素问曰。女子二七而天癸至。任脉通。太冲脉盛。月事以时下。故有子。七七任脉虚。太冲脉衰少。天癸竭。地
道不通。故形坏而无子。盖天癸者。女子之精。月事者。女子之血。谓血为月事者。以事应月也。谓血为月经
者。以月为常也。后人谓先期而至者为热。后期而至者为寒。其实先期有虚实。后期亦有虚实。故先不可
偏用寒。后不可偏用热。而况有先后不定。通闭无常者乎。况有避年居季。逆行暗行。盛胎漏胎者乎。然则
就形色而诊者。是或一道也。诊之之法。诸书以为根据期消长为安。血红不结为正。来去失时为弱。色杂而
凝为病。浓而多者血盛。淡而少者血衰。赤而紫者属热。淡而红者属虚。陷经漏下。黑不解者。治用胶姜。以
其下寒也。行经暴下。血去多者。则为夺血。以其中虚也。鲜紫而成块成条者。多由血热。黑败而或散或抟
者。必属虚寒。成块者气之滞。疼痛者血之凝。行后作痛者为虚。将行作痛者为实。非时血下。淋沥不止者。
谓之漏下。忽然暴下。倾注不断者。谓之崩中。至若如屋漏水。如豆汁水者。前人谓其病气实。而属于湿。吾
直以为形气虚。而感于寒。然必参之脉证。合之形容。以辨其虚实。而判其寒热焉。若夫五崩之诊。王氏脉
经以为白崩者形如涕。赤崩者形如绛津。黄崩者形如烂瓜。青崩者形如蓝色。黑崩者形如 血。释之者
曰。五色带下。伤肝则青如泥色。伤心则赤如红津。伤肺则白如鼻涕。伤脾则黄如烂瓜。伤肾则黑如 血。
五色各应五脏。五脏俱虚。五色并下。是皆血之为病也。愚谓带之为病属乎任。经之为病属乎冲。而经色
之分。又当以红紫辨寒热。浓淡分虚实。鲜败分新久。六法合观。则红紫浓淡鲜败之变。皆可交推以解。而
其寒热虚实新久之变。亦可错综而知。第色虽属望。而理不容观。其将因问而得欤。医为司命。尚其毋忽。
《素问》说：女子到了十四岁，天癸（促进生殖功能成熟的物质）到来。任脉通畅，太冲脉气血旺盛，月经按时来潮，所以能够怀孕生子。到了四十九岁，任脉气血虚弱，太冲脉气血衰少，天癸枯竭，地道（指胞宫、月经通道）不通畅，所以身体衰老而不能生育。大概天癸是女子的精气，月事是女子的血液。称血液为“月事”，是因为它应和月份周期；称血液为“月经”，是因为它以月为常规周期。后人认为提前来潮的是热证，推后来潮的是寒证。其实提前也有虚证和实证，推后也有虚证和实证。所以不能对提前者偏用寒凉药，也不能对推后者偏用温热药。更何况有先后不固定、通闭无常的情况呢？何况有避年（一年一行经）、居季（三年一行经）、逆行（倒经）、暗行（经期无出血但受孕）、盛胎（妊娠期间仍有少量周期性出血）、漏胎（妊娠期阴道持续少量出血）等情况呢？然而，通过观察面色和经血形色来进行诊断，也是一种方法。诊断的方法，各种医书认为根据经期长短变化来判断是否安稳，经血红活不凝结是正常的，来去失去时间规律的是虚弱，颜色杂乱且凝结的是病态，浓稠量多的是血盛，淡少的是血衰，色赤紫的是属热，色淡红的是属虚。陷经（经血下陷不止）漏下，黑色不解的，治疗用胶姜汤，因为这是下焦虚寒所致。行经时暴下，失血多的，称为夺血，因为这是中气虚损所致。鲜紫色并成块成条的，多由血热引起；黑败色且或散或聚的，必属虚寒。成块的，是气机阻滞；疼痛的，是血液凝滞。经后作痛的是虚证，经前作痛的是实证。非经期出血，淋沥不止的，称为漏下。忽然暴下，倾注不断的，称为崩中。至于像屋漏水、像豆汁水一样的，前人认为其病气实而属于湿，我直接认为是形气虚而感于寒。但必须参考脉象和症状，结合形体表现，来辨别虚实，判断寒热。至于五崩的诊断，《王氏脉经》认为白崩形状如鼻涕，赤崩形状如深红色的津液，黄崩形状如烂瓜，青崩形状如蓝色，黑崩形状如瘀血。解释的人说：五色带下，伤肝则青色如泥色，伤心则红色如红津，伤肺则白色如鼻涕，伤脾则黄色如烂瓜，伤肾则黑色如瘀血。五色各对应五脏，五脏都虚，五色并下，这些都是血液引起的疾病。我认为带下病属于任脉，经病属于冲脉。而经色的区分，又应当以红紫辨别寒热，以浓淡分辩虚实，以新鲜败坏分辨新久。六法合观，那么红紫浓淡鲜败的变化，都可以相互推断来解释，而其寒热虚实新久的变化，也可以错综地知晓。虽然颜色属于望诊范畴，但道理不容轻视，这难道不是需要通过问诊来获得吗？医生掌管人的生死，千万不要忽视。
The *Suwen* states: When a girl reaches fourteen years of age, Tian Gui (substances that promote reproductive function and maturity) arrives. The Ren Mai (Conception Vessel) becomes unobstructed, and the Chong Mai (Penetrating Vessel) becomes abundant in Qi and Blood. Menstruation occurs at regular intervals, thus enabling conception. By forty-nine years of age, the Ren Mai becomes deficient, the Chong Mai declines in Qi and Blood, Tian Gui is exhausted, and the Di Dao (uterine cavity and menstrual pathway) becomes obstructed. Consequently, the body deteriorates, and childbearing ceases. Generally speaking, Tian Gui refers to the Jing Essence of women, while Yue Shi (menstrual blood) refers to the Xue Blood of women. It is called "Yue Shi" because it corresponds to the lunar month cycle; it is called "Jing Yue" because it follows a monthly regularity. Later generations believed that early onset indicates Heat syndrome, while late onset indicates Cold syndrome. In reality, early onset can be either Deficiency or Excess, just as late onset can be either Deficiency or Excess. Therefore, one should not exclusively use Cold-natured herbs for early onset, nor exclusively use Warm-natured herbs for late onset. Moreover, there are cases where the timing is irregular, and the flow alternates between obstruction and free flow. Furthermore, there are conditions such as Bi Nian (menstruation occurring once a year), Ju Ji (menstruation occurring once every three years), Ni Xing (retrograde menstruation, e.g., epistaxis during menses), An Xing (conception without visible menstruation), Sheng Tai (cyclic bleeding during pregnancy resembling