经行发热时潮热，经前血热经后虚，发热无时察客热，潮热午后审阴虚。
【注】经行发热，时热潮热之病，若在经前则为血热之热；经后则为血虚之热。发热
时热，多是外感，须察客邪之热。午后潮热，多属里热，当审阴虚之热也。
经来寒热身体痛，当分荣卫与虚实，有汗不胀卫不足，无汗而胀荣有余。
【注】经来之时，恶寒、发热，身体疼痛
者，当分荣卫虚实∶若发热、恶寒，身痛不胀而有汗者，属卫虚荣不足；若发热、恶寒，
身胀痛而无汗者，属荣实卫有余也。
腹痛经后气血弱，痛在经前气血凝，气滞腹胀血滞痛，更审虚实寒热情。
【注】凡经来腹痛，在经后痛，则为气血虚弱；经前痛，则为气血凝滞，若因气滞血
者，则多胀满。因血滞气者，则多疼痛。更当审其凝滞作胀痛之故，或因虚、因实、因
寒、因热而分治之也。
经行泄泻是脾虚，鸭溏清痛乃寒湿；胃弱饮伤多呕饮，食伤必痛吐其食。
【注】经行泄泻，乃脾虚也，若鸭溏、冷痛，是寒湿也。经行呕吐，是胃弱也。若呕
出涎饮，则是伤饮。若吐出食物，则是伤食。然伤食者多痛而吐食，伤饮者不痛而呕饮也。
逆行吐血错行崩，热伤阴阳络妄行；血多热去当用补，血少虽虚须主清。
【注】妇女经血逆行，上为吐血、衄血，及错行下为崩血者，皆因热盛也。伤阴络则
下行为崩，伤阳络则上行为吐衄也。若去血过多，则热随血去，当以补为主。如血少热
尚未减，虽虚仍当以清为主也。
月经期间出现发热或定时潮热，经前发热多因血分有热，经后发热多因血虚所致。发热无固定时间者，需辨别是否为外感客邪引起的发热；午后定时潮热者，应审察是否为阴虚内热。
【注】月经期间出现的发热、时发时止的潮热病症，若在经期之前发生，属于血热导致的发热；若在经期之后发生，则属于血虚导致的发热。发热且发作时间不固定的，多由外感引起，必须仔细辨别外感邪气所致的发热。午后定时潮热的，多属于里热证，应当审察是否为阴虚内热。
月经来潮时出现寒热往来及身体疼痛，应当分辨是营卫失调还是虚实证候。若有汗出且腹部不胀满，属于卫气不足；若无汗且腹部胀满，属于营血有余（实）。
【注】月经来潮时，出现恶寒、发热、身体疼痛的症状，应当分辨营卫与虚实的区别：如果发热、恶寒、身痛但不胀满且有汗出的，属于卫虚荣气不足；如果发热、恶寒、身体胀痛且无汗出的，属于营实卫气有余。
腹痛发生在经期之后，是因为气血虚弱；腹痛发生在经期之前，是因为气血凝滞。气机阻滞主要导致腹胀，血行瘀滞主要导致疼痛，还需进一步审察是虚证、实证、寒证还是热证。
【注】凡是月经来潮时腹痛，如果在经期结束后才痛，则是气血虚弱所致；如果在经期之前痛，则是气血凝滞所致。如果是因气滞导致血行不畅，则多表现为胀满；如果是因血滞导致气机受阻，则多表现为疼痛。更应当审察造成胀痛的原因，根据是因虚、因实、因寒、因热而分别进行治疗。
月经期间泄泻是由于脾虚，大便如鸭粪清稀且伴有冷痛的是寒湿证；胃气虚弱或因饮水过多损伤胃部常导致呕吐，饮食积滞必然伴随腹痛并吐出未消化的食物。
【注】月经期间泄泻，是脾虚的表现，如果出现像鸭粪一样的稀便、冷痛，则是寒湿证。月经期间呕吐，是胃气虚弱。如果呕吐出涎沫和痰饮，则是伤于水饮。如果吐出食物，则是伤于饮食。然而，伤食的人大多腹痛并吐出食物，伤饮的人则不痛而仅呕吐痰饮。
经血逆行导致吐血或错行导致崩漏，是因为热邪损伤了阴络或阳络导致血液妄行；出血量大且热势消退后应当使用补法，出血量少但热势仍在，虽然体虚仍应以清热为主。
【注】妇女经血逆行，向上表现为吐血、鼻衄，向下错行表现为崩漏的，都是因为热盛所致。损伤阴络则血液向下溢出形成崩漏，损伤阳络则血液向上溢出形成吐血和鼻衄。如果失血过多，热邪随血液流失，治疗当以补益为主。如果血量少但热势尚未减退，虽然身体虚弱，仍应当以清热为主。
Fever during menstruation or tidal fever: Fever before menstruation is due to blood heat, while fever after menstruation is due to blood deficiency. Fever without a fixed time should be examined for external pathogenic heat; tidal fever in the afternoon should be assessed for yin deficiency heat.
