一月如露珠,二月如桃花,三月分男女,四月形象具,五月骨节成,六月毛发生,七月动右手(是男于母左,
是女于母右,)八月动左手(是男于母右,是女于母左,)九月三转身,十月始满足。
凡病起于血气之衰,脾胃之虚。况产妇气血脾胃之虚弱,殆有甚焉。丹溪论∶产后当以大补气血为主,虽有他
症,以末治之。故治法∶有气毋专耗气,有食毋专消食,热不用芩连,寒不用附桂。如中虚外感,见三阳表证之多,
似可汗也,在产后而用麻黄则重伤其阳。见三阴里症之多,似宜下也,在产后而用承气则重亡其阴。至若耳聋、
胁痛、肾虚、恶露之停,休用柴胡。谵语、汗出、中风恶寒之症,莫作风治。其由阳气之衰,非大补不能回阳
而起弱。即如因阴血之涸,非滋补不能舒筋而活络。又乍寒乍热,发作有期,症类疟也,若以疟治,淹滞难痊。神
不守舍,言语无伦,病似邪也,若以邪治,危亡可待。去血而大便闭结,苁蓉加于生化。汗多而小便短涩,六君
倍用参 。肛脱、茄症,俱是气虚下陷,补中益气是良方也。口禁、拳握,无非血燥类风,加参生化,十有益焉。
产户入风,服以养荣、羌、独。玉门伤冷,洗须床、兔、萸、硫。怔忡惊悸,生化汤加以远志。似邪恍惚,安
神丸兼服。脾气因喘咳而满闷、虚烦,生化汤加木香为佐。因过食而呕吐、呃逆、六君子加神曲为良。苏木、棱、
蓬,大能破血。青皮、枳实,最消膨胀。一应耗气破血之药,汗出泄下之方,只可施于强壮,不宜用于虚弱。大抵
新产之后,先问恶露何如,块痛何如,参术不可遽加。至若亡阳汗脱,气虚喘促,加参生化是从权也。如亡阴太
热,晕厥血崩,升举大补乃急救耳。王太仆云∶
治下补下,制以缓急,制缓以滋道路,制急乃气味俱薄,力与缓同。是治法当遵丹溪,服法须效太仆。虽未尽产
症之详,已统括治疗之要,敢曰济阴之指南,其于女科不无小补云。
In the first month, the fetus is like a dewdrop; in the second month, like a peach blossom; in the third month, male and female distinctions appear; in the fourth month, features and form are complete; in the fifth month, bone joints are formed; in the sixth month, hair grows; in the seventh month, movement of the right hand occurs (if male, movement is on the mother's left side; if female, on the mother's right side); in the eighth month, movement of the left hand occurs (if male, movement is on the mother's right side; if female, on the mother's left side); in the ninth month, the fetus turns three times; in the tenth month, it is fully mature.
