凡病起于血气之衰,脾胃之虚。而产后尤甚。是以丹溪先生论产后,必大补气血为先,虽有他症,以末治之,
斯言尽治产之大旨。若能扩充立方,则治产可无过矣。夫产后忧、惊、劳、倦,气血暴虚,诸症乘虚易入,如有气
毋专耗散,有食毋专消导;热不可用芩、连,寒不可用桂、附;寒则血块停滞,热则新血崩流。至若中虚外感,见三
阳表症之多,似可汗也,在产后而用麻黄,则重竭其阳;见三阴里症之多,似可下也,在产后而用承气,则重亡阴
血。耳聋胁痛,乃肾虚恶露之停,休用柴胡。谵语出汗,乃元弱似邪之症,非同胃实。厥由阳气之衰,无分寒热,
非大补不能回阳而起弱。痉因阴血之亏,不论刚柔,非滋荣不能舒筋而活终。乍寒乍热,发作无期,症似疟也,若
以疟治,迁延难愈。言论无伦,神不守舍,病似邪也,若以邪治,危亡可待。去血过多而大便燥结,肉苁蓉加于生
化,非润肠承气之能通。去汗过多而小便短涩,六君子倍加参、 ,必生津助液之可利。加参生化汤频服,救产后
之危;长生活命丹屡用,苏绝谷之人。 疝脱肛,多是气虚下陷,补中益气之方,口噤拳挛,乃因血燥类风,加参
生化之剂。产户入风而痛甚,服宜羌活养荣汤。玉门伤凉而不闭,洗宜 儿黄硫散。怔忡惊悸,生化汤加以定志。似邪恍
惚,安神丸助以归脾。因气而闷满虚烦,生化汤加木香为佐。因食而嗳酸恶食,六君子加神曲、麦芽为良。苏木、莪术 大
能破血;青皮、枳壳,最消满胀。一应耗气破血之剂,汗吐宣下之法,只可施诸壮实,岂宜用于胎产。大抵新产后,先
问恶露如何,块痛未除,不可遽加参术;腹中痛止,补中益气无疑。至若亡阳脱汗,气虚喘促,频服加参生化汤,是从
权也。又如亡阴火热,血崩厥晕,速煎生化原方,是救急也。王太仆云∶“治下补下,治以急缓,缓则道路达而力微,急
则气味浓而力重。”故治产当遵丹溪而固本,服法宜效太仆以频加。凡付生死之重寄,须着意于极危;欲求俯仰之无亏,
用存心于爱物。此虽未尽产症之详,然所闻一症,皆援近乡治验为据,亦未必无小补云。
Any disease originates from the decline of blood and qi, and the deficiency of the spleen and stomach. This condition is particularly severe postpartum. Therefore, when Master Zhu Danxi discussed postpartum conditions, he emphasized that tonifying blood and qi must be the primary priority; even if other symptoms exist, they should be treated as secondary concerns. This statement encapsulates the fundamental principle of treating postpartum disorders. If one can expand upon this to formulate prescriptions accordingly, there will be no errors in treating postpartum conditions.
Postpartum anxiety, fright, fatigue, and overwork lead to a sudden and severe depletion of blood and qi, making various pathological factors prone to invading due to this deficiency. In such cases, if there is qi stagnation, one should not exclusively use dispersing agents; if there is food retention, one should not exclusively use digestive aids. For heat patterns, one must not indiscriminately use Scutellariae Radix (Huangqin) and Coptidis Rhizoma (Huanglian); for cold patterns, one must not indiscriminately use Cinnamomi Ramulus (Guizhi) and Aconiti Lateralis Radix Praeparata (Fuzi). Cold causes blood stasis to stagnate, while heat may cause fresh blood to hemorrhage.
Regarding exterior deficiency with external pathogenic invasion, if there are many Taiyang, Yangming, and Shaoyang exterior symptoms, sweating might seem appropriate; however, using Ephedrae Herba (Mahuang) postpartum would severely deplete yang qi. If there are many Taiyin, Shaoyin, and Jueyin interior symptoms, purging might seem appropriate; however, using Chengqi Decoction variants postpartum would severely damage yin blood.
