病患服前药，胸膈不满闷者，此上焦有阳也。或药力太过，上焦有热。腹满虚鸣，时时疼痛，此是被阳药
消，逐得上焦阴气并入下焦也，虽是下焦积寒冷，奈上焦阳盛，更难用温下焦药也，当用灰包熨之。其法用稻
草灰或桑柴灰二三升许，入好醋拌和，干湿得所，铫内炒，令灰热，以帛包裹，置脐下熨之。频先炒灰包，常
更换，令常热，以腹不满痛为度。初熨时病患不受者，勿听，但令亟熨之不住可也。如灰包熨后，得下利三两
行，或小便二三升，或微似有汗，此是阴气外出或下泄也，勿疑之。病轻者，乃得愈，后出余气而解。病患三
部脉沉，寸脉小于关尺，此为阴盛，当温中药以消阴气，宜浓朴丸。
浓朴丸
人参 白术 浓朴 陈皮 藿香 当归 细辛
神术汤，亦同治。阴躁而渴，不可误用凉药。若热药冷服，内有伏阳则可。若脉已虚，按之全无力，
或病患素无食养者，只可温服。
〔《保》〕妇人童幼，天癸未行之间，皆属少阴；天癸既行，皆属厥阴；天癸既绝，乃属太阴经也。治胎
产之病，从厥阴者，是祖气生化之原也。厥阴与少阳相表里，故治法无犯胃气，及上二焦，为三禁，不可汗，
不可下，不可利小便。若发汗者，同伤寒下早之症；利大便，则脉数而已动于脾；利小便，则内亡津液，胃中
枯燥。制药之法，能不犯此三禁，则荣卫自和而寒热止矣。外则和于荣卫，内则调于清便，先将此法为初治。
次后详而论之，见症消息。同坏症伤寒，为之缓治。或小便不利、大便秘结，或积热于肠胃之间，或已成痿，
或散血气而为浮肿，盖产理多门，故曰同伤寒坏症。如发渴而用白虎，气弱而用黄 ，血刺痛而用当归，腹痛
而加芍药。以上例症，不犯三禁，谓产后之久病也。若产后暴病，又不可拘也。如产后热入血室者，用桃仁承
气、抵当汤等药；胃坚燥者，大承气，不可以泄药言之。产后世人多用乌金四物汤，是不分四时之寒热，不分
血气之虚实，盲然一概用药，如此而愈加增剧，是误也。大抵产病天行则增损柴胡，杂症则加减四物。又春夏
从柴胡，秋冬从四物。药性寒热，病症虚实，不可不察也。四物汤常宜服饵，令立四时增损法于后。
四物汤加减治妇人杂病。（四物汤见治虚实法。）
春倍川芎。（一曰春，二曰脉弦，三曰头痛。）夏倍芍药。（一曰夏，二曰脉洪，三曰泄。）秋倍地黄。
（一曰秋，二曰脉涩，三曰血虚。）冬倍当归。（一曰冬，二曰脉沉，三曰寒而不食。）若脐下虚冷腹痛，
及腰脊间闷痛，宜玄胡六合∶四物汤四两，玄胡、苦楝各一两。（炒焦。）
若小腹痛，亦用玄胡六合。若气滞经脉，故月事频并，脐下多痛，宜芍药六合∶四物汤四两，芍药
一两。若腹中刺痛，恶物不下，加当归、芍药。若妇人血虚，心痛腹 痛不可忍者，去地黄，加干姜，
名四神汤。若血崩者，加生地黄、蒲黄。若血藏虚冷崩中，去血过多，加胶艾。若赤白带下，
宜香桂六合汤∶四物汤四两，桂
枝香、附各五钱。若以四物汤为末，炼蜜丸如桐子大，空心米饮下三四十丸，治高年妇人白带，良验。若以四
物汤四两，加甘草半两，蜜丸，每两分作八丸，酒醋共半盏，用温汤化下，名当归煎。去败血，生
好血。若妇人血积者，四物汤加广术、京三棱、桂心、干漆各一两。若妇人筋骨肢节痛，及头痛，脉弦，憎
寒如疟，宜 治风六合∶四物汤四两，羌活、防风各一两。若妇人或因伤酒，或因产亡血，或虚劳五心烦
热者，宜四物二连汤∶四物汤四两，生地黄、生黄连、胡黄连各一两。若妇人骨蒸，加地骨皮、牡丹皮。
若妇人伤寒，汗下后饮食减少，虚者宜八物汤∶四物汤四两，黄 、甘草、茯苓、白术各一两。
凡妇人百病，只四物汤加吴茱萸煎。若阳藏少使茱萸，阴藏多使茱萸，无不效者。
上加减杂病例。
若保胎气，令人有子，四物与缩砂四君子汤各半，名八珍汤。若妊娠胎动不安，下血不止者，加艾十叶、
阿胶五钱、葱白、黄 。四物汤加减，治妊娠伤寒，名六合汤，方一十五道。（方见伤寒部。）四物汤加减
调经方七道。（见调经部。）
上加减治胎前病例。
若产后一月内，恶物积滞，败血作病，或胀或痛，胸膈胀闷，或发寒热，四肢疼痛，加延胡索、没药、香
白芷，与四物等分，为细末，淡醋汤或童便调下。若血风于产后乘虚发作，或产后伤风，头痛发热，百节疼
痛，加荆芥穗、天麻、香附、石膏、藿香各二钱半，四物料共一两中加之，水煎服。若产后虚劳，日久而
脉浮疾，宜柴胡四物汤。
川芎 熟地 当归 芍药 加柴胡 人参 黄芩 甘草 半夏曲（各三钱）
上 咀，水煎服。
若产妇诸症，各随六经，以四物与仲景药各半服之，其效如神。
〔海〕芎归汤 治一切去血过多，眩晕闷绝，伤胎去血，产后崩中去血，拔牙去血，金疮去血不止者，举头欲
倒，
悉能治之。
当归 川芎（各等分）
上每服五钱，水煎服，不拘时。若产后眩晕，加芍药。产后腹痛不可忍，加官桂、童便，酒浸。妊娠
子死，或不死胎动，酒水合煎即下，未死者即安。若虚损腹痛少气，头眩自汗，每服加羊肉一两，生姜十
片，水煎。若临月服之，则缩胎易生。若室女妇人心腹 痛，经水不调，水煎服。若妊娠胎气不安，产后诸
疾，酒煎服。若难生倒横，子死腹中，先用黑豆一大合，炒热，与小便合煎服。若难产，用百草霜、香白
芷等分，童便、好醋各一，沸汤浸服。甚者再服，即分娩矣。若伤藏毒，每服加槐花末五分，三日取下血
块即愈。若吐血，亦服此。若血气上喘下肿，空心，煎艾汤调下。若产后恶血注心，迷闷，喘急腹痛，
根据前用黑豆加生姜自然汁，煎服。若产后头痛，加荆芥。若崩中漏下，失血不止，加炒香附，每两入甘草
一钱，沸汤点服。若有白带者，加芍药半两，干姜等分，米饮调下。
〔《保》〕诸六合治妇人常病，及产后常用之药。治妇人虚劳，《局方》中谓首尾六合，如大圣散、熟
地黄丸，是治无热虚劳也。中道药牡丹煎丸空心食前，人参荆芥散临卧食后，是治有热虚劳也。（大圣散、
熟地黄丸、人参荆芥散、牡丹煎丸并见《局方》，然亦当参考药味用之。）
〔丹〕妇人以血为主，血属阴，易于亏欠。若非善调摄者，不能保全也。神仙聚宝丹治血海虚寒，虚热盗
汗，理宜补养，琥珀之燥，麝香之散，可以用乎？面色痿黄，肢体浮肿，理宜导湿，乳香、没药，固可治血，
可以用乎？胎前、产后虚实不同，逐败养新，攻补难并，积块坚症，赤白漏崩，宜于彼者，必妨于此，而
欲一方通治可乎？世人以其品贵名雅，又喜其常服，可以安神去邪，令人有子，殊不知久服者无不有祸，
自非脏腑能言，医者终不知觉，及至变生他病，何曾归咎此丹？予侄女形色俱实，迟于得子，久服此丹，
痈发于背，症候甚危，脉散大而涩，急以四物汤加减百余帖而安。