All diseases arise from the decline of Xue Qi (Blood and Qi) and the deficiency of Pi Wei (Spleen and Stomach). How much more so for postpartum women, whose Xue Qi and Pi Wei are even more deficient. Zhu Danxi stated: Postpartum treatment should primarily focus on greatly tonifying Xue Qi. Even if other symptoms exist, they should be treated as secondary. Therefore, the therapeutic principles are: if there is Qi deficiency, do not specifically deplete Qi; if there is food stagnation, do not specifically reduce food accumulation; for heat patterns, do not use Huang Qin (Scutellariae Radix) or Lian Zi (Nelumbinis Semen); for cold patterns, do not use Fu Zi (Aconiti Lateralis Radix Praeparata) or Rou Gui (Cinnamomi Cortex). If there is middle Jiao deficiency with external pathogenic invasion, presenting with many Tai Yang (Greater Yang), Yang Ming (Yang Brightness), or Shao Yang (Lesser Yang) exterior syndrome signs, sweating might seem appropriate, but using Ma Huang (Ephedrae Herba) in the postpartum period would severely damage Yang Qi. If there are many Tai Yin (Lesser Yin), Shao Yin (Lesser Yin), or Jue Yin (Terminal Yin) interior syndrome signs, purgation might seem suitable, but using Cheng Qi Tang (Ordering the Qi Decoction) in the postpartum period would severely consume Yin fluids. As for tinnitus, hypochondriac pain, Shen Jing (Kidney Deficiency), and retention of E Lu (Lochia), Chai Hu (Bupleuri Radix) should not be used. For delirium, sweating, and aversion to wind/cold resembling Zhong Feng (Wind Stroke), these should not be treated as Wind pathogens. If the condition stems from the decline of Yang Qi, only great tonification can restore Yang and alleviate weakness. If it stems from the exhaustion of Yin Blood, only nourishing tonification can relax sinews and unblock collaterals. Sudden chills and fever occurring at regular intervals resemble Nue (Malaria); treating it as Malaria will lead to lingering and difficult recovery. Restlessness of the Shen (Spirit) and incoherent speech resemble possession by evil spirits; treating it as such portends imminent danger. Constipation due to blood loss requires adding Rong Ren (Cistancheae Caulis) to Sheng Hua Tang (Transform the Stasis Decoction). Excessive sweating with scanty, dysuric urine requires doubling the dose of Ren Shen (Ginseng Radix) in Liu Jun Zi Tang (Six Gentlemen Decoction). Uterine prolapse and vaginal protrusions are caused by Qi deficiency sinking; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is an excellent formula. Trismus and clenched fists are essentially dry-blood patterns resembling Wind; adding Ren Shen to Sheng Hua Tang yields ten benefits out of ten cases. Wind entering the birth canal should be treated with Yang Rong Tang (Nourish the Ying Decoction) plus Qiang Huo (Notopterygii Rhizoma et Radix) and Du Huo (Angelicae Pubescentis Radix). Cold injuring the vulva requires washing with Chuang Xin (Cnidii Fructus), Tu Si Zi (Cuscutae Semen), Shan Yu Rou (Corni Fructus), and Liu Huang (Sulfur). Palpitations and fright require adding Yuan Zhi (Polygalae Radix) to Sheng Hua Tang. Delirious trance resembling spirit possession requires concurrent administration of An Shen Wan (Calming the Spirit Pill). Fullness, distension, and empty irritability due to Spleen Qi deficiency exacerbated by coughing and panting require adding Mu Xiang (Aucklandiae Radix) as an assistant herb to Sheng Hua Tang. Vomiting and hiccups due to overeating are best treated with Liu Jun Zi Tang (Six Gentlemen Decoction) plus Shen Qu (Massa Medicata Fermentata). Su Mu (Sappan Lignum), San Leng (Sparganii Rhizoma), and E Zhu (Curcumae Rhizoma) strongly break blood stasis. Qing Pi (Citri Reticulatae Pericarpium Viride) and Zhi Shi (Aurantii Fructus Immaturus) most effectively reduce distension. All herbs that deplete Qi and break blood, and all formulas that induce sweating or purgation, are only applicable to robust individuals and unsuitable for the weak. Generally, after recent childbirth, one must first inquire about the state of E Lu (Lochia) and abdominal mass pain; Ren Shen (Ginseng Radix) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) should not be added hastily. In cases of Yang collapse with sweating and impending collapse, or Qi deficiency with panting, adding Ren Shen to Sheng Hua Tang (Transform the Stasis Decoction) is a flexible adaptation. In cases of severe Yin collapse with intense heat, syncope, or metrorrhagia, Sheng Ju Da Bu Tang (Lifting and Great Tonification Decoction) is for emergency rescue. Wang Bing stated: "Treating lower jiao disorders, the preparation method depends on urgency. Gentle preparation moistens the pathway; urgent preparation results in thin flavor and aroma, yet efficacy matches gentle preparations." Thus, treatment methods should follow Zhu Danxi, and administration methods should emulate Wang Bing. Although this does not detail every postpartum disorder, it summarizes the essentials of treatment. It may be called a guide for saving women, offering no small benefit to Gynecology.