男女均禀天地之气而生，凡外感内伤之症，未尝不同，但女则别有调经、胎前、产后之
治，
所以别立一科也。男子之血宜静而不宜动，如或动焉，则吐血、衄血、泻血之病生矣。女子
之血宜动而不宜静，如或静焉，则经闭、血枯之病生矣。总而言之，调经专理气，补心脾为
主，盖血非气不行，心生血，脾统血也。胎前专以清热补脾为主，盖热清而胎安，脾健则不
堕也。产后专以大补气血，兼行滞为主，盖产后气血大虚，且有瘀滞，虽有诸症，皆以末治
，生化汤实为圣方也。知乎此，女科之大要得矣。
女人于少阴心脉动甚，其胎已结；若按之滑疾不散，胎必三月；但疾不散，五月可别；
左疾
为男，右疾为女。故《脉诀》云∶尺数关滑而寸盛，阳搏阴别而雀跃是也。若胎离经，或一
息二至三至，为将产之候。胎前脉宜洪数有力，若沉微者必难产，谓气血已败也。产后脉宜
缓小无力，忌实大弦牢者，谓脉与病反，邪气盛也。
经云∶女子二七而天癸至，冲任满盛，月事以时下，乃有子。故得其常候者为无病。苟
不及
期而经先行，或过期而后行，或一月而经再行，或数月而经一行，或闭而不行，或崩或漏，
皆失其常候，不可不调也。调治之法，热则清之，冷则温之，虚则补之，滞则行之，滑则固
之，下陷则举之，对症施治，以平为期。如芩、连、栀、柏，清经药也；丁、桂、姜、附，
温经药也；参、术、归、茯，补虚药也；川芎、归、附、青皮、元胡，行滞药也；牡蛎、赤
石脂、棕榈灰、侧柏叶，固涩药也；升麻、柴胡、荆芥、白芷，升举药也。随症用之，无不
效者矣。
妇人经候不调有三∶一曰脾虚，二曰冲任损伤，三曰脂痰凝塞，治之不可不审。脾胃虚
弱者
，经曰∶二阳之病发心脾，女子不月。夫二阳者，阳明胃也。胃主受纳五谷，长养血气，灌
溉
脏腑，流行经络，乃水谷之海，血气之母也，惟忧思虑则伤心，心气受伤，脾气失养，郁结
不通，腐化不行，所谓长养灌溉者，失其全矣，故脾胃虚弱，饮食减少，气日渐耗，血日渐
少，始有血枯、血闭及血少色淡，过期始行，数月一行之病。
冲任损伤者，经曰∶气以 之，血以濡之。故气行则血行，气止则血止也。女子之性，
执拗
偏急，忿怒妒忌，以伤肝气。肝为血海，冲任之系。冲任失守，血气妄行也。又褚氏曰∶女
子血未行，而强合以动其血，他日有难名之病。故女未及二七天癸之期，而男子强与之合；
或于月事未断之时，男子纵欲不已，冲任内伤，血海不固。由斯二者，为崩为漏，有一月再
行，不及期而行者矣。
脂痰凝塞者，盖妇人之身，内而肠胃开通，无所阻塞，外而经络流行，无所凝滞，则气
血和
畅，经水应期，惟彼肥硕者，脂膏充满，玄室之户不开；挟痰者，痰涎凝滞，血海之波不流
。故有过期而经始行，或数月而经一行，及为滞为带，为经闭，为无子之病。
男女都禀受天地之气而诞生，凡是外感或内伤引起的病症，并没有不同，只是女性另有调经、胎前、产后的治疗方法，所以单独设立妇科这一科。男子的血宜静不宜动，如果妄动，就会产生吐血、鼻出血、便血等病证。女子的血宜动不宜静，如果停滞，就会产生经闭、血枯等病证。总而言之，调经专门调理气机，以补益心脾为主，因为血没有气的推动就不能运行，心主生血，脾主统血。胎前治疗以清热和补脾为主，因为热清则胎安，脾健则胎不堕。产后治疗以大补气血，兼以行滞为主，因为产后气血大虚，且有瘀滞，虽然有各种症状，但都作为次要处理，生化汤实在是圣方。懂得这些，就掌握了妇科的大要。
女性在少阴心脉处跳动明显，说明胎已结；如果按之滑利疾速而不散，胎儿必为三个月；如果仅见疾速而不散，五个月可以辨别性别；左脉疾速为男，右脉疾速为女。所以《脉诀》说：尺部数脉、关部滑脉而寸部盛，阳脉搏指而阴脉有别，如雀跳跃，就是这个道理。如果胎气离经，或者一息二至三至，是将生产的征兆。胎前脉象宜洪数有力，如果沉微的必定难产，这是因为气血已经败坏。产后脉象宜缓小无力，忌实大弦牢，这是因为脉与病相反，邪气旺盛。
经文说：女子十四岁天癸至，冲任二脉满盛，月经按时来潮，才能受孕。所以符合正常规律的就是无病。如果不及期而经先行，或过期而后行，或一月行两次，或数月行一次，或闭经不行，或崩中漏下，都是失去了正常规律，不可不调治。调治的方法，热则清之，冷则温之，虚则补之，滞则行之，滑则固之，下陷则举之，对症施治，以平和为期。如黄芩、黄连、栀子、黄柏，是清经药；丁香、肉桂、干姜、附子，是温经药；人参、白术、当归、茯苓，是补虚药；川芎、当归、附子、青皮、元胡，是行滞药；牡蛎、赤石脂、棕榈灰、侧柏叶，是固涩药；升麻、柴胡、荆芥、白芷，是升举药。随症使用，没有不有效的。
妇人经候不调有三种：一是脾虚，二是冲任损伤，三是脂痰凝塞，治疗时不可不审慎。脾胃虚弱者，经文说：阳明胃与太阴脾的病发于心脾，女子会出现闭经。所谓二阳，就是阳明胃。胃主受纳五谷，长期滋养血气，灌溉脏腑，流行经络，是水谷之海，血气之母。只有忧思虑则伤心，心气受伤，脾气失养，郁结不通，腐化不行，所谓长期滋养灌溉的功能，就失去其完整性了，所以脾胃虚弱，饮食减少，气日渐耗损，血日渐减少，开始有血枯、血闭及血少色淡，过期始行，数月一行等病证。
冲任损伤者，经文说：气以煦之，血以濡之。所以气行则血行，气止则血止。女子的性情，执拗偏急，忿怒妒忌，会损伤肝气。肝为血海，冲任所系。冲任失守，血气妄行。又褚氏说：女子月经未行，强行交合以动其血，日后会有难以名状的病。所以女子未到十四岁天癸至的时期，男子强行与之交合；或在月经未断之时，男子纵欲不已，导致冲任内伤，血海不固。由于这两种情况，出现崩中漏下，有一月再行，不及期而行的病证。
脂痰凝塞者，大概妇人的身体，内而肠胃开通，无所阻塞，外而经络流行，无所凝滞，则气血和畅，经水应期。只有那些肥胖的人，脂膏充满，子宫之门不开；挟痰者，痰涎凝滞，血海之波不流。所以有过期而经始行，或数月而经一行，以及成为滞证、带下、经闭、不孕等病证。
