产后咳嗽,悉属胃气不足,胃为五脏之本,胃气一虚,五脏失所,百病生焉。虽谓
肺主皮毛,腠理不密所致,不知肺属辛金,生于已土,亦因土虚不能生金,所以腠理不
密,外邪易感,其阴火上炎者,宜壮土以生金,滋肾水以制火。前论肺病而责及胃者,
以上不能生金也。何独不思子能令母虚,而责及肾乎?况肺主出气,肾主纳气,咳嗽
者,气不能纳,虽肺病而实肾病也。
产后半月内外,寒热往来,或日哺夜间发热,或一日二三度,其发有期,其证类
疟,由气血并竭,阳虚作寒,阴虚发热也。毋以疟治,柴胡汤不可轻用,惟调补气血,
寒热自除,欲阳藏纳,浮越自己。
产后腹痛泻痢者,由产后肠胃虚怯,寒邪易侵,故腹痛如刺,水谷不化,洞泻肠
鸣,或下赤白,急服调中汤立愈。若非外因所伤,乃属肾气亏损,阳虚不能生土,阴虚
不能闭藏耳。必用四神八味补肾,倘误投分利导水之剂,是益虚其虚也。
产后蓐劳,由生产日浅,血气虚弱,将养失所,致使虚乏劳倦,乍卧乍起,容颜憔
悴,饮食不甘,咳嗽口干,头昏目眩,百节疼痛,时有盗汗,寒热如疟,四肢不举,沉
重着床,此皆蓐劳之候也。毋论日期,必须调养平复,方可动作,否则气血复伤,终成
痨瘵。其治当补脾胃为主,佐以调和气血。盖饮食一进,精气生化,诸脏有所赖矣。
Postpartum cough is entirely attributed to insufficient Stomach Qi. The Stomach is the root of the Five Zang Organs; once Stomach Qi becomes deficient, the Five Zang Organs lose their nourishment, and various diseases arise. Although it is often said that the Lung governs the skin and hair (Pifu), and that this condition results from loose Cou Li (skin texture and sweat pores), one must not forget that the Lung belongs to Xin Metal and is born from Ji Earth (Spleen/Stomach). It is precisely because Earth deficiency fails to generate Metal that the Cou Li become loose, making the body susceptible to external pathogens. For cases where Yin Fire flares upward, treatment should focus on strengthening Earth to generate Metal and nourishing Kidney Water to control the Fire. The previous discussion attributing Lung disease to the Stomach was due to the failure of the upper source (referring to the ascending Qi from the Middle Jiao) to generate Lung Metal. Why only consider that the "child" organ can cause the "mother" organ to become deficient and blame the Kidney? Moreover, the Lung governs exhalation, while the Kidney governs inhalation. Cough occurs when Qi cannot be grasped downward; although it manifests as a Lung disease, it is essentially a Kidney disease.
Around half a month postpartum, alternating chills and fever may occur, or fever may manifest in the late afternoon or at night, occurring two or three times a day with a regular pattern. The symptoms resemble Malaria, caused by the exhaustion of both Qi and Blood: Yang deficiency leads to cold sensations, while Yin deficiency leads to fever. Do not treat this as Malaria; Chai Hu Tang (Bupleurum Decoction) should not be used lightly. Only by regulating and tonifying Qi and Blood will the chills and fever resolve spontaneously, allowing the floating Yang to return to its proper storage and location.
Postpartum abdominal pain accompanied by diarrhea and dysentery is due to the weakness and timidity of the intestines and stomach after childbirth, making them susceptible to invasion by Cold pathogens. Thus, abdominal pain feels like stabbing, food and water are not digested, resulting in watery diarrhea with borborygmus, or the passage of red and white mucus. One should immediately administer Tiao Zhong Tang (Regulate the Middle Decoction) for rapid recovery. If not caused by external factors, it belongs to Kidney Qi deficiency, where Yang deficiency fails to warm the Spleen Earth, and Yin deficiency fails to secure and store. Treatment must employ Si Shen Wan (Four Spirits Pill) combined with Ba Wei Wan (Eight-Ingredient Pill, i.e., Jin Gui Shen Qi Wan) to tonify the Kidneys. If diuretic and draining agents are mistakenly administered, this further exacerbates the deficiency.
Postpartum Ru Lao (Childbed Exhaustion) arises from the short time since delivery, weak Qi and Blood, and improper nursing care, leading to general weakness and fatigue, alternating between lying down and getting up, haggard appearance, loss of appetite, cough with dry mouth, dizziness, pain in all joints, occasional night sweats, chills and fever resembling malaria, inability to lift the limbs, and heaviness such that the patient remains bedridden. These are all signs of Ru Lao. Regardless of the duration, the body must be restored to balance through proper care before engaging in physical activity; otherwise, Qi and Blood will be injured again, eventually developing into Lao Zhai (chronic consumptive disease). Treatment should primarily focus on tonifying the Spleen and Stomach, assisted by harmonizing Qi and Blood. Once diet is taken, Essence and Qi are generated, providing support for all Zang Organs.