临盆之时。专赖气血旺足。然后能生。此时惟有多服参 归桂。甘温重补。儿信一下。频频
服之。自无横生逆产胎衣不下之病矣。有不耐药气者。独参汤妙。服法于未下产时。用芎归参
。浓煎饮之。自然紧痛易产矣。儿下后即用前药。加肉桂一钱。煎服。自无血块痛之病矣。
产后血晕。用醋炭熏鼻法。好老酒和童便服。不可放倒。（产后败血不尽。血迷血晕。腹中胎
衣不下。至死心头暖者。急用花蕊石散一服。化水即出。其效如神。不可不知。）如气血脱而晕
者。必唇口手足厥冷无脉。此时间不容发。当以大剂参附回其阳。如认作血晕。而以前法治之。
则毙矣。
产后发热。乃气血大亏也。（亦有食物太早。气弱不能运而生热者。必兼恶心饱闷。治宜健
运为主。又有乳结不通作热者。宜通乳。）即有见识者。亦必曰发散固不可。且以轻剂疏通之。
此一句害人不浅。总之脉必浮数。与外感无辨。（外感而发热者。必兼头痛拘急等症。脉必浮数
有力。补中益气加芎苏热服。补以散之。切忌妄汗。）一时不敢骤补也。殊不知产后发热。吾不
管其是邪非邪。有脉无脉。一味八珍十全峻补之。有邪自然汗解。无邪自然竟退矣。（如此胆气。
庸工那得到此。然胆由于识。彼只缘见不透耳。见得透定干得来矣。有识自有胆矣。）如瘀血发热
者。（腹必痛。口必微渴。）四物汤加桃仁红花丹皮足矣。然俟腹痛口微渴一退。即以八珍汤与之。
血块痛不发热者。四物汤加桃仁牛膝青皮丹皮。服二三剂自除。除后以八珍汤与之。（凡妇人血
虚阻滞。不能流畅而痛极者。当以水济水。若江河一决。而积垢皆去。宜用熟地当归牛膝泽泻肉
桂乌药。随症加减治之。如呕恶加炒黑干姜。阴滞加附子。大便干燥加楂肉。甚加苁蓉。下焦痛
极加吴茱萸。气滞者加香附陈皮。血滞者加红花。如气虚者宜少用香附陈皮之类。甚者不用亦可
。此系景岳决津煎。乃以补为泻之神剂也。）产后泄泻。切不可利水。（产后泄泻。责在脾虚。若
再加利水。则脾肾皆虚。故不可也。）如有此等症。只一味补中益气汤。加白芍。（酒洗炒为妙）
如发热而渴。乃阴竭也。六味丸。另煎六君子汤。或人参汤下之。（泻多则亡阴。故症兼发热作
渴也。然因泻而热而渴。则原是由脾传肾。故须仍用六君参汤下六味丸。此亦标本兼治之义。）
产后不便。有至二十余日者。不足为病。然产妇急于便。必多努责。往往成玉门不闭。子宫
下坠之病。治之贵早。一味用八珍汤。加桃仁杏仁各二钱。多则三剂自下。（产后气血未有不虚者
。即此症亦属气虚不能推送。血虚不能濡润之故。八珍汤乃治气血两虚之的剂也。然用于此症。则
其妙处却在加桃仁杏仁两味。盖人第知桃仁能破血。而不知桃仁又能利血而滑肠。人第知杏仁
能润肺。而不知杏仁兼能润肠而利便。故单用八珍以养气补阴。燥矢亦未始不下。然产妇既急于
便。而不加此二味。以使之速下。则恐仍多努责之劳也。前辈立法。必准理揆情如此。）
子宫下
坠。乃劳力所伤也。补中益气汤加白芍。倍用参 白术。如下坠而痛。大剂归脾汤加白芍。如因
恼下坠而痛。此骤动肝火所致。归脾汤加丹皮山栀。然当治之于早。如子宫干枯。不能升矣。玉
门不闭治同。产后感风。率多成痉者。气血虚故也。刚痉由血虚。（无汗为刚痉）四物汤倍归地。加软柴胡钩藤钩柔痉
由
气虚。（有汗为柔痉）补中益气汤加软柴胡钩藤钩。如主去风燥血之剂。则筋挛而成痉矣。（双林许炳如
侄妇。产后三日。忽喑哑不语。手足痉搐。延予视之。曰此怒动肝火而血燥也。用加味逍遥散
加熟地钩藤。一剂而痉搐全愈。三剂而口酸身热腰痛胁痛诸症悉除。惟语言尚不能出。予于前方中
又加菖蒲钱许。一剂。睡至半夜。言语如常。）产后咳嗽。弱症之渐也。六味饮加人参主之。如
兼发热。归脾汤去木香加白芍麦冬五味。吞六味丸。然须于初起时。即用此药。或有可救者。如
经发散。用过凉药。不效。
At the time of delivery, success relies entirely on sufficient and vigorous Qi and Blood. Only then can birth occur. At this time, it is advisable to take multiple doses of Ren Shen (Ginseng), Dang Gui (Angelica Sinensis), and Gui Zhi (Cinnamon Twig) to provide heavy tonification with sweet-warm properties. Once the fetus descends, frequent administration of these medicines will naturally prevent complications such as dystocia, abnormal presentation, or retained placenta. For those who cannot tolerate strong medicinal odors, Du Shen Tang (Single Ginseng Decoction) is excellent. The method of administration is to decoct Xiong Gui Can (a mixture of Chuan Xiong, Dang Gui, and Ren Shen) thickly and drink it before the baby is born; this will naturally facilitate tight contractions and easier delivery. Immediately after the baby is born, administer the previous prescription with the addition of one qian of Rou Gui (Cinnamon Bark), decocted and taken orally; this will naturally prevent pain caused by blood stasis clots.