Both men and women are born endowing the qi of heaven and earth. The syndromes caused by external contraction or internal injury are not different, but women have specific treatments for regulating menstruation, antenatal care, and postpartum care; therefore, a separate department (Gynecology) is established. Men's blood should be quiet rather than active; if it becomes active, diseases such as hematemesis (vomiting blood), epistaxis (nosebleed), and hematochezia (blood in stool) will arise. Women's blood should be active rather than static; if it becomes static, diseases such as amenorrhea (closure of menstruation) and blood dryness will arise. In summary, regulating menstruation focuses on regulating qi, with tonifying the Heart and Spleen as the main approach, because blood cannot circulate without qi, the Heart generates blood, and the Spleen controls blood. Antenatal treatment focuses on clearing heat and tonifying the Spleen, because when heat is cleared, the fetus is secure, and when the Spleen is strong, the fetus does not miscarry. Postpartum treatment focuses on greatly tonifying qi and blood, while simultaneously moving stagnation, because after childbirth, qi and blood are severely deficient, and there is often blood stasis. Although various symptoms may appear, they are treated as secondary; Shenghua Tang (Decoction for Generating Blood) is truly a sage prescription. Understanding this, one grasps the essentials of Gynecology.
When the Shaoyin Heart pulse beats vigorously in women, pregnancy has been conceived; if it feels slippery and rapid without dispersing upon palpation, the pregnancy is likely three months old; if only rapid without dispersing, the gender can be distinguished at five months; a rapid pulse on the left indicates a male fetus, and on the right, a female fetus. Thus, the *Mai Jue* (Pulse Classic) states: "Rapid pulse at the Chi position, slippery at the Guan position, and full at the Cun position; Yang pulse thunders while Yin pulse distinguishes itself, like a sparrow jumping." This refers to these phenomena. If the fetal qi deviates from the normal course, or if the pulse rate is two or three beats per breath, it is a sign of impending delivery. During pregnancy, the pulse should be surging, rapid, and forceful; if it is deep and faint, difficult delivery is certain, indicating that qi and blood have deteriorated. After childbirth, the pulse should be slow, small, and weak; a solid, large, wiry, or firm pulse is contraindicated, indicating that the pulse contradicts the condition and pathogenic qi is excessive.
