谚云∶宁治十男子，莫治一妇人。此谓妇人之病不易治也。何也？不知妇人之病，本与
男子同，而妇人之情，则与男子异。盖以妇人幽居多郁，常无所伸，阴性偏拗，每不可解，
加之慈恋爱憎，嫉妒忧恚，罔知义命，每多怨尤，或有怀不能畅遂，或有病不可告人，或信
师巫，或畏药饵，故染着坚牢，根深蒂固，而治之有不易耳，此其情之使然也。然尚有人事
之难，如寇宗 引黄帝之论曰∶凡治病察其形气色泽，形气相得，谓之可治；色泽以浮，谓
之易已；形气相失，色夭不泽，谓之难治。又曰∶诊病之道，观人勇怯、骨肉、皮肤，能知
其虚实，以为诊法。故曰∶治之要极，无失色脉，此治之大则也。今富贵之家，居奥室之中
，处帷幔之内，复有以绵帕蒙其手者，既不能行望色之神，又不能尽切脉之巧。使脉有弗合
，未免多问，问之觉繁，必谓医学不精，往往并药不信，不知问亦非易，其有善问者，正非
医之善者不能也。望闻问切，欲于四者去其三，吾恐神医不神矣。世之通患，若此最多，此
妇人之所以不易也。故凡医家病家，皆当以此为意。
《上古天真论》曰∶女子二七，天癸至，任脉通，太冲脉盛，月事以时下，故有子。盖
天癸者，言后天之阴气，阴气足而月事通，是即所为月经也。正以女体属阴，其气应月，月
以三旬而一盈，经以三旬而一至，月月如期，经常不变，故谓之月经，又谓之月信。夫经者
，常也。一有不调，则失其常度而诸病见矣。然经本阴血，何脏无之，惟脏腑之血皆归冲脉
，而冲为五脏六腑之血海，故经言太冲脉盛，则月事以时下，此可见冲脉为月经之本也。然
血气之化，由于水谷，水谷盛则血气亦盛，水谷衰则血气亦衰，而水谷之海，又在阳明。考
之《痿论》曰∶阳明者，五脏六腑之海，主润宗筋，宗筋主束骨而利机关也。冲脉者，经脉
之海也，主渗灌溪谷，与阳明合于宗筋。阴阳总宗筋之会，会于气街，而阳明为之长。是以
男精女血，皆由前阴而降，此可见冲脉之血，又总由阳明水谷之所化，而阳明胃气又为冲脉
之本也。故月经之本，所重在冲脉，所重在胃气，所重在心脾生化之源耳。其他如七情六淫
，饮食起居之失宜者，无非皆心脾胃气之贼。何者当顾，何者当去，学人于此，当知所从矣。
俗话说：“宁愿治疗十个男子，也不愿治疗一个妇人。”这是说妇女的疾病不容易治疗。为什么呢？因为不了解妇女的疾病，其根本与男子相同，但妇女的情志，却与男子不同。大概因为妇女幽居深闺，多生郁结，常常心情无法舒展，阴柔之性偏于执拗，往往难以理解，加上慈爱、喜爱、憎恶、嫉妒、忧愁、愤怒等情绪，不懂顺应天命道理，常常产生怨恨抱怨，有的心事不能畅达抒发，有的疾病不便告诉他人，有的迷信巫师，有的畏惧药物，所以病情附着牢固，根深蒂固，因此治疗起来不容易，这是情志使然。然而还有人事方面的困难，如寇宗奭引用黄帝的话说：“大凡治病要观察病人的形体、气色、光泽，形体与气色相协调，叫做可治；色泽浮润，叫做容易痊愈；形体与气色不相协调，面色枯槁无光泽，叫做难治。”又说：“诊病的道理，要观察人的勇敢或怯懦、骨骼肌肉、皮肤状况，能据此判断虚实，作为诊法依据。”所以说：“治疗的极致关键，在于不忽视色脉的变化，这是治疗的大原则。”如今富贵人家，居住在深邃的居室中，处在帷幔之内，又有用丝帕蒙住手部的，既不能施展望色的神妙，又不能尽施切脉的技巧。如果脉象不合常理，难免要多问，问了觉得繁琐，必定认为医术不精，往往连药都不相信，不知道问诊也不容易，善于问诊的人，正不是医术不高明的医生所能做到的。望、闻、问、切四诊，想要去掉其中三项，我恐怕即使是神医也不灵了。世间的通病，像这样的很多，这就是妇女之所以不易治疗的原因。所以凡是医家和病家，都应当对此在意。
《上古天真论》说：“女子十四岁，天癸（促进生殖功能发育的精微物质）到来，任脉通畅，太冲脉旺盛，月经按时来潮，所以能够生育。”所谓天癸，是指后天的阴气，阴气充足则月经通畅，这就是所说的月经。正因为女性身体属阴，其气机应合月亮，月亮每三十天圆满一次，月经每三十天来潮一次，月月如期，经常不变，所以称为月经，又称为月信。经，就是常的意思。一旦不调，就失去了常规限度，各种疾病就会显现。然而经血本质是阴血，哪一脏没有呢？只是脏腑的血都汇聚于冲脉，而冲脉是五脏六腑之血海，所以说太冲脉旺盛，则月经按时来潮，这可见冲脉是月经的根本。然而气血的化生，源于水谷，水谷充足则气血也充足，水谷衰少则气血也衰少，而水谷之海，又在阳明胃经。考证《痿论》说：“阳明经，是五脏六腑之海，主要滋润宗筋，宗筋主要约束骨骼而利于关节运动。”冲脉，是十二经脉之海，主要渗透灌溉溪谷，与阳明经会合于宗筋。阴阳总汇于宗筋，会合于气街穴，而阳明经为之主导。因此男子的精液和女子的血液，都由前阴排出，这可见冲脉之血，又总由阳明水谷所化生，而阳明胃气又是冲脉的根本。所以月经的根本，关键在于冲脉，关键在于胃气，关键在于心脾生化之源。其他如七情（喜、怒、忧、思、悲、恐、惊）、六淫（风、寒、暑、湿、燥、火），饮食起居失宜等因素，无非都是损害心脾胃气的贼邪。哪些应当顾护，哪些应当去除，学习中医的人在此应当知道遵循的方向了。
As the proverb goes: "It is better to treat ten men than one woman." This refers to the difficulty in treating women's diseases. Why? It stems from a lack of understanding that while the fundamental nature of women's diseases is the same as men's, their emotional constitution differs. Generally, women live in seclusion and are prone to depression, often feeling unable to express themselves freely. Their Yin nature tends to be rigid and difficult to comprehend. Furthermore, influenced by affection, love, hatred, jealousy, worry, and anger, they may fail to understand the principles of destiny, often harboring resentment or complaint. Some have unexpressed desires, some have illnesses they cannot disclose, some trust in shamans, and some fear medication. Consequently, their conditions become deeply entrenched and stubborn, making treatment difficult; this is due to the influence of their emotions. However, there are also difficulties arising from social circumstances. For instance, Kou Zongshi quotes the Yellow Emperor: "In treating diseases, one must observe the patient's form, Qi, complexion, and luster. If form and Qi are harmonious, it is termed 'treatable'; if the complexion is floating and lustrous, it is termed 'easy to cure'; if form and Qi are discordant, and the color is dull and lacking luster, it is termed 'difficult to treat'." He further states: "The way to diagnose involves observing whether a person is courageous or timid, examining their bones, muscles, and skin, to determine deficiency or excess, thereby establishing diagnostic methods." Thus it is said: "The ultimate