If the patient, after taking the previous medicine, does not feel distension or stuffiness in the chest and diaphragm, this indicates that there is Yang Qi in the Upper Jiao (Upper Burner). Or perhaps the medicinal force was too strong, causing heat in the Upper Jiao. Abdominal distension with empty borborygmus and frequent pain indicates that the warming-Yang medicines have consumed and driven the Yin Qi from the Upper Jiao into the Lower Jiao. Although there is accumulated cold in the Lower Jiao, because the Yang Qi in the Upper Jiao is abundant, it is difficult to use medicines to warm the Lower Jiao directly; instead, one should use the method of applying hot ash bags. The method is as follows: take about two or three sheng of rice straw ash or mulch wood ash, mix it well with good vinegar until the moisture content is appropriate, stir-fry it in a ding (a type of cauldron) until the ash becomes hot, wrap it in cloth, and apply it below the umbilicus for moxibustion-like heating. Frequently re-heat the ash bags and replace them often to maintain constant heat, stopping when the abdominal distension and pain subside. If the patient cannot tolerate the heat at the beginning, do not heed their complaints; simply ensure they continue the application. After applying the hot ash bag, if the patient passes stool two or three times, urinates two or three sheng, or sweats slightly, this indicates that Yin Qi is moving outward or downward for excretion; do not doubt this. For mild cases, the disease will resolve as residual pathogenic factors are expelled. If the pulse at all three positions (Cun, Guan, Chi) is deep, and the Cun pulse is smaller than the Guan and Chi pulses, this indicates excess Yin. One should use middle-jiao warming medicines to dissipate Yin Qi; Nongpo Wan (Thick Bark Pill) is suitable.
Nongpo Wan (Thick Bark Pill)
Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Hou Po (Magnolia Bark), Chen Pi (Tangerine Peel), Huo Xiang (Patchouli Herb), Dang Gui (Angelica Sinensis Root), Xi Xin (Asarum Root).
Shenzhu Tang (Divine Efficacy Decoction) is also used to treat the same condition. If there is Yin restlessness accompanied by thirst, cool medicines must not be mistakenly used. However, if hot medicines are taken cold, it may be suitable for latent Yang (hidden heat) within. If the pulse is already deficient and completely powerless upon pressure, or if the patient has historically lacked proper dietary nourishment, only warm administration is permissible.