The Classics state: "At fourteen years of age, Tian Gui (heavenly water/essence) arrives in women, the Chong and Ren meridians become full and abundant, menstruation occurs regularly, and conception becomes possible." Therefore, those who follow the normal pattern are disease-free. If menstruation comes early, late, twice a month, once every few months, stops completely, or presents as metrorrhagia (heavy bleeding) or leukorrhea with spotting, all represent a deviation from the normal pattern and require regulation. The methods of regulation are: clear heat if hot, warm cold if cold, tonify deficiency if weak, move stagnation if blocked, consolidate if slipping, lift sinking if prolapsed, treat according to the syndrome, and aim for balance. For example, Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), and Huangbai (Phellodendri Cortex) are heat-clearing menstrual regulators; Dingxiang (Caryophylli Flos), Rougui (Cinnamomi Cortex), Jiang (Zingiberis Rhizoma), and Fuzi (Aconiti Lateralis Radix Praeparata) are warming menstrual regulators; Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Danggui (Angelicae Sinensis Radix), and Fuling (Poria) are deficiency-tonifying agents; Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui, Fuzi, Qingpi (Citri Reticulatae Pericarpium Viride), and Yuanhu (Corydalis Rhizoma) are stagnation-moving agents; Muli (Ostreae Concha), Chishizhi (Halloysit Rubrum), Zonglühui (Caryotae Fibra Cinis), and Cebaiye (Platycladi Cacumen) are astringent agents; Shengma (Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Jingjie (Schizonepetae Spica), and Baizhi (Angelicae Dahuricae Radix) are lifting agents. Used according to the syndrome, they are invariably effective.
There are three types of irregular menstruation in women: first, Spleen deficiency; second, damage to the Chong and Ren meridians; third, obstruction by phlegm-fat. Treatment must be carefully considered. For those with Spleen-Stomach weakness, the Classics state: "Diseases of the Two Yangs originate in the Heart and Spleen, leading to amenorrhea in women." The "Two Yangs" refer to the Yangming Stomach. The Stomach governs the reception of grains, nourishing qi and blood over time, irrigating the zang-fu organs, and circulating through the collaterals; it is the sea of food and fluid and the mother of qi and blood. Only worry and overthinking injure the Heart; when Heart qi is injured, Spleen qi loses nourishment, leading to depression and blockage, failure of transformation and transportation. Consequently, the function of long-term nourishment and irrigation is lost. Thus, Spleen-Stomach weakness leads to reduced appetite, gradual consumption of qi, gradual depletion of blood, resulting initially in blood dryness, blood closure, pale blood color, delayed onset of menstruation, and infrequent menstruation.
Regarding damage to the Chong and Ren meridians, the Classics state: "Qi warms, and blood moistens." Therefore, when qi moves, blood moves; when qi stops, blood stops. Women's temperament is often stubborn and impatient; anger and jealousy can injure Liver qi. The Liver is the Sea of Blood and is connected to the Chong and Ren meridians. When the Chong and Ren lose their control, qi and blood flow recklessly. Additionally, Chu Shi stated: "If intercourse forcibly stimulates the blood before menstruation has begun, obscure diseases will arise later." Thus, if men force intercourse with girls before they reach the age of fourteen when Tian Gui arrives, or if men indulge in lust while menstruation has not yet ceased, internal injury to the Chong and Ren occurs, and the Sea of Blood becomes insecure. Due to these two factors, metrorrhagia and leukorrhea with spotting occur, including menstruation twice a month or coming early.
Regarding obstruction by phlegm-fat: generally, in women's bodies, if the intestines and stomach are open without obstruction, and the collaterals circulate freely without stagnation, then qi and blood are harmonious and smooth, and menstruation arrives on schedule. However, in obese individuals, fat fills the body, and the opening of the uterus remains closed; in those with phlegm, phlegm-saliva stagnates, and the waves of the Sea of Blood do not flow. Thus, conditions such as delayed menstruation, infrequent menstruation, stagnation syndromes, leukorrhea, amenorrhea, and infertility arise.