Library

Women suffering from warm diseases follow the same principles as men. The differences lie in the periods before and after childbirth, as well as during menstruation when it has just started or just stopped. Generally, for illnesses occurring during pregnancy, ancient physicians used modifications of Siwu Tang (Four Substance Decoction), emphasizing the protection of the fetus to prevent harm to the pregnancy. Measures such as applying mud from the bottom of a well or covering the abdomen with blue cloth soaked in cold water when heat is extreme were all intended for protection. However, one must also assess whether the pathogenic factor can be resolved from the exterior; if blood-nourishing and cloying herbs are ineffective, further examination is required, and rigid adherence to fixed methods should be avoided. Nevertheless, steps must be taken at every stage to protect the fetal origin, fearing that the pathogenic evil may sink inward. Regarding postpartum treatment, formularies advise caution with bitter-cold herbs to avoid damaging the already depleted Yin. Yet, one must distinguish whether the pathogen can be resolved from the Upper or Middle Jiao; slight use according to symptoms is acceptable, provided the Lower Jiao is not violated. Since the postpartum body is deficient, treatment should resemble that for weak individuals suffering from pathogenic invasion. In summary, one must not commit the error of "reinforcing the excess and depleting the deficiency." Moreover, during the postpartum period, when Qi and Blood are turbulent, there are many empty spaces within the body; the pathogenic force will inevitably sink inward by taking advantage of this deficiency. Pathogens affecting these deficient areas are difficult to treat. For instance, when menstruation has just started or stopped, the pathogen is about to sink into the Blood Chamber (Xueshi). Shaoyang Cold Damage discusses this in detail, so no further elaboration is needed here. However, warm diseases differ from standard cold damage. Zhang Zhongjing established Xiaochaihu Tang (Minor Bupleurum Decoction) to extract the sunk heat pathogen; Ginseng and Jujube support Stomach Qi, as the Chong Mai (Penetrating Vessel) belongs to the Yangming channel. This aligns with the treatment principle for deficiency patterns. If the heat pathogen sinks and binds with blood, one should follow Tao's modification of Xiaochaihu Tang, removing Ophiopogon (Maidong) and Jujube (Dazao), and adding Rehmannia (Shengdi), Peach Kernel (Taoren), Hawthorn Fruit (Zharen), Moutan Cortex (Danpi), and Rhinoceros Horn (Xijiao - note: typically substituted in modern practice). If the blood binding in the original channel is severe, there will necessarily be fullness and pain in the lower abdomen. For mild cases, puncture Qimen (LR14); for severe cases, use Xiaochaihu Tang removing sweet/calmative herbs like Licorice (Gancao), adding Corydalis (Yanhusuo), Angelica Sinensis Tail (Guizui), and Peach Kernel (Taoren). If accompanied by cold, add Cinnamon Bark (Rougui); if Heart Qi is stagnant, add Cyperus (Xiangfu), Tangerine Peel (Chenpi), and Aurantium (Zhiqiao). However, symptoms of heat sinking into the Blood Chamber often present with delirium and mania-like states; one must guard against Yangming Stomach Excess syndrome and differentiate accordingly. In blood binding, the body feels heavy, unlike the lightness and ease of movement seen in Yangming syndrome. Why? Yin governs heaviness and turbidity; when collaterals are obstructed, Qi stagnation affects the sides, connecting to the chest and back, causing stiffness and immobility. Therefore, dispelling pathogens and unblocking collaterals fits the pathology perfectly. Often, lingering over time, the pathogen rebels upward to invade the Pericardium, causing chest pain, which Tao referred to as "Blood Binding Chest" (Xue Ji Xiong). Wang Haizang proposed Guizhi Honghua Tang (Cinnamon Twig and Safflower Decoction), adding Clam Shell (Haige) and Peach Kernel (Taoren), originally based on the principle of resolving the interior, exterior, upper, and lower simultaneously. This formula is quite ingenious, so it is recorded for scholars' reference. In cold damage, Wind injuring the Defensive layer uses Guizhi Tang, while Cold injuring the Nutrient layer uses Mahuang Tang. Children have loose skin and sweat easily, making them unable to tolerate the acrid-warm diaphoretic effects of Ephedra (Mahuang) and Cinnamon Twig (Guizhi). For Taiyang disease, light agents such as Perilla Leaf (Zisu) and Saposhnikovia Root (Fangfeng) are used. For body pain, Notopterygium Root (Qianghuo) is used, usually for only one dose. Wind injury syndromes often involve the Lung; Peucedanum (Qianhu), Apricot Seed (Xingren), Aurantium (Zhiqiao), and Platycodon Root (Jiegeng) are examples; their acrid nature acts as diaphoretics. Congchi Tang (Scallion and Fermented Soybean Decoction) is a general-purpose formula. For pregnancy conditions, the main approach is tonifying Qi and nourishing Blood to calm the fetus, whereby myriad diseases are naturally eliminated.