[Note] Fevers occurring during menstruation, whether intermittent or tidal, if they occur before menstruation, are fevers caused by blood heat; if they occur after menstruation, they are fevers caused by blood deficiency. Fevers that occur at irregular times are mostly due to external contraction and require careful differentiation of the heat from external pathogens. Tidal fevers in the afternoon mostly belong to interior heat and should be assessed as yin deficiency heat.
Chills and fever with body pain upon onset of menstruation: Differentiate between Ying-Wei disharmony and deficiency/excess patterns. Sweating without abdominal distension indicates Wei Qi insufficiency; no sweating with abdominal distension indicates Ying Blood excess.
[Note] When chills, fever, and body pain occur during menstruation, one must differentiate between Ying-Wei conditions and deficiency/excess: If there is fever, chills, body pain without distension, and sweating, it belongs to Wei Qi deficiency and Ying Blood insufficiency; if there is fever, chills, painful distension of the body, and no sweating, it belongs to Ying excess and Wei Qi surplus.
Abdominal pain after menstruation indicates Qi and Blood weakness; abdominal pain before menstruation indicates Qi and Blood stagnation. Qi stagnation primarily causes abdominal distension, while Blood stasis primarily causes pain. One must further examine whether the pattern is deficiency, excess, cold, or heat.
[Note] For abdominal pain during menstruation, pain occurring after menstruation ends is due to Qi and Blood deficiency; pain occurring before menstruation begins is due to Qi and Blood stagnation. If Qi stagnation leads to Blood stasis, abdominal distension predominates; if Blood stasis impedes Qi movement, pain predominates. One must further investigate the cause of the distension and pain, treating according to whether it is due to deficiency, excess, cold, or heat.
Diarrhea during menstruation is due to Spleen deficiency; duck-like loose stools with cold pain indicate Cold-Dampness. Weak Stomach Qi or injury from drinking fluids often causes vomiting; food injury inevitably causes pain and vomiting of undigested food.
[Note] Diarrhea during menstruation is a manifestation of Spleen deficiency. If the stool resembles duck feces and is accompanied by cold pain, it indicates Cold-Dampness. Vomiting during menstruation indicates weak Stomach Qi. If vomitus consists of saliva and phlegm-fluids, it indicates injury from fluid retention. If vomitus consists of food, it indicates food injury. However, those injured by food usually experience pain and vomit food, while those injured by fluids do not experience pain but only vomit phlegm-fluids.
Retrograde menstruation causing hematemesis or aberrant flow causing metrorrhagia is due to heat damaging Yin or Yang collaterals, causing blood to move recklessly. If blood loss is excessive and heat dissipates with the blood, tonification should be used. If blood loss is minimal but heat persists, despite deficiency, clearing heat should remain the primary treatment.
[Note] Retrograde menstrual blood manifesting upward as hematemesis or epistaxis, or downward as metrorrhagia due to aberrant flow, is all caused by excessive heat. Damage to Yin collaterals leads to downward bleeding forming metrorrhagia; damage to Yang collaterals leads to upward bleeding forming hematemesis and epistaxis. If blood loss is excessive, heat dissipates along with the blood, so treatment should focus on tonification. If blood volume is low but heat has not yet subsided, even though there is deficiency, treatment should still prioritize clearing heat.