[From *Baoming Ji*] Women during childhood, before the arrival of Tian Gui (menstrual fluid), belong to the Shao Yin (Lesser Yin) channel; after the arrival of Tian Gui, they belong to the Jue Yin (Terminal Yin) channel; after Tian Gui ceases, they belong to the Tai Yin (Greater Yin) channel. When treating diseases related to pregnancy and childbirth, focusing on the Jue Yin channel is appropriate because it is the source of the generation and transformation of ancestral Qi. Jue Yin and Shaoyang (Lesser Yang) are exterior-interiorly related. Therefore, treatment methods must observe three prohibitions: do not violate Stomach Qi, and do not affect the Upper and Middle Jiao. Specifically: do not induce sweating, do not purge downwards, and do not promote urination. Inducing sweating is equivalent to the symptoms of premature purging in Shanghan (Cold Damage); promoting bowel movements disturbs the Spleen even if the pulse is rapid; promoting urination leads to the loss of body fluids and dryness in the Stomach. If herbal preparation adheres to these three prohibitions, Ying (Nutritive) and Wei (Defensive) Qi will harmonize naturally, and chills and fever will cease. Externally, it harmonizes Ying and Wei; internally, it regulates clear turbidity. Use this method as initial treatment. Subsequently, discuss in detail and adjust based on symptoms. Treat it similarly to complicated Shanghan cases, using gentle methods. If there is difficulty urinating, constipation, accumulated heat in the intestines and stomach, formation of Wei syndrome (wasting-thirst), or edema due to scattered blood and Qi, it is said to be similar to complicated Shanghan because obstetric pathology is diverse. For example, use Baihu Tang (White Tiger Decoction) for thirst, Huang Qi (Astragalus Root) for Qi deficiency, Dang Gui (Angelica Sinensis Root) for stabbing blood pain, and add Shao Yao (Peony Root) for abdominal pain. The above examples do not violate the three prohibitions and refer to chronic conditions postpartum. If acute diseases occur immediately postpartum, one must not be bound by these rules. For example, if heat enters the Blood Chamber postpartum, use Taoren Chengqi Tang (Peach Kernel and Rheum Decoction) or Didang Tang (Definite Victory Decoction); if the Stomach is firm and dry, use Dachengqi Tang (Major Order the Qi Decoction), which cannot be described merely as laxative drugs. Postpartum, people often use Wu Jin Siwu Tang (Black Gold Four Substances Decoction) indiscriminately, without considering seasonal cold/heat or blood/Qi deficiency/excess, blindly administering medication uniformly, which exacerbates the condition; this is an error. Generally, for postpartum diseases caused by epidemic pathogens, modify Chaihu formulas; for miscellaneous diseases, modify Siwu Tang (Four Substances Decoction). In spring and summer, start with Chaihu formulas; in autumn and winter, start with Siwu Tang. The cold/heat nature of medicines and the deficiency/excess nature of diseases must be carefully observed. Siwu Tang (Four Substances Decoction) is commonly suitable for consumption; the following methods for seasonal modification are established.