menstruation), and Lou Tai (persistent slight vaginal bleeding during pregnancy). However, diagnosing based on complexion and the appearance of menstrual blood is indeed one valid approach. The methods of diagnosis hold that stability is determined by the regularity of the cycle; red, vibrant, and non-clotted blood is normal; irregular timing indicates weakness; mixed colors with clots indicate pathology; thick and abundant blood indicates Excess of Blood; pale and scanty blood indicates Deficiency of Blood; red-purple color belongs to Heat; pale-red color belongs to Deficiency. In cases of Xian Jing (prolapsed menstruation) with persistent leakage, if the blood remains black and does not resolve, treatment employs Jiao Jiang Tang (Gelatin and Ginger Decoction) because this indicates Lower Jiao Deficiency-Cold. During menstruation, if there is sudden profuse bleeding leading to significant blood loss, it is termed Duo Xue (Loss of Blood), indicating Middle Jiao Deficiency. Bright purple blood forming clots or strips is mostly due to Blood Heat; dark, spoiled blood that is either scattered or aggregated must belong to Deficiency-Cold. Clots indicate Qi Stagnation; pain indicates Blood Stasis. Pain occurring after menstruation indicates Deficiency; pain occurring before menstruation indicates Excess. Non-menstrual bleeding that drips continuously is called Lou Xia (Leaking Down); sudden profuse bleeding that pours without stopping is called Beng Zhong (Central Collapse). As for discharge resembling leaking roof water or bean dregs, predecessors considered it an Excess of pathogenic Qi belonging to Dampness, whereas I directly consider it a Deficiency of Form and Qi caused by Cold invasion. However, one must refer to the Pulse and Symptoms, and combine them with physical appearance, to differentiate Deficiency from Excess, and determine Cold from Heat. Regarding the diagnosis of Wu Beng (Five Types of Collapse), Wang’s *Mai Jing* states: White Beng resembles mucus; Red Beng resembles dark red fluid; Yellow Beng resembles rotten melon; Green Beng resembles blue color; Black Beng resembles congealed blood. Commentators explain: Five-colored leukorrhea: injury to the Liver results in green like mud; injury to the Heart results in red like red fluid; injury to the Lung results in white like nasal mucus; injury to the Spleen results in yellow like rotten melon; injury to the Kidney results in black like congealed blood. Each of the five colors corresponds to the Zang Organs. If all five Zang Organs are deficient, all five colors appear together. These are all diseases arising from Blood. I believe that leukorrhea disease pertains to the Ren Mai, while menstrual disease pertains to the Chong Mai. The differentiation of menstrual color should further distinguish Cold and Heat by red versus purple, Deficiency and Excess by thickness versus paleness, and new versus old by freshness versus spoilage. Observing these six aspects comprehensively allows one to deduce changes in red/purple, thick/pale, fresh/spoiled, and consequently understand the variations in Cold/Heat, Deficiency/Excess, and New/Old. Although color observation falls under Wang Zhen (Inspection), the underlying principles cannot be ignored. Is this not knowledge obtained through Wen Zhen (Inquiry)? Physicians hold the lives of people in their hands; they must not neglect this.