朱丹溪曰∶有妇人病疟，饮食少，经脉不行，诊其脉，两手并无。时寒月，以虚寒
治之，四物加附子、吴茱、神曲丸与之。予思处方殊未当，次早再求诊视，见其起居如常，并无倦怠，惊曰∶
前药误矣。经不行者，非无血也，为痰所碍而不行也。无脉者，非血衰少而脉绝也，积痰生热，结伏而脉不见
尔。当作实热治之，用三花神佑丸，六脉俱出。
朱丹溪曰∶有积痰下流于胞门，闭塞不行，用浓朴二陈汤。又有痰多占住血海，因而不下者，痰多血虚，
南星、二术、黄连、川芎末丸。有肥人脂满者，导痰汤加川芎、黄连，不用地黄，泥膈故也。
娄全善曰∶妇人经闭，有污血凝滞胞门，小腹 痛，有热有寒。如热而经闭者，罗谦甫血极膏，一味大黄
为末，醋熬成膏，治妇人干血气，大便利一二行，经血自下，是妇人之仙药也。仲景抵当汤，亦主妇人经水不
利。《千金》桃仁煎，治血积月水不行。若寒结污血而不下，云岐红花当归散，治妇人室女经候不行，或积瘀
血，腰腹疼痛。
慎斋按∶以上三条，序妇人经闭属于积痰污血，而致经水之不行，是有余之实邪为病也，宜导痰逐瘀为主。
朱丹溪说：有一位女性患疟疾，饮食减少，月经停止来潮。诊察她的脉象，两手均无脉搏。当时正值寒冷月份，我按照虚寒证进行治疗，使用四物汤加入附子、吴茱萸和神曲制成丸药给她服用。我思考后认为这个处方非常不当。第二天早上再次求诊时，见她的起居如常，并没有倦怠感，于是惊讶地说：“之前的药方用错了。”月经不行，并不是因为没有血，而是被痰邪阻碍导致不能下行。无脉，并不是因为血液衰少导致脉绝，而是积痰生热，结伏于内使得脉象隐伏不见罢了。应当作为实热证治疗，使用三花神佑丸，结果六脉全部显现出来。
朱丹溪说：有因积痰下流至胞门（子宫口），闭塞不通的情况，使用浓朴二陈汤。又有因痰多占据血海（冲脉），导致月经不下的情况，若痰多且血虚，可用南星、二术（苍术、白术）、黄连、川芎研末制成丸药。对于形体肥胖、体内脂膏满盛的人，使用导痰汤加入川芎、黄连，不用地黄，因为地黄滋腻会阻滞胸膈。
娄全善说：女性经闭，有污血凝滞于胞门，伴有小腹疼痛，症状或热或寒。如果是热证导致的经闭，可用罗谦甫的血极膏，即一味大黄研为细末，用醋熬成膏状，治疗女性的干血气病，使大便通利一两次，经血自然下行，这可以说是女性的仙药。张仲景的抵当汤，也主治女性经水不利。《千金方》中的桃仁煎，治疗血积导致月经不行。如果是寒邪凝结污血导致经血不下，可用云岐的红花当归散，治疗女性及未婚女子经候不行，或积瘀血引起的腰腹疼痛。
慎斋按语：以上三条，叙述了女性经闭属于积痰和污血，从而导致经水不行的情况，这是有余的实邪致病，应以导痰逐瘀为主要治法。
Zhu Danxi said: There was a woman suffering from malaria, with reduced appetite and amenorrhea. Upon examining her pulse, no pulse could be felt in either hand. At that time, during the cold season, I treated it as a deficiency-cold syndrome, prescribing Siwu Tang (Four Substances Decoction) added with Fuzi (Prepared Aconite Root), Wuzhuyu (Evodia Fruit), and Shenqu (Medicated Leaven) made into pills for her to take. I reflected that this prescription was highly inappropriate. The next morning, upon seeking another consultation, I saw that her daily activities were normal and she showed no signs of fatigue. I exclaimed, "The previous medication was mistaken." Amenorrhea is not due to a lack of blood, but rather obstruction by phlegm preventing its flow. The absence of a pulse is not due to blood deficiency causing pulse extinction, but rather accumulated phlegm generating heat, which knots and hides within, making the pulse invisible. It should be treated as an excess-heat syndrome using Sanhua Shenyu Wan (Three-Flower Divine Protection Pill), after which all six pulses became palpable.
Zhu Danxi said: In cases where accumulated phlegm flows downward to the Baomen (uterine opening), causing blockage and cessation of menstruation, use Nongpu Erchen Tang (Magnolia Bark and Two-Ingredient Decoction). In other cases where excessive phlegm occupies the Xuehai (Sea of Blood, referring to the Chong Mai), leading to amenorrhea, if there is excessive phlegm combined with blood deficiency, one may use pills made from Nanxing (Arisaema Rhizome), Erzhu (Cangzhu and Baizhu, i.e., Atractylodes Rhizomes), Huanglian (Coptis Rhizome), and Chuanxiong (Ligusticum Rhizome). For obese individuals with abundant internal fat/phlegm, use Daotan Tang (Phlegm-Guiding Decoction) added with Chuanxiong and Huanglian, omitting Dihuang (Rehmannia Root), because Dihuang is cloying and would obstruct the chest and diaphragm.
Lou Quanshan said: Female amenorrhea can be caused by foul blood stagnating at the Baomen, accompanied by lower abdominal pain, presenting with either heat or cold symptoms. If the amenorrhea is due to heat, one may use Luo Qianfu's Xuexi Gao (Blood Extremity Ointment), which consists solely of Dahuang (Rhubarb Rhizome) ground into powder and boiled with vinegar into an ointment. This treats female Ganxue Qi (Dry Blood Syndrome), promoting one or two bowel movements, after which menstrual blood naturally flows; it can be considered a miraculous medicine for women. Zhang Zhongjing's Didang Tang (Resolutely Overcome Decoction) also treats irregular menstruation in women. Tao Ren Jian (Peach Kernel Decoction) from *Qianjin Fang* (*Essential Prescriptions Worth a Thousand Gold*) treats amenorrhea caused by blood accumulation. If cold congeals foul blood preventing menstruation, Yunqi's Honghua Danggui San (Safflower and Angelica Powder) can be used to treat amenorrhea in married or unmarried women, or lower abdominal pain caused by accumulated stasis.
Shenzhen commented: The above three cases describe female amenorrhea resulting from accumulated phlegm and foul blood, leading to the cessation of menstruation. This is a disease caused by excess pathogenic factors (excess evil). The primary treatment should focus on guiding out phlegm and expelling stasis.
*Neizhao Jing* (*Internal Illumination Classic*) states: Amenorrhea in women is a disorder of blood stagnation. Tracing it to its root, it arises from the failure of Heart Qi to circulate freely. Therefore, instead of directly treating the blood, one should treat the Heart.
Zhu Danxi said: The medical classics state, "When Qi forces upward against the Lung, Heart Qi cannot descend smoothly," thus causing amenorrhea. The classics also state, "Amenorrhea occurs because the Baomai (Uterine Vessels) are closed."