Siwu Tang (Four Substances Decoction) modifications for treating miscellaneous gynecological diseases. (See *Zhi Xu Shi Fa* for Siwu Tang.)
In Spring, double Chuan Xiong (Sichuan Lovage Rhizome). (1. Spring season; 2. Wiry pulse; 3. Headache.)
In Summer, double Shao Yao (Peony Root). (1. Summer season; 2. Surging pulse; 3. Diarrhea.)
In Autumn, double Di Huang (Rehmannia Root). (1. Autumn season; 2. Choppy pulse; 3. Blood deficiency.)
In Winter, double Dang Gui (Angelica Sinensis Root). (1. Winter season; 2. Deep pulse; 3. Cold and poor appetite.)
For cold-deficiency abdominal pain below the navel and dull pain in the waist and spine, Xuanhu Liuhe Tang (Six-Harmony Decoction with Corydalis) is suitable: Siwu Tang (4 liang), Xuan Hu Suo (Corydalis Rhizome), Ku Lian Pi (Chinaberry Bark) each 1 liang (stir-fried until charred).
For lower abdominal pain, also use Xuanhu Liuhe Tang.
For Qi stagnation in the meridians causing frequent and heavy menstruation with much pain below the navel, Shaoyao Liuhe Tang (Six-Harmony Decoction with Peony) is suitable: Siwu Tang (4 liang), Shao Yao (Peony Root) 1 liang.
For stabbing pain in the abdomen with failure of lochia to pass, add Dang Gui (Angelica Sinensis Root) and Shao Yao (Peony Root).
For women with blood deficiency causing unbearable heart and abdominal pain, remove Di Huang (Rehmannia Root) and add Gan Jiang (Dried Ginger), named Six-Shen Tang (Four-God Decoction).
For metrorrhagia (uterine bleeding), add Sheng Di Huang (Raw Rehmannia Root) and Pu Huang (Typha Pollen).
For uterine bleeding due to cold-deficiency in the Blood Store with excessive blood loss, add E Jiao (Donkey-Hide Gelatin) and Ai Ye (Mugwort Leaf).
For red and white leukorrhea, Xianggui Liuhe Tang (Six-Harmony Decoction with Cinnamon and Cyperus) is suitable: Siwu Tang (4 liang), Gui Zhi (Cinnamon Twig), Xiang Fu (Cyperus Rhizome) each 5 qian.
If Siwu Tang (Four Substances Decoction) is powdered, refined honey is added to make pills the size of paulownia seeds, taken with rice water on an empty stomach (30-40 pills) to treat leukorrhea in elderly women, with excellent results.
If Siwu Tang (4 liang) is mixed with Gan Cao (Licorice Root, 0.5 liang) and made into honey pills, divided into eight pills per liang, dissolved in half a cup of warm water mixed with wine and vinegar, it is named Dang Gui Jian (Angelica Infusion). It removes bad blood and generates good blood.
For women with blood stasis masses, add E Zhu (Curcuma Rhizome), San Leng (Burreed Tuber), Gui Xin (Cinnamon Heart), and Gan Qi (Dry Lacquer) each 1 liang to Siwu Tang.
