方氏曰∶妇人经病，有月候不调者，有月候不通者。然不调不通中，有兼疼痛者，有兼发热者，此分而为
四也。细详之，不调中，有趱前者，有退后者。趱前为热，退后为虚。不通中，有血枯者，有血滞者。血滞宜
破，血枯宜补也。疼痛中，有常时作痛者，有经前经后作痛者。常时与经前为血积，经后为血虚也。发热中，
有常时发热者，有经行发热
者。常时为血虚有积，经行为血虚而有热也。是四者之中，又分为八矣。人之气血周流，忽有忧思忿怒，则
郁结不行。经前产后，忽遇饮冷形寒，则恶露不尽。此经候不调不通，作痛发热，所由作也。大抵气行血
行，气止血止。故治血病，以行气为先，香附之类是也。热则流通，寒则凝塞，故治血病，以热药为佐，肉
桂之类是也。
慎斋按∶妇人有先病而后致经不调者，有因经不调而生诸病者。如先因病而后经不调，当先治病，病去则
经自调。若因经不调而后生病，当先调经，经调则病自除。李氏一论，可谓调经之要。然偏而不全，予故补其
未尽之旨。若方氏分因详证，诚得统论调经大法。
《济生方》曰∶经云百病皆生于气。有七气，有九气。喜怒忧思悲恐惊，七气也。益之以寒热，为九气。
气之为病，男子妇人皆有之，唯妇人之气为尤甚。盖人身血随气行，气一滞，则血为气并。或月事不调，心腹作
痛；或月事将行，预先作痛；或月事已行，淋沥不断；或作寒热，或为 瘕；或疼痛连腰胁，或引背膂，上下
攻刺，吐逆不食，肌肉消瘦。非特不能受孕，久不治，转为劳瘵者多。是皆气之为病也。故调经养血，莫先以
顺气为主。
方氏说：妇女的月经病，有月经周期不规律的，有月经闭止不通的。然而在不调与不通之中，又有兼见疼痛的，有兼见发热的，这便分为了四种情况。仔细详察，不调之中，有月经提前的，有月经推后的。提前属于热证，推后属于虚证。不通之中，有血枯（血液枯竭）的，有血滞（血液瘀滞）的。血滞应当用破血法治疗，血枯应当用补血法治疗。疼痛之中，有平时常痛的，有经前或经后作痛的。平时痛和经前痛属于血积（瘀血积聚），经后痛属于血虚。发热之中，有平时常发热的，有行经期间发热的。平时发热属于血虚且有瘀积，经期发热属于血虚而有内热。这四种情况之中，又细分为八种了。人的气血周流全身，如果忽然遇到忧愁思虑或愤怒，就会导致气机郁结而运行不畅。在经前产后，如果忽然遭遇饮冷或受寒，就会导致恶露不尽。这就是月经不调、不通、作痛、发热产生的原因。大抵气行则血行，气停则血止。所以治疗血病，以行气为先导，如香附之类的药物就是如此。热则气血流通，寒则气血凝塞，所以治疗血病，以温热药为辅助，如肉桂之类的药物就是如此。
慎斋按语：妇女中有先患病而后导致月经不调的，有因月经不调而产生各种疾病的。如果是先因病而后月经不调，应当先治疗疾病，病去则月经自然调和。如果是因月经不调而后生病，应当先调理月经，月经调和则疾病自然消除。李氏的这一论述，可以说是调理月经的关键。然而其论述偏颇而不全面，所以我补充他未尽的宗旨。至于方氏区分病因详细辨证，确实掌握了统论调理月经的大法。
《济生方》说：医经云百病皆生于气。有七气，有九气。喜、怒、忧、思、悲、恐、惊，称为七气。加上寒、热，成为九气。气致病，男子妇人都会有，唯独妇女的气病更为严重。因为人身之血随气而行，气一旦停滞，血就会与气并聚在一起。或者月经不调，心腹作痛；或者月经将要来潮，预先作痛；或者月经已经来潮，淋漓不断；或者出现寒热往来，或者形成瘕（腹中结块）；或者疼痛牵连腰胁，或者牵引背部脊柱，上下攻刺般疼痛，呕吐逆气不能进食，肌肉消瘦。这不仅不能受孕，若久治不愈，多转为劳瘵（慢性消耗性疾病）。这些都是气致病所致。所以调理月经、养血，没有比顺气更重要的了。
Fang stated: Women's menstrual diseases include irregular menstruation (menstrual cycle irregularity) and amenorrhea (absence of menstruation). Among these conditions of irregularity and obstruction, some are accompanied by pain, and some by fever; thus, they are divided into four categories. Upon detailed examination, among irregularities, there are those with early onset and those with delayed onset. Early onset indicates heat syndrome, while delayed onset indicates deficiency syndrome. Among obstructions, there are cases of blood depletion (blood exhaustion) and cases of blood stasis (blood stagnation). Blood stasis should be treated with blood-breaking methods, and blood depletion with blood-nourishing methods. Regarding pain, there is constant pain and pain occurring before or after menstruation. Constant pain and pre-menstrual pain indicate blood accumulation (stagnant blood accumulation), whereas post-menstrual pain indicates blood deficiency. Regarding fever, there is constant fever and fever during menstruation. Constant fever indicates blood deficiency with accumulation, while menstrual fever indicates blood deficiency with internal heat. Thus, within these four categories, eight sub-categories are further distinguished. Human qi and blood circulate throughout the body; if one suddenly experiences sorrow, worry, or anger, qi becomes depressed and fails to flow smoothly. Before or after menstruation, if one suddenly consumes cold drinks or is exposed to cold, lochia may fail to clear. These are the causes of irregular menstruation, obstruction, pain, and fever. Generally, when qi moves, blood moves; when qi stops, blood stops. Therefore, in treating blood diseases, promoting qi movement is prioritized, as seen with herbs like Cyperi Rhizoma (Xiangfu). Heat promotes circulation, while cold causes coagulation and blockage; thus, in treating blood diseases, warm-natured herbs serve as assistants, such as Cinnamomi Cortex (Rougui).
Shenzhai commented: Some women develop menstrual irregularities due to prior illness, while others develop various diseases due to menstrual irregularities. If illness precedes menstrual irregularity, the illness should be treated first; once the illness is resolved, menstruation will naturally regulate itself. If menstrual irregularity precedes the development of disease, menstruation should be regulated first; once menstruation is regulated, the disease will naturally disappear. Li’s discussion can be considered the key principle for regulating menstruation. However, it is partial and incomplete; therefore, I supplement his unfinished points. Fang’s method of distinguishing causes and detailing symptoms indeed grasps the general principles of regulating menstruation.
The *Jisheng Fang* states: The medical classics say that all diseases arise from qi. There are seven qi and nine qi. Joy, anger, worry, thought, grief, fear, and shock constitute the seven qi. Adding cold and heat makes nine qi. Qi-related diseases occur in both men and women, but they are particularly severe in women. This is because blood follows qi in its movement; when qi stagnates, blood accumulates with it. This may result in irregular menstruation with abdominal pain; or pain preceding the onset of menstruation; or prolonged, dripping bleeding after menstruation has started; or alternating chills and fever; or the formation of masses (zheng jia); or pain radiating to the waist and hypochondrium, extending to the back and spine, with stabbing sensations up and down, vomiting, inability to eat, and emaciation. Not only does this prevent conception, but if left untreated for a long time, it often transforms into consumptive disease (lao zhai). All these are caused by qi dysfunction. Therefore, in regulating menstruation and nourishing blood, nothing is more important than smoothing qi.