女人以血为主，血王则经调，而子嗣、身体之盛衰，无不肇端于此。故治妇人之病，当
以经血为先。而血之所主，在古方书皆言心主血，肝藏血，脾统血，故凡伤心、伤脾、伤肝
者，均能为经脉之病。又曰∶肾为阴中之阴，肾主闭藏；肝为阴中之阳，肝主疏泄。二藏俱
有相火，其系上属于心，故心火一动，则相火翕然从之，多致血不静而妄行，此固一说。然
相火动而妄行者有之，由火之盛也。若中气脱陷及门户不固而妄行者亦有之，此由脾肾之虚
，不得尽言为火也。再如气道逆而不行者有之，由肝之滞也。若精血败而不行者亦有之，此
由真阴之枯竭。其证极多，不得误以为滞也。是固心脾肝肾四脏之病，而独于肺脏多不言及
，不知血之行与不行，无不由气。如《经脉别论》曰∶饮入于胃，游溢精气，下输于脾；脾
气散精，上归于肺；通调水道，下输膀胱，水精四布，五经并行，合于四时五行阴阳，揆度
以为常也。此言由胃达脾，由脾达肺，而后传布诸经。故血脱者当益气，气滞者当调气，气
主于肺，其义可知。是皆诸经之当辨者如此。然其微甚本末，则犹有当辨者。盖其病之肇端
，则或由思虑，或由郁怒，或以积劳，或以六淫、饮食，多起于心肺肝脾四脏，及其甚也，
则四脏相移，必归脾肾。盖阳分日亏，则饮食日减，而脾气胃气竭矣；阴分日亏，则精血日
涸，而冲任肾气竭矣。故予曰∶阳邪之至，害必归阴；五脏之伤，穷必及肾。此源流之必然
，即治疗之要着。故凡治经脉之病，或其未甚，则宜解初病，而先其所因；若其已剧，则必
计所归，而专当顾本。甚至脾肾大伤，泉源日涸，由色淡而短少，由短少而继绝，此其枯竭
已甚也。昧者无知，犹云积血，而通之破之，祸不旋踵矣。
妇女以血为本，血液充盈则月经调顺，而生育能力、身体的盛衰，无不由此发端。因此治疗妇女的疾病，应当以调理经血为首要任务。关于血的生理主宰，古代医书中都说心主血，肝藏血，脾统血，所以凡是损伤心、脾、肝的，都能导致经脉方面的疾病。又有说法称：肾为阴中之阴，肾主闭藏；肝为阴中之阳，肝主疏泄。这两脏都含有相火（寄居于肝肾之间的命门之火），其经络联系上属于心，所以心火一旦发动，相火就会随之翕然兴起，多导致血液不宁静而妄行出血，这固然是其中一种说法。然而，相火妄动导致出血的情况确实存在，这是由于火势旺盛所致。如果是中气下陷脱失以及冲任二脉门户不固导致的出血，也存在这种情况，这源于脾肾的虚弱，不能一概归咎于火邪。再如，气道逆乱而不通畅导致的出血，也有这种情况，这是由肝气郁滞所致。若是精血败坏而不流通的情况，也有这种情形，这是由真阴枯竭所致。这类证候非常多，不能误认为是气滞血瘀。这确实是心、脾、肝、肾四脏的疾病，但唯独很少提及肺脏，殊不知血的运行与不运行，无不与气有关。如《黄帝内经·经脉别论》中说：饮食进入胃中，游溢精气，向下输送到脾；脾气散布精微物质，向上归于肺；肺通调水道，向下输送到膀胱，水液精微四处布散，配合五脏经脉并行运行，顺应四时五行阴阳的变化，以此作为正常的规律。这说明气血由胃达脾，由脾达肺，然后传布到各条经脉。所以血脱的患者应当益气，气滞的患者应当调气，气主要由肺所主，其中的道理就可以明白了。这些都是各条经脉需要辨别的地方。然而病情的轻重、本末，还有需要进一步辨别的。大概疾病的起因，或者是由于思虑过度，或者是由于抑郁愤怒，或者是由于长期劳累，或者是由于六淫（风、寒、暑、湿、燥、火六种外感病邪）和饮食不当，大多起于心、肺、肝、脾四脏，等到病情严重时，这四脏的病邪会相互传变，最终必然归结于脾肾。如果阳分日渐亏损，那么饮食就会日渐减少，从而导致脾气和胃气衰竭；如果阴分日渐亏损，那么精血就会日渐枯竭，从而导致冲任二脉和肾气衰竭。所以我说道：阳邪侵袭人体，危害最终必归于阴分；五脏受到损伤，穷尽之时必然波及肾脏。这是疾病源流发展的必然规律，也是治疗的关键要点。所以凡是治疗经脉方面的疾病，如果病情尚不严重，就应当解除初起的病邪，并先追究致病的原因；如果病情已经严重，就必须考虑病邪的最终归属，专门注重顾护根本。甚至出现脾肾大伤，水源日渐枯竭，表现为经血色淡且量少，由量少进而发展到闭经断绝，这是枯竭非常严重的情况。无知的庸医，还说是积血，采用通利、攻破的方法治疗，灾祸很快就会降临。
Women are primarily governed by blood; when blood is abundant, menstruation is regular, and fertility as well as the vitality or decline of the body all originate from this. Therefore, in treating diseases in women, regulating menstrual blood should be the priority. Regarding the physiological governance of blood, ancient medical texts state that the Heart governs blood, the Liver stores blood, and the Spleen controls blood. Thus, any damage to the Heart, Spleen, or Liver can lead to disorders of the meridians. Another view holds: the Kidney is Yin within Yin, governing retention; the Liver is Yang within Yin, governing dispersion and free flow. Both organs contain Ministerial Fire (Xiang Huo, a fire residing in the Liver and Kidneys), and their connections ascend to belong to the Heart. Therefore, when Heart Fire moves, Ministerial Fire rises with it, often causing blood to become restless and bleed recklessly. This is indeed one perspective. However, while reckless bleeding due to moving Ministerial Fire does occur, it is caused by excessive heat. There are also cases of reckless bleeding due to sinking and collapse of Middle Qi (Spleen Qi) and insecurity of the gateways (Chong and Ren vessels); these stem from deficiency of the Spleen and Kidney and cannot be entirely attributed to