For women with pain in bones, sinews, limbs, and joints, headache, wiry pulse, and aversion to cold resembling malaria, Zhifeng Liuhe Tang (Wind-Treating Six-Harmony Decoction) is suitable: Siwu Tang (4 liang), Qiang Huo (Notopterygium Rhizome), Fang Feng (Saposhnikovia Root) each 1 liang.
For women suffering from alcohol injury, blood loss from childbirth, or deficiency-labor with five-palm heat, Siwu Erlian Tang (Four Substances with Two Coptis Decoction) is suitable: Siwu Tang (4 liang), Sheng Di Huang (Raw Rehmannia Root), Sheng Huang Lian (Raw Coptis Rhizome), Hu Huang Lian (Picrorhiza Rhizome) each 1 liang.
For bone-steaming fever, add Di Gu Pi (Lycium Bark) and Mu Dan Pi (Moutan Cortex).
For women with Shanghan (Cold Damage) who have reduced appetite after sweating and purging, those who are deficient should use Bawu Tang (Eight Substances Decoction): Siwu Tang (4 liang), Huang Qi (Astragalus Root), Gan Cao (Licorice Root), Fu Ling (Poria), Bai Zhu (Atractylodes Rhizome) each 1 liang.
For all hundred diseases in women, simply use Siwu Tang (Four Substances Decoction) decocted with Wu Zhu Yu (Evodia Fruit). Use less Wu Zhu Yu for Yang constitutions and more for Yin constitutions; there is no case where it is ineffective.
Above are cases of modified miscellaneous diseases.
To preserve fetal Qi and aid conception, combine Siwu Tang (Four Substances Decoction) and Si Jun Zi Tang (Four Gentlemen Decoction with Amomum) in equal halves, named Bazhen Tang (Eight Treasures Decoction).
For restless fetus and continuous bleeding during pregnancy, add 10 leaves of Ai Ye (Mugwort Leaf), 5 qian of E Jiao (Donkey-Hide Gelatin), Cong Bai (Scallion White), and Huang Qi (Astragalus Root).
Modifications of Siwu Tang for treating Shanghan during pregnancy are named Liuhe Tang (Six-Harmony Decoctions), fifteen formulas in total. (Formulas see *Shanghan* section.)
Seven menstrual-regulating formulas modifying Siwu Tang. (See *Tiao Jing* section.)
Above are cases of modified pre-natal treatments.
Within one month postpartum, if lochia is stagnant and bad blood causes disease, resulting in distension or pain, chest stuffiness, chills and fever, or limb pain, add Yan Hu Suo (Corydalis Rhizome), Mo Yao (Myrrh), and Xiang Bai Zhi (Angelica Dahurica Root) in equal parts to Siwu Tang, powder finely, and take with light vinegar water or child's urine.
If wind-blood attacks postpartum due to deficiency, or wind-cold invasion causes headache, fever, and joint pain, add Jing Jie Sui (Schizonepeta Flower Spike), Tian Ma (Gastrodia Rhizome), Xiang Fu (Cyperus Rhizome), Shi Gao (Gypsum), and Huo Xiang (Patchouli Herb) each 2.5 qian, added to 1 liang of Siwu ingredients, decocted in water.
For postpartum deficiency-labor with floating and rapid pulse over time, Chaihu Siwu Tang (Bupleurum Four Substances Decoction) is suitable.
Chuan Xiong (Sichuan Lovage Rhizome), Shu Di Huang (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis Root), Shao Yao (Peony Root), plus Chai Hu (Bupleurum Root), Ren Shen (Ginseng Root), Huang Qin (Scutellaria Root), Gan Cao (Licorice Root), Ban Xia Qu (Pinellia Fermented Paste) (each 3 qian).
Cut into pieces, decoct in water, and drink.
For various postpartum syndromes, follow the Six Channels, taking half Siwu Tang and half Zhang Zhongjing’s medicines; the effect is miraculous.
[Hai Zang] Xiong Gui Tang (Ligusticum and Angelica Decoction) treats all conditions caused by excessive blood loss, such as dizziness, fainting, blood loss from injured fetus, metrorrhagia postpartum, blood loss from tooth extraction, unceasing bleeding from metal wounds, feeling like falling when lifting the head—all can be treated.
Dang Gui (Angelica Sinensis Root), Chuan Xiong (Sichuan Lovage Rhizome) (equal parts).