For postpartum syncope due to blood loss, use the method of fumigating the nose with vinegar-treated charcoal, and consume good aged wine mixed with children's urine. Do not lay the patient flat. (If postpartum lochia is incomplete, leading to blood confusion and syncope, with the placenta remaining in the abdomen, even if death appears imminent but the heart remains warm, urgently administer one dose of Hua Rui Shi San (Flower Pyrite Powder). Dissolve in water and administer; its efficacy is miraculous and must be known.) If syncope is caused by depletion of Qi and Blood, there will inevitably be coldness of the lips, mouth, hands, and feet, and absence of pulse. In this critical moment, large doses of Shen Fu Tang (Ginseng and Aconite Decoction) must be used to restore Yang. If mistaken for blood-stasis syncope and treated with methods for blood stasis, the patient will die.
Postpartum fever is due to severe deficiency of Qi and Blood. (There are also cases where early consumption of food leads to heat generation because weak Qi cannot transform it; these cases necessarily include nausea and fullness/distension, and treatment should focus on strengthening and transforming the Spleen. There are also cases of fever caused by blocked lactation, which should be treated by promoting milk flow.) Even experienced physicians often say that dispersing methods are absolutely contraindicated and that only light agents for unblocking should be used. This statement causes significant harm. In general, the pulse will be floating and rapid, making it indistinguishable from exterior contraction fever. (Exterior contraction fever is accompanied by headache and stiffness/tightness, and the pulse is floating, rapid, and forceful; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Chuan Xiong (Szechwan Lovage Rhizome) and Zi Su (Perilla Leaf) should be taken hot, using a method of tonifying while dispersing. Profuse sweating must be strictly avoided.) One hesitates to tonify abruptly at first. However, one fails to realize that for postpartum fever, regardless of whether it is pathogenic or not, and regardless of the presence or absence of a pulse, one should simply use Ba Zhen Tang (Eight-Treasure Decoction) or Shi Quan Da Bu Tang (Ten-Ingredient Great Tonifying Decoction) for vigorous tonification. If there is pathogenic factor, it will resolve through sweating; if not, the fever will subside naturally. (Such courage stems from insight; how could mediocre practitioners achieve this? Courage comes from understanding. They fail because their insight is insufficient. With clear insight, action follows naturally. Insight brings courage.) If fever is caused by blood stasis, (there will necessarily be abdominal pain and slight thirst), Si Wu Tang (Four-Substance Decoction) plus Tao Ren (Peach Kernel), Hong Hua (Carthamus Flower), and Mu Dan Pi (Moutan Cortex) is sufficient. However, once the abdominal pain and slight thirst subside, immediately administer Ba Zhen Tang. If there is pain from blood clots without fever, Si Wu Tang plus Tao Ren (Peach Kernel), Niu Xi (Achyranthes Root), Qing Pi (Tangerine Peel), and Mu Dan Pi (Moutan Cortex) should be taken for two to three doses to eliminate the condition naturally. After elimination, administer Ba Zhen Tang. (In women with blood deficiency causing obstruction and inability to flow smoothly, resulting in extreme pain, it is appropriate to "use water to assist water," akin to a river bursting its banks, washing away accumulated filth. Suitable herbs include Shu Di Huang (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis), Niu Xi (Achyranthes Root), Ze Xie (Alisma Rhizome), Rou Gui (Cinnamon Bark), and Wu Yao (Lindera Root), modified according to symptoms. Add Chao Hei Gan Jiang (Stir-fried Black Ginger) for vomiting/nausea; add Fu Zi (Aconite Lateral Root) for Yin stagnation/cold; add Zha Rou (Hawthorn Flesh) for dry stool; add Cong Rong (Cistanche Stem) for severe cases; add Wu Zhu Yu (Evodia Fruit) for extreme lower jiao pain. For Qi stagnation, add Xiang Fu (Cyperus Rhizome) and Chen Pi (Tangerine Peel); for Blood stagnation, add Hong Hua (Carthamus Flower). If Qi deficiency exists, use Xiang Fu and Chen Pi sparingly, or omit them in severe cases. This is Zhang Jingyue's Jue Jin Jian (Decoction for Crossing the Ford), a miraculous agent that uses tonification as purgation.)