Fire. Furthermore, there are cases where bleeding results from rebellious and obstructed Qi flow, caused by Liver stagnation. There are also cases where blood fails to circulate due to deterioration of essence and blood, caused by exhaustion of True Yin. These syndromes are numerous and must not be mistaken for Qi stagnation. These are indeed diseases of the Heart, Spleen, Liver, and Kidney, yet the Lung organ is rarely mentioned. One should not know that the movement or immobility of blood is never unrelated to Qi. As stated in *Jing Mai Bie Lun* (Treatise on Meridian Differences): "When drink enters the Stomach, its essence floats and overflows, transmitting downward to the Spleen; the Spleen scatters essences, sending them upward to return to the Lung; the Lung regulates water passages, transmitting downward to the Bladder. Water essences distribute in all directions, running parallel with the Five Meridians, harmonizing with the Four Seasons, Five Elements, and Yin-Yang, serving as the constant standard." This indicates that substances travel from the Stomach to the Spleen, then to the Lung, before distributing through the various meridians. Therefore, in cases of blood loss, one should tonify Qi; in cases of Qi stagnation, one should regulate Qi. Since Qi is primarily governed by the Lung, the principle is clear. These are the matters requiring differentiation in the various meridians. However, regarding the severity and root causes, further differentiation is necessary. The onset of disease may arise from excessive thinking, depression and anger, chronic fatigue, or the Six Excesses (Wind, Cold, Summerheat, Dampness, Dryness, Fire) and dietary irregularities. It mostly originates in the Heart, Lung, Liver, and Spleen. When the condition becomes severe, pathogenic factors shift among these four organs and ultimately converge on the Spleen and Kidney. If Yang aspects decline daily, food intake decreases daily, leading to exhaustion of Spleen and Stomach Qi; if Yin aspects decline daily, essence and blood dry up daily, leading to exhaustion of Chong, Ren, and Kidney Qi. Thus, I say: when Yang pathogens arrive, harm inevitably returns to Yin; when the Five Zang organs are injured, the depletion inevitably reaches the Kidney. This is the inevitable course of disease origin and progression, which constitutes the key point of treatment. Therefore, when treating meridian diseases, if the condition is not yet severe, one should resolve the initial pathogen and address the primary cause first; if the condition is already critical, one must consider the final destination of the pathology and focus specifically on protecting the root. Even in cases of severe damage to the Spleen and Kidney, where the source dries up daily, manifesting as pale and scanty menses progressing from scarcity to amenorrhea, this indicates extreme exhaustion. Ignorant practitioners, lacking knowledge, still attribute this to accumulated blood and use methods to unblock and break down stasis, bringing disaster upon themselves swiftly.