bubble_chart Concept

During menstruation, most women experience a sudden cessation of menstruation on the first or second day due to certain reasons, which is called "sudden cessation of menstruation." For example, Jingui Yaolue records, "Women with Zabing pulse syndrome and treatment mention, 'Women with philtrum wind, after seven or eight days, continue to have chills and fever, occurring at certain times, and the menstrual flow suddenly stops,...'" Jingyue Quanshu states in the rules for women: "Women with cold-damage disease... coinciding with menstruation, leading to heat entering the uterus, or continuous bleeding, or cessation of bleeding..." Song Dynasty's Chen Zi-ming in Furen Liangfang Daquan under the section on regulating menstruation refers to it as "menstruation starting and stopping" or "Jingmai suddenly ceasing," all referring to this condition. This condition is different from the concept of "amenorrhea." Sudden cessation of menstruation refers to the abrupt interruption of menstrual flow during menstruation, while "amenorrhea" refers to the absence of menstruation when it is due, not occurring for several months. There is a clear distinction between the two. Women experiencing intermittent menstrual flow during menstruation, stopping and starting again; or sudden cessation of lochia after childbirth, are not within the scope of discussion for this condition.

bubble_chart Pattern Analysis

1. Heat Entering the Blood Chamber︰Sudden cessation of menstruation, hardness and fullness in the lower abdomen or chest and hypochondrium. Fever and chills, or alternating chills and fever, bitter taste in the mouth, and dry throat. The tongue texture is reddish, and the pulse is wiry and rapid. During menstruation, women are affected by wind-cold or warm-heat pathogens, which take advantage of the weakened state to invade the blood chamber and contend with menstrual blood, leading to the abrupt cessation of menstruation. Symptoms include fever and chills, or alternating chills and fever, hardness and fullness in the hypochondrium, and stabbing pain in the abdomen. Treatment may involve acupuncture at Qimen (Liv 14) to drain the pathogen, along with Minor Bupleurum Decoction to clear heat from the blood chamber.
2. Cold Evil Congealing and Stagnation︰The sudden cessation of menstrual flow, accompanied by colicky pain in the lower abdomen, or cold pain that resists pressure, cold limbs, normal tongue texture, white and moist tongue coating, and a deep, tight pulse. $The sudden cessation due to cold congealing and stagnation versus the sudden cessation due to static blood obstruction! Both are excess patterns, with disease causes and mechanisms that are interconnected yet distinct. Jingyue Quanshu and *Furen Gui* state: "During menstruation, it is strictly forbidden to consume cold or cooling medications, as this may lead to emaciation due to improper food intake." Zhubing Yuanhou Lun, in the *Furen* Zabing section, states: "Blood becomes congested and stagnant when exposed to cold." If menstruation is ongoing but excessive consumption of raw or cold foods or the use of cold-cooling medications occurs, cold invades the uterus with appendages; or if during menstruation one is exposed to rain or wades through water, allowing cold to invade the Chong vessel due to deficiency-type inward invasion, the menstrual flow will abruptly cease. The lower abdominal colicky pain is alleviated by warmth, accompanied by a pale face, bluish lips, cold limbs, and a chilly back, with a deep, tight pulse. The disease mechanism emphasizes "cold," as *The Complete Compendium of Medical Consultations* refers to it as "cold invading the uterus." Treatment should focus on warming yang to promote blood circulation and regulate menstruation, using Cinnamon Twig and Peach Kernel Decoction or Meridian-Warming Decoction with modifications. The cause of sudden cessation due to static blood obstruction is related to careless daily habits during menstruation, leading to cold congealing and blood stagnation. The disease mechanism emphasizes "stasis." Abdominal pain is more severe, presenting as distending pain or stabbing pain that resists pressure, along with a dull complexion, purplish-dark tongue texture, and a choppy pulse. Treatment should aim to resolve stasis and unblock menstruation, using Lesser Abdomen Stasis-Expelling Decoction with modifications.
3. Static Blood︰Sudden cessation of menstrual flow, lumbar abdominal distension and fullness pain or stabbing pain, aggravated by pressure, dark purple tongue, and deep hesitant pulse. Both cold congealing and stagnation leading to sudden cessation of menstruation and static blood obstruction causing sudden cessation of menstruation are excess patterns, with interconnected yet distinct disease causes and mechanisms of disease. Jingyue Quanshu and *Furen Gui* state: "During menstruation, it is strictly forbidden to consume cold or cooling medications, as this may lead to emaciation due to improper food intake." Zhubing Yuanhou Lun, *Furen* Zabing Lunhou, says: "Blood becomes congested and stagnant when exposed to cold." If menstruation is ongoing but excessive consumption of raw or cold foods or the use of cold-cooling drugs occurs, cold may invade the uterus with appendages; or if one is exposed to rain or wades through water during menstruation, cold may take advantage of deficiency-type inward invasion to enter the thoroughfare vessel, causing the menstrual flow to suddenly stop. Lower abdominal colicky pain is alleviated by warmth, accompanied by a pale face, bluish lips, cold limbs, and a chilly back, with a deep and tight pulse. The mechanism of disease focuses on "cold," as *The Complete Compendium of Medical Consultations* terms it "cold invading the uterus." Treatment should focus on warming yang to promote blood circulation and regulate menstruation, using Cinnamon Twig and Peach Kernel Decoction or Meridian-Warming Decoction with modifications. The cause of static blood obstruction leading to sudden cessation of menstruation is related to careless daily activities during menstruation and cold congealing blood stagnation, with the mechanism of disease emphasizing "stasis." Abdominal pain is more severe, presenting as distending pain or stabbing pain, aggravated by pressure, along with a dull complexion, purple-dark tongue texture, and a hesitant pulse. Treatment should focus on resolving stasis and unblocking menstruation, using Lesser Abdomen Stasis-Expelling Decoction with modifications.
4. Liver Qi Depression︰Sudden cessation of menstrual flow, distension and fullness in both flanks and lower abdomen. The tongue texture is normal with thin white coating, and the pulse is deep and wiry. This condition results from emotional distress, liver qi stagnation, and qi stagnation with blood stasis, leading to the obstruction of menstrual flow. It often occurs during menstruation, presenting not only with abrupt cessation of menstruation but also with symptoms such as distension in the chest, flanks, and breasts, lower abdominal distension and fullness, belching, hiccups, and poor appetite—all signs of constrained liver qi. Treatment should focus on moving qi to relieve stagnation, primarily using modified Lindera Powder.

The symptom of sudden cessation of menstruation is clinically more often associated with excess pattern, especially those caused by heat entering the uterus. Regarding the treatment of heat entering the uterus, many medical practitioners throughout history have advocated for the use of Zhongjing's Minor Bupleurum Decoction to clear and resolve pathogenic heat. However, Ye Tian-shi believed that one should not be confined to the use of Minor Bupleurum Decoction alone. He once proposed the use of Tao's Minor Bupleurum Decoction or Cinnamon TwigPeach Blossom Decoction with modifications for treatment, which indeed reflects his clinical insights.

bubble_chart Documentation

1. "Wang Weichuan's Experience in Gynecological Treatment": "Generally, during the actual menstruation or just after it begins, encountering high fever can lead to a tendency of amenorrhea, which the ancients referred to as heat entering the uterus. However, during menstruation, if one is exposed to cold water, it can also cause temporary amenorrhea, which could be termed as cold invading the uterus, an issue not considered by the ancients. There are also instances where encountering terrifying situations can lead to amenorrhea. For example, during the Nanjing Massacre in the Anti-Japanese War, it caused temporary amenorrhea among women throughout the city." (Dr. Shen Manli)