Deafness and hypochondriac pain result from kidney deficiency and lochia retention; do not use Bupleuri Radix (Chaihu). Delirium and sweating indicate a pattern of yuan qi weakness resembling pathogenic interference, which is different from Stomach excess heat syndrome. Limb coldness (Jue) is caused by the decline of yang qi; regardless of cold or heat patterns, only major tonification can restore yang and revive the weak body. Spasms (Jing) are due to yin blood deficiency; whether rigid or flaccid spasms, only nourishing the nutritive level can relax the sinews and restore vitality.
Alternating chills and fever without a fixed schedule resemble malaria; if treated as malaria, the condition will linger and be difficult to cure. Disordered speech and loss of mental possession resemble demonic influence; if treated as such, death may ensue quickly. Excessive blood loss leading to dry, hard stools requires adding Cistanche Herba (Roucongrou) to Shenghua Decoction; this cannot be achieved by Run Chang Chengqi Decoction alone. Excessive sweating leading to scanty, dysuric urine requires doubling the dosage of Ginseng Radix et Rhizoma (Renshen) and Poria (Fuling/Baizhu - *text missing specific herb but implies tonification*) in Liu Junzi Decoction; only generating fluids and assisting yin can promote urination. Frequent administration of Renshen-added Shenghua Decoction saves critical postpartum emergencies; repeated use of Changsheng Huoming Pill revives those on the verge of death from starvation/collapse.
Hernia and rectal prolapse are mostly due to qi deficiency with sinking; Buy Zhong Yi Qi Tang is indicated. Trismus and clenched fists resemble wind patterns due to blood dryness; Renshen-added Shenghua Decoction is indicated. Severe pain in the vaginal introitus due to wind invasion requires Qianghuo Yangrong Decoction. Cold injury to the vulva causing failure to close requires washing with Erhuangliu San. Palpitations and fright require adding Dingzhi Wan to Shenghua Decoction. Mental confusion resembling demonic influence requires Anshen Wan assisted by Guipi Decoction. Chest fullness and empty irritability due to qi stagnation require adding Aucklandiae Radix (Muxiang) as an assistant to Shenghua Decoction. Belching of sour taste and aversion to food due to food retention require adding Medicated Leaven (Shenqu) and Hordeum Fructus Germinatus (Maiya) to Liu Junzi Decoction.
Lignum Sappan Wood (Sumu) and Curcumae Rhizoma (Ezhu) strongly break blood stasis; Citri Reticulatae Pericarpium (Qingpi) and Aurantii Fructus (Zhike) best eliminate distension. All formulas that consume qi and break blood, as well as methods of sweating, vomiting, promoting circulation, and purging, are only suitable for robust individuals and certainly not for pregnancy or postpartum states.
Generally, immediately after childbirth, first inquire about the lochia. If blood clots and pain persist, do not hastily add Codonopsis Radix (Dangshen/Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu). If abdominal pain has ceased, using Buy Zhong Yi Qi Tang is undoubtedly correct. For yang collapse with sweating and qi deficiency with panting, frequent administration of Renshen-added Shenghua Decoction is a provisional measure. For yin collapse with fire heat, hemorrhage, syncope, and dizziness, rapidly decocting the original Shenghua Decoction is an emergency rescue.
Wang Bing (Wang Taipu) stated: "When treating lower jiao diseases, the urgency determines the method. If slow, the medicinal power is weak like a distant journey; if urgent, the flavor is strong and the power heavy." Therefore, treating postpartum conditions should follow Danxi's principle of consolidating the root, and the method of administration should emulate Taipu's principle of frequent dosing. Physicians entrusted with life-and-death responsibilities must pay special attention to critical cases; to achieve peace of mind, one must harbor compassion for all living beings. Although this does not exhaustively detail all postpartum syndromes, every symptom mentioned is based on clinical experiences from nearby regions, offering perhaps some minor benefit.