Take 5 qian each time, decoct in water, at any time.
For postpartum dizziness, add Shao Yao (Peony Root).
For unbearable postpartum abdominal pain, add Guan Gui (Cinnamon Bark) and Tong Bian (Child's Urine), soaked in wine.
For dead fetus in pregnancy or restless living fetus, decoct with wine and water to expel; if alive, it calms.
For deficiency-induced abdominal pain with shortness of breath, dizziness, and spontaneous sweating, add 1 liang of Mutton and 10 slices of Ginger to each dose, decoct in water.
Taking it near term shrinks the fetus and facilitates birth.
For virgins or married women with heart/abdominal stabbing pain and irregular menstruation, decoct in water.
For restless fetal Qi in pregnancy or various postpartum diseases, decoct in wine.
For dystocia, breech presentation, or dead fetus in uterus, first fry 1 he of Black Beans until hot, decoct with child's urine, and drink.
For difficult labor, use Bai Cao Shuang (Soot from Hundred Herbs) and Xiang Bai Zhi (Angelica Dahurica Root) in equal parts, soak in child's urine and good vinegar (1 part each) in boiling water, and drink. Severe cases repeat the dose, leading to delivery.
For internal organ toxicity, add 5 fen of Huai Hua (Sophora Flower) powder per dose; blood clots will be passed in three days, curing the disease.
Also take this for hematemesis (vomiting blood).
For wheezing from ascending blood/Qi and lower edema, take on an empty stomach with Mugwort Water decoction.
For postpartum bad blood attacking the Heart causing confusion, panting, urgent abdominal pain, use Black Beans and fresh Ginger juice as previously described, decoct and drink.
For postpartum headache, add Jing Jie (Schizonepeta).
For metrorrhagia and dripping blood with unceasing loss, add fried Xiang Fu (Cyperus Rhizome), add 1 qian Gan Cao (Licorice Root) per liang, sprinkle with boiling water to brew.
For leukorrhea, add 0.5 liang Shao Yao (Peony Root) and equal parts Gan Jiang (Dried Ginger), take with rice water.
[From *Baoming Ji*] Various Liuhe Tangs (Six-Harmony Decoctions) treat common gynecological diseases and are commonly used postpartum. To treat female deficiency-labor, *Ju Fang* refers to Shouwei Liuhe (Head-and-Tail Six-Harmonies), such as Da Sheng San (Great Sage Powder) and Shu Di Huang Wan (Prepared Rehmannia Pill), which treat deficiency-labor without heat. Mid-course medicines include Mudan Jian Wan (Moutan Frying Pill) taken on an empty stomach before meals, and Ren Shen Jing Jie San (Ginseng and Schizonepeta Powder) taken before bed after meals, which treat deficiency-labor with heat. (Da Sheng San, Shu Di Huang Wan, Ren Shen Jing Jie San, Mudan Jian Jian Wan are all in *Ju Fang*, but one should also refer to the ingredients when using them.)
[Danjix] Women prioritize blood; blood belongs to Yin and is prone to deficiency. Without proper regulation and care, health cannot be preserved. Shenxian Jubao Dan (Immortal Treasure-Preserving Pill) treats Empty-Cold in the Sea of Blood and empty-heat night sweats; supplementation is indicated, but can one use the drying nature of Hu Po (Amber) and the dispersing nature of She Xiang (Musk)? With sallow complexion and limb edema, dampness should be guided out, but can one use Ru Xiang (Frankincense) and Mo Yao (Myrrh), which indeed treat blood? Pre-natal and post-natal states differ in deficiency and excess; expelling bad blood and nourishing new blood, attacking and tonifying are hard to combine simultaneously. For solid masses and red/white discharge, what is suitable for one situation hinders another; how can one formula treat all? People value its expensive ingredients and elegant name, liking its daily use for calming the Spirit, removing evil, and aiding conception. They do not know that long-term use inevitably brings disaster. Unless the Zang-Fu organs could speak, physicians would never realize it. Only when other diseases arise does anyone blame this pill? My niece had a robust constitution but delayed conception; after long-term use of this pill, a carbuncle erupted on her back, a critical condition. Her pulse was scattered, large, and choppy. I urgently prescribed modified Siwu Tang (Four Substances Decoction) for over a hundred doses, and she recovered.