For postpartum diarrhea, diuresis must never be used. (Postpartum diarrhea is attributed to Spleen deficiency; adding diuretics would further deplete both Spleen and Kidney, hence it is contraindicated.) If such symptoms occur, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) alone, plus Bai Shao (White Peony Root). (Washing with wine and stir-frying is ideal.) If accompanied by fever and thirst, this indicates exhaustion of Yin. Use Liu Wei Wan (Six-Ingredient Pill with Rehmannia), separately decocted Liu Jun Zi Tang (Six-Gentlemen Decoction), or administered via Ren Shen Tang (Ginseng Decoction). (Excessive diarrhea leads to loss of Yin, hence symptoms include fever and thirst. Since the fever and thirst arise from diarrhea, the pathology originally transmits from Spleen to Kidney; thus, Liu Wei Wan should still be administered via Liu Jun Zi Tang or Ren Shen Tang. This embodies the principle of treating both root and branch simultaneously.)
Postpartum constipation may last over twenty days and is not necessarily pathological. However, because postpartum women are anxious to defecate, they often strain excessively, frequently leading to prolapse of the vaginal opening (Yu Men) and uterus. Early treatment is crucial. Use Ba Zhen Tang (Eight-Treasure Decoction) alone, plus Tao Ren (Peach Kernel) and Xing Ren (Apricot Seed), each 2 qian. Within three doses, relief will naturally occur. (Qi and Blood are invariably deficient postpartum; this symptom is also due to Qi deficiency failing to push and Blood deficiency failing to moisten. Ba Zhen Tang is the precise formula for dual Qi and Blood deficiency. Its efficacy here lies in the addition of Tao Ren and Xing Ren. People know Tao Ren breaks blood but do not know it also promotes blood flow and lubricates the intestines; people know Xing Ren moistens the Lungs but do not know it also moistens the intestines and facilitates bowel movements. Thus, using Ba Zhen Tang alone to nourish Qi and Yin might eventually pass dry stools. However, since the patient is anxious to defecate, without these two herbs to accelerate passage, excessive straining may persist. Ancient masters established laws based on reason and human nature.)
Uterine prolapse is caused by labor injury. Use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Bai Shao (White Peony Root), doubling the dosage of Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala Rhizome). If prolapse is accompanied by pain, use a large dose of Gui Pi Tang (Restore the Spleen Decoction) plus Bai Shao (White Peony Root). If prolapse and pain are triggered by anger, this is due to sudden stirring of Liver Fire; use Gui Pi Tang (Restore the Spleen Decoction) plus Mu Dan Pi (Moutan Cortex) and Shan Zhi (Gardenia Fruit). Treatment should begin early. If the uterus becomes dry and cannot ascend, the treatment for Yu Men non-closure (vaginal laxity/prolapse) is the same. Postpartum wind invasion often results in spasms due to Qi and Blood deficiency. Gang Spasm (rigid spasm) is caused by Blood deficiency (characterized by absence of sweat); use Si Wu Tang (Four-Substance Decoction) with doubled Dang Gui (Angelica Sinensis) and Shu Di Huang (Prepared Rehmannia Root), plus Ruan Chai Hu (Bupleurum Root) and Gou Teng (Uncaria Rhynchophylla). Rou Spasm (flaccid spasm) is caused by Qi deficiency (characterized by presence of sweat); use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Ruan Chai Hu (Bupleurum Root) and Gou Teng (Uncaria Rhynchophylla). If one uses formulas primarily aimed at expelling wind and drying blood, muscle convulsions leading to spasm will result. (Case: The niece-in-law of Xu Bingru from Shuanglin developed aphasia and limb spasms three days postpartum. I examined her and diagnosed Liver Fire agitation causing Blood dryness. I prescribed Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) plus Shu Di Huang (Prepared Rehmannia Root) and Gou Teng (Uncaria Rhynchophylla). After one dose, spasms resolved completely; after three doses, acid taste in mouth, body heat, lower back pain, and hypochondriac pain all disappeared, except for speech. I added a small amount of Shi Chang Pu (Acorus Rhizome) to the previous formula. After one dose, she slept until midnight and spoke normally.)
Postpartum cough is a sign of declining health. Treat with Liu Wei Yin (Six-Ingredient Decoction) plus Ren Shen (Ginseng). If accompanied by fever, use Gui Pi Tang (Restore the Spleen Decoction) minus Mu Xiang (Aucklandia Root), plus Bai Shao (White Peony Root), Mai Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Berry), swallowing Liu Wei Wan (Six-Ingredient Pill with Rehmannia). However, these medications must be used at the onset; otherwise, rescue may be impossible. If dispersing methods have been used and cooling agents administered without effect...