〔大〕夫产伤动于血气，其后虚损未复，而为风冷所伤，血之为性，得冷则凝结，故
风冷伤于经血，结于胞络之间，故令月水不通也。凡血结月水不通，则成血瘕，水血相
并，复遇脾胃衰弱，肌肉虚者，则为水肿也。
妇人冲任之脉，为经络之海，皆起于胞内，而手太阳小肠之经、手少阴心之经，此
二经上为乳汁，下为月水，若产后月水不通者，盖新产之后，劳伤气血，或去血过多，乳
汁通行，自是不通，若乳子岁半或一岁之内，而月经不行，此是常候，即非病也，何必通
之。谚云奶假是也。若半岁而行者，或四五个月便经行者，皆是少壮血盛之人，注受极
易，产乳必众，其子失乳，必四肢 羸，肚大青筋，头大发焦，好啖泥土，病名无辜。若
经血有余者，不可以药止之。若产后一二岁，月经不通，而无疾苦，何必服药。或劳伤气
血，冲任脉虚，气血衰少而不能行者，但服健脾胃，资气血之药，自然通行。若用牛膝、
红花、苏木、干漆、虻虫、水蛭等药以通之，
则为害滋大，经水枯竭则无以滋养，其能行乎。初虞世所谓譬犹索万金于乞丐之手，虽
捶楚并下，而不可得也。后之学人，更宜详番而疗之。
〔薛〕前证脾胃虚弱，用六君子汤。若兼郁火伤脾，用归脾汤加丹皮、山栀。若怒
火伤血，宜用四物合小柴胡。气血俱虚，用八珍、牡丹皮。仍参前论主之。一产妇月
经年余不通，内热晡热，服分气丸，经行不止，恶寒作渴，食少倦怠，胸满气壅。朝用
加味逍遥散，夕用四君子汤，月许，诸证稍愈。佐以八珍汤，兼服两月而愈。
以上三证，宜于调经门中参看通用。
【大论】分娩时损伤了血气，此后虚损未能恢复，又受到风冷邪气的侵袭。血的性质是遇到寒冷就会凝结，因此风冷邪气伤害了经血，使其凝结在胞宫络脉之间，从而导致月经不通。凡是血液凝结导致的月经不通，就会形成血瘕（腹部结块）；如果水湿与血液相互搏结，再加上脾胃功能衰弱、肌肉消瘦的人，就会发生水肿。
妇女的冲脉和任脉，是经络之海，都起源于胞宫内部。手太阳小肠经和手少阴心经这两条经脉，向上化生为乳汁，向下化为月经。如果在产后出现月经不通，大概是因为新近分娩后，气血劳伤，或者失血过多，导致乳汁运行通畅，月经自然就不通行了。如果在哺乳半年到一年之内，月经没有来潮，这是正常的生理现象，并不是疾病，何必强行通经呢？谚语所说的“奶假”（因哺乳而暂时停经）就是这个道理。如果是半岁就来月经，或者四五个月就来月经的，都是年轻体壮、血气旺盛的人，受孕非常容易，生育哺乳次数必然很多，孩子失去母乳，必定会出现四肢瘦弱、肚子大且青筋暴露、头发干枯发黄、喜欢吃泥土等症状，这种病名叫“无辜疳”。如果经血有余，不可以用药物强行止住。如果产后一两年内，月经不通，但没有其他病痛困扰，何必服药治疗？如果是因劳伤气血，导致冲任脉虚弱，气血衰少而不能运行，只需服用健运脾胃、滋养气血的药物，月经自然会通行。如果使用牛膝、红花、苏木、干漆、虻虫、水蛭等破血逐瘀的药物来强行通经，危害就太大了。经血枯竭就无法滋养身体，月经怎么能行得通呢？初虞世曾说：这就像向乞丐索要万金，即使鞭打拷问，也是得不到的。后来的学医之人，更应当仔细审察并加以治疗。
【薛己按语】上述证候若属脾胃虚弱，使用六君子汤（Six Gentlemen Decoction）。如果兼有郁火伤脾，使用归脾汤（Restore the Spleen Decoction）加牡丹皮、山栀。如果因怒火伤血，适宜使用四物汤（Four Substances Decoction）合小柴胡汤（Minor Bupleurum Decoction）。气血俱虚，使用八珍汤（Eight Treasures Decoction）加牡丹皮。仍参考前面的论述作为主治依据。有一位产妇月经一年多不通，伴有内热和傍晚发热，服用了分气丸后，导致经血不止，出现恶寒、口渴、食欲减退、倦怠、胸满气壅等症状。早晨服用加味逍遥散（Modified Free and Easy Wanderer Powder），晚上服用四君子汤（Four Gentlemen Decoction），约一个月后，各种症状稍有好转。再辅以八珍汤，连续服用两个月而痊愈。以上三个病例，宜在调经门中参考通用治法。
[Da Lun] Childbirth injures Qi and Blood. If the subsequent deficiency is not restored, and one is injured by Wind-Cold pathogenic factors, the nature of Blood is to coagulate when exposed to Cold. Therefore, when Wind-Cold damages the menstrual Blood, causing it to coagulate between the uterus and its collaterals, menstruation becomes obstructed. Whenever Blood coagulation leads to amenorrhea, a Blood mass (Xue Jia) forms; if Water-Dampness and Blood bind together, compounded by weak Spleen-Stomach function and emaciated muscles, edema occurs.
