气血不足，腠理不紧密，风冷乘虚而入，以致邪正相搏，所以骨节疼痛，肢体发热，口苦咽干，这是血风。东垣说：饮食失节，脾胃虚弱，是血所生的病，所以口中津液不足。如果火热来侵犯土位，就肢体痛，皮肤发热，这是血虚。立斋的治疗方法：肝经风热，用四物汤加羌活、防风、秦艽、黄芩。肝经血虚，逍遥散加熟地黄、川芎、牡丹皮。风湿兼痰，四物汤加天南星、半夏、羌活、苍术。风湿伤脾，用羌活胜湿汤。暑湿伤气，用清燥汤。肝气郁结伤脾，用四君子汤加木香、枳壳、槟榔。瘀血流注，用四物汤加桃仁、红花。
Jujing (Resident Menses) refers to menstruation occurring once every three months. Generally, a woman's constitution requires abundant blood to conceive, and the pulse during pregnancy is slippery and rapid. *Jinkui Yaolue* states: The Wei pulse at Cun Kou is floating and large, while the Ying pulse is conversely weak (It is said that the Chi pulse in women should be vigorous; seeing it weak now indicates insufficient Ying blood below. A floating and large Wei pulse at Cun Kou indicates excessive Wei Qi above). Floating and large indicate strong Qi, while weakness indicates scanty Blood. Solitary Yang exhales alone, Yin cannot inhale; the two Qi do not interact harmoniously. With strong Wei and weak Ying, Yin becomes accumulated cold, and Yang becomes gathered heat. Excessive Yang fails to moisten, and the meridians are deficient. Yin deficiency with Yang excess leads to scanty blood. One may frequently experience chills, dry throat with sweating, or thick and frequent urination, along with excessive saliva and phlegm. This is termed double deficiency. As fluids leak and essence drains, it is known that this is not blood stasis causing fullness and vexation, but rather receiving one meridian cycle per month, arriving every three months. When Yin is excessive, discharge occurs, named Jujing.
Commentary: The floating and large Wei pulse refers to the right pulse being floating and large. The conversely weak Ying pulse refers to the left pulse being weak. Generally, the left pulse governs Blood, corresponding to the Heart, Liver, and Kidney regions. The right pulse governs Qi, corresponding to the Lung, Spleen, and Kidney regions. In women, when Qi and Blood are balanced and the pulse is slippery and smooth, conception can occur. Now, with insufficient Ying Blood and dominant Wei Qi, this is a sign of Yin decline and Yang flourishing; how can pregnancy be achieved? Therefore, although menstruation does not arrive until the third month, this is a symptom of Jujing, not pregnancy. Treatment should focus on nourishing Blood and regulating Ying.
When a woman's menses are about to begin, she must suffer from diarrhea for three days before menstruation starts. If the pulse is soggy and weak, this indicates Spleen Deficiency. The Spleen belongs to Earth and Dampness. When menstruation is about to move, Spleen Blood first flows into the Sea of Blood, then descends as menstrual flow. Once Spleen Blood is depleted, it becomes too weak to transport Dampness. It is appropriate to administer Shen Ling Bai Zhu San ("Soggy and weak" sufficiently proves Spleen Deficiency; this is Qi deficiency of the Spleen, not Blood deficiency, so the medication is correct. However, the theory that Blood deficiency fails to transport is questionable).
*Chanbao Fang* states: Menstruation circulates Qi and Blood, connects Yin and Yang, and nourishes the body. When Qi and Blood are abundant and Yin and Yang are harmonious, the body is smooth and healthy. If external Wei Qi lacks nourishment, or internal Ying Qi lacks irrigation, leading to insufficiency of Qi and Blood, then when menstruation is about to start, the body will ache first (Based on this, formulas such as Shiquan Dabu Tang, Bazhen Tang, or Renshen Yangrong Tang are suitable).
Commentary: The aforementioned symptoms may belong to Blood Deficiency, Blood Wind, Phlegm Stagnation, or Blood Stasis; the causes differ. As stated in *Liangfang*: Women's Blood Wind arises from insufficiency of Qi and Blood, loose interstices, and invasion by Wind-Cold, causing struggle between pathogenic and righteous factors, resulting in joint pain, limb fever, bitter taste in the mouth, and dry throat; this is Blood Wind. Dong Yuan stated: Irregular diet and weak Spleen-Stomach lead to diseases of the Blood, resulting in insufficient saliva in the mouth. If Fire-Heat attacks the Earth position, limb pain and skin fever occur; this is Blood Deficiency. Lizai's treatment methods: For Liver Meridian Wind-Heat, use Siwu Tang plus Qianghuo, Fangfeng, Qinjiao, and Huangqin. For Liver Meridian Blood Deficiency, use Xiaoyao San plus Shudi, Chuanxiong, and Mudanpi. For Wind-Dampness combined with Phlegm, use Siwu Tang plus Tian Nanxing, Banxia, Qianghuo, and Cangzhu. For Wind-Dampness injuring the Spleen, use Qianghuo Shengshi Tang. For Summerheat-Dampness injuring Qi, use Qingzao Tang. For Liver Qi stagnation injuring the Spleen, use Sijunzi Tang plus Muxiang, Zhike, and Binglang. For Blood Stasis flowing and accumulating, use Siwu Tang plus Taoren and Honghua.