key to treatment lies not neglecting the observation of complexion and pulse; this is the great principle of treatment." Nowadays, people of wealth reside in deep chambers, behind curtains, and often cover their hands with silk handkerchiefs. This prevents the physician from performing the divine art of observing complexion and fully utilizing the skill of pulse palpation. If the pulse does not conform to expectations, questioning becomes necessary. Patients may find excessive questioning tedious and accuse the physician of poor skill, often refusing to believe in the medicine. They do not realize that effective questioning is difficult; only a skilled physician can ask questions well. If one were to discard three of the four diagnostic methods—Inspection (Wang), Auscultation and Olfaction (Wen), Inquiry (Wen), and Palpation (Qie)—I fear even a divine healer would lose their efficacy. Such widespread issues are common, which explains why women's diseases are difficult to treat. Therefore, both physicians and patients should pay close attention to this.
The *Suwen: Shanggu Tianzhen Lun* states: "When a girl reaches fourteen years of age, Tian Gui (a subtle substance promoting reproductive development) arrives, the Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes vigorous. Menstruation occurs on time, enabling conception." Tian Gui refers to postnatal Yin Qi. When Yin Qi is sufficient, menstruation flows smoothly; this is what is called menstruation. Since the female body belongs to Yin, its Qi corresponds to the moon. The moon completes its cycle every thirty days, and menstruation arrives every thirty days, regularly and consistently, hence the name "Menstruation" (Yue Jing) or "Monthly Trust" (Yue Xin). "Jing" implies constancy. Once irregular, it loses its normal rhythm, leading to various diseases. Although menstrual blood is essentially Yin blood present in all organs, all blood from the Zang-Fu organs converges into the Chong Mai. As the Chong Mai is the "Sea of Blood" for the five Zang and six Fu organs, the text notes that when the Chong Mai is vigorous, menstruation occurs on time. This demonstrates that the Chong Mai is the root of menstruation. However, the transformation of Qi and Blood originates from Grain and Water (dietary nutrients). Abundant dietary intake leads to abundant Qi and Blood; deficient intake leads to deficiency. The "Sea of Grain and Water" resides in the Yangming Stomach Channel. Examining the *Suwen: Wei Lun*: "The Yangming Channel is the Sea of the Five Zang and Six Fu organs; it primarily moistens the Zong Jin (Major Sinews). The Zong Jin binds the bones and facilitates joint movement." The Chong Mai is the "Sea of the Twelve Primary Channels," primarily permeating and irrigating the muscle spaces (Xi Gu), merging with the Yangming at the Zong Jin. Yin and Yang converge at the Zong Jin, meeting at the Qichuan acupoint, with the Yangming serving as the leader. Thus, male essence and female blood descend through the anterior yin. This shows that the blood in the Chong Mai is ultimately transformed from Yangming dietary nutrients, and Yangming Stomach Qi is the root of the Chong Mai. Therefore, the root of menstruation lies in the Chong Mai, the Stomach Qi, and the source of transformation in the Heart and Spleen. Other factors such as the Seven Emotions (Joy, Anger, Worry, Thought, Sadness, Fear, Fright), Six Exogenous Pathogens (Wind, Cold, Summer-heat, Dampness, Dryness, Fire), and improper diet and lifestyle are all thieves damaging the Qi of the Heart, Spleen, and Stomach. One must know what to protect and what to eliminate; students of medicine should understand the correct approach here.