The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) of women are the sea of the meridians and collaterals, both originating within the uterus. The Hand-Taiyin Small Intestine Meridian and the Hand-Shaoyin Heart Meridian transform into breast milk upwards and into menstruation downwards. If menstruation is obstructed postpartum, it is generally because after recent childbirth, Qi and Blood are exhausted by labor, or excessive blood loss has occurred, allowing breast milk to flow freely while menstruation naturally ceases. If menstruation does not resume during breastfeeding for six months to one year, this is a normal physiological state, not a disease, so why force menstruation? As the proverb says, "Nai Jia" (temporary amenorrhea due to lactation) refers to this. If menstruation resumes at half a year, or even four to five months postpartum, these are young and robust individuals with abundant Blood and Qi, who conceive easily and have many pregnancies and lactations. Their infants, deprived of breast milk, will inevitably suffer from limb emaciation, abdominal distension with visible veins, dry and scorched hair, and pica (eating dirt), a condition named "Wugu" (Innocent Disease). If there is an excess of menstrual Blood, it should not be stopped with medication. If menstruation is absent for one or two years postpartum but without other discomforts, why take medicine? If Qi and Blood are damaged by overwork, leading to deficiency of the Chong and Ren vessels, and insufficient Qi and Blood to flow, one should simply administer herbs that strengthen the Spleen and Stomach and nourish Qi and Blood, and menstruation will naturally resume. Using herbs such as Achyranthes Root (Niuxi), Safflower (Honghua), Bryony Root (Sumu), Drynaria Resin (Ganqi), Blister Beetle (Mangchong), and Leech (Shuizhi) to forcibly unblock menstruation causes great harm. When menstrual Blood is depleted, there is nothing to nourish the body, how can menstruation flow? Chu Yushi once said: This is like demanding ten thousand gold pieces from a beggar; even under beating and torture, it cannot be obtained. Scholars in later generations should examine carefully and treat accordingly.
[Xue Ji's Commentary] For the aforementioned syndromes caused by Spleen-Stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction). If complicated by constrained Fire injuring the Spleen, use Guipi Tang (Restore the Spleen Decoction) plus Mudanpi (Tree Peony Bark) and Shanzhi (Gardenia Fruit). If Anger-Fire injures Blood, Siwu Tang (Four Substances Decoction) combined with Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. For simultaneous deficiency of Qi and Blood, use Bazhen Tang (Eight Treasures Decoction) plus Mudanpi. Refer to the previous discussion for main treatment principles. A certain patient had no menstruation for over a year, accompanied by internal heat and afternoon tidal fever. After taking Fenqi Wan (Qi-Regulating Pill), menstruation became continuous, accompanied by aversion to cold, thirst, poor appetite, fatigue, chest fullness, and Qi stagnation. In the morning, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was administered; in the evening, Sijunzi Tang (Four Gentlemen Decoction) was given. After about a month, symptoms improved slightly. Then, Bazhen Tang (Eight Treasures Decoction) was added as an adjunct, taken concurrently for two months until recovery. The above three cases should be consulted in the Menstrual Regulation section for general application.